HB6694 93RD GENERAL ASSEMBLY

LRB093 21009 WGH 47019 b

93RD GENERAL ASSEMBLY
State of Illinois
2003 and 2004
HB6694

Introduced 2/9/2004, by Patricia R. Bellock

SYNOPSIS AS INTRODUCED:

820 ILCS 320/10

Amends provisions of the Public Safety Employee Benefits Act requiring an employer that employs a full-time law enforcement, correctional or correctional probation officer or firefighter who suffers a catastrophic injury or is killed in the line of duty to pay the health insurance premium for the injured employee and his or her spouse and dependent children. Defines "catastrophic injury" as a permanent grievous or serious injury or impairment of a nature that is sufficient to preclude subsequent employment or re-employment, and excludes from the definition: conditions that are temporary or short-term in nature; common injuries; or injuries the effects of which may be mitigated by work-related rehabilitative or vocational training. Provides that an employer-selected physician's determination as to the seriousness and permanency of an employee's injury may be appealed to the employer's governing body and the final administrative decision of a governing body is subject to judicial review under the Administrative Review Law.

FISCAL NOTE ACT MAY APPLY

STATE MANDATES ACT MAY REQUIRE REIMBURSEMENT

A BILL FOR

AN ACT concerning employment.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 5. The Public Safety Employee Benefits Act is amended by changing Section 10 as follows:

(820 ILCS 320/10)

Sec. 10. Required health coverage benefits.

(a) An employer who employs a full-time law enforcement, correctional or correctional probation officer, or firefighter, who, on or after the effective date of this Act suffers a catastrophic injury or is killed in the line of duty shall pay the entire premium of the employer's health insurance plan for the injured employee, the injured employee's spouse, and for each dependent child of the injured employee until the child reaches the age of majority or until the end of the calendar year in which the child reaches the age of 25 if the child continues to be dependent for support or the child is a full-time or part-time student and is dependent for support. The term "health insurance plan" does not include supplemental benefits that are not part of the basic group health insurance plan. If the injured employee subsequently dies, the employer shall continue to pay the entire health insurance premium for the surviving spouse until remarried and for the dependent children under the conditions established in this Section. However:

(1) Health insurance benefits payable from any other source shall reduce benefits payable under this Section.

(2) It is unlawful for a person to willfully and knowingly make, or cause to be made, or to assist, conspire with, or urge another to make, or cause to be made, any false, fraudulent, or misleading oral or written statement to obtain health insurance coverage as provided under this Section. A violation of this item is a Class A misdemeanor.

(3) Upon conviction for a violation described in item (2), a law enforcement, correctional or correctional probation officer, or other beneficiary who receives or seeks to receive health insurance benefits under this Section shall forfeit the right to receive health insurance benefits and shall reimburse the employer for all benefits paid due to the fraud or other prohibited activity. For purposes of this item, "conviction" means a determination of guilt that is the result of a plea or trial, regardless of whether adjudication is withheld.

(b) In order for the law enforcement, correctional or correctional probation officer, firefighter, spouse, or dependent children to be eligible for insurance coverage under this Act, the injury or death must have occurred as the result of the officer's response to fresh pursuit, the officer or firefighter's response to what is reasonably believed to be an emergency, an unlawful act perpetrated by another, or during the investigation of a criminal act. Nothing in this Section shall be construed to limit health insurance coverage or pension benefits for which the officer, firefighter, spouse, or dependent children may otherwise be eligible.

(c) As used in this Section, "catastrophic injury" means a permanent grievous or serious injury or impairment of a nature that is sufficient to preclude subsequent employment or re-employment and is validated by a licensed physician selected by the employer. "Catastrophic injury" does not include: conditions that are temporary or short-term in nature; common injuries; or injuries the effects of which may be mitigated by work-related rehabilitative or vocational training. The employer-selected physician's determination as to the seriousness and permanency of an employee's injury may be appealed to the employer's governing body. The final administrative decision of a governing body is subject to judicial review under the Administrative Review Law.

(Source: P.A. 90-535, eff. 11-14-97.)