State of Illinois
91st General Assembly
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91_SB0854sam001

 










                                           LRB9105994EGfgam01

 1                    AMENDMENT TO SENATE BILL 854

 2        AMENDMENT NO.     .  Amend Senate Bill 854  by  replacing
 3    the title with the following:
 4        "AN ACT concerning retired teachers."; and

 5    by  replacing  everything  after the enacting clause with the
 6    following:

 7        "Section 5.  The State Employees Group Insurance  Act  of
 8    1971 is amended by changing Sections 6.5 and 10 as follows:

 9        (5 ILCS 375/6.5)
10        Sec.  6.5. Health benefits for TRS benefit recipients and
11    TRS dependent beneficiaries.
12        (a)  Purpose.  It is the purpose of this  amendatory  Act
13    of  1995  to  transfer  the  administration of the program of
14    health benefits established for benefit recipients and  their
15    dependent  beneficiaries  under  Article  16  of the Illinois
16    Pension  Code  to  the  Department  of   Central   Management
17    Services.
18        (b)  Transition provisions.  The Board of Trustees of the
19    Teachers'  Retirement System shall continue to administer the
20    health benefit program established under Article  16  of  the
21    Illinois  Pension  Code through December 31, 1995.  Beginning
 
                            -2-            LRB9105994EGfgam01
 1    January  1,  1996,  the  Department  of  Central   Management
 2    Services  shall be responsible for administering a program of
 3    health benefits for TRS benefit recipients and TRS  dependent
 4    beneficiaries  under this Section.  The Department of Central
 5    Management Services and the Teachers' Retirement System shall
 6    cooperate  in  this  endeavor  and  shall  coordinate   their
 7    activities   so   as   to  ensure  a  smooth  transition  and
 8    uninterrupted health benefit coverage.
 9        (c)  Eligibility.  All persons who were enrolled  in  the
10    Article  16  program  at  the  time  of the transfer shall be
11    eligible to participate in the program established under this
12    Section without any interruption  or  delay  in  coverage  or
13    limitation    as    to   pre-existing   medical   conditions.
14    Eligibility  to  participate  shall  be  determined  by   the
15    Teachers'  Retirement  System.  Eligibility information shall
16    be communicated  to  the  Department  of  Central  Management
17    Services in a format acceptable to the Department.
18        (d)  Coverage.   The  level  of  health benefits provided
19    under this Section shall be similar to the level of  benefits
20    provided  by the program previously established under Article
21    16 of the Illinois Pension Code;  except  that  beginning  in
22    State  fiscal  year  2001, the benefits and participant costs
23    for the following listed benefit areas shall be substantially
24    the same as for the program of basic health benefits provided
25    under this Act for retired State employees:

26    For Managed Health Care Plans:
27             (i)  inpatient admission copayment.

28    For the Major Medical Plan:
29             (1)  annual deductible;
30             (2)  general out-of-pocket maximum;
31             (3)  Medicare coordination of benefit.
32        Group life insurance benefits are  not  included  in  the
33    benefits  to  be  provided  to TRS benefit recipients and TRS
 
                            -3-            LRB9105994EGfgam01
 1    dependent beneficiaries under this Act.
 2        The program of health benefits  under  this  Section  may
 3    include  any or all of the benefit limitations, including but
 4    not limited to a reduction in benefits based  on  eligibility
 5    for  federal  medicare  benefits,  that  are  provided  under
 6    subsection  (a)  of  Section  6  of this Act for other health
 7    benefit programs under this Act.
 8        (e)  Insurance rates and premiums.   The  Director  shall
 9    determine  the  insurance  rates and premiums for TRS benefit
10    recipients and TRS dependent beneficiaries.  For Fiscal  Year
11    1996,  the  premium  shall  be  equal to the premium actually
12    charged in  Fiscal  Year  1995.   In  subsequent  years,  the
13    premium  shall  never  be  lower  than the premium charged in
14    Fiscal Year 1995.  Rates and premiums may be based in part on
15    age and eligibility for federal medicare coverage.
16        The cost of health benefits under the  program  shall  be
17    paid as follows:
18             (1)  For a TRS benefit recipient selecting a managed
19        care program, up to 75% of the total insurance rate shall
20        be paid from the Teacher Health Insurance Security Fund.
21             (2)  For a TRS benefit recipient selecting the major
22        medical   coverage  program,  up  to  50%  of  the  total
23        insurance rate shall be  paid  from  the  Teacher  Health
24        Insurance  Security  Fund  if  a  managed care program is
25        accessible, as determined  by  the  Teachers'  Retirement
26        System.
27             (3)  For a TRS benefit recipient selecting the major
28        medical   coverage  program,  up  to  75%  of  the  total
29        insurance rate shall be  paid  from  the  Teacher  Health
30        Insurance  Security Fund if a managed care program is not
31        accessible, as determined  by  the  Teachers'  Retirement
32        System.
33             (4)  The balance of the rate of insurance, including
34        the  entire  premium  of  any  coverage for TRS dependent
 
                            -4-            LRB9105994EGfgam01
 1        beneficiaries that has been elected,  shall  be  paid  by
 2        deductions  authorized by the TRS benefit recipient to be
 3        withheld from his  or  her  monthly  annuity  or  benefit
 4        payment from the Teachers' Retirement System; except that
 5        (i)  if  the  balance of the cost of coverage exceeds the
 6        amount of the monthly annuity  or  benefit  payment,  the
 7        difference  shall  be  paid  directly  to  the  Teachers'
 8        Retirement  System by the TRS benefit recipient, and (ii)
 9        all or part of the balance of the cost of  coverage  may,
10        at  the  school  board's option, be paid to the Teachers'
11        Retirement System by  the  school  board  of  the  school
12        district from which the TRS benefit recipient retired, in
13        accordance with Section 10-22.3b of the School Code.  The
14        Teachers'  Retirement  System  shall promptly deposit all
15        moneys withheld by or paid to it under  this  subdivision
16        (e)(4)  into  the Teacher Health Insurance Security Fund.
17        These moneys  shall  not  be  considered  assets  of  the
18        Retirement System.
19        (f)  Financing.   Beginning  July  1,  1995, all revenues
20    arising  from  the  administration  of  the  health   benefit
21    programs established under Article 16 of the Illinois Pension
22    Code  or  this  Section  shall  be deposited into the Teacher
23    Health Insurance Security Fund, which is hereby created as  a
24    nonappropriated  trust  fund  to  be  held  outside the State
25    Treasury,  with  the  State  Treasurer  as  custodian.    Any
26    interest  earned  on  moneys  in the Teacher Health Insurance
27    Security Fund shall be deposited into the Fund.
28        Moneys in the  Teacher  Health  Insurance  Security  Fund
29    shall  be  used  only  to pay the costs of the health benefit
30    program established under this Section, including  associated
31    administrative  costs,  and  the  costs  associated  with the
32    health benefit program established under Article  16  of  the
33    Illinois   Pension  Code,  as  authorized  in  this  Section.
34    Beginning July 1, 1995, the Department of Central  Management
 
                            -5-            LRB9105994EGfgam01
 1    Services  may  make  expenditures  from  the  Teacher  Health
 2    Insurance Security Fund for those costs.
 3        After other funds authorized for the payment of the costs
 4    of the health benefit program established under Article 16 of
 5    the  Illinois Pension Code are exhausted and until January 1,
 6    1996 (or such later  date  as  may  be  agreed  upon  by  the
 7    Director  of Central Management Services and the Secretary of
 8    the  Teachers'  Retirement  System),  the  Secretary  of  the
 9    Teachers' Retirement System may make  expenditures  from  the
10    Teacher Health Insurance Security Fund as necessary to pay up
11    to  75%  of the cost of providing health coverage to eligible
12    benefit recipients  (as  defined  in  Sections  16-153.1  and
13    16-153.3  of  the  Illinois Pension Code) who are enrolled in
14    the Article 16 health benefit program and to  facilitate  the
15    transfer  of  administration of the health benefit program to
16    the Department of Central Management Services.
17        (g)  Contract  for  benefits.   The  Director  shall   by
18    contract,  self-insurance,  or  otherwise  make available the
19    program of health benefits for  TRS  benefit  recipients  and
20    their  TRS  dependent  beneficiaries  that is provided for in
21    this Section.  The contract  or  other  arrangement  for  the
22    provision  of  these health benefits shall be on terms deemed
23    by the Director to be in the best interest of  the  State  of
24    Illinois  and  the  TRS  benefit recipients based on, but not
25    limited to, such criteria  as  administrative  cost,  service
26    capabilities  of  the  carrier  or  other contractor, and the
27    costs of the benefits.
28        (h)  Continuation of program.  It is the intention of the
29    General Assembly that the program of health benefits provided
30    under this Section be maintained on  an  ongoing,  affordable
31    basis.   The  program  of health benefits provided under this
32    Section may be amended by the State and is not intended to be
33    a pension or retirement benefit subject to  protection  under
34    Article XIII, Section 5 of the Illinois Constitution.
 
                            -6-            LRB9105994EGfgam01
 1    (Source: P.A. 89-21, eff. 6-21-95; 89-25, eff. 6-21-95.)

 2        (5 ILCS 375/10) (from Ch. 127, par. 530)
 3        Sec. 10. Payments by State; premiums.
 4        (a)  The    State   shall   pay   the   cost   of   basic
 5    non-contributory group life insurance and, subject to  member
 6    paid  contributions set by the Department or required by this
 7    Section, the basic program of group health benefits  on  each
 8    eligible  member,  except  a member, not otherwise covered by
 9    this Act, who has retired as  a  participating  member  under
10    Article  2 of the Illinois Pension Code but is ineligible for
11    the retirement annuity under Section 2-119  of  the  Illinois
12    Pension  Code, and part of each eligible member's and retired
13    member's premiums for health insurance coverage for  enrolled
14    dependents as provided by Section 9.  The State shall pay the
15    cost of the basic program of group health benefits only after
16    benefits  are  reduced  by  the amount of benefits covered by
17    Medicare for all retired members and retired dependents  aged
18    65  years  or older who are entitled to benefits under Social
19    Security  or  the  Railroad  Retirement  system  or  who  had
20    sufficient Medicare-covered government employment except that
21    such reduction in benefits shall apply only to those  retired
22    members  or  retired dependents who (1) first become eligible
23    for such Medicare coverage on or after July 1, 1992;  or  (2)
24    remain  eligible for, but no longer receive Medicare coverage
25    which they had been receiving on or after July 1,  1992.  The
26    Department  may  determine the aggregate level of the State's
27    contribution on the basis of actual cost of medical  services
28    adjusted  for  age,  sex  or  geographic or other demographic
29    characteristics which affect the costs of such programs.
30        (a-1)  Beginning January 1, 1998,  for  each  person  who
31    becomes  a  new  SERS annuitant and participates in the basic
32    program of group health benefits, the State shall  contribute
33    toward  the  cost of the annuitant's coverage under the basic
 
                            -7-            LRB9105994EGfgam01
 1    program of group health benefits an amount  equal  to  5%  of
 2    that cost for each full year of creditable service upon which
 3    the  annuitant's retirement annuity is based, up to a maximum
 4    of 100% for an annuitant with 20 or more years of  creditable
 5    service.  The remainder of the cost of a new SERS annuitant's
 6    coverage  under  the  basic  program of group health benefits
 7    shall be the responsibility of the annuitant.
 8        (a-2)  Beginning January 1, 1998,  for  each  person  who
 9    becomes  a  new  SERS  survivor and participates in the basic
10    program of group health benefits, the State shall  contribute
11    toward  the  cost  of the survivor's coverage under the basic
12    program of group health benefits an amount  equal  to  5%  of
13    that  cost  for  each full year of the deceased employee's or
14    deceased  annuitant's  creditable  service   in   the   State
15    Employees'  Retirement  System  of  Illinois  on  the date of
16    death, up to a maximum of 100% for a survivor of an  employee
17    or  annuitant  with  20  or more years of creditable service.
18    The remainder of the cost of the new SERS survivor's coverage
19    under the basic program of group health benefits shall be the
20    responsibility of the survivor.
21        (a-3)  Beginning January 1, 1998,  for  each  person  who
22    becomes  a  new  SURS annuitant and participates in the basic
23    program of group health benefits, the State shall  contribute
24    toward  the  cost of the annuitant's coverage under the basic
25    program of group health benefits an amount  equal  to  5%  of
26    that cost for each full year of creditable service upon which
27    the  annuitant's retirement annuity is based, up to a maximum
28    of 100% for an annuitant with 20 or more years of  creditable
29    service.  The remainder of the cost of a new SURS annuitant's
30    coverage  under  the  basic  program of group health benefits
31    shall be the responsibility of the annuitant.
32        (a-4)  Beginning January 1, 1998,  for  each  person  who
33    becomes  a  new SURS retired employee and participates in the
34    basic program of  group  health  benefits,  the  State  shall
 
                            -8-            LRB9105994EGfgam01
 1    contribute toward the cost of the retired employee's coverage
 2    under  the  basic  program of group health benefits an amount
 3    equal to 5% of that cost for each full year that the  retired
 4    employee  was  an  employee  as defined in Section 3, up to a
 5    maximum of 100% for a retired employee who  was  an  employee
 6    for  20  or  more  years.  The remainder of the cost of a new
 7    SURS retired employee's coverage under the basic  program  of
 8    group  health  benefits  shall  be  the responsibility of the
 9    retired employee.
10        (a-5)  Beginning January 1, 1998,  for  each  person  who
11    becomes  a  new  SURS  survivor and participates in the basic
12    program of group health benefits, the State shall  contribute
13    toward  the  cost  of the survivor's coverage under the basic
14    program of group health benefits an amount  equal  to  5%  of
15    that  cost  for  each full year of the deceased employee's or
16    deceased  annuitant's  creditable  service   in   the   State
17    Universities  Retirement System on the date of death, up to a
18    maximum of 100% for a survivor of an  employee  or  annuitant
19    with  20  or more years of creditable service.  The remainder
20    of the cost of the new SURS  survivor's  coverage  under  the
21    basic   program   of  group  health  benefits  shall  be  the
22    responsibility of the survivor.
23        (a-6)  Beginning  July  1,  1998,  for  each  person  who
24    becomes a new TRS State annuitant  and  participates  in  the
25    basic  program  of  group  health  benefits,  the State shall
26    contribute toward the cost of the annuitant's coverage  under
27    the basic program of group health benefits an amount equal to
28    5% of that cost for each full year of creditable service as a
29    teacher  as  defined in paragraph (2), (3), or (5) of Section
30    16-106  of  the  Illinois  Pension  Code   upon   which   the
31    annuitant's  retirement  annuity is based, up to a maximum of
32    100%  for  an  annuitant  with  20  or  more  years  of  such
33    creditable service.  The remainder of the cost of a  new  TRS
34    State  annuitant's  coverage under the basic program of group
 
                            -9-            LRB9105994EGfgam01
 1    health benefits shall be the responsibility of the annuitant.
 2        (a-7)  Beginning  July  1,  1998,  for  each  person  who
 3    becomes a new TRS State  survivor  and  participates  in  the
 4    basic  program  of  group  health  benefits,  the State shall
 5    contribute toward the cost of the survivor's  coverage  under
 6    the basic program of group health benefits an amount equal to
 7    5% of that cost for each full year of the deceased employee's
 8    or  deceased  annuitant's  creditable service as a teacher as
 9    defined in paragraph (2), (3), or (5) of  Section  16-106  of
10    the  Illinois  Pension  Code  on  the  date of death, up to a
11    maximum of 100% for a survivor of an  employee  or  annuitant
12    with  20  or  more  years  of  such  creditable service.  The
13    remainder of  the  cost  of  the  new  TRS  State  survivor's
14    coverage  under  the  basic  program of group health benefits
15    shall be the responsibility of the survivor.
16        (a-8)  A new SERS annuitant, new SERS survivor, new  SURS
17    annuitant,  new SURS retired employee, new SURS survivor, new
18    TRS State annuitant, or new TRS State survivor may  waive  or
19    terminate  coverage  in the program of group health benefits.
20    Any such annuitant, survivor, or  retired  employee  who  has
21    waived  or terminated coverage may enroll or re-enroll in the
22    program of group  health  benefits  only  during  the  annual
23    benefit  choice period, as determined by the Director; except
24    that  in  the  event  of  termination  of  coverage  due   to
25    nonpayment  of  premiums, the annuitant, survivor, or retired
26    employee may not re-enroll in the program.
27        (a-9)  No later than May 1 of  each  calendar  year,  the
28    Director  of  Central  Management  Services  shall certify in
29    writing to the Executive Secretary of  the  State  Employees'
30    Retirement  System  of Illinois and the Executive Director of
31    the Teachers' Retirement System of the State of Illinois  the
32    amounts  of  the Medicare supplement health care premiums and
33    the amounts  of  the  health  care  premiums  for  all  other
34    retirees who are not Medicare eligible.
 
                            -10-           LRB9105994EGfgam01
 1        A  separate  calculation  of  the premiums based upon the
 2    actual cost of each health care plan shall be so certified.
 3        The Director of Central Management Services shall provide
 4    to the Executive Secretary of the State Employees' Retirement
 5    System  of  Illinois  and  the  Executive  Director  of   the
 6    Teachers'  Retirement  System  of  the State of Illinois such
 7    information, statistics, and other data as they he or she may
 8    require to  review  the  premium  amounts  certified  by  the
 9    Director of Central Management Services.
10        (b)  State employees who become eligible for this program
11    on  or  after January 1, 1980 in positions normally requiring
12    actual performance of duty not less than 1/2 of a normal work
13    period but not equal to that of a normal work  period,  shall
14    be  given  the  option  of  participating  in  the  available
15    program.   If  the  employee elects coverage, the State shall
16    contribute on behalf of such employee  to  the  cost  of  the
17    employee's  benefit  and any applicable dependent supplement,
18    that sum which bears the same percentage as  that  percentage
19    of  time the employee regularly works when compared to normal
20    work period.
21        (c)  The basic non-contributory coverage from  the  basic
22    program  of group health benefits shall be continued for each
23    employee not in pay status or on active service by reason  of
24    (1) leave of absence due to illness or injury, (2) authorized
25    educational  leave  of  absence  or  sabbatical leave, or (3)
26    military leave with pay and  benefits.  This  coverage  shall
27    continue  until  expiration of authorized leave and return to
28    active service, but not to exceed 24 months for leaves  under
29    item (1) or (2). This 24-month limitation and the requirement
30    of  returning  to  active  service shall not apply to persons
31    receiving  ordinary  or  accidental  disability  benefits  or
32    retirement benefits through the appropriate State  retirement
33    system   or  benefits  under  the  Workers'  Compensation  or
34    Occupational Disease Act.
 
                            -11-           LRB9105994EGfgam01
 1        (d)  The  basic  group  life  insurance  coverage   shall
 2    continue,  with full State contribution, where such person is
 3    (1) absent  from  active  service  by  reason  of  disability
 4    arising  from  any  cause  other  than self-inflicted, (2) on
 5    authorized educational leave of absence or sabbatical  leave,
 6    or (3) on military leave with pay and benefits.
 7        (e)  Where  the  person is in non-pay status for a period
 8    in excess of 30 days or on leave of absence,  other  than  by
 9    reason  of  disability,  educational  or sabbatical leave, or
10    military  leave  with  pay  and  benefits,  such  person  may
11    continue coverage only by making personal  payment  equal  to
12    the amount normally contributed by the State on such person's
13    behalf.  Such  payments  and  coverage  may be continued: (1)
14    until such time as the person returns to  a  status  eligible
15    for  coverage  at State expense, but not to exceed 24 months,
16    (2) until such person's employment or annuitant  status  with
17    the  State  is  terminated,  or (3) for a maximum period of 4
18    years for members on military leave with pay and benefits and
19    military leave without pay and  benefits  (exclusive  of  any
20    additional service imposed pursuant to law).
21        (f)  The  Department  shall  establish by rule the extent
22    to which other employee benefits will continue for persons in
23    non-pay status or who are not in active service.
24        (g)  The State shall  not  pay  the  cost  of  the  basic
25    non-contributory  group  life  insurance,  program  of health
26    benefits and other employee  benefits  for  members  who  are
27    survivors  as defined by paragraphs (1) and (2) of subsection
28    (q) of Section 3 of this Act.   The  costs  of  benefits  for
29    these  survivors  shall  be  paid  by the survivors or by the
30    University of Illinois Cooperative Extension Service, or  any
31    combination thereof.
32        (h)  Those   persons   occupying   positions   with   any
33    department  as a result of emergency appointments pursuant to
34    Section 8b.8 of the Personnel Code  who  are  not  considered
 
                            -12-           LRB9105994EGfgam01
 1    employees  under  this  Act  shall  be  given  the  option of
 2    participating in the programs of group life insurance, health
 3    benefits and other employee benefits.  Such persons  electing
 4    coverage  may participate only by making payment equal to the
 5    amount  normally  contributed  by  the  State  for  similarly
 6    situated employees.  Such amounts shall be determined by  the
 7    Director.   Such payments and coverage may be continued until
 8    such time as the person becomes an employee pursuant to  this
 9    Act or such person's appointment is terminated.
10        (i)  Any  unit  of  local  government within the State of
11    Illinois may apply to the Director  to  have  its  employees,
12    annuitants,   and  their  dependents  provided  group  health
13    coverage  under  this  Act  on  a  non-insured   basis.    To
14    participate,  a unit of local government must agree to enroll
15    all of its employees, who may select  coverage  under  either
16    the State group health insurance plan or a health maintenance
17    organization  that  has  contracted  with  the  State  to  be
18    available  as a health care provider for employees as defined
19    in this Act.  A unit  of  local  government  must  remit  the
20    entire  cost  of  providing  coverage  under  the State group
21    health  insurance  plan  or,  for  coverage  under  a  health
22    maintenance  organization,  an  amount  determined   by   the
23    Director  based  on  an  analysis of the sex, age, geographic
24    location, or other relevant  demographic  variables  for  its
25    employees, except that the unit of local government shall not
26    be  required to enroll those of its employees who are covered
27    spouses or dependents under this plan or another group policy
28    or  plan  providing  health  benefits  as  long  as  (1)   an
29    appropriate  official  from  the  unit  of  local  government
30    attests  that  each employee not enrolled is a covered spouse
31    or dependent under this plan or another group policy or plan,
32    and (2) at least 85% of the employees are  enrolled  and  the
33    unit  of local government remits the entire cost of providing
34    coverage to those employees.  Employees  of  a  participating
 
                            -13-           LRB9105994EGfgam01
 1    unit of local government who are not enrolled due to coverage
 2    under  another  group  health  policy or plan may enroll at a
 3    later date subject to submission of satisfactory evidence  of
 4    insurability  and  provided that no benefits shall be payable
 5    for services incurred during the first 6 months  of  coverage
 6    to  the  extent  the  services  are   in  connection with any
 7    pre-existing  condition.   A  participating  unit  of   local
 8    government may also elect to cover its annuitants.  Dependent
 9    coverage  shall  be  offered  on  an optional basis, with the
10    costs paid by the unit of local government, its employees, or
11    some combination of the two as  determined  by  the  unit  of
12    local  government.   The  unit  of  local government shall be
13    responsible  for  timely  collection  and   transmission   of
14    dependent premiums.
15        The  Director  shall  annually determine monthly rates of
16    payment, subject to the following constraints:
17             (1)  In the first year of coverage, the rates  shall
18        be   equal  to  the  amount  normally  charged  to  State
19        employees for elected optional coverages or for  enrolled
20        dependents  coverages or other contributory coverages, or
21        contributed by the State for basic insurance coverages on
22        behalf of its employees, adjusted for differences between
23        State employees and employees of the local government  in
24        age,   sex,   geographic   location   or  other  relevant
25        demographic variables, plus an amount sufficient  to  pay
26        for  the  additional  administrative  costs  of providing
27        coverage to employees of the unit of local government and
28        their dependents.
29             (2)  In subsequent years, a further adjustment shall
30        be  made  to  reflect  the  actual  prior  years'  claims
31        experience  of  the  employees  of  the  unit  of   local
32        government.
33        In  the  case  of  coverage of local government employees
34    under a health maintenance organization, the  Director  shall
 
                            -14-           LRB9105994EGfgam01
 1    annually  determine  for  each  participating  unit  of local
 2    government the maximum monthly amount the unit may contribute
 3    toward that coverage, based on an analysis of  (i)  the  age,
 4    sex,  geographic  location,  and  other  relevant demographic
 5    variables of the unit's employees and (ii) the cost to  cover
 6    those  employees under the State group health insurance plan.
 7    The Director may  similarly  determine  the  maximum  monthly
 8    amount  each  unit  of local government may contribute toward
 9    coverage  of  its  employees'  dependents  under   a   health
10    maintenance organization.
11        Monthly  payments  by the unit of local government or its
12    employees for group health insurance  or  health  maintenance
13    organization   coverage  shall  be  deposited  in  the  Local
14    Government  Health  Insurance  Reserve   Fund.    The   Local
15    Government   Health   Insurance   Reserve  Fund  shall  be  a
16    continuing fund not subject to fiscal year limitations.   All
17    expenditures  from  this  fund shall be used for payments for
18    health care benefits for local government and  rehabilitation
19    facility   employees,  annuitants,  and  dependents,  and  to
20    reimburse  the  Department  or  its  administrative   service
21    organization  for all expenses incurred in the administration
22    of benefits.  No other State funds  may  be  used  for  these
23    purposes.
24        A  local government employer's participation or desire to
25    participate in a program created under this subsection  shall
26    not   limit   that   employer's  duty  to  bargain  with  the
27    representative of  any  collective  bargaining  unit  of  its
28    employees.
29        (j)  Any  rehabilitation  facility  within  the  State of
30    Illinois may apply to the Director  to  have  its  employees,
31    annuitants,   and  their  dependents  provided  group  health
32    coverage  under  this  Act  on  a   non-insured   basis.   To
33    participate,  a  rehabilitation facility must agree to enroll
34    all of its employees and remit the entire cost  of  providing
 
                            -15-           LRB9105994EGfgam01
 1    such   coverage   for   its   employees,   except   that  the
 2    rehabilitation facility shall not be required to enroll those
 3    of its employees who are covered spouses or dependents  under
 4    this  plan  or  another group policy or plan providing health
 5    benefits as long as (1)  an  appropriate  official  from  the
 6    rehabilitation   facility  attests  that  each  employee  not
 7    enrolled is a covered spouse or dependent under this plan  or
 8    another  group  policy  or  plan, and (2) at least 85% of the
 9    employees are enrolled and the rehabilitation facility remits
10    the entire cost of providing  coverage  to  those  employees.
11    Employees  of a participating rehabilitation facility who are
12    not enrolled due  to  coverage  under  another  group  health
13    policy  or  plan  may  enroll  at  a  later  date  subject to
14    submission  of  satisfactory  evidence  of  insurability  and
15    provided that no  benefits  shall  be  payable  for  services
16    incurred  during the first 6 months of coverage to the extent
17    the  services  are  in  connection  with   any   pre-existing
18    condition.  A  participating rehabilitation facility may also
19    elect to cover its annuitants. Dependent  coverage  shall  be
20    offered  on  an  optional  basis,  with the costs paid by the
21    rehabilitation facility, its employees, or  some  combination
22    of  the  2  as determined by the rehabilitation facility. The
23    rehabilitation  facility  shall  be  responsible  for  timely
24    collection and transmission of dependent premiums.
25        The Director shall annually determine quarterly rates  of
26    payment, subject to the following constraints:
27             (1)  In  the first year of coverage, the rates shall
28        be  equal  to  the  amount  normally  charged  to   State
29        employees  for elected optional coverages or for enrolled
30        dependents coverages or other contributory  coverages  on
31        behalf of its employees, adjusted for differences between
32        State  employees  and  employees  of  the  rehabilitation
33        facility  in  age,  sex,  geographic  location  or  other
34        relevant demographic variables, plus an amount sufficient
 
                            -16-           LRB9105994EGfgam01
 1        to   pay  for  the  additional  administrative  costs  of
 2        providing coverage to  employees  of  the  rehabilitation
 3        facility and their dependents.
 4             (2)  In subsequent years, a further adjustment shall
 5        be  made  to  reflect  the  actual  prior  years'  claims
 6        experience   of   the  employees  of  the  rehabilitation
 7        facility.
 8        Monthly payments by the rehabilitation  facility  or  its
 9    employees  for  group  health insurance shall be deposited in
10    the Local Government Health Insurance Reserve Fund.
11        (k)  Any domestic violence shelter or service within  the
12    State  of  Illinois  may  apply  to  the Director to have its
13    employees, annuitants, and their  dependents  provided  group
14    health  coverage  under  this Act on a non-insured basis.  To
15    participate, a domestic  violence  shelter  or  service  must
16    agree  to enroll all of its employees and pay the entire cost
17    of  providing   such   coverage   for   its   employees.    A
18    participating  domestic  violence  shelter  may also elect to
19    cover its annuitants.  Dependent coverage shall be offered on
20    an optional basis, with employees, or some combination of the
21    2 as determined by the domestic violence shelter or  service.
22    The domestic violence shelter or service shall be responsible
23    for timely collection and transmission of dependent premiums.
24        The  Director shall annually determine quarterly rates of
25    payment, subject to the following constraints:
26             (1)  In the first year of coverage, the rates  shall
27        be   equal  to  the  amount  normally  charged  to  State
28        employees for elected optional coverages or for  enrolled
29        dependents  coverages  or other contributory coverages on
30        behalf of its employees, adjusted for differences between
31        State employees and employees of  the  domestic  violence
32        shelter  or  service  in age, sex, geographic location or
33        other relevant  demographic  variables,  plus  an  amount
34        sufficient to pay for the additional administrative costs
 
                            -17-           LRB9105994EGfgam01
 1        of  providing  coverage  to  employees  of  the  domestic
 2        violence shelter or service and their dependents.
 3             (2)  In subsequent years, a further adjustment shall
 4        be  made  to  reflect  the  actual  prior  years'  claims
 5        experience  of  the  employees  of  the domestic violence
 6        shelter or service.
 7             (3)  In no case shall the  rate  be  less  than  the
 8        amount normally charged to State employees or contributed
 9        by the State on behalf of its employees.
10        Monthly  payments  by  the  domestic  violence shelter or
11    service or its employees for group health insurance shall  be
12    deposited  in  the  Local Government Health Insurance Reserve
13    Fund.
14        (l)  A  public  community  college  or  entity  organized
15    pursuant to the Public Community College Act may apply to the
16    Director initially to have only annuitants not covered  prior
17    to July 1, 1992 by the district's health plan provided health
18    coverage   under  this  Act  on  a  non-insured  basis.   The
19    community  college  must  execute  a   2-year   contract   to
20    participate  in  the  Local  Government  Health  Plan.  Those
21    annuitants enrolled initially under this contract shall  have
22    no  benefits payable for services incurred during the first 6
23    months  of  coverage  to  the  extent  the  services  are  in
24    connection with any pre-existing  condition.   Any  annuitant
25    who  may enroll after this initial enrollment period shall be
26    subject   to   submission   of   satisfactory   evidence   of
27    insurability and to the pre-existing conditions limitation.
28        The Director shall annually determine  monthly  rates  of
29    payment  subject  to  the  following  constraints:  for those
30    community colleges with annuitants only enrolled, first  year
31    rates  shall be equal to the average cost to cover claims for
32    a  State   member   adjusted   for   demographics,   Medicare
33    participation,  and  other factors; and in the second year, a
34    further adjustment of rates shall  be  made  to  reflect  the
 
                            -18-           LRB9105994EGfgam01
 1    actual   first   year's  claims  experience  of  the  covered
 2    annuitants.
 3        (m)  The Director shall adopt any rules deemed  necessary
 4    for implementation of this amendatory Act of 1989 (Public Act
 5    86-978).
 6    (Source:  P.A.  89-53,  eff.  7-1-95;  89-236,  eff.  8-4-95;
 7    89-324,  eff.  8-13-95;  89-626,  eff.  8-9-96;  90-65,  eff.
 8    7-7-97;  90-582,  eff. 5-27-98; 90-655, eff. 7-30-98; revised
 9    8-3-98.)

10        Section 99. Effective date.  This Act takes  effect  upon
11    becoming law.".

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