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92_HB4611 LRB9213029JMmb 1 AN ACT concerning health benefits. 2 Be it enacted by the People of the State of Illinois, 3 represented in the General Assembly: 4 Section 5. The State Employees Group Insurance Act of 5 1971 is amended by changing Section 6.5 as follows: 6 (5 ILCS 375/6.5) 7 (Section scheduled to be repealed on July 1, 2004) 8 Sec. 6.5. Health benefits for TRS benefit recipients and 9 TRS dependent beneficiaries. 10 (a) Purpose.
It isThe purpose of this amendatory Act 11 of 1995 is to transfer the administration of the program of 12 health benefits established for benefit recipients and their 13 dependent beneficiaries under Article 16 of the Illinois 14 Pension Code to the Department of Central Management 15 Services. 16 (b) Transition provisions. The Board of Trustees of the 17 Teachers' Retirement System shall continue to administer the 18 health benefit program established under Article 16 of the 19 Illinois Pension Code through December 31, 1995. Beginning 20 January 1, 1996, the Department of Central Management 21 Services shall be responsible for administering a program of 22 health benefits for TRS benefit recipients and TRS dependent 23 beneficiaries under this Section. The Department of Central 24 Management Services and the Teachers' Retirement System shall 25 cooperate in this endeavor and shall coordinate their 26 activities so as to ensure a smooth transition and 27 uninterrupted health benefit coverage. 28 (c) Eligibility. All persons who were enrolled in the 29 Article 16 program at the time of the transfer shall be 30 eligible to participate in the program established under this 31 Section without any interruption or delay in coverage or -2- LRB9213029JMmb 1 limitation as to pre-existing medical conditions. 2 Eligibility to participate shall be determined by the 3 Teachers' Retirement System. Eligibility information shall 4 be communicated to the Department of Central Management 5 Services in a format acceptable to the Department. 6 (d) Coverage. The level of health benefits provided 7 under this Section shall be similar to the level of benefits 8 provided by the program previously established under Article 9 16 of the Illinois Pension Code. 10 Group life insurance benefits are not included in the 11 benefits to be provided to TRS benefit recipients and TRS 12 dependent beneficiaries under this Act. 13 The program of health benefits under this Section may 14 include any or all of the benefit limitations, including but 15 not limited to a reduction in benefits based on eligibility 16 for federal medicare benefits, that are provided under 17 subsection (a) of Section 6 of this Act for other health 18 benefit programs under this Act. 19 (e) Insurance rates and premiums. The Director shall 20 determine the insurance rates and premiums for TRS benefit 21 recipients and TRS dependent beneficiaries, and shall present 22 to the Teachers' Retirement System of the State of Illinois, 23 by April 15 of each calendar year, the rate-setting 24 methodology (including but not limited to utilization levels 25 and costs) used to determine the amount of the health care 26 premiums. 27 For Fiscal Year 1996, the premium shall be equal to the 28 premium actually charged in Fiscal Year 1995; in subsequent 29 years, the premium shall never be lower than the premium 30 charged in Fiscal Year 1995. For Fiscal Year 2003, the 31 premium shall not exceed 110% of the premium actually charged 32 in Fiscal Year 2002. For Fiscal Year 2004, the premium shall 33 not exceed 112% of the premium actually charged in Fiscal 34 Year 2003. -3- LRB9213029JMmb 1 Rates and premiums may be based in part on age and 2 eligibility for federal medicare coverage. 3 The cost of health benefits under the program shall be 4 paid as follows: 5 (1) For a TRS benefit recipient selecting a managed 6 care program, up to 75% of the total insurance rate shall 7 be paid from the Teacher Health Insurance Security Fund. 8 (2) For a TRS benefit recipient selecting the major 9 medical coverage program, up to 50% of the total 10 insurance rate shall be paid from the Teacher Health 11 Insurance Security Fund if a managed care program is 12 accessible, as determined by the Teachers' Retirement 13 System. 14 (3) For a TRS benefit recipient selecting the major 15 medical coverage program, up to 75% of the total 16 insurance rate shall be paid from the Teacher Health 17 Insurance Security Fund if a managed care program is not 18 accessible, as determined by the Teachers' Retirement 19 System. 20 (4) The balance of the rate of insurance, including 21 the entire premium of any coverage for TRS dependent 22 beneficiaries that has been elected, shall be paid by 23 deductions authorized by the TRS benefit recipient to be 24 withheld from his or her monthly annuity or benefit 25 payment from the Teachers' Retirement System; except that 26 (i) if the balance of the cost of coverage exceeds the 27 amount of the monthly annuity or benefit payment, the 28 difference shall be paid directly to the Teachers' 29 Retirement System by the TRS benefit recipient, and (ii) 30 all or part of the balance of the cost of coverage may, 31 at the school board's option, be paid to the Teachers' 32 Retirement System by the school board of the school 33 district from which the TRS benefit recipient retired, in 34 accordance with Section 10-22.3b of the School Code. The -4- LRB9213029JMmb 1 Teachers' Retirement System shall promptly deposit all 2 moneys withheld by or paid to it under this subdivision 3 (e)(4) into the Teacher Health Insurance Security Fund. 4 These moneys shall not be considered assets of the 5 Retirement System. 6 (f) Financing. Beginning July 1, 1995, all revenues 7 arising from the administration of the health benefit 8 programs established under Article 16 of the Illinois Pension 9 Code or this Section shall be deposited into the Teacher 10 Health Insurance Security Fund, which is hereby created as a 11 nonappropriated trust fund to be held outside the State 12 Treasury, with the State Treasurer as custodian. Any 13 interest earned on moneys in the Teacher Health Insurance 14 Security Fund shall be deposited into the Fund. 15 Moneys in the Teacher Health Insurance Security Fund 16 shall be used only to pay the costs of the health benefit 17 program established under this Section, including associated 18 administrative costs, and the costs associated with the 19 health benefit program established under Article 16 of the 20 Illinois Pension Code, as authorized in this Section. 21 Beginning July 1, 1995, the Department of Central Management 22 Services may make expenditures from the Teacher Health 23 Insurance Security Fund for those costs. 24 After other funds authorized for the payment of the costs 25 of the health benefit program established under Article 16 of 26 the Illinois Pension Code are exhausted and until January 1, 27 1996 (or such later date as may be agreed upon by the 28 Director of Central Management Services and the Secretary of 29 the Teachers' Retirement System), the Secretary of the 30 Teachers' Retirement System may make expenditures from the 31 Teacher Health Insurance Security Fund as necessary to pay up 32 to 75% of the cost of providing health coverage to eligible 33 benefit recipients (as defined in Sections 16-153.1 and 34 16-153.3 of the Illinois Pension Code) who are enrolled in -5- LRB9213029JMmb 1 the Article 16 health benefit program and to facilitate the 2 transfer of administration of the health benefit program to 3 the Department of Central Management Services. 4 (g) Contract for benefits. The Director shall by 5 contract, self-insurance, or otherwise make available the 6 program of health benefits for TRS benefit recipients and 7 their TRS dependent beneficiaries that is provided for in 8 this Section. The contract or other arrangement for the 9 provision of these health benefits shall be on terms deemed 10 by the Director to be in the best interest of the State of 11 Illinois and the TRS benefit recipients based on, but not 12 limited to, such criteria as administrative cost, service 13 capabilities of the carrier or other contractor, and the 14 costs of the benefits. 15 (h) Continuation and termination of program. It is the 16 intention of the General Assembly that the program of health 17 benefits provided under this Section be maintained on an 18 ongoing, affordable basis through June 30, 2004. The program 19 of health benefits provided under this Section is terminated 20 on July 1, 2004. 21 The program of health benefits provided under this 22 Section may be amended by the State and is not intended to be 23 a pension or retirement benefit subject to protection under 24 Article XIII, Section 5 of the Illinois Constitution. 25 (i) Repeal. This Section is repealed on July 1, 2004. 26 (Source: P.A. 92-505, eff. 12-20-01.)
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