97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012
HB1350

 

Introduced 2/9/2011, by Rep. Karen May

 

SYNOPSIS AS INTRODUCED:
 
5 ILCS 375/2  from Ch. 127, par. 522
5 ILCS 375/3  from Ch. 127, par. 523
5 ILCS 375/10  from Ch. 127, par. 530
5 ILCS 375/13.2  from Ch. 127, par. 533.2
5 ILCS 375/15  from Ch. 127, par. 535
30 ILCS 105/25  from Ch. 127, par. 161

    Amends the State Employees Group Insurance Act of 1971. Provides that small businesses may be provided group health coverage under the Act. Limits small businesses to those with 50 or fewer employees. Specifically allows for payment for coverage by the employees. Provides that employees that have other coverage do not have to enroll in the coverage. Authorizes the use of State funds, pursuant to appropriation, in operating the plan. Provides for the utilization of insurance producers in the marketing of the plans. Makes other changes concerning domestic violence shelters and services. Amends the State Finance Act to provide for payments made on behalf of the small business employees to be deposited into the Small Employers Health Insurance Reserve Fund.


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FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

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1    AN ACT concerning insurance.
 
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 2, 3, 10, 13.2, and 15 as
6follows:
 
7    (5 ILCS 375/2)  (from Ch. 127, par. 522)
8    Sec. 2. Purpose. The purpose of this Act is to provide a
9program of group life insurance, a program of health benefits
10and other employee benefits for persons in the service of the
11State of Illinois, employees of local governments, employees of
12rehabilitation facilities, employees of domestic violence
13shelters and services, and employees of child advocacy centers,
14and certain of their dependents. It is also the purpose of this
15Act to provide a program of health benefits (i) for certain
16benefit recipients of the Teachers' Retirement System of the
17State of Illinois and their dependent beneficiaries and (ii)
18for certain eligible retired community college employees and
19their dependent beneficiaries. It is also the purpose of this
20Act to provide a program of health benefits for owners and
21employees of qualified small businesses and their dependents.
22(Source: P.A. 94-860, eff. 6-16-06.)
 

 

 

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1    (5 ILCS 375/3)  (from Ch. 127, par. 523)
2    Sec. 3. Definitions. Unless the context otherwise
3requires, the following words and phrases as used in this Act
4shall have the following meanings. The Department may define
5these and other words and phrases separately for the purpose of
6implementing specific programs providing benefits under this
7Act.
8    (a) "Administrative service organization" means any
9person, firm or corporation experienced in the handling of
10claims which is fully qualified, financially sound and capable
11of meeting the service requirements of a contract of
12administration executed with the Department.
13    (b) "Annuitant" means (1) an employee who retires, or has
14retired, on or after January 1, 1966 on an immediate annuity
15under the provisions of Articles 2, 14 (including an employee
16who has elected to receive an alternative retirement
17cancellation payment under Section 14-108.5 of the Illinois
18Pension Code in lieu of an annuity), 15 (including an employee
19who has retired under the optional retirement program
20established under Section 15-158.2), paragraphs (2), (3), or
21(5) of Section 16-106, or Article 18 of the Illinois Pension
22Code; (2) any person who was receiving group insurance coverage
23under this Act as of March 31, 1978 by reason of his status as
24an annuitant, even though the annuity in relation to which such
25coverage was provided is a proportional annuity based on less
26than the minimum period of service required for a retirement

 

 

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1annuity in the system involved; (3) any person not otherwise
2covered by this Act who has retired as a participating member
3under Article 2 of the Illinois Pension Code but is ineligible
4for the retirement annuity under Section 2-119 of the Illinois
5Pension Code; (4) the spouse of any person who is receiving a
6retirement annuity under Article 18 of the Illinois Pension
7Code and who is covered under a group health insurance program
8sponsored by a governmental employer other than the State of
9Illinois and who has irrevocably elected to waive his or her
10coverage under this Act and to have his or her spouse
11considered as the "annuitant" under this Act and not as a
12"dependent"; or (5) an employee who retires, or has retired,
13from a qualified position, as determined according to rules
14promulgated by the Director, under a qualified local
15government, a qualified rehabilitation facility, a qualified
16domestic violence shelter or service, or a qualified child
17advocacy center; or (6) an owner or employee who retires, or
18has retired, from a qualified position, as determined according
19to rules promulgated by the Director, with a qualified small
20business. (For definition of "retired employee", see (p) post).
21    (b-5) "New SERS annuitant" means a person who, on or after
22January 1, 1998, becomes an annuitant, as defined in subsection
23(b), by virtue of beginning to receive a retirement annuity
24under Article 14 of the Illinois Pension Code (including an
25employee who has elected to receive an alternative retirement
26cancellation payment under Section 14-108.5 of that Code in

 

 

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1lieu of an annuity), and is eligible to participate in the
2basic program of group health benefits provided for annuitants
3under this Act.
4    (b-6) "New SURS annuitant" means a person who (1) on or
5after January 1, 1998, becomes an annuitant, as defined in
6subsection (b), by virtue of beginning to receive a retirement
7annuity under Article 15 of the Illinois Pension Code, (2) has
8not made the election authorized under Section 15-135.1 of the
9Illinois Pension Code, and (3) is eligible to participate in
10the basic program of group health benefits provided for
11annuitants under this Act.
12    (b-7) "New TRS State annuitant" means a person who, on or
13after July 1, 1998, becomes an annuitant, as defined in
14subsection (b), by virtue of beginning to receive a retirement
15annuity under Article 16 of the Illinois Pension Code based on
16service as a teacher as defined in paragraph (2), (3), or (5)
17of Section 16-106 of that Code, and is eligible to participate
18in the basic program of group health benefits provided for
19annuitants under this Act.
20    (c) "Carrier" means (1) an insurance company, a corporation
21organized under the Limited Health Service Organization Act or
22the Voluntary Health Services Plan Act, a partnership, or other
23nongovernmental organization, which is authorized to do group
24life or group health insurance business in Illinois, or (2) the
25State of Illinois as a self-insurer.
26    (d) "Compensation" means salary or wages payable on a

 

 

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1regular payroll by the State Treasurer on a warrant of the
2State Comptroller out of any State, trust or federal fund, or
3by the Governor of the State through a disbursing officer of
4the State out of a trust or out of federal funds, or by any
5Department out of State, trust, federal or other funds held by
6the State Treasurer or the Department, to any person for
7personal services currently performed, and ordinary or
8accidental disability benefits under Articles 2, 14, 15
9(including ordinary or accidental disability benefits under
10the optional retirement program established under Section
1115-158.2), paragraphs (2), (3), or (5) of Section 16-106, or
12Article 18 of the Illinois Pension Code, for disability
13incurred after January 1, 1966, or benefits payable under the
14Workers' Compensation or Occupational Diseases Act or benefits
15payable under a sick pay plan established in accordance with
16Section 36 of the State Finance Act. "Compensation" also means
17salary or wages paid to an employee of any qualified local
18government, qualified rehabilitation facility, qualified
19domestic violence shelter or service, or qualified child
20advocacy center. "Compensation" also means salary or wages paid
21to an employee or owner of a qualified small business.
22    (e) "Commission" means the State Employees Group Insurance
23Advisory Commission authorized by this Act. Commencing July 1,
241984, "Commission" as used in this Act means the Commission on
25Government Forecasting and Accountability as established by
26the Legislative Commission Reorganization Act of 1984.

 

 

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1    (f) "Contributory", when referred to as contributory
2coverage, shall mean optional coverages or benefits elected by
3the member toward the cost of which such member makes
4contribution, or which are funded in whole or in part through
5the acceptance of a reduction in earnings or the foregoing of
6an increase in earnings by an employee, as distinguished from
7noncontributory coverage or benefits which are paid entirely by
8the State of Illinois without reduction of the member's salary.
9    (g) "Department" means any department, institution, board,
10commission, officer, court or any agency of the State
11government receiving appropriations and having power to
12certify payrolls to the Comptroller authorizing payments of
13salary and wages against such appropriations as are made by the
14General Assembly from any State fund, or against trust funds
15held by the State Treasurer and includes boards of trustees of
16the retirement systems created by Articles 2, 14, 15, 16 and 18
17of the Illinois Pension Code. "Department" also includes the
18Illinois Comprehensive Health Insurance Board, the Board of
19Examiners established under the Illinois Public Accounting
20Act, and the Illinois Finance Authority.
21    (h) "Dependent", when the term is used in the context of
22the health and life plan, means a member's spouse and any
23unmarried child (1) from birth to age 19 including an adopted
24child, a child who lives with the member from the time of the
25filing of a petition for adoption until entry of an order of
26adoption, a stepchild or recognized child who lives with the

 

 

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1member in a parent-child relationship, or a child who lives
2with the member if such member is a court appointed guardian of
3the child, (2) age 19 to 24 enrolled as a full-time student in
4any accredited school, financially dependent upon the member,
5and eligible to be claimed as a dependent for income tax
6purposes, (2.1) age 19 to 24 on a medical leave of absence as
7described in Section 356z.11 of the Illinois Insurance Code
8(215 ILCS 5/356z.11), or (3) age 19 or over who is mentally or
9physically handicapped. For the purposes of item (2), an
10unmarried child age 19 to 24 who is a member of the United
11States Armed Services, including the Illinois National Guard,
12and is mobilized to active duty shall qualify as a dependent
13beyond the age of 24 and until the age of 25 and while a
14full-time student for the amount of time spent on active duty
15between the ages of 19 and 24. The individual attempting to
16qualify for this additional time must submit written
17documentation of active duty service to the Director. The
18changes made by this amendatory Act of the 94th General
19Assembly apply only to individuals mobilized to active duty in
20the United States Armed Services, including the Illinois
21National Guard, on or after January 1, 2002. For the health
22plan only, the term "dependent" also includes any person
23enrolled prior to the effective date of this Section who is
24dependent upon the member to the extent that the member may
25claim such person as a dependent for income tax deduction
26purposes; no other such person may be enrolled. For the health

 

 

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1plan only, the term "dependent" also includes any person who
2has received after June 30, 2000 an organ transplant and who is
3financially dependent upon the member and eligible to be
4claimed as a dependent for income tax purposes.
5    (i) "Director" means the Director of the Illinois
6Department of Central Management Services or of any successor
7agency designated to administer this Act.
8    (j) "Eligibility period" means the period of time a member
9has to elect enrollment in programs or to select benefits
10without regard to age, sex or health.
11    (k) "Employee" means and includes each officer or employee
12in the service of a department who (1) receives his
13compensation for service rendered to the department on a
14warrant issued pursuant to a payroll certified by a department
15or on a warrant or check issued and drawn by a department upon
16a trust, federal or other fund or on a warrant issued pursuant
17to a payroll certified by an elected or duly appointed officer
18of the State or who receives payment of the performance of
19personal services on a warrant issued pursuant to a payroll
20certified by a Department and drawn by the Comptroller upon the
21State Treasurer against appropriations made by the General
22Assembly from any fund or against trust funds held by the State
23Treasurer, and (2) is employed full-time or part-time in a
24position normally requiring actual performance of duty during
25not less than 1/2 of a normal work period, as established by
26the Director in cooperation with each department, except that

 

 

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1persons elected by popular vote will be considered employees
2during the entire term for which they are elected regardless of
3hours devoted to the service of the State, and (3) except that
4"employee" does not include any person who is not eligible by
5reason of such person's employment to participate in one of the
6State retirement systems under Articles 2, 14, 15 (either the
7regular Article 15 system or the optional retirement program
8established under Section 15-158.2) or 18, or under paragraph
9(2), (3), or (5) of Section 16-106, of the Illinois Pension
10Code, but such term does include persons who are employed
11during the 6 month qualifying period under Article 14 of the
12Illinois Pension Code. Such term also includes any person who
13(1) after January 1, 1966, is receiving ordinary or accidental
14disability benefits under Articles 2, 14, 15 (including
15ordinary or accidental disability benefits under the optional
16retirement program established under Section 15-158.2),
17paragraphs (2), (3), or (5) of Section 16-106, or Article 18 of
18the Illinois Pension Code, for disability incurred after
19January 1, 1966, (2) receives total permanent or total
20temporary disability under the Workers' Compensation Act or
21Occupational Disease Act as a result of injuries sustained or
22illness contracted in the course of employment with the State
23of Illinois, or (3) is not otherwise covered under this Act and
24has retired as a participating member under Article 2 of the
25Illinois Pension Code but is ineligible for the retirement
26annuity under Section 2-119 of the Illinois Pension Code.

 

 

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1However, a person who satisfies the criteria of the foregoing
2definition of "employee" except that such person is made
3ineligible to participate in the State Universities Retirement
4System by clause (4) of subsection (a) of Section 15-107 of the
5Illinois Pension Code is also an "employee" for the purposes of
6this Act. "Employee" also includes any person receiving or
7eligible for benefits under a sick pay plan established in
8accordance with Section 36 of the State Finance Act. "Employee"
9also includes (i) each officer or employee in the service of a
10qualified local government, including persons appointed as
11trustees of sanitary districts regardless of hours devoted to
12the service of the sanitary district, (ii) each employee in the
13service of a qualified rehabilitation facility, (iii) each
14full-time employee in the service of a qualified domestic
15violence shelter or service, and (iv) each full-time employee
16in the service of a qualified child advocacy center, as
17determined according to rules promulgated by the Director.
18"Employee" also includes an owner and a full-time employee in
19the service of a qualified small business, as determined
20according to rules promulgated by the Director.
21    (l) "Member" means an employee, annuitant, retired
22employee or survivor.
23    (m) "Optional coverages or benefits" means those coverages
24or benefits available to the member on his or her voluntary
25election, and at his or her own expense.
26    (n) "Program" means the group life insurance, health

 

 

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1benefits and other employee benefits designed and contracted
2for by the Director under this Act.
3    (o) "Health plan" means a health benefits program offered
4by the State of Illinois for persons eligible for the plan.
5    (p) "Retired employee" means any person who would be an
6annuitant as that term is defined herein but for the fact that
7such person retired prior to January 1, 1966. Such term also
8includes any person formerly employed by the University of
9Illinois in the Cooperative Extension Service who would be an
10annuitant but for the fact that such person was made ineligible
11to participate in the State Universities Retirement System by
12clause (4) of subsection (a) of Section 15-107 of the Illinois
13Pension Code.
14    (q) "Survivor" means a person receiving an annuity as a
15survivor of an employee or of an annuitant. "Survivor" also
16includes: (1) the surviving dependent of a person who satisfies
17the definition of "employee" except that such person is made
18ineligible to participate in the State Universities Retirement
19System by clause (4) of subsection (a) of Section 15-107 of the
20Illinois Pension Code; (2) the surviving dependent of any
21person formerly employed by the University of Illinois in the
22Cooperative Extension Service who would be an annuitant except
23for the fact that such person was made ineligible to
24participate in the State Universities Retirement System by
25clause (4) of subsection (a) of Section 15-107 of the Illinois
26Pension Code; and (3) the surviving dependent of a person who

 

 

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1was an annuitant under this Act by virtue of receiving an
2alternative retirement cancellation payment under Section
314-108.5 of the Illinois Pension Code.
4    (q-2) "SERS" means the State Employees' Retirement System
5of Illinois, created under Article 14 of the Illinois Pension
6Code.
7    (q-3) "SURS" means the State Universities Retirement
8System, created under Article 15 of the Illinois Pension Code.
9    (q-4) "TRS" means the Teachers' Retirement System of the
10State of Illinois, created under Article 16 of the Illinois
11Pension Code.
12    (q-5) "New SERS survivor" means a survivor, as defined in
13subsection (q), whose annuity is paid under Article 14 of the
14Illinois Pension Code and is based on the death of (i) an
15employee whose death occurs on or after January 1, 1998, or
16(ii) a new SERS annuitant as defined in subsection (b-5). "New
17SERS survivor" includes the surviving dependent of a person who
18was an annuitant under this Act by virtue of receiving an
19alternative retirement cancellation payment under Section
2014-108.5 of the Illinois Pension Code.
21    (q-6) "New SURS survivor" means a survivor, as defined in
22subsection (q), whose annuity is paid under Article 15 of the
23Illinois Pension Code and is based on the death of (i) an
24employee whose death occurs on or after January 1, 1998, or
25(ii) a new SURS annuitant as defined in subsection (b-6).
26    (q-7) "New TRS State survivor" means a survivor, as defined

 

 

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1in subsection (q), whose annuity is paid under Article 16 of
2the Illinois Pension Code and is based on the death of (i) an
3employee who is a teacher as defined in paragraph (2), (3), or
4(5) of Section 16-106 of that Code and whose death occurs on or
5after July 1, 1998, or (ii) a new TRS State annuitant as
6defined in subsection (b-7).
7    (r) "Medical services" means the services provided within
8the scope of their licenses by practitioners in all categories
9licensed under the Medical Practice Act of 1987.
10    (s) "Unit of local government" means any county,
11municipality, township, school district (including a
12combination of school districts under the Intergovernmental
13Cooperation Act), special district or other unit, designated as
14a unit of local government by law, which exercises limited
15governmental powers or powers in respect to limited
16governmental subjects, any not-for-profit association with a
17membership that primarily includes townships and township
18officials, that has duties that include provision of research
19service, dissemination of information, and other acts for the
20purpose of improving township government, and that is funded
21wholly or partly in accordance with Section 85-15 of the
22Township Code; any not-for-profit corporation or association,
23with a membership consisting primarily of municipalities, that
24operates its own utility system, and provides research,
25training, dissemination of information, or other acts to
26promote cooperation between and among municipalities that

 

 

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1provide utility services and for the advancement of the goals
2and purposes of its membership; the Southern Illinois
3Collegiate Common Market, which is a consortium of higher
4education institutions in Southern Illinois; the Illinois
5Association of Park Districts; and any hospital provider that
6is owned by a county that has 100 or fewer hospital beds and
7has not already joined the program. "Qualified local
8government" means a unit of local government approved by the
9Director and participating in a program created under
10subsection (i) of Section 10 of this Act.
11    (t) "Qualified rehabilitation facility" means any
12not-for-profit organization that is accredited by the
13Commission on Accreditation of Rehabilitation Facilities or
14certified by the Department of Human Services (as successor to
15the Department of Mental Health and Developmental
16Disabilities) to provide services to persons with disabilities
17and which receives funds from the State of Illinois for
18providing those services, approved by the Director and
19participating in a program created under subsection (j) of
20Section 10 of this Act.
21    (u) "Qualified domestic violence shelter or service" means
22any Illinois domestic violence shelter or service and its
23administrative offices funded by the Department of Human
24Services (as successor to the Illinois Department of Public
25Aid), approved by the Director and participating in a program
26created under subsection (k) of Section 10.

 

 

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1    (v) "TRS benefit recipient" means a person who:
2        (1) is not a "member" as defined in this Section; and
3        (2) is receiving a monthly benefit or retirement
4    annuity under Article 16 of the Illinois Pension Code; and
5        (3) either (i) has at least 8 years of creditable
6    service under Article 16 of the Illinois Pension Code, or
7    (ii) was enrolled in the health insurance program offered
8    under that Article on January 1, 1996, or (iii) is the
9    survivor of a benefit recipient who had at least 8 years of
10    creditable service under Article 16 of the Illinois Pension
11    Code or was enrolled in the health insurance program
12    offered under that Article on the effective date of this
13    amendatory Act of 1995, or (iv) is a recipient or survivor
14    of a recipient of a disability benefit under Article 16 of
15    the Illinois Pension Code.
16    (w) "TRS dependent beneficiary" means a person who:
17        (1) is not a "member" or "dependent" as defined in this
18    Section; and
19        (2) is a TRS benefit recipient's: (A) spouse, (B)
20    dependent parent who is receiving at least half of his or
21    her support from the TRS benefit recipient, or (C)
22    unmarried natural or adopted child who is (i) under age 19,
23    or (ii) enrolled as a full-time student in an accredited
24    school, financially dependent upon the TRS benefit
25    recipient, eligible to be claimed as a dependent for income
26    tax purposes, and either is under age 24 or was, on January

 

 

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1    1, 1996, participating as a dependent beneficiary in the
2    health insurance program offered under Article 16 of the
3    Illinois Pension Code, or (iii) age 19 or over who is
4    mentally or physically handicapped.
5    (x) "Military leave with pay and benefits" refers to
6individuals in basic training for reserves, special/advanced
7training, annual training, emergency call up, or activation by
8the President of the United States with approved pay and
9benefits.
10    (y) "Military leave without pay and benefits" refers to
11individuals who enlist for active duty in a regular component
12of the U.S. Armed Forces or other duty not specified or
13authorized under military leave with pay and benefits.
14    (z) "Community college benefit recipient" means a person
15who:
16        (1) is not a "member" as defined in this Section; and
17        (2) is receiving a monthly survivor's annuity or
18    retirement annuity under Article 15 of the Illinois Pension
19    Code; and
20        (3) either (i) was a full-time employee of a community
21    college district or an association of community college
22    boards created under the Public Community College Act
23    (other than an employee whose last employer under Article
24    15 of the Illinois Pension Code was a community college
25    district subject to Article VII of the Public Community
26    College Act) and was eligible to participate in a group

 

 

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1    health benefit plan as an employee during the time of
2    employment with a community college district (other than a
3    community college district subject to Article VII of the
4    Public Community College Act) or an association of
5    community college boards, or (ii) is the survivor of a
6    person described in item (i).
7    (aa) "Community college dependent beneficiary" means a
8person who:
9        (1) is not a "member" or "dependent" as defined in this
10    Section; and
11        (2) is a community college benefit recipient's: (A)
12    spouse, (B) dependent parent who is receiving at least half
13    of his or her support from the community college benefit
14    recipient, or (C) unmarried natural or adopted child who is
15    (i) under age 19, or (ii) enrolled as a full-time student
16    in an accredited school, financially dependent upon the
17    community college benefit recipient, eligible to be
18    claimed as a dependent for income tax purposes and under
19    age 23, or (iii) age 19 or over and mentally or physically
20    handicapped.
21    (bb) "Qualified child advocacy center" means any Illinois
22child advocacy center and its administrative offices funded by
23the Department of Children and Family Services, as defined by
24the Children's Advocacy Center Act (55 ILCS 80/), approved by
25the Director and participating in a program created under
26subsection (n) of Section 10.

 

 

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1    (cc) "Qualified small business" means a business situated
2in Illinois having 50 or fewer employees, approved by the
3Director and participating in a program created under
4subsection (k-5) of Section 10.
5(Source: P.A. 95-331, eff. 8-21-07; 95-632, eff. 9-25-07;
696-756, eff. 1-1-10.)
 
7    (5 ILCS 375/10)  (from Ch. 127, par. 530)
8    Sec. 10. Payments by State; premiums.
9    (a) The State shall pay the cost of basic non-contributory
10group life insurance and, subject to member paid contributions
11set by the Department or required by this Section, the basic
12program of group health benefits on each eligible member,
13except a member, not otherwise covered by this Act, who has
14retired as a participating member under Article 2 of the
15Illinois Pension Code but is ineligible for the retirement
16annuity under Section 2-119 of the Illinois Pension Code, and
17part of each eligible member's and retired member's premiums
18for health insurance coverage for enrolled dependents as
19provided by Section 9. The State shall pay the cost of the
20basic program of group health benefits only after benefits are
21reduced by the amount of benefits covered by Medicare for all
22members and dependents who are eligible for benefits under
23Social Security or the Railroad Retirement system or who had
24sufficient Medicare-covered government employment, except that
25such reduction in benefits shall apply only to those members

 

 

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1and dependents who (1) first become eligible for such Medicare
2coverage on or after July 1, 1992; or (2) are Medicare-eligible
3members or dependents of a local government unit which began
4participation in the program on or after July 1, 1992; or (3)
5remain eligible for, but no longer receive Medicare coverage
6which they had been receiving on or after July 1, 1992. The
7Department may determine the aggregate level of the State's
8contribution on the basis of actual cost of medical services
9adjusted for age, sex or geographic or other demographic
10characteristics which affect the costs of such programs.
11    The cost of participation in the basic program of group
12health benefits for the dependent or survivor of a living or
13deceased retired employee who was formerly employed by the
14University of Illinois in the Cooperative Extension Service and
15would be an annuitant but for the fact that he or she was made
16ineligible to participate in the State Universities Retirement
17System by clause (4) of subsection (a) of Section 15-107 of the
18Illinois Pension Code shall not be greater than the cost of
19participation that would otherwise apply to that dependent or
20survivor if he or she were the dependent or survivor of an
21annuitant under the State Universities Retirement System.
22    (a-1) Beginning January 1, 1998, for each person who
23becomes a new SERS annuitant and participates in the basic
24program of group health benefits, the State shall contribute
25toward the cost of the annuitant's coverage under the basic
26program of group health benefits an amount equal to 5% of that

 

 

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1cost for each full year of creditable service upon which the
2annuitant's retirement annuity is based, up to a maximum of
3100% for an annuitant with 20 or more years of creditable
4service. The remainder of the cost of a new SERS annuitant's
5coverage under the basic program of group health benefits shall
6be the responsibility of the annuitant. In the case of a new
7SERS annuitant who has elected to receive an alternative
8retirement cancellation payment under Section 14-108.5 of the
9Illinois Pension Code in lieu of an annuity, for the purposes
10of this subsection the annuitant shall be deemed to be
11receiving a retirement annuity based on the number of years of
12creditable service that the annuitant had established at the
13time of his or her termination of service under SERS.
14    (a-2) Beginning January 1, 1998, for each person who
15becomes a new SERS survivor and participates in the basic
16program of group health benefits, the State shall contribute
17toward the cost of the survivor's coverage under the basic
18program of group health benefits an amount equal to 5% of that
19cost for each full year of the deceased employee's or deceased
20annuitant's creditable service in the State Employees'
21Retirement System of Illinois on the date of death, up to a
22maximum of 100% for a survivor of an employee or annuitant with
2320 or more years of creditable service. The remainder of the
24cost of the new SERS survivor's coverage under the basic
25program of group health benefits shall be the responsibility of
26the survivor. In the case of a new SERS survivor who was the

 

 

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1dependent of an annuitant who elected to receive an alternative
2retirement cancellation payment under Section 14-108.5 of the
3Illinois Pension Code in lieu of an annuity, for the purposes
4of this subsection the deceased annuitant's creditable service
5shall be determined as of the date of termination of service
6rather than the date of death.
7    (a-3) Beginning January 1, 1998, for each person who
8becomes a new SURS annuitant and participates in the basic
9program of group health benefits, the State shall contribute
10toward the cost of the annuitant's coverage under the basic
11program of group health benefits an amount equal to 5% of that
12cost for each full year of creditable service upon which the
13annuitant's retirement annuity is based, up to a maximum of
14100% for an annuitant with 20 or more years of creditable
15service. The remainder of the cost of a new SURS annuitant's
16coverage under the basic program of group health benefits shall
17be the responsibility of the annuitant.
18    (a-4) (Blank).
19    (a-5) Beginning January 1, 1998, for each person who
20becomes a new SURS survivor and participates in the basic
21program of group health benefits, the State shall contribute
22toward the cost of the survivor's coverage under the basic
23program of group health benefits an amount equal to 5% of that
24cost for each full year of the deceased employee's or deceased
25annuitant's creditable service in the State Universities
26Retirement System on the date of death, up to a maximum of 100%

 

 

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1for a survivor of an employee or annuitant with 20 or more
2years of creditable service. The remainder of the cost of the
3new SURS survivor's coverage under the basic program of group
4health benefits shall be the responsibility of the survivor.
5    (a-6) Beginning July 1, 1998, for each person who becomes a
6new TRS State annuitant and participates in the basic program
7of group health benefits, the State shall contribute toward the
8cost of the annuitant's coverage under the basic program of
9group health benefits an amount equal to 5% of that cost for
10each full year of creditable service as a teacher as defined in
11paragraph (2), (3), or (5) of Section 16-106 of the Illinois
12Pension Code upon which the annuitant's retirement annuity is
13based, up to a maximum of 100%; except that the State
14contribution shall be 12.5% per year (rather than 5%) for each
15full year of creditable service as a regional superintendent or
16assistant regional superintendent of schools. The remainder of
17the cost of a new TRS State annuitant's coverage under the
18basic program of group health benefits shall be the
19responsibility of the annuitant.
20    (a-7) Beginning July 1, 1998, for each person who becomes a
21new TRS State survivor and participates in the basic program of
22group health benefits, the State shall contribute toward the
23cost of the survivor's coverage under the basic program of
24group health benefits an amount equal to 5% of that cost for
25each full year of the deceased employee's or deceased
26annuitant's creditable service as a teacher as defined in

 

 

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1paragraph (2), (3), or (5) of Section 16-106 of the Illinois
2Pension Code on the date of death, up to a maximum of 100%;
3except that the State contribution shall be 12.5% per year
4(rather than 5%) for each full year of the deceased employee's
5or deceased annuitant's creditable service as a regional
6superintendent or assistant regional superintendent of
7schools. The remainder of the cost of the new TRS State
8survivor's coverage under the basic program of group health
9benefits shall be the responsibility of the survivor.
10    (a-8) A new SERS annuitant, new SERS survivor, new SURS
11annuitant, new SURS survivor, new TRS State annuitant, or new
12TRS State survivor may waive or terminate coverage in the
13program of group health benefits. Any such annuitant or
14survivor who has waived or terminated coverage may enroll or
15re-enroll in the program of group health benefits only during
16the annual benefit choice period, as determined by the
17Director; except that in the event of termination of coverage
18due to nonpayment of premiums, the annuitant or survivor may
19not re-enroll in the program.
20    (a-9) No later than May 1 of each calendar year, the
21Director of Central Management Services shall certify in
22writing to the Executive Secretary of the State Employees'
23Retirement System of Illinois the amounts of the Medicare
24supplement health care premiums and the amounts of the health
25care premiums for all other retirees who are not Medicare
26eligible.

 

 

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1    A separate calculation of the premiums based upon the
2actual cost of each health care plan shall be so certified.
3    The Director of Central Management Services shall provide
4to the Executive Secretary of the State Employees' Retirement
5System of Illinois such information, statistics, and other data
6as he or she may require to review the premium amounts
7certified by the Director of Central Management Services.
8    The Department of Healthcare and Family Services, or any
9successor agency designated to procure healthcare contracts
10pursuant to this Act, is authorized to establish funds,
11separate accounts provided by any bank or banks as defined by
12the Illinois Banking Act, or separate accounts provided by any
13savings and loan association or associations as defined by the
14Illinois Savings and Loan Act of 1985 to be held by the
15Director, outside the State treasury, for the purpose of
16receiving the transfer of moneys from the Local Government
17Health Insurance Reserve Fund. The Department may promulgate
18rules further defining the methodology for the transfers. Any
19interest earned by moneys in the funds or accounts shall inure
20to the Local Government Health Insurance Reserve Fund. The
21transferred moneys, and interest accrued thereon, shall be used
22exclusively for transfers to administrative service
23organizations or their financial institutions for payments of
24claims to claimants and providers under the self-insurance
25health plan. The transferred moneys, and interest accrued
26thereon, shall not be used for any other purpose including, but

 

 

HB1350- 25 -LRB097 06619 RPM 46704 b

1not limited to, reimbursement of administration fees due the
2administrative service organization pursuant to its contract
3or contracts with the Department.
4    (b) State employees who become eligible for this program on
5or after January 1, 1980 in positions normally requiring actual
6performance of duty not less than 1/2 of a normal work period
7but not equal to that of a normal work period, shall be given
8the option of participating in the available program. If the
9employee elects coverage, the State shall contribute on behalf
10of such employee to the cost of the employee's benefit and any
11applicable dependent supplement, that sum which bears the same
12percentage as that percentage of time the employee regularly
13works when compared to normal work period.
14    (c) The basic non-contributory coverage from the basic
15program of group health benefits shall be continued for each
16employee not in pay status or on active service by reason of
17(1) leave of absence due to illness or injury, (2) authorized
18educational leave of absence or sabbatical leave, or (3)
19military leave with pay and benefits. This coverage shall
20continue until expiration of authorized leave and return to
21active service, but not to exceed 24 months for leaves under
22item (1) or (2). This 24-month limitation and the requirement
23of returning to active service shall not apply to persons
24receiving ordinary or accidental disability benefits or
25retirement benefits through the appropriate State retirement
26system or benefits under the Workers' Compensation or

 

 

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1Occupational Disease Act.
2    (d) The basic group life insurance coverage shall continue,
3with full State contribution, where such person is (1) absent
4from active service by reason of disability arising from any
5cause other than self-inflicted, (2) on authorized educational
6leave of absence or sabbatical leave, or (3) on military leave
7with pay and benefits.
8    (e) Where the person is in non-pay status for a period in
9excess of 30 days or on leave of absence, other than by reason
10of disability, educational or sabbatical leave, or military
11leave with pay and benefits, such person may continue coverage
12only by making personal payment equal to the amount normally
13contributed by the State on such person's behalf. Such payments
14and coverage may be continued: (1) until such time as the
15person returns to a status eligible for coverage at State
16expense, but not to exceed 24 months, (2) until such person's
17employment or annuitant status with the State is terminated, or
18(3) for a maximum period of 4 years for members on military
19leave with pay and benefits and military leave without pay and
20benefits (exclusive of any additional service imposed pursuant
21to law).
22    (f) The Department shall establish by rule the extent to
23which other employee benefits will continue for persons in
24non-pay status or who are not in active service.
25    (g) The State shall not pay the cost of the basic
26non-contributory group life insurance, program of health

 

 

HB1350- 27 -LRB097 06619 RPM 46704 b

1benefits and other employee benefits for members who are
2survivors as defined by paragraphs (1) and (2) of subsection
3(q) of Section 3 of this Act. The costs of benefits for these
4survivors shall be paid by the survivors or by the University
5of Illinois Cooperative Extension Service, or any combination
6thereof. However, the State shall pay the amount of the
7reduction in the cost of participation, if any, resulting from
8the amendment to subsection (a) made by this amendatory Act of
9the 91st General Assembly.
10    (h) Those persons occupying positions with any department
11as a result of emergency appointments pursuant to Section 8b.8
12of the Personnel Code who are not considered employees under
13this Act shall be given the option of participating in the
14programs of group life insurance, health benefits and other
15employee benefits. Such persons electing coverage may
16participate only by making payment equal to the amount normally
17contributed by the State for similarly situated employees. Such
18amounts shall be determined by the Director. Such payments and
19coverage may be continued until such time as the person becomes
20an employee pursuant to this Act or such person's appointment
21is terminated.
22    (i) Any unit of local government within the State of
23Illinois may apply to the Director to have its employees,
24annuitants, and their dependents provided group health
25coverage under this Act on a non-insured basis. To participate,
26a unit of local government must agree to enroll all of its

 

 

HB1350- 28 -LRB097 06619 RPM 46704 b

1employees, who may select coverage under either the State group
2health benefits plan or a health maintenance organization that
3has contracted with the State to be available as a health care
4provider for employees as defined in this Act. A unit of local
5government must remit the entire cost of providing coverage
6under the State group health benefits plan or, for coverage
7under a health maintenance organization, an amount determined
8by the Director based on an analysis of the sex, age,
9geographic location, or other relevant demographic variables
10for its employees, except that the unit of local government
11shall not be required to enroll those of its employees who are
12covered spouses or dependents under this plan or another group
13policy or plan providing health benefits as long as (1) an
14appropriate official from the unit of local government attests
15that each employee not enrolled is a covered spouse or
16dependent under this plan or another group policy or plan, and
17(2) at least 50% of the employees are enrolled and the unit of
18local government remits the entire cost of providing coverage
19to those employees, except that a participating school district
20must have enrolled at least 50% of its full-time employees who
21have not waived coverage under the district's group health plan
22by participating in a component of the district's cafeteria
23plan. A participating school district is not required to enroll
24a full-time employee who has waived coverage under the
25district's health plan, provided that an appropriate official
26from the participating school district attests that the

 

 

HB1350- 29 -LRB097 06619 RPM 46704 b

1full-time employee has waived coverage by participating in a
2component of the district's cafeteria plan. For the purposes of
3this subsection, "participating school district" includes a
4unit of local government whose primary purpose is education as
5defined by the Department's rules.
6    Employees of a participating unit of local government who
7are not enrolled due to coverage under another group health
8policy or plan may enroll in the event of a qualifying change
9in status, special enrollment, special circumstance as defined
10by the Director, or during the annual Benefit Choice Period. A
11participating unit of local government may also elect to cover
12its annuitants. Dependent coverage shall be offered on an
13optional basis, with the costs paid by the unit of local
14government, its employees, or some combination of the two as
15determined by the unit of local government. The unit of local
16government shall be responsible for timely collection and
17transmission of dependent premiums.
18    The Director shall annually determine monthly rates of
19payment, subject to the following constraints:
20        (1) In the first year of coverage, the rates shall be
21    equal to the amount normally charged to State employees for
22    elected optional coverages or for enrolled dependents
23    coverages or other contributory coverages, or contributed
24    by the State for basic insurance coverages on behalf of its
25    employees, adjusted for differences between State
26    employees and employees of the local government in age,

 

 

HB1350- 30 -LRB097 06619 RPM 46704 b

1    sex, geographic location or other relevant demographic
2    variables, plus an amount sufficient to pay for the
3    additional administrative costs of providing coverage to
4    employees of the unit of local government and their
5    dependents.
6        (2) In subsequent years, a further adjustment shall be
7    made to reflect the actual prior years' claims experience
8    of the employees of the unit of local government.
9    In the case of coverage of local government employees under
10a health maintenance organization, the Director shall annually
11determine for each participating unit of local government the
12maximum monthly amount the unit may contribute toward that
13coverage, based on an analysis of (i) the age, sex, geographic
14location, and other relevant demographic variables of the
15unit's employees and (ii) the cost to cover those employees
16under the State group health benefits plan. The Director may
17similarly determine the maximum monthly amount each unit of
18local government may contribute toward coverage of its
19employees' dependents under a health maintenance organization.
20    Monthly payments by the unit of local government or its
21employees for group health benefits plan or health maintenance
22organization coverage shall be deposited in the Local
23Government Health Insurance Reserve Fund.
24    The Local Government Health Insurance Reserve Fund is
25hereby created as a nonappropriated trust fund to be held
26outside the State Treasury, with the State Treasurer as

 

 

HB1350- 31 -LRB097 06619 RPM 46704 b

1custodian. The Local Government Health Insurance Reserve Fund
2shall be a continuing fund not subject to fiscal year
3limitations. The Local Government Health Insurance Reserve
4Fund is not subject to administrative charges or charge-backs,
5including but not limited to those authorized under Section 8h
6of the State Finance Act. All revenues arising from the
7administration of the health benefits program established
8under this Section shall be deposited into the Local Government
9Health Insurance Reserve Fund. Any interest earned on moneys in
10the Local Government Health Insurance Reserve Fund shall be
11deposited into the Fund. All expenditures from this Fund shall
12be used for payments for health care benefits for local
13government, domestic violence shelter or service, and
14rehabilitation facility employees, annuitants, and dependents,
15and to reimburse the Department or its administrative service
16organization for all expenses incurred in the administration of
17benefits. No other State funds may be used for these purposes.
18    A local government employer's participation or desire to
19participate in a program created under this subsection shall
20not limit that employer's duty to bargain with the
21representative of any collective bargaining unit of its
22employees.
23    (j) Any rehabilitation facility within the State of
24Illinois may apply to the Director to have its employees,
25annuitants, and their eligible dependents provided group
26health coverage under this Act on a non-insured basis. To

 

 

HB1350- 32 -LRB097 06619 RPM 46704 b

1participate, a rehabilitation facility must agree to enroll all
2of its employees and remit the entire cost of providing such
3coverage for its employees, except that the rehabilitation
4facility shall not be required to enroll those of its employees
5who are covered spouses or dependents under this plan or
6another group policy or plan providing health benefits as long
7as (1) an appropriate official from the rehabilitation facility
8attests that each employee not enrolled is a covered spouse or
9dependent under this plan or another group policy or plan, and
10(2) at least 50% of the employees are enrolled and the
11rehabilitation facility remits the entire cost of providing
12coverage to those employees. Employees of a participating
13rehabilitation facility who are not enrolled due to coverage
14under another group health policy or plan may enroll in the
15event of a qualifying change in status, special enrollment,
16special circumstance as defined by the Director, or during the
17annual Benefit Choice Period. A participating rehabilitation
18facility may also elect to cover its annuitants. Dependent
19coverage shall be offered on an optional basis, with the costs
20paid by the rehabilitation facility, its employees, or some
21combination of the 2 as determined by the rehabilitation
22facility. The rehabilitation facility shall be responsible for
23timely collection and transmission of dependent premiums.
24    The Director shall annually determine quarterly rates of
25payment, subject to the following constraints:
26        (1) In the first year of coverage, the rates shall be

 

 

HB1350- 33 -LRB097 06619 RPM 46704 b

1    equal to the amount normally charged to State employees for
2    elected optional coverages or for enrolled dependents
3    coverages or other contributory coverages on behalf of its
4    employees, adjusted for differences between State
5    employees and employees of the rehabilitation facility in
6    age, sex, geographic location or other relevant
7    demographic variables, plus an amount sufficient to pay for
8    the additional administrative costs of providing coverage
9    to employees of the rehabilitation facility and their
10    dependents.
11        (2) In subsequent years, a further adjustment shall be
12    made to reflect the actual prior years' claims experience
13    of the employees of the rehabilitation facility.
14    Monthly payments by the rehabilitation facility or its
15employees for group health benefits shall be deposited in the
16Local Government Health Insurance Reserve Fund.
17    (k) Any domestic violence shelter or service within the
18State of Illinois may apply to the Director to have its
19employees, annuitants, and their dependents provided group
20health coverage under this Act on a non-insured basis. To
21participate, a domestic violence shelter or service must agree
22to enroll all of its employees and pay the entire cost of
23providing such coverage for its employees. The domestic
24violence shelter shall not be required to enroll those of its
25employees who are covered spouses or dependents under this plan
26or another group policy or plan providing health benefits as

 

 

HB1350- 34 -LRB097 06619 RPM 46704 b

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

 

 

HB1350- 35 -LRB097 06619 RPM 46704 b

1    service in age, sex, geographic location or other relevant
2    demographic variables, plus an amount sufficient to pay for
3    the additional administrative costs of providing coverage
4    to employees of the domestic violence shelter or service
5    and their dependents.
6        (2) In subsequent years, a further adjustment shall be
7    made to reflect the actual prior years' claims experience
8    of the employees of the domestic violence shelter or
9    service.
10    Monthly payments by the domestic violence shelter or
11service or its employees for group health insurance shall be
12deposited in the Local Government Health Insurance Reserve
13Fund.
14    (k-5) Any qualified small business within the State of
15Illinois may apply to the Director to have its employees,
16annuitants, and their dependents provided group health
17coverage under this Act on a non-insured basis. The Department
18may set a limit on the number of qualified small businesses
19that may receive group health coverage under this subsection
20(k-5). In order to control its costs, the Department may
21designate which plans it will offer to qualified small
22businesses under this subsection (k-5). Those plans may
23include, but need not be limited to, minimum, limited, or
24comprehensive coverage plans; Health Maintenance Organization
25and Preferred Provider Organization plans; and medical savings
26plans. The plans may include the utilization of insurance

 

 

HB1350- 36 -LRB097 06619 RPM 46704 b

1producers in the marketing of coverage under the plans. In
2offering plans under this subsection (k-5) the Department shall
3be subject to ratings and minimum coverage in the same manner
4as a private insurer. Any plan offered under this subsection
5(k-5) may provide for employee contributions to the cost of the
6plan. A qualified small business may select one or more of the
7plans offered by the Department to offer to its employees. To
8participate, a qualified small business must agree to offer to
9enroll all of its employees and remit the entire cost of
10providing such coverage for its employees, except that the
11qualified small business shall not be required to enroll those
12of its employees who waive coverage under this subsection (k-5)
13because they are covered spouses or dependents under another
14group policy or plan providing health benefits as long as (1)
15an appropriate official from the qualified small business
16attests that each employee not enrolled is a covered spouse or
17dependent under another group policy or plan and (2) at least
1875% of the remaining employees are enrolled. A participating
19qualified small business may also elect to cover its
20annuitants. Dependent coverage shall be offered on an optional
21basis, with the costs paid by the small business, its
22employees, or some combination of the 2 as determined by the
23qualified small business. The qualified small business shall be
24responsible for timely collection and transmission of all
25premiums.
26    The Director shall annually determine rates of payment

 

 

HB1350- 37 -LRB097 06619 RPM 46704 b

1taking into consideration, among other things, the following:
2        (1) In the first year of coverage, the rates shall be
3    equal to the amount normally charged to State employees for
4    elected optional coverages or for enrolled dependents
5    coverages or other contributory coverages on behalf of its
6    employees, adjusted for differences between State
7    employees and employees of the qualified small business in
8    age, sex, geographic location or other relevant
9    demographic variables, plus an amount sufficient to pay for
10    the additional administrative costs of providing coverage
11    to employees of the qualified small business and their
12    dependents.
13        (2) In subsequent years, a further adjustment shall be
14    made to reflect the actual prior years' claims experience
15    of the employees of the qualified small business.
16    Monthly payments by the qualified small business for group
17health insurance shall be deposited into the Small Employers
18Health Insurance Reserve Fund. The Small Employers Health
19Insurance Reserve Fund shall be a continuing fund not subject
20to fiscal year limitations. All expenditures from this fund
21shall be used for payments for health care benefits for
22employees of qualified small businesses and their annuitants
23and dependents and to reimburse the Department or its
24administrative service organization for all expenses incurred
25in the administration of benefits. No State funds, other than
26those specifically appropriated, may be used for these

 

 

HB1350- 38 -LRB097 06619 RPM 46704 b

1purposes.
2    (l) A public community college or entity organized pursuant
3to the Public Community College Act may apply to the Director
4initially to have only annuitants not covered prior to July 1,
51992 by the district's health plan provided health coverage
6under this Act on a non-insured basis. The community college
7must execute a 2-year contract to participate in the Local
8Government Health Plan. Any annuitant may enroll in the event
9of a qualifying change in status, special enrollment, special
10circumstance as defined by the Director, or during the annual
11Benefit Choice Period.
12    The Director shall annually determine monthly rates of
13payment subject to the following constraints: for those
14community colleges with annuitants only enrolled, first year
15rates shall be equal to the average cost to cover claims for a
16State member adjusted for demographics, Medicare
17participation, and other factors; and in the second year, a
18further adjustment of rates shall be made to reflect the actual
19first year's claims experience of the covered annuitants.
20    (l-5) The provisions of subsection (l) become inoperative
21on July 1, 1999.
22    (m) The Director shall adopt any rules deemed necessary for
23implementation of this amendatory Act of 1989 (Public Act
2486-978).
25    (n) Any child advocacy center within the State of Illinois
26may apply to the Director to have its employees, annuitants,

 

 

HB1350- 39 -LRB097 06619 RPM 46704 b

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

 

 

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1        (1) In the first year of coverage, the rates shall be
2    equal to the amount normally charged to State employees for
3    elected optional coverages or for enrolled dependents
4    coverages or other contributory coverages on behalf of its
5    employees, adjusted for differences between State
6    employees and employees of the child advocacy center in
7    age, sex, geographic location, or other relevant
8    demographic variables, plus an amount sufficient to pay for
9    the additional administrative costs of providing coverage
10    to employees of the child advocacy center and their
11    dependents.
12        (2) In subsequent years, a further adjustment shall be
13    made to reflect the actual prior years' claims experience
14    of the employees of the child advocacy center.
15    Monthly payments by the child advocacy center or its
16employees for group health insurance shall be deposited into
17the Local Government Health Insurance Reserve Fund.
18(Source: P.A. 95-331, eff. 8-21-07; 95-632, eff. 9-25-07;
1995-707, eff. 1-11-08; 96-756, eff. 1-1-10; 96-1232, eff.
207-23-10.)
 
21    (5 ILCS 375/13.2)   (from Ch. 127, par. 533.2)
22    Sec. 13.2. Insurance reserve funds; investments. All
23amounts held in the Health Insurance Reserve Fund, the Group
24Insurance Premium Fund, the Small Employers Health Insurance
25Reserve Fund, and the Local Government Health Insurance Reserve

 

 

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1Fund shall be invested, at interest, by the State Treasurer.
2The investments shall be subject to terms, conditions, and
3limitations imposed by the laws of Illinois on State funds. All
4income derived from the investments shall accrue and be
5deposited to the respective funds no less frequently than
6quarterly. The Health Insurance Reserve Fund, the Small
7Employers Health Insurance Reserve Fund, and the Local
8Government Health Insurance Reserve Fund shall be administered
9by the Director.
10(Source: P.A. 91-390, eff. 7-30-99.)
 
11    (5 ILCS 375/15)  (from Ch. 127, par. 535)
12    Sec. 15. Administration; rules; audit; review.
13    (a) The Director shall administer this Act and shall
14prescribe such rules and regulations as are necessary to give
15full effect to the purposes of this Act.
16    (b) These rules may fix reasonable standards for the group
17life and group health programs and other benefit programs
18offered under this Act, and for the contractors providing them.
19    (c) These rules shall specify that covered and optional
20medical services of the program are services provided within
21the scope of their licenses by practitioners in all categories
22licensed under the Medical Practice Act of 1987 and shall
23provide that all eligible persons be fully informed of this
24specification.
25    (d) These rules shall establish eligibility requirements

 

 

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1for members and dependents as may be necessary to supplement or
2clarify requirements contained in this Act.
3    (e) Each affected department of the State, the State
4Universities Retirement System, the Teachers' Retirement
5System, and each qualified local government, rehabilitation
6facility, domestic violence shelter or service, small
7business, or child advocacy center, shall keep such records,
8make such certifications, and furnish the Director such
9information as may be necessary for the administration of this
10Act, including information concerning number and total amounts
11of payroll of employees of the department who are paid from
12trust funds or federal funds.
13    (f) Each member, each community college benefit recipient
14to whom this Act applies, and each TRS benefit recipient to
15whom this Act applies shall furnish the Director, in such form
16as may be required, any information that may be necessary to
17enroll such member or benefit recipient and, if applicable, his
18or her dependents or dependent beneficiaries under the programs
19or plan, including such data as may be required to allow the
20Director to accumulate statistics on data normally considered
21in actuarial studies of employee groups. Information about
22community college benefit recipients and community college
23dependent beneficiaries shall be furnished through the State
24Universities Retirement System. Information about TRS benefit
25recipients and TRS dependent beneficiaries shall be furnished
26through the Teachers' Retirement System.

 

 

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1    (g) There shall be audits and reports on the programs
2authorized and established by this Act prepared by the Director
3with the assistance of a qualified, independent accounting
4firm. The reports shall provide information on the experience,
5and administrative effectiveness and adequacy of the program
6including, when applicable, recommendations on up-grading of
7benefits and improvement of the program.
8    (h) Any final order, decision or other determination made,
9issued or executed by the Director under the provisions of this
10Act whereby any contractor or person is aggrieved shall be
11subject to review in accordance with the provisions of the
12Administrative Review Law and all amendments and modifications
13thereof, and the rules adopted pursuant thereto, shall apply to
14and govern all proceedings for the judicial review of final
15administrative decisions of the Director.
16(Source: P.A. 94-860, eff. 6-16-06.)
 
17    Section 10. The State Finance Act is amended by changing
18Section 25 as follows:
 
19    (30 ILCS 105/25)  (from Ch. 127, par. 161)
20    Sec. 25. Fiscal year limitations.
21    (a) All appropriations shall be available for expenditure
22for the fiscal year or for a lesser period if the Act making
23that appropriation so specifies. A deficiency or emergency
24appropriation shall be available for expenditure only through

 

 

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1June 30 of the year when the Act making that appropriation is
2enacted unless that Act otherwise provides.
3    (b) Outstanding liabilities as of June 30, payable from
4appropriations which have otherwise expired, may be paid out of
5the expiring appropriations during the 2-month period ending at
6the close of business on August 31. Any service involving
7professional or artistic skills or any personal services by an
8employee whose compensation is subject to income tax
9withholding must be performed as of June 30 of the fiscal year
10in order to be considered an "outstanding liability as of June
1130" that is thereby eligible for payment out of the expiring
12appropriation.
13    (b-1) However, payment of tuition reimbursement claims
14under Section 14-7.03 or 18-3 of the School Code may be made by
15the State Board of Education from its appropriations for those
16respective purposes for any fiscal year, even though the claims
17reimbursed by the payment may be claims attributable to a prior
18fiscal year, and payments may be made at the direction of the
19State Superintendent of Education from the fund from which the
20appropriation is made without regard to any fiscal year
21limitations, except as required by subsection (j) of this
22Section. Beginning on June 30, 2021, payment of tuition
23reimbursement claims under Section 14-7.03 or 18-3 of the
24School Code as of June 30, payable from appropriations that
25have otherwise expired, may be paid out of the expiring
26appropriation during the 4-month period ending at the close of

 

 

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1business on October 31.
2    (b-2) All outstanding liabilities as of June 30, 2010,
3payable from appropriations that would otherwise expire at the
4conclusion of the lapse period for fiscal year 2010, and
5interest penalties payable on those liabilities under the State
6Prompt Payment Act, may be paid out of the expiring
7appropriations until December 31, 2010, without regard to the
8fiscal year in which the payment is made, as long as vouchers
9for the liabilities are received by the Comptroller no later
10than August 31, 2010.
11    (b-3) Medical payments may be made by the Department of
12Veterans' Affairs from its appropriations for those purposes
13for any fiscal year, without regard to the fact that the
14medical services being compensated for by such payment may have
15been rendered in a prior fiscal year, except as required by
16subsection (j) of this Section. Beginning on June 30, 2021,
17medical payments payable from appropriations that have
18otherwise expired may be paid out of the expiring appropriation
19during the 4-month period ending at the close of business on
20October 31.
21    (b-4) Medical payments may be made by the Department of
22Healthcare and Family Services and medical payments and child
23care payments may be made by the Department of Human Services
24(as successor to the Department of Public Aid) from
25appropriations for those purposes for any fiscal year, without
26regard to the fact that the medical or child care services

 

 

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1being compensated for by such payment may have been rendered in
2a prior fiscal year; and payments may be made at the direction
3of the Department of Healthcare and Family Services from the
4Health Insurance Reserve Fund and the Local Government Health
5Insurance Reserve Fund without regard to any fiscal year
6limitations, except as required by subsection (j) of this
7Section. Beginning on June 30, 2021, medical payments made by
8the Department of Healthcare and Family Services, child care
9payments made by the Department of Human Services, and payments
10made at the discretion of the Department of Healthcare and
11Family Services from the Health Insurance Reserve Fund, the
12Small Employers Health Insurance Reserve Fund, and the Local
13Government Health Insurance Reserve Fund payable from
14appropriations that have otherwise expired may be paid out of
15the expiring appropriation during the 4-month period ending at
16the close of business on October 31.
17    (b-5) Medical payments may be made by the Department of
18Human Services from its appropriations relating to substance
19abuse treatment services for any fiscal year, without regard to
20the fact that the medical services being compensated for by
21such payment may have been rendered in a prior fiscal year,
22provided the payments are made on a fee-for-service basis
23consistent with requirements established for Medicaid
24reimbursement by the Department of Healthcare and Family
25Services, except as required by subsection (j) of this Section.
26Beginning on June 30, 2021, medical payments made by the

 

 

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1Department of Human Services relating to substance abuse
2treatment services payable from appropriations that have
3otherwise expired may be paid out of the expiring appropriation
4during the 4-month period ending at the close of business on
5October 31.
6    (b-6) Additionally, payments may be made by the Department
7of Human Services from its appropriations, or any other State
8agency from its appropriations with the approval of the
9Department of Human Services, from the Immigration Reform and
10Control Fund for purposes authorized pursuant to the
11Immigration Reform and Control Act of 1986, without regard to
12any fiscal year limitations, except as required by subsection
13(j) of this Section. Beginning on June 30, 2021, payments made
14by the Department of Human Services from the Immigration Reform
15and Control Fund for purposes authorized pursuant to the
16Immigration Reform and Control Act of 1986 payable from
17appropriations that have otherwise expired may be paid out of
18the expiring appropriation during the 4-month period ending at
19the close of business on October 31.
20    (b-7) Payments may be made in accordance with a plan
21authorized by paragraph (11) or (12) of Section 405-105 of the
22Department of Central Management Services Law from
23appropriations for those payments without regard to fiscal year
24limitations.
25    (c) Further, payments may be made by the Department of
26Public Health, the Department of Human Services (acting as

 

 

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1successor to the Department of Public Health under the
2Department of Human Services Act), and the Department of
3Healthcare and Family Services from their respective
4appropriations for grants for medical care to or on behalf of
5persons suffering from chronic renal disease, persons
6suffering from hemophilia, rape victims, and premature and
7high-mortality risk infants and their mothers and for grants
8for supplemental food supplies provided under the United States
9Department of Agriculture Women, Infants and Children
10Nutrition Program, for any fiscal year without regard to the
11fact that the services being compensated for by such payment
12may have been rendered in a prior fiscal year, except as
13required by subsection (j) of this Section. Beginning on June
1430, 2021, payments made by the Department of Public Health, the
15Department of Human Services, and the Department of Healthcare
16and Family Services from their respective appropriations for
17grants for medical care to or on behalf of persons suffering
18from chronic renal disease, persons suffering from hemophilia,
19rape victims, and premature and high-mortality risk infants and
20their mothers and for grants for supplemental food supplies
21provided under the United States Department of Agriculture
22Women, Infants and Children Nutrition Program payable from
23appropriations that have otherwise expired may be paid out of
24the expiring appropriations during the 4-month period ending at
25the close of business on October 31.
26    (d) The Department of Public Health and the Department of

 

 

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1Human Services (acting as successor to the Department of Public
2Health under the Department of Human Services Act) shall each
3annually submit to the State Comptroller, Senate President,
4Senate Minority Leader, Speaker of the House, House Minority
5Leader, and the respective Chairmen and Minority Spokesmen of
6the Appropriations Committees of the Senate and the House, on
7or before December 31, a report of fiscal year funds used to
8pay for services provided in any prior fiscal year. This report
9shall document by program or service category those
10expenditures from the most recently completed fiscal year used
11to pay for services provided in prior fiscal years.
12    (e) The Department of Healthcare and Family Services, the
13Department of Human Services (acting as successor to the
14Department of Public Aid), and the Department of Human Services
15making fee-for-service payments relating to substance abuse
16treatment services provided during a previous fiscal year shall
17each annually submit to the State Comptroller, Senate
18President, Senate Minority Leader, Speaker of the House, House
19Minority Leader, the respective Chairmen and Minority
20Spokesmen of the Appropriations Committees of the Senate and
21the House, on or before November 30, a report that shall
22document by program or service category those expenditures from
23the most recently completed fiscal year used to pay for (i)
24services provided in prior fiscal years and (ii) services for
25which claims were received in prior fiscal years.
26    (f) The Department of Human Services (as successor to the

 

 

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1Department of Public Aid) shall annually submit to the State
2Comptroller, Senate President, Senate Minority Leader, Speaker
3of the House, House Minority Leader, and the respective
4Chairmen and Minority Spokesmen of the Appropriations
5Committees of the Senate and the House, on or before December
631, a report of fiscal year funds used to pay for services
7(other than medical care) provided in any prior fiscal year.
8This report shall document by program or service category those
9expenditures from the most recently completed fiscal year used
10to pay for services provided in prior fiscal years.
11    (g) In addition, each annual report required to be
12submitted by the Department of Healthcare and Family Services
13under subsection (e) shall include the following information
14with respect to the State's Medicaid program:
15        (1) Explanations of the exact causes of the variance
16    between the previous year's estimated and actual
17    liabilities.
18        (2) Factors affecting the Department of Healthcare and
19    Family Services' liabilities, including but not limited to
20    numbers of aid recipients, levels of medical service
21    utilization by aid recipients, and inflation in the cost of
22    medical services.
23        (3) The results of the Department's efforts to combat
24    fraud and abuse.
25    (h) As provided in Section 4 of the General Assembly
26Compensation Act, any utility bill for service provided to a

 

 

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1General Assembly member's district office for a period
2including portions of 2 consecutive fiscal years may be paid
3from funds appropriated for such expenditure in either fiscal
4year.
5    (i) An agency which administers a fund classified by the
6Comptroller as an internal service fund may issue rules for:
7        (1) billing user agencies in advance for payments or
8    authorized inter-fund transfers based on estimated charges
9    for goods or services;
10        (2) issuing credits, refunding through inter-fund
11    transfers, or reducing future inter-fund transfers during
12    the subsequent fiscal year for all user agency payments or
13    authorized inter-fund transfers received during the prior
14    fiscal year which were in excess of the final amounts owed
15    by the user agency for that period; and
16        (3) issuing catch-up billings to user agencies during
17    the subsequent fiscal year for amounts remaining due when
18    payments or authorized inter-fund transfers received from
19    the user agency during the prior fiscal year were less than
20    the total amount owed for that period.
21User agencies are authorized to reimburse internal service
22funds for catch-up billings by vouchers drawn against their
23respective appropriations for the fiscal year in which the
24catch-up billing was issued or by increasing an authorized
25inter-fund transfer during the current fiscal year. For the
26purposes of this Act, "inter-fund transfers" means transfers

 

 

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1without the use of the voucher-warrant process, as authorized
2by Section 9.01 of the State Comptroller Act.
3    (i-1) Beginning on July 1, 2021, all outstanding
4liabilities, not payable during the 4-month lapse period as
5described in subsections (b-1), (b-3), (b-4), (b-5), (b-6), and
6(c) of this Section, that are made from appropriations for that
7purpose for any fiscal year, without regard to the fact that
8the services being compensated for by those payments may have
9been rendered in a prior fiscal year, are limited to only those
10claims that have been incurred but for which a proper bill or
11invoice as defined by the State Prompt Payment Act has not been
12received by September 30th following the end of the fiscal year
13in which the service was rendered.
14    (j) Notwithstanding any other provision of this Act, the
15aggregate amount of payments to be made without regard for
16fiscal year limitations as contained in subsections (b-1),
17(b-3), (b-4), (b-5), (b-6), and (c) of this Section, and
18determined by using Generally Accepted Accounting Principles,
19shall not exceed the following amounts:
20        (1) $6,000,000,000 for outstanding liabilities related
21    to fiscal year 2012;
22        (2) $5,300,000,000 for outstanding liabilities related
23    to fiscal year 2013;
24        (3) $4,600,000,000 for outstanding liabilities related
25    to fiscal year 2014;
26        (4) $4,000,000,000 for outstanding liabilities related

 

 

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1    to fiscal year 2015;
2        (5) $3,300,000,000 for outstanding liabilities related
3    to fiscal year 2016;
4        (6) $2,600,000,000 for outstanding liabilities related
5    to fiscal year 2017;
6        (7) $2,000,000,000 for outstanding liabilities related
7    to fiscal year 2018;
8        (8) $1,300,000,000 for outstanding liabilities related
9    to fiscal year 2019;
10        (9) $600,000,000 for outstanding liabilities related
11    to fiscal year 2020; and
12        (10) $0 for outstanding liabilities related to fiscal
13    year 2021 and fiscal years thereafter.
14(Source: P.A. 95-331, eff. 8-21-07; 96-928, eff. 6-15-10;
1596-958, eff. 7-1-10; 96-1501, eff. 1-25-11.)