Bill Text: IL SB1538 | 2011-2012 | 97th General Assembly | Amended

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

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Bill Title: Amends the Department of Human Services Act. Requires the Governor to create a Management Improvement Initiative Committee that shall include the Management Improvement Initiative Departmental Leadership Team to implement the recommendations made in the report submitted to the General Assembly on January 1, 2011 as required under Public Act 96-1141. Provides that the Team shall be comprised of a representative from the Department on Aging and the Departments of Children and Family Services, Healthcare and Family Services, Human Services, and Public Health, and that the Team members shall integrate the Committee's objectives into their respective departmental operations and shall submit a progress report to the General Assembly by May 1, 2011 on the progress made in implementing the recommendations made in the report submitted to the General Assembly on January 1, 2011 as required under Public Act 96-1141. Provides that additional duties of the Committee shall include reviewing contracts held with community health and human service providers on the regulations and work processes required by the departments and their divisions; and describing how improved regulations, reporting, monitoring, compliance, auditing, certification, licensing, and work processes are measured at the community vendor, contractor, and departmental levels, and how they have reduced redundant regulations, reporting, monitoring, compliance, auditing, certification, licensing, and work processes. Contains provisions concerning the composition of the Committee. Effective immediately.

Spectrum: Moderate Partisan Bill (Democrat 8-1)

Status: (Passed) 2012-01-13 - Public Act . . . . . . . . . 97-0668 [SB1538 Detail]

Download: Illinois-2011-SB1538-Amended.html

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Rep. Chapin Rose

Filed: 11/7/2011

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AMENDMENT TO SENATE BILL 1538
AMENDMENT NO. ______. Amend Senate Bill 1538 by replacing
everything after the enacting clause with the following:
"Section 5. The State Employees Group Insurance Act of 1971
is amended by changing Sections 3 and 8 as follows:
(5 ILCS 375/3) (from Ch. 127, par. 523)
Sec. 3. Definitions. Unless the context otherwise
requires, the following words and phrases as used in this Act
shall have the following meanings. The Department may define
these and other words and phrases separately for the purpose of
implementing specific programs providing benefits under this
Act.
(a) "Administrative service organization" means any
person, firm or corporation experienced in the handling of
claims which is fully qualified, financially sound and capable
of meeting the service requirements of a contract of

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administration executed with the Department.
(b) "Annuitant" means (1) an employee who retires, or has
retired, on or after January 1, 1966 on an immediate annuity
under the provisions of Articles 2, 14 (including an employee
who has elected to receive an alternative retirement
cancellation payment under Section 14-108.5 of the Illinois
Pension Code in lieu of an annuity), 15 (including an employee
who has retired under the optional retirement program
established under Section 15-158.2), paragraphs (2), (3), or
(5) of Section 16-106, or Article 18 of the Illinois Pension
Code; (2) any person who was receiving group insurance coverage
under this Act as of March 31, 1978 by reason of his status as
an annuitant, even though the annuity in relation to which such
coverage was provided is a proportional annuity based on less
than the minimum period of service required for a retirement
annuity in the system involved; (3) any person not otherwise
covered by this Act who has retired as a participating member
under Article 2 of the Illinois Pension Code but is ineligible
for the retirement annuity under Section 2-119 of the Illinois
Pension Code; (4) the spouse of any person who is receiving a
retirement annuity under Article 18 of the Illinois Pension
Code and who is covered under a group health insurance program
sponsored by a governmental employer other than the State of
Illinois and who has irrevocably elected to waive his or her
coverage under this Act and to have his or her spouse
considered as the "annuitant" under this Act and not as a

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"dependent"; or (5) an employee who retires, or has retired,
from a qualified position, as determined according to rules
promulgated by the Director, under a qualified local
government, a qualified rehabilitation facility, a qualified
domestic violence shelter or service, or a qualified child
advocacy center. (For definition of "retired employee", see (p)
post).
(b-5) "New SERS annuitant" means a person who, on or after
January 1, 1998, becomes an annuitant, as defined in subsection
(b), by virtue of beginning to receive a retirement annuity
under Article 14 of the Illinois Pension Code (including an
employee who has elected to receive an alternative retirement
cancellation payment under Section 14-108.5 of that Code in
lieu of an annuity), and is eligible to participate in the
basic program of group health benefits provided for annuitants
under this Act.
(b-6) "New SURS annuitant" means a person who (1) on or
after January 1, 1998, becomes an annuitant, as defined in
subsection (b), by virtue of beginning to receive a retirement
annuity under Article 15 of the Illinois Pension Code, (2) has
not made the election authorized under Section 15-135.1 of the
Illinois Pension Code, and (3) is eligible to participate in
the basic program of group health benefits provided for
annuitants under this Act.
(b-7) "New TRS State annuitant" means a person who, on or
after July 1, 1998, becomes an annuitant, as defined in

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subsection (b), by virtue of beginning to receive a retirement
annuity under Article 16 of the Illinois Pension Code based on
service as a teacher as defined in paragraph (2), (3), or (5)
of Section 16-106 of that Code, and is eligible to participate
in the basic program of group health benefits provided for
annuitants under this Act.
(c) "Carrier" means (1) an insurance company, a corporation
organized under the Limited Health Service Organization Act or
the Voluntary Health Services Plan Act, a partnership, or other
nongovernmental organization, which is authorized to do group
life or group health insurance business in Illinois, or (2) the
State of Illinois as a self-insurer.
(d) "Compensation" means salary or wages payable on a
regular payroll by the State Treasurer on a warrant of the
State Comptroller out of any State, trust or federal fund, or
by the Governor of the State through a disbursing officer of
the State out of a trust or out of federal funds, or by any
Department out of State, trust, federal or other funds held by
the State Treasurer or the Department, to any person for
personal services currently performed, and ordinary or
accidental disability benefits under Articles 2, 14, 15
(including ordinary or accidental disability benefits under
the optional retirement program established under Section
15-158.2), paragraphs (2), (3), or (5) of Section 16-106, or
Article 18 of the Illinois Pension Code, for disability
incurred after January 1, 1966, or benefits payable under the

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Workers' Compensation or Occupational Diseases Act or benefits
payable under a sick pay plan established in accordance with
Section 36 of the State Finance Act. "Compensation" also means
salary or wages paid to an employee of any qualified local
government, qualified rehabilitation facility, qualified
domestic violence shelter or service, or qualified child
advocacy center.
(e) "Commission" means the State Employees Group Insurance
Advisory Commission authorized by this Act. Commencing July 1,
1984, "Commission" as used in this Act means the Commission on
Government Forecasting and Accountability as established by
the Legislative Commission Reorganization Act of 1984.
(f) "Contributory", when referred to as contributory
coverage, shall mean optional coverages or benefits elected by
the member toward the cost of which such member makes
contribution, or which are funded in whole or in part through
the acceptance of a reduction in earnings or the foregoing of
an increase in earnings by an employee, as distinguished from
noncontributory coverage or benefits which are paid entirely by
the State of Illinois without reduction of the member's salary.
(g) "Department" means any department, institution, board,
commission, officer, court or any agency of the State
government receiving appropriations and having power to
certify payrolls to the Comptroller authorizing payments of
salary and wages against such appropriations as are made by the
General Assembly from any State fund, or against trust funds

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held by the State Treasurer and includes boards of trustees of
the retirement systems created by Articles 2, 14, 15, 16 and 18
of the Illinois Pension Code. "Department" also includes the
Illinois Comprehensive Health Insurance Board, the Board of
Examiners established under the Illinois Public Accounting
Act, and the Illinois Finance Authority.
(h) "Dependent", when the term is used in the context of
the health and life plan, means a member's spouse and any child
(1) from birth to age 26 including an adopted child, a child
who lives with the member from the time of the filing of a
petition for adoption until entry of an order of adoption, a
stepchild or adjudicated child, or a child who lives with the
member if such member is a court appointed guardian of the
child or (2) age 19 or over who is mentally or physically
disabled from a cause originating prior to the age of 19 (age
26 if enrolled as an adult child dependent). For the health
plan only, the term "dependent" also includes (1) any person
enrolled prior to the effective date of this Section who is
dependent upon the member to the extent that the member may
claim such person as a dependent for income tax deduction
purposes and (2) any person who has received after June 30,
2000 an organ transplant and who is financially dependent upon
the member and eligible to be claimed as a dependent for income
tax purposes. A member requesting to cover any dependent must
provide documentation as requested by the Department of Central
Management Services and file with the Department any and all

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forms required by the Department.
(i) "Director" means the Director of the Illinois
Department of Central Management Services or of any successor
agency designated to administer this Act.
(j) "Eligibility period" means the period of time a member
has to elect enrollment in programs or to select benefits
without regard to age, sex or health.
(k) "Employee" means and includes each officer or employee
in the service of a department who (1) receives his
compensation for service rendered to the department on a
warrant issued pursuant to a payroll certified by a department
or on a warrant or check issued and drawn by a department upon
a trust, federal or other fund or on a warrant issued pursuant
to a payroll certified by an elected or duly appointed officer
of the State or who receives payment of the performance of
personal services on a warrant issued pursuant to a payroll
certified by a Department and drawn by the Comptroller upon the
State Treasurer against appropriations made by the General
Assembly from any fund or against trust funds held by the State
Treasurer, and (2) is employed full-time or part-time in a
position normally requiring actual performance of duty during
not less than 1/2 of a normal work period, as established by
the Director in cooperation with each department, except that
persons elected by popular vote will be considered employees
during the entire term for which they are elected regardless of
hours devoted to the service of the State, and (3) except that

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"employee" does not include any person who is not eligible by
reason of such person's employment to participate in one of the
State retirement systems under Articles 2, 14, 15 (either the
regular Article 15 system or the optional retirement program
established under Section 15-158.2) or 18, or under paragraph
(2), (3), or (5) of Section 16-106, of the Illinois Pension
Code, but such term does include persons who are employed
during the 6 month qualifying period under Article 14 of the
Illinois Pension Code. Such term also includes any person who
(1) after January 1, 1966, is receiving ordinary or accidental
disability benefits under Articles 2, 14, 15 (including
ordinary or accidental disability benefits under the optional
retirement program established under Section 15-158.2),
paragraphs (2), (3), or (5) of Section 16-106, or Article 18 of
the Illinois Pension Code, for disability incurred after
January 1, 1966, (2) receives total permanent or total
temporary disability under the Workers' Compensation Act or
Occupational Disease Act as a result of injuries sustained or
illness contracted in the course of employment with the State
of Illinois, or (3) is not otherwise covered under this Act and
has retired as a participating member under Article 2 of the
Illinois Pension Code but is ineligible for the retirement
annuity under Section 2-119 of the Illinois Pension Code.
However, a person who satisfies the criteria of the foregoing
definition of "employee" except that such person is made
ineligible to participate in the State Universities Retirement

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System by clause (4) of subsection (a) of Section 15-107 of the
Illinois Pension Code is also an "employee" for the purposes of
this Act. "Employee" also includes any person receiving or
eligible for benefits under a sick pay plan established in
accordance with Section 36 of the State Finance Act. "Employee"
also includes (i) each officer or employee in the service of a
qualified local government, including persons appointed as
trustees of sanitary districts regardless of hours devoted to
the service of the sanitary district, (ii) each employee in the
service of a qualified rehabilitation facility, (iii) each
full-time employee in the service of a qualified domestic
violence shelter or service, and (iv) each full-time employee
in the service of a qualified child advocacy center, as
determined according to rules promulgated by the Director.
(l) "Member" means an employee, annuitant, retired
employee or survivor. In the case of an annuitant or retired
employee who first becomes an annuitant or retired employee on
or after the effective date of this amendatory Act of the 97th
General Assembly, the individual must meet the minimum vesting
requirements of the applicable retirement system in order to be
eligible for group insurance benefits under that system. In the
case of a survivor who first becomes a survivor on or after the
effective date of this amendatory Act of the 97th General
Assembly, the deceased employee, annuitant, or retired
employee upon whom the annuity is based must have been eligible
to participate in the group insurance system under the

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applicable retirement system in order for the survivor to be
eligible for group insurance benefits under that system.
(m) "Optional coverages or benefits" means those coverages
or benefits available to the member on his or her voluntary
election, and at his or her own expense.
(n) "Program" means the group life insurance, health
benefits and other employee benefits designed and contracted
for by the Director under this Act.
(o) "Health plan" means a health benefits program offered
by the State of Illinois for persons eligible for the plan.
(p) "Retired employee" means any person who would be an
annuitant as that term is defined herein but for the fact that
such person retired prior to January 1, 1966. Such term also
includes any person formerly employed by the University of
Illinois in the Cooperative Extension Service who would be an
annuitant but for the fact that such person was made ineligible
to participate in the State Universities Retirement System by
clause (4) of subsection (a) of Section 15-107 of the Illinois
Pension Code.
(q) "Survivor" means a person receiving an annuity as a
survivor of an employee or of an annuitant. "Survivor" also
includes: (1) the surviving dependent of a person who satisfies
the definition of "employee" except that such person is made
ineligible to participate in the State Universities Retirement
System by clause (4) of subsection (a) of Section 15-107 of the
Illinois Pension Code; (2) the surviving dependent of any

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person formerly employed by the University of Illinois in the
Cooperative Extension Service who would be an annuitant except
for the fact that such person was made ineligible to
participate in the State Universities Retirement System by
clause (4) of subsection (a) of Section 15-107 of the Illinois
Pension Code; and (3) the surviving dependent of a person who
was an annuitant under this Act by virtue of receiving an
alternative retirement cancellation payment under Section
14-108.5 of the Illinois Pension Code.
(q-2) "SERS" means the State Employees' Retirement System
of Illinois, created under Article 14 of the Illinois Pension
Code.
(q-3) "SURS" means the State Universities Retirement
System, created under Article 15 of the Illinois Pension Code.
(q-4) "TRS" means the Teachers' Retirement System of the
State of Illinois, created under Article 16 of the Illinois
Pension Code.
(q-5) "New SERS survivor" means a survivor, as defined in
subsection (q), whose annuity is paid under Article 14 of the
Illinois Pension Code and is based on the death of (i) an
employee whose death occurs on or after January 1, 1998, or
(ii) a new SERS annuitant as defined in subsection (b-5). "New
SERS survivor" includes the surviving dependent of a person who
was an annuitant under this Act by virtue of receiving an
alternative retirement cancellation payment under Section
14-108.5 of the Illinois Pension Code.

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(q-6) "New SURS survivor" means a survivor, as defined in
subsection (q), whose annuity is paid under Article 15 of the
Illinois Pension Code and is based on the death of (i) an
employee whose death occurs on or after January 1, 1998, or
(ii) a new SURS annuitant as defined in subsection (b-6).
(q-7) "New TRS State survivor" means a survivor, as defined
in subsection (q), whose annuity is paid under Article 16 of
the Illinois Pension Code and is based on the death of (i) an
employee who is a teacher as defined in paragraph (2), (3), or
(5) of Section 16-106 of that Code and whose death occurs on or
after July 1, 1998, or (ii) a new TRS State annuitant as
defined in subsection (b-7).
(r) "Medical services" means the services provided within
the scope of their licenses by practitioners in all categories
licensed under the Medical Practice Act of 1987.
(s) "Unit of local government" means any county,
municipality, township, school district (including a
combination of school districts under the Intergovernmental
Cooperation Act), special district or other unit, designated as
a unit of local government by law, which exercises limited
governmental powers or powers in respect to limited
governmental subjects, any not-for-profit association with a
membership that primarily includes townships and township
officials, that has duties that include provision of research
service, dissemination of information, and other acts for the
purpose of improving township government, and that is funded

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wholly or partly in accordance with Section 85-15 of the
Township Code; any not-for-profit corporation or association,
with a membership consisting primarily of municipalities, that
operates its own utility system, and provides research,
training, dissemination of information, or other acts to
promote cooperation between and among municipalities that
provide utility services and for the advancement of the goals
and purposes of its membership; the Southern Illinois
Collegiate Common Market, which is a consortium of higher
education institutions in Southern Illinois; the Illinois
Association of Park Districts; and any hospital provider that
is owned by a county that has 100 or fewer hospital beds and
has not already joined the program. "Qualified local
government" means a unit of local government approved by the
Director and participating in a program created under
subsection (i) of Section 10 of this Act.
(t) "Qualified rehabilitation facility" means any
not-for-profit organization that is accredited by the
Commission on Accreditation of Rehabilitation Facilities or
certified by the Department of Human Services (as successor to
the Department of Mental Health and Developmental
Disabilities) to provide services to persons with disabilities
and which receives funds from the State of Illinois for
providing those services, approved by the Director and
participating in a program created under subsection (j) of
Section 10 of this Act.

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(u) "Qualified domestic violence shelter or service" means
any Illinois domestic violence shelter or service and its
administrative offices funded by the Department of Human
Services (as successor to the Illinois Department of Public
Aid), approved by the Director and participating in a program
created under subsection (k) of Section 10.
(v) "TRS benefit recipient" means a person who:
(1) is not a "member" as defined in this Section; and
(2) is receiving a monthly benefit or retirement
annuity under Article 16 of the Illinois Pension Code; and
(3) either (i) has at least 8 years of creditable
service under Article 16 of the Illinois Pension Code, or
(ii) was enrolled in the health insurance program offered
under that Article on January 1, 1996, or (iii) is the
survivor of a benefit recipient who had at least 8 years of
creditable service under Article 16 of the Illinois Pension
Code or was enrolled in the health insurance program
offered under that Article on the effective date of this
amendatory Act of 1995, or (iv) is a recipient or survivor
of a recipient of a disability benefit under Article 16 of
the Illinois Pension Code.
(w) "TRS dependent beneficiary" means a person who:
(1) is not a "member" or "dependent" as defined in this
Section; and
(2) is a TRS benefit recipient's: (A) spouse, (B)
dependent parent who is receiving at least half of his or

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her support from the TRS benefit recipient, or (C) natural,
step, adjudicated, or adopted child who is (i) under age
26, (ii) was, on January 1, 1996, participating as a
dependent beneficiary in the health insurance program
offered under Article 16 of the Illinois Pension Code, or
(iii) age 19 or over who is mentally or physically disabled
from a cause originating prior to the age of 19 (age 26 if
enrolled as an adult child).
"TRS dependent beneficiary" does not include, as indicated
under paragraph (2) of this subsection (w), a dependent of the
survivor of a TRS benefit recipient who first becomes a
dependent of a survivor of a TRS benefit recipient on or after
the effective date of this amendatory Act of the 97th General
Assembly unless that dependent would have been eligible for
coverage as a dependent of the deceased TRS benefit recipient
upon whom the survivor benefit is based.
(x) "Military leave" refers to individuals in basic
training for reserves, special/advanced training, annual
training, emergency call up, activation by the President of the
United States, or any other training or duty in service to the
United States Armed Forces.
(y) (Blank).
(z) "Community college benefit recipient" means a person
who:
(1) is not a "member" as defined in this Section; and
(2) is receiving a monthly survivor's annuity or

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retirement annuity under Article 15 of the Illinois Pension
Code; and
(3) either (i) was a full-time employee of a community
college district or an association of community college
boards created under the Public Community College Act
(other than an employee whose last employer under Article
15 of the Illinois Pension Code was a community college
district subject to Article VII of the Public Community
College Act) and was eligible to participate in a group
health benefit plan as an employee during the time of
employment with a community college district (other than a
community college district subject to Article VII of the
Public Community College Act) or an association of
community college boards, or (ii) is the survivor of a
person described in item (i).
(aa) "Community college dependent beneficiary" means a
person who:
(1) is not a "member" or "dependent" as defined in this
Section; and
(2) is a community college benefit recipient's: (A)
spouse, (B) dependent parent who is receiving at least half
of his or her support from the community college benefit
recipient, or (C) natural, step, adjudicated, or adopted
child who is (i) under age 26, or (ii) age 19 or over and
mentally or physically disabled from a cause originating
prior to the age of 19 (age 26 if enrolled as an adult

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child).
"Community college dependent beneficiary" does not
include, as indicated under paragraph (2) of this subsection
(aa), a dependent of the survivor of a community college
benefit recipient who first becomes a dependent of a survivor
of a community college benefit recipient on or after the
effective date of this amendatory Act of the 97th General
Assembly unless that dependent would have been eligible for
coverage as a dependent of the deceased community college
benefit recipient upon whom the survivor annuity is based.
(bb) "Qualified child advocacy center" means any Illinois
child advocacy center and its administrative offices funded by
the Department of Children and Family Services, as defined by
the Children's Advocacy Center Act (55 ILCS 80/), approved by
the Director and participating in a program created under
subsection (n) of Section 10.
(Source: P.A. 95-331, eff. 8-21-07; 95-632, eff. 9-25-07;
96-756, eff. 1-1-10; 96-1519, eff. 2-4-11.)
(5 ILCS 375/8) (from Ch. 127, par. 528)
Sec. 8. Eligibility.
(a) Each employee member eligible under the provisions of
this Act and any rules and regulations promulgated and adopted
hereunder by the Director shall become immediately eligible and
covered for all benefits available under the programs.
Employees Members electing coverage for eligible dependents

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shall have the coverage effective immediately, provided that
the election is properly filed in accordance with required
filing dates and procedures specified by the Director,
including the completion and submission of all documentation
and forms required by the Director.
(1) Every member originally eligible to elect
dependent coverage, but not electing it during the original
eligibility period, may subsequently obtain dependent
coverage only in the event of a qualifying change in
status, special enrollment, special circumstance as
defined by the Director, or during the annual Benefit
Choice Period.
(2) Members described above being transferred from
previous coverage towards which the State has been
contributing shall be transferred regardless of
preexisting conditions, waiting periods, or other
requirements that might jeopardize claim payments to which
they would otherwise have been entitled.
(3) Eligible and covered members that are eligible for
coverage as dependents except for the fact of being members
shall be transferred to, and covered under, dependent
status regardless of preexisting conditions, waiting
periods, or other requirements that might jeopardize claim
payments to which they would otherwise have been entitled
upon cessation of member status and the election of
dependent coverage by a member eligible to elect that

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coverage.
(b) New employees shall be immediately insured for the
basic group life insurance and covered by the program of health
benefits on the first day of active State service. Optional
life insurance coverage one to 4 times the basic amount, if
elected during the relevant eligibility period, will become
effective on the date of employment. Optional life insurance
coverage exceeding 4 times the basic amount and all life
insurance amounts applied for after the eligibility period will
be effective, subject to satisfactory evidence of insurability
when applicable, or other necessary qualifications, pursuant
to the requirements of the applicable benefit program, unless
there is a change in status that would confer new eligibility
for change of enrollment under rules established supplementing
this Act, in which event application must be made within the
new eligibility period.
(c) As to the group health benefits program contracted to
begin or continue after June 30, 1973, each annuitant,
survivor, and retired employee shall become immediately
eligible and covered for all benefits available under that
program. Each annuitant, survivor, and retired employee shall
have coverage effective immediately, provided that the
election is properly filed in accordance with the required
filing dates and procedures specified by the Director,
including the completion and submission of all documentation
and forms required by the Director. Annuitants, survivors, and

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retired Retired employees may elect coverage for eligible
dependents and shall have the coverage effective immediately,
provided that the election is properly filed in accordance with
required filing dates and procedures specified by the Director,
except that, for a survivor, the dependent sought to be added
on or after the effective date of this amendatory Act of the
97th General Assembly must have been eligible for coverage as a
dependent under the deceased member upon whom the survivor's
annuity is based in order to be eligible for coverage under the
survivor.
Except as otherwise provided in this Act, where husband and
wife are both eligible members, each shall be enrolled as a
member and coverage on their eligible dependent children, if
any, may be under the enrollment and election of either.
Regardless of other provisions herein regarding late
enrollment or other qualifications, as appropriate, the
Director may periodically authorize open enrollment periods
for each of the benefit programs at which time each member may
elect enrollment or change of enrollment without regard to age,
sex, health, or other qualification under the conditions as may
be prescribed in rules and regulations supplementing this Act.
Special open enrollment periods may be declared by the Director
for certain members only when special circumstances occur that
affect only those members.
(d) Beginning with fiscal year 2003 and for all subsequent
years, eligible members may elect not to participate in the

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program of health benefits as defined in this Act. The election
must be made during the annual benefit choice period, subject
to the conditions in this subsection.
(1) Members must furnish proof of health benefit
coverage, either comprehensive major medical coverage or
comprehensive managed care plan, from a source other than
the Department of Central Management Services in order to
elect not to participate in the program.
(2) Members may re-enroll in the Department of Central
Management Services program of health benefits upon
showing a qualifying change in status, as defined in the
U.S. Internal Revenue Code, without evidence of
insurability and with no limitations on coverage for
pre-existing conditions, provided that there was not a
break in coverage of more than 63 days.
(3) Members may also re-enroll in the program of health
benefits during any annual benefit choice period, without
evidence of insurability.
(4) Members who elect not to participate in the program
of health benefits shall be furnished a written explanation
of the requirements and limitations for the election not to
participate in the program and for re-enrolling in the
program. The explanation shall also be included in the
annual benefit choice options booklets furnished to
members.
(d-5) Beginning July 1, 2005, the Director may establish a

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program of financial incentives to encourage annuitants
receiving a retirement annuity from the State Employees
Retirement System, but who are not eligible for benefits under
the federal Medicare health insurance program (Title XVIII of
the Social Security Act, as added by Public Law 89-97) to elect
not to participate in the program of health benefits provided
under this Act. The election by an annuitant not to participate
under this program must be made in accordance with the
requirements set forth under subsection (d). The financial
incentives provided to these annuitants under the program may
not exceed $150 per month for each annuitant electing not to
participate in the program of health benefits provided under
this Act.
(e) Notwithstanding any other provision of this Act or the
rules adopted under this Act, if a person participating in the
program of health benefits as the dependent spouse of an
eligible member becomes an annuitant, the person may elect, at
the time of becoming an annuitant or during any subsequent
annual benefit choice period, to continue participation as a
dependent rather than as an eligible member for as long as the
person continues to be an eligible dependent. In order to be
eligible to make such an election, the person must have been
enrolled as a dependent under the program of health benefits
for no less than one year prior to becoming an annuitant.
An eligible member who has elected to participate as a
dependent may re-enroll in the program of health benefits as an

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eligible member (i) during any subsequent annual benefit choice
period or (ii) upon showing a qualifying change in status, as
defined in the U.S. Internal Revenue Code, without evidence of
insurability and with no limitations on coverage for
pre-existing conditions.
A person who elects to participate in the program of health
benefits as a dependent rather than as an eligible member shall
be furnished a written explanation of the consequences of
electing to participate as a dependent and the conditions and
procedures for re-enrolling as an eligible member. The
explanation shall also be included in the annual benefit choice
options booklet furnished to members.
(Source: P.A. 94-95, eff. 7-1-05; 94-109, eff. 7-1-05; 95-331,
eff. 8-21-07.)
Section 99. Effective date. This Act takes effect upon
becoming law.".