Bill Text: IL SB1245 | 2013-2014 | 98th General Assembly | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft

---

Bill Title: Amends the Public Safety Employee Benefits Act. Defines "catastrophic injury" to mean the consequences of an injury that permanently prevent an individual from performing any gainful work. Effective immediately.

Spectrum: Bipartisan Bill

Status: (Passed) 2013-08-27 - Public Act . . . . . . . . . 98-0561 [SB1245 Detail]

Download: Illinois-2013-SB1245-Amended.html

---

Rep. Ann Williams

Filed: 5/28/2013

09800SB1245ham001 LRB098 00197 KTG 46568 a
AMENDMENT TO SENATE BILL 1245
AMENDMENT NO. ______. Amend Senate Bill 1245 by replacing
everything after the enacting clause with the following:
"Section 5. The Public Safety Employee Benefits Act is
amended by changing Section 10 as follows:
(820 ILCS 320/10)
Sec. 10. Required health coverage benefits.
(a) An employer who employs a full-time law enforcement,
correctional or correctional probation officer, or firefighter
(hereinafter referred to as "PSEBA recipient"), who, on or
after the effective date of this Act suffers a catastrophic
injury or is killed in the line of duty shall pay the entire
premium of the employer's health insurance plan for the PSEBA
recipient injured employee, the PSEBA recipient's injured
employee's spouse, and for each dependent child of the PSEBA
recipient injured employee until the child reaches the age of

09800SB1245ham001 - 2 - LRB098 00197 KTG 46568 a
majority or until the end of the calendar year in which the
child reaches the age of 25 if the child continues to be
dependent for support or the child is a full-time or part-time
student and is dependent for support. The term "health
insurance plan" does not include supplemental benefits that are
not part of the basic group health insurance plan. If the PSEBA
recipient injured employee subsequently dies, the employer
shall continue to pay the entire health insurance premium for
the surviving spouse until remarried and for the dependent
children under the conditions established in this Section.
However:
(1) Health insurance benefits payable from any other
source shall reduce benefits payable under this Section.
(2) It is unlawful for a person to willfully and
knowingly make, or cause to be made, or to assist, conspire
with, or urge another to make, or cause to be made, any
false, fraudulent, or misleading oral or written statement
to obtain health insurance coverage as provided under this
Section. A violation of this item is a Class A misdemeanor.
(3) Upon conviction for a violation described in item
(2), a law enforcement, correctional or correctional
probation officer, or other beneficiary who receives or
seeks to receive health insurance benefits under this
Section shall forfeit the right to receive health insurance
benefits and shall reimburse the employer for all benefits
paid due to the fraud or other prohibited activity. For

09800SB1245ham001 - 3 - LRB098 00197 KTG 46568 a
purposes of this item, "conviction" means a determination
of guilt that is the result of a plea or trial, regardless
of whether adjudication is withheld.
(b) In order for the law enforcement, correctional or
correctional probation officer, firefighter, spouse, or
dependent children to be eligible for insurance coverage under
this Act, the injury or death must have occurred as the result
of the officer's response to fresh pursuit, the officer or
firefighter's response to what is reasonably believed to be an
emergency, an unlawful act perpetrated by another, or during
the investigation of a criminal act. Nothing in this Section
shall be construed to limit health insurance coverage or
pension benefits for which the officer, firefighter, spouse, or
dependent children may otherwise be eligible.
(c) A PSEBA benefit recipient who qualified for benefits
under subsections (a) and (b) of this Section shall be required
to file a form with his or her employer as prescribed in this
Section. The Commission on Government Forecasting and
Accountability (COGFA) shall use the form created in this Act
and prescribe the content of the report in cooperation with one
statewide labor organization representing police, one
statewide law enforcement organization, one statewide labor
organization representing firefighters employed by at least
100 municipalities in this State that is affiliated with the
Illinois State Federation of Labor, one statewide labor
organization representing correctional officers and parole

09800SB1245ham001 - 4 - LRB098 00197 KTG 46568 a
agents, that is affiliated with the Illinois State Federation
of Labor, one statewide labor organization representing
correctional officers and parole agents that is affiliated with
the Illinois State Federation of Labor, one statewide
organization representing municipalities, and one regional
organization representing municipalities. COGFA may accept
comment from any source, but shall not be required to solicit
public comment. Within 60 days after the effective date of this
amendatory Act of the 98th General Assembly, COGFA shall remit
a copy of the form contained in this subsection to all
employers subject to this Act.
"PSEBA RECIPIENT REPORTING FORM:
Under Section 10 of the Public Safety Employee Benefits
Act (820 ILCS 320/10), the Commission on Government
Forecasting and Accountability (COGFA) is charged with
creating and submitting a report to the Governor and the
General Assembly setting forth information regarding
recipients and benefits payable under the Public Safety
Employee Benefits Act (Act). The Act requires employers
providing PSEBA benefits to distribute this form to any
former peace officer, firefighter, or correctional officer
currently in receipt of PSEBA benefits.
The responses to the questions below will be used by
COGFA to compile information regarding the PSEBA benefit
for its report. The Act prohibits the release of any

09800SB1245ham001 - 5 - LRB098 00197 KTG 46568 a
personal information concerning the PSEBA recipient and
exempts the reported information from the requirements of
the Freedom of Information Act (FOIA).
The Act requires the PSEBA recipient to complete this
form and submit it to the employer providing PSEBA benefits
within 60 days of receipt. If the PSEBA recipient fails to
submit this form within 60 days of receipt, the employer is
required to notify the PSEBA recipient of non-compliance
and provide an additional 30 days to submit the required
form. Failure to submit the form in a timely manner will
result in the PSEBA recipient incurring responsibility for
reimbursing the employer for premiums paid during the
period the form is due and not filed.
(1) PSEBA recipient's name:
(2) PSEBA recipient's date of birth:
(3) Name of the employer providing PSEBA benefits:
(4) Date the PSEBA benefit first became payable:
(5) What was the medical diagnosis of the injury
that qualified you for the PSEBA benefit?
(6) Are you currently employed with compensation?
(7) If so, what is the name(s) of your current
employer(s)?
(8) Are you or your spouse enrolled in a health
insurance plan provided by your current employer or
another source?
(9) Have you or your spouse been offered or

09800SB1245ham001 - 6 - LRB098 00197 KTG 46568 a
provided access to health insurance from your current
employer(s)?
If you answered yes to question 8 or 9, please provide
the name of the employer, the name of the insurance
provider(s), and a general description of the type(s) of
insurance offered (HMO, PPO, HSA, etc.):
(10) Are you or your spouse enrolled in a health
insurance plan provided by a current employer of your
spouse?
(11) Have you or your spouse been offered or
provided access to health insurance provided by a
current employer of your spouse?
If you answered yes to question 10 or 11, please
provide the name of the employer, the name of the insurance
provider, and a general description of the type of
insurance offered (HMO, PPO, HSA, etc.) by an employer of
your spouse:"
Within 30 days after receipt of this form, COFGA shall
notify an employer of its obligation to notify any PSEBA
recipient receiving benefits under this Act of that recipient's
obligation to file a report under this Section. The employer
shall include a copy of the form and a self-addressed stamped
envelope for the form to be returned to the employer. A PSEBA
recipient receiving benefits under this Act must complete and
return this form to the employer within 60 days of receipt of

09800SB1245ham001 - 7 - LRB098 00197 KTG 46568 a
such form. Any PSEBA recipient who has been given notice as
provided under this Section and who fails to timely file a
report under this Section within 60 days after receipt of this
form shall be notified by the employer that he or she has 30
days to submit the report or risk incurring the cost of his or
her benefits provided under this Act. An employer may seek
reimbursement for premium payments for a PSEBA recipient who
fails to file this report with the employer 30 days after
receiving this notice. The PSEBA recipient is responsible for
reimbursing the employer for premiums paid during the period
the report is due and not filed. Employers shall return this
form to COGFA within 30 days after receiving the form from the
PSEBA recipient.
Any information collected by the employer under this
Section shall be exempt from the requirements of the Freedom of
Information Act except for data collected in the aggregate that
does not reveal any personal information concerning the PSEBA
recipient.
By July 1 of every odd-numbered year, beginning in 2015,
employers subject to this Act must send the form contained in
this subsection to all PSEBA recipients eligible for benefits
under this Act. The PSEBA recipient must complete and return
this form by September 1 of that year. Any PSEBA recipient who
has been given notice as provided under this Section and who
fails to timely file a completed form under this Section within
60 days after receipt of this form shall be notified by the

09800SB1245ham001 - 8 - LRB098 00197 KTG 46568 a
employer that he or she has 30 days to submit the form or risk
incurring the costs of his or her benefits provided under this
Act. The PSEBA recipient is responsible for reimbursing the
employer for premiums paid during the period the report is due
and not filed. The employer shall resume premium payments upon
receipt of the completed form. Employers shall return this form
to COGFA within 30 days after receiving the form from the PSEBA
recipient.
(d) An employer subject to this Act shall complete and file
the form contained in this subsection.
"EMPLOYER SUBJECT TO PSEBA REPORTING FORM:
Under Section 10 of the Public Safety Employee Benefits
Act (820 ILCS 320/10), the Commission on Government
Forecasting and Accountability (COGFA) is charged with
creating and submitting a report to the Governor and
General Assembly setting forth information regarding
recipients and benefits payable under the Public Safety
Employee Benefits Act (Act).
The responses to the questions below will be used by
COGFA to compile information regarding the PSEBA benefit
for its report.
The Act requires all employers subject to the PSEBA Act
to submit the following information within 120 days after
receipt of this form.
(1) Name of the employer:

09800SB1245ham001 - 9 - LRB098 00197 KTG 46568 a
(2) The number of PSEBA benefit applications filed
under the Act during the reporting period provided in
the aggregate and listed individually by name of
applicant and date of application:
(3) The number of PSEBA benefits and names of PSEBA
recipients receiving benefits awarded under the Act
during the reporting period provided in the aggregate
and listed individually by name of applicant and date
of application:
(4) The cost of the health insurance premiums paid
due to PSEBA benefits awarded under the Act during the
reporting period provided in the aggregate and listed
individually by name of PSEBA recipient:
(5) The number of PSEBA benefit applications filed
under the Act since the inception of the Act provided
in the aggregate and listed individually by name of
applicant and date of application:
(6) The number of PSEBA benefits awarded under the
Act since the inception of the Act provided in the
aggregate and listed individually by name of applicant
and date of application:
(7) The cost of health insurance premiums paid due
to PSEBA benefits awarded under the Act since the
inception of the Act provided in the aggregate and
listed individually by name of PSEBA recipient:
(8) The current annual cost of health insurance

09800SB1245ham001 - 10 - LRB098 00197 KTG 46568 a
premiums paid for PSEBA benefits awarded under the Act
provided in the aggregate and listed individually by
name of PSEBA recipient:
(9) The annual cost of health insurance premiums
paid for PSEBA benefits awarded under the Act listed by
year since the inception of the Act provided in annual
aggregate amounts and listed individually by name of
PSEBA recipient:
(10) A description of health insurance benefit
levels currently provided by the employer to the PSEBA
recipient:
(11) The total cost of the monthly health insurance
premium currently provided to the PSEBA recipient:
(12) The other costs of the health insurance
benefit currently provided to the PSEBA recipient
including, but not limited to:
(i) the co-pay requirements of the health
insurance policy provided to the PSEBA recipient;
(ii) the out-of-pocket deductibles of the
health insurance policy provided to the PSEBA
recipient;
(iii) any pharmaceutical benefits and co-pays
provided in the insurance policy; and
(iv) any policy limits of the health insurance
policy provided to the PSEBA recipient."

09800SB1245ham001 - 11 - LRB098 00197 KTG 46568 a
An employer covered under this Act shall file copies of the
PSEBA Recipient Reporting Form and the Employer Subject to the
PSEBA Act Reporting Form with COGFA within 120 days after
receipt of the Employer Subject to the PSEBA Act Reporting
Form.
The first form filed with COGFA under this Section shall
contain all information required by this Section. All forms
filed by the employer thereafter shall set forth the required
information for the 24-month period ending on June 30 preceding
the deadline date for filing the report.
Whenever possible, communication between COGFA and
employers as required by this Act shall be through electronic
means.
(e) For the purpose of creating the report required under
subsection (f), upon receipt of each PSEBA Benefit Recipient
Form, or as soon as reasonably practicable, COGFA shall make a
determination of whether the PSEBA benefit recipient or the
PSEBA benefit recipient's spouse meets one of the following
criteria:
(1) the PSEBA benefit recipient or the PSEBA benefit
recipient's spouse is receiving health insurance from a
current employer, a current employer of his or her spouse,
or another source;
(2) the PSEBA benefit recipient or the PSEBA benefit
recipient's spouse has been offered or provided access to
health insurance from a current employer or employers.

09800SB1245ham001 - 12 - LRB098 00197 KTG 46568 a
If one or both of the criteria are met, COGFA shall make
the following determinations of the associated costs and
benefit levels of health insurance provided or offered to the
PSEBA benefit recipient or the PSEBA benefit recipient's
spouse:
(A) a description of health insurance benefit levels
offered to or received by the PSEBA benefit recipient or
the PSEBA benefit recipient's spouse from a current
employer or a current employer of the PSEBA benefit
recipient's spouse;
(B) the monthly premium cost of health insurance
benefits offered to or received by the PSEBA benefit
recipient or the PSEBA benefit recipient's spouse from a
current employer or a current employer of the PSEBA benefit
recipient's spouse including, but not limited to:
(i) the total monthly cost of the health insurance
premium;
(ii) the monthly amount of the health insurance
premium to be paid by the employer;
(iii) the monthly amount of the health insurance
premium to be paid by the PSEBA benefit recipient or
the PSEBA benefit recipient's spouse;
(iv) the co-pay requirements of the health
insurance policy;
(v) the out-of-pocket deductibles of the health
insurance policy;

09800SB1245ham001 - 13 - LRB098 00197 KTG 46568 a
(vi) any pharmaceutical benefits and co-pays
provided in the insurance policy;
(vii) any policy limits of the health insurance
policy.
COGFA shall summarize the related costs and benefit levels
of health insurance provided or available to the PSEBA benefit
recipient or the PSEBA benefit recipient's spouse and contrast
the results to the cost and benefit levels of health insurance
currently provided by the employer subject to this Act. This
information shall be included in the report required in
subsection (f).
(f) By June 1, 2014, and by January 1 of every
even-numbered year thereafter beginning in 2016, COGFA shall
submit a report to the Governor and the General Assembly
setting forth the information received under subsections (c)
and (d). The report shall aggregate data in such a way as to
not reveal the identity of any single beneficiary. The
requirement for reporting to the General Assembly shall be
satisfied by filing copies of the report with the Speaker,
Minority Leader, and Clerk of the House of Representatives, the
President, Minority Leader, and Secretary of the Senate, the
Legislative Research Unit as required under Section 3.1 of the
General Assembly Organization Act, and the State Government
Report Distribution Center for the General Assembly as required
under paragraph (t) of Section 7 of the State Library Act.
COGFA shall make this report available electronically on a

09800SB1245ham001 - 14 - LRB098 00197 KTG 46568 a
publicly accessible website.
(Source: P.A. 90-535, eff. 11-14-97.)
Section 99. Effective date. This Act takes effect upon
becoming law.".