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92_SB1859eng SB1859 Engrossed LRB9215806EGfg 1 AN ACT concerning health benefits. 2 Be it enacted by the People of the State of Illinois, 3 represented in the General Assembly: 4 Section 5. The State Employees Group Insurance Act of 5 1971 is amended by changing Section 8 as follows: 6 (5 ILCS 375/8) (from Ch. 127, par. 528) 7 Sec. 8. Eligibility. 8 (a) Each member eligible under the provisions of this 9 Act and any rules and regulations promulgated and adopted 10 hereunder by the Director shall become immediately eligible 11 and covered for all benefits available under the programs. 12 Members electing coverage for eligible dependents shall have 13 the coverage effective immediately, provided that the 14 election is properly filed in accordance with required filing 15 dates and procedures specified by the Director. 16 (1) Every member originally eligible to elect 17 dependent coverage, but not electing it during the 18 original eligibility period, may subsequently obtain 19 dependent coverage only in the event of a qualifying 20 change in status, special enrollment, special 21 circumstance as defined by the Director, or during the 22 annual Benefit Choice Period. 23 (2) Members described above being transferred from 24 previous coverage towards which the State has been 25 contributing shall be transferred regardless of 26 preexisting conditions, waiting periods, or other 27 requirements that might jeopardize claim payments to 28 which they would otherwise have been entitled. 29 (3) Eligible and covered members that are eligible 30 for coverage as dependents except for the fact of being 31 members shall be transferred to, and covered under, SB1859 Engrossed -2- LRB9215806EGfg 1 dependent status regardless of preexisting conditions, 2 waiting periods, or other requirements that might 3 jeopardize claim payments to which they would otherwise 4 have been entitled upon cessation of member status and 5 the election of dependent coverage by a member eligible 6 to elect that coverage. 7 (b) New employees shall be immediately insured for the 8 basic group life insurance and covered by the program of 9 health benefits on the first day of active State service. 10 Optional coverages or benefits, if elected during the 11 relevant eligibility period, will become effective on the 12 date of employment. Optional coverages or benefits applied 13 for after the eligibility period will be effective, subject 14 to satisfactory evidence of insurability when applicable, or 15 other necessary qualifications, pursuant to the requirements 16 of the applicable benefit program, unless there is a change 17 in status that would confer new eligibility for change of 18 enrollment under rules established supplementing this Act, in 19 which event application must be made within the new 20 eligibility period. 21 (c) As to the group health benefits program contracted 22 to begin or continue after June 30, 1973, each retired 23 employee shall become immediately eligible and covered for 24 all benefits available under that program. Retired employees 25 may elect coverage for eligible dependents and shall have the 26 coverage effective immediately, provided that the election is 27 properly filed in accordance with required filing dates and 28 procedures specified by the Director. 29 Where husband and wife are both eligible members, each 30 shall be enrolled as a member and coverage on their eligible 31 dependent children, if any, may be under the enrollment and 32 election of either. 33 Regardless of other provisions herein regarding late 34 enrollment or other qualifications, as appropriate, the SB1859 Engrossed -3- LRB9215806EGfg 1 Director may periodically authorize open enrollment periods 2 for each of the benefit programs at which time each member 3 may elect enrollment or change of enrollment without regard 4 to age, sex, health, or other qualification under the 5 conditions as may be prescribed in rules and regulations 6 supplementing this Act. Special open enrollment periods may 7 be declared by the Director for certain members only when 8 special circumstances occur that affect only those members. 9 (d) Beginning with fiscal year 2003 and for all 10 subsequent years, eligible employees may elect not to 11 participate in the program of health benefits as defined in 12 this Act. The election must be made during the annual 13 benefit choice period, subject to the conditions in this 14 subsection. 15 (1) Employees must furnish proof of health benefit 16 coverage, either comprehensive major medical coverage or 17 comprehensive managed care plan, from a source other than 18 the Department of Central Management Services in order to 19 elect not to participate in the program. 20 (2) Employees may re-enroll in the Department of 21 Central Management Services program of health benefits 22 upon showing a qualifying change in status, as defined in 23 the U.S. Internal Revenue Code, without evidence of 24 insurability and with no limitations on coverage for 25 pre-existing conditions, provided that there was not a 26 break in coverage of more than 63 days. 27 (3) Employees may also re-enroll in the program of 28 health benefits during any annual benefit choice period, 29 without evidence of insurability. 30 (4) Employees who elect not to participate in the 31 program of health benefits shall be furnished a written 32 explanation of the requirements and limitations for the 33 election not to participate in the program and for 34 re-enrolling in the program. The explanation shall also SB1859 Engrossed -4- LRB9215806EGfg 1 be included in the annual benefit choice options booklets 2 furnished to employees. 3 (Source: P.A. 91-390, eff. 7-30-99.) 4 Section 99. Effective date. This Act takes effect upon 5 becoming law.