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

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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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AN ACT concerning State government.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The State Employees Group Insurance Act of 1971
is amended by changing Sections 3, 5, 8, and 10 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
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

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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
"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).

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(b-5) (Blank).
(b-6) (Blank).
(b-7) (Blank).
(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
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

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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
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

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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 has a mental or physical
disability 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
forms required by the Department.
(i) "Director" means the Director of the Illinois
Department of Central Management Services.

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(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
"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

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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
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

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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
applicable retirement system in order for the survivor to be
eligible for group insurance benefits under that system.
References to the term "member" include State benefit
recipients, but only with respect to the basic program of group

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health benefits and not for the purposes of enrollment in any
group life insurance benefits or optional coverages or
benefits.
(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

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Illinois Pension Code; (2) the surviving dependent of any
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-2.1) "State benefit recipient" means a person in the
service of a department who: (1) is not a member, as defined in
this Section; (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, except that "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.
(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

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State of Illinois, created under Article 16 of the Illinois
Pension Code.
(q-5) (Blank).
(q-6) (Blank).
(q-7) (Blank).
(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
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

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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.
(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:

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(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
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 has a mental or physical
disability from a cause originating prior to the age of 19

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(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
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

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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
has a mental or physical disability from a cause
originating prior to the age of 19 (age 26 if enrolled as
an adult 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

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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. 98-488, eff. 8-16-13; 99-143, eff. 7-27-15.)
(5 ILCS 375/5) (from Ch. 127, par. 525)
Sec. 5. Employee benefits; declaration of State policy. The
General Assembly declares that it is the policy of the State
and in the best interest of the State to assure quality
benefits to members and their dependents under this Act. The
implementation of this policy depends upon, among other things,
stability and continuity of coverage, care, and services under
benefit programs for members and their dependents.
Specifically, but without limitation, members should have
continued access, on substantially similar terms and
conditions, to trusted family health care providers with whom
they have developed long-term relationships through a benefit
program under this Act. Therefore, the Director must administer
this Act consistent with that State policy, but may consider
affordability, cost of coverage and care, and competition among

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

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

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

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

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

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

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(5 ILCS 375/8) (from Ch. 127, par. 528)
Sec. 8. Eligibility.
(a) Each employee 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
electing coverage for eligible dependents 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

SB2314 Engrossed - 24 - LRB099 16031 HLH 40349 b
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
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

SB2314 Engrossed - 25 - LRB099 16031 HLH 40349 b
eligible 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 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

SB2314 Engrossed - 26 - LRB099 16031 HLH 40349 b
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
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

SB2314 Engrossed - 27 - LRB099 16031 HLH 40349 b
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
program of financial incentives to encourage annuitants
receiving a retirement annuity, 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.
(d-6) Beginning July 1, 2013, the Director may establish a
program of financial incentives to encourage annuitants with 20
or more years of creditable service 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

SB2314 Engrossed - 28 - LRB099 16031 HLH 40349 b
accordance with the requirements set forth under subsection
(d). The program established under this subsection (d-6) may
include a prorated incentive for annuitants with fewer than 20
years of creditable service, as determined by the Director. The
financial incentives provided to these annuitants under this
program may not exceed $500 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
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.

SB2314 Engrossed - 29 - LRB099 16031 HLH 40349 b
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.
(f) State benefit recipients shall be eligible to enroll in
the program of health benefits on the first day of active State
service. State benefit recipients who were not eligible to
enroll in the program of health benefits immediately prior to
the effective date of this amendatory Act of the 99th General
Assembly, but who became eligible to enroll in the program of
health benefits as a result of this amendatory Act of the 99th
General Assembly, may elect to participate in coverage in
accordance with procedures specified by the Director or during
any annual benefit choice period. Notwithstanding any other
provision of this Act, State benefit recipients shall be
eligible only for the program of health benefits and shall not
be eligible for group life insurance benefits or other optional
coverages or benefits available to employees.
(Source: P.A. 97-668, eff. 1-13-12; 98-19, eff. 6-10-13.)
(5 ILCS 375/10) (from Ch. 127, par. 530)
Sec. 10. Contributions by the State and members.
(a) The State shall pay the cost of basic non-contributory

SB2314 Engrossed - 30 - LRB099 16031 HLH 40349 b
group life insurance and, subject to member paid contributions
set by the Department or required by this Section and except as
provided in this Section, the basic program of group health
benefits on each eligible member, except a member, 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, and part of each eligible
member's and retired member's premiums for health insurance
coverage for enrolled dependents as provided by Section 9. The
State shall pay the cost of the basic program of group health
benefits only after benefits are reduced by the amount of
benefits covered by Medicare for all members and dependents who
are eligible for benefits under Social Security or the Railroad
Retirement system or who had sufficient Medicare-covered
government employment, except that such reduction in benefits
shall apply only to those members and dependents who (1) first
become eligible for such Medicare coverage on or after July 1,
1992; or (2) are Medicare-eligible members or dependents of a
local government unit which began participation in the program
on or after July 1, 1992; or (3) remain eligible for, but no
longer receive Medicare coverage which they had been receiving
on or after July 1, 1992. The Department may determine the
aggregate level of the State's contribution on the basis of
actual cost of medical services adjusted for age, sex or
geographic or other demographic characteristics which affect

SB2314 Engrossed - 31 - LRB099 16031 HLH 40349 b
the costs of such programs.
The cost of participation in the basic program of group
health benefits for the dependent or survivor of a living or
deceased retired employee who was formerly employed by the
University of Illinois in the Cooperative Extension Service and
would be an annuitant but for the fact that he or she 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 shall not be greater than the cost of
participation that would otherwise apply to that dependent or
survivor if he or she were the dependent or survivor of an
annuitant under the State Universities Retirement System.
(a-1) (Blank).
(a-2) (Blank).
(a-3) (Blank).
(a-4) (Blank).
(a-5) (Blank).
(a-6) (Blank).
(a-7) (Blank).
(a-8) Any annuitant, survivor, or retired employee may
waive or terminate coverage in the program of group health
benefits. Any such annuitant, survivor, or retired employee who
has waived or terminated coverage may enroll or re-enroll in
the program of group health benefits only during the annual
benefit choice period, as determined by the Director; except
that in the event of termination of coverage due to nonpayment

SB2314 Engrossed - 32 - LRB099 16031 HLH 40349 b
of premiums, the annuitant, survivor, or retired employee may
not re-enroll in the program.
(a-8.5) Beginning on the effective date of this amendatory
Act of the 97th General Assembly, the Director of Central
Management Services shall, on an annual basis, determine the
amount that the State shall contribute toward the basic program
of group health benefits on behalf of annuitants (including
individuals who (i) participated in the General Assembly
Retirement System, the State Employees' Retirement System of
Illinois, the State Universities Retirement System, the
Teachers' Retirement System of the State of Illinois, or the
Judges Retirement System of Illinois and (ii) qualify as
annuitants under subsection (b) of Section 3 of this Act),
survivors (including individuals who (i) receive an annuity as
a survivor of an individual who participated in the General
Assembly Retirement System, the State Employees' Retirement
System of Illinois, the State Universities Retirement System,
the Teachers' Retirement System of the State of Illinois, or
the Judges Retirement System of Illinois and (ii) qualify as
survivors under subsection (q) of Section 3 of this Act), and
retired employees (as defined in subsection (p) of Section 3 of
this Act). The remainder of the cost of coverage for each
annuitant, survivor, or retired employee, as determined by the
Director of Central Management Services, shall be the
responsibility of that annuitant, survivor, or retired
employee.

SB2314 Engrossed - 33 - LRB099 16031 HLH 40349 b
Contributions required of annuitants, survivors, and
retired employees shall be the same for all retirement systems
and shall also be based on whether an individual has made an
election under Section 15-135.1 of the Illinois Pension Code.
Contributions may be based on annuitants', survivors', or
retired employees' Medicare eligibility, but may not be based
on Social Security eligibility.
(a-9) No later than May 1 of each calendar year, the
Director of Central Management Services shall certify in
writing to the Executive Secretary of the State Employees'
Retirement System of Illinois the amounts of the Medicare
supplement health care premiums and the amounts of the health
care premiums for all other retirees who are not Medicare
eligible.
A separate calculation of the premiums based upon the
actual cost of each health care plan shall be so certified.
The Director of Central Management Services shall provide
to the Executive Secretary of the State Employees' Retirement
System of Illinois such information, statistics, and other data
as he or she may require to review the premium amounts
certified by the Director of Central Management Services.
The Department of Central Management Services, or any
successor agency designated to procure healthcare contracts
pursuant to this Act, is authorized to establish funds,
separate accounts provided by any bank or banks as defined by
the Illinois Banking Act, or separate accounts provided by any

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

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

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

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

SB2314 Engrossed - 38 - LRB099 16031 HLH 40349 b
shall not be required to enroll those of its employees who are
covered spouses or dependents under this plan or another group
policy or plan providing health benefits as long as (1) an
appropriate official from the unit of local government attests
that each employee not enrolled is a covered spouse or
dependent under this plan or another group policy or plan, and
(2) at least 50% of the employees are enrolled and the unit of
local government remits the entire cost of providing coverage
to those employees, except that a participating school district
must have enrolled at least 50% of its full-time employees who
have not waived coverage under the district's group health plan
by participating in a component of the district's cafeteria
plan. A participating school district is not required to enroll
a full-time employee who has waived coverage under the
district's health plan, provided that an appropriate official
from the participating school district attests that the
full-time employee has waived coverage by participating in a
component of the district's cafeteria plan. For the purposes of
this subsection, "participating school district" includes a
unit of local government whose primary purpose is education as
defined by the Department's rules.
Employees of a participating unit of local government who
are not enrolled due to coverage under another group health
policy or plan may enroll 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. A

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

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

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

SB2314 Engrossed - 42 - LRB099 16031 HLH 40349 b
rehabilitation facility remits the entire cost of providing
coverage to those employees. Employees of a participating
rehabilitation facility who are not enrolled due to coverage
under another group health policy or plan may enroll 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. A participating rehabilitation
facility may also elect to cover its annuitants. Dependent
coverage shall be offered on an optional basis, with the costs
paid by the rehabilitation facility, its employees, or some
combination of the 2 as determined by the rehabilitation
facility. The rehabilitation facility shall be responsible for
timely collection and transmission of dependent premiums.
The Director shall annually determine quarterly rates of
payment, subject to the following constraints:
(1) In the first year of coverage, the rates shall be
equal to the amount normally charged to State employees for
elected optional coverages or for enrolled dependents
coverages or other contributory coverages on behalf of its
employees, adjusted for differences between State
employees and employees of the rehabilitation facility in
age, sex, geographic location or other relevant
demographic variables, plus an amount sufficient to pay for
the additional administrative costs of providing coverage
to employees of the rehabilitation facility and their
dependents.

SB2314 Engrossed - 43 - LRB099 16031 HLH 40349 b
(2) In subsequent years, a further adjustment shall be
made to reflect the actual prior years' claims experience
of the employees of the rehabilitation facility.
Monthly payments by the rehabilitation facility or its
employees for group health benefits shall be deposited in the
Local Government Health Insurance Reserve Fund.
(k) Any domestic violence shelter or service within the
State of Illinois may apply to the Director to have its
employees, annuitants, and their dependents provided group
health coverage under this Act on a non-insured basis. To
participate, a domestic violence shelter or service must agree
to enroll all of its employees and pay the entire cost of
providing such coverage for its employees. The domestic
violence shelter shall not be required to enroll those of its
employees who are covered spouses or dependents under this plan
or another group policy or plan providing health benefits as
long as (1) an appropriate official from the domestic violence
shelter attests that each employee not enrolled is a covered
spouse or dependent under this plan or another group policy or
plan and (2) at least 50% of the employees are enrolled and the
domestic violence shelter remits the entire cost of providing
coverage to those employees. Employees of a participating
domestic violence shelter who are not enrolled due to coverage
under another group health policy or plan may enroll in the
event of a qualifying change in status, special enrollment, or
special circumstance as defined by the Director or during the

SB2314 Engrossed - 44 - LRB099 16031 HLH 40349 b
annual Benefit Choice Period. A participating domestic
violence shelter may also elect to cover its annuitants.
Dependent coverage shall be offered on an optional basis, with
employees, or some combination of the 2 as determined by the
domestic violence shelter or service. The domestic violence
shelter or service shall be responsible for timely collection
and transmission of dependent premiums.
The Director shall annually determine rates of payment,
subject to the following constraints:
(1) In the first year of coverage, the rates shall be
equal to the amount normally charged to State employees for
elected optional coverages or for enrolled dependents
coverages or other contributory coverages on behalf of its
employees, adjusted for differences between State
employees and employees of the domestic violence shelter or
service in age, sex, geographic location or other relevant
demographic variables, plus an amount sufficient to pay for
the additional administrative costs of providing coverage
to employees of the domestic violence shelter or service
and their dependents.
(2) In subsequent years, a further adjustment shall be
made to reflect the actual prior years' claims experience
of the employees of the domestic violence shelter or
service.
Monthly payments by the domestic violence shelter or
service or its employees for group health insurance shall be

SB2314 Engrossed - 45 - LRB099 16031 HLH 40349 b
deposited in the Local Government Health Insurance Reserve
Fund.
(l) A public community college or entity organized pursuant
to the Public Community College Act may apply to the Director
initially to have only annuitants not covered prior to July 1,
1992 by the district's health plan provided health coverage
under this Act on a non-insured basis. The community college
must execute a 2-year contract to participate in the Local
Government Health Plan. Any annuitant may enroll 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.
The Director shall annually determine monthly rates of
payment subject to the following constraints: for those
community colleges with annuitants only enrolled, first year
rates shall be equal to the average cost to cover claims for a
State member adjusted for demographics, Medicare
participation, and other factors; and in the second year, a
further adjustment of rates shall be made to reflect the actual
first year's claims experience of the covered annuitants.
(l-5) The provisions of subsection (l) become inoperative
on July 1, 1999.
(m) The Director shall adopt any rules deemed necessary for
implementation of this amendatory Act of 1989 (Public Act
86-978).
(n) Any child advocacy center within the State of Illinois

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

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