Bill Text: IL SB2248 | 2023-2024 | 103rd General Assembly | Introduced
Bill Title: Amends the State Employees Group Insurance Act of 1971. Provides that beginning January 1, 2024, the Director of Central Management Services shall establish a program of financial incentives to encourage Medicare-primary members to elect not to participate in the group health benefits program for Medicare-primary members and their Medicare-primary dependents. Provides that the program of financial incentives shall include a monthly voucher in the amount that the State would have contributed toward that member's monthly premium if the Medicare-primary member elected to participate in the group health benefits program. Provides that the voucher shall be used by the Medicare-primary member to pay the monthly premium cost of an individual Medicare Advantage plan of his or her choosing. Effective immediately.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced) 2023-02-10 - Referred to Assignments [SB2248 Detail]
Download: Illinois-2023-SB2248-Introduced.html
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1 | AN ACT concerning State government.
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2 | Be it enacted by the People of the State of Illinois,
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3 | represented in the General Assembly:
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4 | Section 5. The State Employees Group Insurance Act of 1971 | |||||||||||||||||||
5 | is amended by changing Section 8 as follows:
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6 | (5 ILCS 375/8) (from Ch. 127, par. 528)
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7 | Sec. 8. Eligibility.
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8 | (a) Each employee eligible under the provisions of this | |||||||||||||||||||
9 | Act and any rules
and regulations promulgated and adopted | |||||||||||||||||||
10 | hereunder by the Director shall
become immediately eligible | |||||||||||||||||||
11 | and covered for all benefits available under
the programs. | |||||||||||||||||||
12 | Employees electing coverage for eligible dependents shall have
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13 | the coverage effective immediately, provided that the election | |||||||||||||||||||
14 | is properly
filed in accordance with required filing dates and | |||||||||||||||||||
15 | procedures specified by
the Director, including the completion | |||||||||||||||||||
16 | and submission of all documentation and forms required by the | |||||||||||||||||||
17 | Director.
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18 | (1) Every member originally eligible to elect | |||||||||||||||||||
19 | dependent coverage, but not
electing it during the | |||||||||||||||||||
20 | original eligibility period, may subsequently obtain
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21 | dependent coverage only in the event of a qualifying | |||||||||||||||||||
22 | change in status, special
enrollment, special circumstance | |||||||||||||||||||
23 | as defined by the Director, or during the
annual Benefit |
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1 | Choice Period.
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2 | (2) Members described above being transferred from | ||||||
3 | previous
coverage towards which the State has been | ||||||
4 | contributing shall be
transferred regardless of | ||||||
5 | preexisting conditions, waiting periods, or
other | ||||||
6 | requirements that might jeopardize claim payments to which | ||||||
7 | they
would otherwise have been entitled.
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8 | (3) Eligible and covered members that are eligible for | ||||||
9 | coverage as
dependents except for the fact of being | ||||||
10 | members shall be transferred to,
and covered under, | ||||||
11 | dependent status regardless of preexisting conditions,
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12 | waiting periods, or other requirements that might | ||||||
13 | jeopardize claim payments
to which they would otherwise | ||||||
14 | have been entitled upon cessation of member
status and the | ||||||
15 | election of dependent coverage by a member eligible to | ||||||
16 | elect
that coverage.
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17 | (b) New employees shall be immediately insured for the | ||||||
18 | basic group
life insurance and covered by the program of | ||||||
19 | health benefits on the first
day of active State service. | ||||||
20 | Optional life insurance coverage one to 4 times the basic | ||||||
21 | amount, if elected
during the relevant eligibility period, | ||||||
22 | will become effective on the date
of employment. Optional life | ||||||
23 | insurance coverage exceeding 4 times the basic amount and all | ||||||
24 | life insurance amounts applied for after the
eligibility | ||||||
25 | period will be effective, subject to satisfactory evidence of
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26 | insurability when applicable, or other necessary |
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1 | qualifications, pursuant to
the requirements of the applicable | ||||||
2 | benefit program, unless there is a change in
status that would | ||||||
3 | confer new eligibility for change of enrollment under rules
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4 | established supplementing this Act, in which event application | ||||||
5 | must be made
within the new eligibility period.
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6 | (c) As to the group health benefits program contracted to | ||||||
7 | begin or
continue after June 30, 1973, each annuitant, | ||||||
8 | survivor, and retired employee shall become immediately
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9 | eligible for all benefits available under that program. Each | ||||||
10 | annuitant, survivor, and retired employee shall have coverage | ||||||
11 | effective immediately, provided that the election is properly | ||||||
12 | filed in accordance with the required filing dates and | ||||||
13 | procedures specified by the Director, including the completion | ||||||
14 | and submission of all documentation and forms required by the | ||||||
15 | Director. Annuitants, survivors, and retired
employees may | ||||||
16 | elect coverage for eligible dependents and shall have the
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17 | coverage effective immediately, provided that the election is | ||||||
18 | properly
filed in accordance with required filing dates and | ||||||
19 | procedures specified
by the Director, except that, for a | ||||||
20 | survivor, the dependent sought to be added on or after the | ||||||
21 | effective date of this amendatory Act of the 97th General | ||||||
22 | Assembly must have been eligible for coverage as a dependent | ||||||
23 | under the deceased member upon whom the survivor's annuity is | ||||||
24 | based in order to be eligible for coverage under the survivor.
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25 | Except as otherwise provided in this Act, where husband | ||||||
26 | and wife are
both eligible members, each shall be enrolled as a |
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1 | member and coverage on
their eligible dependent children, if | ||||||
2 | any, may be under the enrollment and
election of either.
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3 | Regardless of other provisions herein regarding late | ||||||
4 | enrollment or other
qualifications, as appropriate, the
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5 | Director may periodically authorize open enrollment periods | ||||||
6 | for each of the
benefit programs at which time each member may | ||||||
7 | elect enrollment or change
of enrollment without regard to | ||||||
8 | age, sex, health, or other qualification
under the conditions | ||||||
9 | as may be prescribed in rules and regulations
supplementing | ||||||
10 | this Act. Special open enrollment periods may be declared by
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11 | the Director for certain members only when special | ||||||
12 | circumstances occur that
affect only those members.
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13 | (d) Eligible
members may elect not to participate in the | ||||||
14 | program of health benefits as
defined in this Act. The | ||||||
15 | election must be made during the annual benefit
choice period | ||||||
16 | or upon showing a qualifying change in status as defined in the | ||||||
17 | U.S. Internal Revenue Code, subject to the conditions in this | ||||||
18 | subsection.
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19 | (1) (Blank).
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20 | (2) Members may re-enroll in the Department of Central | ||||||
21 | Management Services
program of health benefits upon | ||||||
22 | showing a qualifying change in status, as
defined in the | ||||||
23 | U.S. Internal Revenue Code, without evidence of | ||||||
24 | insurability
and with no limitations on coverage for | ||||||
25 | pre-existing conditions.
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26 | (3) Members may also re-enroll in the program of |
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1 | health benefits during
any annual benefit choice period, | ||||||
2 | without evidence of insurability.
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3 | (4) Members who elect not to participate in the | ||||||
4 | program of health benefits
shall be furnished a written | ||||||
5 | explanation of the requirements and limitations
for the | ||||||
6 | election not to participate in the program and for | ||||||
7 | re-enrolling in the
program. The explanation shall also be | ||||||
8 | included in the annual benefit choice
options booklets | ||||||
9 | furnished to members.
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10 | (d-5) Beginning July 1, 2005, the Director may establish a | ||||||
11 | program of financial incentives to encourage annuitants | ||||||
12 | receiving a retirement annuity, but who are not eligible for | ||||||
13 | benefits under the federal Medicare health insurance program | ||||||
14 | (Title XVIII of the Social Security Act, as added by Public Law | ||||||
15 | 89-97) to elect not to participate in the program of health | ||||||
16 | benefits provided under this Act. The election by an annuitant | ||||||
17 | not to participate under this program must be made in | ||||||
18 | accordance with the requirements set forth under subsection | ||||||
19 | (d). The financial incentives provided to these annuitants | ||||||
20 | under the program may not exceed $150 per month for each | ||||||
21 | annuitant electing not to participate in the program of health | ||||||
22 | benefits provided under this Act.
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23 | (d-6) Beginning July 1, 2013, the Director may establish a | ||||||
24 | program of financial incentives to encourage annuitants with | ||||||
25 | 20 or more years of creditable service but who are not eligible | ||||||
26 | for benefits under the federal Medicare health insurance |
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1 | program (Title XVIII of the Social Security Act, as added by | ||||||
2 | Public Law 89-97) to elect not to participate in the program of | ||||||
3 | health benefits provided under this Act. The election by an | ||||||
4 | annuitant not to participate under this program must be made | ||||||
5 | in accordance with the requirements set forth under subsection | ||||||
6 | (d). The program established under this subsection (d-6) may | ||||||
7 | include a prorated incentive for annuitants with fewer than 20 | ||||||
8 | years of creditable service, as determined by the Director. | ||||||
9 | The financial incentives provided to these annuitants under | ||||||
10 | this program may not exceed $500 per month for each annuitant | ||||||
11 | electing not to participate in the program of health benefits | ||||||
12 | provided under this Act. | ||||||
13 | (d-7) Beginning January 1, 2024, the Director shall | ||||||
14 | establish a program of financial incentives to encourage | ||||||
15 | Medicare-primary members to elect not to participate in the | ||||||
16 | group health benefits program for Medicare-primary members and | ||||||
17 | their Medicare-primary dependents provided under this Act. The | ||||||
18 | program of financial incentives established under this | ||||||
19 | subsection (d-7) shall include a voucher, to be issued | ||||||
20 | monthly, in the amount that the State would have contributed | ||||||
21 | toward that member's monthly premium if the Medicare-primary | ||||||
22 | member elected to participate in the group health benefits | ||||||
23 | program for Medicare-primary members and their | ||||||
24 | Medicare-primary dependents provided under this Act. The | ||||||
25 | voucher shall be used by the Medicare-primary member to pay | ||||||
26 | the monthly premium cost of an individual Medicare Advantage |
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1 | plan of his or her choosing. Any amount of premium cost in | ||||||
2 | excess of the amount of the voucher is the Medicare-primary | ||||||
3 | member's responsibility. | ||||||
4 | (e) Notwithstanding any other provision of this Act or the | ||||||
5 | rules adopted
under this Act, if a person participating in the | ||||||
6 | program of health benefits as
the dependent spouse of an | ||||||
7 | eligible member becomes an annuitant, the person may
elect, at | ||||||
8 | the time of becoming an annuitant or during any subsequent | ||||||
9 | annual
benefit choice period, to continue participation as a | ||||||
10 | dependent rather than
as an eligible member for as long as the | ||||||
11 | person continues to be an eligible
dependent. In order to be | ||||||
12 | eligible to make such an election, the person must have been | ||||||
13 | enrolled as a dependent under the program of health benefits | ||||||
14 | for no less than one year prior to becoming an annuitant.
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15 | An eligible member who has elected to participate as a | ||||||
16 | dependent may
re-enroll in the program of health benefits as | ||||||
17 | an eligible member (i)
during any subsequent annual benefit | ||||||
18 | choice period or (ii) upon showing a
qualifying change in | ||||||
19 | status, as defined in the U.S. Internal Revenue Code,
without | ||||||
20 | evidence of insurability and with no limitations on coverage | ||||||
21 | for
pre-existing conditions.
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22 | A person who elects to participate in the program of | ||||||
23 | health benefits as
a dependent rather than as an eligible | ||||||
24 | member shall be furnished a written
explanation of the | ||||||
25 | consequences of electing to participate as a dependent and
the | ||||||
26 | conditions and procedures for re-enrolling as an eligible |
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1 | member. The
explanation shall also be included in the annual | ||||||
2 | benefit choice options booklet
furnished to members.
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3 | (Source: P.A. 102-19, eff. 7-1-21.)
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4 | Section 99. Effective date. This Act takes effect upon | ||||||
5 | becoming law.
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