Rep. Michael J. Madigan

Filed: 4/30/2012

 

 


 

 


 
09700SB1313ham008LRB097 06593 JDS 69076 a

1
AMENDMENT TO SENATE BILL 1313

2    AMENDMENT NO. ______. Amend Senate Bill 1313 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. The State Employees Group Insurance Act of 1971
5is amended by changing Sections 3 and 10 as follows:
 
6    (5 ILCS 375/3)  (from Ch. 127, par. 523)
7    Sec. 3. Definitions. Unless the context otherwise
8requires, the following words and phrases as used in this Act
9shall have the following meanings. The Department may define
10these and other words and phrases separately for the purpose of
11implementing specific programs providing benefits under this
12Act.
13    (a) "Administrative service organization" means any
14person, firm or corporation experienced in the handling of
15claims which is fully qualified, financially sound and capable
16of meeting the service requirements of a contract of

 

 

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1administration executed with the Department.
2    (b) "Annuitant" means (1) an employee who retires, or has
3retired, on or after January 1, 1966 on an immediate annuity
4under the provisions of Articles 2, 14 (including an employee
5who has elected to receive an alternative retirement
6cancellation payment under Section 14-108.5 of the Illinois
7Pension Code in lieu of an annuity), 15 (including an employee
8who has retired under the optional retirement program
9established under Section 15-158.2), paragraphs (2), (3), or
10(5) of Section 16-106, or Article 18 of the Illinois Pension
11Code; (2) any person who was receiving group insurance coverage
12under this Act as of March 31, 1978 by reason of his status as
13an annuitant, even though the annuity in relation to which such
14coverage was provided is a proportional annuity based on less
15than the minimum period of service required for a retirement
16annuity in the system involved; (3) any person not otherwise
17covered by this Act who has retired as a participating member
18under Article 2 of the Illinois Pension Code but is ineligible
19for the retirement annuity under Section 2-119 of the Illinois
20Pension Code; (4) the spouse of any person who is receiving a
21retirement annuity under Article 18 of the Illinois Pension
22Code and who is covered under a group health insurance program
23sponsored by a governmental employer other than the State of
24Illinois and who has irrevocably elected to waive his or her
25coverage under this Act and to have his or her spouse
26considered as the "annuitant" under this Act and not as a

 

 

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1"dependent"; or (5) an employee who retires, or has retired,
2from a qualified position, as determined according to rules
3promulgated by the Director, under a qualified local
4government, a qualified rehabilitation facility, a qualified
5domestic violence shelter or service, or a qualified child
6advocacy center. (For definition of "retired employee", see (p)
7post).
8    (b-5) (Blank). "New SERS annuitant" means a person who, on
9or after January 1, 1998, becomes an annuitant, as defined in
10subsection (b), by virtue of beginning to receive a retirement
11annuity under Article 14 of the Illinois Pension Code
12(including an employee who has elected to receive an
13alternative retirement cancellation payment under Section
1414-108.5 of that Code in lieu of an annuity), and is eligible
15to participate in the basic program of group health benefits
16provided for annuitants under this Act.
17    (b-6) (Blank). "New SURS annuitant" means a person who (1)
18on or after January 1, 1998, becomes an annuitant, as defined
19in subsection (b), by virtue of beginning to receive a
20retirement annuity under Article 15 of the Illinois Pension
21Code, (2) has not made the election authorized under Section
2215-135.1 of the Illinois Pension Code, and (3) is eligible to
23participate in the basic program of group health benefits
24provided for annuitants under this Act.
25    (b-7) (Blank). "New TRS State annuitant" means a person
26who, on or after July 1, 1998, becomes an annuitant, as defined

 

 

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1in subsection (b), by virtue of beginning to receive a
2retirement annuity under Article 16 of the Illinois Pension
3Code based on service as a teacher as defined in paragraph (2),
4(3), or (5) of Section 16-106 of that Code, and is eligible to
5participate in the basic program of group health benefits
6provided for annuitants under this Act.
7    (c) "Carrier" means (1) an insurance company, a corporation
8organized under the Limited Health Service Organization Act or
9the Voluntary Health Services Plan Act, a partnership, or other
10nongovernmental organization, which is authorized to do group
11life or group health insurance business in Illinois, or (2) the
12State of Illinois as a self-insurer.
13    (d) "Compensation" means salary or wages payable on a
14regular payroll by the State Treasurer on a warrant of the
15State Comptroller out of any State, trust or federal fund, or
16by the Governor of the State through a disbursing officer of
17the State out of a trust or out of federal funds, or by any
18Department out of State, trust, federal or other funds held by
19the State Treasurer or the Department, to any person for
20personal services currently performed, and ordinary or
21accidental disability benefits under Articles 2, 14, 15
22(including ordinary or accidental disability benefits under
23the optional retirement program established under Section
2415-158.2), paragraphs (2), (3), or (5) of Section 16-106, or
25Article 18 of the Illinois Pension Code, for disability
26incurred after January 1, 1966, or benefits payable under the

 

 

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1Workers' Compensation or Occupational Diseases Act or benefits
2payable under a sick pay plan established in accordance with
3Section 36 of the State Finance Act. "Compensation" also means
4salary or wages paid to an employee of any qualified local
5government, qualified rehabilitation facility, qualified
6domestic violence shelter or service, or qualified child
7advocacy center.
8    (e) "Commission" means the State Employees Group Insurance
9Advisory Commission authorized by this Act. Commencing July 1,
101984, "Commission" as used in this Act means the Commission on
11Government Forecasting and Accountability as established by
12the Legislative Commission Reorganization Act of 1984.
13    (f) "Contributory", when referred to as contributory
14coverage, shall mean optional coverages or benefits elected by
15the member toward the cost of which such member makes
16contribution, or which are funded in whole or in part through
17the acceptance of a reduction in earnings or the foregoing of
18an increase in earnings by an employee, as distinguished from
19noncontributory coverage or benefits which are paid entirely by
20the State of Illinois without reduction of the member's salary.
21    (g) "Department" means any department, institution, board,
22commission, officer, court or any agency of the State
23government receiving appropriations and having power to
24certify payrolls to the Comptroller authorizing payments of
25salary and wages against such appropriations as are made by the
26General Assembly from any State fund, or against trust funds

 

 

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1held by the State Treasurer and includes boards of trustees of
2the retirement systems created by Articles 2, 14, 15, 16 and 18
3of the Illinois Pension Code. "Department" also includes the
4Illinois Comprehensive Health Insurance Board, the Board of
5Examiners established under the Illinois Public Accounting
6Act, and the Illinois Finance Authority.
7    (h) "Dependent", when the term is used in the context of
8the health and life plan, means a member's spouse and any child
9(1) from birth to age 26 including an adopted child, a child
10who lives with the member from the time of the filing of a
11petition for adoption until entry of an order of adoption, a
12stepchild or adjudicated child, or a child who lives with the
13member if such member is a court appointed guardian of the
14child or (2) age 19 or over who is mentally or physically
15disabled from a cause originating prior to the age of 19 (age
1626 if enrolled as an adult child dependent). For the health
17plan only, the term "dependent" also includes (1) any person
18enrolled prior to the effective date of this Section who is
19dependent upon the member to the extent that the member may
20claim such person as a dependent for income tax deduction
21purposes and (2) any person who has received after June 30,
222000 an organ transplant and who is financially dependent upon
23the member and eligible to be claimed as a dependent for income
24tax purposes. A member requesting to cover any dependent must
25provide documentation as requested by the Department of Central
26Management Services and file with the Department any and all

 

 

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

 

 

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

 

 

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1System by clause (4) of subsection (a) of Section 15-107 of the
2Illinois Pension Code is also an "employee" for the purposes of
3this Act. "Employee" also includes any person receiving or
4eligible for benefits under a sick pay plan established in
5accordance with Section 36 of the State Finance Act. "Employee"
6also includes (i) each officer or employee in the service of a
7qualified local government, including persons appointed as
8trustees of sanitary districts regardless of hours devoted to
9the service of the sanitary district, (ii) each employee in the
10service of a qualified rehabilitation facility, (iii) each
11full-time employee in the service of a qualified domestic
12violence shelter or service, and (iv) each full-time employee
13in the service of a qualified child advocacy center, as
14determined according to rules promulgated by the Director.
15    (l) "Member" means an employee, annuitant, retired
16employee or survivor. In the case of an annuitant or retired
17employee who first becomes an annuitant or retired employee on
18or after the effective date of this amendatory Act of the 97th
19General Assembly, the individual must meet the minimum vesting
20requirements of the applicable retirement system in order to be
21eligible for group insurance benefits under that system. In the
22case of a survivor who first becomes a survivor on or after the
23effective date of this amendatory Act of the 97th General
24Assembly, the deceased employee, annuitant, or retired
25employee upon whom the annuity is based must have been eligible
26to participate in the group insurance system under the

 

 

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

 

 

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1person formerly employed by the University of Illinois in the
2Cooperative Extension Service who would be an annuitant except
3for the fact that such person was made ineligible to
4participate in the State Universities Retirement System by
5clause (4) of subsection (a) of Section 15-107 of the Illinois
6Pension Code; and (3) the surviving dependent of a person who
7was an annuitant under this Act by virtue of receiving an
8alternative retirement cancellation payment under Section
914-108.5 of the Illinois Pension Code.
10    (q-2) "SERS" means the State Employees' Retirement System
11of Illinois, created under Article 14 of the Illinois Pension
12Code.
13    (q-3) "SURS" means the State Universities Retirement
14System, created under Article 15 of the Illinois Pension Code.
15    (q-4) "TRS" means the Teachers' Retirement System of the
16State of Illinois, created under Article 16 of the Illinois
17Pension Code.
18    (q-5) (Blank). "New SERS survivor" means a survivor, as
19defined in subsection (q), whose annuity is paid under Article
2014 of the Illinois Pension Code and is based on the death of
21(i) an employee whose death occurs on or after January 1, 1998,
22or (ii) a new SERS annuitant as defined in subsection (b-5).
23"New SERS survivor" includes the surviving dependent of a
24person who was an annuitant under this Act by virtue of
25receiving an alternative retirement cancellation payment under
26Section 14-108.5 of the Illinois Pension Code.

 

 

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

 

 

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1wholly or partly in accordance with Section 85-15 of the
2Township Code; any not-for-profit corporation or association,
3with a membership consisting primarily of municipalities, that
4operates its own utility system, and provides research,
5training, dissemination of information, or other acts to
6promote cooperation between and among municipalities that
7provide utility services and for the advancement of the goals
8and purposes of its membership; the Southern Illinois
9Collegiate Common Market, which is a consortium of higher
10education institutions in Southern Illinois; the Illinois
11Association of Park Districts; and any hospital provider that
12is owned by a county that has 100 or fewer hospital beds and
13has not already joined the program. "Qualified local
14government" means a unit of local government approved by the
15Director and participating in a program created under
16subsection (i) of Section 10 of this Act.
17    (t) "Qualified rehabilitation facility" means any
18not-for-profit organization that is accredited by the
19Commission on Accreditation of Rehabilitation Facilities or
20certified by the Department of Human Services (as successor to
21the Department of Mental Health and Developmental
22Disabilities) to provide services to persons with disabilities
23and which receives funds from the State of Illinois for
24providing those services, approved by the Director and
25participating in a program created under subsection (j) of
26Section 10 of this Act.

 

 

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1    (u) "Qualified domestic violence shelter or service" means
2any Illinois domestic violence shelter or service and its
3administrative offices funded by the Department of Human
4Services (as successor to the Illinois Department of Public
5Aid), approved by the Director and participating in a program
6created under subsection (k) of Section 10.
7    (v) "TRS benefit recipient" means a person who:
8        (1) is not a "member" as defined in this Section; and
9        (2) is receiving a monthly benefit or retirement
10    annuity under Article 16 of the Illinois Pension Code; and
11        (3) either (i) has at least 8 years of creditable
12    service under Article 16 of the Illinois Pension Code, or
13    (ii) was enrolled in the health insurance program offered
14    under that Article on January 1, 1996, or (iii) is the
15    survivor of a benefit recipient who had at least 8 years of
16    creditable service under Article 16 of the Illinois Pension
17    Code or was enrolled in the health insurance program
18    offered under that Article on the effective date of this
19    amendatory Act of 1995, or (iv) is a recipient or survivor
20    of a recipient of a disability benefit under Article 16 of
21    the Illinois Pension Code.
22    (w) "TRS dependent beneficiary" means a person who:
23        (1) is not a "member" or "dependent" as defined in this
24    Section; and
25        (2) is a TRS benefit recipient's: (A) spouse, (B)
26    dependent parent who is receiving at least half of his or

 

 

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1    her support from the TRS benefit recipient, or (C) natural,
2    step, adjudicated, or adopted child who is (i) under age
3    26, (ii) was, on January 1, 1996, participating as a
4    dependent beneficiary in the health insurance program
5    offered under Article 16 of the Illinois Pension Code, or
6    (iii) age 19 or over who is mentally or physically disabled
7    from a cause originating prior to the age of 19 (age 26 if
8    enrolled as an adult child).
9    "TRS dependent beneficiary" does not include, as indicated
10under paragraph (2) of this subsection (w), a dependent of the
11survivor of a TRS benefit recipient who first becomes a
12dependent of a survivor of a TRS benefit recipient on or after
13the effective date of this amendatory Act of the 97th General
14Assembly unless that dependent would have been eligible for
15coverage as a dependent of the deceased TRS benefit recipient
16upon whom the survivor benefit is based.
17    (x) "Military leave" refers to individuals in basic
18training for reserves, special/advanced training, annual
19training, emergency call up, activation by the President of the
20United States, or any other training or duty in service to the
21United States Armed Forces.
22    (y) (Blank).
23    (z) "Community college benefit recipient" means a person
24who:
25        (1) is not a "member" as defined in this Section; and
26        (2) is receiving a monthly survivor's annuity or

 

 

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1    retirement annuity under Article 15 of the Illinois Pension
2    Code; and
3        (3) either (i) was a full-time employee of a community
4    college district or an association of community college
5    boards created under the Public Community College Act
6    (other than an employee whose last employer under Article
7    15 of the Illinois Pension Code was a community college
8    district subject to Article VII of the Public Community
9    College Act) and was eligible to participate in a group
10    health benefit plan as an employee during the time of
11    employment with a community college district (other than a
12    community college district subject to Article VII of the
13    Public Community College Act) or an association of
14    community college boards, or (ii) is the survivor of a
15    person described in item (i).
16    (aa) "Community college dependent beneficiary" means a
17person who:
18        (1) is not a "member" or "dependent" as defined in this
19    Section; and
20        (2) is a community college benefit recipient's: (A)
21    spouse, (B) dependent parent who is receiving at least half
22    of his or her support from the community college benefit
23    recipient, or (C) natural, step, adjudicated, or adopted
24    child who is (i) under age 26, or (ii) age 19 or over and
25    mentally or physically disabled from a cause originating
26    prior to the age of 19 (age 26 if enrolled as an adult

 

 

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1    child).
2    "Community college dependent beneficiary" does not
3include, as indicated under paragraph (2) of this subsection
4(aa), a dependent of the survivor of a community college
5benefit recipient who first becomes a dependent of a survivor
6of a community college benefit recipient on or after the
7effective date of this amendatory Act of the 97th General
8Assembly unless that dependent would have been eligible for
9coverage as a dependent of the deceased community college
10benefit recipient upon whom the survivor annuity is based.
11    (bb) "Qualified child advocacy center" means any Illinois
12child advocacy center and its administrative offices funded by
13the Department of Children and Family Services, as defined by
14the Children's Advocacy Center Act (55 ILCS 80/), approved by
15the Director and participating in a program created under
16subsection (n) of Section 10.
17(Source: P.A. 96-756, eff. 1-1-10; 96-1519, eff. 2-4-11;
1897-668, eff. 1-13-12.)
 
19    (5 ILCS 375/10)  (from Ch. 127, par. 530)
20    Sec. 10. Payments by State; premiums.
21    (a) The State shall pay the cost of basic non-contributory
22group life insurance and, subject to member paid contributions
23set by the Department or required by this Section, the basic
24program of group health benefits on each eligible member,
25except a member, not otherwise covered by this Act, who has

 

 

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1retired as a participating member under Article 2 of the
2Illinois Pension Code but is ineligible for the retirement
3annuity under Section 2-119 of the Illinois Pension Code, and
4part of each eligible member's and retired member's premiums
5for health insurance coverage for enrolled dependents as
6provided by Section 9. The State shall pay the cost of the
7basic program of group health benefits only after benefits are
8reduced by the amount of benefits covered by Medicare for all
9members and dependents who are eligible for benefits under
10Social Security or the Railroad Retirement system or who had
11sufficient Medicare-covered government employment, except that
12such reduction in benefits shall apply only to those members
13and dependents who (1) first become eligible for such Medicare
14coverage on or after July 1, 1992; or (2) are Medicare-eligible
15members or dependents of a local government unit which began
16participation in the program on or after July 1, 1992; or (3)
17remain eligible for, but no longer receive Medicare coverage
18which they had been receiving on or after July 1, 1992. The
19Department may determine the aggregate level of the State's
20contribution on the basis of actual cost of medical services
21adjusted for age, sex or geographic or other demographic
22characteristics which affect the costs of such programs.
23    The cost of participation in the basic program of group
24health benefits for the dependent or survivor of a living or
25deceased retired employee who was formerly employed by the
26University of Illinois in the Cooperative Extension Service and

 

 

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1would be an annuitant but for the fact that he or she was made
2ineligible to participate in the State Universities Retirement
3System by clause (4) of subsection (a) of Section 15-107 of the
4Illinois Pension Code shall not be greater than the cost of
5participation that would otherwise apply to that dependent or
6survivor if he or she were the dependent or survivor of an
7annuitant under the State Universities Retirement System.
8    (a-1) (Blank). Beginning January 1, 1998, for each person
9who becomes a new SERS annuitant and participates in the basic
10program of group health benefits, the State shall contribute
11toward the cost of the annuitant's coverage under the basic
12program of group health benefits an amount equal to 5% of that
13cost for each full year of creditable service upon which the
14annuitant's retirement annuity is based, up to a maximum of
15100% for an annuitant with 20 or more years of creditable
16service. The remainder of the cost of a new SERS annuitant's
17coverage under the basic program of group health benefits shall
18be the responsibility of the annuitant. In the case of a new
19SERS annuitant who has elected to receive an alternative
20retirement cancellation payment under Section 14-108.5 of the
21Illinois Pension Code in lieu of an annuity, for the purposes
22of this subsection the annuitant shall be deemed to be
23receiving a retirement annuity based on the number of years of
24creditable service that the annuitant had established at the
25time of his or her termination of service under SERS.
26    (a-2) (Blank). Beginning January 1, 1998, for each person

 

 

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1who becomes a new SERS survivor and participates in the basic
2program of group health benefits, the State shall contribute
3toward the cost of the survivor's coverage under the basic
4program of group health benefits an amount equal to 5% of that
5cost for each full year of the deceased employee's or deceased
6annuitant's creditable service in the State Employees'
7Retirement System of Illinois on the date of death, up to a
8maximum of 100% for a survivor of an employee or annuitant with
920 or more years of creditable service. The remainder of the
10cost of the new SERS survivor's coverage under the basic
11program of group health benefits shall be the responsibility of
12the survivor. In the case of a new SERS survivor who was the
13dependent of an annuitant who elected to receive an alternative
14retirement cancellation payment under Section 14-108.5 of the
15Illinois Pension Code in lieu of an annuity, for the purposes
16of this subsection the deceased annuitant's creditable service
17shall be determined as of the date of termination of service
18rather than the date of death.
19    (a-3) (Blank). Beginning January 1, 1998, for each person
20who becomes a new SURS annuitant and participates in the basic
21program of group health benefits, the State shall contribute
22toward the cost of the annuitant's coverage under the basic
23program of group health benefits an amount equal to 5% of that
24cost for each full year of creditable service upon which the
25annuitant's retirement annuity is based, up to a maximum of
26100% for an annuitant with 20 or more years of creditable

 

 

09700SB1313ham008- 21 -LRB097 06593 JDS 69076 a

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

 

 

09700SB1313ham008- 22 -LRB097 06593 JDS 69076 a

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

 

 

09700SB1313ham008- 23 -LRB097 06593 JDS 69076 a

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

 

 

09700SB1313ham008- 24 -LRB097 06593 JDS 69076 a

1    (a-9) No later than May 1 of each calendar year, the
2Director of Central Management Services shall certify in
3writing to the Executive Secretary of the State Employees'
4Retirement System of Illinois the amounts of the Medicare
5supplement health care premiums and the amounts of the health
6care premiums for all other retirees who are not Medicare
7eligible.
8    A separate calculation of the premiums based upon the
9actual cost of each health care plan shall be so certified.
10    The Director of Central Management Services shall provide
11to the Executive Secretary of the State Employees' Retirement
12System of Illinois such information, statistics, and other data
13as he or she may require to review the premium amounts
14certified by the Director of Central Management Services.
15    The Department of Healthcare and Family Services, or any
16successor agency designated to procure healthcare contracts
17pursuant to this Act, is authorized to establish funds,
18separate accounts provided by any bank or banks as defined by
19the Illinois Banking Act, or separate accounts provided by any
20savings and loan association or associations as defined by the
21Illinois Savings and Loan Act of 1985 to be held by the
22Director, outside the State treasury, for the purpose of
23receiving the transfer of moneys from the Local Government
24Health Insurance Reserve Fund. The Department may promulgate
25rules further defining the methodology for the transfers. Any
26interest earned by moneys in the funds or accounts shall inure

 

 

09700SB1313ham008- 25 -LRB097 06593 JDS 69076 a

1to the Local Government Health Insurance Reserve Fund. The
2transferred moneys, and interest accrued thereon, shall be used
3exclusively for transfers to administrative service
4organizations or their financial institutions for payments of
5claims to claimants and providers under the self-insurance
6health plan. The transferred moneys, and interest accrued
7thereon, shall not be used for any other purpose including, but
8not limited to, reimbursement of administration fees due the
9administrative service organization pursuant to its contract
10or contracts with the Department.
11    (b) State employees who become eligible for this program on
12or after January 1, 1980 in positions normally requiring actual
13performance of duty not less than 1/2 of a normal work period
14but not equal to that of a normal work period, shall be given
15the option of participating in the available program. If the
16employee elects coverage, the State shall contribute on behalf
17of such employee to the cost of the employee's benefit and any
18applicable dependent supplement, that sum which bears the same
19percentage as that percentage of time the employee regularly
20works when compared to normal work period.
21    (c) The basic non-contributory coverage from the basic
22program of group health benefits shall be continued for each
23employee not in pay status or on active service by reason of
24(1) leave of absence due to illness or injury, (2) authorized
25educational leave of absence or sabbatical leave, or (3)
26military leave. This coverage shall continue until expiration

 

 

09700SB1313ham008- 26 -LRB097 06593 JDS 69076 a

1of authorized leave and return to active service, but not to
2exceed 24 months for leaves under item (1) or (2). This
324-month limitation and the requirement of returning to active
4service shall not apply to persons receiving ordinary or
5accidental disability benefits or retirement benefits through
6the appropriate State retirement system or benefits under the
7Workers' Compensation or Occupational Disease Act.
8    (d) The basic group life insurance coverage shall continue,
9with full State contribution, where such person is (1) absent
10from active service by reason of disability arising from any
11cause other than self-inflicted, (2) on authorized educational
12leave of absence or sabbatical leave, or (3) on military leave.
13    (e) Where the person is in non-pay status for a period in
14excess of 30 days or on leave of absence, other than by reason
15of disability, educational or sabbatical leave, or military
16leave, such person may continue coverage only by making
17personal payment equal to the amount normally contributed by
18the State on such person's behalf. Such payments and coverage
19may be continued: (1) until such time as the person returns to
20a status eligible for coverage at State expense, but not to
21exceed 24 months or (2) until such person's employment or
22annuitant status with the State is terminated (exclusive of any
23additional service imposed pursuant to law).
24    (f) The Department shall establish by rule the extent to
25which other employee benefits will continue for persons in
26non-pay status or who are not in active service.

 

 

09700SB1313ham008- 27 -LRB097 06593 JDS 69076 a

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

 

 

09700SB1313ham008- 28 -LRB097 06593 JDS 69076 a

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

 

 

09700SB1313ham008- 29 -LRB097 06593 JDS 69076 a

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

 

 

09700SB1313ham008- 30 -LRB097 06593 JDS 69076 a

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

 

 

09700SB1313ham008- 31 -LRB097 06593 JDS 69076 a

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

 

 

09700SB1313ham008- 32 -LRB097 06593 JDS 69076 a

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

 

 

09700SB1313ham008- 33 -LRB097 06593 JDS 69076 a

1payment, subject to the following constraints:
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 rehabilitation facility 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 rehabilitation facility 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 rehabilitation facility.
16    Monthly payments by the rehabilitation facility or its
17employees for group health benefits shall be deposited in the
18Local Government Health Insurance Reserve Fund.
19    (k) Any domestic violence shelter or service within the
20State of Illinois may apply to the Director to have its
21employees, annuitants, and their dependents provided group
22health coverage under this Act on a non-insured basis. To
23participate, a domestic violence shelter or service must agree
24to enroll all of its employees and pay the entire cost of
25providing such coverage for its employees. The domestic
26violence shelter shall not be required to enroll those of its

 

 

09700SB1313ham008- 34 -LRB097 06593 JDS 69076 a

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

 

 

09700SB1313ham008- 35 -LRB097 06593 JDS 69076 a

1    employees and employees of the domestic violence shelter or
2    service in age, sex, geographic location or other relevant
3    demographic variables, plus an amount sufficient to pay for
4    the additional administrative costs of providing coverage
5    to employees of the domestic violence shelter or service
6    and their dependents.
7        (2) In subsequent years, a further adjustment shall be
8    made to reflect the actual prior years' claims experience
9    of the employees of the domestic violence shelter or
10    service.
11    Monthly payments by the domestic violence shelter or
12service or its employees for group health insurance shall be
13deposited in the Local Government Health Insurance Reserve
14Fund.
15    (l) A public community college or entity organized pursuant
16to the Public Community College Act may apply to the Director
17initially to have only annuitants not covered prior to July 1,
181992 by the district's health plan provided health coverage
19under this Act on a non-insured basis. The community college
20must execute a 2-year contract to participate in the Local
21Government Health Plan. Any annuitant may enroll in the event
22of a qualifying change in status, special enrollment, special
23circumstance as defined by the Director, or during the annual
24Benefit Choice Period.
25    The Director shall annually determine monthly rates of
26payment subject to the following constraints: for those

 

 

09700SB1313ham008- 36 -LRB097 06593 JDS 69076 a

1community colleges with annuitants only enrolled, first year
2rates shall be equal to the average cost to cover claims for a
3State member adjusted for demographics, Medicare
4participation, and other factors; and in the second year, a
5further adjustment of rates shall be made to reflect the actual
6first year's claims experience of the covered annuitants.
7    (l-5) The provisions of subsection (l) become inoperative
8on July 1, 1999.
9    (m) The Director shall adopt any rules deemed necessary for
10implementation of this amendatory Act of 1989 (Public Act
1186-978).
12    (n) Any child advocacy center within the State of Illinois
13may apply to the Director to have its employees, annuitants,
14and their dependents provided group health coverage under this
15Act on a non-insured basis. To participate, a child advocacy
16center must agree to enroll all of its employees and pay the
17entire cost of providing coverage for its employees. The child
18advocacy center shall not be required to enroll those of its
19employees who are covered spouses or dependents under this plan
20or another group policy or plan providing health benefits as
21long as (1) an appropriate official from the child advocacy
22center attests that each employee not enrolled is a covered
23spouse or dependent under this plan or another group policy or
24plan and (2) at least 50% of the employees are enrolled and the
25child advocacy center remits the entire cost of providing
26coverage to those employees. Employees of a participating child

 

 

09700SB1313ham008- 37 -LRB097 06593 JDS 69076 a

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

 

 

09700SB1313ham008- 38 -LRB097 06593 JDS 69076 a

1    of the employees of the child advocacy center.
2    Monthly payments by the child advocacy center or its
3employees for group health insurance shall be deposited into
4the Local Government Health Insurance Reserve Fund.
5(Source: P.A. 95-331, eff. 8-21-07; 95-632, eff. 9-25-07;
695-707, eff. 1-11-08; 96-756, eff. 1-1-10; 96-1232, eff.
77-23-10; 96-1519, eff. 2-4-11.)
 
8    Section 99. Effective date. This Act takes effect July 1,
92012.".