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Public Act 094-0082
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| HB0731 Enrolled |
LRB094 06618 JAM 36710 b |
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AN ACT concerning government.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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Section 5. The State Employees Group Insurance Act of 1971 |
is amended by changing Section 3 as follows:
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(5 ILCS 375/3) (from Ch. 127, par. 523)
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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.
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(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.
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(b) "Annuitant" means (1) an employee who retires, or has |
retired,
on or after January 1, 1966 on an immediate annuity |
under the provisions
of Articles 2, 14 (including an employee |
who has elected to receive an alternative retirement |
cancellation payment under Section 14-108.5 of the Illinois |
Pension Code in lieu of an annuity), 15 (including an employee |
who has retired under the optional
retirement program |
established under Section 15-158.2),
paragraphs (2), (3), or |
(5) of Section 16-106, or
Article 18 of the Illinois Pension |
Code; (2) any person who was receiving
group insurance coverage |
under this Act as of March 31, 1978 by
reason of his status as |
an annuitant, even though the annuity in relation
to which such |
coverage was provided is a proportional annuity based on less
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than the minimum period of service required for a retirement |
annuity in
the system involved; (3) any person not otherwise |
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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
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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 |
or a qualified rehabilitation
facility or a qualified domestic |
violence shelter or service. (For definition
of "retired |
employee", see (p) post).
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(b-5) "New SERS annuitant" means a person who, on or after |
January 1,
1998, becomes an annuitant, as defined in subsection |
(b), by virtue of
beginning to receive a retirement annuity |
under Article 14 of the Illinois
Pension Code (including an |
employee who has elected to receive an alternative retirement |
cancellation payment under Section 14-108.5 of that Code in |
lieu of an annuity), and is eligible to participate in the |
basic program of group
health benefits provided for annuitants |
under this Act.
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(b-6) "New SURS annuitant" means a person who (1) on or |
after January 1,
1998, becomes an annuitant, as defined in |
subsection (b), by virtue of
beginning to receive a retirement |
annuity under Article 15 of the Illinois
Pension Code, (2) has |
not made the election authorized under Section 15-135.1
of the |
Illinois Pension Code, and (3) is eligible to participate in |
the basic
program of group
health benefits provided for |
annuitants under this Act.
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(b-7) "New TRS State annuitant" means a person who, on or |
after July
1, 1998, becomes an annuitant, as defined in |
subsection (b), by virtue of
beginning to receive a retirement |
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annuity under Article 16 of the Illinois
Pension Code based on |
service as a teacher as defined in
paragraph (2), (3), or (5) |
of Section 16-106 of that Code, and is eligible
to participate |
in the basic program of group health benefits provided for
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annuitants under this Act.
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(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.
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(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
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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 |
salary or wages paid to an employee of any
qualified local |
government or qualified rehabilitation facility or a
qualified |
domestic violence shelter or service.
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(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.
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(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.
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(g) "Department" means any department, institution, board,
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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 |
Illinois
Comprehensive Health Insurance Board, the Board of |
Examiners established under
the Illinois Public Accounting |
Act, and the Illinois Finance Authority.
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(h) "Dependent", when the term is used in the context of |
the health
and life plan, means a member's spouse and any |
unmarried child (1) from
birth to age 19 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 recognized child who lives with the
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member in a parent-child relationship, or a child who lives |
with the member
if such member is a court appointed guardian of |
the child, or (2)
age 19 to 23 enrolled as a full-time student |
in any accredited school,
financially dependent upon the |
member, and eligible to be claimed as a
dependent for income |
tax purposes, or (3) age 19 or over who is mentally
or |
physically handicapped. For
the health plan only, the term |
"dependent" also includes 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
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dependent for income tax deduction purposes; no other such
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person may be enrolled.
For the health plan only, the term |
"dependent" also includes any person who
has received after |
June 30, 2000 an organ transplant and who is financially
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dependent upon the member and eligible to be claimed as a |
dependent for income
tax purposes.
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(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.
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(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
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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 |
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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
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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 |
accordance with Section 36 of the State Finance Act.
"Employee" |
also includes each officer or employee in the service of a
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qualified local government, including persons appointed as |
trustees of
sanitary districts regardless of hours devoted to |
the service of the
sanitary district, and each employee in the |
service of a qualified
rehabilitation facility and each |
full-time employee in the service of a
qualified domestic |
violence shelter or service, as determined according to
rules |
promulgated by the Director.
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(l) "Member" means an employee, annuitant, retired |
employee or survivor.
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(m) "Optional coverages or benefits" means those coverages |
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or
benefits available to the member on his or her voluntary |
election, and at
his or her own expense.
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(n) "Program" means the group life insurance, health |
benefits and other
employee benefits designed and contracted |
for by the Director under this Act.
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(o) "Health plan" means a health benefits
program offered
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by the State of Illinois for persons eligible for the plan.
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(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
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Pension Code.
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(q) "Survivor" means a person receiving an annuity as a |
survivor of an
employee or of an annuitant. "Survivor" also |
includes: (1) the surviving
dependent of a person who satisfies |
the definition of "employee" except that
such person is made |
ineligible to participate in the State Universities
Retirement |
System by clause (4) of subsection (a)
of Section 15-107 of the |
Illinois Pension Code; (2) the surviving
dependent of any |
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.
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(q-2) "SERS" means the State Employees' Retirement System |
of Illinois, created under Article 14 of the Illinois Pension |
Code.
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(q-3) "SURS" means the State Universities Retirement |
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System, created under Article 15 of the Illinois Pension Code.
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(q-4) "TRS" means the Teachers' Retirement System of the |
State of Illinois, created under Article 16 of the Illinois |
Pension Code.
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(q-5) "New SERS survivor" means a survivor, as defined in |
subsection (q),
whose annuity is paid under Article 14 of the |
Illinois Pension Code and is
based on the death of (i) an |
employee whose death occurs on or after January 1,
1998, or |
(ii) a new SERS annuitant as defined in subsection (b-5). "New |
SERS survivor" includes the surviving dependent of a person who |
was an annuitant under this Act by virtue of receiving an |
alternative retirement cancellation payment under Section |
14-108.5 of the Illinois Pension Code.
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(q-6) "New SURS survivor" means a survivor, as defined in |
subsection (q),
whose annuity is paid under Article 15 of the |
Illinois Pension Code and is
based on the death of (i) an |
employee whose death occurs on or after January 1,
1998, or |
(ii) a new SURS annuitant as defined in subsection (b-6).
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(q-7) "New TRS State survivor" means a survivor, as defined |
in subsection
(q), whose annuity is paid under Article 16 of |
the Illinois Pension Code and is
based on the death of (i) an |
employee who is a teacher as defined in paragraph
(2), (3), or |
(5) of Section 16-106 of that Code and whose death occurs on or
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after July 1, 1998, or (ii) a new TRS State annuitant as |
defined in subsection
(b-7).
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(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.
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(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 |
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officials, that has duties that include provision of
research |
service, dissemination of information, and other acts for the
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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
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promote cooperation between and among municipalities that |
provide utility
services and for the advancement of the goals |
and purposes of its
membership;
the Southern Illinois |
Collegiate Common Market, which is a consortium of higher
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education institutions in Southern Illinois; and 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.
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(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
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and which receives funds from the State of Illinois for |
providing those
services, approved by the Director and |
participating in a program created
under subsection (j) of |
Section 10 of this Act.
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(u) "Qualified domestic violence shelter or service" means |
any Illinois
domestic violence shelter or service and its |
administrative offices funded
by the Department of Human |
Services (as successor to the Illinois Department of
Public |
Aid),
approved by the Director and
participating in a program |
created under subsection (k) of Section 10.
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(v) "TRS benefit recipient" means a person who:
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(1) is not a "member" as defined in this Section; and
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(2) is receiving a monthly benefit or retirement |
annuity
under Article 16 of the Illinois Pension Code; and
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(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.
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(w) "TRS dependent beneficiary" means a person who:
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(1) is not a "member" or "dependent" as defined in this |
Section; and
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(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) |
unmarried natural or adopted child who is (i) under age
19, |
or (ii) enrolled as a full-time student in
an accredited |
school, financially dependent upon the TRS benefit |
recipient,
eligible to be claimed as a dependent for income |
tax
purposes, and
either is under age 24 or was, on January |
1, 1996, participating as a dependent
beneficiary in the |
health insurance program offered under Article 16 of the
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Illinois Pension Code, or (iii) age 19 or over who is |
mentally or physically
handicapped.
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(x) "Military leave with pay and benefits" refers to |
individuals in basic
training for reserves, special/advanced |
training, annual training, emergency
call up, or activation by |
the President of the United States with approved pay
and |
benefits.
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(y) "Military leave without pay and benefits" refers to
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individuals who enlist for active duty in a regular component |
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of the U.S. Armed
Forces or other duty not specified or |
authorized under military leave with pay
and benefits.
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(z) "Community college benefit recipient" means a person |
who:
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(1) is not a "member" as defined in this Section; and
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(2) is receiving a monthly survivor's annuity or |
retirement annuity
under Article 15 of the Illinois Pension |
Code; and
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(3) either (i) was a full-time employee of a community |
college district or
an association of community college |
boards created under the Public Community
College Act |
(other than an employee whose last employer under Article |
15 of the
Illinois Pension Code was a community college |
district subject to Article VII
of the Public Community |
College Act) and was eligible to participate in a group
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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).
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(aa) "Community college dependent beneficiary" means a |
person who:
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(1) is not a "member" or "dependent" as defined in this |
Section; and
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(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) unmarried natural or adopted child who is |
(i)
under age 19, or (ii) enrolled as a full-time student |
in an accredited school,
financially dependent upon the |
community college benefit recipient, eligible
to be |
claimed as a dependent for income tax purposes and under |
age 23, or (iii)
age 19 or over and mentally or physically |
handicapped.
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(Source: P.A. 92-16, eff. 6-28-01; 92-186, eff. 1-1-02; 92-204, |