No policy of group accident and health insurance under which firefighters
employed by a municipality are insured for their individual benefit shall
be issued or delivered in this State to any municipality unless such group
policy provides for the election of continued group insurance coverage for
the retirement or disability period of each firefighter who is insured under the
provisions of the group policy on the day immediately preceding the day
on which the retirement or disability period of such firefighter begins. So
long as any required premiums for continued group insurance coverage are
paid in accordance with the provisions of the group policy, an election
made pursuant to this Section shall provide continued group insurance
coverage for a firefighter throughout the retirement or disability period of
the firefighter and, unless the firefighter otherwise elects and subject to any
other provisions of the group policy which relate either to the provision
or to the termination of dependents' coverage and which are not
inconsistent with this Section, for any dependents of the firefighter who are
insured under the group policy on the day immediately preceding the day on
which the retirement or disability period of the firefighter begins; provided,
however, that when such continued group insurance coverage is in effect
with respect to a firefighter on the date
of the firefighter's death but the retirement or disability period of the firefighter
does not end with such firefighter's death, then the deceased firefighter's surviving
spouse upon whose death or remarriage such retirement or disability period
will end shall be entitled, without further election and upon payment of
any required premiums in accordance with the provisions of the group policy,
to maintain such continued group
insurance coverage in effect until the end of such retirement or disability
period. Continued group insurance coverage shall be provided in accordance
with this Section at the same premium rate from time to time charged for
equivalent coverage provided under the group policy with respect to covered
firefighters whose retirement or disability period has not begun, and no distinction
or discrimination in the amount or rate of premiums or in any waiver of premium
or other benefit provision shall be made between continued group insurance
coverage elected pursuant to this Section and equivalent coverage provided
to firefighters under the group policy other than pursuant to the provisions
of this Section; provided that no municipality shall be required by reason
of any provision of this Section to pay any group insurance premium other
than one that may be negotiated in a collective bargaining agreement.
If a person electing continued coverage under this Section becomes
eligible for medicare coverage, benefits under the group policy may
continue as a supplement to the medicare coverage upon payment of any
required premiums to maintain the benefits of the group policy as
supplemental coverage.
Within 15 days of the beginning of the retirement or disability period
of any firefighter entitled to elect continued group insurance coverage under any
group policy affected by this Section, the municipality last employing such
firefighter shall give written notice of such beginning by certified mail, return
receipt requested to the insurance company issuing such policy. The notice
shall include the firefighter's name and last known place of residence and the
beginning date of the firefighter's retirement or disability period.
Within 15 days of the date of receipt of such notice from the municipality,
the insurance company by certified mail, return receipt requested, shall
give written notice to the firefighter at the firefighter's last known place of
residence that coverage under the group policy may be continued for the
retirement or disability period of the firefighter as provided in this Section.
Such notice shall set forth: (i) a statement of election to be filed by
the firefighter if the firefighter wishes to continue such group insurance coverage,
(ii) the amount of monthly premium, including a statement of the portion
of such monthly premium attributable to any dependents' coverage which the
firefighter may elect, and (iii) instructions as to the return of the election
form to the insurance company issuing such policy. Election shall be made,
if at all, by returning the statement of election to the insurance company by
certified mail, return receipt requested within 15 days after having received it.
If the firefighter elects to continue coverage, it shall be the obligation
of the firefighter to pay the monthly premium directly to the municipality which
shall forward it to the insurance company
issuing the group insurance policy, or as otherwise directed by the insurance
company; provided, however, that the firefighter shall be entitled to designate
on the statement of election required to be filed with the insurance company
that the total monthly premium, or such portion thereof as is not
contributed by a municipality, be deducted by a Firefighter's Pension
Fund from any monthly pension payment otherwise payable
to or on behalf of the firefighter pursuant to Article 4 of the Illinois Pension
Code, and be remitted by such Pension Fund to the insurance company. The
portion, if any, of the monthly premium contributed by a
municipality for such continued group insurance coverage shall be paid by
the municipality directly to the insurance company issuing the group insurance
policy, or as otherwise directed by the insurance company. Such continued
group insurance coverage shall relate back to the beginning of the firefighter's
retirement or disability period.
The amendment, renewal or extension of any group insurance policy affected
by this Section shall be deemed to be the issuance of a new policy of insurance
for purposes of this Section.
In the event that a municipality makes a program of accident, health,
hospital or medical benefits available to its firefighters through
self-insurance, or by participation in a pool or reciprocal insurer, or by
contract in a form other than a policy of group insurance with one or more
medical service plans, health care service corporations, health maintenance
organizations, or any other professional corporations or plans under which
health care or reimbursement for the costs thereof is
provided, whether the cost of such benefits is borne by the municipality or
the firefighters or both, such firefighters and their surviving spouses shall have
the same right to elect continued coverage under such program of benefits
as they would have if such benefits were provided by a policy of group
accident and health insurance. In such cases, the notice of right to elect
continued coverage shall be sent by the municipality; the statement of
election shall be sent to the municipality; and references to the required
premium shall refer to that portion of the cost of such benefits which is not
borne by the municipality, either voluntarily or pursuant to the provisions
of a collective bargaining agreement. In the case of a municipality
providing such benefits through self-insurance or participation in a pool or
reciprocal insurer, the right to elect continued coverage which is provided
by this paragraph shall be implemented and made available to the firefighters of
the municipality and qualifying surviving spouses not later than July 1, 1985.
The amendment, renewal or extension of any such contract in a form other
than a policy of group insurance policy shall be deemed the formation of a
new contract for the purposes of this Section.
This Section shall not limit the exercise of any conversion privileges
available under Section 367e.
Pursuant to paragraphs (h) and (i) of Section 6 of Article VII of the
Illinois Constitution, this Section specifically denies and limits the
exercise by a home rule unit of any power which is inconsistent with this
Section and all existing laws and ordinances which are inconsistent with
this Section are hereby superseded. This Section does not preempt the
concurrent exercise by home rule units of powers consistent herewith.
The Division of Insurance of the Department of Financial and Professional Regulation shall enforce the provisions of this Section, including provisions relating to municipality self-insured benefit plans.
(Source: P.A. 103-52, eff. 1-1-24.)
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