97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012
SB3919

 

Introduced 5/10/2012, by Sen. Dale A. Righter

 

SYNOPSIS AS INTRODUCED:
 
5 ILCS 375/10  from Ch. 127, par. 530

    Amends the State Employees Group Insurance Act of 1971. Requires, beginning on the effective date of the amendatory Act, retired employees, annuitants, and survivors to pay premiums in order to obtain coverage for themselves and any dependents under the program of group health benefits. Requires the Director to determine the amount of the premium to be paid by each retired employee, annuitant, and survivor, based upon a system that takes into account (i) points, which are calculated by summing the retiree's age when benefits commenced and his or her total years of service, and (ii) annual State pension income. Specifies that, with respect to any annuitant, retired employee, or survivor covered by a collective bargaining agreement in effect on the effective date of the amendatory Act and until that collective bargaining agreement terminates, the obligation of each retired employee, annuitant, and survivor to pay the required premium applies only to the extent that the obligation is consistent with any contractual obligations existing in any collective bargaining agreement in effect on the effective date of the amendatory Act. Allows the Director, upon the expiration of any collective bargaining agreement in effect on the effective date of the amendatory Act, to alter the schedule of premium contributions to ensure that 49% of the costs associated with the basic program of group health benefits are covered by participating retired employees, annuitants, and survivors. Defines "State pension income". Effective July 1, 2012.


LRB097 21447 JDS 69476 b

FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

SB3919LRB097 21447 JDS 69476 b

1    AN ACT concerning government.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The State Employees Group Insurance Act of 1971
5is amended by changing Section 10 as follows:
 
6    (5 ILCS 375/10)  (from Ch. 127, par. 530)
7    Sec. 10. Payments by State; premiums.
8    (a) The State shall pay the cost of basic non-contributory
9group life insurance and, subject to member paid contributions
10set by the Department or required by this Section, the basic
11program of group health benefits on each eligible member,
12except a member, not otherwise covered by this Act, who has
13retired as a participating member under Article 2 of the
14Illinois Pension Code but is ineligible for the retirement
15annuity under Section 2-119 of the Illinois Pension Code, and
16part of each eligible member's and retired member's premiums
17for health insurance coverage for enrolled dependents as
18provided by Section 9. The State shall pay the cost of the
19basic program of group health benefits only after benefits are
20reduced by the amount of benefits covered by Medicare for all
21members and dependents who are eligible for benefits under
22Social Security or the Railroad Retirement system or who had
23sufficient Medicare-covered government employment, except that

 

 

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1such reduction in benefits shall apply only to those members
2and dependents who (1) first become eligible for such Medicare
3coverage on or after July 1, 1992; or (2) are Medicare-eligible
4members or dependents of a local government unit which began
5participation in the program on or after July 1, 1992; or (3)
6remain eligible for, but no longer receive Medicare coverage
7which they had been receiving on or after July 1, 1992. The
8Department may determine the aggregate level of the State's
9contribution on the basis of actual cost of medical services
10adjusted for age, sex or geographic or other demographic
11characteristics which affect the costs of such programs.
12    The cost of participation in the basic program of group
13health benefits for the dependent or survivor of a living or
14deceased retired employee who was formerly employed by the
15University of Illinois in the Cooperative Extension Service and
16would be an annuitant but for the fact that he or she was made
17ineligible to participate in the State Universities Retirement
18System by clause (4) of subsection (a) of Section 15-107 of the
19Illinois Pension Code shall not be greater than the cost of
20participation that would otherwise apply to that dependent or
21survivor if he or she were the dependent or survivor of an
22annuitant under the State Universities Retirement System.
23    (a-1) Beginning January 1, 1998, for each person who
24becomes a new SERS annuitant and participates in the basic
25program of group health benefits, the State shall contribute
26toward the cost of the annuitant's coverage under the basic

 

 

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1program of group health benefits an amount equal to 5% of that
2cost for each full year of creditable service upon which the
3annuitant's retirement annuity is based, up to a maximum of
4100% for an annuitant with 20 or more years of creditable
5service. The remainder of the cost of a new SERS annuitant's
6coverage under the basic program of group health benefits shall
7be the responsibility of the annuitant. In the case of a new
8SERS annuitant who has elected to receive an alternative
9retirement cancellation payment under Section 14-108.5 of the
10Illinois Pension Code in lieu of an annuity, for the purposes
11of this subsection the annuitant shall be deemed to be
12receiving a retirement annuity based on the number of years of
13creditable service that the annuitant had established at the
14time of his or her termination of service under SERS.
15    (a-2) Beginning January 1, 1998, for each person who
16becomes a new SERS survivor and participates in the basic
17program of group health benefits, the State shall contribute
18toward the cost of the survivor's coverage under the basic
19program of group health benefits an amount equal to 5% of that
20cost for each full year of the deceased employee's or deceased
21annuitant's creditable service in the State Employees'
22Retirement System of Illinois on the date of death, up to a
23maximum of 100% for a survivor of an employee or annuitant with
2420 or more years of creditable service. The remainder of the
25cost of the new SERS survivor's coverage under the basic
26program of group health benefits shall be the responsibility of

 

 

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1the survivor. In the case of a new SERS survivor who was the
2dependent of an annuitant who elected to receive an alternative
3retirement cancellation payment under Section 14-108.5 of the
4Illinois Pension Code in lieu of an annuity, for the purposes
5of this subsection the deceased annuitant's creditable service
6shall be determined as of the date of termination of service
7rather than the date of death.
8    (a-3) Beginning January 1, 1998, for each person who
9becomes a new SURS annuitant and participates in the basic
10program of group health benefits, the State shall contribute
11toward the cost of the annuitant's coverage under the basic
12program of group health benefits an amount equal to 5% of that
13cost for each full year of creditable service upon which the
14annuitant's retirement annuity is based, up to a maximum of
15100% for an annuitant with 20 or more years of creditable
16service. The remainder of the cost of a new SURS annuitant's
17coverage under the basic program of group health benefits shall
18be the responsibility of the annuitant.
19    (a-4) (Blank).
20    (a-5) Beginning January 1, 1998, for each person who
21becomes a new SURS survivor and participates in the basic
22program of group health benefits, the State shall contribute
23toward the cost of the survivor's coverage under the basic
24program of group health benefits an amount equal to 5% of that
25cost for each full year of the deceased employee's or deceased
26annuitant's creditable service in the State Universities

 

 

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1Retirement System on the date of death, up to a maximum of 100%
2for a survivor of an employee or annuitant with 20 or more
3years of creditable service. The remainder of the cost of the
4new SURS survivor's coverage under the basic program of group
5health benefits shall be the responsibility of the survivor.
6    (a-6) Beginning July 1, 1998, for each person who becomes a
7new TRS State annuitant and participates in the basic program
8of group health benefits, the State shall contribute toward the
9cost of the annuitant's coverage under the basic program of
10group health benefits an amount equal to 5% of that cost for
11each full year of creditable service as a teacher as defined in
12paragraph (2), (3), or (5) of Section 16-106 of the Illinois
13Pension Code upon which the annuitant's retirement annuity is
14based, up to a maximum of 100%; except that the State
15contribution shall be 12.5% per year (rather than 5%) for each
16full year of creditable service as a regional superintendent or
17assistant regional superintendent of schools. The remainder of
18the cost of a new TRS State annuitant's coverage under the
19basic program of group health benefits shall be the
20responsibility of the annuitant.
21    (a-7) Beginning July 1, 1998, for each person who becomes a
22new TRS State survivor and participates in the basic program of
23group health benefits, the State shall contribute toward the
24cost of the survivor's coverage under the basic program of
25group health benefits an amount equal to 5% of that cost for
26each full year of the deceased employee's or deceased

 

 

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1annuitant's creditable service as a teacher as defined in
2paragraph (2), (3), or (5) of Section 16-106 of the Illinois
3Pension Code on the date of death, up to a maximum of 100%;
4except that the State contribution shall be 12.5% per year
5(rather than 5%) for each full year of the deceased employee's
6or deceased annuitant's creditable service as a regional
7superintendent or assistant regional superintendent of
8schools. The remainder of the cost of the new TRS State
9survivor's coverage under the basic program of group health
10benefits shall be the responsibility of the survivor.
11    (a-8) A new SERS annuitant, new SERS survivor, new SURS
12annuitant, new SURS survivor, new TRS State annuitant, or new
13TRS State survivor may waive or terminate coverage in the
14program of group health benefits. Any such annuitant or
15survivor who has waived or terminated coverage may enroll or
16re-enroll in the program of group health benefits only during
17the annual benefit choice period, as determined by the
18Director; except that in the event of termination of coverage
19due to nonpayment of premiums, the annuitant or survivor may
20not re-enroll in the program.
21    (a-9) No later than May 1 of each calendar year, the
22Director of Central Management Services shall certify in
23writing to the Executive Secretary of the State Employees'
24Retirement System of Illinois the amounts of the Medicare
25supplement health care premiums and the amounts of the health
26care premiums for all other retirees who are not Medicare

 

 

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1eligible.
2    A separate calculation of the premiums based upon the
3actual cost of each health care plan shall be so certified.
4    The Director of Central Management Services shall provide
5to the Executive Secretary of the State Employees' Retirement
6System of Illinois such information, statistics, and other data
7as he or she may require to review the premium amounts
8certified by the Director of Central Management Services.
9    The Department of Healthcare and Family Services, or any
10successor agency designated to procure healthcare contracts
11pursuant to this Act, is authorized to establish funds,
12separate accounts provided by any bank or banks as defined by
13the Illinois Banking Act, or separate accounts provided by any
14savings and loan association or associations as defined by the
15Illinois Savings and Loan Act of 1985 to be held by the
16Director, outside the State treasury, for the purpose of
17receiving the transfer of moneys from the Local Government
18Health Insurance Reserve Fund. The Department may promulgate
19rules further defining the methodology for the transfers. Any
20interest earned by moneys in the funds or accounts shall inure
21to the Local Government Health Insurance Reserve Fund. The
22transferred moneys, and interest accrued thereon, shall be used
23exclusively for transfers to administrative service
24organizations or their financial institutions for payments of
25claims to claimants and providers under the self-insurance
26health plan. The transferred moneys, and interest accrued

 

 

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1thereon, shall not be used for any other purpose including, but
2not limited to, reimbursement of administration fees due the
3administrative service organization pursuant to its contract
4or contracts with the Department.
5    (a-10) Notwithstanding any provision of this Act to the
6contrary, beginning July 1, 2012, annuitants, retired
7employees, and survivors must pay premiums in order to obtain
8coverage for themselves and any dependents under the program of
9group health benefits provided under this Act. The Director
10shall determine the amount of the premium to be paid by each
11annuitant, retired employee, and survivor, based upon a system
12that takes into account (i) points, which are calculated by
13summing the retiree's age when benefits commenced and his or
14her total years of service, and (ii) annual State pension
15income, according to the following schedule:
16        (1) For a retired employee, annuitant, or survivor with
17    78 or fewer points and:
18            (A) An annual State pension income of less than
19        $15,000, 50% of the applicable premium.
20            (B) An annual State pension income of at least
21        $15,000 but less than $30,000, 60% of the applicable
22        premium.
23            (C) An annual State pension income of at least
24        $30,000 but less than $50,000, 70% of the applicable
25        premium.
26            (D) An annual State pension income of at least

 

 

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1        $50,000 but less than $100,000, 80% of the applicable
2        premium.
3            (E) An annual State pension income of at least
4        $100,000 but less than $125,000, 90% of the applicable
5        premium.
6            (F) An annual State pension income of $125,000 or
7        more, 100% of the applicable premium.
8        (2) For a retired employee, annuitant, or survivor with
9    79 to 85 points and:
10            (A) An annual State pension income of less than
11        $15,000, 35% of the applicable premium.
12            (B) An annual State pension income of at least
13        $15,000 but less than $30,000, 45% of the applicable
14        premium.
15            (C) An annual State pension income of at least
16        $30,000 but less than $50,000, 55% of the applicable
17        premium.
18            (D) An annual State pension income of at least
19        $50,000 but less than $100,000, 65% of the applicable
20        premium.
21            (E) An annual State pension income of at least
22        $100,000 but less than $125,000, 75% of the applicable
23        premium.
24            (F) An annual State pension income of $125,000 or
25        more, 100% of the applicable premium.
26        (3) For a retired employee, annuitant, or survivor with

 

 

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1    86 to 92 points and:
2            (A) An annual State pension income of less than
3        $15,000, 20% of the applicable premium.
4            (B) An annual State pension income of at least
5        $15,000 but less than $30,000, 30% of the applicable
6        premium.
7            (C) An annual State pension income of at least
8        $30,000 but less than $50,000, 40% of the applicable
9        premium.
10            (D) An annual State pension income of at least
11        $50,000 but less than $100,000, 50% of the applicable
12        premium.
13            (E) An annual State pension income of at least
14        $100,000 but less than $125,000, 60% of the applicable
15        premium.
16            (F) An annual State pension income of $125,000 or
17        more, 100% of the applicable premium.
18        (4) For a retired employee, annuitant, or survivor with
19    93 or more points and:
20            (A) An annual State pension income of less than
21        $15,000, 5% of the applicable premium.
22            (B) An annual State pension income of at least
23        $15,000 but less than $30,000, 15% of the applicable
24        premium.
25            (C) An annual State pension income of at least
26        $30,000 but less than $50,000, 25% of the applicable

 

 

SB3919- 11 -LRB097 21447 JDS 69476 b

1        premium.
2            (D) An annual State pension income of at least
3        $50,000 but less than $100,000, 35% of the applicable
4        premium.
5            (E) An annual State pension income of at least
6        $100,000 but less than $125,000, 45% of the applicable
7        premium.
8            (F) An annual State pension income of $125,000 or
9        more, 85% of the applicable premium.
10    The schedule of premium contributions for annuitants,
11retired employees, and survivors that is set forth in this
12subsection (a-10) shall also be used for the purpose of
13calculating the portion of premiums that is to be paid by those
14persons for dependent coverage.
15    The Director shall establish by rule a process for retired
16employees, annuitants, and survivors to appeal determinations
17of annual State pension income.
18    With respect to any annuitant, retired employee, or
19survivor covered by a collective bargaining agreement in effect
20on the effective date of this amendatory Act of the 97th
21General Assembly and until that collective bargaining
22agreement terminates, the obligation of each retired employee,
23annuitant, or survivor to pay the required premium applies only
24to the extent that the obligation is consistent with any
25contractual obligations existing in any collective bargaining
26agreement.

 

 

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1    Upon the expiration of any collective bargaining agreement
2in effect on the effective date of this amendatory Act of the
397th General Assembly, the Director may alter the schedule
4above to ensure that 49% of the costs associated with the basic
5program of group health benefits are covered by retired
6employees, annuitants, and survivors.
7    For the purposes of this subsection (a-10), "State pension
8income" means income paid or payable to an individual from a
9retirement system created under Article 2, 14, 15, 16, or 18 of
10the Illinois Pension Code.
11    (b) State employees who become eligible for this program on
12or after January 1, 1980 in positions normally requiring actual
13performance of duty not less than 1/2 of a normal work period
14but not equal to that of a normal work period, shall be given
15the option of participating in the available program. If the
16employee elects coverage, the State shall contribute on behalf
17of such employee to the cost of the employee's benefit and any
18applicable dependent supplement, that sum which bears the same
19percentage as that percentage of time the employee regularly
20works when compared to normal work period.
21    (c) The basic non-contributory coverage from the basic
22program of group health benefits shall be continued for each
23employee not in pay status or on active service by reason of
24(1) leave of absence due to illness or injury, (2) authorized
25educational leave of absence or sabbatical leave, or (3)
26military leave. This coverage shall continue until expiration

 

 

SB3919- 13 -LRB097 21447 JDS 69476 b

1of authorized leave and return to active service, but not to
2exceed 24 months for leaves under item (1) or (2). This
324-month limitation and the requirement of returning to active
4service shall not apply to persons receiving ordinary or
5accidental disability benefits or retirement benefits through
6the appropriate State retirement system or benefits under the
7Workers' Compensation or Occupational Disease Act.
8    (d) The basic group life insurance coverage shall continue,
9with full State contribution, where such person is (1) absent
10from active service by reason of disability arising from any
11cause other than self-inflicted, (2) on authorized educational
12leave of absence or sabbatical leave, or (3) on military leave.
13    (e) Where the person is in non-pay status for a period in
14excess of 30 days or on leave of absence, other than by reason
15of disability, educational or sabbatical leave, or military
16leave, such person may continue coverage only by making
17personal payment equal to the amount normally contributed by
18the State on such person's behalf. Such payments and coverage
19may be continued: (1) until such time as the person returns to
20a status eligible for coverage at State expense, but not to
21exceed 24 months or (2) until such person's employment or
22annuitant status with the State is terminated (exclusive of any
23additional service imposed pursuant to law).
24    (f) The Department shall establish by rule the extent to
25which other employee benefits will continue for persons in
26non-pay status or who are not in active service.

 

 

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1    (g) The State shall not pay the cost of the basic
2non-contributory group life insurance, program of health
3benefits and other employee benefits for members who are
4survivors as defined by paragraphs (1) and (2) of subsection
5(q) of Section 3 of this Act. The costs of benefits for these
6survivors shall be paid by the survivors or by the University
7of Illinois Cooperative Extension Service, or any combination
8thereof. However, the State shall pay the amount of the
9reduction in the cost of participation, if any, resulting from
10the amendment to subsection (a) made by this amendatory Act of
11the 91st General Assembly.
12    (h) Those persons occupying positions with any department
13as a result of emergency appointments pursuant to Section 8b.8
14of the Personnel Code who are not considered employees under
15this Act shall be given the option of participating in the
16programs of group life insurance, health benefits and other
17employee benefits. Such persons electing coverage may
18participate only by making payment equal to the amount normally
19contributed by the State for similarly situated employees. Such
20amounts shall be determined by the Director. Such payments and
21coverage may be continued until such time as the person becomes
22an employee pursuant to this Act or such person's appointment
23is terminated.
24    (i) Any unit of local government within the State of
25Illinois may apply to the Director to have its employees,
26annuitants, and their dependents provided group health

 

 

SB3919- 15 -LRB097 21447 JDS 69476 b

1coverage under this Act on a non-insured basis. To participate,
2a unit of local government must agree to enroll all of its
3employees, who may select coverage under either the State group
4health benefits plan or a health maintenance organization that
5has contracted with the State to be available as a health care
6provider for employees as defined in this Act. A unit of local
7government must remit the entire cost of providing coverage
8under the State group health benefits plan or, for coverage
9under a health maintenance organization, an amount determined
10by the Director based on an analysis of the sex, age,
11geographic location, or other relevant demographic variables
12for its employees, except that the unit of local government
13shall not be required to enroll those of its employees who are
14covered spouses or dependents under this plan or another group
15policy or plan providing health benefits as long as (1) an
16appropriate official from the unit of local government attests
17that each employee not enrolled is a covered spouse or
18dependent under this plan or another group policy or plan, and
19(2) at least 50% of the employees are enrolled and the unit of
20local government remits the entire cost of providing coverage
21to those employees, except that a participating school district
22must have enrolled at least 50% of its full-time employees who
23have not waived coverage under the district's group health plan
24by participating in a component of the district's cafeteria
25plan. A participating school district is not required to enroll
26a full-time employee who has waived coverage under the

 

 

SB3919- 16 -LRB097 21447 JDS 69476 b

1district's health plan, provided that an appropriate official
2from the participating school district attests that the
3full-time employee has waived coverage by participating in a
4component of the district's cafeteria plan. For the purposes of
5this subsection, "participating school district" includes a
6unit of local government whose primary purpose is education as
7defined by the Department's rules.
8    Employees of a participating unit of local government who
9are not enrolled due to coverage under another group health
10policy or plan may enroll in the event of a qualifying change
11in status, special enrollment, special circumstance as defined
12by the Director, or during the annual Benefit Choice Period. A
13participating unit of local government may also elect to cover
14its annuitants. Dependent coverage shall be offered on an
15optional basis, with the costs paid by the unit of local
16government, its employees, or some combination of the two as
17determined by the unit of local government. The unit of local
18government shall be responsible for timely collection and
19transmission of dependent premiums.
20    The Director shall annually determine monthly rates of
21payment, subject to the following constraints:
22        (1) In the first year of coverage, the rates shall be
23    equal to the amount normally charged to State employees for
24    elected optional coverages or for enrolled dependents
25    coverages or other contributory coverages, or contributed
26    by the State for basic insurance coverages on behalf of its

 

 

SB3919- 17 -LRB097 21447 JDS 69476 b

1    employees, adjusted for differences between State
2    employees and employees of the local government in age,
3    sex, geographic location or other relevant demographic
4    variables, plus an amount sufficient to pay for the
5    additional administrative costs of providing coverage to
6    employees of the unit of local government 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 unit of local government.
11    In the case of coverage of local government employees under
12a health maintenance organization, the Director shall annually
13determine for each participating unit of local government the
14maximum monthly amount the unit may contribute toward that
15coverage, based on an analysis of (i) the age, sex, geographic
16location, and other relevant demographic variables of the
17unit's employees and (ii) the cost to cover those employees
18under the State group health benefits plan. The Director may
19similarly determine the maximum monthly amount each unit of
20local government may contribute toward coverage of its
21employees' dependents under a health maintenance organization.
22    Monthly payments by the unit of local government or its
23employees for group health benefits plan or health maintenance
24organization coverage shall be deposited in the Local
25Government Health Insurance Reserve Fund.
26    The Local Government Health Insurance Reserve Fund is

 

 

SB3919- 18 -LRB097 21447 JDS 69476 b

1hereby created as a nonappropriated trust fund to be held
2outside the State Treasury, with the State Treasurer as
3custodian. The Local Government Health Insurance Reserve Fund
4shall be a continuing fund not subject to fiscal year
5limitations. The Local Government Health Insurance Reserve
6Fund is not subject to administrative charges or charge-backs,
7including but not limited to those authorized under Section 8h
8of the State Finance Act. All revenues arising from the
9administration of the health benefits program established
10under this Section shall be deposited into the Local Government
11Health Insurance Reserve Fund. Any interest earned on moneys in
12the Local Government Health Insurance Reserve Fund shall be
13deposited into the Fund. All expenditures from this Fund shall
14be used for payments for health care benefits for local
15government and rehabilitation facility employees, annuitants,
16and dependents, and to reimburse the Department or its
17administrative service organization for all expenses incurred
18in the administration of benefits. No other State funds may be
19used for these purposes.
20    A local government employer's participation or desire to
21participate in a program created under this subsection shall
22not limit that employer's duty to bargain with the
23representative of any collective bargaining unit of its
24employees.
25    (j) Any rehabilitation facility within the State of
26Illinois may apply to the Director to have its employees,

 

 

SB3919- 19 -LRB097 21447 JDS 69476 b

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

 

 

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1payment, subject to the following constraints:
2        (1) In the first year of coverage, the rates shall be
3    equal to the amount normally charged to State employees for
4    elected optional coverages or for enrolled dependents
5    coverages or other contributory coverages on behalf of its
6    employees, adjusted for differences between State
7    employees and employees of the rehabilitation facility in
8    age, sex, geographic location or other relevant
9    demographic variables, plus an amount sufficient to pay for
10    the additional administrative costs of providing coverage
11    to employees of the rehabilitation facility and their
12    dependents.
13        (2) In subsequent years, a further adjustment shall be
14    made to reflect the actual prior years' claims experience
15    of the employees of the rehabilitation facility.
16    Monthly payments by the rehabilitation facility or its
17employees for group health benefits shall be deposited in the
18Local Government Health Insurance Reserve Fund.
19    (k) Any domestic violence shelter or service within the
20State of Illinois may apply to the Director to have its
21employees, annuitants, and their dependents provided group
22health coverage under this Act on a non-insured basis. To
23participate, a domestic violence shelter or service must agree
24to enroll all of its employees and pay the entire cost of
25providing such coverage for its employees. The domestic
26violence shelter shall not be required to enroll those of its

 

 

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1employees who are covered spouses or dependents under this plan
2or another group policy or plan providing health benefits as
3long as (1) an appropriate official from the domestic violence
4shelter attests that each employee not enrolled is a covered
5spouse or dependent under this plan or another group policy or
6plan and (2) at least 50% of the employees are enrolled and the
7domestic violence shelter remits the entire cost of providing
8coverage to those employees. Employees of a participating
9domestic violence shelter who are not enrolled due to coverage
10under another group health policy or plan may enroll in the
11event of a qualifying change in status, special enrollment, or
12special circumstance as defined by the Director or during the
13annual Benefit Choice Period. A participating domestic
14violence shelter may also elect to cover its annuitants.
15Dependent coverage shall be offered on an optional basis, with
16employees, or some combination of the 2 as determined by the
17domestic violence shelter or service. The domestic violence
18shelter or service shall be responsible for timely collection
19and transmission of dependent premiums.
20    The Director shall annually determine rates of payment,
21subject to the following constraints:
22        (1) In the first year of coverage, the rates shall be
23    equal to the amount normally charged to State employees for
24    elected optional coverages or for enrolled dependents
25    coverages or other contributory coverages on behalf of its
26    employees, adjusted for differences between State

 

 

SB3919- 22 -LRB097 21447 JDS 69476 b

1    employees and employees of the domestic violence shelter or
2    service in age, sex, geographic location or other relevant
3    demographic variables, plus an amount sufficient to pay for
4    the additional administrative costs of providing coverage
5    to employees of the domestic violence shelter or service
6    and their dependents.
7        (2) In subsequent years, a further adjustment shall be
8    made to reflect the actual prior years' claims experience
9    of the employees of the domestic violence shelter or
10    service.
11    Monthly payments by the domestic violence shelter or
12service or its employees for group health insurance shall be
13deposited in the Local Government Health Insurance Reserve
14Fund.
15    (l) A public community college or entity organized pursuant
16to the Public Community College Act may apply to the Director
17initially to have only annuitants not covered prior to July 1,
181992 by the district's health plan provided health coverage
19under this Act on a non-insured basis. The community college
20must execute a 2-year contract to participate in the Local
21Government Health Plan. Any annuitant may enroll in the event
22of a qualifying change in status, special enrollment, special
23circumstance as defined by the Director, or during the annual
24Benefit Choice Period.
25    The Director shall annually determine monthly rates of
26payment subject to the following constraints: for those

 

 

SB3919- 23 -LRB097 21447 JDS 69476 b

1community colleges with annuitants only enrolled, first year
2rates shall be equal to the average cost to cover claims for a
3State member adjusted for demographics, Medicare
4participation, and other factors; and in the second year, a
5further adjustment of rates shall be made to reflect the actual
6first year's claims experience of the covered annuitants.
7    (l-5) The provisions of subsection (l) become inoperative
8on July 1, 1999.
9    (m) The Director shall adopt any rules deemed necessary for
10implementation of this amendatory Act of 1989 (Public Act
1186-978).
12    (n) Any child advocacy center within the State of Illinois
13may apply to the Director to have its employees, annuitants,
14and their dependents provided group health coverage under this
15Act on a non-insured basis. To participate, a child advocacy
16center must agree to enroll all of its employees and pay the
17entire cost of providing coverage for its employees. The child
18advocacy center shall not be required to enroll those of its
19employees who are covered spouses or dependents under this plan
20or another group policy or plan providing health benefits as
21long as (1) an appropriate official from the child advocacy
22center attests that each employee not enrolled is a covered
23spouse or dependent under this plan or another group policy or
24plan and (2) at least 50% of the employees are enrolled and the
25child advocacy center remits the entire cost of providing
26coverage to those employees. Employees of a participating child

 

 

SB3919- 24 -LRB097 21447 JDS 69476 b

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

 

 

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1    of the employees of the child advocacy center.
2    Monthly payments by the child advocacy center or its
3employees for group health insurance shall be deposited into
4the Local Government Health Insurance Reserve Fund.
5(Source: P.A. 95-331, eff. 8-21-07; 95-632, eff. 9-25-07;
695-707, eff. 1-11-08; 96-756, eff. 1-1-10; 96-1232, eff.
77-23-10; 96-1519, eff. 2-4-11.)
 
8    Section 99. Effective date. This Act takes effect July 1,
92012.