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91_HB1140
LRB9100995EGfg
1 AN ACT in relation to public employee benefits, amending
2 named Acts.
3 Be it enacted by the People of the State of Illinois,
4 represented in the General Assembly:
5 Section 5. The State Employees Group Insurance Act of
6 1971 is amended by changing Sections 3 and 10 as follows:
7 (5 ILCS 375/3) (from Ch. 127, par. 523)
8 Sec. 3. Definitions. Unless the context otherwise
9 requires, the following words and phrases as used in this Act
10 shall have the following meanings. The Department may define
11 these and other words and phrases separately for the purpose
12 of implementing specific programs providing benefits under
13 this Act.
14 (a) "Administrative service organization" means any
15 person, firm or corporation experienced in the handling of
16 claims which is fully qualified, financially sound and
17 capable of meeting the service requirements of a contract of
18 administration executed with the Department.
19 (b) "Annuitant" means (1) an employee who retires, or
20 has retired, on or after January 1, 1966 on an immediate
21 annuity under the provisions of Articles 2, 14, 15 (including
22 an employee who has retired under the optional retirement
23 program established under Section 15-158.2), paragraphs (2),
24 (3), or (5) of Section 16-106, or Article 18 of the Illinois
25 Pension Code; (2) any person who was receiving group
26 insurance coverage under this Act as of March 31, 1978 by
27 reason of his status as an annuitant, even though the annuity
28 in relation to which such coverage was provided is a
29 proportional annuity based on less than the minimum period of
30 service required for a retirement annuity in the system
31 involved; (3) any person not otherwise covered by this Act
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1 who has retired as a participating member under Article 2 of
2 the Illinois Pension Code but is ineligible for the
3 retirement annuity under Section 2-119 of the Illinois
4 Pension Code; (4) the spouse of any person who is receiving a
5 retirement annuity under Article 18 of the Illinois Pension
6 Code and who is covered under a group health insurance
7 program sponsored by a governmental employer other than the
8 State of Illinois and who has irrevocably elected to waive
9 his or her coverage under this Act and to have his or her
10 spouse considered as the "annuitant" under this Act and not
11 as a "dependent"; or (5) an employee who retires, or has
12 retired, from a qualified position, as determined according
13 to rules promulgated by the Director, under a qualified local
14 government or a qualified rehabilitation facility or a
15 qualified domestic violence shelter or service. (For
16 definition of "retired employee", see (p) post).
17 (b-5) "New SERS annuitant" means a person who, on or
18 after January 1, 1998, becomes an annuitant, as defined in
19 subsection (b), by virtue of beginning to receive a
20 retirement annuity under Article 14 of the Illinois Pension
21 Code, and is eligible to participate in the basic program of
22 group health benefits provided for annuitants under this Act.
23 (b-6) "New SURS annuitant" means a person who (1), on or
24 after January 1, 1998, becomes an annuitant, as defined in
25 subsection (b), by virtue of beginning to receive a
26 retirement annuity under Article 15 of the Illinois Pension
27 Code, (2) has not made the election authorized under Section
28 15-135.1 of the Illinois Pension Code, and (3) is eligible to
29 participate in the basic program of group health benefits
30 provided for annuitants under this Act.
31 (b-7) "New TRS State annuitant" means a person who, on
32 or after July 1, 1998, becomes an annuitant, as defined in
33 subsection (b), by virtue of beginning to receive a
34 retirement annuity under Article 16 of the Illinois Pension
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1 Code based on service as a teacher as defined in paragraph
2 (2), (3), or (5) of Section 16-106 of that Code, and is
3 eligible to participate in the basic program of group health
4 benefits provided for annuitants under this Act.
5 (c) "Carrier" means (1) an insurance company, a
6 corporation organized under the Limited Health Service
7 Organization Act or the Voluntary Health Services Plan Act, a
8 partnership, or other nongovernmental organization, which is
9 authorized to do group life or group health insurance
10 business in Illinois, or (2) the State of Illinois as a
11 self-insurer.
12 (d) "Compensation" means salary or wages payable on a
13 regular payroll by the State Treasurer on a warrant of the
14 State Comptroller out of any State, trust or federal fund, or
15 by the Governor of the State through a disbursing officer of
16 the State out of a trust or out of federal funds, or by any
17 Department out of State, trust, federal or other funds held
18 by the State Treasurer or the Department, to any person for
19 personal services currently performed, and ordinary or
20 accidental disability benefits under Articles 2, 14, 15
21 (including ordinary or accidental disability benefits under
22 the optional retirement program established under Section
23 15-158.2), paragraphs (2), (3), or (5) of Section 16-106, or
24 Article 18 of the Illinois Pension Code, for disability
25 incurred after January 1, 1966, or benefits payable under the
26 Workers' Compensation or Occupational Diseases Act or
27 benefits payable under a sick pay plan established in
28 accordance with Section 36 of the State Finance Act.
29 "Compensation" also means salary or wages paid to an employee
30 of any qualified local government or qualified rehabilitation
31 facility or a qualified domestic violence shelter or service.
32 (e) "Commission" means the State Employees Group
33 Insurance Advisory Commission authorized by this Act.
34 Commencing July 1, 1984, "Commission" as used in this Act
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1 means the Illinois Economic and Fiscal Commission as
2 established by the Legislative Commission Reorganization Act
3 of 1984.
4 (f) "Contributory", when referred to as contributory
5 coverage, shall mean optional coverages or benefits elected
6 by the member toward the cost of which such member makes
7 contribution, or which are funded in whole or in part through
8 the acceptance of a reduction in earnings or the foregoing of
9 an increase in earnings by an employee, as distinguished from
10 noncontributory coverage or benefits which are paid entirely
11 by the State of Illinois without reduction of the member's
12 salary.
13 (g) "Department" means any department, institution,
14 board, commission, officer, court or any agency of the State
15 government receiving appropriations and having power to
16 certify payrolls to the Comptroller authorizing payments of
17 salary and wages against such appropriations as are made by
18 the General Assembly from any State fund, or against trust
19 funds held by the State Treasurer and includes boards of
20 trustees of the retirement systems created by Articles 2, 14,
21 15, 16 and 18 of the Illinois Pension Code. "Department"
22 also includes the Illinois Comprehensive Health Insurance
23 Board, the Board of Examiners established under the Illinois
24 Public Accounting Act, and the Illinois Rural Bond Bank.
25 (h) "Dependent", when the term is used in the context of
26 the health and life plan, means a member's spouse and any
27 unmarried child (1) from birth to age 19 including an adopted
28 child, a child who lives with the member from the time of the
29 filing of a petition for adoption until entry of an order of
30 adoption, a stepchild or recognized child who lives with the
31 member in a parent-child relationship, or a child who lives
32 with the member if such member is a court appointed guardian
33 of the child, or (2) age 19 to 23 enrolled as a full-time
34 student in any accredited school, financially dependent upon
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1 the member, and eligible as a dependent for Illinois State
2 income tax purposes, or (3) age 19 or over who is mentally or
3 physically handicapped as defined in the Illinois Insurance
4 Code. For the health plan only, the term "dependent" also
5 includes any person enrolled prior to the effective date of
6 this Section who is dependent upon the member to the extent
7 that the member may claim such person as a dependent for
8 Illinois State income tax deduction purposes; no other such
9 person may be enrolled.
10 (i) "Director" means the Director of the Illinois
11 Department of Central Management Services.
12 (j) "Eligibility period" means the period of time a
13 member has to elect enrollment in programs or to select
14 benefits without regard to age, sex or health.
15 (k) "Employee" means and includes each officer or
16 employee in the service of a department who (1) receives his
17 compensation for service rendered to the department on a
18 warrant issued pursuant to a payroll certified by a
19 department or on a warrant or check issued and drawn by a
20 department upon a trust, federal or other fund or on a
21 warrant issued pursuant to a payroll certified by an elected
22 or duly appointed officer of the State or who receives
23 payment of the performance of personal services on a warrant
24 issued pursuant to a payroll certified by a Department and
25 drawn by the Comptroller upon the State Treasurer against
26 appropriations made by the General Assembly from any fund or
27 against trust funds held by the State Treasurer, and (2) is
28 employed full-time or part-time in a position normally
29 requiring actual performance of duty during not less than 1/2
30 of a normal work period, as established by the Director in
31 cooperation with each department, except that persons elected
32 by popular vote will be considered employees during the
33 entire term for which they are elected regardless of hours
34 devoted to the service of the State, and (3) except that
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1 "employee" does not include any person who is not eligible by
2 reason of such person's employment to participate in one of
3 the State retirement systems under Articles 2, 14, 15 (either
4 the regular Article 15 system or the optional retirement
5 program established under Section 15-158.2) or 18, or under
6 paragraph (2), (3), or (5) of Section 16-106, of the Illinois
7 Pension Code, but such term does include persons who are
8 employed during the 6 month qualifying period under Article
9 14 of the Illinois Pension Code. Such term also includes any
10 person who (1) after January 1, 1966, is receiving ordinary
11 or accidental disability benefits under Articles 2, 14, 15
12 (including ordinary or accidental disability benefits under
13 the optional retirement program established under Section
14 15-158.2), paragraphs (2), (3), or (5) of Section 16-106, or
15 Article 18 of the Illinois Pension Code, for disability
16 incurred after January 1, 1966, (2) receives total permanent
17 or total temporary disability under the Workers' Compensation
18 Act or Occupational Disease Act as a result of injuries
19 sustained or illness contracted in the course of employment
20 with the State of Illinois, or (3) is not otherwise covered
21 under this Act and has retired as a participating member
22 under Article 2 of the Illinois Pension Code but is
23 ineligible for the retirement annuity under Section 2-119 of
24 the Illinois Pension Code. However, a person who satisfies
25 the criteria of the foregoing definition of "employee" except
26 that such person is made ineligible to participate in the
27 State Universities Retirement System by clause (4) of
28 subsection (a) of Section 15-107 of the Illinois Pension Code
29 is also an "employee" for the purposes of this Act.
30 "Employee" also includes any person receiving or eligible for
31 benefits under a sick pay plan established in accordance with
32 Section 36 of the State Finance Act. "Employee" also includes
33 each officer or employee in the service of a qualified local
34 government, including persons appointed as trustees of
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1 sanitary districts regardless of hours devoted to the service
2 of the sanitary district, and each employee in the service of
3 a qualified rehabilitation facility and each full-time
4 employee in the service of a qualified domestic violence
5 shelter or service, as determined according to rules
6 promulgated by the Director.
7 (l) "Member" means an employee, annuitant, retired
8 employee or survivor.
9 (m) "Optional coverages or benefits" means those
10 coverages or benefits available to the member on his or her
11 voluntary election, and at his or her own expense.
12 (n) "Program" means the group life insurance, health
13 benefits and other employee benefits designed and contracted
14 for by the Director under this Act.
15 (o) "Health plan" means a self-insured health insurance
16 program offered by the State of Illinois for the purposes of
17 benefiting employees by means of providing, among others,
18 wellness programs, utilization reviews, second opinions and
19 medical fee reviews, as well as for paying for hospital and
20 medical care up to the maximum coverage provided by the plan,
21 to its members and their dependents.
22 (p) "Retired employee" means any person who would be an
23 annuitant as that term is defined herein but for the fact
24 that such person retired prior to January 1, 1966. Such term
25 also includes any person formerly employed by the University
26 of Illinois in the Cooperative Extension Service who would be
27 an annuitant but for the fact that such person was made
28 ineligible to participate in the State Universities
29 Retirement System by clause (4) of subsection (a) of Section
30 15-107 of the Illinois Pension Code.
31 (p-6) "New SURS retired employee" means a person who, on
32 or after January 1, 1998, becomes a retired employee, as
33 defined in subsection (p), by virtue of being a person
34 formerly employed by the University of Illinois in the
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1 Cooperative Extension Service who would be an annuitant but
2 for the fact that he or she was made ineligible to
3 participate in the State Universities Retirement System by
4 clause (4) of subsection (a) of Section 15-107 of the
5 Illinois Pension Code, and who is eligible to participate in
6 the basic program of group health benefits provided for
7 retired employees under this Act.
8 (q) "Survivor" means a person receiving an annuity as a
9 survivor of an employee or of an annuitant. "Survivor" also
10 includes: (1) the surviving dependent of a person who
11 satisfies the definition of "employee" except that such
12 person is made ineligible to participate in the State
13 Universities Retirement System by clause (4) of subsection
14 (a) of Section 15-107 of the Illinois Pension Code; and (2)
15 the surviving dependent of any person formerly employed by
16 the University of Illinois in the Cooperative Extension
17 Service who would be an annuitant except for the fact that
18 such person was made ineligible to participate in the State
19 Universities Retirement System by clause (4) of subsection
20 (a) of Section 15-107 of the Illinois Pension Code.
21 (q-5) "New SERS survivor" means a survivor, as defined
22 in subsection (q), whose annuity is paid under Article 14 of
23 the Illinois Pension Code and is based on the death of (i) an
24 employee whose death occurs on or after January 1, 1998, or
25 (ii) a new SERS annuitant as defined in subsection (b-5).
26 (q-6) "New SURS survivor" means a survivor, as defined
27 in subsection (q), whose annuity is paid under Article 15 of
28 the Illinois Pension Code and is based on the death of (i) an
29 employee whose death occurs on or after January 1, 1998, or
30 (ii) a new SURS annuitant as defined in subsection (b-6), or
31 (iii) a new SURS retired employee as defined in subsection
32 (p-6).
33 (q-7) "New TRS State survivor" means a survivor, as
34 defined in subsection (q), whose annuity is paid under
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1 Article 16 of the Illinois Pension Code and is based on the
2 death of (i) an employee who is a teacher as defined in
3 paragraph (2), (3), or (5) of Section 16-106 of that Code and
4 whose death occurs on or after July 1, 1998, or (ii) a new
5 TRS State annuitant as defined in subsection (b-7).
6 (r) "Medical services" means the services provided
7 within the scope of their licenses by practitioners in all
8 categories licensed under the Medical Practice Act of 1987.
9 (s) "Unit of local government" means any county,
10 municipality, township, school district, special district or
11 other unit, designated as a unit of local government by law,
12 which exercises limited governmental powers or powers in
13 respect to limited governmental subjects, any not-for-profit
14 association with a membership that primarily includes
15 townships and township officials, that has duties that
16 include provision of research service, dissemination of
17 information, and other acts for the purpose of improving
18 township government, and that is funded wholly or partly in
19 accordance with Section 85-15 of the Township Code; any
20 not-for-profit corporation or association, with a membership
21 consisting primarily of municipalities, that operates its own
22 utility system, and provides research, training,
23 dissemination of information, or other acts to promote
24 cooperation between and among municipalities that provide
25 utility services and for the advancement of the goals and
26 purposes of its membership; and the Illinois Association of
27 Park Districts. "Qualified local government" means a unit of
28 local government approved by the Director and participating
29 in a program created under subsection (i) of Section 10 of
30 this Act.
31 (t) "Qualified rehabilitation facility" means any
32 not-for-profit organization that is accredited by the
33 Commission on Accreditation of Rehabilitation Facilities or
34 certified by the Department of Human Services (as successor
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1 to the Department of Mental Health and Developmental
2 Disabilities) to provide services to persons with
3 disabilities and which receives funds from the State of
4 Illinois for providing those services, approved by the
5 Director and participating in a program created under
6 subsection (j) of Section 10 of this Act.
7 (u) "Qualified domestic violence shelter or service"
8 means any Illinois domestic violence shelter or service and
9 its administrative offices funded by the Department of Human
10 Services (as successor to the Illinois Department of Public
11 Aid), approved by the Director and participating in a program
12 created under subsection (k) of Section 10.
13 (v) "TRS benefit recipient" means a person who:
14 (1) is not a "member" as defined in this Section;
15 and
16 (2) is receiving a monthly benefit or retirement
17 annuity under Article 16 of the Illinois Pension Code;
18 and
19 (3) either (i) has at least 8 years of creditable
20 service under Article 16 of the Illinois Pension Code, or
21 (ii) was enrolled in the health insurance program offered
22 under that Article on January 1, 1996, or (iii) is the
23 survivor of a benefit recipient who had at least 8 years
24 of creditable service under Article 16 of the Illinois
25 Pension Code or was enrolled in the health insurance
26 program offered under that Article on the effective date
27 of this amendatory Act of 1995, or (iv) is a recipient or
28 survivor of a recipient of a disability benefit under
29 Article 16 of the Illinois Pension Code.
30 (w) "TRS dependent beneficiary" means a person who:
31 (1) is not a "member" or "dependent" as defined in
32 this Section; and
33 (2) is a TRS benefit recipient's: (A) spouse, (B)
34 dependent parent who is receiving at least half of his or
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1 her support from the TRS benefit recipient, or (C)
2 unmarried natural or adopted child who is (i) under age
3 19, or (ii) enrolled as a full-time student in an
4 accredited school, financially dependent upon the TRS
5 benefit recipient, eligible as a dependent for Illinois
6 State income tax purposes, and either is under age 24 or
7 was, on January 1, 1996, participating as a dependent
8 beneficiary in the health insurance program offered under
9 Article 16 of the Illinois Pension Code, or (iii) age 19
10 or over who is mentally or physically handicapped as
11 defined in the Illinois Insurance Code.
12 (x) "Military leave with pay and benefits" refers to
13 individuals in basic training for reserves, special/advanced
14 training, annual training, emergency call up, or activation
15 by the President of the United States with approved pay and
16 benefits.
17 (y) "Military leave without pay and benefits" refers to
18 individuals who enlist for active duty in a regular component
19 of the U.S. Armed Forces or other duty not specified or
20 authorized under military leave with pay and benefits.
21 (z) "Community college benefit recipient" means a person
22 who:
23 (1) is not a "member" as defined in this Section;
24 and
25 (2) is receiving a monthly survivor's annuity or
26 retirement annuity under Article 15 of the Illinois
27 Pension Code; and
28 (3) either (i) was a full-time employee of a
29 community college district or an association of community
30 college boards created under the Public Community College
31 Act (other than an employee whose last employer under
32 Article 15 of the Illinois Pension Code was a community
33 college district subject to Article VII of the Public
34 Community College Act) and was eligible to participate in
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1 a group health benefit plan as an employee during the
2 time of employment with a community college district
3 (other than a community college district subject to
4 Article VII of the Public Community College Act) or an
5 association of community college boards, or (ii) is the
6 survivor of a person described in item (i).
7 (aa) "Community college dependent beneficiary" means a
8 person who:
9 (1) is not a "member" or "dependent" as defined in
10 this Section; and
11 (2) is a community college benefit recipient's: (A)
12 spouse, (B) dependent parent who is receiving at least
13 half of his or her support from the community college
14 benefit recipient, or (C) unmarried natural or adopted
15 child who is (i) under age 19, or (ii) enrolled as a
16 full-time student in an accredited school, financially
17 dependent upon the community college benefit recipient,
18 eligible as a dependent for Illinois State income tax
19 purposes and under age 23, or (iii) age 19 or over and
20 mentally or physically handicapped as defined in the
21 Illinois Insurance Code.
22 (Source: P.A. 89-21, eff. 6-21-95; 89-25, eff. 6-21-95;
23 89-76, eff. 7-1-95; 89-324, eff. 8-13-95; 89-430, eff.
24 12-15-95; 89-502, eff. 7-1-96; 89-507, eff. 7-1-97; 89-628,
25 eff. 8-9-96; 90-14, eff. 7-1-97; 90-65, eff. 7-7-97; 90-448,
26 eff. 8-16-97; 90-497, eff. 8-18-97; 90-511, eff. 8-22-97;
27 90-582, eff. 5-27-98; 90-655, eff. 7-30-98.)
28 (5 ILCS 375/10) (from Ch. 127, par. 530)
29 Sec. 10. Payments by State; premiums.
30 (a) The State shall pay the cost of basic
31 non-contributory group life insurance and, subject to member
32 paid contributions set by the Department or required by this
33 Section, the basic program of group health benefits on each
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1 eligible member, except a member, not otherwise covered by
2 this Act, who has retired as a participating member under
3 Article 2 of the Illinois Pension Code but is ineligible for
4 the retirement annuity under Section 2-119 of the Illinois
5 Pension Code, and part of each eligible member's and retired
6 member's premiums for health insurance coverage for enrolled
7 dependents as provided by Section 9. The State shall pay the
8 cost of the basic program of group health benefits only after
9 benefits are reduced by the amount of benefits covered by
10 Medicare for all retired members and retired dependents aged
11 65 years or older who are entitled to benefits under Social
12 Security or the Railroad Retirement system or who had
13 sufficient Medicare-covered government employment except that
14 such reduction in benefits shall apply only to those retired
15 members or retired dependents who (1) first become eligible
16 for such Medicare coverage on or after July 1, 1992; or (2)
17 remain eligible for, but no longer receive Medicare coverage
18 which they had been receiving on or after July 1, 1992. The
19 Department may determine the aggregate level of the State's
20 contribution on the basis of actual cost of medical services
21 adjusted for age, sex or geographic or other demographic
22 characteristics which affect the costs of such programs.
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
27 program of group health benefits an amount equal to 5% of
28 that cost for each full year of creditable service upon which
29 the annuitant's retirement annuity is based, up to a maximum
30 of 100% for an annuitant with 20 or more years of creditable
31 service. The remainder of the cost of a new SERS annuitant's
32 coverage under the basic program of group health benefits
33 shall be the responsibility of the annuitant.
34 (a-2) Beginning January 1, 1998, for each person who
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1 becomes a new SERS survivor and participates in the basic
2 program of group health benefits, the State shall contribute
3 toward the cost of the survivor's coverage under the basic
4 program of group health benefits an amount equal to 5% of
5 that cost for each full year of the deceased employee's or
6 deceased annuitant's creditable service in the State
7 Employees' Retirement System of Illinois on the date of
8 death, up to a maximum of 100% for a survivor of an employee
9 or annuitant with 20 or more years of creditable service.
10 The remainder of the cost of the new SERS survivor's coverage
11 under the basic program of group health benefits shall be the
12 responsibility of the survivor.
13 (a-3) Beginning January 1, 1998, for each person who
14 becomes a new SURS annuitant and participates in the basic
15 program of group health benefits, the State shall contribute
16 toward the cost of the annuitant's coverage under the basic
17 program of group health benefits an amount equal to 5% of
18 that cost for each full year of creditable service upon which
19 the annuitant's retirement annuity is based, up to a maximum
20 of 100% for an annuitant with 20 or more years of creditable
21 service. The remainder of the cost of a new SURS annuitant's
22 coverage under the basic program of group health benefits
23 shall be the responsibility of the annuitant.
24 (a-4) (Blank). Beginning January 1, 1998, for each
25 person who becomes a new SURS retired employee and
26 participates in the basic program of group health benefits,
27 the State shall contribute toward the cost of the retired
28 employee's coverage under the basic program of group health
29 benefits an amount equal to 5% of that cost for each full
30 year that the retired employee was an employee as defined in
31 Section 3, up to a maximum of 100% for a retired employee who
32 was an employee for 20 or more years. The remainder of the
33 cost of a new SURS retired employee's coverage under the
34 basic program of group health benefits shall be the
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1 responsibility of the retired employee.
2 (a-5) Beginning January 1, 1998, for each person who
3 becomes a new SURS survivor and participates in the basic
4 program of group health benefits, the State shall contribute
5 toward the cost of the survivor's coverage under the basic
6 program of group health benefits an amount equal to 5% of
7 that cost for each full year of the deceased employee's or
8 deceased annuitant's creditable service in the State
9 Universities Retirement System on the date of death, up to a
10 maximum of 100% for a survivor of an employee or annuitant
11 with 20 or more years of creditable service. The remainder
12 of the cost of the new SURS survivor's coverage under the
13 basic program of group health benefits shall be the
14 responsibility of the survivor.
15 (a-6) Beginning July 1, 1998, for each person who
16 becomes a new TRS State annuitant and participates in the
17 basic program of group health benefits, the State shall
18 contribute toward the cost of the annuitant's coverage under
19 the basic program of group health benefits an amount equal to
20 5% of that cost for each full year of creditable service as a
21 teacher as defined in paragraph (2), (3), or (5) of Section
22 16-106 of the Illinois Pension Code upon which the
23 annuitant's retirement annuity is based, up to a maximum of
24 100% for an annuitant with 20 or more years of such
25 creditable service. The remainder of the cost of a new TRS
26 State annuitant's coverage under the basic program of group
27 health benefits shall be the responsibility of the annuitant.
28 (a-7) Beginning July 1, 1998, for each person who
29 becomes a new TRS State survivor and participates in the
30 basic program of group health benefits, the State shall
31 contribute toward the cost of the survivor's coverage under
32 the basic program of group health benefits an amount equal to
33 5% of that cost for each full year of the deceased employee's
34 or deceased annuitant's creditable service as a teacher as
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1 defined in paragraph (2), (3), or (5) of Section 16-106 of
2 the Illinois Pension Code on the date of death, up to a
3 maximum of 100% for a survivor of an employee or annuitant
4 with 20 or more years of such creditable service. The
5 remainder of the cost of the new TRS State survivor's
6 coverage under the basic program of group health benefits
7 shall be the responsibility of the survivor.
8 (a-8) A new SERS annuitant, new SERS survivor, new SURS
9 annuitant, new SURS retired employee, new SURS survivor, new
10 TRS State annuitant, or new TRS State survivor may waive or
11 terminate coverage in the program of group health benefits.
12 Any such annuitant or, survivor, or retired employee who has
13 waived or terminated coverage may enroll or re-enroll in the
14 program of group health benefits only during the annual
15 benefit choice period, as determined by the Director; except
16 that in the event of termination of coverage due to
17 nonpayment of premiums, the annuitant or, survivor, or
18 retired employee may not re-enroll in the program.
19 (a-9) No later than May 1 of each calendar year, the
20 Director of Central Management Services shall certify in
21 writing to the Executive Secretary of the State Employees'
22 Retirement System of Illinois the amounts of the Medicare
23 supplement health care premiums and the amounts of the health
24 care premiums for all other retirees who are not Medicare
25 eligible.
26 A separate calculation of the premiums based upon the
27 actual cost of each health care plan shall be so certified.
28 The Director of Central Management Services shall provide
29 to the Executive Secretary of the State Employees' Retirement
30 System of Illinois such information, statistics, and other
31 data as he or she may require to review the premium amounts
32 certified by the Director of Central Management Services.
33 (b) State employees who become eligible for this program
34 on or after January 1, 1980 in positions normally requiring
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1 actual performance of duty not less than 1/2 of a normal work
2 period but not equal to that of a normal work period, shall
3 be given the option of participating in the available
4 program. If the employee elects coverage, the State shall
5 contribute on behalf of such employee to the cost of the
6 employee's benefit and any applicable dependent supplement,
7 that sum which bears the same percentage as that percentage
8 of time the employee regularly works when compared to normal
9 work period.
10 (c) The basic non-contributory coverage from the basic
11 program of group health benefits shall be continued for each
12 employee not in pay status or on active service by reason of
13 (1) leave of absence due to illness or injury, (2) authorized
14 educational leave of absence or sabbatical leave, or (3)
15 military leave with pay and benefits. This coverage shall
16 continue until expiration of authorized leave and return to
17 active service, but not to exceed 24 months for leaves under
18 item (1) or (2). This 24-month limitation and the requirement
19 of returning to active service shall not apply to persons
20 receiving ordinary or accidental disability benefits or
21 retirement benefits through the appropriate State retirement
22 system or benefits under the Workers' Compensation or
23 Occupational Disease Act.
24 (d) The basic group life insurance coverage shall
25 continue, with full State contribution, where such person is
26 (1) absent from active service by reason of disability
27 arising from any cause other than self-inflicted, (2) on
28 authorized educational leave of absence or sabbatical leave,
29 or (3) on military leave with pay and benefits.
30 (e) Where the person is in non-pay status for a period
31 in excess of 30 days or on leave of absence, other than by
32 reason of disability, educational or sabbatical leave, or
33 military leave with pay and benefits, such person may
34 continue coverage only by making personal payment equal to
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1 the amount normally contributed by the State on such person's
2 behalf. Such payments and coverage may be continued: (1)
3 until such time as the person returns to a status eligible
4 for coverage at State expense, but not to exceed 24 months,
5 (2) until such person's employment or annuitant status with
6 the State is terminated, or (3) for a maximum period of 4
7 years for members on military leave with pay and benefits and
8 military leave without pay and benefits (exclusive of any
9 additional service imposed pursuant to law).
10 (f) The Department shall establish by rule the extent
11 to which other employee benefits will continue for persons in
12 non-pay status or who are not in active service.
13 (g) The State shall not pay the cost of the basic
14 non-contributory group life insurance, program of health
15 benefits and other employee benefits for members who are
16 survivors as defined by paragraphs (1) and (2) of subsection
17 (q) of Section 3 of this Act. The costs of benefits for
18 these survivors shall be paid by the survivors or by the
19 University of Illinois Cooperative Extension Service, or any
20 combination thereof.
21 (h) Those persons occupying positions with any
22 department as a result of emergency appointments pursuant to
23 Section 8b.8 of the Personnel Code who are not considered
24 employees under this Act shall be given the option of
25 participating in the programs of group life insurance, health
26 benefits and other employee benefits. Such persons electing
27 coverage may participate only by making payment equal to the
28 amount normally contributed by the State for similarly
29 situated employees. Such amounts shall be determined by the
30 Director. Such payments and coverage may be continued until
31 such time as the person becomes an employee pursuant to this
32 Act or such person's appointment is terminated.
33 (i) Any unit of local government within the State of
34 Illinois may apply to the Director to have its employees,
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1 annuitants, and their dependents provided group health
2 coverage under this Act on a non-insured basis. To
3 participate, a unit of local government must agree to enroll
4 all of its employees, who may select coverage under either
5 the State group health insurance plan or a health maintenance
6 organization that has contracted with the State to be
7 available as a health care provider for employees as defined
8 in this Act. A unit of local government must remit the
9 entire cost of providing coverage under the State group
10 health insurance plan or, for coverage under a health
11 maintenance organization, an amount determined by the
12 Director based on an analysis of the sex, age, geographic
13 location, or other relevant demographic variables for its
14 employees, except that the unit of local government shall not
15 be required to enroll those of its employees who are covered
16 spouses or dependents under this plan or another group policy
17 or plan providing health benefits as long as (1) an
18 appropriate official from the unit of local government
19 attests that each employee not enrolled is a covered spouse
20 or dependent under this plan or another group policy or plan,
21 and (2) at least 85% of the employees are enrolled and the
22 unit of local government remits the entire cost of providing
23 coverage to those employees. Employees of a participating
24 unit of local government who are not enrolled due to coverage
25 under another group health policy or plan may enroll at a
26 later date subject to submission of satisfactory evidence of
27 insurability and provided that no benefits shall be payable
28 for services incurred during the first 6 months of coverage
29 to the extent the services are in connection with any
30 pre-existing condition. A participating unit of local
31 government may also elect to cover its annuitants. Dependent
32 coverage shall be offered on an optional basis, with the
33 costs paid by the unit of local government, its employees, or
34 some combination of the two as determined by the unit of
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1 local government. The unit of local government shall be
2 responsible for timely collection and transmission of
3 dependent premiums.
4 The Director shall annually determine monthly rates of
5 payment, subject to the following constraints:
6 (1) In the first year of coverage, the rates shall
7 be equal to the amount normally charged to State
8 employees for elected optional coverages or for enrolled
9 dependents coverages or other contributory coverages, or
10 contributed by the State for basic insurance coverages on
11 behalf of its employees, adjusted for differences between
12 State employees and employees of the local government in
13 age, sex, geographic location or other relevant
14 demographic variables, plus an amount sufficient to pay
15 for the additional administrative costs of providing
16 coverage to employees of the unit of local government and
17 their dependents.
18 (2) In subsequent years, a further adjustment shall
19 be made to reflect the actual prior years' claims
20 experience of the employees of the unit of local
21 government.
22 In the case of coverage of local government employees
23 under a health maintenance organization, the Director shall
24 annually determine for each participating unit of local
25 government the maximum monthly amount the unit may contribute
26 toward that coverage, based on an analysis of (i) the age,
27 sex, geographic location, and other relevant demographic
28 variables of the unit's employees and (ii) the cost to cover
29 those employees under the State group health insurance plan.
30 The Director may similarly determine the maximum monthly
31 amount each unit of local government may contribute toward
32 coverage of its employees' dependents under a health
33 maintenance organization.
34 Monthly payments by the unit of local government or its
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1 employees for group health insurance or health maintenance
2 organization coverage shall be deposited in the Local
3 Government Health Insurance Reserve Fund. The Local
4 Government Health Insurance Reserve Fund shall be a
5 continuing fund not subject to fiscal year limitations. All
6 expenditures from this fund shall be used for payments for
7 health care benefits for local government and rehabilitation
8 facility employees, annuitants, and dependents, and to
9 reimburse the Department or its administrative service
10 organization for all expenses incurred in the administration
11 of benefits. No other State funds may be used for these
12 purposes.
13 A local government employer's participation or desire to
14 participate in a program created under this subsection shall
15 not limit that employer's duty to bargain with the
16 representative of any collective bargaining unit of its
17 employees.
18 (j) Any rehabilitation facility within the State of
19 Illinois may apply to the Director to have its employees,
20 annuitants, and their dependents provided group health
21 coverage under this Act on a non-insured basis. To
22 participate, a rehabilitation facility must agree to enroll
23 all of its employees and remit the entire cost of providing
24 such coverage for its employees, except that the
25 rehabilitation facility shall not be required to enroll those
26 of its employees who are covered spouses or dependents under
27 this plan or another group policy or plan providing health
28 benefits as long as (1) an appropriate official from the
29 rehabilitation facility attests that each employee not
30 enrolled is a covered spouse or dependent under this plan or
31 another group policy or plan, and (2) at least 85% of the
32 employees are enrolled and the rehabilitation facility remits
33 the entire cost of providing coverage to those employees.
34 Employees of a participating rehabilitation facility who are
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1 not enrolled due to coverage under another group health
2 policy or plan may enroll at a later date subject to
3 submission of satisfactory evidence of insurability and
4 provided that no benefits shall be payable for services
5 incurred during the first 6 months of coverage to the extent
6 the services are in connection with any pre-existing
7 condition. A participating rehabilitation facility may also
8 elect to cover its annuitants. Dependent coverage shall be
9 offered on an optional basis, with the costs paid by the
10 rehabilitation facility, its employees, or some combination
11 of the 2 as determined by the rehabilitation facility. The
12 rehabilitation facility shall be responsible for timely
13 collection and transmission of dependent premiums.
14 The Director shall annually determine quarterly rates of
15 payment, subject to the following constraints:
16 (1) In the first year of coverage, the rates shall
17 be equal to the amount normally charged to State
18 employees for elected optional coverages or for enrolled
19 dependents coverages or other contributory coverages on
20 behalf of its employees, adjusted for differences between
21 State employees and employees of the rehabilitation
22 facility in age, sex, geographic location or other
23 relevant demographic variables, plus an amount sufficient
24 to pay for the additional administrative costs of
25 providing coverage to employees of the rehabilitation
26 facility and their dependents.
27 (2) In subsequent years, a further adjustment shall
28 be made to reflect the actual prior years' claims
29 experience of the employees of the rehabilitation
30 facility.
31 Monthly payments by the rehabilitation facility or its
32 employees for group health insurance shall be deposited in
33 the Local Government Health Insurance Reserve Fund.
34 (k) Any domestic violence shelter or service within the
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1 State of Illinois may apply to the Director to have its
2 employees, annuitants, and their dependents provided group
3 health coverage under this Act on a non-insured basis. To
4 participate, a domestic violence shelter or service must
5 agree to enroll all of its employees and pay the entire cost
6 of providing such coverage for its employees. A
7 participating domestic violence shelter may also elect to
8 cover its annuitants. Dependent coverage shall be offered on
9 an optional basis, with employees, or some combination of the
10 2 as determined by the domestic violence shelter or service.
11 The domestic violence shelter or service shall be responsible
12 for timely collection and transmission of dependent premiums.
13 The Director shall annually determine quarterly rates of
14 payment, subject to the following constraints:
15 (1) In the first year of coverage, the rates shall
16 be equal to the amount normally charged to State
17 employees for elected optional coverages or for enrolled
18 dependents coverages or other contributory coverages on
19 behalf of its employees, adjusted for differences between
20 State employees and employees of the domestic violence
21 shelter or service in age, sex, geographic location or
22 other relevant demographic variables, plus an amount
23 sufficient to pay for the additional administrative costs
24 of providing coverage to employees of the domestic
25 violence shelter or service and their dependents.
26 (2) In subsequent years, a further adjustment shall
27 be made to reflect the actual prior years' claims
28 experience of the employees of the domestic violence
29 shelter or service.
30 (3) In no case shall the rate be less than the
31 amount normally charged to State employees or contributed
32 by the State on behalf of its employees.
33 Monthly payments by the domestic violence shelter or
34 service or its employees for group health insurance shall be
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1 deposited in the Local Government Health Insurance Reserve
2 Fund.
3 (l) A public community college or entity organized
4 pursuant to the Public Community College Act may apply to the
5 Director initially to have only annuitants not covered prior
6 to July 1, 1992 by the district's health plan provided health
7 coverage under this Act on a non-insured basis. The
8 community college must execute a 2-year contract to
9 participate in the Local Government Health Plan. Those
10 annuitants enrolled initially under this contract shall have
11 no benefits payable for services incurred during the first 6
12 months of coverage to the extent the services are in
13 connection with any pre-existing condition. Any annuitant
14 who may enroll after this initial enrollment period shall be
15 subject to submission of satisfactory evidence of
16 insurability and to the pre-existing conditions limitation.
17 The Director shall annually determine monthly rates of
18 payment subject to the following constraints: for those
19 community colleges with annuitants only enrolled, first year
20 rates shall be equal to the average cost to cover claims for
21 a State member adjusted for demographics, Medicare
22 participation, and other factors; and in the second year, a
23 further adjustment of rates shall be made to reflect the
24 actual first year's claims experience of the covered
25 annuitants.
26 (m) The Director shall adopt any rules deemed necessary
27 for implementation of this amendatory Act of 1989 (Public Act
28 86-978).
29 (Source: P.A. 89-53, eff. 7-1-95; 89-236, eff. 8-4-95;
30 89-324, eff. 8-13-95; 89-626, eff. 8-9-96; 90-65, eff.
31 7-7-97; 90-582, eff. 5-27-98; 90-655, eff. 7-30-98; revised
32 8-3-98.)
33 Section 10. The Illinois Pension Code is amended by
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1 adding Section 15-135.1 as follows:
2 (40 ILCS 5/15-135.1 new)
3 Sec. 15-135.1. Election to avoid application of P.A.
4 90-65.
5 (a) A participant who was an employee on July 7, 1997
6 and retires on or after the effective date of this amendatory
7 Act of the 91st General Assembly may elect in writing at the
8 time of retirement to have the retirement annuity calculated
9 in accordance with the provisions of Sections 15-135 and
10 15-136 as they existed immediately prior to amendment by
11 Public Act 90-65. This election, once made, is irrevocable.
12 (b) The fact that a person has elected to participate in
13 the optional retirement program under Section 15-158.2 or has
14 elected the portability option under subsection (a-1) of
15 Section 15-154 does not prevent the person from making an
16 election under subsection (a) of this Section; the fact that
17 such a person makes an election under subsection (a) does not
18 allow the person to change the irrevocable election that he
19 or she made under Section 15-158.2 or subsection (a-1) of
20 Section 15-154.
21 (c) The System shall promptly notify the Department of
22 Central Management Services of each election made under this
23 Section.
24 Section 99. Effective date. This Act takes effect upon
25 becoming law.