Illinois General Assembly - Full Text of SB1256
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Full Text of SB1256  98th General Assembly

SB1256enr 98TH GENERAL ASSEMBLY



 


 
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1    AN ACT concerning State government.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 1. Short title. This Act may be cited as the
5Executive Order 1 (2012) Implementation Act.
 
6    Section 5. Effect. This Act, including all of the
7amendatory provisions of this Act, implements and supersedes
8Executive Order 1 (2012).
 
9    Section 10. Revocation of Executive Order 3 (2005). On the
10date 6 months after the effective date of this Act, Executive
11Order 3 (2005) is revoked and rescinded with the exception of
12Section I (renaming the Department of Public Aid as the
13Department of Healthcare and Family Services), which remains in
14effect.
 
15    Section 15. Transfer back of State healthcare purchasing
16functions transferred by Executive Order 3 (2005).
17    (a) On the date 6 months after the effective date of this
18Act or as soon thereafter as practical, all of the powers,
19duties, rights, and responsibilities related to State
20healthcare purchasing that were transferred from the
21Department of Central Management Services, the Department of

 

 

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1Corrections, the Department of Human Services, and the
2Department of Veterans' Affairs to the Department of Healthcare
3and Family Services by Executive Order 3 (2005) are transferred
4back to the Departments from which those powers, duties,
5rights, and responsibilities were transferred; however,
6powers, duties, rights, and responsibilities related to State
7healthcare purchasing that were exercised by the Department of
8Corrections before the effective date of Executive Order 3
9(2005) but that pertain to individuals resident in facilities
10operated by the Department of Juvenile Justice are transferred
11to the Department of Juvenile Justice.
12    (b) The functions associated with State healthcare
13purchasing that are transferred from the Department of
14Healthcare and Family Services under this Section include,
15without limitation, the following:
16        (1) Rate development and negotiation with hospitals,
17    physicians, and managed care providers.
18        (2) Health care procurement development.
19        (3) Contract implementation and fiscal monitoring.
20        (4) Contract amendments.
21        (5) Payment processing.
22        (6) Purchasing aspects of health care plans
23    administered by the State on behalf of the following:
24            (A) State employees. These healthcare purchasing
25        functions include the following health care plans:
26        quality care health plan; managed care health plan;

 

 

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1        vision plan; pharmacy benefits plan; dental plan;
2        behavioral health plan; employee assistance plan;
3        utilization management plan; and SHIPs and various
4        subrogation agreements. These healthcare purchasing
5        functions also include the purchasing and
6        administration of flu shots, hepatitis B vaccinations,
7        and tuberculosis tests.
8            (B) Persons other than State employees. These
9        healthcare purchasing functions include the following
10        health care plans: the retired teachers' health
11        insurance plan under the State Employees Group
12        Insurance Act of 1971; the local government health
13        insurance plan under the State Employees Group
14        Insurance Act of 1971; the community colleges health
15        insurance plan under the State Employees Group
16        Insurance Act of 1971; the active teacher prescription
17        program; and the Illinois Prescription Drug Discount
18        Program.
19            (C) Residents of State-operated facilities,
20        including (i) correctional and youth facilities
21        operated by the Department of Corrections or the
22        Department of Juvenile Justice, (ii) mental health
23        centers and developmental centers operated by the
24        Department of Human Services, and (iii) veterans homes
25        operated by the Department of Veterans' Affairs.
26    (c) The powers, duties, rights, and responsibilities

 

 

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1vested in or associated with State healthcare purchasing are
2not affected by this Act, except that all management and staff
3support or other resources necessary to the operation of a
4State healthcare purchasing function shall be provided by the
5Department to which that function is transferred under this
6Act.
 
7    Section 20. Representation on boards or other entities.
8When any provision of an Executive Order or Act provides for
9the membership of the Director of Healthcare and Family
10Services on any council, commission, board, or other entity
11that exercises any of the State healthcare purchasing functions
12transferred by this Act, the Director or Secretary of the
13Department to which the State healthcare purchasing function is
14transferred under this Act, or his or her designee, shall serve
15in the place of the Director of Healthcare and Family Services,
16but only with regard to the exercise of the function
17transferred under this Act. If more than one such person is
18required by law to serve on any council, commission, board, or
19other entity, then an equivalent number of the representatives
20of the Department to which the applicable function is
21transferred under this Act shall so serve. In addition, any
22statutory mandate that provides for action on the part of the
23Director of Healthcare and Family Services relating to a State
24healthcare purchasing function transferred under this Act
25shall become the responsibility of the Director or Secretary of

 

 

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1the Department to which that function is transferred under this
2Act.
 
3    Section 25. Personnel transferred.
4    (a) Personnel and positions within the Department of
5Healthcare and Family Services that are engaged in the
6performance of State healthcare purchasing functions
7transferred back to the Department of Central Management
8Services are transferred to and shall continue their service
9within the Department of Central Management Services. The
10status and rights of those employees under the Personnel Code
11are not affected by this Act.
12    (b) Personnel and positions of the Department of
13Corrections, the Department of Juvenile Justice, the
14Department of Human Services, and the Department of Veterans'
15Affairs were not in fact transferred under Executive Order 3
16(2005) and are not affected by this Act.
 
17    Section 30. Books and records transferred. All books,
18records, papers, documents, property (real and personal),
19contracts, and pending business pertaining to the powers,
20duties, rights, and responsibilities related to any of the
21State healthcare purchasing functions transferred under this
22Act from the Department of Healthcare and Family Services to
23the Department of Central Management Services, the Department
24of Corrections, the Department of Juvenile Justice, the

 

 

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1Department of Human Services, and the Department of Veterans'
2Affairs, including, but not limited to, material in electronic
3or magnetic format and necessary computer hardware and
4software, shall be delivered to the Department to which that
5State healthcare purchasing function is transferred under this
6Act, provided that the delivery of that information may not
7violate any applicable confidentiality constraints. The access
8by personnel of the Department of Central Management Services,
9the Department of Corrections, the Department of Juvenile
10Justice, the Department of Human Services, and the Department
11of Veterans' Affairs to databases and electronic health
12information that are currently maintained by the Department of
13Healthcare and Family Services and that contain data and
14information necessary to the performance of the State
15healthcare purchasing functions shall continue in the same
16manner and level of access as before the effective date of
17Executive Order 1 (2012). Staff of the Department of Central
18Management Services, the Department of Corrections, the
19Department of Juvenile Justice, the Department of Human
20Services, and the Department of Veterans' Affairs may work with
21staff of the Department of Healthcare and Family Services to
22add new information relevant to State healthcare purchasing
23functions.
 
24    Section 35. Unexpended moneys transferred.
25    (a) With respect to the State healthcare purchasing

 

 

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1functions transferred under this Act, the Department of Central
2Management Services is the successor agency to the Department
3of Healthcare and Family Services under the Successor Agency
4Act and Section 9b of the State Finance Act. All unexpended
5appropriations and balances and other moneys available for use
6in connection with any of the State healthcare purchasing
7functions transferred from the Department of Healthcare and
8Family Services to the Department of Central Management
9Services are transferred for use by the Department of Central
10Management Services for the exercise of those functions
11pursuant to the direction of the Governor. Unexpended balances
12so transferred shall be expended only for the purpose for which
13the appropriations were originally made.
14    (b) Appropriations of the Department of Corrections, the
15Department of Juvenile Justice, the Department of Human
16Services, and the Department of Veterans' Affairs were not in
17fact transferred under Executive Order 3 (2005) and are not
18affected by this Act.
 
19    Section 40. Exercise of transferred powers; savings
20provisions. The powers, duties, rights, and responsibilities
21related to the State healthcare purchasing functions
22transferred under this Act are vested in and shall be exercised
23by the Department to which the applicable function is
24transferred. Each act done in the exercise of those powers,
25duties, rights, and responsibilities shall have the same legal

 

 

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1effect as if done by the Department of Healthcare and Family
2Services or its divisions, officers, or employees.
 
3    Section 45. Rules.
4    (a) Any rules that (i) relate to the Illinois Prescription
5Drug Discount Program or to any other State healthcare
6purchasing function or program transferred to the Department of
7Central Management Services by this Act, (ii) are in full force
8on the effective date of Executive Order 1 (2012), and (iii)
9have been duly adopted by the Department of Healthcare and
10Family Services shall become the rules of the Department of
11Central Management Services. This Act shall not affect the
12legality of any such rules in the Illinois Administrative Code.
13    (b) Any proposed rule filed with the Secretary of State by
14the Department of Healthcare and Family Services that pertains
15to the Illinois Prescription Drug Discount Program, or to any
16other State healthcare purchasing function or program
17transferred to the Department of Central Management Services by
18this Act, and that is pending in the rulemaking process on the
19effective date of Executive Order 1 (2012) shall be deemed to
20have been filed by the Department of Central Management
21Services.
22    (c) On and after the effective date of Executive Order 1
23(2012), the Department of Central Management Services may
24propose and adopt, under the Illinois Administrative Procedure
25Act, other rules that relate to the Illinois Prescription Drug

 

 

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1Discount Program, or to any other State healthcare purchasing
2function or program transferred to the Department of Central
3Management Services by this Act.
 
4    Section 50. Rights, obligations, and duties unaffected by
5transfer. The transfer of powers, duties, rights, and
6responsibilities from the Department of Healthcare and Family
7Services under this Act does not affect any person's rights,
8obligations, or duties, including any civil or criminal
9penalties applicable thereto, arising out of those transferred
10powers, duties, rights, and responsibilities.
 
11    Section 55. Agency officers; penalties. Every officer of
12the Department of Central Management Services, the Department
13of Corrections, the Department of Juvenile Justice, the
14Department of Human Services, and the Department of Veterans'
15Affairs is, for any offense, subject to the same penalty or
16penalties, civil or criminal, as are prescribed by existing law
17for the same offense by any officer whose powers or duties are
18transferred under this Act.
 
19    Section 60. Reports, notices, or papers. Whenever reports
20or notices are required to be made or given or papers or
21documents furnished or served by any person to or upon the
22Department of Healthcare and Family Services in connection with
23any State healthcare purchasing function transferred under

 

 

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1this Act, the same shall be made, given, furnished, or served
2in the same manner to or upon the Department to which that
3State healthcare purchasing function is transferred.
 
4    Section 65. Interagency agreements. To the extent
5necessary or prudent to fully implement the intent of this Act,
6the Department of Central Management Services, the Department
7of Corrections, the Department of Human Services, the
8Department of Juvenile Justice, the Department of Veterans'
9Affairs, and the Department of Healthcare and Family Services
10may enter into one or more interagency agreements to ensure the
11full and appropriate transfer of all State healthcare
12purchasing functions transferred from the Department of
13Healthcare and Family Services under this Act.
 
14    Section 70. Acts and actions unaffected by transfer. This
15Act does not affect any act done, ratified, or canceled, or any
16right occurring or established, before the effective date of
17Executive Order 1 (2012), in connection with any State
18healthcare purchasing function transferred under this Act.
19This Act does not affect any action or proceeding had or
20commenced before the effective date of Executive Order 1 (2012)
21in an administrative, civil, or criminal cause regarding a
22State healthcare purchasing function transferred from the
23Department of Healthcare and Family Services under this Act,
24but any such action or proceeding may be defended, prosecuted,

 

 

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1or continued by the Department to which the applicable State
2healthcare purchasing function is transferred.
 
3    Section 900. The State Employees Group Insurance Act of
41971 is amended by adding Section 2.5 and changing Sections 3,
56.5, 6.10, 10, and 13.1 as follows:
 
6    (5 ILCS 375/2.5 new)
7    Sec. 2.5. State healthcare purchasing. On and after the
8date 6 months after the effective date of this amendatory Act
9of the 98th General Assembly, as provided in the Executive
10Order 1 (2012) Implementation Act, all of the powers, duties,
11rights, and responsibilities related to State healthcare
12purchasing under this Act that were transferred from the
13Department of Central Management Services to the Department of
14Healthcare and Family Services by Executive Order 3 (2005) are
15transferred back to the Department.
 
16    (5 ILCS 375/3)  (from Ch. 127, par. 523)
17    Sec. 3. Definitions. Unless the context otherwise
18requires, the following words and phrases as used in this Act
19shall have the following meanings. The Department may define
20these and other words and phrases separately for the purpose of
21implementing specific programs providing benefits under this
22Act.
23    (a) "Administrative service organization" means any

 

 

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

 

 

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1Illinois and who has irrevocably elected to waive his or her
2coverage under this Act and to have his or her spouse
3considered as the "annuitant" under this Act and not as a
4"dependent"; or (5) an employee who retires, or has retired,
5from a qualified position, as determined according to rules
6promulgated by the Director, under a qualified local
7government, a qualified rehabilitation facility, a qualified
8domestic violence shelter or service, or a qualified child
9advocacy center. (For definition of "retired employee", see (p)
10post).
11    (b-5) (Blank).
12    (b-6) (Blank).
13    (b-7) (Blank).
14    (c) "Carrier" means (1) an insurance company, a corporation
15organized under the Limited Health Service Organization Act or
16the Voluntary Health Services Plan Act, a partnership, or other
17nongovernmental organization, which is authorized to do group
18life or group health insurance business in Illinois, or (2) the
19State of Illinois as a self-insurer.
20    (d) "Compensation" means salary or wages payable on a
21regular payroll by the State Treasurer on a warrant of the
22State Comptroller out of any State, trust or federal fund, or
23by the Governor of the State through a disbursing officer of
24the State out of a trust or out of federal funds, or by any
25Department out of State, trust, federal or other funds held by
26the State Treasurer or the Department, to any person for

 

 

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1personal services currently performed, and ordinary or
2accidental disability benefits under Articles 2, 14, 15
3(including ordinary or accidental disability benefits under
4the optional retirement program established under Section
515-158.2), paragraphs (2), (3), or (5) of Section 16-106, or
6Article 18 of the Illinois Pension Code, for disability
7incurred after January 1, 1966, or benefits payable under the
8Workers' Compensation or Occupational Diseases Act or benefits
9payable under a sick pay plan established in accordance with
10Section 36 of the State Finance Act. "Compensation" also means
11salary or wages paid to an employee of any qualified local
12government, qualified rehabilitation facility, qualified
13domestic violence shelter or service, or qualified child
14advocacy center.
15    (e) "Commission" means the State Employees Group Insurance
16Advisory Commission authorized by this Act. Commencing July 1,
171984, "Commission" as used in this Act means the Commission on
18Government Forecasting and Accountability as established by
19the Legislative Commission Reorganization Act of 1984.
20    (f) "Contributory", when referred to as contributory
21coverage, shall mean optional coverages or benefits elected by
22the member toward the cost of which such member makes
23contribution, or which are funded in whole or in part through
24the acceptance of a reduction in earnings or the foregoing of
25an increase in earnings by an employee, as distinguished from
26noncontributory coverage or benefits which are paid entirely by

 

 

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1the State of Illinois without reduction of the member's salary.
2    (g) "Department" means any department, institution, board,
3commission, officer, court or any agency of the State
4government receiving appropriations and having power to
5certify payrolls to the Comptroller authorizing payments of
6salary and wages against such appropriations as are made by the
7General Assembly from any State fund, or against trust funds
8held by the State Treasurer and includes boards of trustees of
9the retirement systems created by Articles 2, 14, 15, 16 and 18
10of the Illinois Pension Code. "Department" also includes the
11Illinois Comprehensive Health Insurance Board, the Board of
12Examiners established under the Illinois Public Accounting
13Act, and the Illinois Finance Authority.
14    (h) "Dependent", when the term is used in the context of
15the health and life plan, means a member's spouse and any child
16(1) from birth to age 26 including an adopted child, a child
17who lives with the member from the time of the filing of a
18petition for adoption until entry of an order of adoption, a
19stepchild or adjudicated child, or a child who lives with the
20member if such member is a court appointed guardian of the
21child or (2) age 19 or over who is mentally or physically
22disabled from a cause originating prior to the age of 19 (age
2326 if enrolled as an adult child dependent). For the health
24plan only, the term "dependent" also includes (1) any person
25enrolled prior to the effective date of this Section who is
26dependent upon the member to the extent that the member may

 

 

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1claim such person as a dependent for income tax deduction
2purposes and (2) any person who has received after June 30,
32000 an organ transplant and who is financially dependent upon
4the member and eligible to be claimed as a dependent for income
5tax purposes. A member requesting to cover any dependent must
6provide documentation as requested by the Department of Central
7Management Services and file with the Department any and all
8forms required by the Department.
9    (i) "Director" means the Director of the Illinois
10Department of Central Management Services or of any successor
11agency designated to administer this Act.
12    (j) "Eligibility period" means the period of time a member
13has to elect enrollment in programs or to select benefits
14without regard to age, sex or health.
15    (k) "Employee" means and includes each officer or employee
16in the service of a department who (1) receives his
17compensation for service rendered to the department on a
18warrant issued pursuant to a payroll certified by a department
19or on a warrant or check issued and drawn by a department upon
20a trust, federal or other fund or on a warrant issued pursuant
21to a payroll certified by an elected or duly appointed officer
22of the State or who receives payment of the performance of
23personal services on a warrant issued pursuant to a payroll
24certified by a Department and drawn by the Comptroller upon the
25State Treasurer against appropriations made by the General
26Assembly from any fund or against trust funds held by the State

 

 

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

 

 

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1of Illinois, or (3) is not otherwise covered under this Act and
2has retired as a participating member under Article 2 of the
3Illinois Pension Code but is ineligible for the retirement
4annuity under Section 2-119 of the Illinois Pension Code.
5However, a person who satisfies the criteria of the foregoing
6definition of "employee" except that such person is made
7ineligible to participate in the State Universities Retirement
8System by clause (4) of subsection (a) of Section 15-107 of the
9Illinois Pension Code is also an "employee" for the purposes of
10this Act. "Employee" also includes any person receiving or
11eligible for benefits under a sick pay plan established in
12accordance with Section 36 of the State Finance Act. "Employee"
13also includes (i) each officer or employee in the service of a
14qualified local government, including persons appointed as
15trustees of sanitary districts regardless of hours devoted to
16the service of the sanitary district, (ii) each employee in the
17service of a qualified rehabilitation facility, (iii) each
18full-time employee in the service of a qualified domestic
19violence shelter or service, and (iv) each full-time employee
20in the service of a qualified child advocacy center, as
21determined according to rules promulgated by the Director.
22    (l) "Member" means an employee, annuitant, retired
23employee or survivor. In the case of an annuitant or retired
24employee who first becomes an annuitant or retired employee on
25or after the effective date of this amendatory Act of the 97th
26General Assembly, the individual must meet the minimum vesting

 

 

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1requirements of the applicable retirement system in order to be
2eligible for group insurance benefits under that system. In the
3case of a survivor who first becomes a survivor on or after the
4effective date of this amendatory Act of the 97th General
5Assembly, the deceased employee, annuitant, or retired
6employee upon whom the annuity is based must have been eligible
7to participate in the group insurance system under the
8applicable retirement system in order for the survivor to be
9eligible for group insurance benefits under that system.
10    (m) "Optional coverages or benefits" means those coverages
11or benefits available to the member on his or her voluntary
12election, and at his or her own expense.
13    (n) "Program" means the group life insurance, health
14benefits and other employee benefits designed and contracted
15for by the Director under this Act.
16    (o) "Health plan" means a health benefits program offered
17by the State of Illinois for persons eligible for the plan.
18    (p) "Retired employee" means any person who would be an
19annuitant as that term is defined herein but for the fact that
20such person retired prior to January 1, 1966. Such term also
21includes any person formerly employed by the University of
22Illinois in the Cooperative Extension Service who would be an
23annuitant but for the fact that such person was made ineligible
24to participate in the State Universities Retirement System by
25clause (4) of subsection (a) of Section 15-107 of the Illinois
26Pension Code.

 

 

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1    (q) "Survivor" means a person receiving an annuity as a
2survivor of an employee or of an annuitant. "Survivor" also
3includes: (1) the surviving dependent of a person who satisfies
4the definition of "employee" except that such person is made
5ineligible to participate in the State Universities Retirement
6System by clause (4) of subsection (a) of Section 15-107 of the
7Illinois Pension Code; (2) the surviving dependent of any
8person formerly employed by the University of Illinois in the
9Cooperative Extension Service who would be an annuitant except
10for the fact that such person was made ineligible to
11participate in the State Universities Retirement System by
12clause (4) of subsection (a) of Section 15-107 of the Illinois
13Pension Code; and (3) the surviving dependent of a person who
14was an annuitant under this Act by virtue of receiving an
15alternative retirement cancellation payment under Section
1614-108.5 of the Illinois Pension Code.
17    (q-2) "SERS" means the State Employees' Retirement System
18of Illinois, created under Article 14 of the Illinois Pension
19Code.
20    (q-3) "SURS" means the State Universities Retirement
21System, created under Article 15 of the Illinois Pension Code.
22    (q-4) "TRS" means the Teachers' Retirement System of the
23State of Illinois, created under Article 16 of the Illinois
24Pension Code.
25    (q-5) (Blank).
26    (q-6) (Blank).

 

 

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1    (q-7) (Blank).
2    (r) "Medical services" means the services provided within
3the scope of their licenses by practitioners in all categories
4licensed under the Medical Practice Act of 1987.
5    (s) "Unit of local government" means any county,
6municipality, township, school district (including a
7combination of school districts under the Intergovernmental
8Cooperation Act), special district or other unit, designated as
9a unit of local government by law, which exercises limited
10governmental powers or powers in respect to limited
11governmental subjects, any not-for-profit association with a
12membership that primarily includes townships and township
13officials, that has duties that include provision of research
14service, dissemination of information, and other acts for the
15purpose of improving township government, and that is funded
16wholly or partly in accordance with Section 85-15 of the
17Township Code; any not-for-profit corporation or association,
18with a membership consisting primarily of municipalities, that
19operates its own utility system, and provides research,
20training, dissemination of information, or other acts to
21promote cooperation between and among municipalities that
22provide utility services and for the advancement of the goals
23and purposes of its membership; the Southern Illinois
24Collegiate Common Market, which is a consortium of higher
25education institutions in Southern Illinois; the Illinois
26Association of Park Districts; and any hospital provider that

 

 

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1is owned by a county that has 100 or fewer hospital beds and
2has not already joined the program. "Qualified local
3government" means a unit of local government approved by the
4Director and participating in a program created under
5subsection (i) of Section 10 of this Act.
6    (t) "Qualified rehabilitation facility" means any
7not-for-profit organization that is accredited by the
8Commission on Accreditation of Rehabilitation Facilities or
9certified by the Department of Human Services (as successor to
10the Department of Mental Health and Developmental
11Disabilities) to provide services to persons with disabilities
12and which receives funds from the State of Illinois for
13providing those services, approved by the Director and
14participating in a program created under subsection (j) of
15Section 10 of this Act.
16    (u) "Qualified domestic violence shelter or service" means
17any Illinois domestic violence shelter or service and its
18administrative offices funded by the Department of Human
19Services (as successor to the Illinois Department of Public
20Aid), approved by the Director and participating in a program
21created under subsection (k) of Section 10.
22    (v) "TRS benefit recipient" means a person who:
23        (1) is not a "member" as defined in this Section; and
24        (2) is receiving a monthly benefit or retirement
25    annuity under Article 16 of the Illinois Pension Code; and
26        (3) either (i) has at least 8 years of creditable

 

 

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

 

 

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1dependent of a survivor of a TRS benefit recipient on or after
2the effective date of this amendatory Act of the 97th General
3Assembly unless that dependent would have been eligible for
4coverage as a dependent of the deceased TRS benefit recipient
5upon whom the survivor benefit is based.
6    (x) "Military leave" refers to individuals in basic
7training for reserves, special/advanced training, annual
8training, emergency call up, activation by the President of the
9United States, or any other training or duty in service to the
10United States Armed Forces.
11    (y) (Blank).
12    (z) "Community college benefit recipient" means a person
13who:
14        (1) is not a "member" as defined in this Section; and
15        (2) is receiving a monthly survivor's annuity or
16    retirement annuity under Article 15 of the Illinois Pension
17    Code; and
18        (3) either (i) was a full-time employee of a community
19    college district or an association of community college
20    boards created under the Public Community College Act
21    (other than an employee whose last employer under Article
22    15 of the Illinois Pension Code was a community college
23    district subject to Article VII of the Public Community
24    College Act) and was eligible to participate in a group
25    health benefit plan as an employee during the time of
26    employment with a community college district (other than a

 

 

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

 

 

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1child advocacy center and its administrative offices funded by
2the Department of Children and Family Services, as defined by
3the Children's Advocacy Center Act (55 ILCS 80/), approved by
4the Director and participating in a program created under
5subsection (n) of Section 10.
6(Source: P.A. 96-756, eff. 1-1-10; 96-1519, eff. 2-4-11;
797-668, eff. 1-13-12; 97-695, eff. 7-1-12.)
 
8    (5 ILCS 375/6.5)
9    Sec. 6.5. Health benefits for TRS benefit recipients and
10TRS dependent beneficiaries.
11    (a) Purpose. It is the purpose of this amendatory Act of
121995 to transfer the administration of the program of health
13benefits established for benefit recipients and their
14dependent beneficiaries under Article 16 of the Illinois
15Pension Code to the Department of Central Management Services.
16    (b) Transition provisions. The Board of Trustees of the
17Teachers' Retirement System shall continue to administer the
18health benefit program established under Article 16 of the
19Illinois Pension Code through December 31, 1995. Beginning
20January 1, 1996, the Department of Central Management Services
21shall be responsible for administering a program of health
22benefits for TRS benefit recipients and TRS dependent
23beneficiaries under this Section. The Department of Central
24Management Services and the Teachers' Retirement System shall
25cooperate in this endeavor and shall coordinate their

 

 

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1activities so as to ensure a smooth transition and
2uninterrupted health benefit coverage.
3    (c) Eligibility. All persons who were enrolled in the
4Article 16 program at the time of the transfer shall be
5eligible to participate in the program established under this
6Section without any interruption or delay in coverage or
7limitation as to pre-existing medical conditions. Eligibility
8to participate shall be determined by the Teachers' Retirement
9System. Eligibility information shall be communicated to the
10Department of Central Management Services in a format
11acceptable to the Department.
12    A TRS dependent beneficiary who is a child age 19 or over
13and mentally or physically disabled does not become ineligible
14to participate by reason of (i) becoming ineligible to be
15claimed as a dependent for Illinois or federal income tax
16purposes or (ii) receiving earned income, so long as those
17earnings are insufficient for the child to be fully
18self-sufficient.
19    (d) Coverage. The level of health benefits provided under
20this Section shall be similar to the level of benefits provided
21by the program previously established under Article 16 of the
22Illinois Pension Code.
23    Group life insurance benefits are not included in the
24benefits to be provided to TRS benefit recipients and TRS
25dependent beneficiaries under this Act.
26    The program of health benefits under this Section may

 

 

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1include any or all of the benefit limitations, including but
2not limited to a reduction in benefits based on eligibility for
3federal medicare benefits, that are provided under subsection
4(a) of Section 6 of this Act for other health benefit programs
5under this Act.
6    (e) Insurance rates and premiums. The Director shall
7determine the insurance rates and premiums for TRS benefit
8recipients and TRS dependent beneficiaries, and shall present
9to the Teachers' Retirement System of the State of Illinois, by
10April 15 of each calendar year, the rate-setting methodology
11(including but not limited to utilization levels and costs)
12used to determine the amount of the health care premiums.
13        For Fiscal Year 1996, the premium shall be equal to the
14    premium actually charged in Fiscal Year 1995; in subsequent
15    years, the premium shall never be lower than the premium
16    charged in Fiscal Year 1995.
17        For Fiscal Year 2003, the premium shall not exceed 110%
18    of the premium actually charged in Fiscal Year 2002.
19        For Fiscal Year 2004, the premium shall not exceed 112%
20    of the premium actually charged in Fiscal Year 2003.
21        For Fiscal Year 2005, the premium shall not exceed a
22    weighted average of 106.6% of the premium actually charged
23    in Fiscal Year 2004.
24        For Fiscal Year 2006, the premium shall not exceed a
25    weighted average of 109.1% of the premium actually charged
26    in Fiscal Year 2005.

 

 

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1        For Fiscal Year 2007, the premium shall not exceed a
2    weighted average of 103.9% of the premium actually charged
3    in Fiscal Year 2006.
4        For Fiscal Year 2008 and thereafter, the premium in
5    each fiscal year shall not exceed 105% of the premium
6    actually charged in the previous fiscal year.
7    Rates and premiums may be based in part on age and
8eligibility for federal medicare coverage. However, the cost of
9participation for a TRS dependent beneficiary who is an
10unmarried child age 19 or over and mentally or physically
11disabled shall not exceed the cost for a TRS dependent
12beneficiary who is an unmarried child under age 19 and
13participates in the same major medical or managed care program.
14    The cost of health benefits under the program shall be paid
15as follows:
16        (1) For a TRS benefit recipient selecting a managed
17    care program, up to 75% of the total insurance rate shall
18    be paid from the Teacher Health Insurance Security Fund.
19    Effective with Fiscal Year 2007 and thereafter, for a TRS
20    benefit recipient selecting a managed care program, 75% of
21    the total insurance rate shall be paid from the Teacher
22    Health Insurance Security Fund.
23        (2) For a TRS benefit recipient selecting the major
24    medical coverage program, up to 50% of the total insurance
25    rate shall be paid from the Teacher Health Insurance
26    Security Fund if a managed care program is accessible, as

 

 

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1    determined by the Teachers' Retirement System. Effective
2    with Fiscal Year 2007 and thereafter, for a TRS benefit
3    recipient selecting the major medical coverage program,
4    50% of the total insurance rate shall be paid from the
5    Teacher Health Insurance Security Fund if a managed care
6    program is accessible, as determined by the Department of
7    Central Management Services.
8        (3) For a TRS benefit recipient selecting the major
9    medical coverage program, up to 75% of the total insurance
10    rate shall be paid from the Teacher Health Insurance
11    Security Fund if a managed care program is not accessible,
12    as determined by the Teachers' Retirement System.
13    Effective with Fiscal Year 2007 and thereafter, for a TRS
14    benefit recipient selecting the major medical coverage
15    program, 75% of the total insurance rate shall be paid from
16    the Teacher Health Insurance Security Fund if a managed
17    care program is not accessible, as determined by the
18    Department of Central Management Services.
19        (3.1) For a TRS dependent beneficiary who is Medicare
20    primary and enrolled in a managed care plan, or the major
21    medical coverage program if a managed care plan is not
22    available, 25% of the total insurance rate shall be paid
23    from the Teacher Health Security Fund as determined by the
24    Department of Central Management Services. For the purpose
25    of this item (3.1), the term "TRS dependent beneficiary who
26    is Medicare primary" means a TRS dependent beneficiary who

 

 

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1    is participating in Medicare Parts A and B.
2        (4) Except as otherwise provided in item (3.1), the
3    balance of the rate of insurance, including the entire
4    premium of any coverage for TRS dependent beneficiaries
5    that has been elected, shall be paid by deductions
6    authorized by the TRS benefit recipient to be withheld from
7    his or her monthly annuity or benefit payment from the
8    Teachers' Retirement System; except that (i) if the balance
9    of the cost of coverage exceeds the amount of the monthly
10    annuity or benefit payment, the difference shall be paid
11    directly to the Teachers' Retirement System by the TRS
12    benefit recipient, and (ii) all or part of the balance of
13    the cost of coverage may, at the school board's option, be
14    paid to the Teachers' Retirement System by the school board
15    of the school district from which the TRS benefit recipient
16    retired, in accordance with Section 10-22.3b of the School
17    Code. The Teachers' Retirement System shall promptly
18    deposit all moneys withheld by or paid to it under this
19    subdivision (e)(4) into the Teacher Health Insurance
20    Security Fund. These moneys shall not be considered assets
21    of the Retirement System.
22    (f) Financing. Beginning July 1, 1995, all revenues arising
23from the administration of the health benefit programs
24established under Article 16 of the Illinois Pension Code or
25this Section shall be deposited into the Teacher Health
26Insurance Security Fund, which is hereby created as a

 

 

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1nonappropriated trust fund to be held outside the State
2Treasury, with the State Treasurer as custodian. Any interest
3earned on moneys in the Teacher Health Insurance Security Fund
4shall be deposited into the Fund.
5    Moneys in the Teacher Health Insurance Security Fund shall
6be used only to pay the costs of the health benefit program
7established under this Section, including associated
8administrative costs, and the costs associated with the health
9benefit program established under Article 16 of the Illinois
10Pension Code, as authorized in this Section. Beginning July 1,
111995, the Department of Central Management Services may make
12expenditures from the Teacher Health Insurance Security Fund
13for those costs.
14    After other funds authorized for the payment of the costs
15of the health benefit program established under Article 16 of
16the Illinois Pension Code are exhausted and until January 1,
171996 (or such later date as may be agreed upon by the Director
18of Central Management Services and the Secretary of the
19Teachers' Retirement System), the Secretary of the Teachers'
20Retirement System may make expenditures from the Teacher Health
21Insurance Security Fund as necessary to pay up to 75% of the
22cost of providing health coverage to eligible benefit
23recipients (as defined in Sections 16-153.1 and 16-153.3 of the
24Illinois Pension Code) who are enrolled in the Article 16
25health benefit program and to facilitate the transfer of
26administration of the health benefit program to the Department

 

 

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1of Central Management Services.
2    The Department of Central Management Healthcare and Family
3Services, or any successor agency designated to procure
4healthcare contracts pursuant to this Act, is authorized to
5establish funds, separate accounts provided by any bank or
6banks as defined by the Illinois Banking Act, or separate
7accounts provided by any savings and loan association or
8associations as defined by the Illinois Savings and Loan Act of
91985 to be held by the Director, outside the State treasury,
10for the purpose of receiving the transfer of moneys from the
11Teacher Health Insurance Security Fund. The Department may
12promulgate rules further defining the methodology for the
13transfers. Any interest earned by moneys in the funds or
14accounts shall inure to the Teacher Health Insurance Security
15Fund. The transferred moneys, and interest accrued thereon,
16shall be used exclusively for transfers to administrative
17service organizations or their financial institutions for
18payments of claims to claimants and providers under the
19self-insurance health plan. The transferred moneys, and
20interest accrued thereon, shall not be used for any other
21purpose including, but not limited to, reimbursement of
22administration fees due the administrative service
23organization pursuant to its contract or contracts with the
24Department.
25    (g) Contract for benefits. The Director shall by contract,
26self-insurance, or otherwise make available the program of

 

 

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1health benefits for TRS benefit recipients and their TRS
2dependent beneficiaries that is provided for in this Section.
3The contract or other arrangement for the provision of these
4health benefits shall be on terms deemed by the Director to be
5in the best interest of the State of Illinois and the TRS
6benefit recipients based on, but not limited to, such criteria
7as administrative cost, service capabilities of the carrier or
8other contractor, and the costs of the benefits.
9    (g-5) Committee. A Teacher Retirement Insurance Program
10Committee shall be established, to consist of 10 persons
11appointed by the Governor.
12    The Committee shall convene at least 4 times each year, and
13shall consider and make recommendations on issues affecting the
14program of health benefits provided under this Section.
15Recommendations of the Committee shall be based on a consensus
16of the members of the Committee.
17    If the Teacher Health Insurance Security Fund experiences a
18deficit balance based upon the contribution and subsidy rates
19established in this Section and Section 6.6 for Fiscal Year
202008 or thereafter, the Committee shall make recommendations
21for adjustments to the funding sources established under these
22Sections.
23    In addition, the Committee shall identify proposed
24solutions to the funding shortfalls that are affecting the
25Teacher Health Insurance Security Fund, and it shall report
26those solutions to the Governor and the General Assembly within

 

 

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16 months after August 15, 2011 (the effective date of Public
2Act 97-386).
3    (h) Continuation of program. It is the intention of the
4General Assembly that the program of health benefits provided
5under this Section be maintained on an ongoing, affordable
6basis.
7    The program of health benefits provided under this Section
8may be amended by the State and is not intended to be a pension
9or retirement benefit subject to protection under Article XIII,
10Section 5 of the Illinois Constitution.
11    (i) Repeal. (Blank).
12(Source: P.A. 96-1519, eff. 2-4-11; 97-386, eff. 8-15-11;
1397-813, eff. 7-13-12.)
 
14    (5 ILCS 375/6.10)
15    Sec. 6.10. Contributions to the Community College Health
16Insurance Security Fund.
17    (a) Beginning January 1, 1999, every active contributor of
18the State Universities Retirement System (established under
19Article 15 of the Illinois Pension Code) who (1) is a full-time
20employee of a community college district (other than a
21community college district subject to Article VII of the Public
22Community College Act) or an association of community college
23boards and (2) is not an employee as defined in Section 3 of
24this Act shall make contributions toward the cost of community
25college annuitant and survivor health benefits at the rate of

 

 

SB1256 Enrolled- 36 -LRB098 06209 KTG 36250 b

10.50% of salary.
2    These contributions shall be deducted by the employer and
3paid to the State Universities Retirement System as service
4agent for the Department of Central Management Services. The
5System may use the same processes for collecting the
6contributions required by this subsection that it uses to
7collect the contributions received from those employees under
8Section 15-157 of the Illinois Pension Code. An employer may
9agree to pick up or pay the contributions required under this
10subsection on behalf of the employee; such contributions shall
11be deemed to have been paid by the employee.
12    The State Universities Retirement System shall promptly
13deposit all moneys collected under this subsection (a) into the
14Community College Health Insurance Security Fund created in
15Section 6.9 of this Act. The moneys collected under this
16Section shall be used only for the purposes authorized in
17Section 6.9 of this Act and shall not be considered to be
18assets of the State Universities Retirement System.
19Contributions made under this Section are not transferable to
20other pension funds or retirement systems and are not
21refundable upon termination of service.
22    (b) Beginning January 1, 1999, every community college
23district (other than a community college district subject to
24Article VII of the Public Community College Act) or association
25of community college boards that is an employer under the State
26Universities Retirement System shall contribute toward the

 

 

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1cost of the community college health benefits provided under
2Section 6.9 of this Act an amount equal to 0.50% of the salary
3paid to its full-time employees who participate in the State
4Universities Retirement System and are not members as defined
5in Section 3 of this Act.
6    These contributions shall be paid by the employer to the
7State Universities Retirement System as service agent for the
8Department of Central Management Services. The System may use
9the same processes for collecting the contributions required by
10this subsection that it uses to collect the contributions
11received from those employers under Section 15-155 of the
12Illinois Pension Code.
13    The State Universities Retirement System shall promptly
14deposit all moneys collected under this subsection (b) into the
15Community College Health Insurance Security Fund created in
16Section 6.9 of this Act. The moneys collected under this
17Section shall be used only for the purposes authorized in
18Section 6.9 of this Act and shall not be considered to be
19assets of the State Universities Retirement System.
20Contributions made under this Section are not transferable to
21other pension funds or retirement systems and are not
22refundable upon termination of service.
23    The Department of Central Management Healthcare and Family
24Services, or any successor agency designated to procure
25healthcare contracts pursuant to this Act, is authorized to
26establish funds, separate accounts provided by any bank or

 

 

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1banks as defined by the Illinois Banking Act, or separate
2accounts provided by any savings and loan association or
3associations as defined by the Illinois Savings and Loan Act of
41985 to be held by the Director, outside the State treasury,
5for the purpose of receiving the transfer of moneys from the
6Community College Health Insurance Security Fund. The
7Department may promulgate rules further defining the
8methodology for the transfers. Any interest earned by moneys in
9the funds or accounts shall inure to the Community College
10Health Insurance Security Fund. The transferred moneys, and
11interest accrued thereon, shall be used exclusively for
12transfers to administrative service organizations or their
13financial institutions for payments of claims to claimants and
14providers under the self-insurance health plan. The
15transferred moneys, and interest accrued thereon, shall not be
16used for any other purpose including, but not limited to,
17reimbursement of administration fees due the administrative
18service organization pursuant to its contract or contracts with
19the Department.
20    (c) On or before November 15 of each year, the Board of
21Trustees of the State Universities Retirement System shall
22certify to the Governor, the Director of Central Management
23Services, and the State Comptroller its estimate of the total
24amount of contributions to be paid under subsection (a) of this
25Section for the next fiscal year. Beginning in fiscal year
262008, the amount certified shall be decreased or increased each

 

 

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1year by the amount that the actual active employee
2contributions either fell short of or exceeded the estimate
3used by the Board in making the certification for the previous
4fiscal year. The State Universities Retirement System shall
5calculate the amount of actual active employee contributions in
6fiscal years 1999 through 2005. Based upon this calculation,
7the fiscal year 2008 certification shall include an amount
8equal to the cumulative amount that the actual active employee
9contributions either fell short of or exceeded the estimate
10used by the Board in making the certification for those fiscal
11years. The certification shall include a detailed explanation
12of the methods and information that the Board relied upon in
13preparing its estimate. As soon as possible after the effective
14date of this Section, the Board shall submit its estimate for
15fiscal year 1999.
16    (d) Beginning in fiscal year 1999, on the first day of each
17month, or as soon thereafter as may be practical, the State
18Treasurer and the State Comptroller shall transfer from the
19General Revenue Fund to the Community College Health Insurance
20Security Fund 1/12 of the annual amount appropriated for that
21fiscal year to the State Comptroller for deposit into the
22Community College Health Insurance Security Fund under Section
231.4 of the State Pension Funds Continuing Appropriation Act.
24    (e) Except where otherwise specified in this Section, the
25definitions that apply to Article 15 of the Illinois Pension
26Code apply to this Section.

 

 

SB1256 Enrolled- 40 -LRB098 06209 KTG 36250 b

1(Source: P.A. 94-839, eff. 6-6-06; 95-632, eff. 9-25-07.)
 
2    (5 ILCS 375/10)  (from Ch. 127, par. 530)
3    Sec. 10. Contributions by the State and members.
4    (a) The State shall pay the cost of basic non-contributory
5group life insurance and, subject to member paid contributions
6set by the Department or required by this Section and except as
7provided in this Section, the basic program of group health
8benefits on each eligible member, except a member, not
9otherwise covered by this Act, who has retired as a
10participating member under Article 2 of the Illinois Pension
11Code but is ineligible for the retirement annuity under Section
122-119 of the Illinois Pension Code, and part of each eligible
13member's and retired member's premiums for health insurance
14coverage for enrolled dependents as provided by Section 9. The
15State shall pay the cost of the basic program of group health
16benefits only after benefits are reduced by the amount of
17benefits covered by Medicare for all members and dependents who
18are eligible for benefits under Social Security or the Railroad
19Retirement system or who had sufficient Medicare-covered
20government employment, except that such reduction in benefits
21shall apply only to those members and dependents who (1) first
22become eligible for such Medicare coverage on or after July 1,
231992; or (2) are Medicare-eligible members or dependents of a
24local government unit which began participation in the program
25on or after July 1, 1992; or (3) remain eligible for, but no

 

 

SB1256 Enrolled- 41 -LRB098 06209 KTG 36250 b

1longer receive Medicare coverage which they had been receiving
2on or after July 1, 1992. The Department may determine the
3aggregate level of the State's contribution on the basis of
4actual cost of medical services adjusted for age, sex or
5geographic or other demographic characteristics which affect
6the costs of such programs.
7    The cost of participation in the basic program of group
8health benefits for the dependent or survivor of a living or
9deceased retired employee who was formerly employed by the
10University of Illinois in the Cooperative Extension Service and
11would be an annuitant but for the fact that he or she was made
12ineligible to participate in the State Universities Retirement
13System by clause (4) of subsection (a) of Section 15-107 of the
14Illinois Pension Code shall not be greater than the cost of
15participation that would otherwise apply to that dependent or
16survivor if he or she were the dependent or survivor of an
17annuitant under the State Universities Retirement System.
18    (a-1) (Blank).
19    (a-2) (Blank).
20    (a-3) (Blank).
21    (a-4) (Blank).
22    (a-5) (Blank).
23    (a-6) (Blank).
24    (a-7) (Blank).
25    (a-8) Any annuitant, survivor, or retired employee may
26waive or terminate coverage in the program of group health

 

 

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

 

 

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

 

 

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1    The Department of Central Management Healthcare and Family
2Services, or any successor agency designated to procure
3healthcare contracts pursuant to this Act, is authorized to
4establish funds, separate accounts provided by any bank or
5banks as defined by the Illinois Banking Act, or separate
6accounts provided by any savings and loan association or
7associations as defined by the Illinois Savings and Loan Act of
81985 to be held by the Director, outside the State treasury,
9for the purpose of receiving the transfer of moneys from the
10Local Government Health Insurance Reserve Fund. The Department
11may promulgate rules further defining the methodology for the
12transfers. Any interest earned by moneys in the funds or
13accounts shall inure to the Local Government Health Insurance
14Reserve Fund. The transferred moneys, and interest accrued
15thereon, shall be used exclusively for transfers to
16administrative service organizations or their financial
17institutions for payments of claims to claimants and providers
18under the self-insurance health plan. The transferred moneys,
19and interest accrued thereon, shall not be used for any other
20purpose including, but not limited to, reimbursement of
21administration fees due the administrative service
22organization pursuant to its contract or contracts with the
23Department.
24    (b) State employees who become eligible for this program on
25or after January 1, 1980 in positions normally requiring actual
26performance of duty not less than 1/2 of a normal work period

 

 

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1but not equal to that of a normal work period, shall be given
2the option of participating in the available program. If the
3employee elects coverage, the State shall contribute on behalf
4of such employee to the cost of the employee's benefit and any
5applicable dependent supplement, that sum which bears the same
6percentage as that percentage of time the employee regularly
7works when compared to normal work period.
8    (c) The basic non-contributory coverage from the basic
9program of group health benefits shall be continued for each
10employee not in pay status or on active service by reason of
11(1) leave of absence due to illness or injury, (2) authorized
12educational leave of absence or sabbatical leave, or (3)
13military leave. This coverage shall continue until expiration
14of authorized leave and return to active service, but not to
15exceed 24 months for leaves under item (1) or (2). This
1624-month limitation and the requirement of returning to active
17service shall not apply to persons receiving ordinary or
18accidental disability benefits or retirement benefits through
19the appropriate State retirement system or benefits under the
20Workers' Compensation or Occupational Disease Act.
21    (d) The basic group life insurance coverage shall continue,
22with full State contribution, where such person is (1) absent
23from active service by reason of disability arising from any
24cause other than self-inflicted, (2) on authorized educational
25leave of absence or sabbatical leave, or (3) on military leave.
26    (e) Where the person is in non-pay status for a period in

 

 

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

 

 

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

 

 

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

 

 

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

 

 

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

 

 

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1be used for payments for health care benefits for local
2government and rehabilitation facility employees, annuitants,
3and dependents, and to reimburse the Department or its
4administrative service organization for all expenses incurred
5in the administration of benefits. No other State funds may be
6used for these purposes.
7    A local government employer's participation or desire to
8participate in a program created under this subsection shall
9not limit that employer's duty to bargain with the
10representative of any collective bargaining unit of its
11employees.
12    (j) Any rehabilitation facility within the State of
13Illinois may apply to the Director to have its employees,
14annuitants, and their eligible dependents provided group
15health coverage under this Act on a non-insured basis. To
16participate, a rehabilitation facility must agree to enroll all
17of its employees and remit the entire cost of providing such
18coverage for its employees, except that the rehabilitation
19facility shall not be required to enroll those of its employees
20who are covered spouses or dependents under this plan or
21another group policy or plan providing health benefits as long
22as (1) an appropriate official from the rehabilitation facility
23attests that each employee not enrolled is a covered spouse or
24dependent under this plan or another group policy or plan, and
25(2) at least 50% of the employees are enrolled and the
26rehabilitation facility remits the entire cost of providing

 

 

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

 

 

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

 

 

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

 

 

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

 

 

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

 

 

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1        (1) In the first year of coverage, the rates shall be
2    equal to the amount normally charged to State employees for
3    elected optional coverages or for enrolled dependents
4    coverages or other contributory coverages on behalf of its
5    employees, adjusted for differences between State
6    employees and employees of the child advocacy center in
7    age, sex, geographic location, or other relevant
8    demographic variables, plus an amount sufficient to pay for
9    the additional administrative costs of providing coverage
10    to employees of the child advocacy center and their
11    dependents.
12        (2) In subsequent years, a further adjustment shall be
13    made to reflect the actual prior years' claims experience
14    of the employees of the child advocacy center.
15    Monthly payments by the child advocacy center or its
16employees for group health insurance shall be deposited into
17the Local Government Health Insurance Reserve Fund.
18(Source: P.A. 96-756, eff. 1-1-10; 96-1232, eff. 7-23-10;
1996-1519, eff. 2-4-11; 97-695, eff. 7-1-12.)
 
20    (5 ILCS 375/13.1)  (from Ch. 127, par. 533.1)
21    Sec. 13.1. (a) All contributions, appropriations,
22interest, and dividend payments to fund the program of health
23benefits and other employee benefits, and all other revenues
24arising from the administration of any employee health benefits
25program, shall be deposited in a trust fund outside the State

 

 

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1Treasury, with the State Treasurer as ex-officio custodian, to
2be known as the Health Insurance Reserve Fund.
3    (b) Upon the adoption of a self-insurance health plan, any
4monies attributable to the group health insurance program shall
5be deposited in or transferred to the Health Insurance Reserve
6Fund for use by the Department. As of the effective date of
7this amendatory Act of 1986, the Department shall certify to
8the Comptroller the amount of money in the Group Insurance
9Premium Fund attributable to the State group health insurance
10program and the Comptroller shall transfer such money from the
11Group Insurance Premium Fund to the Health Insurance Reserve
12Fund. Contributions by the State to the Health Insurance
13Reserve Fund to meet the requirements of this Act, as
14established by the Director, from the General Revenue Fund and
15the Road Fund to the Health Insurance Reserve Fund shall be by
16annual appropriations, and all other contributions to meet the
17requirements of the programs of health benefits or other
18employee benefits shall be deposited in the Health Insurance
19Reserve Fund. The Department shall draw the appropriation from
20the General Revenue Fund and the Road Fund from time to time as
21necessary to make expenditures authorized under this Act.
22    The Director may employ such assistance and services and
23may purchase such goods as may be necessary for the proper
24development and administration of any of the benefit programs
25authorized by this Act. The Director may promulgate rules and
26regulations in regard to the administration of these programs.

 

 

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1    All monies received by the Department for deposit in or
2transfer to the Health Insurance Reserve Fund, through
3appropriation or otherwise, shall be used to provide for the
4making of payments to claimants and providers and to reimburse
5the Department for all expenses directly incurred relating to
6Department development and administration of the program of
7health benefits and other employee benefits.
8    Any administrative service organization administering any
9self-insurance health plan and paying claims and benefits under
10authority of this Act may receive, pursuant to written
11authorization and direction of the Director, an initial
12transfer and periodic transfers of funds from the Health
13Insurance Reserve Fund in amounts determined by the Director
14who may consider the amount recommended by the administrative
15service organization. Notwithstanding any other statute, such
16transferred funds shall be retained by the administrative
17service organization in a separate account provided by any bank
18as defined by the Illinois Banking Act. The Department may
19promulgate regulations further defining the banks authorized
20to accept such funds and all methodology for transfer of such
21funds. Any interest earned by monies in such account shall
22inure to the Health Insurance Reserve Fund, shall remain in
23such account and shall be used exclusively to pay claims and
24benefits under this Act. Such transferred funds shall be used
25exclusively for administrative service organization payment of
26claims to claimants and providers under the self-insurance

 

 

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1health plan by the drawing of checks against such account. The
2administrative service organization may not use such
3transferred funds, or interest accrued thereon, for any other
4purpose including, but not limited to, reimbursement of
5administrative expenses or payments of administration fees due
6the organization pursuant to its contract or contracts with the
7Department of Central Management Services.
8    The account of the administrative service organization
9established under this Section, any transfers from the Health
10Insurance Reserve Fund to such account and the use of such
11account and funds shall be subject to (1) audit by the
12Department or private contractor authorized by the Department
13to conduct audits, and (2) post audit pursuant to the Illinois
14State Auditing Act.
15    The Department of Central Management Healthcare and Family
16Services, or any successor agency designated to procure
17healthcare contracts pursuant to this Act, is authorized to
18establish funds, separate accounts provided by any bank or
19banks as defined by the Illinois Banking Act, or separate
20accounts provided by any savings and loan association or
21associations as defined by the Illinois Savings and Loan Act of
221985 to be held by the Director, outside the State treasury,
23for the purpose of receiving the transfer of moneys from the
24Health Insurance Reserve Fund. The Department may promulgate
25rules further defining the methodology for the transfers. Any
26interest earned by monies in the funds or accounts shall inure

 

 

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1to the Health Insurance Reserve Fund. The transferred moneys,
2and interest accrued thereon, shall be used exclusively for
3transfers to administrative service organizations or their
4financial institutions for payments of claims to claimants and
5providers under the self-insurance health plan. The
6transferred moneys, and interest accrued thereon, shall not be
7used for any other purpose including, but not limited to,
8reimbursement of administration fees due the administrative
9service organization pursuant to its contract or contracts with
10the Department.
11    (c) The Director, with the advice and consent of the
12Commission, shall establish premiums for optional coverage for
13dependents of eligible members for the health plans. The
14eligible members shall be responsible for their portion of such
15optional premium. The State shall contribute an amount per
16month for each eligible member who has enrolled one or more
17dependents under the health plans. Such contribution shall be
18made directly to the Health Insurance Reserve Fund. Those
19employees described in subsection (b) of Section 9 of this Act
20shall be allowed to continue in the health plan by making
21personal payments with the premiums to be deposited in the
22Health Insurance Reserve Fund.
23    (d) The Health Insurance Reserve Fund shall be a continuing
24fund not subject to fiscal year limitations. All expenditures
25from that fund shall be at the direction of the Director and
26shall be only for the purpose of:

 

 

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1        (1) the payment of administrative expenses incurred by
2    the Department for the program of health benefits or other
3    employee benefit programs, including but not limited to the
4    costs of audits or actuarial consultations, professional
5    and contractual services, electronic data processing
6    systems and services, and expenses in connection with the
7    development and administration of such programs;
8        (2) the payment of administrative expenses incurred by
9    the Administrative Service Organization;
10        (3) the payment of health benefits;
11        (3.5) the payment of medical expenses incurred by the
12    Department for the treatment of employees who suffer
13    accidental injury or death within the scope of their
14    employment;
15        (4) refunds to employees for erroneous payments of
16    their selected dependent coverage;
17        (5) payment of premium for stop-loss or re-insurance;
18        (6) payment of premium to health maintenance
19    organizations pursuant to Section 6.1 of this Act;
20        (7) payment of adoption program benefits; and
21        (8) payment of other benefits offered to members and
22    dependents under this Act.
23(Source: P.A. 94-839, eff. 6-6-06; 95-632, eff. 9-25-07;
2495-744, eff. 7-18-08.)
 
25    Section 905. The Department of Central Management Services

 

 

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1Law of the Civil Administrative Code of Illinois is amended by
2adding Section 405-520 as follows:
 
3    (20 ILCS 405/405-520 new)
4    Sec. 405-520. State healthcare purchasing. On and after the
5date 6 months after the effective date of this amendatory Act
6of the 98th General Assembly, as provided in the Executive
7Order 1 (2012) Implementation Act, all of the powers, duties,
8rights, and responsibilities related to State healthcare
9purchasing under this Law that were transferred from the
10Department to the Department of Healthcare and Family Services
11by Executive Order 3 (2005) are transferred back to the
12Department.
 
13    Section 910. The Department of Human Services Act is
14amended by changing Section 1-20 as follows:
 
15    (20 ILCS 1305/1-20)
16    Sec. 1-20. General powers and duties.
17    (a) The Department shall exercise the rights, powers,
18duties, and functions provided by law, including (but not
19limited to) the rights, powers, duties, and functions
20transferred to the Department under Article 80 and Article 90
21of this Act.
22    (b) The Department may employ personnel (in accordance with
23the Personnel Code), provide facilities, contract for goods and

 

 

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1services, and adopt rules as necessary to carry out its
2functions and purposes, all in accordance with applicable State
3and federal law.
4    (c) On and after the date 6 months after the effective date
5of this amendatory Act of the 98th General Assembly, as
6provided in the Executive Order 1 (2012) Implementation Act,
7all of the powers, duties, rights, and responsibilities related
8to State healthcare purchasing under this Act that were
9transferred from the Department to the Department of Healthcare
10and Family Services by Executive Order 3 (2005) are transferred
11back to the Department.
12(Source: P.A. 89-507, eff. 7-3-96.)
 
13    Section 915. The Department of Healthcare and Family
14Services Law of the Civil Administrative Code of Illinois is
15amended by adding Section 2205-20 as follows:
 
16    (20 ILCS 2205/2205-20 new)
17    Sec. 2205-20. State healthcare purchasing. On and after the
18date 6 months after the effective date of this amendatory Act
19of the 98th General Assembly, as provided in the Executive
20Order 1 (2012) Implementation Act, all of the powers, duties,
21rights, and responsibilities related to State healthcare
22purchasing under this Law that were transferred to the
23Department of Healthcare and Family Services by Executive Order
243 (2005) are transferred back to the Departments from which

 

 

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1those powers, duties, rights, and responsibilities were
2transferred; however, powers, duties, rights, and
3responsibilities related to State healthcare purchasing under
4this Law that were exercised by the Department of Corrections
5before the effective date of Executive Order 3 (2005) but that
6pertain to individuals resident in facilities operated by the
7Department of Juvenile Justice shall be transferred to the
8Department of Juvenile Justice.
 
9    Section 920. The Department of Veterans Affairs Act is
10amended by adding Section 2.08 as follows:
 
11    (20 ILCS 2805/2.08 new)
12    Sec. 2.08. State healthcare purchasing. On and after the
13date 6 months after the effective date of this amendatory Act
14of the 98th General Assembly, as provided in the Executive
15Order 1 (2012) Implementation Act, all of the powers, duties,
16rights, and responsibilities related to State healthcare
17purchasing under this Act that were transferred from the
18Department to the Department of Healthcare and Family Services
19by Executive Order 3 (2005) are transferred back to the
20Department.
 
21    Section 925. The School Employee Benefit Act is amended by
22adding Section 7 as follows:
 

 

 

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1    (105 ILCS 55/7 new)
2    Sec. 7. State healthcare purchasing. On and after the date
36 months after the effective date of this amendatory Act of the
498th General Assembly, as provided in the Executive Order 1
5(2012) Implementation Act, all of the powers, duties, rights,
6and responsibilities related to State healthcare purchasing
7under this Act that were transferred from the Department to the
8Department of Healthcare and Family Services by Executive Order
93 (2005) are transferred back to the Department.
 
10    Section 930. The Illinois Prescription Drug Discount
11Program Act is amended by changing Sections 10 and 15 and by
12adding Section 2 as follows:
 
13    (320 ILCS 55/2 new)
14    Sec. 2. State healthcare purchasing. On and after the date
156 months after the effective date of this amendatory Act of the
1698th General Assembly, as provided in the Executive Order 1
17(2012) Implementation Act, all of the powers, duties, rights,
18and responsibilities related to State healthcare purchasing
19under this Act that were transferred from the Department of
20Central Management Services to the Department of Healthcare and
21Family Services by Executive Order 3 (2005) are transferred
22back to the Department of Central Management Services.
 
23    (320 ILCS 55/10)

 

 

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1    Sec. 10. Purpose. The purpose of this program is to require
2the Department of Central Management Healthcare and Family
3Services to establish and administer a program that will enable
4eligible Illinois residents to purchase prescription drugs at
5discounted prices.
6(Source: P.A. 93-18, eff. 7-1-03; 94-86, eff. 1-1-06.)
 
7    (320 ILCS 55/15)
8    Sec. 15. Definitions. As used in this Act:
9    "Authorized pharmacy" means any pharmacy registered in
10this State under the Pharmacy Practice Act or approved by the
11Department of Financial and Professional Regulation and
12approved by the Department or its program administrator.
13    "AWP" or "average wholesale price" means the amount
14determined from the latest publication of the Red Book, a
15universally subscribed pharmacist reference guide annually
16published by the Hearst Corporation. "AWP" or "average
17wholesale price" may also be derived electronically from the
18drug pricing database synonymous with the latest publication of
19the Red Book and furnished in the National Drug Data File
20(NDDF) by First Data Bank (FDB), a service of the Hearst
21Corporation.
22    "Covered medication" means any medication included in the
23Illinois Prescription Drug Discount Program.
24    "Department" means the Department of Central Management
25Healthcare and Family Services.

 

 

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1    "Director" means the Director of Central Management
2Healthcare and Family Services.
3    "Drug manufacturer" means any entity (1) that is located
4within or outside Illinois that is engaged in (i) the
5production, preparation, propagation, compounding, conversion,
6or processing of prescription drug products covered under the
7program, either directly or indirectly by extraction from
8substances of natural origin, independently by means of
9chemical synthesis, or by a combination of extraction and
10chemical synthesis or (ii) the packaging, repackaging,
11leveling, labeling, or distribution of prescription drug
12products covered under the program and (2) that elects to
13provide prescription drugs either directly or under contract
14with any entity providing prescription drug services on behalf
15of the State of Illinois. "Drug manufacturer", however, does
16not include a wholesale distributor of drugs or a retail
17pharmacy licensed under Illinois law.
18    "Federal Poverty Limit" or "FPL" means the Federal Poverty
19Income Guidelines published annually in the Federal Register.
20    "Prescription drug" means any prescribed drug that may be
21legally dispensed by an authorized pharmacy.
22    "Program" means the Illinois Prescription Drug Discount
23Program created under this Act.
24    "Program administrator" means the entity that is chosen by
25the Department to administer the program. The program
26administrator may, in this case, be the Director or a Pharmacy

 

 

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1Benefits Manager (PBM) chosen to subcontract with the Director.
2    "Rules" includes rules adopted and forms prescribed by the
3Department.
4(Source: P.A. 94-86, eff. 1-1-06; 95-689, eff. 10-29-07.)
 
5    Section 935. The Unified Code of Corrections is amended by
6changing Sections 3-2-2 and 3-2.5-20 as follows:
 
7    (730 ILCS 5/3-2-2)  (from Ch. 38, par. 1003-2-2)
8    Sec. 3-2-2. Powers and Duties of the Department.
9    (1) In addition to the powers, duties and responsibilities
10which are otherwise provided by law, the Department shall have
11the following powers:
12        (a) To accept persons committed to it by the courts of
13    this State for care, custody, treatment and
14    rehabilitation, and to accept federal prisoners and aliens
15    over whom the Office of the Federal Detention Trustee is
16    authorized to exercise the federal detention function for
17    limited purposes and periods of time.
18        (b) To develop and maintain reception and evaluation
19    units for purposes of analyzing the custody and
20    rehabilitation needs of persons committed to it and to
21    assign such persons to institutions and programs under its
22    control or transfer them to other appropriate agencies. In
23    consultation with the Department of Alcoholism and
24    Substance Abuse (now the Department of Human Services), the

 

 

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1    Department of Corrections shall develop a master plan for
2    the screening and evaluation of persons committed to its
3    custody who have alcohol or drug abuse problems, and for
4    making appropriate treatment available to such persons;
5    the Department shall report to the General Assembly on such
6    plan not later than April 1, 1987. The maintenance and
7    implementation of such plan shall be contingent upon the
8    availability of funds.
9        (b-1) To create and implement, on January 1, 2002, a
10    pilot program to establish the effectiveness of
11    pupillometer technology (the measurement of the pupil's
12    reaction to light) as an alternative to a urine test for
13    purposes of screening and evaluating persons committed to
14    its custody who have alcohol or drug problems. The pilot
15    program shall require the pupillometer technology to be
16    used in at least one Department of Corrections facility.
17    The Director may expand the pilot program to include an
18    additional facility or facilities as he or she deems
19    appropriate. A minimum of 4,000 tests shall be included in
20    the pilot program. The Department must report to the
21    General Assembly on the effectiveness of the program by
22    January 1, 2003.
23        (b-5) To develop, in consultation with the Department
24    of State Police, a program for tracking and evaluating each
25    inmate from commitment through release for recording his or
26    her gang affiliations, activities, or ranks.

 

 

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1        (c) To maintain and administer all State correctional
2    institutions and facilities under its control and to
3    establish new ones as needed. Pursuant to its power to
4    establish new institutions and facilities, the Department
5    may, with the written approval of the Governor, authorize
6    the Department of Central Management Services to enter into
7    an agreement of the type described in subsection (d) of
8    Section 405-300 of the Department of Central Management
9    Services Law (20 ILCS 405/405-300). The Department shall
10    designate those institutions which shall constitute the
11    State Penitentiary System.
12        Pursuant to its power to establish new institutions and
13    facilities, the Department may authorize the Department of
14    Central Management Services to accept bids from counties
15    and municipalities for the construction, remodeling or
16    conversion of a structure to be leased to the Department of
17    Corrections for the purposes of its serving as a
18    correctional institution or facility. Such construction,
19    remodeling or conversion may be financed with revenue bonds
20    issued pursuant to the Industrial Building Revenue Bond Act
21    by the municipality or county. The lease specified in a bid
22    shall be for a term of not less than the time needed to
23    retire any revenue bonds used to finance the project, but
24    not to exceed 40 years. The lease may grant to the State
25    the option to purchase the structure outright.
26        Upon receipt of the bids, the Department may certify

 

 

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1    one or more of the bids and shall submit any such bids to
2    the General Assembly for approval. Upon approval of a bid
3    by a constitutional majority of both houses of the General
4    Assembly, pursuant to joint resolution, the Department of
5    Central Management Services may enter into an agreement
6    with the county or municipality pursuant to such bid.
7        (c-5) To build and maintain regional juvenile
8    detention centers and to charge a per diem to the counties
9    as established by the Department to defray the costs of
10    housing each minor in a center. In this subsection (c-5),
11    "juvenile detention center" means a facility to house
12    minors during pendency of trial who have been transferred
13    from proceedings under the Juvenile Court Act of 1987 to
14    prosecutions under the criminal laws of this State in
15    accordance with Section 5-805 of the Juvenile Court Act of
16    1987, whether the transfer was by operation of law or
17    permissive under that Section. The Department shall
18    designate the counties to be served by each regional
19    juvenile detention center.
20        (d) To develop and maintain programs of control,
21    rehabilitation and employment of committed persons within
22    its institutions.
23        (d-5) To provide a pre-release job preparation program
24    for inmates at Illinois adult correctional centers.
25        (e) To establish a system of supervision and guidance
26    of committed persons in the community.

 

 

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1        (f) To establish in cooperation with the Department of
2    Transportation to supply a sufficient number of prisoners
3    for use by the Department of Transportation to clean up the
4    trash and garbage along State, county, township, or
5    municipal highways as designated by the Department of
6    Transportation. The Department of Corrections, at the
7    request of the Department of Transportation, shall furnish
8    such prisoners at least annually for a period to be agreed
9    upon between the Director of Corrections and the Director
10    of Transportation. The prisoners used on this program shall
11    be selected by the Director of Corrections on whatever
12    basis he deems proper in consideration of their term,
13    behavior and earned eligibility to participate in such
14    program - where they will be outside of the prison facility
15    but still in the custody of the Department of Corrections.
16    Prisoners convicted of first degree murder, or a Class X
17    felony, or armed violence, or aggravated kidnapping, or
18    criminal sexual assault, aggravated criminal sexual abuse
19    or a subsequent conviction for criminal sexual abuse, or
20    forcible detention, or arson, or a prisoner adjudged a
21    Habitual Criminal shall not be eligible for selection to
22    participate in such program. The prisoners shall remain as
23    prisoners in the custody of the Department of Corrections
24    and such Department shall furnish whatever security is
25    necessary. The Department of Transportation shall furnish
26    trucks and equipment for the highway cleanup program and

 

 

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1    personnel to supervise and direct the program. Neither the
2    Department of Corrections nor the Department of
3    Transportation shall replace any regular employee with a
4    prisoner.
5        (g) To maintain records of persons committed to it and
6    to establish programs of research, statistics and
7    planning.
8        (h) To investigate the grievances of any person
9    committed to the Department, to inquire into any alleged
10    misconduct by employees or committed persons, and to
11    investigate the assets of committed persons to implement
12    Section 3-7-6 of this Code; and for these purposes it may
13    issue subpoenas and compel the attendance of witnesses and
14    the production of writings and papers, and may examine
15    under oath any witnesses who may appear before it; to also
16    investigate alleged violations of a parolee's or
17    releasee's conditions of parole or release; and for this
18    purpose it may issue subpoenas and compel the attendance of
19    witnesses and the production of documents only if there is
20    reason to believe that such procedures would provide
21    evidence that such violations have occurred.
22        If any person fails to obey a subpoena issued under
23    this subsection, the Director may apply to any circuit
24    court to secure compliance with the subpoena. The failure
25    to comply with the order of the court issued in response
26    thereto shall be punishable as contempt of court.

 

 

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1        (i) To appoint and remove the chief administrative
2    officers, and administer programs of training and
3    development of personnel of the Department. Personnel
4    assigned by the Department to be responsible for the
5    custody and control of committed persons or to investigate
6    the alleged misconduct of committed persons or employees or
7    alleged violations of a parolee's or releasee's conditions
8    of parole shall be conservators of the peace for those
9    purposes, and shall have the full power of peace officers
10    outside of the facilities of the Department in the
11    protection, arrest, retaking and reconfining of committed
12    persons or where the exercise of such power is necessary to
13    the investigation of such misconduct or violations.
14        (j) To cooperate with other departments and agencies
15    and with local communities for the development of standards
16    and programs for better correctional services in this
17    State.
18        (k) To administer all moneys and properties of the
19    Department.
20        (l) To report annually to the Governor on the committed
21    persons, institutions and programs of the Department.
22        (l-5) (Blank).
23        (m) To make all rules and regulations and exercise all
24    powers and duties vested by law in the Department.
25        (n) To establish rules and regulations for
26    administering a system of sentence credits, established in

 

 

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1    accordance with Section 3-6-3, subject to review by the
2    Prisoner Review Board.
3        (o) To administer the distribution of funds from the
4    State Treasury to reimburse counties where State penal
5    institutions are located for the payment of assistant
6    state's attorneys' salaries under Section 4-2001 of the
7    Counties Code.
8        (p) To exchange information with the Department of
9    Human Services and the Department of Healthcare and Family
10    Services for the purpose of verifying living arrangements
11    and for other purposes directly connected with the
12    administration of this Code and the Illinois Public Aid
13    Code.
14        (q) To establish a diversion program.
15        The program shall provide a structured environment for
16    selected technical parole or mandatory supervised release
17    violators and committed persons who have violated the rules
18    governing their conduct while in work release. This program
19    shall not apply to those persons who have committed a new
20    offense while serving on parole or mandatory supervised
21    release or while committed to work release.
22        Elements of the program shall include, but shall not be
23    limited to, the following:
24            (1) The staff of a diversion facility shall provide
25        supervision in accordance with required objectives set
26        by the facility.

 

 

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1            (2) Participants shall be required to maintain
2        employment.
3            (3) Each participant shall pay for room and board
4        at the facility on a sliding-scale basis according to
5        the participant's income.
6            (4) Each participant shall:
7                (A) provide restitution to victims in
8            accordance with any court order;
9                (B) provide financial support to his
10            dependents; and
11                (C) make appropriate payments toward any other
12            court-ordered obligations.
13            (5) Each participant shall complete community
14        service in addition to employment.
15            (6) Participants shall take part in such
16        counseling, educational and other programs as the
17        Department may deem appropriate.
18            (7) Participants shall submit to drug and alcohol
19        screening.
20            (8) The Department shall promulgate rules
21        governing the administration of the program.
22        (r) To enter into intergovernmental cooperation
23    agreements under which persons in the custody of the
24    Department may participate in a county impact
25    incarceration program established under Section 3-6038 or
26    3-15003.5 of the Counties Code.

 

 

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1        (r-5) (Blank).
2        (r-10) To systematically and routinely identify with
3    respect to each streetgang active within the correctional
4    system: (1) each active gang; (2) every existing inter-gang
5    affiliation or alliance; and (3) the current leaders in
6    each gang. The Department shall promptly segregate leaders
7    from inmates who belong to their gangs and allied gangs.
8    "Segregate" means no physical contact and, to the extent
9    possible under the conditions and space available at the
10    correctional facility, prohibition of visual and sound
11    communication. For the purposes of this paragraph (r-10),
12    "leaders" means persons who:
13            (i) are members of a criminal streetgang;
14            (ii) with respect to other individuals within the
15        streetgang, occupy a position of organizer,
16        supervisor, or other position of management or
17        leadership; and
18            (iii) are actively and personally engaged in
19        directing, ordering, authorizing, or requesting
20        commission of criminal acts by others, which are
21        punishable as a felony, in furtherance of streetgang
22        related activity both within and outside of the
23        Department of Corrections.
24    "Streetgang", "gang", and "streetgang related" have the
25    meanings ascribed to them in Section 10 of the Illinois
26    Streetgang Terrorism Omnibus Prevention Act.

 

 

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1        (s) To operate a super-maximum security institution,
2    in order to manage and supervise inmates who are disruptive
3    or dangerous and provide for the safety and security of the
4    staff and the other inmates.
5        (t) To monitor any unprivileged conversation or any
6    unprivileged communication, whether in person or by mail,
7    telephone, or other means, between an inmate who, before
8    commitment to the Department, was a member of an organized
9    gang and any other person without the need to show cause or
10    satisfy any other requirement of law before beginning the
11    monitoring, except as constitutionally required. The
12    monitoring may be by video, voice, or other method of
13    recording or by any other means. As used in this
14    subdivision (1)(t), "organized gang" has the meaning
15    ascribed to it in Section 10 of the Illinois Streetgang
16    Terrorism Omnibus Prevention Act.
17        As used in this subdivision (1)(t), "unprivileged
18    conversation" or "unprivileged communication" means a
19    conversation or communication that is not protected by any
20    privilege recognized by law or by decision, rule, or order
21    of the Illinois Supreme Court.
22        (u) To establish a Women's and Children's Pre-release
23    Community Supervision Program for the purpose of providing
24    housing and services to eligible female inmates, as
25    determined by the Department, and their newborn and young
26    children.

 

 

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1        (u-5) To issue an order, whenever a person committed to
2    the Department absconds or absents himself or herself,
3    without authority to do so, from any facility or program to
4    which he or she is assigned. The order shall be certified
5    by the Director, the Supervisor of the Apprehension Unit,
6    or any person duly designated by the Director, with the
7    seal of the Department affixed. The order shall be directed
8    to all sheriffs, coroners, and police officers, or to any
9    particular person named in the order. Any order issued
10    pursuant to this subdivision (1) (u-5) shall be sufficient
11    warrant for the officer or person named in the order to
12    arrest and deliver the committed person to the proper
13    correctional officials and shall be executed the same as
14    criminal process.
15        (v) To do all other acts necessary to carry out the
16    provisions of this Chapter.
17    (2) The Department of Corrections shall by January 1, 1998,
18consider building and operating a correctional facility within
19100 miles of a county of over 2,000,000 inhabitants, especially
20a facility designed to house juvenile participants in the
21impact incarceration program.
22    (3) When the Department lets bids for contracts for medical
23services to be provided to persons committed to Department
24facilities by a health maintenance organization, medical
25service corporation, or other health care provider, the bid may
26only be let to a health care provider that has obtained an

 

 

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1irrevocable letter of credit or performance bond issued by a
2company whose bonds have an investment grade or higher rating
3by a bond rating organization.
4    (4) When the Department lets bids for contracts for food or
5commissary services to be provided to Department facilities,
6the bid may only be let to a food or commissary services
7provider that has obtained an irrevocable letter of credit or
8performance bond issued by a company whose bonds have an
9investment grade or higher rating by a bond rating
10organization.
11    (5) On and after the date 6 months after the effective date
12of this amendatory Act of the 98th General Assembly, as
13provided in the Executive Order 1 (2012) Implementation Act,
14all of the powers, duties, rights, and responsibilities related
15to State healthcare purchasing under this Code that were
16transferred from the Department of Corrections to the
17Department of Healthcare and Family Services by Executive Order
183 (2005) are transferred back to the Department of Corrections;
19however, powers, duties, rights, and responsibilities related
20to State healthcare purchasing under this Code that were
21exercised by the Department of Corrections before the effective
22date of Executive Order 3 (2005) but that pertain to
23individuals resident in facilities operated by the Department
24of Juvenile Justice are transferred to the Department of
25Juvenile Justice.
26(Source: P.A. 96-1265, eff. 7-26-10; 97-697, eff. 6-22-12;

 

 

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197-800, eff. 7-13-12; 97-802, eff. 7-13-12; revised 7-23-12.)
 
2    (730 ILCS 5/3-2.5-20)
3    Sec. 3-2.5-20. General powers and duties.
4    (a) In addition to the powers, duties, and responsibilities
5which are otherwise provided by law or transferred to the
6Department as a result of this Article, the Department, as
7determined by the Director, shall have, but are not limited to,
8the following rights, powers, functions and duties:
9        (1) To accept juveniles committed to it by the courts
10    of this State for care, custody, treatment, and
11    rehabilitation.
12        (2) To maintain and administer all State juvenile
13    correctional institutions previously under the control of
14    the Juvenile and Women's & Children Divisions of the
15    Department of Corrections, and to establish and maintain
16    institutions as needed to meet the needs of the youth
17    committed to its care.
18        (3) To identify the need for and recommend the funding
19    and implementation of an appropriate mix of programs and
20    services within the juvenile justice continuum, including
21    but not limited to prevention, nonresidential and
22    residential commitment programs, day treatment, and
23    conditional release programs and services, with the
24    support of educational, vocational, alcohol, drug abuse,
25    and mental health services where appropriate.

 

 

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1        (4) To establish and provide transitional and
2    post-release treatment programs for juveniles committed to
3    the Department. Services shall include but are not limited
4    to:
5            (i) family and individual counseling and treatment
6        placement;
7            (ii) referral services to any other State or local
8        agencies;
9            (iii) mental health services;
10            (iv) educational services;
11            (v) family counseling services; and
12            (vi) substance abuse services.
13        (5) To access vital records of juveniles for the
14    purposes of providing necessary documentation for
15    transitional services such as obtaining identification,
16    educational enrollment, employment, and housing.
17        (6) To develop staffing and workload standards and
18    coordinate staff development and training appropriate for
19    juvenile populations.
20        (7) To develop, with the approval of the Office of the
21    Governor and the Governor's Office of Management and
22    Budget, annual budget requests.
23        (8) To administer the Interstate Compact for
24    Juveniles, with respect to all juveniles under its
25    jurisdiction, and to cooperate with the Department of Human
26    Services with regard to all non-offender juveniles subject

 

 

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1    to the Interstate Compact for Juveniles.
2    (b) The Department may employ personnel in accordance with
3the Personnel Code and Section 3-2.5-15 of this Code, provide
4facilities, contract for goods and services, and adopt rules as
5necessary to carry out its functions and purposes, all in
6accordance with applicable State and federal law.
7    (c) On and after the date 6 months after the effective date
8of this amendatory Act of the 98th General Assembly, as
9provided in the Executive Order 1 (2012) Implementation Act,
10all of the powers, duties, rights, and responsibilities related
11to State healthcare purchasing under this Code that were
12transferred from the Department of Corrections to the
13Department of Healthcare and Family Services by Executive Order
143 (2005) are transferred back to the Department of Corrections;
15however, powers, duties, rights, and responsibilities related
16to State healthcare purchasing under this Code that were
17exercised by the Department of Corrections before the effective
18date of Executive Order 3 (2005) but that pertain to
19individuals resident in facilities operated by the Department
20of Juvenile Justice are transferred to the Department of
21Juvenile Justice.
22(Source: P.A. 94-696, eff. 6-1-06; 95-937, eff. 8-26-08.)
 
23    Section 997. Severability. The provisions of this Act are
24severable under Section 1.31 of the Statute on Statutes.
 
25    Section 999. Effective date. This Act takes effect upon

 

 

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1becoming law.