Bill Text: IL SB2314 | 2015-2016 | 99th General Assembly | Engrossed


Bill Title: Amends the State Employees Group Insurance Act of 1971. Provides that State benefit recipients are eligible for the basic program of health benefits, but are not eligible for group life insurance benefits or other optional coverages or benefits available to employees. Provides that the term "State benefit recipient" means a person in the service of a department who: (1) is not a member; (2) receives salary or wages for personal service rendered to the department; and (3) is employed in a position normally requiring actual performance of duty during not less than 30 hours per week. Provides that the term "State benefit recipient" does not include any person deemed to be an independent contractor or any person who is employed by any State-contracted vendor and is performing services pursuant to the contract between the vendor and the State.

Spectrum: Partisan Bill (Republican 2-0)

Status: (Engrossed - Dead) 2016-04-22 - Referred to Rules Committee [SB2314 Detail]

Download: Illinois-2015-SB2314-Engrossed.html



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1 AN ACT concerning State government.
2 Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4 Section 5. The State Employees Group Insurance Act of 1971
5is amended by changing Sections 3, 5, 8, and 10 as follows:
6 (5 ILCS 375/3) (from Ch. 127, par. 523)
7 Sec. 3. Definitions. Unless the context otherwise
8requires, the following words and phrases as used in this Act
9shall have the following meanings. The Department may define
10these and other words and phrases separately for the purpose of
11implementing specific programs providing benefits under this
12Act.
13 (a) "Administrative service organization" means any
14person, firm or corporation experienced in the handling of
15claims which is fully qualified, financially sound and capable
16of meeting the service requirements of a contract of
17administration executed with the Department.
18 (b) "Annuitant" means (1) an employee who retires, or has
19retired, on or after January 1, 1966 on an immediate annuity
20under the provisions of Articles 2, 14 (including an employee
21who has elected to receive an alternative retirement
22cancellation payment under Section 14-108.5 of the Illinois
23Pension Code in lieu of an annuity), 15 (including an employee

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1who has retired under the optional retirement program
2established under Section 15-158.2), paragraphs (2), (3), or
3(5) of Section 16-106, or Article 18 of the Illinois Pension
4Code; (2) any person who was receiving group insurance coverage
5under this Act as of March 31, 1978 by reason of his status as
6an annuitant, even though the annuity in relation to which such
7coverage was provided is a proportional annuity based on less
8than the minimum period of service required for a retirement
9annuity in the system involved; (3) any person not otherwise
10covered by this Act who has retired as a participating member
11under Article 2 of the Illinois Pension Code but is ineligible
12for the retirement annuity under Section 2-119 of the Illinois
13Pension Code; (4) the spouse of any person who is receiving a
14retirement annuity under Article 18 of the Illinois Pension
15Code and who is covered under a group health insurance program
16sponsored by a governmental employer other than the State of
17Illinois and who has irrevocably elected to waive his or her
18coverage under this Act and to have his or her spouse
19considered as the "annuitant" under this Act and not as a
20"dependent"; or (5) an employee who retires, or has retired,
21from a qualified position, as determined according to rules
22promulgated by the Director, under a qualified local
23government, a qualified rehabilitation facility, a qualified
24domestic violence shelter or service, or a qualified child
25advocacy center. (For definition of "retired employee", see (p)
26post).

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1 (b-5) (Blank).
2 (b-6) (Blank).
3 (b-7) (Blank).
4 (c) "Carrier" means (1) an insurance company, a corporation
5organized under the Limited Health Service Organization Act or
6the Voluntary Health Services Plan Act, a partnership, or other
7nongovernmental organization, which is authorized to do group
8life or group health insurance business in Illinois, or (2) the
9State of Illinois as a self-insurer.
10 (d) "Compensation" means salary or wages payable on a
11regular payroll by the State Treasurer on a warrant of the
12State Comptroller out of any State, trust or federal fund, or
13by the Governor of the State through a disbursing officer of
14the State out of a trust or out of federal funds, or by any
15Department out of State, trust, federal or other funds held by
16the State Treasurer or the Department, to any person for
17personal services currently performed, and ordinary or
18accidental disability benefits under Articles 2, 14, 15
19(including ordinary or accidental disability benefits under
20the optional retirement program established under Section
2115-158.2), paragraphs (2), (3), or (5) of Section 16-106, or
22Article 18 of the Illinois Pension Code, for disability
23incurred after January 1, 1966, or benefits payable under the
24Workers' Compensation or Occupational Diseases Act or benefits
25payable under a sick pay plan established in accordance with
26Section 36 of the State Finance Act. "Compensation" also means

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1salary or wages paid to an employee of any qualified local
2government, qualified rehabilitation facility, qualified
3domestic violence shelter or service, or qualified child
4advocacy center.
5 (e) "Commission" means the State Employees Group Insurance
6Advisory Commission authorized by this Act. Commencing July 1,
71984, "Commission" as used in this Act means the Commission on
8Government Forecasting and Accountability as established by
9the Legislative Commission Reorganization Act of 1984.
10 (f) "Contributory", when referred to as contributory
11coverage, shall mean optional coverages or benefits elected by
12the member toward the cost of which such member makes
13contribution, or which are funded in whole or in part through
14the acceptance of a reduction in earnings or the foregoing of
15an increase in earnings by an employee, as distinguished from
16noncontributory coverage or benefits which are paid entirely by
17the State of Illinois without reduction of the member's salary.
18 (g) "Department" means any department, institution, board,
19commission, officer, court or any agency of the State
20government receiving appropriations and having power to
21certify payrolls to the Comptroller authorizing payments of
22salary and wages against such appropriations as are made by the
23General Assembly from any State fund, or against trust funds
24held by the State Treasurer and includes boards of trustees of
25the retirement systems created by Articles 2, 14, 15, 16 and 18
26of the Illinois Pension Code. "Department" also includes the

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1Illinois Comprehensive Health Insurance Board, the Board of
2Examiners established under the Illinois Public Accounting
3Act, and the Illinois Finance Authority.
4 (h) "Dependent", when the term is used in the context of
5the health and life plan, means a member's spouse and any child
6(1) from birth to age 26 including an adopted child, a child
7who lives with the member from the time of the filing of a
8petition for adoption until entry of an order of adoption, a
9stepchild or adjudicated child, or a child who lives with the
10member if such member is a court appointed guardian of the
11child or (2) age 19 or over who has a mental or physical
12disability from a cause originating prior to the age of 19 (age
1326 if enrolled as an adult child dependent). For the health
14plan only, the term "dependent" also includes (1) any person
15enrolled prior to the effective date of this Section who is
16dependent upon the member to the extent that the member may
17claim such person as a dependent for income tax deduction
18purposes and (2) any person who has received after June 30,
192000 an organ transplant and who is financially dependent upon
20the member and eligible to be claimed as a dependent for income
21tax purposes. A member requesting to cover any dependent must
22provide documentation as requested by the Department of Central
23Management Services and file with the Department any and all
24forms required by the Department.
25 (i) "Director" means the Director of the Illinois
26Department of Central Management Services.

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1 (j) "Eligibility period" means the period of time a member
2has to elect enrollment in programs or to select benefits
3without regard to age, sex or health.
4 (k) "Employee" means and includes each officer or employee
5in the service of a department who (1) receives his
6compensation for service rendered to the department on a
7warrant issued pursuant to a payroll certified by a department
8or on a warrant or check issued and drawn by a department upon
9a trust, federal or other fund or on a warrant issued pursuant
10to a payroll certified by an elected or duly appointed officer
11of the State or who receives payment of the performance of
12personal services on a warrant issued pursuant to a payroll
13certified by a Department and drawn by the Comptroller upon the
14State Treasurer against appropriations made by the General
15Assembly from any fund or against trust funds held by the State
16Treasurer, and (2) is employed full-time or part-time in a
17position normally requiring actual performance of duty during
18not less than 1/2 of a normal work period, as established by
19the Director in cooperation with each department, except that
20persons elected by popular vote will be considered employees
21during the entire term for which they are elected regardless of
22hours devoted to the service of the State, and (3) except that
23"employee" does not include any person who is not eligible by
24reason of such person's employment to participate in one of the
25State retirement systems under Articles 2, 14, 15 (either the
26regular Article 15 system or the optional retirement program

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1established under Section 15-158.2) or 18, or under paragraph
2(2), (3), or (5) of Section 16-106, of the Illinois Pension
3Code, but such term does include persons who are employed
4during the 6 month qualifying period under Article 14 of the
5Illinois Pension Code. Such term also includes any person who
6(1) after January 1, 1966, is receiving ordinary or accidental
7disability benefits under Articles 2, 14, 15 (including
8ordinary or accidental disability benefits under the optional
9retirement program established under Section 15-158.2),
10paragraphs (2), (3), or (5) of Section 16-106, or Article 18 of
11the Illinois Pension Code, for disability incurred after
12January 1, 1966, (2) receives total permanent or total
13temporary disability under the Workers' Compensation Act or
14Occupational Disease Act as a result of injuries sustained or
15illness contracted in the course of employment with the State
16of Illinois, or (3) is not otherwise covered under this Act and
17has retired as a participating member under Article 2 of the
18Illinois Pension Code but is ineligible for the retirement
19annuity under Section 2-119 of the Illinois Pension Code.
20However, a person who satisfies the criteria of the foregoing
21definition of "employee" except that such person is made
22ineligible to participate in the State Universities Retirement
23System by clause (4) of subsection (a) of Section 15-107 of the
24Illinois Pension Code is also an "employee" for the purposes of
25this Act. "Employee" also includes any person receiving or
26eligible for benefits under a sick pay plan established in

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1accordance with Section 36 of the State Finance Act. "Employee"
2also includes (i) each officer or employee in the service of a
3qualified local government, including persons appointed as
4trustees of sanitary districts regardless of hours devoted to
5the service of the sanitary district, (ii) each employee in the
6service of a qualified rehabilitation facility, (iii) each
7full-time employee in the service of a qualified domestic
8violence shelter or service, and (iv) each full-time employee
9in the service of a qualified child advocacy center, as
10determined according to rules promulgated by the Director.
11 (l) "Member" means an employee, annuitant, retired
12employee or survivor. In the case of an annuitant or retired
13employee who first becomes an annuitant or retired employee on
14or after the effective date of this amendatory Act of the 97th
15General Assembly, the individual must meet the minimum vesting
16requirements of the applicable retirement system in order to be
17eligible for group insurance benefits under that system. In the
18case of a survivor who first becomes a survivor on or after the
19effective date of this amendatory Act of the 97th General
20Assembly, the deceased employee, annuitant, or retired
21employee upon whom the annuity is based must have been eligible
22to participate in the group insurance system under the
23applicable retirement system in order for the survivor to be
24eligible for group insurance benefits under that system.
25References to the term "member" include State benefit
26recipients, but only with respect to the basic program of group

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1health benefits and not for the purposes of enrollment in any
2group life insurance benefits or optional coverages or
3benefits.
4 (m) "Optional coverages or benefits" means those coverages
5or benefits available to the member on his or her voluntary
6election, and at his or her own expense.
7 (n) "Program" means the group life insurance, health
8benefits and other employee benefits designed and contracted
9for by the Director under this Act.
10 (o) "Health plan" means a health benefits program offered
11by the State of Illinois for persons eligible for the plan.
12 (p) "Retired employee" means any person who would be an
13annuitant as that term is defined herein but for the fact that
14such person retired prior to January 1, 1966. Such term also
15includes any person formerly employed by the University of
16Illinois in the Cooperative Extension Service who would be an
17annuitant but for the fact that such person was made ineligible
18to participate in the State Universities Retirement System by
19clause (4) of subsection (a) of Section 15-107 of the Illinois
20Pension Code.
21 (q) "Survivor" means a person receiving an annuity as a
22survivor of an employee or of an annuitant. "Survivor" also
23includes: (1) the surviving dependent of a person who satisfies
24the definition of "employee" except that such person is made
25ineligible to participate in the State Universities Retirement
26System by clause (4) of subsection (a) of Section 15-107 of the

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1Illinois Pension Code; (2) the surviving dependent of any
2person formerly employed by the University of Illinois in the
3Cooperative Extension Service who would be an annuitant except
4for the fact that such person was made ineligible to
5participate in the State Universities Retirement System by
6clause (4) of subsection (a) of Section 15-107 of the Illinois
7Pension Code; and (3) the surviving dependent of a person who
8was an annuitant under this Act by virtue of receiving an
9alternative retirement cancellation payment under Section
1014-108.5 of the Illinois Pension Code.
11 (q-2) "SERS" means the State Employees' Retirement System
12of Illinois, created under Article 14 of the Illinois Pension
13Code.
14 (q-2.1) "State benefit recipient" means a person in the
15service of a department who: (1) is not a member, as defined in
16this Section; (2) receives salary or wages for personal service
17rendered to the department; and (3) is employed in a position
18normally requiring actual performance of duty during not less
19than 30 hours per week, except that "state benefit recipient"
20does not include any person deemed to be an independent
21contractor or any person who is employed by any
22State-contracted vendor and is performing services pursuant to
23the contract between the vendor and the State.
24 (q-3) "SURS" means the State Universities Retirement
25System, created under Article 15 of the Illinois Pension Code.
26 (q-4) "TRS" means the Teachers' Retirement System of the

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1State of Illinois, created under Article 16 of the Illinois
2Pension Code.
3 (q-5) (Blank).
4 (q-6) (Blank).
5 (q-7) (Blank).
6 (r) "Medical services" means the services provided within
7the scope of their licenses by practitioners in all categories
8licensed under the Medical Practice Act of 1987.
9 (s) "Unit of local government" means any county,
10municipality, township, school district (including a
11combination of school districts under the Intergovernmental
12Cooperation Act), special district or other unit, designated as
13a unit of local government by law, which exercises limited
14governmental powers or powers in respect to limited
15governmental subjects, any not-for-profit association with a
16membership that primarily includes townships and township
17officials, that has duties that include provision of research
18service, dissemination of information, and other acts for the
19purpose of improving township government, and that is funded
20wholly or partly in accordance with Section 85-15 of the
21Township Code; any not-for-profit corporation or association,
22with a membership consisting primarily of municipalities, that
23operates its own utility system, and provides research,
24training, dissemination of information, or other acts to
25promote cooperation between and among municipalities that
26provide utility services and for the advancement of the goals

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1and purposes of its membership; the Southern Illinois
2Collegiate Common Market, which is a consortium of higher
3education institutions in Southern Illinois; the Illinois
4Association of Park Districts; and any hospital provider that
5is owned by a county that has 100 or fewer hospital beds and
6has not already joined the program. "Qualified local
7government" means a unit of local government approved by the
8Director and participating in a program created under
9subsection (i) of Section 10 of this Act.
10 (t) "Qualified rehabilitation facility" means any
11not-for-profit organization that is accredited by the
12Commission on Accreditation of Rehabilitation Facilities or
13certified by the Department of Human Services (as successor to
14the Department of Mental Health and Developmental
15Disabilities) to provide services to persons with disabilities
16and which receives funds from the State of Illinois for
17providing those services, approved by the Director and
18participating in a program created under subsection (j) of
19Section 10 of this Act.
20 (u) "Qualified domestic violence shelter or service" means
21any Illinois domestic violence shelter or service and its
22administrative offices funded by the Department of Human
23Services (as successor to the Illinois Department of Public
24Aid), approved by the Director and participating in a program
25created under subsection (k) of Section 10.
26 (v) "TRS benefit recipient" means a person who:

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1 (1) is not a "member" as defined in this Section; and
2 (2) is receiving a monthly benefit or retirement
3 annuity under Article 16 of the Illinois Pension Code; and
4 (3) either (i) has at least 8 years of creditable
5 service under Article 16 of the Illinois Pension Code, or
6 (ii) was enrolled in the health insurance program offered
7 under that Article on January 1, 1996, or (iii) is the
8 survivor of a benefit recipient who had at least 8 years of
9 creditable service under Article 16 of the Illinois Pension
10 Code or was enrolled in the health insurance program
11 offered under that Article on the effective date of this
12 amendatory Act of 1995, or (iv) is a recipient or survivor
13 of a recipient of a disability benefit under Article 16 of
14 the Illinois Pension Code.
15 (w) "TRS dependent beneficiary" means a person who:
16 (1) is not a "member" or "dependent" as defined in this
17 Section; and
18 (2) is a TRS benefit recipient's: (A) spouse, (B)
19 dependent parent who is receiving at least half of his or
20 her support from the TRS benefit recipient, or (C) natural,
21 step, adjudicated, or adopted child who is (i) under age
22 26, (ii) was, on January 1, 1996, participating as a
23 dependent beneficiary in the health insurance program
24 offered under Article 16 of the Illinois Pension Code, or
25 (iii) age 19 or over who has a mental or physical
26 disability from a cause originating prior to the age of 19

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1 (age 26 if enrolled as an adult child).
2 "TRS dependent beneficiary" does not include, as indicated
3under paragraph (2) of this subsection (w), a dependent of the
4survivor of a TRS benefit recipient who first becomes a
5dependent of a survivor of a TRS benefit recipient on or after
6the effective date of this amendatory Act of the 97th General
7Assembly unless that dependent would have been eligible for
8coverage as a dependent of the deceased TRS benefit recipient
9upon whom the survivor benefit is based.
10 (x) "Military leave" refers to individuals in basic
11training for reserves, special/advanced training, annual
12training, emergency call up, activation by the President of the
13United States, or any other training or duty in service to the
14United States Armed Forces.
15 (y) (Blank).
16 (z) "Community college benefit recipient" means a person
17who:
18 (1) is not a "member" as defined in this Section; and
19 (2) is receiving a monthly survivor's annuity or
20 retirement annuity under Article 15 of the Illinois Pension
21 Code; and
22 (3) either (i) was a full-time employee of a community
23 college district or an association of community college
24 boards created under the Public Community College Act
25 (other than an employee whose last employer under Article
26 15 of the Illinois Pension Code was a community college

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1 district subject to Article VII of the Public Community
2 College Act) and was eligible to participate in a group
3 health benefit plan as an employee during the time of
4 employment with a community college district (other than a
5 community college district subject to Article VII of the
6 Public Community College Act) or an association of
7 community college boards, or (ii) is the survivor of a
8 person described in item (i).
9 (aa) "Community college dependent beneficiary" means a
10person who:
11 (1) is not a "member" or "dependent" as defined in this
12 Section; and
13 (2) is a community college benefit recipient's: (A)
14 spouse, (B) dependent parent who is receiving at least half
15 of his or her support from the community college benefit
16 recipient, or (C) natural, step, adjudicated, or adopted
17 child who is (i) under age 26, or (ii) age 19 or over and
18 has a mental or physical disability from a cause
19 originating prior to the age of 19 (age 26 if enrolled as
20 an adult child).
21 "Community college dependent beneficiary" does not
22include, as indicated under paragraph (2) of this subsection
23(aa), a dependent of the survivor of a community college
24benefit recipient who first becomes a dependent of a survivor
25of a community college benefit recipient on or after the
26effective date of this amendatory Act of the 97th General

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1Assembly unless that dependent would have been eligible for
2coverage as a dependent of the deceased community college
3benefit recipient upon whom the survivor annuity is based.
4 (bb) "Qualified child advocacy center" means any Illinois
5child advocacy center and its administrative offices funded by
6the Department of Children and Family Services, as defined by
7the Children's Advocacy Center Act (55 ILCS 80/), approved by
8the Director and participating in a program created under
9subsection (n) of Section 10.
10(Source: P.A. 98-488, eff. 8-16-13; 99-143, eff. 7-27-15.)
11 (5 ILCS 375/5) (from Ch. 127, par. 525)
12 Sec. 5. Employee benefits; declaration of State policy. The
13General Assembly declares that it is the policy of the State
14and in the best interest of the State to assure quality
15benefits to members and their dependents under this Act. The
16implementation of this policy depends upon, among other things,
17stability and continuity of coverage, care, and services under
18benefit programs for members and their dependents.
19Specifically, but without limitation, members should have
20continued access, on substantially similar terms and
21conditions, to trusted family health care providers with whom
22they have developed long-term relationships through a benefit
23program under this Act. Therefore, the Director must administer
24this Act consistent with that State policy, but may consider
25affordability, cost of coverage and care, and competition among

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1health insurers and providers. All contracts for provision of
2employee benefits, including those portions of any proposed
3collective bargaining agreement that would require
4implementation through contracts entered into under this Act,
5are subject to the following requirements:
6 (i) By April 1 of each year, the Director must report
7 and provide information to the Commission concerning the
8 status of the employee benefits program to be offered for
9 the next fiscal year. Information includes, but is not
10 limited to, documents, reports of negotiations, bid
11 invitations, requests for proposals, specifications,
12 copies of proposed and final contracts or agreements, and
13 any other materials concerning contracts or agreements for
14 the employee benefits program. By the first of each month
15 thereafter, the Director must provide updated, and any new,
16 information to the Commission until the employee benefits
17 program for the next fiscal year is determined. In addition
18 to these monthly reporting requirements, at any time the
19 Commission makes a written request, the Director must
20 promptly, but in no event later than 5 business days after
21 receipt of the request, provide to the Commission any
22 additional requested information in the possession of the
23 Director concerning employee benefits programs. The
24 Commission may waive any of the reporting requirements of
25 this item (i) upon the written request by the Director. Any
26 waiver granted under this item (i) must be in writing.

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1 Nothing in this item is intended to abrogate any
2 attorney-client privilege.
3 (ii) Within 30 days after notice of the awarding or
4 letting of a contract has appeared in the Illinois
5 Procurement Bulletin in accordance with subsection (b) of
6 Section 15-25 of the Illinois Procurement Code, the
7 Commission may request in writing from the Director and the
8 Director shall promptly, but in no event later than 5
9 business days after receipt of the request, provide to the
10 Commission information in the possession of the Director
11 concerning the proposed contract. Nothing in this item is
12 intended to waive or abrogate any privilege or right of
13 confidentiality authorized by law.
14 (iii) Except as otherwise provided in this item (iii),
15 no contract subject to this Section may be entered into
16 until the 30-day period described in item (ii) has expired,
17 unless the Director requests in writing that the Commission
18 waive the period and the Commission grants the waiver in
19 writing. This item (iii) does not apply to any contract
20 entered into after the effective date of this amendatory
21 Act of the 98th General Assembly and through January 1,
22 2014 to provide a program of group health benefits for
23 Medicare-primary members and their Medicare-primary
24 dependents that is comparable in stability and continuity
25 of coverage, care, and services to the program of health
26 benefits offered to other members and their dependents

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1 under this Act.
2 (iv) If the Director seeks to make any substantive
3 modification to any provision of a proposed contract after
4 it is submitted to the Commission in accordance with item
5 (ii), the modified contract shall be subject to the
6 requirements of items (ii) and (iii) unless the Commission
7 agrees, in writing, to a waiver of those requirements with
8 respect to the modified contract.
9 (v) By the date of the beginning of the annual benefit
10 choice period, the Director must transmit to the Commission
11 a copy of each final contract or agreement for the employee
12 benefits program to be offered for the next fiscal year.
13 The annual benefit choice period for an employee benefits
14 program must begin on May 1 of the fiscal year preceding
15 the year for which the program is to be offered. If,
16 however, in any such preceding fiscal year collective
17 bargaining over employee benefit programs for the next
18 fiscal year remains pending on April 15, the beginning date
19 of the annual benefit choice period shall be not later than
20 15 days after ratification of the collective bargaining
21 agreement.
22 (vi) The Director must provide the reports,
23 information, and contracts required under items (i), (ii),
24 (iv), and (v) by electronic or other means satisfactory to
25 the Commission. Reports, information, and contracts in the
26 possession of the Commission pursuant to items (i), (ii),

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1 (iv), and (v) are exempt from disclosure by the Commission
2 and its members and employees under the Freedom of
3 Information Act. Reports, information, and contracts
4 received by the Commission pursuant to items (i), (ii),
5 (iv), and (v) must be kept confidential by and may not be
6 disclosed or used by the Commission or its members or
7 employees if such disclosure or use could compromise the
8 fairness or integrity of the procurement, bidding, or
9 contract process. Commission meetings, or portions of
10 Commission meetings, in which reports, information, and
11 contracts received by the Commission pursuant to items (i),
12 (ii), (iv), and (v) are discussed must be closed if
13 disclosure or use of the report or information could
14 compromise the fairness or integrity of the procurement,
15 bidding, or contract process.
16 All contracts entered into under this Section are subject
17to appropriation and shall comply with Section 20-60(b) of the
18Illinois Procurement Code (30 ILCS 500/20-60(b)).
19 The Director shall contract or otherwise make available
20group life insurance, health benefits and other employee
21benefits to eligible members and, where elected, their eligible
22dependents. The Director shall contract or otherwise make
23available health benefits to eligible State benefit
24recipients, members, and, where elected, their eligible
25dependents. Any contract or, if applicable, contracts or other
26arrangement for provision of benefits shall be on terms

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1consistent with State policy and based on, but not limited to,
2such criteria as administrative cost, service capabilities of
3the carrier or other contractor and premiums, fees or charges
4as related to benefits.
5 Notwithstanding any other provisions of this Act, by
6January 1, 2014, the Department of Central Management Services,
7in consultation with and subject to the approval of the Chief
8Procurement Officer, shall contract or make otherwise
9available a program of group health benefits for
10Medicare-primary members and their Medicare-primary
11dependents. The Director may procure a single contract or
12multiple contracts that provide a program of group health
13benefits that is comparable in stability and continuity of
14coverage, care, and services to the program of health benefits
15offered to other members and their dependents under this Act.
16The initial procurement of a contract or contracts under this
17paragraph is not subject to the provisions of the Illinois
18Procurement Code, except for Sections 20-60, 20-65, 20-70, and
1920-160 and Article 50 of that Code, provided that the Chief
20Procurement Officer may, in writing with justification, waive
21any certification required under Article 50.
22 The Director may prepare and issue specifications for group
23life insurance, health benefits, other employee benefits and
24administrative services for the purpose of receiving proposals
25from interested parties.
26 The Director is authorized to execute a contract, or

SB2314 Engrossed- 22 -LRB099 16031 HLH 40349 b
1contracts, for the programs of group life insurance, health
2benefits, other employee benefits and administrative services
3authorized by this Act (including, without limitation,
4prescription drug benefits). All of the benefits provided under
5this Act may be included in one or more contracts, or the
6benefits may be classified into different types with each type
7included under one or more similar contracts with the same or
8different companies.
9 The term of any contract may not extend beyond 5 fiscal
10years. Upon recommendation of the Commission, the Director may
11exercise renewal options of the same contract for up to a
12period of 5 years. Any increases in premiums, fees or charges
13requested by a contractor whose contract may be renewed
14pursuant to a renewal option contained therein, must be
15justified on the basis of (1) audited experience data, (2)
16increases in the costs of health care services provided under
17the contract, (3) contractor performance, (4) increases in
18contractor responsibilities, or (5) any combination thereof.
19 Any contractor shall agree to abide by all requirements of
20this Act and Rules and Regulations promulgated and adopted
21thereto; to submit such information and data as may from time
22to time be deemed necessary by the Director for effective
23administration of the provisions of this Act and the programs
24established hereunder, and to fully cooperate in any audit.
25(Source: P.A. 98-19, eff. 6-10-13.)

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1 (5 ILCS 375/8) (from Ch. 127, par. 528)
2 Sec. 8. Eligibility.
3 (a) Each employee eligible under the provisions of this Act
4and any rules and regulations promulgated and adopted hereunder
5by the Director shall become immediately eligible and covered
6for all benefits available under the programs. Employees
7electing coverage for eligible dependents shall have the
8coverage effective immediately, provided that the election is
9properly filed in accordance with required filing dates and
10procedures specified by the Director, including the completion
11and submission of all documentation and forms required by the
12Director.
13 (1) Every member originally eligible to elect
14 dependent coverage, but not electing it during the original
15 eligibility period, may subsequently obtain dependent
16 coverage only in the event of a qualifying change in
17 status, special enrollment, special circumstance as
18 defined by the Director, or during the annual Benefit
19 Choice Period.
20 (2) Members described above being transferred from
21 previous coverage towards which the State has been
22 contributing shall be transferred regardless of
23 preexisting conditions, waiting periods, or other
24 requirements that might jeopardize claim payments to which
25 they would otherwise have been entitled.
26 (3) Eligible and covered members that are eligible for

SB2314 Engrossed- 24 -LRB099 16031 HLH 40349 b
1 coverage as dependents except for the fact of being members
2 shall be transferred to, and covered under, dependent
3 status regardless of preexisting conditions, waiting
4 periods, or other requirements that might jeopardize claim
5 payments to which they would otherwise have been entitled
6 upon cessation of member status and the election of
7 dependent coverage by a member eligible to elect that
8 coverage.
9 (b) New employees shall be immediately insured for the
10basic group life insurance and covered by the program of health
11benefits on the first day of active State service. Optional
12life insurance coverage one to 4 times the basic amount, if
13elected during the relevant eligibility period, will become
14effective on the date of employment. Optional life insurance
15coverage exceeding 4 times the basic amount and all life
16insurance amounts applied for after the eligibility period will
17be effective, subject to satisfactory evidence of insurability
18when applicable, or other necessary qualifications, pursuant
19to the requirements of the applicable benefit program, unless
20there is a change in status that would confer new eligibility
21for change of enrollment under rules established supplementing
22this Act, in which event application must be made within the
23new eligibility period.
24 (c) As to the group health benefits program contracted to
25begin or continue after June 30, 1973, each annuitant,
26survivor, and retired employee shall become immediately

SB2314 Engrossed- 25 -LRB099 16031 HLH 40349 b
1eligible for all benefits available under that program. Each
2annuitant, survivor, and retired employee shall have coverage
3effective immediately, provided that the election is properly
4filed in accordance with the required filing dates and
5procedures specified by the Director, including the completion
6and submission of all documentation and forms required by the
7Director. Annuitants, survivors, and retired employees may
8elect coverage for eligible dependents and shall have the
9coverage effective immediately, provided that the election is
10properly filed in accordance with required filing dates and
11procedures specified by the Director, except that, for a
12survivor, the dependent sought to be added on or after the
13effective date of this amendatory Act of the 97th General
14Assembly must have been eligible for coverage as a dependent
15under the deceased member upon whom the survivor's annuity is
16based in order to be eligible for coverage under the survivor.
17 Except as otherwise provided in this Act, where husband and
18wife are both eligible members, each shall be enrolled as a
19member and coverage on their eligible dependent children, if
20any, may be under the enrollment and election of either.
21 Regardless of other provisions herein regarding late
22enrollment or other qualifications, as appropriate, the
23Director may periodically authorize open enrollment periods
24for each of the benefit programs at which time each member may
25elect enrollment or change of enrollment without regard to age,
26sex, health, or other qualification under the conditions as may

SB2314 Engrossed- 26 -LRB099 16031 HLH 40349 b
1be prescribed in rules and regulations supplementing this Act.
2Special open enrollment periods may be declared by the Director
3for certain members only when special circumstances occur that
4affect only those members.
5 (d) Beginning with fiscal year 2003 and for all subsequent
6years, eligible members may elect not to participate in the
7program of health benefits as defined in this Act. The election
8must be made during the annual benefit choice period, subject
9to the conditions in this subsection.
10 (1) Members must furnish proof of health benefit
11 coverage, either comprehensive major medical coverage or
12 comprehensive managed care plan, from a source other than
13 the Department of Central Management Services in order to
14 elect not to participate in the program.
15 (2) Members may re-enroll in the Department of Central
16 Management Services program of health benefits upon
17 showing a qualifying change in status, as defined in the
18 U.S. Internal Revenue Code, without evidence of
19 insurability and with no limitations on coverage for
20 pre-existing conditions, provided that there was not a
21 break in coverage of more than 63 days.
22 (3) Members may also re-enroll in the program of health
23 benefits during any annual benefit choice period, without
24 evidence of insurability.
25 (4) Members who elect not to participate in the program
26 of health benefits shall be furnished a written explanation

SB2314 Engrossed- 27 -LRB099 16031 HLH 40349 b
1 of the requirements and limitations for the election not to
2 participate in the program and for re-enrolling in the
3 program. The explanation shall also be included in the
4 annual benefit choice options booklets furnished to
5 members.
6 (d-5) Beginning July 1, 2005, the Director may establish a
7program of financial incentives to encourage annuitants
8receiving a retirement annuity, but who are not eligible for
9benefits under the federal Medicare health insurance program
10(Title XVIII of the Social Security Act, as added by Public Law
1189-97) to elect not to participate in the program of health
12benefits provided under this Act. The election by an annuitant
13not to participate under this program must be made in
14accordance with the requirements set forth under subsection
15(d). The financial incentives provided to these annuitants
16under the program may not exceed $150 per month for each
17annuitant electing not to participate in the program of health
18benefits provided under this Act.
19 (d-6) Beginning July 1, 2013, the Director may establish a
20program of financial incentives to encourage annuitants with 20
21or more years of creditable service but who are not eligible
22for benefits under the federal Medicare health insurance
23program (Title XVIII of the Social Security Act, as added by
24Public Law 89-97) to elect not to participate in the program of
25health benefits provided under this Act. The election by an
26annuitant not to participate under this program must be made in

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1accordance with the requirements set forth under subsection
2(d). The program established under this subsection (d-6) may
3include a prorated incentive for annuitants with fewer than 20
4years of creditable service, as determined by the Director. The
5financial incentives provided to these annuitants under this
6program may not exceed $500 per month for each annuitant
7electing not to participate in the program of health benefits
8provided under this Act.
9 (e) Notwithstanding any other provision of this Act or the
10rules adopted under this Act, if a person participating in the
11program of health benefits as the dependent spouse of an
12eligible member becomes an annuitant, the person may elect, at
13the time of becoming an annuitant or during any subsequent
14annual benefit choice period, to continue participation as a
15dependent rather than as an eligible member for as long as the
16person continues to be an eligible dependent. In order to be
17eligible to make such an election, the person must have been
18enrolled as a dependent under the program of health benefits
19for no less than one year prior to becoming an annuitant.
20 An eligible member who has elected to participate as a
21dependent may re-enroll in the program of health benefits as an
22eligible member (i) during any subsequent annual benefit choice
23period or (ii) upon showing a qualifying change in status, as
24defined in the U.S. Internal Revenue Code, without evidence of
25insurability and with no limitations on coverage for
26pre-existing conditions.

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1 A person who elects to participate in the program of health
2benefits as a dependent rather than as an eligible member shall
3be furnished a written explanation of the consequences of
4electing to participate as a dependent and the conditions and
5procedures for re-enrolling as an eligible member. The
6explanation shall also be included in the annual benefit choice
7options booklet furnished to members.
8 (f) State benefit recipients shall be eligible to enroll in
9the program of health benefits on the first day of active State
10service. State benefit recipients who were not eligible to
11enroll in the program of health benefits immediately prior to
12the effective date of this amendatory Act of the 99th General
13Assembly, but who became eligible to enroll in the program of
14health benefits as a result of this amendatory Act of the 99th
15General Assembly, may elect to participate in coverage in
16accordance with procedures specified by the Director or during
17any annual benefit choice period. Notwithstanding any other
18provision of this Act, State benefit recipients shall be
19eligible only for the program of health benefits and shall not
20be eligible for group life insurance benefits or other optional
21coverages or benefits available to employees.
22(Source: P.A. 97-668, eff. 1-13-12; 98-19, eff. 6-10-13.)
23 (5 ILCS 375/10) (from Ch. 127, par. 530)
24 Sec. 10. Contributions by the State and members.
25 (a) The State shall pay the cost of basic non-contributory

SB2314 Engrossed- 30 -LRB099 16031 HLH 40349 b
1group life insurance and, subject to member paid contributions
2set by the Department or required by this Section and except as
3provided in this Section, the basic program of group health
4benefits on each eligible member, except a member, not
5otherwise covered by this Act, who has retired as a
6participating member under Article 2 of the Illinois Pension
7Code but is ineligible for the retirement annuity under Section
82-119 of the Illinois Pension Code, and part of each eligible
9member's and retired member's premiums for health insurance
10coverage for enrolled dependents as provided by Section 9. The
11State shall pay the cost of the basic program of group health
12benefits only after benefits are reduced by the amount of
13benefits covered by Medicare for all members and dependents who
14are eligible for benefits under Social Security or the Railroad
15Retirement system or who had sufficient Medicare-covered
16government employment, except that such reduction in benefits
17shall apply only to those members and dependents who (1) first
18become eligible for such Medicare coverage on or after July 1,
191992; or (2) are Medicare-eligible members or dependents of a
20local government unit which began participation in the program
21on or after July 1, 1992; or (3) remain eligible for, but no
22longer receive Medicare coverage which they had been receiving
23on or after July 1, 1992. The Department may determine the
24aggregate level of the State's contribution on the basis of
25actual cost of medical services adjusted for age, sex or
26geographic or other demographic characteristics which affect

SB2314 Engrossed- 31 -LRB099 16031 HLH 40349 b
1the costs of such programs.
2 The cost of participation in the basic program of group
3health benefits for the dependent or survivor of a living or
4deceased retired employee who was formerly employed by the
5University of Illinois in the Cooperative Extension Service and
6would be an annuitant but for the fact that he or she was made
7ineligible to participate in the State Universities Retirement
8System by clause (4) of subsection (a) of Section 15-107 of the
9Illinois Pension Code shall not be greater than the cost of
10participation that would otherwise apply to that dependent or
11survivor if he or she were the dependent or survivor of an
12annuitant under the State Universities Retirement System.
13 (a-1) (Blank).
14 (a-2) (Blank).
15 (a-3) (Blank).
16 (a-4) (Blank).
17 (a-5) (Blank).
18 (a-6) (Blank).
19 (a-7) (Blank).
20 (a-8) Any annuitant, survivor, or retired employee may
21waive or terminate coverage in the program of group health
22benefits. Any such annuitant, survivor, or retired employee who
23has waived or terminated coverage may enroll or re-enroll in
24the program of group health benefits only during the annual
25benefit choice period, as determined by the Director; except
26that in the event of termination of coverage due to nonpayment

SB2314 Engrossed- 32 -LRB099 16031 HLH 40349 b
1of premiums, the annuitant, survivor, or retired employee may
2not re-enroll in the program.
3 (a-8.5) Beginning on the effective date of this amendatory
4Act of the 97th General Assembly, the Director of Central
5Management Services shall, on an annual basis, determine the
6amount that the State shall contribute toward the basic program
7of group health benefits on behalf of annuitants (including
8individuals who (i) participated in the General Assembly
9Retirement System, the State Employees' Retirement System of
10Illinois, the State Universities Retirement System, the
11Teachers' Retirement System of the State of Illinois, or the
12Judges Retirement System of Illinois and (ii) qualify as
13annuitants under subsection (b) of Section 3 of this Act),
14survivors (including individuals who (i) receive an annuity as
15a survivor of an individual who participated in the General
16Assembly Retirement System, the State Employees' Retirement
17System of Illinois, the State Universities Retirement System,
18the Teachers' Retirement System of the State of Illinois, or
19the Judges Retirement System of Illinois and (ii) qualify as
20survivors under subsection (q) of Section 3 of this Act), and
21retired employees (as defined in subsection (p) of Section 3 of
22this Act). The remainder of the cost of coverage for each
23annuitant, survivor, or retired employee, as determined by the
24Director of Central Management Services, shall be the
25responsibility of that annuitant, survivor, or retired
26employee.

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1 Contributions required of annuitants, survivors, and
2retired employees shall be the same for all retirement systems
3and shall also be based on whether an individual has made an
4election under Section 15-135.1 of the Illinois Pension Code.
5Contributions may be based on annuitants', survivors', or
6retired employees' Medicare eligibility, but may not be based
7on Social Security eligibility.
8 (a-9) No later than May 1 of each calendar year, the
9Director of Central Management Services shall certify in
10writing to the Executive Secretary of the State Employees'
11Retirement System of Illinois the amounts of the Medicare
12supplement health care premiums and the amounts of the health
13care premiums for all other retirees who are not Medicare
14eligible.
15 A separate calculation of the premiums based upon the
16actual cost of each health care plan shall be so certified.
17 The Director of Central Management Services shall provide
18to the Executive Secretary of the State Employees' Retirement
19System of Illinois such information, statistics, and other data
20as he or she may require to review the premium amounts
21certified by the Director of Central Management Services.
22 The Department of Central Management Services, or any
23successor agency designated to procure healthcare contracts
24pursuant to this Act, is authorized to establish funds,
25separate accounts provided by any bank or banks as defined by
26the Illinois Banking Act, or separate accounts provided by any

SB2314 Engrossed- 34 -LRB099 16031 HLH 40349 b
1savings and loan association or associations as defined by the
2Illinois Savings and Loan Act of 1985 to be held by the
3Director, outside the State treasury, for the purpose of
4receiving the transfer of moneys from the Local Government
5Health Insurance Reserve Fund. The Department may promulgate
6rules further defining the methodology for the transfers. Any
7interest earned by moneys in the funds or accounts shall inure
8to the Local Government Health Insurance Reserve Fund. The
9transferred moneys, and interest accrued thereon, shall be used
10exclusively for transfers to administrative service
11organizations or their financial institutions for payments of
12claims to claimants and providers under the self-insurance
13health plan. The transferred moneys, and interest accrued
14thereon, shall not be used for any other purpose including, but
15not limited to, reimbursement of administration fees due the
16administrative service organization pursuant to its contract
17or contracts with the Department.
18 (b) State employees who become eligible for this program on
19or after January 1, 1980 in positions normally requiring actual
20performance of duty not less than 1/2 of a normal work period
21but not equal to at least 30 hours per week that of a normal
22work period, shall be given the option of participating in the
23available program. If the employee elects coverage, the State
24shall contribute on behalf of such employee to the cost of the
25employee's benefit and any applicable dependent supplement,
26that sum which bears the same percentage as that percentage of

SB2314 Engrossed- 35 -LRB099 16031 HLH 40349 b
1time the employee regularly works when compared to normal work
2period.
3 (c) The basic non-contributory coverage from the basic
4program of group health benefits shall be continued for each
5employee not in pay status or on active service by reason of
6(1) leave of absence due to illness or injury, (2) authorized
7educational leave of absence or sabbatical leave, or (3)
8military leave. This coverage shall continue until expiration
9of authorized leave and return to active service, but not to
10exceed 24 months for leaves under item (1) or (2). This
1124-month limitation and the requirement of returning to active
12service shall not apply to persons receiving ordinary or
13accidental disability benefits or retirement benefits through
14the appropriate State retirement system or benefits under the
15Workers' Compensation or Occupational Disease Act.
16 (c-1) Notwithstanding any other provision of law, a State
17benefit recipient electing to participate in the program of
18health benefits shall be required to pay the entire premium of
19the coverage that has been elected, including the entire
20premium of any coverage elected for eligible dependents of the
21State benefit recipient.
22 (d) The basic group life insurance coverage shall continue,
23with full State contribution, where such person is (1) absent
24from active service by reason of disability arising from any
25cause other than self-inflicted, (2) on authorized educational
26leave of absence or sabbatical leave, or (3) on military leave.

SB2314 Engrossed- 36 -LRB099 16031 HLH 40349 b
1 (e) Where the person is in non-pay status for a period in
2excess of 30 days or on leave of absence, other than by reason
3of disability, educational or sabbatical leave, or military
4leave, such person may continue coverage only by making
5personal payment equal to the amount normally contributed by
6the State on such person's behalf. Such payments and coverage
7may be continued: (1) until such time as the person returns to
8a status eligible for coverage at State expense, but not to
9exceed 24 months or (2) until such person's employment or
10annuitant status with the State is terminated (exclusive of any
11additional service imposed pursuant to law).
12 (f) The Department shall establish by rule the extent to
13which other employee benefits will continue for persons in
14non-pay status or who are not in active service.
15 (g) The State shall not pay the cost of the basic
16non-contributory group life insurance, program of health
17benefits and other employee benefits for members who are
18survivors as defined by paragraphs (1) and (2) of subsection
19(q) of Section 3 of this Act. The costs of benefits for these
20survivors shall be paid by the survivors or by the University
21of Illinois Cooperative Extension Service, or any combination
22thereof. However, the State shall pay the amount of the
23reduction in the cost of participation, if any, resulting from
24the amendment to subsection (a) made by this amendatory Act of
25the 91st General Assembly.
26 (h) Those persons occupying positions with any department

SB2314 Engrossed- 37 -LRB099 16031 HLH 40349 b
1as a result of emergency appointments pursuant to Section 8b.8
2of the Personnel Code who are not considered employees under
3this Act shall be given the option of participating in the
4programs of group life insurance, health benefits and other
5employee benefits. Such persons electing coverage may
6participate only by making payment equal to the amount normally
7contributed by the State for similarly situated employees. Such
8amounts shall be determined by the Director. Such payments and
9coverage may be continued until such time as the person becomes
10an employee pursuant to this Act or such person's appointment
11is terminated.
12 (i) Any unit of local government within the State of
13Illinois may apply to the Director to have its employees,
14annuitants, and their dependents provided group health
15coverage under this Act on a non-insured basis. To participate,
16a unit of local government must agree to enroll all of its
17employees, who may select coverage under either the State group
18health benefits plan or a health maintenance organization that
19has contracted with the State to be available as a health care
20provider for employees as defined in this Act. A unit of local
21government must remit the entire cost of providing coverage
22under the State group health benefits plan or, for coverage
23under a health maintenance organization, an amount determined
24by the Director based on an analysis of the sex, age,
25geographic location, or other relevant demographic variables
26for its employees, except that the unit of local government

SB2314 Engrossed- 38 -LRB099 16031 HLH 40349 b
1shall not be required to enroll those of its employees who are
2covered spouses or dependents under this plan or another group
3policy or plan providing health benefits as long as (1) an
4appropriate official from the unit of local government attests
5that each employee not enrolled is a covered spouse or
6dependent under this plan or another group policy or plan, and
7(2) at least 50% of the employees are enrolled and the unit of
8local government remits the entire cost of providing coverage
9to those employees, except that a participating school district
10must have enrolled at least 50% of its full-time employees who
11have not waived coverage under the district's group health plan
12by participating in a component of the district's cafeteria
13plan. A participating school district is not required to enroll
14a full-time employee who has waived coverage under the
15district's health plan, provided that an appropriate official
16from the participating school district attests that the
17full-time employee has waived coverage by participating in a
18component of the district's cafeteria plan. For the purposes of
19this subsection, "participating school district" includes a
20unit of local government whose primary purpose is education as
21defined by the Department's rules.
22 Employees of a participating unit of local government who
23are not enrolled due to coverage under another group health
24policy or plan may enroll in the event of a qualifying change
25in status, special enrollment, special circumstance as defined
26by the Director, or during the annual Benefit Choice Period. A

SB2314 Engrossed- 39 -LRB099 16031 HLH 40349 b
1participating unit of local government may also elect to cover
2its annuitants. Dependent coverage shall be offered on an
3optional basis, with the costs paid by the unit of local
4government, its employees, or some combination of the two as
5determined by the unit of local government. The unit of local
6government shall be responsible for timely collection and
7transmission of dependent premiums.
8 The Director shall annually determine monthly rates of
9payment, subject to the following constraints:
10 (1) In the first year of coverage, the rates shall be
11 equal to the amount normally charged to State employees for
12 elected optional coverages or for enrolled dependents
13 coverages or other contributory coverages, or contributed
14 by the State for basic insurance coverages on behalf of its
15 employees, adjusted for differences between State
16 employees and employees of the local government in age,
17 sex, geographic location or other relevant demographic
18 variables, plus an amount sufficient to pay for the
19 additional administrative costs of providing coverage to
20 employees of the unit of local government and their
21 dependents.
22 (2) In subsequent years, a further adjustment shall be
23 made to reflect the actual prior years' claims experience
24 of the employees of the unit of local government.
25 In the case of coverage of local government employees under
26a health maintenance organization, the Director shall annually

SB2314 Engrossed- 40 -LRB099 16031 HLH 40349 b
1determine for each participating unit of local government the
2maximum monthly amount the unit may contribute toward that
3coverage, based on an analysis of (i) the age, sex, geographic
4location, and other relevant demographic variables of the
5unit's employees and (ii) the cost to cover those employees
6under the State group health benefits plan. The Director may
7similarly determine the maximum monthly amount each unit of
8local government may contribute toward coverage of its
9employees' dependents under a health maintenance organization.
10 Monthly payments by the unit of local government or its
11employees for group health benefits plan or health maintenance
12organization coverage shall be deposited in the Local
13Government Health Insurance Reserve Fund.
14 The Local Government Health Insurance Reserve Fund is
15hereby created as a nonappropriated trust fund to be held
16outside the State Treasury, with the State Treasurer as
17custodian. The Local Government Health Insurance Reserve Fund
18shall be a continuing fund not subject to fiscal year
19limitations. The Local Government Health Insurance Reserve
20Fund is not subject to administrative charges or charge-backs,
21including but not limited to those authorized under Section 8h
22of the State Finance Act. All revenues arising from the
23administration of the health benefits program established
24under this Section shall be deposited into the Local Government
25Health Insurance Reserve Fund. Any interest earned on moneys in
26the Local Government Health Insurance Reserve Fund shall be

SB2314 Engrossed- 41 -LRB099 16031 HLH 40349 b
1deposited into the Fund. All expenditures from this Fund shall
2be used for payments for health care benefits for local
3government and rehabilitation facility employees, annuitants,
4and dependents, and to reimburse the Department or its
5administrative service organization for all expenses incurred
6in the administration of benefits. No other State funds may be
7used for these purposes.
8 A local government employer's participation or desire to
9participate in a program created under this subsection shall
10not limit that employer's duty to bargain with the
11representative of any collective bargaining unit of its
12employees.
13 (j) Any rehabilitation facility within the State of
14Illinois may apply to the Director to have its employees,
15annuitants, and their eligible dependents provided group
16health coverage under this Act on a non-insured basis. To
17participate, a rehabilitation facility must agree to enroll all
18of its employees and remit the entire cost of providing such
19coverage for its employees, except that the rehabilitation
20facility shall not be required to enroll those of its employees
21who are covered spouses or dependents under this plan or
22another group policy or plan providing health benefits as long
23as (1) an appropriate official from the rehabilitation facility
24attests that each employee not enrolled is a covered spouse or
25dependent under this plan or another group policy or plan, and
26(2) at least 50% of the employees are enrolled and the

SB2314 Engrossed- 42 -LRB099 16031 HLH 40349 b
1rehabilitation facility remits the entire cost of providing
2coverage to those employees. Employees of a participating
3rehabilitation facility who are not enrolled due to coverage
4under another group health policy or plan may enroll in the
5event of a qualifying change in status, special enrollment,
6special circumstance as defined by the Director, or during the
7annual Benefit Choice Period. A participating rehabilitation
8facility may also elect to cover its annuitants. Dependent
9coverage shall be offered on an optional basis, with the costs
10paid by the rehabilitation facility, its employees, or some
11combination of the 2 as determined by the rehabilitation
12facility. The rehabilitation facility shall be responsible for
13timely collection and transmission of dependent premiums.
14 The Director shall annually determine quarterly rates of
15payment, subject to the following constraints:
16 (1) In the first year of coverage, the rates shall be
17 equal to the amount normally charged to State employees for
18 elected optional coverages or for enrolled dependents
19 coverages or other contributory coverages on behalf of its
20 employees, adjusted for differences between State
21 employees and employees of the rehabilitation facility in
22 age, sex, geographic location or other relevant
23 demographic variables, plus an amount sufficient to pay for
24 the additional administrative costs of providing coverage
25 to employees of the rehabilitation facility and their
26 dependents.

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1 (2) In subsequent years, a further adjustment shall be
2 made to reflect the actual prior years' claims experience
3 of the employees of the rehabilitation facility.
4 Monthly payments by the rehabilitation facility or its
5employees for group health benefits shall be deposited in the
6Local Government Health Insurance Reserve Fund.
7 (k) Any domestic violence shelter or service within the
8State of Illinois may apply to the Director to have its
9employees, annuitants, and their dependents provided group
10health coverage under this Act on a non-insured basis. To
11participate, a domestic violence shelter or service must agree
12to enroll all of its employees and pay the entire cost of
13providing such coverage for its employees. The domestic
14violence shelter shall not be required to enroll those of its
15employees who are covered spouses or dependents under this plan
16or another group policy or plan providing health benefits as
17long as (1) an appropriate official from the domestic violence
18shelter attests that each employee not enrolled is a covered
19spouse or dependent under this plan or another group policy or
20plan and (2) at least 50% of the employees are enrolled and the
21domestic violence shelter remits the entire cost of providing
22coverage to those employees. Employees of a participating
23domestic violence shelter who are not enrolled due to coverage
24under another group health policy or plan may enroll in the
25event of a qualifying change in status, special enrollment, or
26special circumstance as defined by the Director or during the

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1annual Benefit Choice Period. A participating domestic
2violence shelter may also elect to cover its annuitants.
3Dependent coverage shall be offered on an optional basis, with
4employees, or some combination of the 2 as determined by the
5domestic violence shelter or service. The domestic violence
6shelter or service shall be responsible for timely collection
7and transmission of dependent premiums.
8 The Director shall annually determine rates of payment,
9subject to the following constraints:
10 (1) In the first year of coverage, the rates shall be
11 equal to the amount normally charged to State employees for
12 elected optional coverages or for enrolled dependents
13 coverages or other contributory coverages on behalf of its
14 employees, adjusted for differences between State
15 employees and employees of the domestic violence shelter or
16 service in age, sex, geographic location or other relevant
17 demographic variables, plus an amount sufficient to pay for
18 the additional administrative costs of providing coverage
19 to employees of the domestic violence shelter or service
20 and their dependents.
21 (2) In subsequent years, a further adjustment shall be
22 made to reflect the actual prior years' claims experience
23 of the employees of the domestic violence shelter or
24 service.
25 Monthly payments by the domestic violence shelter or
26service or its employees for group health insurance shall be

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1deposited in the Local Government Health Insurance Reserve
2Fund.
3 (l) A public community college or entity organized pursuant
4to the Public Community College Act may apply to the Director
5initially to have only annuitants not covered prior to July 1,
61992 by the district's health plan provided health coverage
7under this Act on a non-insured basis. The community college
8must execute a 2-year contract to participate in the Local
9Government Health Plan. Any annuitant may enroll in the event
10of a qualifying change in status, special enrollment, special
11circumstance as defined by the Director, or during the annual
12Benefit Choice Period.
13 The Director shall annually determine monthly rates of
14payment subject to the following constraints: for those
15community colleges with annuitants only enrolled, first year
16rates shall be equal to the average cost to cover claims for a
17State member adjusted for demographics, Medicare
18participation, and other factors; and in the second year, a
19further adjustment of rates shall be made to reflect the actual
20first year's claims experience of the covered annuitants.
21 (l-5) The provisions of subsection (l) become inoperative
22on July 1, 1999.
23 (m) The Director shall adopt any rules deemed necessary for
24implementation of this amendatory Act of 1989 (Public Act
2586-978).
26 (n) Any child advocacy center within the State of Illinois

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1may apply to the Director to have its employees, annuitants,
2and their dependents provided group health coverage under this
3Act on a non-insured basis. To participate, a child advocacy
4center must agree to enroll all of its employees and pay the
5entire cost of providing coverage for its employees. The child
6advocacy center shall not be required to enroll those of its
7employees who are covered spouses or dependents under this plan
8or another group policy or plan providing health benefits as
9long as (1) an appropriate official from the child advocacy
10center attests that each employee not enrolled is a covered
11spouse or dependent under this plan or another group policy or
12plan and (2) at least 50% of the employees are enrolled and the
13child advocacy center remits the entire cost of providing
14coverage to those employees. Employees of a participating child
15advocacy center who are not enrolled due to coverage under
16another group health policy or plan may enroll in the event of
17a qualifying change in status, special enrollment, or special
18circumstance as defined by the Director or during the annual
19Benefit Choice Period. A participating child advocacy center
20may also elect to cover its annuitants. Dependent coverage
21shall be offered on an optional basis, with the costs paid by
22the child advocacy center, its employees, or some combination
23of the 2 as determined by the child advocacy center. The child
24advocacy center shall be responsible for timely collection and
25transmission of dependent premiums.
26 The Director shall annually determine rates of payment,

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1subject to the following constraints:
2 (1) In the first year of coverage, the rates shall be
3 equal to the amount normally charged to State employees for
4 elected optional coverages or for enrolled dependents
5 coverages or other contributory coverages on behalf of its
6 employees, adjusted for differences between State
7 employees and employees of the child advocacy center in
8 age, sex, geographic location, or other relevant
9 demographic variables, plus an amount sufficient to pay for
10 the additional administrative costs of providing coverage
11 to employees of the child advocacy center and their
12 dependents.
13 (2) In subsequent years, a further adjustment shall be
14 made to reflect the actual prior years' claims experience
15 of the employees of the child advocacy center.
16 Monthly payments by the child advocacy center or its
17employees for group health insurance shall be deposited into
18the Local Government Health Insurance Reserve Fund.
19(Source: P.A. 97-695, eff. 7-1-12; 98-488, eff. 8-16-13.)
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