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1 | AN ACT concerning government.
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2 | Be it enacted by the People of the State of Illinois,
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3 | represented in the General Assembly:
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4 | Section 5. The State Employees Group Insurance Act of 1971 | ||||||||||||||||||||||||
5 | is amended by changing Section 10 as follows:
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6 | (5 ILCS 375/10) (from Ch. 127, par. 530)
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7 | Sec. 10. Payments by State; premiums.
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8 | (a) The State shall pay the cost of basic non-contributory | ||||||||||||||||||||||||
9 | group life
insurance and, subject to member paid contributions | ||||||||||||||||||||||||
10 | set by the Department or
required by this Section, the basic | ||||||||||||||||||||||||
11 | program of group health benefits on each
eligible member, | ||||||||||||||||||||||||
12 | except a member, not otherwise
covered by this Act, who has | ||||||||||||||||||||||||
13 | retired as a participating member under Article 2
of the | ||||||||||||||||||||||||
14 | Illinois Pension Code but is ineligible for the retirement | ||||||||||||||||||||||||
15 | annuity under
Section 2-119 of the Illinois Pension Code, and | ||||||||||||||||||||||||
16 | part of each eligible member's
and retired member's premiums | ||||||||||||||||||||||||
17 | for health insurance coverage for enrolled
dependents as | ||||||||||||||||||||||||
18 | provided by Section 9. The State shall pay the cost of the | ||||||||||||||||||||||||
19 | basic
program of group health benefits only after benefits are | ||||||||||||||||||||||||
20 | reduced by the amount
of benefits covered by Medicare for all | ||||||||||||||||||||||||
21 | members and dependents
who are eligible for benefits under | ||||||||||||||||||||||||
22 | Social Security or
the Railroad Retirement system or who had | ||||||||||||||||||||||||
23 | sufficient Medicare-covered
government employment, except that |
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1 | such reduction in benefits shall apply only
to those members | ||||||
2 | and dependents who (1) first become eligible
for such Medicare | ||||||
3 | coverage on or after July 1, 1992; or (2) are
Medicare-eligible | ||||||
4 | members or dependents of a local government unit which began
| ||||||
5 | participation in the program on or after July 1, 1992; or (3) | ||||||
6 | remain eligible
for, but no longer receive Medicare coverage | ||||||
7 | which they had been receiving on
or after July 1, 1992. The | ||||||
8 | Department may determine the aggregate level of the
State's | ||||||
9 | contribution on the basis of actual cost of medical services | ||||||
10 | adjusted
for age, sex or geographic or other demographic | ||||||
11 | characteristics which affect
the costs of such programs.
| ||||||
12 | The cost of participation in the basic program of group | ||||||
13 | health benefits
for the dependent or survivor of a living or | ||||||
14 | deceased retired employee who was
formerly employed by the | ||||||
15 | University of Illinois in the Cooperative Extension
Service and | ||||||
16 | would be an annuitant but for the fact that he or she was made
| ||||||
17 | ineligible to participate in the State Universities Retirement | ||||||
18 | System by clause
(4) of subsection (a) of Section 15-107 of the | ||||||
19 | Illinois Pension Code shall not
be greater than the cost of | ||||||
20 | participation that would otherwise apply to that
dependent or | ||||||
21 | survivor if he or she were the dependent or survivor of an
| ||||||
22 | annuitant under the State Universities Retirement System.
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23 | (a-1) Beginning January 1, 1998, for each person who | ||||||
24 | becomes a new SERS
annuitant and participates in the basic | ||||||
25 | program of group health benefits, the
State shall contribute | ||||||
26 | toward the cost of the annuitant's
coverage under the basic |
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| |||||||
1 | program of group health benefits an amount equal
to 5% of that | ||||||
2 | cost for each full year of creditable service upon which the
| ||||||
3 | annuitant's retirement annuity is based, up to a maximum of | ||||||
4 | 100% for an
annuitant with 20 or more years of creditable | ||||||
5 | service.
The remainder of the cost of a new SERS annuitant's | ||||||
6 | coverage under the basic
program of group health benefits shall | ||||||
7 | be the responsibility of the
annuitant. In the case of a new | ||||||
8 | SERS annuitant who has elected to receive an alternative | ||||||
9 | retirement cancellation payment under Section 14-108.5 of the | ||||||
10 | Illinois Pension Code in lieu of an annuity, for the purposes | ||||||
11 | of this subsection the annuitant shall be deemed to be | ||||||
12 | receiving a retirement annuity based on the number of years of | ||||||
13 | creditable service that the annuitant had established at the | ||||||
14 | time of his or her termination of service under SERS.
| ||||||
15 | (a-2) Beginning January 1, 1998, for each person who | ||||||
16 | becomes a new SERS
survivor and participates in the basic | ||||||
17 | program of group health benefits, the
State shall contribute | ||||||
18 | toward the cost of the survivor's
coverage under the basic | ||||||
19 | program of group health benefits an amount equal
to 5% of that | ||||||
20 | cost for each full year of the deceased employee's or deceased
| ||||||
21 | annuitant's creditable service in the State Employees' | ||||||
22 | Retirement System of
Illinois on the date of death, up to a | ||||||
23 | maximum of 100% for a survivor of an
employee or annuitant with | ||||||
24 | 20 or more years of creditable service. The
remainder of the | ||||||
25 | cost of the new SERS survivor's coverage under the basic
| ||||||
26 | program of group health benefits shall be the responsibility of |
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| |||||||
1 | the survivor. In the case of a new SERS survivor who was the | ||||||
2 | dependent of an annuitant who elected to receive an alternative | ||||||
3 | retirement cancellation payment under Section 14-108.5 of the | ||||||
4 | Illinois Pension Code in lieu of an annuity, for the purposes | ||||||
5 | of this subsection the deceased annuitant's creditable service | ||||||
6 | shall be determined as of the date of termination of service | ||||||
7 | rather than the date of death.
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8 | (a-3) Beginning January 1, 1998, for each person who | ||||||
9 | becomes a new SURS
annuitant and participates in the basic | ||||||
10 | program of group health benefits, the
State shall contribute | ||||||
11 | toward the cost of the annuitant's
coverage under the basic | ||||||
12 | program of group health benefits an amount equal
to 5% of that | ||||||
13 | cost for each full year of creditable service upon which the
| ||||||
14 | annuitant's retirement annuity is based, up to a maximum of | ||||||
15 | 100% for an
annuitant with 20 or more years of creditable | ||||||
16 | service.
The remainder of the cost of a new SURS annuitant's | ||||||
17 | coverage under the basic
program of group health benefits shall | ||||||
18 | be the responsibility of the
annuitant.
| ||||||
19 | (a-4) (Blank).
| ||||||
20 | (a-5) Beginning January 1, 1998, for each person who | ||||||
21 | becomes a new SURS
survivor and participates in the basic | ||||||
22 | program of group health benefits, the
State shall contribute | ||||||
23 | toward the cost of the survivor's coverage under the
basic | ||||||
24 | program of group health benefits an amount equal to 5% of that | ||||||
25 | cost for
each full year of the deceased employee's or deceased | ||||||
26 | annuitant's creditable
service in the State Universities |
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| |||||||
1 | Retirement System on the date of death, up to
a maximum of 100% | ||||||
2 | for a survivor of an
employee or annuitant with 20 or more | ||||||
3 | years of creditable service. The
remainder of the cost of the | ||||||
4 | new SURS survivor's coverage under the basic
program of group | ||||||
5 | health benefits shall be the responsibility of the survivor.
| ||||||
6 | (a-6) Beginning July 1, 1998, for each person who becomes a | ||||||
7 | new TRS
State annuitant and participates in the basic program | ||||||
8 | of group health benefits,
the State shall contribute toward the | ||||||
9 | cost of the annuitant's coverage under
the basic program of | ||||||
10 | group health benefits an amount equal to 5% of that cost
for | ||||||
11 | each full year of creditable service
as a teacher as defined in | ||||||
12 | paragraph (2), (3), or (5) of Section 16-106 of the
Illinois | ||||||
13 | Pension Code
upon which the annuitant's retirement annuity is | ||||||
14 | based, up to a maximum of
100%;
except that
the State | ||||||
15 | contribution shall be 12.5% per year (rather than 5%) for each | ||||||
16 | full
year of creditable service as a regional superintendent or | ||||||
17 | assistant regional
superintendent of schools. The
remainder of | ||||||
18 | the cost of a new TRS State annuitant's coverage under the | ||||||
19 | basic
program of group health benefits shall be the | ||||||
20 | responsibility of the
annuitant.
| ||||||
21 | (a-7) Beginning July 1, 1998, for each person who becomes a | ||||||
22 | new TRS
State survivor and participates in the basic program of | ||||||
23 | group health benefits,
the State shall contribute toward the | ||||||
24 | cost of the survivor's coverage under the
basic program of | ||||||
25 | group health benefits an amount equal to 5% of that cost for
| ||||||
26 | each full year of the deceased employee's or deceased |
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| |||||||
1 | annuitant's creditable
service
as a teacher as defined in | ||||||
2 | paragraph (2), (3), or (5) of Section 16-106 of the
Illinois | ||||||
3 | Pension Code
on the date of death, up to a maximum of 100%;
| ||||||
4 | except that the State contribution shall be 12.5% per year | ||||||
5 | (rather than 5%) for
each full year of the deceased employee's | ||||||
6 | or deceased annuitant's creditable
service as a regional | ||||||
7 | superintendent or assistant regional superintendent of
| ||||||
8 | schools.
The remainder of
the cost of the new TRS State | ||||||
9 | survivor's coverage under the basic program of
group health | ||||||
10 | benefits shall be the responsibility of the survivor.
| ||||||
11 | (a-8) A new SERS annuitant, new SERS survivor, new SURS
| ||||||
12 | annuitant, new SURS survivor, new TRS State
annuitant, or new | ||||||
13 | TRS State survivor may waive or terminate coverage in
the | ||||||
14 | program of group health benefits. Any such annuitant or | ||||||
15 | survivor
who has waived or terminated coverage may enroll or | ||||||
16 | re-enroll in the
program of group health benefits only during | ||||||
17 | the annual benefit choice period,
as determined by the | ||||||
18 | Director; except that in the event of termination of
coverage | ||||||
19 | due to nonpayment of premiums, the annuitant or survivor
may | ||||||
20 | not re-enroll in the program.
| ||||||
21 | (a-9) No later than May 1 of each calendar year, the | ||||||
22 | Director
of Central Management Services shall certify in | ||||||
23 | writing to the Executive
Secretary of the State Employees' | ||||||
24 | Retirement System of Illinois the amounts
of the Medicare | ||||||
25 | supplement health care premiums and the amounts of the
health | ||||||
26 | care premiums for all other retirees who are not Medicare |
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1 | eligible.
| ||||||
2 | A separate calculation of the premiums based upon the | ||||||
3 | actual cost of each
health care plan shall be so certified.
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4 | The Director of Central Management Services shall provide | ||||||
5 | to the
Executive Secretary of the State Employees' Retirement | ||||||
6 | System of
Illinois such information, statistics, and other data | ||||||
7 | as he or she
may require to review the premium amounts | ||||||
8 | certified by the Director
of Central Management Services.
| ||||||
9 | The Department of Healthcare and Family Services, or any | ||||||
10 | successor agency designated to procure healthcare contracts | ||||||
11 | pursuant to this Act, is authorized to establish funds, | ||||||
12 | separate accounts provided by any bank or banks as defined by | ||||||
13 | the Illinois Banking Act, or separate accounts provided by any | ||||||
14 | savings and loan association or associations as defined by the | ||||||
15 | Illinois Savings and Loan Act of 1985 to be held by the | ||||||
16 | Director, outside the State treasury, for the purpose of | ||||||
17 | receiving the transfer of moneys from the Local Government | ||||||
18 | Health Insurance Reserve Fund. The Department may promulgate | ||||||
19 | rules further defining the methodology for the transfers. Any | ||||||
20 | interest earned by moneys in the funds or accounts shall inure | ||||||
21 | to the Local Government Health Insurance Reserve Fund. The | ||||||
22 | transferred moneys, and interest accrued thereon, shall be used | ||||||
23 | exclusively for transfers to administrative service | ||||||
24 | organizations or their financial institutions for payments of | ||||||
25 | claims to claimants and providers under the self-insurance | ||||||
26 | health plan. The transferred moneys, and interest accrued |
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1 | thereon, shall not be used for any other purpose including, but | ||||||
2 | not limited to, reimbursement of administration fees due the | ||||||
3 | administrative service organization pursuant to its contract | ||||||
4 | or contracts with the Department.
| ||||||
5 | (a-10) Notwithstanding any provision of this Act to the | ||||||
6 | contrary, beginning July 1, 2012, annuitants, retired | ||||||
7 | employees, and survivors must pay premiums in order to obtain | ||||||
8 | coverage for themselves and any dependents under the program of | ||||||
9 | group health benefits provided under this Act. The Director | ||||||
10 | shall determine the amount of the premium to be paid by each | ||||||
11 | annuitant, retired employee, and survivor, based upon a system | ||||||
12 | that takes into account (i) points, which are calculated by | ||||||
13 | summing the retiree's age when benefits commenced and his or | ||||||
14 | her total years of service, and (ii) annual State pension | ||||||
15 | income, 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 |
| |||||||
| |||||||
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, | ||||||
11 | retired employees, and survivors that is set forth in this | ||||||
12 | subsection (a-10) shall also be used for the purpose of | ||||||
13 | calculating the portion of premiums that is to be paid by those | ||||||
14 | persons for dependent coverage. | ||||||
15 | The Director shall establish by rule a process for retired | ||||||
16 | employees, annuitants, and survivors to appeal determinations | ||||||
17 | of annual State pension income. | ||||||
18 | With respect to any annuitant, retired employee, or | ||||||
19 | survivor covered by a collective bargaining agreement in effect | ||||||
20 | on the effective date of this amendatory Act of the 97th | ||||||
21 | General Assembly and until that collective bargaining | ||||||
22 | agreement terminates, the obligation of each retired employee, | ||||||
23 | annuitant, or survivor to pay the required premium applies only | ||||||
24 | to the extent that the obligation is consistent with any | ||||||
25 | contractual obligations existing in any collective bargaining | ||||||
26 | agreement. |
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| |||||||
1 | Upon the expiration of any collective bargaining agreement | ||||||
2 | in effect on the effective date of this amendatory Act of the | ||||||
3 | 97th General Assembly, the Director may alter the schedule | ||||||
4 | above to ensure that 49% of the costs associated with the basic | ||||||
5 | program of group health benefits are covered by retired | ||||||
6 | employees, annuitants, and survivors. | ||||||
7 | For the purposes of this subsection (a-10), "State pension | ||||||
8 | income" means income paid or payable to an individual from a | ||||||
9 | retirement system created under Article 2, 14, 15, 16, or 18 of | ||||||
10 | the Illinois Pension Code. | ||||||
11 | (b) State employees who become eligible for this program on | ||||||
12 | or after January
1, 1980 in positions normally requiring actual | ||||||
13 | performance of duty not less
than 1/2 of a normal work period | ||||||
14 | but not equal to that of a normal work period,
shall be given | ||||||
15 | the option of participating in the available program. If the
| ||||||
16 | employee elects coverage, the State shall contribute on behalf | ||||||
17 | of such employee
to the cost of the employee's benefit and any | ||||||
18 | applicable dependent supplement,
that sum which bears the same | ||||||
19 | percentage as that percentage of time the
employee regularly | ||||||
20 | works when compared to normal work period.
| ||||||
21 | (c) The basic non-contributory coverage from the basic | ||||||
22 | program of
group health benefits shall be continued for each | ||||||
23 | employee not in pay status or
on active service by reason of | ||||||
24 | (1) leave of absence due to illness or injury,
(2) authorized | ||||||
25 | educational leave of absence or sabbatical leave, or (3)
| ||||||
26 | military leave. This coverage shall continue until
expiration |
| |||||||
| |||||||
1 | of authorized leave and return to active service, but not to | ||||||
2 | exceed
24 months for leaves under item (1) or (2). This | ||||||
3 | 24-month limitation and the
requirement of returning to active | ||||||
4 | service shall not apply to persons receiving
ordinary or | ||||||
5 | accidental disability benefits or retirement benefits through | ||||||
6 | the
appropriate State retirement system or benefits under the | ||||||
7 | Workers' Compensation
or Occupational Disease Act.
| ||||||
8 | (d) The basic group life insurance coverage shall continue, | ||||||
9 | with
full State contribution, where such person is (1) absent | ||||||
10 | from active
service by reason of disability arising from any | ||||||
11 | cause other than
self-inflicted, (2) on authorized educational | ||||||
12 | leave of absence or
sabbatical leave, or (3) on military leave.
| ||||||
13 | (e) Where the person is in non-pay status for a period in | ||||||
14 | excess of
30 days or on leave of absence, other than by reason | ||||||
15 | of disability,
educational or sabbatical leave, or military | ||||||
16 | leave, such
person may continue coverage only by making | ||||||
17 | personal
payment equal to the amount normally contributed by | ||||||
18 | the State on such person's
behalf. Such payments and coverage | ||||||
19 | may be continued: (1) until such time as
the person returns to | ||||||
20 | a status eligible for coverage at State expense, but not
to | ||||||
21 | exceed 24 months or (2) until such person's employment or | ||||||
22 | annuitant status
with the State is terminated (exclusive of any | ||||||
23 | additional service imposed pursuant to law).
| ||||||
24 | (f) The Department shall establish by rule the extent to | ||||||
25 | which other
employee benefits will continue for persons in | ||||||
26 | non-pay status or who are
not in active service.
|
| |||||||
| |||||||
1 | (g) The State shall not pay the cost of the basic | ||||||
2 | non-contributory
group life insurance, program of health | ||||||
3 | benefits and other employee benefits
for members who are | ||||||
4 | survivors as defined by paragraphs (1) and (2) of
subsection | ||||||
5 | (q) of Section 3 of this Act. The costs of benefits for these
| ||||||
6 | survivors shall be paid by the survivors or by the University | ||||||
7 | of Illinois
Cooperative Extension Service, or any combination | ||||||
8 | thereof.
However, the State shall pay the amount of the | ||||||
9 | reduction in the cost of
participation, if any, resulting from | ||||||
10 | the amendment to subsection (a) made
by this amendatory Act of | ||||||
11 | the 91st General Assembly.
| ||||||
12 | (h) Those persons occupying positions with any department | ||||||
13 | as a result
of emergency appointments pursuant to Section 8b.8 | ||||||
14 | of the Personnel Code
who are not considered employees under | ||||||
15 | this Act shall be given the option
of participating in the | ||||||
16 | programs of group life insurance, health benefits and
other | ||||||
17 | employee benefits. Such persons electing coverage may | ||||||
18 | participate only
by making payment equal to the amount normally | ||||||
19 | contributed by the State for
similarly situated employees. Such | ||||||
20 | amounts shall be determined by the
Director. Such payments and | ||||||
21 | coverage may be continued until such time as the
person becomes | ||||||
22 | an employee pursuant to this Act or such person's appointment | ||||||
23 | is
terminated.
| ||||||
24 | (i) Any unit of local government within the State of | ||||||
25 | Illinois
may apply to the Director to have its employees, | ||||||
26 | annuitants, and their
dependents provided group health |
| |||||||
| |||||||
1 | coverage under this Act on a non-insured
basis. To participate, | ||||||
2 | a unit of local government must agree to enroll
all of its | ||||||
3 | employees, who may select coverage under either the State group
| ||||||
4 | health benefits plan or a health maintenance organization that | ||||||
5 | has
contracted with the State to be available as a health care | ||||||
6 | provider for
employees as defined in this Act. A unit of local | ||||||
7 | government must remit the
entire cost of providing coverage | ||||||
8 | under the State group health benefits plan
or, for coverage | ||||||
9 | under a health maintenance organization, an amount determined
| ||||||
10 | by the Director based on an analysis of the sex, age, | ||||||
11 | geographic location, or
other relevant demographic variables | ||||||
12 | for its employees, except that the unit of
local government | ||||||
13 | shall not be required to enroll those of its employees who are
| ||||||
14 | covered spouses or dependents under this plan or another group | ||||||
15 | policy or plan
providing health benefits as long as (1) an | ||||||
16 | appropriate official from the unit
of local government attests | ||||||
17 | that each employee not enrolled is a covered spouse
or | ||||||
18 | dependent under this plan or another group policy or plan, and | ||||||
19 | (2) at least
50% of the employees are enrolled and the unit of | ||||||
20 | local government remits
the entire cost of providing coverage | ||||||
21 | to those employees, except that a
participating school district | ||||||
22 | must have enrolled at least 50% of its full-time
employees who | ||||||
23 | have not waived coverage under the district's group health
plan | ||||||
24 | by participating in a component of the district's cafeteria | ||||||
25 | plan. A
participating school district is not required to enroll | ||||||
26 | a full-time employee
who has waived coverage under the |
| |||||||
| |||||||
1 | district's health plan, provided that an
appropriate official | ||||||
2 | from the participating school district attests that the
| ||||||
3 | full-time employee has waived coverage by participating in a | ||||||
4 | component of the
district's cafeteria plan. For the purposes of | ||||||
5 | this subsection, "participating
school district" includes a | ||||||
6 | unit of local government whose primary purpose is
education as | ||||||
7 | defined by the Department's rules.
| ||||||
8 | Employees of a participating unit of local government who | ||||||
9 | are not enrolled
due to coverage under another group health | ||||||
10 | policy or plan may enroll in
the event of a qualifying change | ||||||
11 | in status, special enrollment, special
circumstance as defined | ||||||
12 | by the Director, or during the annual Benefit Choice
Period. A | ||||||
13 | participating unit of local government may also elect to cover | ||||||
14 | its
annuitants. Dependent coverage shall be offered on an | ||||||
15 | optional basis, with the
costs paid by the unit of local | ||||||
16 | government, its employees, or some combination
of the two as | ||||||
17 | determined by the unit of local government. The unit of local
| ||||||
18 | government shall be responsible for timely collection and | ||||||
19 | transmission of
dependent premiums.
| ||||||
20 | The Director shall annually determine monthly rates of | ||||||
21 | payment, 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
|
| |||||||
| |||||||
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 | ||||||
12 | a health
maintenance organization, the Director shall annually | ||||||
13 | determine for each
participating unit of local government the | ||||||
14 | maximum monthly amount the unit
may contribute toward that | ||||||
15 | coverage, based on an analysis of (i) the age,
sex, geographic | ||||||
16 | location, and other relevant demographic variables of the
| ||||||
17 | unit's employees and (ii) the cost to cover those employees | ||||||
18 | under the State
group health benefits plan. The Director may | ||||||
19 | similarly determine the
maximum monthly amount each unit of | ||||||
20 | local government may contribute toward
coverage of its | ||||||
21 | employees' dependents under a health maintenance organization.
| ||||||
22 | Monthly payments by the unit of local government or its | ||||||
23 | employees for
group health benefits plan or health maintenance | ||||||
24 | organization coverage shall
be deposited in the Local | ||||||
25 | Government Health Insurance Reserve Fund.
| ||||||
26 | The Local Government Health Insurance Reserve Fund is |
| |||||||
| |||||||
1 | hereby created as a nonappropriated trust fund to be held | ||||||
2 | outside the State Treasury, with the State Treasurer as | ||||||
3 | custodian. The Local Government Health Insurance Reserve Fund | ||||||
4 | shall be a continuing
fund not subject to fiscal year | ||||||
5 | limitations. The Local Government Health Insurance Reserve | ||||||
6 | Fund is not subject to administrative charges or charge-backs, | ||||||
7 | including but not limited to those authorized under Section 8h | ||||||
8 | of the State Finance Act. All revenues arising from the | ||||||
9 | administration of the health benefits program established | ||||||
10 | under this Section shall be deposited into the Local Government | ||||||
11 | Health Insurance Reserve Fund. Any interest earned on moneys in | ||||||
12 | the Local Government Health Insurance Reserve Fund shall be | ||||||
13 | deposited into the Fund. All expenditures from this Fund
shall | ||||||
14 | be used for payments for health care benefits for local | ||||||
15 | government and rehabilitation facility
employees, annuitants, | ||||||
16 | and dependents, and to reimburse the Department or
its | ||||||
17 | administrative service organization for all expenses incurred | ||||||
18 | in the
administration of benefits. No other State funds may be | ||||||
19 | used for these
purposes.
| ||||||
20 | A local government employer's participation or desire to | ||||||
21 | participate
in a program created under this subsection shall | ||||||
22 | not limit that employer's
duty to bargain with the | ||||||
23 | representative of any collective bargaining unit
of its | ||||||
24 | employees.
| ||||||
25 | (j) Any rehabilitation facility within the State of | ||||||
26 | Illinois may apply
to the Director to have its employees, |
| |||||||
| |||||||
1 | annuitants, and their eligible
dependents provided group | ||||||
2 | health coverage under this Act on a non-insured
basis. To | ||||||
3 | participate, a rehabilitation facility must agree to enroll all
| ||||||
4 | of its employees and remit the entire cost of providing such | ||||||
5 | coverage for
its employees, except that the rehabilitation | ||||||
6 | facility shall not be
required to enroll those of its employees | ||||||
7 | who are covered spouses or
dependents under this plan or | ||||||
8 | another group policy or plan providing health
benefits as long | ||||||
9 | as (1) an appropriate official from the rehabilitation
facility | ||||||
10 | attests that each employee not enrolled is a covered spouse or
| ||||||
11 | dependent under this plan or another group policy or plan, and | ||||||
12 | (2) at least
50% of the employees are enrolled and the | ||||||
13 | rehabilitation facility remits
the entire cost of providing | ||||||
14 | coverage to those employees. Employees of a
participating | ||||||
15 | rehabilitation facility who are not enrolled due to coverage
| ||||||
16 | under another group health policy or plan may enroll
in the | ||||||
17 | event of a qualifying change in status, special enrollment, | ||||||
18 | special
circumstance as defined by the Director, or during the | ||||||
19 | annual Benefit Choice
Period. A participating rehabilitation | ||||||
20 | facility may also elect
to cover its annuitants. Dependent | ||||||
21 | coverage shall be offered on an optional
basis, with the costs | ||||||
22 | paid by the rehabilitation facility, its employees, or
some | ||||||
23 | combination of the 2 as determined by the rehabilitation | ||||||
24 | facility. The
rehabilitation facility shall be responsible for | ||||||
25 | timely collection and
transmission of dependent premiums.
| ||||||
26 | The Director shall annually determine quarterly rates of |
| |||||||
| |||||||
1 | payment, 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 | ||||||
17 | employees for
group health benefits shall be deposited in the | ||||||
18 | Local Government Health
Insurance Reserve Fund.
| ||||||
19 | (k) Any domestic violence shelter or service within the | ||||||
20 | State of Illinois
may apply to the Director to have its | ||||||
21 | employees, annuitants, and their
dependents provided group | ||||||
22 | health coverage under this Act on a non-insured
basis. To | ||||||
23 | participate, a domestic violence shelter or service must agree | ||||||
24 | to
enroll all of its employees and pay the entire cost of | ||||||
25 | providing such coverage
for its employees. The domestic | ||||||
26 | violence shelter shall not be required to enroll those of its |
| |||||||
| |||||||
1 | employees who are covered spouses or dependents under this plan | ||||||
2 | or another group policy or plan providing health benefits as | ||||||
3 | long as (1) an appropriate official from the domestic violence | ||||||
4 | shelter attests that each employee not enrolled is a covered | ||||||
5 | spouse or dependent under this plan or another group policy or | ||||||
6 | plan and (2) at least 50% of the employees are enrolled and the | ||||||
7 | domestic violence shelter remits the entire cost of providing | ||||||
8 | coverage to those employees. Employees of a participating | ||||||
9 | domestic violence shelter who are not enrolled due to coverage | ||||||
10 | under another group health policy or plan may enroll in the | ||||||
11 | event of a qualifying change in status, special enrollment, or | ||||||
12 | special circumstance as defined by the Director or during the | ||||||
13 | annual Benefit Choice Period. A participating domestic | ||||||
14 | violence shelter may also elect
to cover its annuitants. | ||||||
15 | Dependent coverage shall be offered on an optional
basis, with
| ||||||
16 | employees, or some combination of the 2 as determined by the | ||||||
17 | domestic violence
shelter or service. The domestic violence | ||||||
18 | shelter or service shall be
responsible for timely collection | ||||||
19 | and transmission of dependent premiums.
| ||||||
20 | The Director shall annually determine rates of payment,
| ||||||
21 | 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 on
behalf of its | ||||||
26 | employees, adjusted for differences between State |
| |||||||
| |||||||
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 | ||||||
12 | service or its employees
for group health insurance shall be | ||||||
13 | deposited in the Local Government Health
Insurance Reserve | ||||||
14 | Fund.
| ||||||
15 | (l) A public community college or entity organized pursuant | ||||||
16 | to the
Public Community College Act may apply to the Director | ||||||
17 | initially to have
only annuitants not covered prior to July 1, | ||||||
18 | 1992 by the district's health
plan provided health coverage | ||||||
19 | under this Act on a non-insured basis. The
community college | ||||||
20 | must execute a 2-year contract to participate in the
Local | ||||||
21 | Government Health Plan.
Any annuitant may enroll in the event | ||||||
22 | of a qualifying change in status, special
enrollment, special | ||||||
23 | circumstance as defined by the Director, or during the
annual | ||||||
24 | Benefit Choice Period.
| ||||||
25 | The Director shall annually determine monthly rates of | ||||||
26 | payment subject to
the following constraints: for those |
| |||||||
| |||||||
1 | community colleges with annuitants
only enrolled, first year | ||||||
2 | rates shall be equal to the average cost to cover
claims for a | ||||||
3 | State member adjusted for demographics, Medicare
| ||||||
4 | participation, and other factors; and in the second year, a | ||||||
5 | further adjustment
of rates shall be made to reflect the actual | ||||||
6 | first year's claims experience
of the covered annuitants.
| ||||||
7 | (l-5) The provisions of subsection (l) become inoperative | ||||||
8 | on July 1, 1999.
| ||||||
9 | (m) The Director shall adopt any rules deemed necessary for
| ||||||
10 | implementation of this amendatory Act of 1989 (Public Act | ||||||
11 | 86-978).
| ||||||
12 | (n) Any child advocacy center within the State of Illinois | ||||||
13 | may apply to the Director to have its employees, annuitants, | ||||||
14 | and their dependents provided group health coverage under this | ||||||
15 | Act on a non-insured basis. To participate, a child advocacy | ||||||
16 | center must agree to enroll all of its employees and pay the | ||||||
17 | entire cost of providing coverage for its employees. The child
| ||||||
18 | advocacy center shall not be required to enroll those of its
| ||||||
19 | employees who are covered spouses or dependents under this plan
| ||||||
20 | or another group policy or plan providing health benefits as
| ||||||
21 | long as (1) an appropriate official from the child advocacy
| ||||||
22 | center attests that each employee not enrolled is a covered
| ||||||
23 | spouse or dependent under this plan or another group policy or
| ||||||
24 | plan and (2) at least 50% of the employees are enrolled and the | ||||||
25 | child advocacy center remits the entire cost of providing | ||||||
26 | coverage to those employees. Employees of a participating child |
| |||||||
| |||||||
1 | advocacy center who are not enrolled due to coverage under | ||||||
2 | another group health policy or plan may enroll in the event of | ||||||
3 | a qualifying change in status, special enrollment, or special | ||||||
4 | circumstance as defined by the Director or during the annual | ||||||
5 | Benefit Choice Period. A participating child advocacy center | ||||||
6 | may also elect to cover its annuitants. Dependent coverage | ||||||
7 | shall be offered on an optional basis, with the costs paid by | ||||||
8 | the child advocacy center, its employees, or some combination | ||||||
9 | of the 2 as determined by the child advocacy center. The child | ||||||
10 | advocacy center shall be responsible for timely collection and | ||||||
11 | transmission of dependent premiums. | ||||||
12 | The Director shall annually determine rates of payment, | ||||||
13 | subject 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 |
| |||||||
| |||||||
1 | of the employees of the child advocacy center. | ||||||
2 | Monthly payments by the child advocacy center or its | ||||||
3 | employees for group health insurance shall be deposited into | ||||||
4 | the Local Government Health Insurance Reserve Fund. | ||||||
5 | (Source: P.A. 95-331, eff. 8-21-07; 95-632, eff. 9-25-07; | ||||||
6 | 95-707, eff. 1-11-08; 96-756, eff. 1-1-10; 96-1232, eff. | ||||||
7 | 7-23-10; 96-1519, eff. 2-4-11.)
| ||||||
8 | Section 99. Effective date. This Act takes effect July 1, | ||||||
9 | 2012. |