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92nd General Assembly

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Public Act 92-0204

SB936 Enrolled                                 LRB9205934JSpc

    AN ACT concerning State employee health benefits.

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

    Section  5.  The  State  Employees Group Insurance Act of
1971 is amended by changing Section 3 and adding Section 6.14
as follows:

    (5 ILCS 375/3) (from Ch. 127, par. 523)
    Sec.  3.  Definitions.   Unless  the  context   otherwise
requires, the following words and phrases as used in this Act
shall have the following meanings.  The Department may define
these  and other words and phrases separately for the purpose
of implementing specific programs  providing  benefits  under
this Act.
    (a)  "Administrative   service  organization"  means  any
person, firm or corporation experienced in  the  handling  of
claims  which  is  fully  qualified,  financially  sound  and
capable  of meeting the service requirements of a contract of
administration executed with the Department.
    (b)  "Annuitant" means (1) an employee  who  retires,  or
has  retired,  on  or  after  January 1, 1966 on an immediate
annuity under the provisions of Articles 2, 14, 15 (including
an employee who has retired  under  the  optional  retirement
program  established under Section 15-158.2), paragraphs (2),
(3), or (5) of Section 16-106, or Article 18 of the  Illinois
Pension   Code;  (2)  any  person  who  was  receiving  group
insurance coverage under this Act as of  March  31,  1978  by
reason of his status as an annuitant, even though the annuity
in  relation  to  which  such  coverage  was  provided  is  a
proportional annuity based on less than the minimum period of
service  required  for  a  retirement  annuity  in the system
involved; (3) any person not otherwise covered  by  this  Act
who  has retired as a participating member under Article 2 of
the  Illinois  Pension  Code  but  is  ineligible   for   the
retirement  annuity  under  Section  2-119  of  the  Illinois
Pension Code; (4) the spouse of any person who is receiving a
retirement  annuity  under Article 18 of the Illinois Pension
Code and who  is  covered  under  a  group  health  insurance
program  sponsored  by a governmental employer other than the
State of Illinois and who has irrevocably  elected  to  waive
his  or  her  coverage  under this Act and to have his or her
spouse considered as the "annuitant" under this Act  and  not
as  a  "dependent";  or  (5)  an employee who retires, or has
retired, from a qualified position, as  determined  according
to rules promulgated by the Director, under a qualified local
government  or  a  qualified  rehabilitation  facility  or  a
qualified   domestic   violence   shelter  or  service.  (For
definition of "retired employee", see (p) post).
    (b-5)  "New SERS annuitant" means a  person  who,  on  or
after  January  1,  1998, becomes an annuitant, as defined in
subsection  (b),  by  virtue  of  beginning  to   receive   a
retirement  annuity  under Article 14 of the Illinois Pension
Code, and is eligible to participate in the basic program  of
group health benefits provided for annuitants under this Act.
    (b-6)  "New  SURS annuitant" means a person who (1) on or
after January 1, 1998, becomes an annuitant,  as  defined  in
subsection   (b),   by  virtue  of  beginning  to  receive  a
retirement annuity under Article 15 of the  Illinois  Pension
Code,  (2) has not made the election authorized under Section
15-135.1 of the Illinois Pension Code, and (3) is eligible to
participate in the basic program  of  group  health  benefits
provided for annuitants under this Act.
    (b-7)  "New  TRS  State annuitant" means a person who, on
or after July 1, 1998, becomes an annuitant,  as  defined  in
subsection   (b),   by  virtue  of  beginning  to  receive  a
retirement annuity under Article 16 of the  Illinois  Pension
Code  based  on  service as a teacher as defined in paragraph
(2), (3), or (5) of Section  16-106  of  that  Code,  and  is
eligible  to participate in the basic program of group health
benefits provided for annuitants under this Act.
    (c)  "Carrier"  means  (1)  an   insurance   company,   a
corporation   organized  under  the  Limited  Health  Service
Organization Act or the Voluntary Health Services Plan Act, a
partnership, or other nongovernmental organization, which  is
authorized  to  do  group  life  or  group  health  insurance
business  in  Illinois,  or  (2)  the  State of Illinois as a
self-insurer.
    (d)  "Compensation" means salary or wages  payable  on  a
regular  payroll  by  the State Treasurer on a warrant of the
State Comptroller out of any State, trust or federal fund, or
by the Governor of the State through a disbursing officer  of
the  State  out of a trust or out of federal funds, or by any
Department out of State, trust, federal or other  funds  held
by  the  State Treasurer or the Department, to any person for
personal  services  currently  performed,  and  ordinary   or
accidental  disability  benefits  under  Articles  2,  14, 15
(including ordinary or accidental disability  benefits  under
the  optional  retirement  program  established under Section
15-158.2), paragraphs (2), (3), or (5) of Section 16-106,  or
Article  18  of  the  Illinois  Pension  Code, for disability
incurred after January 1, 1966, or benefits payable under the
Workers'  Compensation  or  Occupational  Diseases   Act   or
benefits  payable  under  a  sick  pay  plan  established  in
accordance   with  Section  36  of  the  State  Finance  Act.
"Compensation" also means salary or wages paid to an employee
of any qualified local government or qualified rehabilitation
facility or a qualified domestic violence shelter or service.
    (e)  "Commission"  means  the   State   Employees   Group
Insurance   Advisory   Commission  authorized  by  this  Act.
Commencing July 1, 1984, "Commission" as  used  in  this  Act
means   the   Illinois  Economic  and  Fiscal  Commission  as
established by the Legislative Commission Reorganization  Act
of 1984.
    (f)  "Contributory",  when  referred  to  as contributory
coverage, shall mean optional coverages or  benefits  elected
by  the  member  toward  the  cost of which such member makes
contribution, or which are funded in whole or in part through
the acceptance of a reduction in earnings or the foregoing of
an increase in earnings by an employee, as distinguished from
noncontributory coverage or benefits which are paid  entirely
by  the  State  of Illinois without reduction of the member's
salary.
    (g)  "Department"  means  any  department,   institution,
board,  commission, officer, court or any agency of the State
government  receiving  appropriations  and  having  power  to
certify payrolls to the Comptroller authorizing  payments  of
salary  and  wages against such appropriations as are made by
the General Assembly from any State fund,  or  against  trust
funds  held  by  the  State  Treasurer and includes boards of
trustees of the retirement systems created by Articles 2, 14,
15, 16 and 18 of the  Illinois  Pension  Code.   "Department"
also  includes  the  Illinois  Comprehensive Health Insurance
Board, the Board of Examiners established under the  Illinois
Public Accounting Act, and the Illinois Rural Bond Bank.
    (h)  "Dependent", when the term is used in the context of
the  health  and  life  plan, means a member's spouse and any
unmarried child (1) from birth to age 19 including an adopted
child, a child who lives with the member from the time of the
filing of a petition for adoption until entry of an order  of
adoption,  a stepchild or recognized child who lives with the
member in a parent-child relationship, or a child  who  lives
with  the member if such member is a court appointed guardian
of the child, or (2) age 19 to 23  enrolled  as  a  full-time
student  in any accredited school, financially dependent upon
the member, and eligible to be claimed  as  a  dependent  for
income tax purposes, or (3) age 19 or over who is mentally or
physically  handicapped.  For  the health plan only, the term
"dependent" also includes any person enrolled  prior  to  the
effective  date  of  this  Section  who is dependent upon the
member to the extent that the member may claim such person as
a dependent for income tax deduction purposes; no other  such
person  may  be enrolled.  For the health plan only, the term
"dependent" also includes any person who has  received  after
June  30,  2000  an  organ  transplant and who is financially
dependent upon the member and eligible to  be  claimed  as  a
dependent for income tax purposes.
    (i)  "Director"   means  the  Director  of  the  Illinois
Department of Central Management Services.
    (j)  "Eligibility period" means  the  period  of  time  a
member  has  to  elect  enrollment  in  programs or to select
benefits without regard to age, sex or health.
    (k)  "Employee"  means  and  includes  each  officer   or
employee  in the service of a department who (1) receives his
compensation for service rendered  to  the  department  on  a
warrant   issued   pursuant  to  a  payroll  certified  by  a
department or on a warrant or check issued  and  drawn  by  a
department  upon  a  trust,  federal  or  other  fund or on a
warrant issued pursuant to a payroll certified by an  elected
or  duly  appointed  officer  of  the  State  or who receives
payment of the performance of personal services on a  warrant
issued  pursuant  to  a payroll certified by a Department and
drawn by the Comptroller upon  the  State  Treasurer  against
appropriations  made by the General Assembly from any fund or
against trust funds held by the State Treasurer, and  (2)  is
employed  full-time  or  part-time  in  a  position  normally
requiring actual performance of duty during not less than 1/2
of  a  normal  work period, as established by the Director in
cooperation with each department, except that persons elected
by popular vote  will  be  considered  employees  during  the
entire  term  for  which they are elected regardless of hours
devoted to the service of the  State,  and  (3)  except  that
"employee" does not include any person who is not eligible by
reason  of  such person's employment to participate in one of
the State retirement systems under Articles 2, 14, 15 (either
the regular Article 15  system  or  the  optional  retirement
program  established  under Section 15-158.2) or 18, or under
paragraph (2), (3), or (5) of Section 16-106, of the Illinois
Pension Code, but such term  does  include  persons  who  are
employed  during  the 6 month qualifying period under Article
14 of the Illinois Pension Code.  Such term also includes any
person who (1) after January 1, 1966, is  receiving  ordinary
or  accidental  disability  benefits under Articles 2, 14, 15
(including ordinary or accidental disability  benefits  under
the  optional  retirement  program  established under Section
15-158.2), paragraphs (2), (3), or (5) of Section 16-106,  or
Article  18  of  the  Illinois  Pension  Code, for disability
incurred after January 1, 1966, (2) receives total  permanent
or total temporary disability under the Workers' Compensation
Act  or  Occupational  Disease  Act  as  a result of injuries
sustained or illness contracted in the course  of  employment
with  the  State of Illinois, or (3) is not otherwise covered
under this Act and has  retired  as  a  participating  member
under   Article  2  of  the  Illinois  Pension  Code  but  is
ineligible for the retirement annuity under Section 2-119  of
the  Illinois  Pension Code.  However, a person who satisfies
the criteria of the foregoing definition of "employee" except
that such person is made ineligible  to  participate  in  the
State   Universities  Retirement  System  by  clause  (4)  of
subsection (a) of Section 15-107 of the Illinois Pension Code
is  also  an  "employee"  for  the  purposes  of  this   Act.
"Employee" also includes any person receiving or eligible for
benefits under a sick pay plan established in accordance with
Section 36 of the State Finance Act. "Employee" also includes
each  officer or employee in the service of a qualified local
government,  including  persons  appointed  as  trustees   of
sanitary districts regardless of hours devoted to the service
of the sanitary district, and each employee in the service of
a   qualified  rehabilitation  facility  and  each  full-time
employee in the service  of  a  qualified  domestic  violence
shelter   or   service,  as  determined  according  to  rules
promulgated by the Director.
    (l)  "Member"  means  an  employee,  annuitant,   retired
employee or survivor.
    (m)  "Optional   coverages   or   benefits"  means  those
coverages or benefits available to the member on his  or  her
voluntary election, and at his or her own expense.
    (n)  "Program"  means  the  group  life insurance, health
benefits and other employee benefits designed and  contracted
for by the Director under this Act.
    (o)  "Health   plan"  means  a  health  benefits  program
offered by the State of Illinois for persons eligible for the
plan.
    (p)  "Retired employee" means any person who would be  an
annuitant  as  that  term  is defined herein but for the fact
that such person retired prior to January 1, 1966.  Such term
also includes any person formerly employed by the  University
of Illinois in the Cooperative Extension Service who would be
an  annuitant  but  for  the  fact  that such person was made
ineligible  to  participate   in   the   State   Universities
Retirement  System by clause (4) of subsection (a) of Section
15-107 of the Illinois Pension Code.
    (q)  "Survivor" means a person receiving an annuity as  a
survivor  of an employee or of an annuitant.  "Survivor" also
includes:  (1)  the  surviving  dependent  of  a  person  who
satisfies the  definition  of  "employee"  except  that  such
person  is  made  ineligible  to  participate  in  the  State
Universities  Retirement  System  by clause (4) of subsection
(a) of Section 15-107 of the Illinois Pension Code;  and  (2)
the  surviving  dependent  of any person formerly employed by
the University  of  Illinois  in  the  Cooperative  Extension
Service  who  would  be an annuitant except for the fact that
such person was made ineligible to participate in  the  State
Universities  Retirement  System  by clause (4) of subsection
(a) of Section 15-107 of the Illinois Pension Code.
    (q-5)  "New SERS survivor" means a survivor,  as  defined
in  subsection (q), whose annuity is paid under Article 14 of
the Illinois Pension Code and is based on the death of (i) an
employee whose death occurs on or after January 1,  1998,  or
(ii) a new SERS annuitant as defined in subsection (b-5).
    (q-6)  "New  SURS  survivor" means a survivor, as defined
in subsection (q), whose annuity is paid under Article 15  of
the Illinois Pension Code and is based on the death of (i) an
employee  whose  death occurs on or after January 1, 1998, or
(ii) a new SURS annuitant as defined in subsection (b-6).
    (q-7)  "New TRS State  survivor"  means  a  survivor,  as
defined  in  subsection  (q),  whose  annuity  is  paid under
Article 16 of the Illinois Pension Code and is based  on  the
death  of  (i)  an  employee  who  is a teacher as defined in
paragraph (2), (3), or (5) of Section 16-106 of that Code and
whose death occurs on or after July 1, 1998, or  (ii)  a  new
TRS State annuitant as defined in subsection (b-7).
    (r)  "Medical   services"  means  the  services  provided
within the scope of their licenses by  practitioners  in  all
categories licensed under the Medical Practice Act of 1987.
    (s)  "Unit   of   local  government"  means  any  county,
municipality, township, school district, special district  or
other  unit, designated as a unit of local government by law,
which exercises limited  governmental  powers  or  powers  in
respect  to limited governmental subjects, any not-for-profit
association  with  a  membership  that   primarily   includes
townships  and  township  officials,  that  has  duties  that
include  provision  of  research  service,  dissemination  of
information,  and  other  acts  for  the purpose of improving
township government, and that is funded wholly or  partly  in
accordance  with  Section  85-15  of  the  Township Code; any
not-for-profit corporation or association, with a  membership
consisting primarily of municipalities, that operates its own
utility    system,    and    provides   research,   training,
dissemination  of  information,  or  other  acts  to  promote
cooperation between and  among  municipalities  that  provide
utility  services  and  for  the advancement of the goals and
purposes of its membership; the Southern Illinois  Collegiate
Common  Market,  which  is  a  consortium of higher education
institutions  in  Southern   Illinois;   and   the   Illinois
Association  of Park Districts.  "Qualified local government"
means a unit of local government approved by the Director and
participating in a program created under  subsection  (i)  of
Section 10 of this Act.
    (t)  "Qualified   rehabilitation   facility"   means  any
not-for-profit  organization  that  is  accredited   by   the
Commission  on  Accreditation of Rehabilitation Facilities or
certified by the Department of Human Services  (as  successor
to   the   Department  of  Mental  Health  and  Developmental
Disabilities)   to   provide   services   to   persons   with
disabilities and which  receives  funds  from  the  State  of
Illinois  for  providing  those  services,  approved  by  the
Director   and  participating  in  a  program  created  under
subsection (j) of Section 10 of this Act.
    (u)  "Qualified domestic  violence  shelter  or  service"
means  any  Illinois domestic violence shelter or service and
its administrative offices funded by the Department of  Human
Services  (as  successor to the Illinois Department of Public
Aid), approved by the Director and participating in a program
created under subsection (k) of Section 10.
    (v)  "TRS benefit recipient" means a person who:
         (1)  is not a "member" as defined in  this  Section;
    and
         (2)  is  receiving  a  monthly benefit or retirement
    annuity under Article 16 of the  Illinois  Pension  Code;
    and
         (3)  either  (i)  has at least 8 years of creditable
    service under Article 16 of the Illinois Pension Code, or
    (ii) was enrolled in the health insurance program offered
    under that Article on January 1, 1996, or  (iii)  is  the
    survivor  of a benefit recipient who had at least 8 years
    of creditable service under Article 16  of  the  Illinois
    Pension  Code  or  was  enrolled  in the health insurance
    program offered under that Article on the effective  date
    of this amendatory Act of 1995, or (iv) is a recipient or
    survivor  of  a  recipient  of a disability benefit under
    Article 16 of the Illinois Pension Code.
    (w)  "TRS dependent beneficiary" means a person who:
         (1)  is not a "member" or "dependent" as defined  in
    this Section; and
         (2)  is  a  TRS benefit recipient's: (A) spouse, (B)
    dependent parent who is receiving at least half of his or
    her support  from  the  TRS  benefit  recipient,  or  (C)
    unmarried  natural  or adopted child who is (i) under age
    19, or  (ii)  enrolled  as  a  full-time  student  in  an
    accredited  school,  financially  dependent  upon the TRS
    benefit recipient, eligible to be claimed as a  dependent
    for  income  tax  purposes, and either is under age 24 or
    was, on January 1, 1996,  participating  as  a  dependent
    beneficiary in the health insurance program offered under
    Article  16 of the Illinois Pension Code, or (iii) age 19
    or over who is mentally or physically handicapped.
    (x)  "Military leave with pay  and  benefits"  refers  to
individuals  in basic training for reserves, special/advanced
training, annual training, emergency call up,  or  activation
by  the  President of the United States with approved pay and
benefits.
    (y)  "Military leave without pay and benefits" refers  to
individuals who enlist for active duty in a regular component
of  the  U.S.  Armed  Forces  or  other duty not specified or
authorized under military leave with pay and benefits.
    (z)  "Community college benefit recipient" means a person
who:
         (1)  is not a "member" as defined in  this  Section;
    and
         (2)  is  receiving  a  monthly survivor's annuity or
    retirement annuity  under  Article  15  of  the  Illinois
    Pension Code; and
         (3)  either  (i)  was  a  full-time  employee  of  a
    community college district or an association of community
    college boards created under the Public Community College
    Act  (other  than  an  employee whose last employer under
    Article 15 of the Illinois Pension Code was  a  community
    college  district  subject  to  Article VII of the Public
    Community College Act) and was eligible to participate in
    a group health benefit plan as  an  employee  during  the
    time  of  employment  with  a  community college district
    (other than  a  community  college  district  subject  to
    Article  VII  of  the Public Community College Act) or an
    association of community college boards, or (ii)  is  the
    survivor of a person described in item (i).
    (aa)  "Community  college  dependent beneficiary" means a
person who:
         (1)  is not a "member" or "dependent" as defined  in
    this Section; and
         (2)  is a community college benefit recipient's: (A)
    spouse,  (B)  dependent  parent who is receiving at least
    half of his or her support  from  the  community  college
    benefit  recipient,  or  (C) unmarried natural or adopted
    child who is (i) under age 19,  or  (ii)  enrolled  as  a
    full-time  student  in  an accredited school, financially
    dependent upon the community college  benefit  recipient,
    eligible  to  be  claimed  as  a dependent for income tax
    purposes and under age 23, or (iii) age 19  or  over  and
    mentally or physically handicapped.
(Source: P.A. 90-14, eff. 7-1-97; 90-65, eff. 7-7-97; 90-448,
eff.  8-16-97;  90-497,  eff.  8-18-97; 90-511, eff. 8-22-97;
90-582, eff. 5-27-98;  90-655,  eff.  7-30-98;  91-390,  eff.
7-30-99;  91-395, eff. 7-30-99; 91-617, eff, 8-19-99; revised
10-19-99.)

    (5 ILCS 375/6.14 new)
    Sec. 6.14.  Organ donor  costs.  With  respect  to  organ
transplants  occurring  after June 30, 2000 when both a donor
and donee are members of the same family and are both covered
by the program of health  benefits,  the  program  of  health
benefits  shall  pay 100% of the donor's expenses without the
imposition of any deductible or copayment.

    Section 99.  Effective date.  This Act takes effect  upon
becoming law.
    Passed in the General Assembly May 09, 2001.
    Approved August 01, 2001.

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