Rep. Michael J. Madigan

Filed: 5/9/2012

 

 


 

 


 
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1
AMENDMENT TO SENATE BILL 1313

2    AMENDMENT NO. ______. Amend Senate Bill 1313, AS AMENDED,
3by replacing everything after the enacting clause with the
4following:
 
5    "Section 1. The Illinois Administrative Procedure Act is
6amended by changing Section 5-45 as follows:
 
7    (5 ILCS 100/5-45)  (from Ch. 127, par. 1005-45)
8    Sec. 5-45. Emergency rulemaking.
9    (a) "Emergency" means the existence of any situation that
10any agency finds reasonably constitutes a threat to the public
11interest, safety, or welfare.
12    (b) If any agency finds that an emergency exists that
13requires adoption of a rule upon fewer days than is required by
14Section 5-40 and states in writing its reasons for that
15finding, the agency may adopt an emergency rule without prior
16notice or hearing upon filing a notice of emergency rulemaking

 

 

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1with the Secretary of State under Section 5-70. The notice
2shall include the text of the emergency rule and shall be
3published in the Illinois Register. Consent orders or other
4court orders adopting settlements negotiated by an agency may
5be adopted under this Section. Subject to applicable
6constitutional or statutory provisions, an emergency rule
7becomes effective immediately upon filing under Section 5-65 or
8at a stated date less than 10 days thereafter. The agency's
9finding and a statement of the specific reasons for the finding
10shall be filed with the rule. The agency shall take reasonable
11and appropriate measures to make emergency rules known to the
12persons who may be affected by them.
13    (c) An emergency rule may be effective for a period of not
14longer than 150 days, but the agency's authority to adopt an
15identical rule under Section 5-40 is not precluded. No
16emergency rule may be adopted more than once in any 24 month
17period, except that this limitation on the number of emergency
18rules that may be adopted in a 24 month period does not apply
19to (i) emergency rules that make additions to and deletions
20from the Drug Manual under Section 5-5.16 of the Illinois
21Public Aid Code or the generic drug formulary under Section
223.14 of the Illinois Food, Drug and Cosmetic Act, (ii)
23emergency rules adopted by the Pollution Control Board before
24July 1, 1997 to implement portions of the Livestock Management
25Facilities Act, (iii) emergency rules adopted by the Illinois
26Department of Public Health under subsections (a) through (i)

 

 

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1of Section 2 of the Department of Public Health Act when
2necessary to protect the public's health, (iv) emergency rules
3adopted pursuant to subsection (n) of this Section, or (v)
4emergency rules adopted pursuant to subsection (o) of this
5Section, or (vi) emergency rules adopted pursuant to subsection
6(c-5) of this Section. Two or more emergency rules having
7substantially the same purpose and effect shall be deemed to be
8a single rule for purposes of this Section.
9    (c-5) To facilitate the maintenance of the program of group
10health benefits provided to annuitants, survivors, and retired
11employees under the State Employees Group Insurance Act of
121971, rules to alter the contributions to be paid by the State,
13annuitants, survivors, retired employees, or any combination
14of those entities, for that program of group health benefits,
15shall be adopted as emergency rules. The adoption of those
16rules shall be considered an emergency and necessary for the
17public interest, safety, and welfare.
18    (d) In order to provide for the expeditious and timely
19implementation of the State's fiscal year 1999 budget,
20emergency rules to implement any provision of Public Act 90-587
21or 90-588 or any other budget initiative for fiscal year 1999
22may be adopted in accordance with this Section by the agency
23charged with administering that provision or initiative,
24except that the 24-month limitation on the adoption of
25emergency rules and the provisions of Sections 5-115 and 5-125
26do not apply to rules adopted under this subsection (d). The

 

 

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1adoption of emergency rules authorized by this subsection (d)
2shall be deemed to be necessary for the public interest,
3safety, and welfare.
4    (e) In order to provide for the expeditious and timely
5implementation of the State's fiscal year 2000 budget,
6emergency rules to implement any provision of this amendatory
7Act of the 91st General Assembly or any other budget initiative
8for fiscal year 2000 may be adopted in accordance with this
9Section by the agency charged with administering that provision
10or initiative, except that the 24-month limitation on the
11adoption of emergency rules and the provisions of Sections
125-115 and 5-125 do not apply to rules adopted under this
13subsection (e). The adoption of emergency rules authorized by
14this subsection (e) shall be deemed to be necessary for the
15public interest, safety, and welfare.
16    (f) In order to provide for the expeditious and timely
17implementation of the State's fiscal year 2001 budget,
18emergency rules to implement any provision of this amendatory
19Act of the 91st General Assembly or any other budget initiative
20for fiscal year 2001 may be adopted in accordance with this
21Section by the agency charged with administering that provision
22or initiative, except that the 24-month limitation on the
23adoption of emergency rules and the provisions of Sections
245-115 and 5-125 do not apply to rules adopted under this
25subsection (f). The adoption of emergency rules authorized by
26this subsection (f) shall be deemed to be necessary for the

 

 

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1public interest, safety, and welfare.
2    (g) In order to provide for the expeditious and timely
3implementation of the State's fiscal year 2002 budget,
4emergency rules to implement any provision of this amendatory
5Act of the 92nd General Assembly or any other budget initiative
6for fiscal year 2002 may be adopted in accordance with this
7Section by the agency charged with administering that provision
8or initiative, except that the 24-month limitation on the
9adoption of emergency rules and the provisions of Sections
105-115 and 5-125 do not apply to rules adopted under this
11subsection (g). The adoption of emergency rules authorized by
12this subsection (g) shall be deemed to be necessary for the
13public interest, safety, and welfare.
14    (h) In order to provide for the expeditious and timely
15implementation of the State's fiscal year 2003 budget,
16emergency rules to implement any provision of this amendatory
17Act of the 92nd General Assembly or any other budget initiative
18for fiscal year 2003 may be adopted in accordance with this
19Section by the agency charged with administering that provision
20or initiative, except that the 24-month limitation on the
21adoption of emergency rules and the provisions of Sections
225-115 and 5-125 do not apply to rules adopted under this
23subsection (h). The adoption of emergency rules authorized by
24this subsection (h) shall be deemed to be necessary for the
25public interest, safety, and welfare.
26    (i) In order to provide for the expeditious and timely

 

 

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1implementation of the State's fiscal year 2004 budget,
2emergency rules to implement any provision of this amendatory
3Act of the 93rd General Assembly or any other budget initiative
4for fiscal year 2004 may be adopted in accordance with this
5Section by the agency charged with administering that provision
6or initiative, except that the 24-month limitation on the
7adoption of emergency rules and the provisions of Sections
85-115 and 5-125 do not apply to rules adopted under this
9subsection (i). The adoption of emergency rules authorized by
10this subsection (i) shall be deemed to be necessary for the
11public interest, safety, and welfare.
12    (j) In order to provide for the expeditious and timely
13implementation of the provisions of the State's fiscal year
142005 budget as provided under the Fiscal Year 2005 Budget
15Implementation (Human Services) Act, emergency rules to
16implement any provision of the Fiscal Year 2005 Budget
17Implementation (Human Services) Act may be adopted in
18accordance with this Section by the agency charged with
19administering that provision, except that the 24-month
20limitation on the adoption of emergency rules and the
21provisions of Sections 5-115 and 5-125 do not apply to rules
22adopted under this subsection (j). The Department of Public Aid
23may also adopt rules under this subsection (j) necessary to
24administer the Illinois Public Aid Code and the Children's
25Health Insurance Program Act. The adoption of emergency rules
26authorized by this subsection (j) shall be deemed to be

 

 

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1necessary for the public interest, safety, and welfare.
2    (k) In order to provide for the expeditious and timely
3implementation of the provisions of the State's fiscal year
42006 budget, emergency rules to implement any provision of this
5amendatory Act of the 94th General Assembly or any other budget
6initiative for fiscal year 2006 may be adopted in accordance
7with this Section by the agency charged with administering that
8provision or initiative, except that the 24-month limitation on
9the adoption of emergency rules and the provisions of Sections
105-115 and 5-125 do not apply to rules adopted under this
11subsection (k). The Department of Healthcare and Family
12Services may also adopt rules under this subsection (k)
13necessary to administer the Illinois Public Aid Code, the
14Senior Citizens and Disabled Persons Property Tax Relief and
15Pharmaceutical Assistance Act, the Senior Citizens and
16Disabled Persons Prescription Drug Discount Program Act (now
17the Illinois Prescription Drug Discount Program Act), and the
18Children's Health Insurance Program Act. The adoption of
19emergency rules authorized by this subsection (k) shall be
20deemed to be necessary for the public interest, safety, and
21welfare.
22    (l) In order to provide for the expeditious and timely
23implementation of the provisions of the State's fiscal year
242007 budget, the Department of Healthcare and Family Services
25may adopt emergency rules during fiscal year 2007, including
26rules effective July 1, 2007, in accordance with this

 

 

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1subsection to the extent necessary to administer the
2Department's responsibilities with respect to amendments to
3the State plans and Illinois waivers approved by the federal
4Centers for Medicare and Medicaid Services necessitated by the
5requirements of Title XIX and Title XXI of the federal Social
6Security Act. The adoption of emergency rules authorized by
7this subsection (l) shall be deemed to be necessary for the
8public interest, safety, and welfare.
9    (m) In order to provide for the expeditious and timely
10implementation of the provisions of the State's fiscal year
112008 budget, the Department of Healthcare and Family Services
12may adopt emergency rules during fiscal year 2008, including
13rules effective July 1, 2008, in accordance with this
14subsection to the extent necessary to administer the
15Department's responsibilities with respect to amendments to
16the State plans and Illinois waivers approved by the federal
17Centers for Medicare and Medicaid Services necessitated by the
18requirements of Title XIX and Title XXI of the federal Social
19Security Act. The adoption of emergency rules authorized by
20this subsection (m) shall be deemed to be necessary for the
21public interest, safety, and welfare.
22    (n) In order to provide for the expeditious and timely
23implementation of the provisions of the State's fiscal year
242010 budget, emergency rules to implement any provision of this
25amendatory Act of the 96th General Assembly or any other budget
26initiative authorized by the 96th General Assembly for fiscal

 

 

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1year 2010 may be adopted in accordance with this Section by the
2agency charged with administering that provision or
3initiative. The adoption of emergency rules authorized by this
4subsection (n) shall be deemed to be necessary for the public
5interest, safety, and welfare. The rulemaking authority
6granted in this subsection (n) shall apply only to rules
7promulgated during Fiscal Year 2010.
8    (o) In order to provide for the expeditious and timely
9implementation of the provisions of the State's fiscal year
102011 budget, emergency rules to implement any provision of this
11amendatory Act of the 96th General Assembly or any other budget
12initiative authorized by the 96th General Assembly for fiscal
13year 2011 may be adopted in accordance with this Section by the
14agency charged with administering that provision or
15initiative. The adoption of emergency rules authorized by this
16subsection (o) is deemed to be necessary for the public
17interest, safety, and welfare. The rulemaking authority
18granted in this subsection (o) applies only to rules
19promulgated on or after the effective date of this amendatory
20Act of the 96th General Assembly through June 30, 2011.
21(Source: P.A. 95-12, eff. 7-2-07; 95-331, eff. 8-21-07; 96-45,
22eff. 7-15-09; 96-958, eff. 7-1-10; 96-1500, eff. 1-18-11.)
 
23    Section 5. The State Employees Group Insurance Act of 1971
24is amended by changing Sections 3, 10, and 15 as follows:
 

 

 

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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. (For definition of "retired employee", see (p)
18post).
19    (b-5) (Blank). "New SERS annuitant" means a person who, on
20or after January 1, 1998, becomes an annuitant, as defined in
21subsection (b), by virtue of beginning to receive a retirement
22annuity under Article 14 of the Illinois Pension Code
23(including an employee who has elected to receive an
24alternative retirement cancellation payment under Section
2514-108.5 of that Code in lieu of an annuity), and is eligible
26to participate in the basic program of group health benefits

 

 

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1provided for annuitants under this Act.
2    (b-6) (Blank). "New SURS annuitant" means a person who (1)
3on or after January 1, 1998, becomes an annuitant, as defined
4in subsection (b), by virtue of beginning to receive a
5retirement annuity under Article 15 of the Illinois Pension
6Code, (2) has not made the election authorized under Section
715-135.1 of the Illinois Pension Code, and (3) is eligible to
8participate in the basic program of group health benefits
9provided for annuitants under this Act.
10    (b-7) (Blank). "New TRS State annuitant" means a person
11who, on or after July 1, 1998, becomes an annuitant, as defined
12in subsection (b), by virtue of beginning to receive a
13retirement annuity under Article 16 of the Illinois Pension
14Code based on service as a teacher as defined in paragraph (2),
15(3), or (5) of Section 16-106 of that Code, and is eligible to
16participate in the basic program of group health benefits
17provided for annuitants under this Act.
18    (c) "Carrier" means (1) an insurance company, a corporation
19organized under the Limited Health Service Organization Act or
20the Voluntary Health Services Plan Act, a partnership, or other
21nongovernmental organization, which is authorized to do group
22life or group health insurance business in Illinois, or (2) the
23State of Illinois as a self-insurer.
24    (d) "Compensation" means salary or wages payable on a
25regular payroll by the State Treasurer on a warrant of the
26State Comptroller out of any State, trust or federal fund, or

 

 

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1by the Governor of the State through a disbursing officer of
2the State out of a trust or out of federal funds, or by any
3Department out of State, trust, federal or other funds held by
4the State Treasurer or the Department, to any person for
5personal services currently performed, and ordinary or
6accidental disability benefits under Articles 2, 14, 15
7(including ordinary or accidental disability benefits under
8the optional retirement program established under Section
915-158.2), paragraphs (2), (3), or (5) of Section 16-106, or
10Article 18 of the Illinois Pension Code, for disability
11incurred after January 1, 1966, or benefits payable under the
12Workers' Compensation or Occupational Diseases Act or benefits
13payable under a sick pay plan established in accordance with
14Section 36 of the State Finance Act. "Compensation" also means
15salary or wages paid to an employee of any qualified local
16government, qualified rehabilitation facility, qualified
17domestic violence shelter or service, or qualified child
18advocacy center.
19    (e) "Commission" means the State Employees Group Insurance
20Advisory Commission authorized by this Act. Commencing July 1,
211984, "Commission" as used in this Act means the Commission on
22Government Forecasting and Accountability as established by
23the Legislative Commission Reorganization Act of 1984.
24    (f) "Contributory", when referred to as contributory
25coverage, shall mean optional coverages or benefits elected by
26the member toward the cost of which such member makes

 

 

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

 

 

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126 if enrolled as an adult child dependent). For the health
2plan only, the term "dependent" also includes (1) any person
3enrolled prior to the effective date of this Section who is
4dependent upon the member to the extent that the member may
5claim such person as a dependent for income tax deduction
6purposes and (2) any person who has received after June 30,
72000 an organ transplant and who is financially dependent upon
8the member and eligible to be claimed as a dependent for income
9tax purposes. A member requesting to cover any dependent must
10provide documentation as requested by the Department of Central
11Management Services and file with the Department any and all
12forms required by the Department.
13    (i) "Director" means the Director of the Illinois
14Department of Central Management Services or of any successor
15agency designated to administer this Act.
16    (j) "Eligibility period" means the period of time a member
17has to elect enrollment in programs or to select benefits
18without regard to age, sex or health.
19    (k) "Employee" means and includes each officer or employee
20in the service of a department who (1) receives his
21compensation for service rendered to the department on a
22warrant issued pursuant to a payroll certified by a department
23or on a warrant or check issued and drawn by a department upon
24a trust, federal or other fund or on a warrant issued pursuant
25to a payroll certified by an elected or duly appointed officer
26of the State or who receives payment of the performance of

 

 

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1personal services on a warrant issued pursuant to a payroll
2certified by a Department and drawn by the Comptroller upon the
3State Treasurer against appropriations made by the General
4Assembly from any fund or against trust funds held by the State
5Treasurer, and (2) is employed full-time or part-time in a
6position normally requiring actual performance of duty during
7not less than 1/2 of a normal work period, as established by
8the Director in cooperation with each department, except that
9persons elected by popular vote will be considered employees
10during the entire term for which they are elected regardless of
11hours devoted to the service of the State, and (3) except that
12"employee" does not include any person who is not eligible by
13reason of such person's employment to participate in one of the
14State retirement systems under Articles 2, 14, 15 (either the
15regular Article 15 system or the optional retirement program
16established under Section 15-158.2) or 18, or under paragraph
17(2), (3), or (5) of Section 16-106, of the Illinois Pension
18Code, but such term does include persons who are employed
19during the 6 month qualifying period under Article 14 of the
20Illinois Pension Code. Such term also includes any person who
21(1) after January 1, 1966, is receiving ordinary or accidental
22disability benefits under Articles 2, 14, 15 (including
23ordinary or accidental disability benefits under the optional
24retirement program established under Section 15-158.2),
25paragraphs (2), (3), or (5) of Section 16-106, or Article 18 of
26the Illinois Pension Code, for disability incurred after

 

 

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1January 1, 1966, (2) receives total permanent or total
2temporary disability under the Workers' Compensation Act or
3Occupational Disease Act as a result of injuries sustained or
4illness contracted in the course of employment with the State
5of Illinois, or (3) is not otherwise covered under this Act and
6has retired as a participating member under Article 2 of the
7Illinois Pension Code but is ineligible for the retirement
8annuity under Section 2-119 of the Illinois Pension Code.
9However, a person who satisfies the criteria of the foregoing
10definition of "employee" except that such person is made
11ineligible to participate in the State Universities Retirement
12System by clause (4) of subsection (a) of Section 15-107 of the
13Illinois Pension Code is also an "employee" for the purposes of
14this Act. "Employee" also includes any person receiving or
15eligible for benefits under a sick pay plan established in
16accordance with Section 36 of the State Finance Act. "Employee"
17also includes (i) each officer or employee in the service of a
18qualified local government, including persons appointed as
19trustees of sanitary districts regardless of hours devoted to
20the service of the sanitary district, (ii) each employee in the
21service of a qualified rehabilitation facility, (iii) each
22full-time employee in the service of a qualified domestic
23violence shelter or service, and (iv) each full-time employee
24in the service of a qualified child advocacy center, as
25determined according to rules promulgated by the Director.
26    (l) "Member" means an employee, annuitant, retired

 

 

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1employee or survivor. In the case of an annuitant or retired
2employee who first becomes an annuitant or retired employee on
3or after the effective date of this amendatory Act of the 97th
4General Assembly, the individual must meet the minimum vesting
5requirements of the applicable retirement system in order to be
6eligible for group insurance benefits under that system. In the
7case of a survivor who first becomes a survivor on or after the
8effective date of this amendatory Act of the 97th General
9Assembly, the deceased employee, annuitant, or retired
10employee upon whom the annuity is based must have been eligible
11to participate in the group insurance system under the
12applicable retirement system in order for the survivor to be
13eligible for group insurance benefits under that system.
14    (m) "Optional coverages or benefits" means those coverages
15or benefits available to the member on his or her voluntary
16election, and at his or her own expense.
17    (n) "Program" means the group life insurance, health
18benefits and other employee benefits designed and contracted
19for by the Director under this Act.
20    (o) "Health plan" means a health benefits program offered
21by the State of Illinois for persons eligible for the plan.
22    (p) "Retired employee" means any person who would be an
23annuitant as that term is defined herein but for the fact that
24such person retired prior to January 1, 1966. Such term also
25includes any person formerly employed by the University of
26Illinois in the Cooperative Extension Service who would be an

 

 

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1annuitant but for the fact that such person was made ineligible
2to participate in the State Universities Retirement System by
3clause (4) of subsection (a) of Section 15-107 of the Illinois
4Pension Code.
5    (q) "Survivor" means a person receiving an annuity as a
6survivor of an employee or of an annuitant. "Survivor" also
7includes: (1) the surviving dependent of a person who satisfies
8the definition of "employee" except that such person is made
9ineligible to participate in the State Universities Retirement
10System by clause (4) of subsection (a) of Section 15-107 of the
11Illinois Pension Code; (2) the surviving dependent of any
12person formerly employed by the University of Illinois in the
13Cooperative Extension Service who would be an annuitant except
14for the fact that such person was made ineligible to
15participate in the State Universities Retirement System by
16clause (4) of subsection (a) of Section 15-107 of the Illinois
17Pension Code; and (3) 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-2) "SERS" means the State Employees' Retirement System
22of Illinois, created under Article 14 of the Illinois Pension
23Code.
24    (q-3) "SURS" means the State Universities Retirement
25System, created under Article 15 of the Illinois Pension Code.
26    (q-4) "TRS" means the Teachers' Retirement System of the

 

 

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1State of Illinois, created under Article 16 of the Illinois
2Pension Code.
3    (q-5) (Blank). "New SERS survivor" means a survivor, as
4defined in subsection (q), whose annuity is paid under Article
514 of the Illinois Pension Code and is based on the death of
6(i) an employee whose death occurs on or after January 1, 1998,
7or (ii) a new SERS annuitant as defined in subsection (b-5).
8"New SERS survivor" includes the surviving dependent of a
9person who was an annuitant under this Act by virtue of
10receiving an alternative retirement cancellation payment under
11Section 14-108.5 of the Illinois Pension Code.
12    (q-6) (Blank). "New SURS survivor" means a survivor, as
13defined in subsection (q), whose annuity is paid under Article
1415 of the Illinois Pension Code and is based on the death of
15(i) an employee whose death occurs on or after January 1, 1998,
16or (ii) a new SURS annuitant as defined in subsection (b-6).
17    (q-7) (Blank). "New TRS State survivor" means a survivor,
18as defined in subsection (q), whose annuity is paid under
19Article 16 of the Illinois Pension Code and is based on the
20death of (i) an employee who is a teacher as defined in
21paragraph (2), (3), or (5) of Section 16-106 of that Code and
22whose death occurs on or after July 1, 1998, or (ii) a new TRS
23State annuitant as defined in subsection (b-7).
24    (r) "Medical services" means the services provided within
25the scope of their licenses by practitioners in all categories
26licensed under the Medical Practice Act of 1987.

 

 

09700SB1313ham009- 21 -LRB097 06593 JDS 69334 a

1    (s) "Unit of local government" means any county,
2municipality, township, school district (including a
3combination of school districts under the Intergovernmental
4Cooperation Act), special district or other unit, designated as
5a unit of local government by law, which exercises limited
6governmental powers or powers in respect to limited
7governmental subjects, any not-for-profit association with a
8membership that primarily includes townships and township
9officials, that has duties that include provision of research
10service, dissemination of information, and other acts for the
11purpose of improving township government, and that is funded
12wholly or partly in accordance with Section 85-15 of the
13Township Code; any not-for-profit corporation or association,
14with a membership consisting primarily of municipalities, that
15operates its own utility system, and provides research,
16training, dissemination of information, or other acts to
17promote cooperation between and among municipalities that
18provide utility services and for the advancement of the goals
19and purposes of its membership; the Southern Illinois
20Collegiate Common Market, which is a consortium of higher
21education institutions in Southern Illinois; the Illinois
22Association of Park Districts; and any hospital provider that
23is owned by a county that has 100 or fewer hospital beds and
24has not already joined the program. "Qualified local
25government" means a unit of local government approved by the
26Director and participating in a program created under

 

 

09700SB1313ham009- 22 -LRB097 06593 JDS 69334 a

1subsection (i) of Section 10 of this Act.
2    (t) "Qualified rehabilitation facility" means any
3not-for-profit organization that is accredited by the
4Commission on Accreditation of Rehabilitation Facilities or
5certified by the Department of Human Services (as successor to
6the Department of Mental Health and Developmental
7Disabilities) to provide services to persons with disabilities
8and which receives funds from the State of Illinois for
9providing those services, approved by the Director and
10participating in a program created under subsection (j) of
11Section 10 of this Act.
12    (u) "Qualified domestic violence shelter or service" means
13any Illinois domestic violence shelter or service and its
14administrative offices funded by the Department of Human
15Services (as successor to the Illinois Department of Public
16Aid), approved by the Director and participating in a program
17created under subsection (k) of Section 10.
18    (v) "TRS benefit recipient" means a person who:
19        (1) is not a "member" as defined in this Section; and
20        (2) is receiving a monthly benefit or retirement
21    annuity under Article 16 of the Illinois Pension Code; and
22        (3) either (i) has at least 8 years of creditable
23    service under Article 16 of the Illinois Pension Code, or
24    (ii) was enrolled in the health insurance program offered
25    under that Article on January 1, 1996, or (iii) is the
26    survivor of a benefit recipient who had at least 8 years of

 

 

09700SB1313ham009- 23 -LRB097 06593 JDS 69334 a

1    creditable service under Article 16 of the Illinois Pension
2    Code or was enrolled in the health insurance program
3    offered under that Article on the effective date of this
4    amendatory Act of 1995, or (iv) is a recipient or survivor
5    of a recipient of a disability benefit under Article 16 of
6    the Illinois Pension Code.
7    (w) "TRS dependent beneficiary" means a person who:
8        (1) is not a "member" or "dependent" as defined in this
9    Section; and
10        (2) is a TRS benefit recipient's: (A) spouse, (B)
11    dependent parent who is receiving at least half of his or
12    her support from the TRS benefit recipient, or (C) natural,
13    step, adjudicated, or adopted child who is (i) under age
14    26, (ii) was, on January 1, 1996, participating as a
15    dependent beneficiary in the health insurance program
16    offered under Article 16 of the Illinois Pension Code, or
17    (iii) age 19 or over who is mentally or physically disabled
18    from a cause originating prior to the age of 19 (age 26 if
19    enrolled as an adult child).
20    "TRS dependent beneficiary" does not include, as indicated
21under paragraph (2) of this subsection (w), a dependent of the
22survivor of a TRS benefit recipient who first becomes a
23dependent of a survivor of a TRS benefit recipient on or after
24the effective date of this amendatory Act of the 97th General
25Assembly unless that dependent would have been eligible for
26coverage as a dependent of the deceased TRS benefit recipient

 

 

09700SB1313ham009- 24 -LRB097 06593 JDS 69334 a

1upon whom the survivor benefit is based.
2    (x) "Military leave" refers to individuals in basic
3training for reserves, special/advanced training, annual
4training, emergency call up, activation by the President of the
5United States, or any other training or duty in service to the
6United States Armed Forces.
7    (y) (Blank).
8    (z) "Community college benefit recipient" means a person
9who:
10        (1) is not a "member" as defined in this Section; and
11        (2) is receiving a monthly survivor's annuity or
12    retirement annuity under Article 15 of the Illinois Pension
13    Code; and
14        (3) either (i) was a full-time employee of a community
15    college district or an association of community college
16    boards created under the Public Community College Act
17    (other than an employee whose last employer under Article
18    15 of the Illinois Pension Code was a community college
19    district subject to Article VII of the Public Community
20    College Act) and was eligible to participate in a group
21    health benefit plan as an employee during the time of
22    employment with a community college district (other than a
23    community college district subject to Article VII of the
24    Public Community College Act) or an association of
25    community college boards, or (ii) is the survivor of a
26    person described in item (i).

 

 

09700SB1313ham009- 25 -LRB097 06593 JDS 69334 a

1    (aa) "Community college dependent beneficiary" means a
2person who:
3        (1) is not a "member" or "dependent" as defined in this
4    Section; and
5        (2) is a community college benefit recipient's: (A)
6    spouse, (B) dependent parent who is receiving at least half
7    of his or her support from the community college benefit
8    recipient, or (C) natural, step, adjudicated, or adopted
9    child who is (i) under age 26, or (ii) age 19 or over and
10    mentally or physically disabled from a cause originating
11    prior to the age of 19 (age 26 if enrolled as an adult
12    child).
13    "Community college dependent beneficiary" does not
14include, as indicated under paragraph (2) of this subsection
15(aa), a dependent of the survivor of a community college
16benefit recipient who first becomes a dependent of a survivor
17of a community college benefit recipient on or after the
18effective date of this amendatory Act of the 97th General
19Assembly unless that dependent would have been eligible for
20coverage as a dependent of the deceased community college
21benefit recipient upon whom the survivor annuity is based.
22    (bb) "Qualified child advocacy center" means any Illinois
23child advocacy center and its administrative offices funded by
24the Department of Children and Family Services, as defined by
25the Children's Advocacy Center Act (55 ILCS 80/), approved by
26the Director and participating in a program created under

 

 

09700SB1313ham009- 26 -LRB097 06593 JDS 69334 a

1subsection (n) of Section 10.
2(Source: P.A. 96-756, eff. 1-1-10; 96-1519, eff. 2-4-11;
397-668, eff. 1-13-12.)
 
4    (5 ILCS 375/10)  (from Ch. 127, par. 530)
5    Sec. 10. Contributions by the State and members. Payments
6by State; premiums.
7    (a) The State shall pay the cost of basic non-contributory
8group life insurance and, subject to member paid contributions
9set by the Department or required by this Section and except as
10provided in this Section, the basic program of group health
11benefits on each eligible member, except a member, not
12otherwise covered by this Act, who has retired as a
13participating member under Article 2 of the Illinois Pension
14Code but is ineligible for the retirement annuity under Section
152-119 of the Illinois Pension Code, and part of each eligible
16member's and retired member's premiums for health insurance
17coverage for enrolled dependents as provided by Section 9. The
18State shall pay the cost of the basic program of group health
19benefits only after benefits are reduced by the amount of
20benefits covered by Medicare for all members and dependents who
21are eligible for benefits under Social Security or the Railroad
22Retirement system or who had sufficient Medicare-covered
23government employment, except that such reduction in benefits
24shall apply only to those members and dependents who (1) first
25become eligible for such Medicare coverage on or after July 1,

 

 

09700SB1313ham009- 27 -LRB097 06593 JDS 69334 a

11992; or (2) are Medicare-eligible members or dependents of a
2local government unit which began participation in the program
3on or after July 1, 1992; or (3) remain eligible for, but no
4longer receive Medicare coverage which they had been receiving
5on or after July 1, 1992. The Department may determine the
6aggregate level of the State's contribution on the basis of
7actual cost of medical services adjusted for age, sex or
8geographic or other demographic characteristics which affect
9the costs of such programs.
10    The cost of participation in the basic program of group
11health benefits for the dependent or survivor of a living or
12deceased retired employee who was formerly employed by the
13University of Illinois in the Cooperative Extension Service and
14would be an annuitant but for the fact that he or she was made
15ineligible to participate in the State Universities Retirement
16System by clause (4) of subsection (a) of Section 15-107 of the
17Illinois Pension Code shall not be greater than the cost of
18participation that would otherwise apply to that dependent or
19survivor if he or she were the dependent or survivor of an
20annuitant under the State Universities Retirement System.
21    (a-1) (Blank). Beginning January 1, 1998, for each person
22who becomes a new SERS annuitant and participates in the basic
23program of group health benefits, the State shall contribute
24toward the cost of the annuitant's coverage under the basic
25program of group health benefits an amount equal to 5% of that
26cost for each full year of creditable service upon which the

 

 

09700SB1313ham009- 28 -LRB097 06593 JDS 69334 a

1annuitant's retirement annuity is based, up to a maximum of
2100% for an annuitant with 20 or more years of creditable
3service. The remainder of the cost of a new SERS annuitant's
4coverage under the basic program of group health benefits shall
5be the responsibility of the annuitant. In the case of a new
6SERS annuitant who has elected to receive an alternative
7retirement cancellation payment under Section 14-108.5 of the
8Illinois Pension Code in lieu of an annuity, for the purposes
9of this subsection the annuitant shall be deemed to be
10receiving a retirement annuity based on the number of years of
11creditable service that the annuitant had established at the
12time of his or her termination of service under SERS.
13    (a-2) (Blank). Beginning January 1, 1998, for each person
14who becomes a new SERS survivor and participates in the basic
15program of group health benefits, the State shall contribute
16toward the cost of the survivor's coverage under the basic
17program of group health benefits an amount equal to 5% of that
18cost for each full year of the deceased employee's or deceased
19annuitant's creditable service in the State Employees'
20Retirement System of Illinois on the date of death, up to a
21maximum of 100% for a survivor of an employee or annuitant with
2220 or more years of creditable service. The remainder of the
23cost of the new SERS survivor's coverage under the basic
24program of group health benefits shall be the responsibility of
25the survivor. In the case of a new SERS survivor who was the
26dependent of an annuitant who elected to receive an alternative

 

 

09700SB1313ham009- 29 -LRB097 06593 JDS 69334 a

1retirement cancellation payment under Section 14-108.5 of the
2Illinois Pension Code in lieu of an annuity, for the purposes
3of this subsection the deceased annuitant's creditable service
4shall be determined as of the date of termination of service
5rather than the date of death.
6    (a-3) (Blank). Beginning January 1, 1998, for each person
7who becomes a new SURS annuitant and participates in the basic
8program of group health benefits, the State shall contribute
9toward the cost of the annuitant's coverage under the basic
10program of group health benefits an amount equal to 5% of that
11cost for each full year of creditable service upon which the
12annuitant's retirement annuity is based, up to a maximum of
13100% for an annuitant with 20 or more years of creditable
14service. The remainder of the cost of a new SURS annuitant's
15coverage under the basic program of group health benefits shall
16be the responsibility of the annuitant.
17    (a-4) (Blank).
18    (a-5) (Blank). Beginning January 1, 1998, for each person
19who becomes a new SURS survivor and participates in the basic
20program of group health benefits, the State shall contribute
21toward the cost of the survivor's coverage under the basic
22program of group health benefits an amount equal to 5% of that
23cost for each full year of the deceased employee's or deceased
24annuitant's creditable service in the State Universities
25Retirement System on the date of death, up to a maximum of 100%
26for a survivor of an employee or annuitant with 20 or more

 

 

09700SB1313ham009- 30 -LRB097 06593 JDS 69334 a

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

 

 

09700SB1313ham009- 31 -LRB097 06593 JDS 69334 a

1Pension Code on the date of death, up to a maximum of 100%;
2except that the State contribution shall be 12.5% per year
3(rather than 5%) for each full year of the deceased employee's
4or deceased annuitant's creditable service as a regional
5superintendent or assistant regional superintendent of
6schools. The remainder of the cost of the new TRS State
7survivor's coverage under the basic program of group health
8benefits shall be the responsibility of the survivor.
9    (a-8) Any A new SERS annuitant, new SERS survivor, or
10retired employee , new SURS annuitant, new SURS survivor, new
11TRS State annuitant, or new TRS State survivor may waive or
12terminate coverage in the program of group health benefits. Any
13such annuitant, or survivor, or retired employee who has waived
14or terminated coverage may enroll or re-enroll in the program
15of group health benefits only during the annual benefit choice
16period, as determined by the Director; except that in the event
17of termination of coverage due to nonpayment of premiums, the
18annuitant, or survivor, or retired employee may not re-enroll
19in the program.
20    (a-8.5) Beginning on the effective date of this amendatory
21Act of the 97th General Assembly, the Director of Central
22Management Services shall, on an annual basis, determine the
23amount that the State shall contribute toward the basic program
24of group health benefits on behalf of annuitants (including
25individuals who (i) participated in the General Assembly
26Retirement System, the State Employees' Retirement System of

 

 

09700SB1313ham009- 32 -LRB097 06593 JDS 69334 a

1Illinois, the State Universities Retirement System, the
2Teachers' Retirement System of the State of Illinois, or the
3Judges Retirement System of Illinois and (ii) qualify as
4annuitants under subsection (b) of Section 3 of this Act),
5survivors (including individuals who (i) receive an annuity as
6a survivor of an individual who participated in the General
7Assembly Retirement System, the State Employees' Retirement
8System of Illinois, the State Universities Retirement System,
9the Teachers' Retirement System of the State of Illinois, or
10the Judges Retirement System of Illinois and (ii) qualify as
11survivors under subsection (q) of Section 3 of this Act), and
12retired employees (as defined in subsection (p) of Section 3 of
13this Act). The remainder of the cost of coverage for each
14annuitant, survivor, or retired employee, as determined by the
15Director of Central Management Services, shall be the
16responsibility of that annuitant, survivor, or retired
17employee.
18    Contributions required of annuitants, survivors, and
19retired employees shall be the same for all retirement systems
20and shall also be based on whether an individual has made an
21election under Section 15-135.1 of the Illinois Pension Code.
22Contributions may be based on annuitants', survivors', or
23retired employees' Medicare eligibility, but may not be based
24on Social Security eligibility.
25    (a-9) No later than May 1 of each calendar year, the
26Director of Central Management Services shall certify in

 

 

09700SB1313ham009- 33 -LRB097 06593 JDS 69334 a

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

 

 

09700SB1313ham009- 34 -LRB097 06593 JDS 69334 a

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

 

 

09700SB1313ham009- 35 -LRB097 06593 JDS 69334 a

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

 

 

09700SB1313ham009- 36 -LRB097 06593 JDS 69334 a

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

 

 

09700SB1313ham009- 37 -LRB097 06593 JDS 69334 a

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

 

 

09700SB1313ham009- 38 -LRB097 06593 JDS 69334 a

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,

 

 

09700SB1313ham009- 39 -LRB097 06593 JDS 69334 a

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

 

 

09700SB1313ham009- 40 -LRB097 06593 JDS 69334 a

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 and rehabilitation facility employees, annuitants,
14and dependents, and to reimburse the Department or its
15administrative service organization for all expenses incurred
16in the administration of benefits. No other State funds may be
17used 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

 

 

09700SB1313ham009- 41 -LRB097 06593 JDS 69334 a

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

 

 

09700SB1313ham009- 42 -LRB097 06593 JDS 69334 a

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

 

 

09700SB1313ham009- 43 -LRB097 06593 JDS 69334 a

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
14employees, or some combination of the 2 as determined by the
15domestic violence shelter or service. The domestic violence
16shelter or service shall be responsible for timely collection
17and transmission of dependent premiums.
18    The Director shall annually determine rates of payment,
19subject 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 on behalf of its
24    employees, adjusted for differences between State
25    employees and employees of the domestic violence shelter or
26    service in age, sex, geographic location or other relevant

 

 

09700SB1313ham009- 44 -LRB097 06593 JDS 69334 a

1    demographic variables, plus an amount sufficient to pay for
2    the additional administrative costs of providing coverage
3    to employees of the domestic violence shelter or service
4    and their dependents.
5        (2) In subsequent years, a further adjustment shall be
6    made to reflect the actual prior years' claims experience
7    of the employees of the domestic violence shelter or
8    service.
9    Monthly payments by the domestic violence shelter or
10service or its employees for group health insurance shall be
11deposited in the Local Government Health Insurance Reserve
12Fund.
13    (l) A public community college or entity organized pursuant
14to the Public Community College Act may apply to the Director
15initially to have only annuitants not covered prior to July 1,
161992 by the district's health plan provided health coverage
17under this Act on a non-insured basis. The community college
18must execute a 2-year contract to participate in the Local
19Government Health Plan. Any annuitant may enroll in the event
20of a qualifying change in status, special enrollment, special
21circumstance as defined by the Director, or during the annual
22Benefit Choice Period.
23    The Director shall annually determine monthly rates of
24payment subject to the following constraints: for those
25community colleges with annuitants only enrolled, first year
26rates shall be equal to the average cost to cover claims for a

 

 

09700SB1313ham009- 45 -LRB097 06593 JDS 69334 a

1State member adjusted for demographics, Medicare
2participation, and other factors; and in the second year, a
3further adjustment of rates shall be made to reflect the actual
4first year's claims experience of the covered annuitants.
5    (l-5) The provisions of subsection (l) become inoperative
6on July 1, 1999.
7    (m) The Director shall adopt any rules deemed necessary for
8implementation of this amendatory Act of 1989 (Public Act
986-978).
10    (n) Any child advocacy center within the State of Illinois
11may apply to the Director to have its employees, annuitants,
12and their dependents provided group health coverage under this
13Act on a non-insured basis. To participate, a child advocacy
14center must agree to enroll all of its employees and pay the
15entire cost of providing coverage for its employees. The child
16advocacy center shall not be required to enroll those of its
17employees who are covered spouses or dependents under this plan
18or another group policy or plan providing health benefits as
19long as (1) an appropriate official from the child advocacy
20center attests that each employee not enrolled is a covered
21spouse or dependent under this plan or another group policy or
22plan and (2) at least 50% of the employees are enrolled and the
23child advocacy center remits the entire cost of providing
24coverage to those employees. Employees of a participating child
25advocacy center who are not enrolled due to coverage under
26another group health policy or plan may enroll in the event of

 

 

09700SB1313ham009- 46 -LRB097 06593 JDS 69334 a

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

 

 

09700SB1313ham009- 47 -LRB097 06593 JDS 69334 a

1employees for group health insurance shall be deposited into
2the Local Government Health Insurance Reserve Fund.
3(Source: P.A. 95-331, eff. 8-21-07; 95-632, eff. 9-25-07;
495-707, eff. 1-11-08; 96-756, eff. 1-1-10; 96-1232, eff.
57-23-10; 96-1519, eff. 2-4-11.)
 
6    (5 ILCS 375/15)  (from Ch. 127, par. 535)
7    Sec. 15. Administration; rules; audit; review.
8    (a) The Director shall administer this Act and shall
9prescribe such rules and regulations as are necessary to give
10full effect to the purposes of this Act. To facilitate the
11maintenance of the program of group health benefits provided to
12annuitants, survivors, and retired employees under this Act,
13rules adopted by the Director to alter the contributions to be
14paid by the State, annuitants, survivors, retired employees, or
15any combination of those entities, for that program of group
16health benefits, shall be adopted as emergency rules in
17accordance with Section 5-45 of the Illinois Administrative
18Procedure Act.
19    (b) These rules may fix reasonable standards for the group
20life and group health programs and other benefit programs
21offered under this Act, and for the contractors providing them.
22    (c) These rules shall specify that covered and optional
23medical services of the program are services provided within
24the scope of their licenses by practitioners in all categories
25licensed under the Medical Practice Act of 1987 and shall

 

 

09700SB1313ham009- 48 -LRB097 06593 JDS 69334 a

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

 

 

09700SB1313ham009- 49 -LRB097 06593 JDS 69334 a

1Universities Retirement System. Information about TRS benefit
2recipients and TRS dependent beneficiaries shall be furnished
3through the Teachers' Retirement System.
4    (g) There shall be audits and reports on the programs
5authorized and established by this Act prepared by the Director
6with the assistance of a qualified, independent accounting
7firm. The reports shall provide information on the experience,
8and administrative effectiveness and adequacy of the program
9including, when applicable, recommendations on up-grading of
10benefits and improvement of the program.
11    (h) Any final order, decision or other determination made,
12issued or executed by the Director under the provisions of this
13Act whereby any contractor or person is aggrieved shall be
14subject to review in accordance with the provisions of the
15Administrative Review Law and all amendments and modifications
16thereof, and the rules adopted pursuant thereto, shall apply to
17and govern all proceedings for the judicial review of final
18administrative decisions of the Director.
19(Source: P.A. 94-860, eff. 6-16-06.)
 
20    Section 99. Effective date. This Act takes effect July 1,
212012.".