SB2292 EngrossedLRB100 16179 RJF 31300 b

1    AN ACT concerning government.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The State Employees Group Insurance Act of 1971
5is amended by changing Sections 9 and 10 as follows:
 
6    (5 ILCS 375/9)  (from Ch. 127, par. 529)
7    Sec. 9. (a) The eligible member shall be responsible for
8his or her portion of the premiums, charges or other fees for
9all elected coverages or benefits, which shall be paid by means
10of the acceptance of a reduction in earnings or the foregoing
11of an increase in earnings by an employee; provided, however,
12subject to rules and regulations promulgated by the Department,
13the eligible member may make personal payment of the premium,
14charge or fee for any wellness programs implemented under the
15program of health benefits. All contributions and payments by
16the eligible members and the State for all elected coverages
17and benefits shall be deposited in the Health Insurance Reserve
18Fund. Except as otherwise provided in subsection (a-5), the The
19Department may determine the aggregate level of contribution
20required under this Section on the basis of actual cost of
21services adjusted for age, sex or the geographical or other
22demographic characteristics which affect costs of the benefit.
23    (a-5) Notwithstanding any provision of law to the contrary,

 

 

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1any member of the General Assembly sworn into office on and
2after the second Wednesday in January of 2019, and who retires
3a participating member under Article 2 of the Illinois Pension
4Code, shall be responsible for exactly 50% of the applicable
5premiums, charges, or other fees for the basic program of group
6health benefits. The provisions of this subsection (a-5) do not
7apply to any person who previously served as a member of the
8General Assembly in either house prior to the second Wednesday
9of January of 2019. However, a current or retired member of the
10General Assembly who was sworn into or retired from office
11prior to the second Wednesday of January of 2019 may elect to
12be responsible for the applicable premiums, charges, or other
13fees for the basic program of group health benefits in
14accordance with this subsection (a-5).
15    (b) If a member is not entitled to receive any salary,
16wages or other compensation during a period in which premiums,
17charges or other fees are due or does not receive compensation
18sufficient to allow deduction of the required payment of the
19premium, charge or other fee, such member may continue the
20contributory benefit in effect by making personal payment of
21the premium, charge or other fee for the period in such manner,
22in such amount, and for such duration, as may be prescribed in
23rules and regulations promulgated for the administration of
24this Act.
25(Source: P.A. 91-390, eff. 7-30-99.)
 

 

 

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1    (5 ILCS 375/10)  (from Ch. 127, par. 530)
2    Sec. 10. Contributions by the State and members.
3    (a) The State shall pay the cost of basic non-contributory
4group life insurance and, subject to member paid contributions
5set by the Department or required by this Section and except as
6provided in this Section, the basic program of group health
7benefits on each eligible member, except a member, not
8otherwise covered by this Act, who has retired as a
9participating member under Article 2 of the Illinois Pension
10Code but is ineligible for the retirement annuity under Section
112-119 of the Illinois Pension Code, and part of each eligible
12member's and retired member's premiums for health insurance
13coverage for enrolled dependents as provided by Section 9. The
14State shall pay the cost of the basic program of group health
15benefits only after benefits are reduced by the amount of
16benefits covered by Medicare for all members and dependents who
17are eligible for benefits under Social Security or the Railroad
18Retirement system or who had sufficient Medicare-covered
19government employment, except that such reduction in benefits
20shall apply only to those members and dependents who (1) first
21become eligible for such Medicare coverage on or after July 1,
221992; or (2) are Medicare-eligible members or dependents of a
23local government unit which began participation in the program
24on or after July 1, 1992; or (3) remain eligible for, but no
25longer receive Medicare coverage which they had been receiving
26on or after July 1, 1992. The Department may determine the

 

 

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1aggregate level of the State's contribution on the basis of
2actual cost of medical services adjusted for age, sex or
3geographic or other demographic characteristics which affect
4the costs of such programs, except that, subject to a reduction
5based upon Medicare coverage, the State's contribution towards
6the basic program of group health benefits provided to members
7specified under subsection (a-5) of Section 9 shall be exactly
850% of the applicable premiums, charges, or other fees owed.
9    The cost of participation in the basic program of group
10health benefits for the dependent or survivor of a living or
11deceased retired employee who was formerly employed by the
12University of Illinois in the Cooperative Extension Service and
13would be an annuitant but for the fact that he or she was made
14ineligible to participate in the State Universities Retirement
15System by clause (4) of subsection (a) of Section 15-107 of the
16Illinois Pension Code shall not be greater than the cost of
17participation that would otherwise apply to that dependent or
18survivor if he or she were the dependent or survivor of an
19annuitant under the State Universities Retirement System.
20    (a-1) (Blank).
21    (a-2) (Blank).
22    (a-3) (Blank).
23    (a-4) (Blank).
24    (a-5) (Blank).
25    (a-6) (Blank).
26    (a-7) (Blank).

 

 

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1    (a-8) Any annuitant, survivor, or retired employee may
2waive or terminate coverage in the program of group health
3benefits. Any such annuitant, survivor, or retired employee who
4has waived or terminated coverage may enroll or re-enroll in
5the program of group health benefits only during the annual
6benefit choice period, as determined by the Director; except
7that in the event of termination of coverage due to nonpayment
8of premiums, the annuitant, survivor, or retired employee may
9not re-enroll in the program.
10    (a-8.5) Beginning on the effective date of this amendatory
11Act of the 97th General Assembly, and except as otherwise
12provided under subsection (a) of this Section and subsection
13(a-5) of Section 9, the Director of Central Management Services
14shall, on an annual basis, determine the amount that the State
15shall contribute toward the basic program of group health
16benefits on behalf of annuitants (including individuals who (i)
17participated in the General Assembly Retirement System, the
18State Employees' Retirement System of Illinois, the State
19Universities Retirement System, the Teachers' Retirement
20System of the State of Illinois, or the Judges Retirement
21System of Illinois and (ii) qualify as annuitants under
22subsection (b) of Section 3 of this Act), survivors (including
23individuals who (i) receive an annuity as a survivor of an
24individual who participated in the General Assembly Retirement
25System, the State Employees' Retirement System of Illinois, the
26State Universities Retirement System, the Teachers' Retirement

 

 

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1System of the State of Illinois, or the Judges Retirement
2System of Illinois and (ii) qualify as survivors under
3subsection (q) of Section 3 of this Act), and retired employees
4(as defined in subsection (p) of Section 3 of this Act). The
5remainder of the cost of coverage for each annuitant, survivor,
6or retired employee, as determined by the Director of Central
7Management Services, shall be the responsibility of that
8annuitant, survivor, or retired employee.
9    Contributions required of annuitants, survivors, and
10retired employees shall be the same for all retirement systems
11and shall also be based on whether an individual has made an
12election under Section 15-135.1 of the Illinois Pension Code.
13Contributions may be based on annuitants', survivors', or
14retired employees' Medicare eligibility, but may not be based
15on Social Security eligibility.
16    (a-9) No later than May 1 of each calendar year, the
17Director of Central Management Services shall certify in
18writing to the Executive Secretary of the State Employees'
19Retirement System of Illinois the amounts of the Medicare
20supplement health care premiums and the amounts of the health
21care premiums for all other retirees who are not Medicare
22eligible.
23    A separate calculation of the premiums based upon the
24actual cost of each health care plan shall be so certified.
25    The Director of Central Management Services shall provide
26to the Executive Secretary of the State Employees' Retirement

 

 

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1System of Illinois such information, statistics, and other data
2as he or she may require to review the premium amounts
3certified by the Director of Central Management Services.
4    The Department of Central Management Services, or any
5successor agency designated to procure healthcare contracts
6pursuant to this Act, is authorized to establish funds,
7separate accounts provided by any bank or banks as defined by
8the Illinois Banking Act, or separate accounts provided by any
9savings and loan association or associations as defined by the
10Illinois Savings and Loan Act of 1985 to be held by the
11Director, outside the State treasury, for the purpose of
12receiving the transfer of moneys from the Local Government
13Health Insurance Reserve Fund. The Department may promulgate
14rules further defining the methodology for the transfers. Any
15interest earned by moneys in the funds or accounts shall inure
16to the Local Government Health Insurance Reserve Fund. The
17transferred moneys, and interest accrued thereon, shall be used
18exclusively for transfers to administrative service
19organizations or their financial institutions for payments of
20claims to claimants and providers under the self-insurance
21health plan. The transferred moneys, and interest accrued
22thereon, shall not be used for any other purpose including, but
23not limited to, reimbursement of administration fees due the
24administrative service organization pursuant to its contract
25or contracts with the Department.
26    (b) State employees who become eligible for this program on

 

 

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1or after January 1, 1980 in positions normally requiring actual
2performance of duty not less than 1/2 of a normal work period
3but not equal to that of a normal work period, shall be given
4the option of participating in the available program. If the
5employee elects coverage, the State shall contribute on behalf
6of such employee to the cost of the employee's benefit and any
7applicable dependent supplement, that sum which bears the same
8percentage as that percentage of time the employee regularly
9works when compared to normal work period.
10    (c) The basic non-contributory coverage from the basic
11program of group health benefits shall be continued for each
12employee not in pay status or on active service by reason of
13(1) leave of absence due to illness or injury, (2) authorized
14educational leave of absence or sabbatical leave, or (3)
15military leave. This coverage shall continue until expiration
16of authorized leave and return to active service, but not to
17exceed 24 months for leaves under item (1) or (2). This
1824-month limitation and the requirement of returning to active
19service shall not apply to persons receiving ordinary or
20accidental disability benefits or retirement benefits through
21the appropriate State retirement system or benefits under the
22Workers' Compensation or Occupational Disease Act.
23    (d) The basic group life insurance coverage shall continue,
24with full State contribution, where such person is (1) absent
25from active service by reason of disability arising from any
26cause other than self-inflicted, (2) on authorized educational

 

 

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1leave of absence or sabbatical leave, or (3) on military leave.
2    (e) Where the person is in non-pay status for a period in
3excess of 30 days or on leave of absence, other than by reason
4of disability, educational or sabbatical leave, or military
5leave, such person may continue coverage only by making
6personal payment equal to the amount normally contributed by
7the State on such person's behalf. Such payments and coverage
8may be continued: (1) until such time as the person returns to
9a status eligible for coverage at State expense, but not to
10exceed 24 months or (2) until such person's employment or
11annuitant status with the State is terminated (exclusive of any
12additional service imposed pursuant to law).
13    (f) The Department shall establish by rule the extent to
14which other employee benefits will continue for persons in
15non-pay status or who are not in active service.
16    (g) The State shall not pay the cost of the basic
17non-contributory group life insurance, program of health
18benefits and other employee benefits for members who are
19survivors as defined by paragraphs (1) and (2) of subsection
20(q) of Section 3 of this Act. The costs of benefits for these
21survivors shall be paid by the survivors or by the University
22of Illinois Cooperative Extension Service, or any combination
23thereof. However, the State shall pay the amount of the
24reduction in the cost of participation, if any, resulting from
25the amendment to subsection (a) made by this amendatory Act of
26the 91st General Assembly.

 

 

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1    (h) Those persons occupying positions with any department
2as a result of emergency appointments pursuant to Section 8b.8
3of the Personnel Code who are not considered employees under
4this Act shall be given the option of participating in the
5programs of group life insurance, health benefits and other
6employee benefits. Such persons electing coverage may
7participate only by making payment equal to the amount normally
8contributed by the State for similarly situated employees. Such
9amounts shall be determined by the Director. Such payments and
10coverage may be continued until such time as the person becomes
11an employee pursuant to this Act or such person's appointment
12is terminated.
13    (i) Any unit of local government within the State of
14Illinois may apply to the Director to have its employees,
15annuitants, and their dependents provided group health
16coverage under this Act on a non-insured basis. To participate,
17a unit of local government must agree to enroll all of its
18employees, who may select coverage under either the State group
19health benefits plan or a health maintenance organization that
20has contracted with the State to be available as a health care
21provider for employees as defined in this Act. A unit of local
22government must remit the entire cost of providing coverage
23under the State group health benefits plan or, for coverage
24under a health maintenance organization, an amount determined
25by the Director based on an analysis of the sex, age,
26geographic location, or other relevant demographic variables

 

 

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1for its employees, except that the unit of local government
2shall not be required to enroll those of its employees who are
3covered spouses or dependents under this plan or another group
4policy or plan providing health benefits as long as (1) an
5appropriate official from the unit of local government attests
6that each employee not enrolled is a covered spouse or
7dependent under this plan or another group policy or plan, and
8(2) at least 50% of the employees are enrolled and the unit of
9local government remits the entire cost of providing coverage
10to those employees, except that a participating school district
11must have enrolled at least 50% of its full-time employees who
12have not waived coverage under the district's group health plan
13by participating in a component of the district's cafeteria
14plan. A participating school district is not required to enroll
15a full-time employee who has waived coverage under the
16district's health plan, provided that an appropriate official
17from the participating school district attests that the
18full-time employee has waived coverage by participating in a
19component of the district's cafeteria plan. For the purposes of
20this subsection, "participating school district" includes a
21unit of local government whose primary purpose is education as
22defined by the Department's rules.
23    Employees of a participating unit of local government who
24are not enrolled due to coverage under another group health
25policy or plan may enroll in the event of a qualifying change
26in status, special enrollment, special circumstance as defined

 

 

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1by the Director, or during the annual Benefit Choice Period. A
2participating unit of local government may also elect to cover
3its annuitants. Dependent coverage shall be offered on an
4optional basis, with the costs paid by the unit of local
5government, its employees, or some combination of the two as
6determined by the unit of local government. The unit of local
7government shall be responsible for timely collection and
8transmission of dependent premiums.
9    The Director shall annually determine monthly rates of
10payment, subject to the following constraints:
11        (1) In the first year of coverage, the rates shall be
12    equal to the amount normally charged to State employees for
13    elected optional coverages or for enrolled dependents
14    coverages or other contributory coverages, or contributed
15    by the State for basic insurance coverages on behalf of its
16    employees, adjusted for differences between State
17    employees and employees of the local government in age,
18    sex, geographic location or other relevant demographic
19    variables, plus an amount sufficient to pay for the
20    additional administrative costs of providing coverage to
21    employees of the unit of local government and their
22    dependents.
23        (2) In subsequent years, a further adjustment shall be
24    made to reflect the actual prior years' claims experience
25    of the employees of the unit of local government.
26    In the case of coverage of local government employees under

 

 

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1a health maintenance organization, the Director shall annually
2determine for each participating unit of local government the
3maximum monthly amount the unit may contribute toward that
4coverage, based on an analysis of (i) the age, sex, geographic
5location, and other relevant demographic variables of the
6unit's employees and (ii) the cost to cover those employees
7under the State group health benefits plan. The Director may
8similarly determine the maximum monthly amount each unit of
9local government may contribute toward coverage of its
10employees' dependents under a health maintenance organization.
11    Monthly payments by the unit of local government or its
12employees for group health benefits plan or health maintenance
13organization coverage shall be deposited in the Local
14Government Health Insurance Reserve Fund.
15    The Local Government Health Insurance Reserve Fund is
16hereby created as a nonappropriated trust fund to be held
17outside the State Treasury, with the State Treasurer as
18custodian. The Local Government Health Insurance Reserve Fund
19shall be a continuing fund not subject to fiscal year
20limitations. The Local Government Health Insurance Reserve
21Fund is not subject to administrative charges or charge-backs,
22including but not limited to those authorized under Section 8h
23of the State Finance Act. All revenues arising from the
24administration of the health benefits program established
25under this Section shall be deposited into the Local Government
26Health Insurance Reserve Fund. Any interest earned on moneys in

 

 

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1the Local Government Health Insurance Reserve Fund shall be
2deposited into the Fund. All expenditures from this Fund shall
3be used for payments for health care benefits for local
4government and rehabilitation facility employees, annuitants,
5and dependents, and to reimburse the Department or its
6administrative service organization for all expenses incurred
7in the administration of benefits. No other State funds may be
8used for these purposes.
9    A local government employer's participation or desire to
10participate in a program created under this subsection shall
11not limit that employer's duty to bargain with the
12representative of any collective bargaining unit of its
13employees.
14    (j) Any rehabilitation facility within the State of
15Illinois may apply to the Director to have its employees,
16annuitants, and their eligible dependents provided group
17health coverage under this Act on a non-insured basis. To
18participate, a rehabilitation facility must agree to enroll all
19of its employees and remit the entire cost of providing such
20coverage for its employees, except that the rehabilitation
21facility shall not be required to enroll those of its employees
22who are covered spouses or dependents under this plan or
23another group policy or plan providing health benefits as long
24as (1) an appropriate official from the rehabilitation facility
25attests that each employee not enrolled is a covered spouse or
26dependent under this plan or another group policy or plan, and

 

 

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1(2) at least 50% of the employees are enrolled and the
2rehabilitation facility remits the entire cost of providing
3coverage to those employees. Employees of a participating
4rehabilitation facility who are not enrolled due to coverage
5under another group health policy or plan may enroll in the
6event of a qualifying change in status, special enrollment,
7special circumstance as defined by the Director, or during the
8annual Benefit Choice Period. A participating rehabilitation
9facility may also elect to cover its annuitants. Dependent
10coverage shall be offered on an optional basis, with the costs
11paid by the rehabilitation facility, its employees, or some
12combination of the 2 as determined by the rehabilitation
13facility. The rehabilitation facility shall be responsible for
14timely collection and transmission of dependent premiums.
15    The Director shall annually determine quarterly rates of
16payment, subject to the following constraints:
17        (1) In the first year of coverage, the rates shall be
18    equal to the amount normally charged to State employees for
19    elected optional coverages or for enrolled dependents
20    coverages or other contributory coverages on behalf of its
21    employees, adjusted for differences between State
22    employees and employees of the rehabilitation facility in
23    age, sex, geographic location or other relevant
24    demographic variables, plus an amount sufficient to pay for
25    the additional administrative costs of providing coverage
26    to employees of the rehabilitation facility and their

 

 

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1    dependents.
2        (2) In subsequent years, a further adjustment shall be
3    made to reflect the actual prior years' claims experience
4    of the employees of the rehabilitation facility.
5    Monthly payments by the rehabilitation facility or its
6employees for group health benefits shall be deposited in the
7Local Government Health Insurance Reserve Fund.
8    (k) Any domestic violence shelter or service within the
9State of Illinois may apply to the Director to have its
10employees, annuitants, and their dependents provided group
11health coverage under this Act on a non-insured basis. To
12participate, a domestic violence shelter or service must agree
13to enroll all of its employees and pay the entire cost of
14providing such coverage for its employees. The domestic
15violence shelter shall not be required to enroll those of its
16employees who are covered spouses or dependents under this plan
17or another group policy or plan providing health benefits as
18long as (1) an appropriate official from the domestic violence
19shelter attests that each employee not enrolled is a covered
20spouse or dependent under this plan or another group policy or
21plan and (2) at least 50% of the employees are enrolled and the
22domestic violence shelter remits the entire cost of providing
23coverage to those employees. Employees of a participating
24domestic violence shelter who are not enrolled due to coverage
25under another group health policy or plan may enroll in the
26event of a qualifying change in status, special enrollment, or

 

 

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1special circumstance as defined by the Director or during the
2annual Benefit Choice Period. A participating domestic
3violence shelter may also elect to cover its annuitants.
4Dependent coverage shall be offered on an optional basis, with
5employees, or some combination of the 2 as determined by the
6domestic violence shelter or service. The domestic violence
7shelter or service shall be responsible for timely collection
8and transmission of dependent premiums.
9    The Director shall annually determine rates of payment,
10subject to the following constraints:
11        (1) In the first year of coverage, the rates shall be
12    equal to the amount normally charged to State employees for
13    elected optional coverages or for enrolled dependents
14    coverages or other contributory coverages on behalf of its
15    employees, adjusted for differences between State
16    employees and employees of the domestic violence shelter or
17    service in age, sex, geographic location or other relevant
18    demographic variables, plus an amount sufficient to pay for
19    the additional administrative costs of providing coverage
20    to employees of the domestic violence shelter or service
21    and their dependents.
22        (2) In subsequent years, a further adjustment shall be
23    made to reflect the actual prior years' claims experience
24    of the employees of the domestic violence shelter or
25    service.
26    Monthly payments by the domestic violence shelter or

 

 

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1service or its employees for group health insurance shall be
2deposited in the Local Government Health Insurance Reserve
3Fund.
4    (l) A public community college or entity organized pursuant
5to the Public Community College Act may apply to the Director
6initially to have only annuitants not covered prior to July 1,
71992 by the district's health plan provided health coverage
8under this Act on a non-insured basis. The community college
9must execute a 2-year contract to participate in the Local
10Government Health Plan. Any annuitant may enroll in the event
11of a qualifying change in status, special enrollment, special
12circumstance as defined by the Director, or during the annual
13Benefit Choice Period.
14    The Director shall annually determine monthly rates of
15payment subject to the following constraints: for those
16community colleges with annuitants only enrolled, first year
17rates shall be equal to the average cost to cover claims for a
18State member adjusted for demographics, Medicare
19participation, and other factors; and in the second year, a
20further adjustment of rates shall be made to reflect the actual
21first year's claims experience of the covered annuitants.
22    (l-5) The provisions of subsection (l) become inoperative
23on July 1, 1999.
24    (m) The Director shall adopt any rules deemed necessary for
25implementation of this amendatory Act of 1989 (Public Act
2686-978).

 

 

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1    (n) Any child advocacy center within the State of Illinois
2may apply to the Director to have its employees, annuitants,
3and their dependents provided group health coverage under this
4Act on a non-insured basis. To participate, a child advocacy
5center must agree to enroll all of its employees and pay the
6entire cost of providing coverage for its employees. The child
7advocacy center shall not be required to enroll those of its
8employees who are covered spouses or dependents under this plan
9or another group policy or plan providing health benefits as
10long as (1) an appropriate official from the child advocacy
11center attests that each employee not enrolled is a covered
12spouse or dependent under this plan or another group policy or
13plan and (2) at least 50% of the employees are enrolled and the
14child advocacy center remits the entire cost of providing
15coverage to those employees. Employees of a participating child
16advocacy center who are not enrolled due to coverage under
17another group health policy or plan may enroll in the event of
18a qualifying change in status, special enrollment, or special
19circumstance as defined by the Director or during the annual
20Benefit Choice Period. A participating child advocacy center
21may also elect to cover its annuitants. Dependent coverage
22shall be offered on an optional basis, with the costs paid by
23the child advocacy center, its employees, or some combination
24of the 2 as determined by the child advocacy center. The child
25advocacy center shall be responsible for timely collection and
26transmission of dependent premiums.

 

 

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1    The Director shall annually determine rates of payment,
2subject to the following constraints:
3        (1) In the first year of coverage, the rates shall be
4    equal to the amount normally charged to State employees for
5    elected optional coverages or for enrolled dependents
6    coverages or other contributory coverages on behalf of its
7    employees, adjusted for differences between State
8    employees and employees of the child advocacy center in
9    age, sex, geographic location, or other relevant
10    demographic variables, plus an amount sufficient to pay for
11    the additional administrative costs of providing coverage
12    to employees of the child advocacy center and their
13    dependents.
14        (2) In subsequent years, a further adjustment shall be
15    made to reflect the actual prior years' claims experience
16    of the employees of the child advocacy center.
17    Monthly payments by the child advocacy center or its
18employees for group health insurance shall be deposited into
19the Local Government Health Insurance Reserve Fund.
20(Source: P.A. 97-695, eff. 7-1-12; 98-488, eff. 8-16-13.)
 
21    Section 99. Effective date. This Act takes effect upon
22becoming law.