Bill Text: IL SB3004 | 2019-2020 | 101st General Assembly | Introduced
Bill Title: Amends the State Employees Group Insurance Act of 1971. Provides that an annuitant, survivor, or retired employee whose coverage has been terminated for nonpayment of premiums may re-enroll in the program during the next annual benefit choice period if he or she has fully paid all previous nonpayments prior to that re-enrollment. Provides that the changes added by the amendatory Act are inoperative on and after January 1, 2022. Makes conforming changes. Effective immediately.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Failed) 2021-01-13 - Session Sine Die [SB3004 Detail]
Download: Illinois-2019-SB3004-Introduced.html
| ||||||||||||||||||||
| ||||||||||||||||||||
| ||||||||||||||||||||
| ||||||||||||||||||||
| ||||||||||||||||||||
1 | AN ACT concerning State health benefits.
| |||||||||||||||||||
2 | Be it enacted by the People of the State of Illinois,
| |||||||||||||||||||
3 | represented in the General Assembly:
| |||||||||||||||||||
4 | Section 5. The State Employees Group Insurance Act of 1971 | |||||||||||||||||||
5 | is amended by changing Section 10 as follows:
| |||||||||||||||||||
6 | (5 ILCS 375/10) (from Ch. 127, par. 530)
| |||||||||||||||||||
7 | Sec. 10. Contributions by the State and members.
| |||||||||||||||||||
8 | (a) The State shall pay the cost of basic non-contributory | |||||||||||||||||||
9 | group life
insurance and, subject to member paid contributions | |||||||||||||||||||
10 | set by the Department or
required by this Section and except as | |||||||||||||||||||
11 | provided in this Section, the basic program of group health | |||||||||||||||||||
12 | benefits on each
eligible member, except a member, not | |||||||||||||||||||
13 | otherwise
covered by this Act, who has retired as a | |||||||||||||||||||
14 | participating member under Article 2
of the Illinois Pension | |||||||||||||||||||
15 | Code but is ineligible for the retirement annuity under
Section | |||||||||||||||||||
16 | 2-119 of the Illinois Pension Code, and part of each eligible | |||||||||||||||||||
17 | member's
and retired member's premiums for health insurance | |||||||||||||||||||
18 | coverage for enrolled
dependents as provided by Section 9. The | |||||||||||||||||||
19 | State shall pay the cost of the basic
program of group health | |||||||||||||||||||
20 | benefits only after benefits are reduced by the amount
of | |||||||||||||||||||
21 | benefits covered by Medicare for all members and dependents
who | |||||||||||||||||||
22 | are eligible for benefits under Social Security or
the Railroad | |||||||||||||||||||
23 | Retirement system or who had sufficient Medicare-covered
|
| |||||||
| |||||||
1 | government employment, except that such reduction in benefits | ||||||
2 | shall apply only
to those members and dependents who (1) first | ||||||
3 | become eligible
for such Medicare coverage on or after July 1, | ||||||
4 | 1992; or (2) are
Medicare-eligible members or dependents of a | ||||||
5 | local government unit which began
participation in the program | ||||||
6 | on or after July 1, 1992; or (3) remain eligible
for, but no | ||||||
7 | longer receive Medicare coverage which they had been receiving | ||||||
8 | on
or after July 1, 1992. The Department may determine the | ||||||
9 | aggregate level of the
State's contribution on the basis of | ||||||
10 | actual cost of medical services adjusted
for age, sex or | ||||||
11 | geographic or other demographic characteristics which affect
| ||||||
12 | the costs of such programs.
| ||||||
13 | The cost of participation in the basic program of group | ||||||
14 | health benefits
for the dependent or survivor of a living or | ||||||
15 | deceased retired employee who was
formerly employed by the | ||||||
16 | University of Illinois in the Cooperative Extension
Service and | ||||||
17 | would be an annuitant but for the fact that he or she was made
| ||||||
18 | ineligible to participate in the State Universities Retirement | ||||||
19 | System by clause
(4) of subsection (a) of Section 15-107 of the | ||||||
20 | Illinois Pension Code shall not
be greater than the cost of | ||||||
21 | participation that would otherwise apply to that
dependent or | ||||||
22 | survivor if he or she were the dependent or survivor of an
| ||||||
23 | annuitant under the State Universities Retirement System.
| ||||||
24 | (a-1) (Blank).
| ||||||
25 | (a-2) (Blank).
| ||||||
26 | (a-3) (Blank).
|
| |||||||
| |||||||
1 | (a-4) (Blank).
| ||||||
2 | (a-5) (Blank).
| ||||||
3 | (a-6) (Blank).
| ||||||
4 | (a-7) (Blank).
| ||||||
5 | (a-8) Any annuitant, survivor, or retired employee may | ||||||
6 | waive or terminate coverage in
the program of group health | ||||||
7 | benefits. Any such annuitant, survivor, or retired employee
who | ||||||
8 | has waived or terminated coverage may enroll or re-enroll in | ||||||
9 | the
program of group health benefits only during the annual | ||||||
10 | benefit choice period,
as determined by the Director . In ; | ||||||
11 | except that in the event of termination of
coverage due to | ||||||
12 | nonpayment of premiums, the annuitant, survivor, or retired | ||||||
13 | employee
may not re-enroll in the program , except as otherwise | ||||||
14 | provided in this subsection (a-8). Beginning on the effective | ||||||
15 | date of this amendatory Act of the 101st General Assembly, an | ||||||
16 | annuitant, survivor, or retired employee whose coverage has | ||||||
17 | been terminated for nonpayment of premiums may re-enroll in the | ||||||
18 | program during the next annual benefit choice period, as | ||||||
19 | determined by the Director, if he or she has fully paid all | ||||||
20 | previous nonpayments prior to that re-enrollment. The changes | ||||||
21 | added to this subsection (a-8) by this amendatory Act of the | ||||||
22 | 101st General Assembly are inoperative on and after January 1, | ||||||
23 | 2022 .
| ||||||
24 | (a-8.5) Beginning on the effective date of this amendatory | ||||||
25 | Act of the 97th General Assembly, the Director of Central | ||||||
26 | Management Services shall, on an annual basis, determine the |
| |||||||
| |||||||
1 | amount that the State shall contribute toward the basic program | ||||||
2 | of group health benefits on behalf of annuitants (including | ||||||
3 | individuals who (i) participated in the General Assembly | ||||||
4 | Retirement System, the State Employees' Retirement System of | ||||||
5 | Illinois, the State Universities Retirement System, the | ||||||
6 | Teachers' Retirement System of the State of Illinois, or the | ||||||
7 | Judges Retirement System of Illinois and (ii) qualify as | ||||||
8 | annuitants under subsection (b) of Section 3 of this Act), | ||||||
9 | survivors (including individuals who (i) receive an annuity as | ||||||
10 | a survivor of an individual who participated in the General | ||||||
11 | Assembly Retirement System, the State Employees' Retirement | ||||||
12 | System of Illinois, the State Universities Retirement System, | ||||||
13 | the Teachers' Retirement System of the State of Illinois, or | ||||||
14 | the Judges Retirement System of Illinois and (ii) qualify as | ||||||
15 | survivors under subsection (q) of Section 3 of this Act), and | ||||||
16 | retired employees (as defined in subsection (p) of Section 3 of | ||||||
17 | this Act). The remainder of the cost of coverage for each | ||||||
18 | annuitant, survivor, or retired employee, as determined by the | ||||||
19 | Director of Central Management Services, shall be the | ||||||
20 | responsibility of that annuitant, survivor, or retired | ||||||
21 | employee. | ||||||
22 | Contributions required of annuitants, survivors, and | ||||||
23 | retired employees shall be the same for all retirement systems | ||||||
24 | and shall also be based on whether an individual has made an | ||||||
25 | election under Section 15-135.1 of the Illinois Pension Code. | ||||||
26 | Contributions may be based on annuitants', survivors', or |
| |||||||
| |||||||
1 | retired employees' Medicare eligibility, but may not be based | ||||||
2 | on Social Security eligibility. | ||||||
3 | (a-9) No later than May 1 of each calendar year, the | ||||||
4 | Director
of Central Management Services shall certify in | ||||||
5 | writing to the Executive
Secretary of the State Employees' | ||||||
6 | Retirement System of Illinois the amounts
of the Medicare | ||||||
7 | supplement health care premiums and the amounts of the
health | ||||||
8 | care premiums for all other retirees who are not Medicare | ||||||
9 | eligible.
| ||||||
10 | A separate calculation of the premiums based upon the | ||||||
11 | actual cost of each
health care plan shall be so certified.
| ||||||
12 | The Director of Central Management Services shall provide | ||||||
13 | to the
Executive Secretary of the State Employees' Retirement | ||||||
14 | System of
Illinois such information, statistics, and other data | ||||||
15 | as he or she
may require to review the premium amounts | ||||||
16 | certified by the Director
of Central Management Services.
| ||||||
17 | The Department of Central Management Services, or any | ||||||
18 | successor agency designated to procure healthcare contracts | ||||||
19 | pursuant to this Act, is authorized to establish funds, | ||||||
20 | separate accounts provided by any bank or banks as defined by | ||||||
21 | the Illinois Banking Act, or separate accounts provided by any | ||||||
22 | savings and loan association or associations as defined by the | ||||||
23 | Illinois Savings and Loan Act of 1985 to be held by the | ||||||
24 | Director, outside the State treasury, for the purpose of | ||||||
25 | receiving the transfer of moneys from the Local Government | ||||||
26 | Health Insurance Reserve Fund. The Department may promulgate |
| |||||||
| |||||||
1 | rules further defining the methodology for the transfers. Any | ||||||
2 | interest earned by moneys in the funds or accounts shall inure | ||||||
3 | to the Local Government Health Insurance Reserve Fund. The | ||||||
4 | transferred moneys, and interest accrued thereon, shall be used | ||||||
5 | exclusively for transfers to administrative service | ||||||
6 | organizations or their financial institutions for payments of | ||||||
7 | claims to claimants and providers under the self-insurance | ||||||
8 | health plan. The transferred moneys, and interest accrued | ||||||
9 | thereon, shall not be used for any other purpose including, but | ||||||
10 | not limited to, reimbursement of administration fees due the | ||||||
11 | administrative service organization pursuant to its contract | ||||||
12 | or contracts with the Department.
| ||||||
13 | (a-10) To the extent that participation, benefits, or | ||||||
14 | premiums under this Act are based on a person's service credit | ||||||
15 | under an Article of the Illinois Pension Code, service credit | ||||||
16 | terminated in exchange for an accelerated pension benefit | ||||||
17 | payment under Section 14-147.5, 15-185.5, or 16-190.5 of that | ||||||
18 | Code shall be included in determining a person's service credit | ||||||
19 | for the purposes of this Act. | ||||||
20 | (b) State employees who become eligible for this program on | ||||||
21 | or after January
1, 1980 in positions normally requiring actual | ||||||
22 | performance of duty not less
than 1/2 of a normal work period | ||||||
23 | but not equal to that of a normal work period,
shall be given | ||||||
24 | the option of participating in the available program. If the
| ||||||
25 | employee elects coverage, the State shall contribute on behalf | ||||||
26 | of such employee
to the cost of the employee's benefit and any |
| |||||||
| |||||||
1 | applicable dependent supplement,
that sum which bears the same | ||||||
2 | percentage as that percentage of time the
employee regularly | ||||||
3 | works when compared to normal work period.
| ||||||
4 | (c) The basic non-contributory coverage from the basic | ||||||
5 | program of
group health benefits shall be continued for each | ||||||
6 | employee not in pay status or
on active service by reason of | ||||||
7 | (1) leave of absence due to illness or injury,
(2) authorized | ||||||
8 | educational leave of absence or sabbatical leave, or (3)
| ||||||
9 | military leave. This coverage shall continue until
expiration | ||||||
10 | of authorized leave and return to active service, but not to | ||||||
11 | exceed
24 months for leaves under item (1) or (2). This | ||||||
12 | 24-month limitation and the
requirement of returning to active | ||||||
13 | service shall not apply to persons receiving
ordinary or | ||||||
14 | accidental disability benefits or retirement benefits through | ||||||
15 | the
appropriate State retirement system or benefits under the | ||||||
16 | Workers' Compensation
or Occupational Disease Act.
| ||||||
17 | (d) The basic group life insurance coverage shall continue, | ||||||
18 | with
full State contribution, where such person is (1) absent | ||||||
19 | from active
service by reason of disability arising from any | ||||||
20 | cause other than
self-inflicted, (2) on authorized educational | ||||||
21 | leave of absence or
sabbatical leave, or (3) on military leave.
| ||||||
22 | (e) Where the person is in non-pay status for a period in | ||||||
23 | excess of
30 days or on leave of absence, other than by reason | ||||||
24 | of disability,
educational or sabbatical leave, or military | ||||||
25 | leave, such
person may continue coverage only by making | ||||||
26 | personal
payment equal to the amount normally contributed by |
| |||||||
| |||||||
1 | the State on such person's
behalf. Such payments and coverage | ||||||
2 | may be continued: (1) until such time as
the person returns to | ||||||
3 | a status eligible for coverage at State expense, but not
to | ||||||
4 | exceed 24 months or (2) until such person's employment or | ||||||
5 | annuitant status
with the State is terminated (exclusive of any | ||||||
6 | additional service imposed pursuant to law).
| ||||||
7 | (f) The Department shall establish by rule the extent to | ||||||
8 | which other
employee benefits will continue for persons in | ||||||
9 | non-pay status or who are
not in active service.
| ||||||
10 | (g) The State shall not pay the cost of the basic | ||||||
11 | non-contributory
group life insurance, program of health | ||||||
12 | benefits and other employee benefits
for members who are | ||||||
13 | survivors as defined by paragraphs (1) and (2) of
subsection | ||||||
14 | (q) of Section 3 of this Act. The costs of benefits for these
| ||||||
15 | survivors shall be paid by the survivors or by the University | ||||||
16 | of Illinois
Cooperative Extension Service, or any combination | ||||||
17 | thereof.
However, the State shall pay the amount of the | ||||||
18 | reduction in the cost of
participation, if any, resulting from | ||||||
19 | the amendment to subsection (a) made
by this amendatory Act of | ||||||
20 | the 91st General Assembly.
| ||||||
21 | (h) Those persons occupying positions with any department | ||||||
22 | as a result
of emergency appointments pursuant to Section 8b.8 | ||||||
23 | of the Personnel Code
who are not considered employees under | ||||||
24 | this Act shall be given the option
of participating in the | ||||||
25 | programs of group life insurance, health benefits and
other | ||||||
26 | employee benefits. Such persons electing coverage may |
| |||||||
| |||||||
1 | participate only
by making payment equal to the amount normally | ||||||
2 | contributed by the State for
similarly situated employees. Such | ||||||
3 | amounts shall be determined by the
Director. Such payments and | ||||||
4 | coverage may be continued until such time as the
person becomes | ||||||
5 | an employee pursuant to this Act or such person's appointment | ||||||
6 | is
terminated.
| ||||||
7 | (i) Any unit of local government within the State of | ||||||
8 | Illinois
may apply to the Director to have its employees, | ||||||
9 | annuitants, and their
dependents provided group health | ||||||
10 | coverage under this Act on a non-insured
basis. To participate, | ||||||
11 | a unit of local government must agree to enroll
all of its | ||||||
12 | employees, who may select coverage under either the State group
| ||||||
13 | health benefits plan or a health maintenance organization that | ||||||
14 | has
contracted with the State to be available as a health care | ||||||
15 | provider for
employees as defined in this Act. A unit of local | ||||||
16 | government must remit the
entire cost of providing coverage | ||||||
17 | under the State group health benefits plan
or, for coverage | ||||||
18 | under a health maintenance organization, an amount determined
| ||||||
19 | by the Director based on an analysis of the sex, age, | ||||||
20 | geographic location, or
other relevant demographic variables | ||||||
21 | for its employees, except that the unit of
local government | ||||||
22 | shall not be required to enroll those of its employees who are
| ||||||
23 | covered spouses or dependents under this plan or another group | ||||||
24 | policy or plan
providing health benefits as long as (1) an | ||||||
25 | appropriate official from the unit
of local government attests | ||||||
26 | that each employee not enrolled is a covered spouse
or |
| |||||||
| |||||||
1 | dependent under this plan or another group policy or plan, and | ||||||
2 | (2) at least
50% of the employees are enrolled and the unit of | ||||||
3 | local government remits
the entire cost of providing coverage | ||||||
4 | to those employees, except that a
participating school district | ||||||
5 | must have enrolled at least 50% of its full-time
employees who | ||||||
6 | have not waived coverage under the district's group health
plan | ||||||
7 | by participating in a component of the district's cafeteria | ||||||
8 | plan. A
participating school district is not required to enroll | ||||||
9 | a full-time employee
who has waived coverage under the | ||||||
10 | district's health plan, provided that an
appropriate official | ||||||
11 | from the participating school district attests that the
| ||||||
12 | full-time employee has waived coverage by participating in a | ||||||
13 | component of the
district's cafeteria plan. For the purposes of | ||||||
14 | this subsection, "participating
school district" includes a | ||||||
15 | unit of local government whose primary purpose is
education as | ||||||
16 | defined by the Department's rules.
| ||||||
17 | Employees of a participating unit of local government who | ||||||
18 | are not enrolled
due to coverage under another group health | ||||||
19 | policy or plan may enroll in
the event of a qualifying change | ||||||
20 | in status, special enrollment, special
circumstance as defined | ||||||
21 | by the Director, or during the annual Benefit Choice
Period. A | ||||||
22 | participating unit of local government may also elect to cover | ||||||
23 | its
annuitants. Dependent coverage shall be offered on an | ||||||
24 | optional basis, with the
costs paid by the unit of local | ||||||
25 | government, its employees, or some combination
of the two as | ||||||
26 | determined by the unit of local government. The unit of local
|
| |||||||
| |||||||
1 | government shall be responsible for timely collection and | ||||||
2 | transmission of
dependent premiums.
| ||||||
3 | The Director shall annually determine monthly rates of | ||||||
4 | payment, subject
to the following constraints:
| ||||||
5 | (1) In the first year of coverage, the rates shall be | ||||||
6 | equal to the
amount normally charged to State employees for | ||||||
7 | elected optional coverages
or for enrolled dependents | ||||||
8 | coverages or other contributory coverages, or
contributed | ||||||
9 | by the State for basic insurance coverages on behalf of its
| ||||||
10 | employees, adjusted for differences between State | ||||||
11 | employees and employees
of the local government in age, | ||||||
12 | sex, geographic location or other relevant
demographic | ||||||
13 | variables, plus an amount sufficient to pay for the | ||||||
14 | additional
administrative costs of providing coverage to | ||||||
15 | employees of the unit of
local government and their | ||||||
16 | dependents.
| ||||||
17 | (2) In subsequent years, a further adjustment shall be | ||||||
18 | made to reflect
the actual prior years' claims experience | ||||||
19 | of the employees of the unit of
local government.
| ||||||
20 | In the case of coverage of local government employees under | ||||||
21 | a health
maintenance organization, the Director shall annually | ||||||
22 | determine for each
participating unit of local government the | ||||||
23 | maximum monthly amount the unit
may contribute toward that | ||||||
24 | coverage, based on an analysis of (i) the age,
sex, geographic | ||||||
25 | location, and other relevant demographic variables of the
| ||||||
26 | unit's employees and (ii) the cost to cover those employees |
| |||||||
| |||||||
1 | under the State
group health benefits plan. The Director may | ||||||
2 | similarly determine the
maximum monthly amount each unit of | ||||||
3 | local government may contribute toward
coverage of its | ||||||
4 | employees' dependents under a health maintenance organization.
| ||||||
5 | Monthly payments by the unit of local government or its | ||||||
6 | employees for
group health benefits plan or health maintenance | ||||||
7 | organization coverage shall
be deposited in the Local | ||||||
8 | Government Health Insurance Reserve Fund.
| ||||||
9 | The Local Government Health Insurance Reserve Fund is | ||||||
10 | hereby created as a nonappropriated trust fund to be held | ||||||
11 | outside the State Treasury, with the State Treasurer as | ||||||
12 | custodian. The Local Government Health Insurance Reserve Fund | ||||||
13 | shall be a continuing
fund not subject to fiscal year | ||||||
14 | limitations. The Local Government Health Insurance Reserve | ||||||
15 | Fund is not subject to administrative charges or charge-backs, | ||||||
16 | including but not limited to those authorized under Section 8h | ||||||
17 | of the State Finance Act. All revenues arising from the | ||||||
18 | administration of the health benefits program established | ||||||
19 | under this Section shall be deposited into the Local Government | ||||||
20 | Health Insurance Reserve Fund. Any interest earned on moneys in | ||||||
21 | the Local Government Health Insurance Reserve Fund shall be | ||||||
22 | deposited into the Fund. All expenditures from this Fund
shall | ||||||
23 | be used for payments for health care benefits for local | ||||||
24 | government and rehabilitation facility
employees, annuitants, | ||||||
25 | and dependents, and to reimburse the Department or
its | ||||||
26 | administrative service organization for all expenses incurred |
| |||||||
| |||||||
1 | in the
administration of benefits. No other State funds may be | ||||||
2 | used for these
purposes.
| ||||||
3 | A local government employer's participation or desire to | ||||||
4 | participate
in a program created under this subsection shall | ||||||
5 | not limit that employer's
duty to bargain with the | ||||||
6 | representative of any collective bargaining unit
of its | ||||||
7 | employees.
| ||||||
8 | (j) Any rehabilitation facility within the State of | ||||||
9 | Illinois may apply
to the Director to have its employees, | ||||||
10 | annuitants, and their eligible
dependents provided group | ||||||
11 | health coverage under this Act on a non-insured
basis. To | ||||||
12 | participate, a rehabilitation facility must agree to enroll all
| ||||||
13 | of its employees and remit the entire cost of providing such | ||||||
14 | coverage for
its employees, except that the rehabilitation | ||||||
15 | facility shall not be
required to enroll those of its employees | ||||||
16 | who are covered spouses or
dependents under this plan or | ||||||
17 | another group policy or plan providing health
benefits as long | ||||||
18 | as (1) an appropriate official from the rehabilitation
facility | ||||||
19 | attests that each employee not enrolled is a covered spouse or
| ||||||
20 | dependent under this plan or another group policy or plan, and | ||||||
21 | (2) at least
50% of the employees are enrolled and the | ||||||
22 | rehabilitation facility remits
the entire cost of providing | ||||||
23 | coverage to those employees. Employees of a
participating | ||||||
24 | rehabilitation facility who are not enrolled due to coverage
| ||||||
25 | under another group health policy or plan may enroll
in the | ||||||
26 | event of a qualifying change in status, special enrollment, |
| |||||||
| |||||||
1 | special
circumstance as defined by the Director, or during the | ||||||
2 | annual Benefit Choice
Period. A participating rehabilitation | ||||||
3 | facility may also elect
to cover its annuitants. Dependent | ||||||
4 | coverage shall be offered on an optional
basis, with the costs | ||||||
5 | paid by the rehabilitation facility, its employees, or
some | ||||||
6 | combination of the 2 as determined by the rehabilitation | ||||||
7 | facility. The
rehabilitation facility shall be responsible for | ||||||
8 | timely collection and
transmission of dependent premiums.
| ||||||
9 | The Director shall annually determine quarterly rates of | ||||||
10 | payment, subject
to the following constraints:
| ||||||
11 | (1) In the first year of coverage, the rates shall be | ||||||
12 | equal to the amount
normally charged to State employees for | ||||||
13 | elected optional coverages or for
enrolled dependents | ||||||
14 | coverages or other contributory coverages on behalf of
its | ||||||
15 | employees, adjusted for differences between State | ||||||
16 | employees and
employees of the rehabilitation facility in | ||||||
17 | age, sex, geographic location
or other relevant | ||||||
18 | demographic variables, plus an amount sufficient to pay
for | ||||||
19 | the additional administrative costs of providing coverage | ||||||
20 | to employees
of the rehabilitation facility 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
rehabilitation facility.
| ||||||
25 | Monthly payments by the rehabilitation facility or its | ||||||
26 | employees for
group health benefits shall be deposited in the |
| |||||||
| |||||||
1 | Local Government Health
Insurance Reserve Fund.
| ||||||
2 | (k) Any domestic violence shelter or service within the | ||||||
3 | State of Illinois
may apply to the Director to have its | ||||||
4 | employees, annuitants, and their
dependents provided group | ||||||
5 | health coverage under this Act on a non-insured
basis. To | ||||||
6 | participate, a domestic violence shelter or service must agree | ||||||
7 | to
enroll all of its employees and pay the entire cost of | ||||||
8 | providing such coverage
for its employees. The domestic | ||||||
9 | violence shelter shall not be required to enroll those of its | ||||||
10 | employees who are covered spouses or dependents under this plan | ||||||
11 | or another group policy or plan providing health benefits as | ||||||
12 | long as (1) an appropriate official from the domestic violence | ||||||
13 | shelter attests that each employee not enrolled is a covered | ||||||
14 | spouse or dependent under this plan or another group policy or | ||||||
15 | plan and (2) at least 50% of the employees are enrolled and the | ||||||
16 | domestic violence shelter remits the entire cost of providing | ||||||
17 | coverage to those employees. Employees of a participating | ||||||
18 | domestic violence shelter who are not enrolled due to coverage | ||||||
19 | under another group health policy or plan may enroll in the | ||||||
20 | event of a qualifying change in status, special enrollment, or | ||||||
21 | special circumstance as defined by the Director or during the | ||||||
22 | annual Benefit Choice Period. A participating domestic | ||||||
23 | violence shelter may also elect
to cover its annuitants. | ||||||
24 | Dependent coverage shall be offered on an optional
basis, with
| ||||||
25 | employees, or some combination of the 2 as determined by the | ||||||
26 | domestic violence
shelter or service. The domestic violence |
| |||||||
| |||||||
1 | shelter or service shall be
responsible for timely collection | ||||||
2 | and transmission of dependent premiums.
| ||||||
3 | The Director shall annually determine rates of payment,
| ||||||
4 | subject to the following constraints:
| ||||||
5 | (1) In the first year of coverage, the rates shall be | ||||||
6 | equal to the
amount normally charged to State employees for | ||||||
7 | elected optional coverages
or for enrolled dependents | ||||||
8 | coverages or other contributory coverages on
behalf of its | ||||||
9 | employees, adjusted for differences between State | ||||||
10 | employees and
employees of the domestic violence shelter or | ||||||
11 | service in age, sex, geographic
location or other relevant | ||||||
12 | demographic variables, plus an amount sufficient
to pay for | ||||||
13 | the additional administrative costs of providing coverage | ||||||
14 | to
employees of the domestic violence shelter or service | ||||||
15 | and their dependents.
| ||||||
16 | (2) In subsequent years, a further adjustment shall be | ||||||
17 | made to reflect
the actual prior years' claims experience | ||||||
18 | of the employees of the domestic
violence shelter or | ||||||
19 | service.
| ||||||
20 | Monthly payments by the domestic violence shelter or | ||||||
21 | service or its employees
for group health insurance shall be | ||||||
22 | deposited in the Local Government Health
Insurance Reserve | ||||||
23 | Fund.
| ||||||
24 | (l) A public community college or entity organized pursuant | ||||||
25 | to the
Public Community College Act may apply to the Director | ||||||
26 | initially to have
only annuitants not covered prior to July 1, |
| |||||||
| |||||||
1 | 1992 by the district's health
plan provided health coverage | ||||||
2 | under this Act on a non-insured basis. The
community college | ||||||
3 | must execute a 2-year contract to participate in the
Local | ||||||
4 | Government Health Plan.
Any annuitant may enroll in the event | ||||||
5 | of a qualifying change in status, special
enrollment, special | ||||||
6 | circumstance as defined by the Director, or during the
annual | ||||||
7 | Benefit Choice Period.
| ||||||
8 | The Director shall annually determine monthly rates of | ||||||
9 | payment subject to
the following constraints: for those | ||||||
10 | community colleges with annuitants
only enrolled, first year | ||||||
11 | rates shall be equal to the average cost to cover
claims for a | ||||||
12 | State member adjusted for demographics, Medicare
| ||||||
13 | participation, and other factors; and in the second year, a | ||||||
14 | further adjustment
of rates shall be made to reflect the actual | ||||||
15 | first year's claims experience
of the covered annuitants.
| ||||||
16 | (l-5) The provisions of subsection (l) become inoperative | ||||||
17 | on July 1, 1999.
| ||||||
18 | (m) The Director shall adopt any rules deemed necessary for
| ||||||
19 | implementation of this amendatory Act of 1989 (Public Act | ||||||
20 | 86-978).
| ||||||
21 | (n) Any child advocacy center within the State of Illinois | ||||||
22 | may apply to the Director to have its employees, annuitants, | ||||||
23 | and their dependents provided group health coverage under this | ||||||
24 | Act on a non-insured basis. To participate, a child advocacy | ||||||
25 | center must agree to enroll all of its employees and pay the | ||||||
26 | entire cost of providing coverage for its employees. The child
|
| |||||||
| |||||||
1 | advocacy center shall not be required to enroll those of its
| ||||||
2 | employees who are covered spouses or dependents under this plan
| ||||||
3 | or another group policy or plan providing health benefits as
| ||||||
4 | long as (1) an appropriate official from the child advocacy
| ||||||
5 | center attests that each employee not enrolled is a covered
| ||||||
6 | spouse or dependent under this plan or another group policy or
| ||||||
7 | plan and (2) at least 50% of the employees are enrolled and the | ||||||
8 | child advocacy center remits the entire cost of providing | ||||||
9 | coverage to those employees. Employees of a participating child | ||||||
10 | advocacy center who are not enrolled due to coverage under | ||||||
11 | another group health policy or plan may enroll in the event of | ||||||
12 | a qualifying change in status, special enrollment, or special | ||||||
13 | circumstance as defined by the Director or during the annual | ||||||
14 | Benefit Choice Period. A participating child advocacy center | ||||||
15 | may also elect to cover its annuitants. Dependent coverage | ||||||
16 | shall be offered on an optional basis, with the costs paid by | ||||||
17 | the child advocacy center, its employees, or some combination | ||||||
18 | of the 2 as determined by the child advocacy center. The child | ||||||
19 | advocacy center shall be responsible for timely collection and | ||||||
20 | transmission of dependent premiums. | ||||||
21 | The Director shall annually determine rates of payment, | ||||||
22 | subject to the following constraints: | ||||||
23 | (1) In the first year of coverage, the rates shall be | ||||||
24 | equal to the amount normally charged to State employees for | ||||||
25 | elected optional coverages or for enrolled dependents | ||||||
26 | coverages or other contributory coverages on behalf of its |
| |||||||
| |||||||
1 | employees, adjusted for differences between State | ||||||
2 | employees and employees of the child advocacy center in | ||||||
3 | age, sex, geographic location, or other relevant | ||||||
4 | demographic variables, plus an amount sufficient to pay for | ||||||
5 | the additional administrative costs of providing coverage | ||||||
6 | to employees of the child advocacy center and their | ||||||
7 | dependents. | ||||||
8 | (2) In subsequent years, a further adjustment shall be | ||||||
9 | made to reflect the actual prior years' claims experience | ||||||
10 | of the employees of the child advocacy center. | ||||||
11 | Monthly payments by the child advocacy center or its | ||||||
12 | employees for group health insurance shall be deposited into | ||||||
13 | the Local Government Health Insurance Reserve Fund. | ||||||
14 | (Source: P.A. 100-587, eff. 6-4-18.)
|