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Public Act 92-0204
SB936 Enrolled LRB9205934JSpc
AN ACT concerning State employee health benefits.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The State Employees Group Insurance Act of
1971 is amended by changing Section 3 and adding Section 6.14
as follows:
(5 ILCS 375/3) (from Ch. 127, par. 523)
Sec. 3. Definitions. Unless the context otherwise
requires, the following words and phrases as used in this Act
shall have the following meanings. The Department may define
these and other words and phrases separately for the purpose
of implementing specific programs providing benefits under
this Act.
(a) "Administrative service organization" means any
person, firm or corporation experienced in the handling of
claims which is fully qualified, financially sound and
capable of meeting the service requirements of a contract of
administration executed with the Department.
(b) "Annuitant" means (1) an employee who retires, or
has retired, on or after January 1, 1966 on an immediate
annuity under the provisions of Articles 2, 14, 15 (including
an employee who has retired under the optional retirement
program established under Section 15-158.2), paragraphs (2),
(3), or (5) of Section 16-106, or Article 18 of the Illinois
Pension Code; (2) any person who was receiving group
insurance coverage under this Act as of March 31, 1978 by
reason of his status as an annuitant, even though the annuity
in relation to which such coverage was provided is a
proportional annuity based on less than the minimum period of
service required for a retirement annuity in the system
involved; (3) any person not otherwise covered by this Act
who has retired as a participating member under Article 2 of
the Illinois Pension Code but is ineligible for the
retirement annuity under Section 2-119 of the Illinois
Pension Code; (4) the spouse of any person who is receiving a
retirement annuity under Article 18 of the Illinois Pension
Code and who is covered under a group health insurance
program sponsored by a governmental employer other than the
State of Illinois and who has irrevocably elected to waive
his or her coverage under this Act and to have his or her
spouse considered as the "annuitant" under this Act and not
as a "dependent"; or (5) an employee who retires, or has
retired, from a qualified position, as determined according
to rules promulgated by the Director, under a qualified local
government or a qualified rehabilitation facility or a
qualified domestic violence shelter or service. (For
definition of "retired employee", see (p) post).
(b-5) "New SERS annuitant" means a person who, on or
after January 1, 1998, becomes an annuitant, as defined in
subsection (b), by virtue of beginning to receive a
retirement annuity under Article 14 of the Illinois Pension
Code, and is eligible to participate in the basic program of
group health benefits provided for annuitants under this Act.
(b-6) "New SURS annuitant" means a person who (1) on or
after January 1, 1998, becomes an annuitant, as defined in
subsection (b), by virtue of beginning to receive a
retirement annuity under Article 15 of the Illinois Pension
Code, (2) has not made the election authorized under Section
15-135.1 of the Illinois Pension Code, and (3) is eligible to
participate in the basic program of group health benefits
provided for annuitants under this Act.
(b-7) "New TRS State annuitant" means a person who, on
or after July 1, 1998, becomes an annuitant, as defined in
subsection (b), by virtue of beginning to receive a
retirement annuity under Article 16 of the Illinois Pension
Code based on service as a teacher as defined in paragraph
(2), (3), or (5) of Section 16-106 of that Code, and is
eligible to participate in the basic program of group health
benefits provided for annuitants under this Act.
(c) "Carrier" means (1) an insurance company, a
corporation organized under the Limited Health Service
Organization Act or the Voluntary Health Services Plan Act, a
partnership, or other nongovernmental organization, which is
authorized to do group life or group health insurance
business in Illinois, or (2) the State of Illinois as a
self-insurer.
(d) "Compensation" means salary or wages payable on a
regular payroll by the State Treasurer on a warrant of the
State Comptroller out of any State, trust or federal fund, or
by the Governor of the State through a disbursing officer of
the State out of a trust or out of federal funds, or by any
Department out of State, trust, federal or other funds held
by the State Treasurer or the Department, to any person for
personal services currently performed, and ordinary or
accidental disability benefits under Articles 2, 14, 15
(including ordinary or accidental disability benefits under
the optional retirement program established under Section
15-158.2), paragraphs (2), (3), or (5) of Section 16-106, or
Article 18 of the Illinois Pension Code, for disability
incurred after January 1, 1966, or benefits payable under the
Workers' Compensation or Occupational Diseases Act or
benefits payable under a sick pay plan established in
accordance with Section 36 of the State Finance Act.
"Compensation" also means salary or wages paid to an employee
of any qualified local government or qualified rehabilitation
facility or a qualified domestic violence shelter or service.
(e) "Commission" means the State Employees Group
Insurance Advisory Commission authorized by this Act.
Commencing July 1, 1984, "Commission" as used in this Act
means the Illinois Economic and Fiscal Commission as
established by the Legislative Commission Reorganization Act
of 1984.
(f) "Contributory", when referred to as contributory
coverage, shall mean optional coverages or benefits elected
by the member toward the cost of which such member makes
contribution, or which are funded in whole or in part through
the acceptance of a reduction in earnings or the foregoing of
an increase in earnings by an employee, as distinguished from
noncontributory coverage or benefits which are paid entirely
by the State of Illinois without reduction of the member's
salary.
(g) "Department" means any department, institution,
board, commission, officer, court or any agency of the State
government receiving appropriations and having power to
certify payrolls to the Comptroller authorizing payments of
salary and wages against such appropriations as are made by
the General Assembly from any State fund, or against trust
funds held by the State Treasurer and includes boards of
trustees of the retirement systems created by Articles 2, 14,
15, 16 and 18 of the Illinois Pension Code. "Department"
also includes the Illinois Comprehensive Health Insurance
Board, the Board of Examiners established under the Illinois
Public Accounting Act, and the Illinois Rural Bond Bank.
(h) "Dependent", when the term is used in the context of
the health and life plan, means a member's spouse and any
unmarried child (1) from birth to age 19 including an adopted
child, a child who lives with the member from the time of the
filing of a petition for adoption until entry of an order of
adoption, a stepchild or recognized child who lives with the
member in a parent-child relationship, or a child who lives
with the member if such member is a court appointed guardian
of the child, or (2) age 19 to 23 enrolled as a full-time
student in any accredited school, financially dependent upon
the member, and eligible to be claimed as a dependent for
income tax purposes, or (3) age 19 or over who is mentally or
physically handicapped. For the health plan only, the term
"dependent" also includes any person enrolled prior to the
effective date of this Section who is dependent upon the
member to the extent that the member may claim such person as
a dependent for income tax deduction purposes; no other such
person may be enrolled. For the health plan only, the term
"dependent" also includes any person who has received after
June 30, 2000 an organ transplant and who is financially
dependent upon the member and eligible to be claimed as a
dependent for income tax purposes.
(i) "Director" means the Director of the Illinois
Department of Central Management Services.
(j) "Eligibility period" means the period of time a
member has to elect enrollment in programs or to select
benefits without regard to age, sex or health.
(k) "Employee" means and includes each officer or
employee in the service of a department who (1) receives his
compensation for service rendered to the department on a
warrant issued pursuant to a payroll certified by a
department or on a warrant or check issued and drawn by a
department upon a trust, federal or other fund or on a
warrant issued pursuant to a payroll certified by an elected
or duly appointed officer of the State or who receives
payment of the performance of personal services on a warrant
issued pursuant to a payroll certified by a Department and
drawn by the Comptroller upon the State Treasurer against
appropriations made by the General Assembly from any fund or
against trust funds held by the State Treasurer, and (2) is
employed full-time or part-time in a position normally
requiring actual performance of duty during not less than 1/2
of a normal work period, as established by the Director in
cooperation with each department, except that persons elected
by popular vote will be considered employees during the
entire term for which they are elected regardless of hours
devoted to the service of the State, and (3) except that
"employee" does not include any person who is not eligible by
reason of such person's employment to participate in one of
the State retirement systems under Articles 2, 14, 15 (either
the regular Article 15 system or the optional retirement
program established under Section 15-158.2) or 18, or under
paragraph (2), (3), or (5) of Section 16-106, of the Illinois
Pension Code, but such term does include persons who are
employed during the 6 month qualifying period under Article
14 of the Illinois Pension Code. Such term also includes any
person who (1) after January 1, 1966, is receiving ordinary
or accidental disability benefits under Articles 2, 14, 15
(including ordinary or accidental disability benefits under
the optional retirement program established under Section
15-158.2), paragraphs (2), (3), or (5) of Section 16-106, or
Article 18 of the Illinois Pension Code, for disability
incurred after January 1, 1966, (2) receives total permanent
or total temporary disability under the Workers' Compensation
Act or Occupational Disease Act as a result of injuries
sustained or illness contracted in the course of employment
with the State of Illinois, or (3) is not otherwise covered
under this Act and has retired as a participating member
under Article 2 of the Illinois Pension Code but is
ineligible for the retirement annuity under Section 2-119 of
the Illinois Pension Code. However, a person who satisfies
the criteria of the foregoing definition of "employee" except
that such person is made ineligible to participate in the
State Universities Retirement System by clause (4) of
subsection (a) of Section 15-107 of the Illinois Pension Code
is also an "employee" for the purposes of this Act.
"Employee" also includes any person receiving or eligible for
benefits under a sick pay plan established in accordance with
Section 36 of the State Finance Act. "Employee" also includes
each officer or employee in the service of a qualified local
government, including persons appointed as trustees of
sanitary districts regardless of hours devoted to the service
of the sanitary district, and each employee in the service of
a qualified rehabilitation facility and each full-time
employee in the service of a qualified domestic violence
shelter or service, as determined according to rules
promulgated by the Director.
(l) "Member" means an employee, annuitant, retired
employee or survivor.
(m) "Optional coverages or benefits" means those
coverages or benefits available to the member on his or her
voluntary election, and at his or her own expense.
(n) "Program" means the group life insurance, health
benefits and other employee benefits designed and contracted
for by the Director under this Act.
(o) "Health plan" means a health benefits program
offered by the State of Illinois for persons eligible for the
plan.
(p) "Retired employee" means any person who would be an
annuitant as that term is defined herein but for the fact
that such person retired prior to January 1, 1966. Such term
also includes any person formerly employed by the University
of Illinois in the Cooperative Extension Service who would be
an annuitant but for the fact that such person was made
ineligible to participate in the State Universities
Retirement System by clause (4) of subsection (a) of Section
15-107 of the Illinois Pension Code.
(q) "Survivor" means a person receiving an annuity as a
survivor of an employee or of an annuitant. "Survivor" also
includes: (1) the surviving dependent of a person who
satisfies the definition of "employee" except that such
person is made ineligible to participate in the State
Universities Retirement System by clause (4) of subsection
(a) of Section 15-107 of the Illinois Pension Code; and (2)
the surviving dependent of any person formerly employed by
the University of Illinois in the Cooperative Extension
Service who would be an annuitant except for the fact that
such person was made ineligible to participate in the State
Universities Retirement System by clause (4) of subsection
(a) of Section 15-107 of the Illinois Pension Code.
(q-5) "New SERS survivor" means a survivor, as defined
in subsection (q), whose annuity is paid under Article 14 of
the Illinois Pension Code and is based on the death of (i) an
employee whose death occurs on or after January 1, 1998, or
(ii) a new SERS annuitant as defined in subsection (b-5).
(q-6) "New SURS survivor" means a survivor, as defined
in subsection (q), whose annuity is paid under Article 15 of
the Illinois Pension Code and is based on the death of (i) an
employee whose death occurs on or after January 1, 1998, or
(ii) a new SURS annuitant as defined in subsection (b-6).
(q-7) "New TRS State survivor" means a survivor, as
defined in subsection (q), whose annuity is paid under
Article 16 of the Illinois Pension Code and is based on the
death of (i) an employee who is a teacher as defined in
paragraph (2), (3), or (5) of Section 16-106 of that Code and
whose death occurs on or after July 1, 1998, or (ii) a new
TRS State annuitant as defined in subsection (b-7).
(r) "Medical services" means the services provided
within the scope of their licenses by practitioners in all
categories licensed under the Medical Practice Act of 1987.
(s) "Unit of local government" means any county,
municipality, township, school district, special district or
other unit, designated as a unit of local government by law,
which exercises limited governmental powers or powers in
respect to limited governmental subjects, any not-for-profit
association with a membership that primarily includes
townships and township officials, that has duties that
include provision of research service, dissemination of
information, and other acts for the purpose of improving
township government, and that is funded wholly or partly in
accordance with Section 85-15 of the Township Code; any
not-for-profit corporation or association, with a membership
consisting primarily of municipalities, that operates its own
utility system, and provides research, training,
dissemination of information, or other acts to promote
cooperation between and among municipalities that provide
utility services and for the advancement of the goals and
purposes of its membership; the Southern Illinois Collegiate
Common Market, which is a consortium of higher education
institutions in Southern Illinois; and the Illinois
Association of Park Districts. "Qualified local government"
means a unit of local government approved by the Director and
participating in a program created under subsection (i) of
Section 10 of this Act.
(t) "Qualified rehabilitation facility" means any
not-for-profit organization that is accredited by the
Commission on Accreditation of Rehabilitation Facilities or
certified by the Department of Human Services (as successor
to the Department of Mental Health and Developmental
Disabilities) to provide services to persons with
disabilities and which receives funds from the State of
Illinois for providing those services, approved by the
Director and participating in a program created under
subsection (j) of Section 10 of this Act.
(u) "Qualified domestic violence shelter or service"
means any Illinois domestic violence shelter or service and
its administrative offices funded by the Department of Human
Services (as successor to the Illinois Department of Public
Aid), approved by the Director and participating in a program
created under subsection (k) of Section 10.
(v) "TRS benefit recipient" means a person who:
(1) is not a "member" as defined in this Section;
and
(2) is receiving a monthly benefit or retirement
annuity under Article 16 of the Illinois Pension Code;
and
(3) either (i) has at least 8 years of creditable
service under Article 16 of the Illinois Pension Code, or
(ii) was enrolled in the health insurance program offered
under that Article on January 1, 1996, or (iii) is the
survivor of a benefit recipient who had at least 8 years
of creditable service under Article 16 of the Illinois
Pension Code or was enrolled in the health insurance
program offered under that Article on the effective date
of this amendatory Act of 1995, or (iv) is a recipient or
survivor of a recipient of a disability benefit under
Article 16 of the Illinois Pension Code.
(w) "TRS dependent beneficiary" means a person who:
(1) is not a "member" or "dependent" as defined in
this Section; and
(2) is a TRS benefit recipient's: (A) spouse, (B)
dependent parent who is receiving at least half of his or
her support from the TRS benefit recipient, or (C)
unmarried natural or adopted child who is (i) under age
19, or (ii) enrolled as a full-time student in an
accredited school, financially dependent upon the TRS
benefit recipient, eligible to be claimed as a dependent
for income tax purposes, and either is under age 24 or
was, on January 1, 1996, participating as a dependent
beneficiary in the health insurance program offered under
Article 16 of the Illinois Pension Code, or (iii) age 19
or over who is mentally or physically handicapped.
(x) "Military leave with pay and benefits" refers to
individuals in basic training for reserves, special/advanced
training, annual training, emergency call up, or activation
by the President of the United States with approved pay and
benefits.
(y) "Military leave without pay and benefits" refers to
individuals who enlist for active duty in a regular component
of the U.S. Armed Forces or other duty not specified or
authorized under military leave with pay and benefits.
(z) "Community college benefit recipient" means a person
who:
(1) is not a "member" as defined in this Section;
and
(2) is receiving a monthly survivor's annuity or
retirement annuity under Article 15 of the Illinois
Pension Code; and
(3) either (i) was a full-time employee of a
community college district or an association of community
college boards created under the Public Community College
Act (other than an employee whose last employer under
Article 15 of the Illinois Pension Code was a community
college district subject to Article VII of the Public
Community College Act) and was eligible to participate in
a group health benefit plan as an employee during the
time of employment with a community college district
(other than a community college district subject to
Article VII of the Public Community College Act) or an
association of community college boards, or (ii) is the
survivor of a person described in item (i).
(aa) "Community college dependent beneficiary" means a
person who:
(1) is not a "member" or "dependent" as defined in
this Section; and
(2) is a community college benefit recipient's: (A)
spouse, (B) dependent parent who is receiving at least
half of his or her support from the community college
benefit recipient, or (C) unmarried natural or adopted
child who is (i) under age 19, or (ii) enrolled as a
full-time student in an accredited school, financially
dependent upon the community college benefit recipient,
eligible to be claimed as a dependent for income tax
purposes and under age 23, or (iii) age 19 or over and
mentally or physically handicapped.
(Source: P.A. 90-14, eff. 7-1-97; 90-65, eff. 7-7-97; 90-448,
eff. 8-16-97; 90-497, eff. 8-18-97; 90-511, eff. 8-22-97;
90-582, eff. 5-27-98; 90-655, eff. 7-30-98; 91-390, eff.
7-30-99; 91-395, eff. 7-30-99; 91-617, eff, 8-19-99; revised
10-19-99.)
(5 ILCS 375/6.14 new)
Sec. 6.14. Organ donor costs. With respect to organ
transplants occurring after June 30, 2000 when both a donor
and donee are members of the same family and are both covered
by the program of health benefits, the program of health
benefits shall pay 100% of the donor's expenses without the
imposition of any deductible or copayment.
Section 99. Effective date. This Act takes effect upon
becoming law.
Passed in the General Assembly May 09, 2001.
Approved August 01, 2001.
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