[ Search ] [ Legislation ]
[ Home ] [ Back ] [ Bottom ]
91_HB4471
LRB9112039JMmb
1 AN ACT to amend the State Employees Group Insurance Act
2 of 1971 by changing Section 3 and adding Section 6.15.
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 Section 3 and adding Section 6.15
7 as follows:
8 (5 ILCS 375/3) (from Ch. 127, par. 523)
9 Sec. 3. Definitions. Unless the context otherwise
10 requires, the following words and phrases as used in this Act
11 shall have the following meanings. The Department may define
12 these and other words and phrases separately for the purpose
13 of implementing specific programs providing benefits under
14 this Act.
15 (a) "Administrative service organization" means any
16 person, firm or corporation experienced in the handling of
17 claims which is fully qualified, financially sound and
18 capable of meeting the service requirements of a contract of
19 administration executed with the Department.
20 (b) "Annuitant" means (1) an employee who retires, or
21 has retired, on or after January 1, 1966 on an immediate
22 annuity under the provisions of Articles 2, 14, 15 (including
23 an employee who has retired under the optional retirement
24 program established under Section 15-158.2), paragraphs (2),
25 (3), or (5) of Section 16-106, or Article 18 of the Illinois
26 Pension Code; (2) any person who was receiving group
27 insurance coverage under this Act as of March 31, 1978 by
28 reason of his status as an annuitant, even though the annuity
29 in relation to which such coverage was provided is a
30 proportional annuity based on less than the minimum period of
31 service required for a retirement annuity in the system
-2- LRB9112039JMmb
1 involved; (3) any person not otherwise covered by this Act
2 who has retired as a participating member under Article 2 of
3 the Illinois Pension Code but is ineligible for the
4 retirement annuity under Section 2-119 of the Illinois
5 Pension Code; (4) the spouse of any person who is receiving a
6 retirement annuity under Article 18 of the Illinois Pension
7 Code and who is covered under a group health insurance
8 program sponsored by a governmental employer other than the
9 State of Illinois and who has irrevocably elected to waive
10 his or her coverage under this Act and to have his or her
11 spouse considered as the "annuitant" under this Act and not
12 as a "dependent"; or (5) an employee who retires, or has
13 retired, from a qualified position, as determined according
14 to rules promulgated by the Director, under a qualified local
15 government or a qualified rehabilitation facility or a
16 qualified domestic violence shelter or service. (For
17 definition of "retired employee", see (p) post).
18 (b-5) "New SERS annuitant" means a person who, on or
19 after January 1, 1998, becomes an annuitant, as defined in
20 subsection (b), by virtue of beginning to receive a
21 retirement annuity under Article 14 of the Illinois Pension
22 Code, and is eligible to participate in the basic program of
23 group health benefits provided for annuitants under this Act.
24 (b-6) "New SURS annuitant" means a person who (1) on or
25 after January 1, 1998, becomes an annuitant, as defined in
26 subsection (b), by virtue of beginning to receive a
27 retirement annuity under Article 15 of the Illinois Pension
28 Code, (2) has not made the election authorized under Section
29 15-135.1 of the Illinois Pension Code, and (3) is eligible to
30 participate in the basic program of group health benefits
31 provided for annuitants under this Act.
32 (b-7) "New TRS State annuitant" means a person who, on
33 or after July 1, 1998, becomes an annuitant, as defined in
34 subsection (b), by virtue of beginning to receive a
-3- LRB9112039JMmb
1 retirement annuity under Article 16 of the Illinois Pension
2 Code based on service as a teacher as defined in paragraph
3 (2), (3), or (5) of Section 16-106 of that Code, and is
4 eligible to participate in the basic program of group health
5 benefits provided for annuitants under this Act.
6 (c) "Carrier" means (1) an insurance company, a
7 corporation organized under the Limited Health Service
8 Organization Act or the Voluntary Health Services Plan Act, a
9 partnership, or other nongovernmental organization, which is
10 authorized to do group life or group health insurance
11 business in Illinois, or (2) the State of Illinois as a
12 self-insurer.
13 (d) "Compensation" means salary or wages payable on a
14 regular payroll by the State Treasurer on a warrant of the
15 State Comptroller out of any State, trust or federal fund, or
16 by the Governor of the State through a disbursing officer of
17 the State out of a trust or out of federal funds, or by any
18 Department out of State, trust, federal or other funds held
19 by the State Treasurer or the Department, to any person for
20 personal services currently performed, and ordinary or
21 accidental disability benefits under Articles 2, 14, 15
22 (including ordinary or accidental disability benefits under
23 the optional retirement program established under Section
24 15-158.2), paragraphs (2), (3), or (5) of Section 16-106, or
25 Article 18 of the Illinois Pension Code, for disability
26 incurred after January 1, 1966, or benefits payable under the
27 Workers' Compensation or Occupational Diseases Act or
28 benefits payable under a sick pay plan established in
29 accordance with Section 36 of the State Finance Act.
30 "Compensation" also means salary or wages paid to an employee
31 of any qualified local government or qualified rehabilitation
32 facility or a qualified domestic violence shelter or service.
33 (e) "Commission" means the State Employees Group
34 Insurance Advisory Commission authorized by this Act.
-4- LRB9112039JMmb
1 Commencing July 1, 1984, "Commission" as used in this Act
2 means the Illinois Economic and Fiscal Commission as
3 established by the Legislative Commission Reorganization Act
4 of 1984.
5 (f) "Contributory", when referred to as contributory
6 coverage, shall mean optional coverages or benefits elected
7 by the member toward the cost of which such member makes
8 contribution, or which are funded in whole or in part through
9 the acceptance of a reduction in earnings or the foregoing of
10 an increase in earnings by an employee, as distinguished from
11 noncontributory coverage or benefits which are paid entirely
12 by the State of Illinois without reduction of the member's
13 salary.
14 (g) "Department" means any department, institution,
15 board, commission, officer, court or any agency of the State
16 government receiving appropriations and having power to
17 certify payrolls to the Comptroller authorizing payments of
18 salary and wages against such appropriations as are made by
19 the General Assembly from any State fund, or against trust
20 funds held by the State Treasurer and includes boards of
21 trustees of the retirement systems created by Articles 2, 14,
22 15, 16 and 18 of the Illinois Pension Code. "Department"
23 also includes the Illinois Comprehensive Health Insurance
24 Board, the Board of Examiners established under the Illinois
25 Public Accounting Act, and the Illinois Rural Bond Bank.
26 (h) "Dependent", when the term is used in the context of
27 the health and life plan, means a member's spouse and any
28 unmarried child (1) from birth to age 19 including an adopted
29 child, a child who lives with the member from the time of the
30 filing of a petition for adoption until entry of an order of
31 adoption, a stepchild or recognized child who lives with the
32 member in a parent-child relationship, or a child who lives
33 with the member if such member is a court appointed guardian
34 of the child, or (2) age 19 to 23 enrolled as a full-time
-5- LRB9112039JMmb
1 student in any accredited school, financially dependent upon
2 the member, and eligible to be claimed as a dependent for
3 income tax purposes, or (3) age 19 or over who is mentally or
4 physically handicapped. For the health plan only, the term
5 "dependent" also includes any person enrolled prior to the
6 effective date of this Section who is dependent upon the
7 member to the extent that the member may claim such person as
8 a dependent for 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
-6- LRB9112039JMmb
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
-7- LRB9112039JMmb
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. "Member", when used in the context of
9 the health plan, does not include a member who has opted out
10 of the health plan.
11 (m) "Optional coverages or benefits" means those
12 coverages or benefits available to the member on his or her
13 voluntary election, and at his or her own expense.
14 (n) "Program" means the group life insurance, health
15 benefits and other employee benefits designed and contracted
16 for by the Director under this Act.
17 (o) "Health plan" means a health benefits program
18 offered by the State of Illinois for persons eligible for the
19 plan.
20 (p) "Retired employee" means any person who would be an
21 annuitant as that term is defined herein but for the fact
22 that such person retired prior to January 1, 1966. Such term
23 also includes any person formerly employed by the University
24 of Illinois in the Cooperative Extension Service who would be
25 an annuitant but for the fact that such person was made
26 ineligible to participate in the State Universities
27 Retirement System by clause (4) of subsection (a) of Section
28 15-107 of the Illinois Pension Code.
29 (q) "Survivor" means a person receiving an annuity as a
30 survivor of an employee or of an annuitant. "Survivor" also
31 includes: (1) the surviving dependent of a person who
32 satisfies the definition of "employee" except that such
33 person is made ineligible to participate in the State
34 Universities Retirement System by clause (4) of subsection
-8- LRB9112039JMmb
1 (a) of Section 15-107 of the Illinois Pension Code; and (2)
2 the surviving dependent of any person formerly employed by
3 the University of Illinois in the Cooperative Extension
4 Service who would be an annuitant except for the fact that
5 such person was made ineligible to participate in the State
6 Universities Retirement System by clause (4) of subsection
7 (a) of Section 15-107 of the Illinois Pension Code.
8 (q-5) "New SERS survivor" means a survivor, as defined
9 in subsection (q), whose annuity is paid under Article 14 of
10 the Illinois Pension Code and is based on the death of (i) an
11 employee whose death occurs on or after January 1, 1998, or
12 (ii) a new SERS annuitant as defined in subsection (b-5).
13 (q-6) "New SURS survivor" means a survivor, as defined
14 in subsection (q), whose annuity is paid under Article 15 of
15 the Illinois Pension Code and is based on the death of (i) an
16 employee whose death occurs on or after January 1, 1998, or
17 (ii) a new SURS annuitant as defined in subsection (b-6).
18 (q-7) "New TRS State survivor" means a survivor, as
19 defined in subsection (q), whose annuity is paid under
20 Article 16 of the Illinois Pension Code and is based on the
21 death of (i) an employee who is a teacher as defined in
22 paragraph (2), (3), or (5) of Section 16-106 of that Code and
23 whose death occurs on or after July 1, 1998, or (ii) a new
24 TRS State annuitant as defined in subsection (b-7).
25 (r) "Medical services" means the services provided
26 within the scope of their licenses by practitioners in all
27 categories licensed under the Medical Practice Act of 1987.
28 (s) "Unit of local government" means any county,
29 municipality, township, school district, special district or
30 other unit, designated as a unit of local government by law,
31 which exercises limited governmental powers or powers in
32 respect to limited governmental subjects, any not-for-profit
33 association with a membership that primarily includes
34 townships and township officials, that has duties that
-9- LRB9112039JMmb
1 include provision of research service, dissemination of
2 information, and other acts for the purpose of improving
3 township government, and that is funded wholly or partly in
4 accordance with Section 85-15 of the Township Code; any
5 not-for-profit corporation or association, with a membership
6 consisting primarily of municipalities, that operates its own
7 utility system, and provides research, training,
8 dissemination of information, or other acts to promote
9 cooperation between and among municipalities that provide
10 utility services and for the advancement of the goals and
11 purposes of its membership; the Southern Illinois Collegiate
12 Common Market, which is a consortium of higher education
13 institutions in Southern Illinois; and the Illinois
14 Association of Park Districts. "Qualified local government"
15 means a unit of local government approved by the Director and
16 participating in a program created under subsection (i) of
17 Section 10 of this Act.
18 (t) "Qualified rehabilitation facility" means any
19 not-for-profit organization that is accredited by the
20 Commission on Accreditation of Rehabilitation Facilities or
21 certified by the Department of Human Services (as successor
22 to the Department of Mental Health and Developmental
23 Disabilities) to provide services to persons with
24 disabilities and which receives funds from the State of
25 Illinois for providing those services, approved by the
26 Director and participating in a program created under
27 subsection (j) of Section 10 of this Act.
28 (u) "Qualified domestic violence shelter or service"
29 means any Illinois domestic violence shelter or service and
30 its administrative offices funded by the Department of Human
31 Services (as successor to the Illinois Department of Public
32 Aid), approved by the Director and participating in a program
33 created under subsection (k) of Section 10.
34 (v) "TRS benefit recipient" means a person who:
-10- LRB9112039JMmb
1 (1) is not a "member" as defined in this Section;
2 and
3 (2) is receiving a monthly benefit or retirement
4 annuity under Article 16 of the Illinois Pension Code;
5 and
6 (3) either (i) has at least 8 years of creditable
7 service under Article 16 of the Illinois Pension Code, or
8 (ii) was enrolled in the health insurance program offered
9 under that Article on January 1, 1996, or (iii) is the
10 survivor of a benefit recipient who had at least 8 years
11 of creditable service under Article 16 of the Illinois
12 Pension Code or was enrolled in the health insurance
13 program offered under that Article on the effective date
14 of this amendatory Act of 1995, or (iv) is a recipient or
15 survivor of a recipient of a disability benefit under
16 Article 16 of the Illinois Pension Code.
17 (w) "TRS dependent beneficiary" means a person who:
18 (1) is not a "member" or "dependent" as defined in
19 this Section; and
20 (2) is a TRS benefit recipient's: (A) spouse, (B)
21 dependent parent who is receiving at least half of his or
22 her support from the TRS benefit recipient, or (C)
23 unmarried natural or adopted child who is (i) under age
24 19, or (ii) enrolled as a full-time student in an
25 accredited school, financially dependent upon the TRS
26 benefit recipient, eligible to be claimed as a dependent
27 for income tax purposes, and either is under age 24 or
28 was, on January 1, 1996, participating as a dependent
29 beneficiary in the health insurance program offered under
30 Article 16 of the Illinois Pension Code, or (iii) age 19
31 or over who is mentally or physically handicapped.
32 (x) "Military leave with pay and benefits" refers to
33 individuals in basic training for reserves, special/advanced
34 training, annual training, emergency call up, or activation
-11- LRB9112039JMmb
1 by the President of the United States with approved pay and
2 benefits.
3 (y) "Military leave without pay and benefits" refers to
4 individuals who enlist for active duty in a regular component
5 of the U.S. Armed Forces or other duty not specified or
6 authorized under military leave with pay and benefits.
7 (z) "Community college benefit recipient" means a person
8 who:
9 (1) is not a "member" as defined in this Section;
10 and
11 (2) is receiving a monthly survivor's annuity or
12 retirement annuity under Article 15 of the Illinois
13 Pension Code; and
14 (3) either (i) was a full-time employee of a
15 community college district or an association of community
16 college boards created under the Public Community College
17 Act (other than an employee whose last employer under
18 Article 15 of the Illinois Pension Code was a community
19 college district subject to Article VII of the Public
20 Community College Act) and was eligible to participate in
21 a group health benefit plan as an employee during the
22 time of employment with a community college district
23 (other than a community college district subject to
24 Article VII of the Public Community College Act) or an
25 association of community college boards, or (ii) is the
26 survivor of a person described in item (i).
27 (aa) "Community college dependent beneficiary" means a
28 person who:
29 (1) is not a "member" or "dependent" as defined in
30 this Section; and
31 (2) is a community college benefit recipient's: (A)
32 spouse, (B) dependent parent who is receiving at least
33 half of his or her support from the community college
34 benefit recipient, or (C) unmarried natural or adopted
-12- LRB9112039JMmb
1 child who is (i) under age 19, or (ii) enrolled as a
2 full-time student in an accredited school, financially
3 dependent upon the community college benefit recipient,
4 eligible to be claimed as a dependent for income tax
5 purposes and under age 23, or (iii) age 19 or over and
6 mentally or physically handicapped.
7 (Source: P.A. 90-14, eff. 7-1-97; 90-65, eff. 7-7-97; 90-448,
8 eff. 8-16-97; 90-497, eff. 8-18-97; 90-511, eff. 8-22-97;
9 90-582, eff. 5-27-98; 90-655, eff. 7-30-98; 91-390, eff.
10 7-30-99; 91-395, eff. 7-30-99; 91-617, eff, 8-19-99; revised
11 10-19-99.)
12 (5 ILCS 375/6.15 new)
13 Sec. 6.15. Health plan; election to opt out. Any member
14 may at any time elect to remove himself or herself and any
15 dependents from coverage under the health plan. Members and
16 dependents who have been removed from coverage under the
17 health plan shall not be assessed premiums. Members who have
18 removed themselves or their dependents from coverage under
19 the health plan may rejoin the health plan and may arrange to
20 have their dependents rejoin the health plan at any time.