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| Public Act 094-0082 |
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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 | ||||
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 | ||
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 | ||
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 | ||
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 | ||
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 | ||
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 | ||
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, | ||
eff. 8-1-01; 92-651, eff. 7-11-02; 93-205, eff. 1-1-04; 93-839, | ||
eff. 7-30-04; 93-1067, eff. 1-15-05.)
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