102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
HB0706

 

Introduced 2/8/2021, by Rep. Bob Morgan

 

SYNOPSIS AS INTRODUCED:
 
5 ILCS 375/2  from Ch. 127, par. 522
5 ILCS 375/6.1  from Ch. 127, par. 526.1
5 ILCS 375/6.2  from Ch. 127, par. 526.2
5 ILCS 375/7  from Ch. 127, par. 527
5 ILCS 375/8  from Ch. 127, par. 528
5 ILCS 375/10  from Ch. 127, par. 530
5 ILCS 375/13  from Ch. 127, par. 533
5 ILCS 375/13.1  from Ch. 127, par. 533.1
40 ILCS 5/15-158.3

    Amends the State Employees Group Insurance Act of 1971. Provides that the program of health benefits may offer as an alternative, available on an optional basis, coverage through health maintenance organizations or other managed care programs. Provides that the election to participate in a program of health benefits under the Act must be made during the annual benefit choice period or upon showing a qualifying change in status as defined in the U.S. Internal Revenue Code. Further modifies the conditions of eligibility to participate in a program of health benefits. Provides that refunds to members for premiums paid for optional life insurance coverage may be paid from the Group Insurance Premium Fund. Makes other changes concerning a program of health benefits as provided under the Act. Amends the State Universities Article of the Illinois Pension Code. Removes a provision requiring the Department of Central Management Services to prepare a report showing, on a fiscal year by fiscal year basis, the amount by which the State's cost for health insurance coverage under the State Employees Group Insurance Act of 1971 for retirees of the State's universities and their survivors has declined as a result of requiring some of those retirees and survivors to contribute to the cost of their basic health insurance. Effective July 1, 2021.


LRB102 11853 RJF 17189 b

 

 

A BILL FOR

 

HB0706LRB102 11853 RJF 17189 b

1    AN ACT concerning government.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The State Employees Group Insurance Act of 1971
5is amended by changing Sections 2, 6.1, 6.2, 7, 8, 10, 13, and
613.1 as follows:
 
7    (5 ILCS 375/2)  (from Ch. 127, par. 522)
8    Sec. 2. Purpose. The purpose of this Act is to provide a
9program of group life insurance, a program of health benefits
10and other employee benefits for persons in the service of the
11State of Illinois, employees of local governments, employees
12of rehabilitation facilities, employees of domestic violence
13shelters and services, and employees of child advocacy
14centers, and certain of their dependents. It is also the
15purpose of this Act to provide a program of health benefits (i)
16for certain benefit recipients of the Teachers' Retirement
17System of the State of Illinois and their dependent
18beneficiaries, and (ii) for certain eligible retired community
19college employees and their dependent beneficiaries, and (iii)
20for employees of local governments, employees of
21rehabilitation facilities, employees of domestic violence
22shelters and services, and employees of child advocacy
23centers, and certain of their dependents.

 

 

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1(Source: P.A. 94-860, eff. 6-16-06.)
 
2    (5 ILCS 375/6.1)  (from Ch. 127, par. 526.1)
3    Sec. 6.1. The program of health benefits may offer as an
4alternative, available on an optional basis, coverage through
5health maintenance organizations or other managed care
6programs. That part of the premium for such coverage which is
7in excess of the amount which would otherwise be paid by the
8State for the program of health benefits shall be paid by the
9member who elects such alternative coverage and shall be
10collected as provided for premiums for other optional
11coverages.
12(Source: P.A. 100-538, eff. 1-1-18.)
 
13    (5 ILCS 375/6.2)  (from Ch. 127, par. 526.2)
14    Sec. 6.2. When the Director, with the advice and consent
15of the Commission, determines that it would be in the best
16interests of the State and its employees, any the program of
17health benefits under this Act may be administered with the
18State as a self-insurer in whole or in part. The State assumes
19the risks of any such the program. The State may provide the
20administrative services in connection with any the
21self-insurance health plan or purchase administrative services
22from an administrative service organization. A plan of
23self-insurance may combine forms of re-insurance or stop-loss
24insurance which limits the amount of State liability.

 

 

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1    The program of health benefits shall provide a
2continuation and conversion privilege for persons whose State
3employment is terminated and a continuation privilege for
4members' spouses and dependent children who are covered under
5the provisions of the program, consistent with the
6requirements of federal law and Sections 367.2, 367e, and
7367e.1 of the Illinois Insurance Code.
8(Source: P.A. 93-477, eff. 1-1-04.)
 
9    (5 ILCS 375/7)  (from Ch. 127, par. 527)
10    Sec. 7. Group life insurance program.
11    (a) The basic noncontributory group life insurance program
12shall provide coverage as follows:
13        (1) employees shall be insured in an amount equal to
14    the basic annual salary rate, exclusive of overtime,
15    bonus, or other cumulative additional income factors,
16    raised to the next round hundred dollar amount if it is not
17    already a round hundred dollar amount;
18        (2) annuitants shall be insured in the same manner as
19    described for active employees, based on the salary in
20    force immediately before retirement, with coverage
21    becoming effective on the effective date of retirement
22    benefits or the first day of the month of application,
23    whichever occurs later, except that at age 60 the amount
24    of coverage for the annuitant shall be reduced to $5,000;
25        (3) survivors whose coverage became effective prior to

 

 

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1    September 22, 1979 shall be insured for $2,000;
2        (4) retired employees shall not be eligible under the
3    group life insurance program contracted to begin or
4    continue after June 30, 1973.
5    (a-5) There shall also be available on an optional basis
6to employees, annuitants whose retirement benefits begin
7within one year of their receipt of final compensation, and
8survivors whose coverage became effective prior to September
922, 1979, a contributory program of:
10        (1) supplemental life insurance in an amount not
11    exceeding 8 times the basic life benefits for active
12    employees and annuitants under age 60 and not exceeding 4
13    times the basic life benefits for annuitants age 60 and
14    over, as described above, except that (a) amounts selected
15    by employees and annuitants must be in full multiples of
16    the basic amount, and (b) premiums may be adjusted by age
17    bracket established in rules supplementing this Act;
18    beginning July 1, 1981, survivors whose coverage becomes
19    effective on or after September 22, 1979, shall have the
20    option of participating in the contributory program of
21    life insurance in an amount of $5,000 coverage;
22        (2) accidental death and dismemberment, with the
23    employee and annuitant having the option of electing an
24    amount equal to the basic noncontributory life benefits
25    only, or an amount equaling the combined total of basic
26    plus optional life benefits not exceeding 5 times basic

 

 

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1    life benefits, or $3,000,000, whichever is less;
2        (3) dependent life insurance in an amount of $10,000
3    coverage on the spouse; however, coverage reduces to
4    $5,000 when the eligible spouse annuitant turns 60; and
5        (4) dependent life insurance in an amount of $10,000
6    coverage on each dependent other than the spouse.
7    (b) A member, not otherwise covered by this Act, who has
8retired as a participating member under Article 2 of the
9Illinois Pension Code, but is ineligible for the retirement
10annuity under Section 2-119 of the Illinois Pension Code,
11shall pay the premiums for coverage under the group life
12insurance program under this Act. The Director shall
13promulgate rules and regulations to determine the premiums to
14be paid by a member under this subsection (b).
15(Source: P.A. 94-95, eff. 7-1-05.)
 
16    (5 ILCS 375/8)  (from Ch. 127, par. 528)
17    Sec. 8. Eligibility.
18    (a) Each employee eligible under the provisions of this
19Act and any rules and regulations promulgated and adopted
20hereunder by the Director shall become immediately eligible
21and covered for all benefits available under the programs.
22Employees electing coverage for eligible dependents shall have
23the coverage effective immediately, provided that the election
24is properly filed in accordance with required filing dates and
25procedures specified by the Director, including the completion

 

 

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1and submission of all documentation and forms required by the
2Director.
3        (1) Every member originally eligible to elect
4    dependent coverage, but not electing it during the
5    original eligibility period, may subsequently obtain
6    dependent coverage only in the event of a qualifying
7    change in status, special enrollment, special circumstance
8    as defined by the Director, or during the annual Benefit
9    Choice Period.
10        (2) Members described above being transferred from
11    previous coverage towards which the State has been
12    contributing shall be transferred regardless of
13    preexisting conditions, waiting periods, or other
14    requirements that might jeopardize claim payments to which
15    they would otherwise have been entitled.
16        (3) Eligible and covered members that are eligible for
17    coverage as dependents except for the fact of being
18    members shall be transferred to, and covered under,
19    dependent status regardless of preexisting conditions,
20    waiting periods, or other requirements that might
21    jeopardize claim payments to which they would otherwise
22    have been entitled upon cessation of member status and the
23    election of dependent coverage by a member eligible to
24    elect that coverage.
25    (b) New employees shall be immediately insured for the
26basic group life insurance and covered by the program of

 

 

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1health benefits on the first day of active State service.
2Optional life insurance coverage one to 4 times the basic
3amount, if elected during the relevant eligibility period,
4will become effective on the date of employment. Optional life
5insurance coverage exceeding 4 times the basic amount and all
6life insurance amounts applied for after the eligibility
7period will be effective, subject to satisfactory evidence of
8insurability when applicable, or other necessary
9qualifications, pursuant to the requirements of the applicable
10benefit program, unless there is a change in status that would
11confer new eligibility for change of enrollment under rules
12established supplementing this Act, in which event application
13must be made within the new eligibility period.
14    (c) As to the group health benefits program contracted to
15begin or continue after June 30, 1973, each annuitant,
16survivor, and retired employee shall become immediately
17eligible for all benefits available under that program. Each
18annuitant, survivor, and retired employee shall have coverage
19effective immediately, provided that the election is properly
20filed in accordance with the required filing dates and
21procedures specified by the Director, including the completion
22and submission of all documentation and forms required by the
23Director. Annuitants, survivors, and retired employees may
24elect coverage for eligible dependents and shall have the
25coverage effective immediately, provided that the election is
26properly filed in accordance with required filing dates and

 

 

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1procedures specified by the Director, except that, for a
2survivor, the dependent sought to be added on or after the
3effective date of this amendatory Act of the 97th General
4Assembly must have been eligible for coverage as a dependent
5under the deceased member upon whom the survivor's annuity is
6based in order to be eligible for coverage under the survivor.
7    Except as otherwise provided in this Act, where husband
8and wife are both eligible members, each shall be enrolled as a
9member and coverage on their eligible dependent children, if
10any, may be under the enrollment and election of either.
11    Regardless of other provisions herein regarding late
12enrollment or other qualifications, as appropriate, the
13Director may periodically authorize open enrollment periods
14for each of the benefit programs at which time each member may
15elect enrollment or change of enrollment without regard to
16age, sex, health, or other qualification under the conditions
17as may be prescribed in rules and regulations supplementing
18this Act. Special open enrollment periods may be declared by
19the Director for certain members only when special
20circumstances occur that affect only those members.
21    (d) Eligible Beginning with fiscal year 2003 and for all
22subsequent years, eligible members may elect not to
23participate in the program of health benefits as defined in
24this Act. The election must be made during the annual benefit
25choice period or upon showing a qualifying change in status as
26defined in the U.S. Internal Revenue Code, subject to the

 

 

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1conditions in this subsection.
2        (1) (Blank). Members must furnish proof of health
3    benefit coverage, either comprehensive major medical
4    coverage or comprehensive managed care plan, from a source
5    other than the Department of Central Management Services
6    in order to elect not to participate in the program.
7        (2) Members may re-enroll in the Department of Central
8    Management Services program of health benefits upon
9    showing a qualifying change in status, as defined in the
10    U.S. Internal Revenue Code, without evidence of
11    insurability and with no limitations on coverage for
12    pre-existing conditions, provided that there was not a
13    break in coverage of more than 63 days.
14        (3) Members may also re-enroll in the program of
15    health benefits during any annual benefit choice period,
16    without evidence of insurability.
17        (4) Members who elect not to participate in the
18    program of health benefits shall be furnished a written
19    explanation of the requirements and limitations for the
20    election not to participate in the program and for
21    re-enrolling in the program. The explanation shall also be
22    included in the annual benefit choice options booklets
23    furnished to members.
24    (d-5) Beginning July 1, 2005, the Director may establish a
25program of financial incentives to encourage annuitants
26receiving a retirement annuity, but who are not eligible for

 

 

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1benefits under the federal Medicare health insurance program
2(Title XVIII of the Social Security Act, as added by Public Law
389-97) to elect not to participate in the program of health
4benefits provided under this Act. The election by an annuitant
5not to participate under this program must be made in
6accordance with the requirements set forth under subsection
7(d). The financial incentives provided to these annuitants
8under the program may not exceed $150 per month for each
9annuitant electing not to participate in the program of health
10benefits provided under this Act.
11    (d-6) Beginning July 1, 2013, the Director may establish a
12program of financial incentives to encourage annuitants with
1320 or more years of creditable service but who are not eligible
14for benefits under the federal Medicare health insurance
15program (Title XVIII of the Social Security Act, as added by
16Public Law 89-97) to elect not to participate in the program of
17health benefits provided under this Act. The election by an
18annuitant not to participate under this program must be made
19in accordance with the requirements set forth under subsection
20(d). The program established under this subsection (d-6) may
21include a prorated incentive for annuitants with fewer than 20
22years of creditable service, as determined by the Director.
23The financial incentives provided to these annuitants under
24this program may not exceed $500 per month for each annuitant
25electing not to participate in the program of health benefits
26provided under this Act.

 

 

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1    (e) Notwithstanding any other provision of this Act or the
2rules adopted under this Act, if a person participating in the
3program of health benefits as the dependent spouse of an
4eligible member becomes an annuitant, the person may elect, at
5the time of becoming an annuitant or during any subsequent
6annual benefit choice period, to continue participation as a
7dependent rather than as an eligible member for as long as the
8person continues to be an eligible dependent. In order to be
9eligible to make such an election, the person must have been
10enrolled as a dependent under the program of health benefits
11for no less than one year prior to becoming an annuitant.
12    An eligible member who has elected to participate as a
13dependent may re-enroll in the program of health benefits as
14an eligible member (i) during any subsequent annual benefit
15choice period or (ii) upon showing a qualifying change in
16status, as defined in the U.S. Internal Revenue Code, without
17evidence of insurability and with no limitations on coverage
18for pre-existing conditions.
19    A person who elects to participate in the program of
20health benefits as a dependent rather than as an eligible
21member shall be furnished a written explanation of the
22consequences of electing to participate as a dependent and the
23conditions and procedures for re-enrolling as an eligible
24member. The explanation shall also be included in the annual
25benefit choice options booklet furnished to members.
26(Source: P.A. 97-668, eff. 1-13-12; 98-19, eff. 6-10-13.)
 

 

 

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1    (5 ILCS 375/10)  (from Ch. 127, par. 530)
2    Sec. 10. Contributions by the State and members.
3    (a) The State shall pay the cost of basic non-contributory
4group life insurance and, subject to member paid contributions
5set by the Department or required by this Section and except as
6provided in this Section, the basic program of group health
7benefits on each eligible member, except a member, not
8otherwise covered by this Act, who has retired as a
9participating member under Article 2 of the Illinois Pension
10Code but is ineligible for the retirement annuity under
11Section 2-119 of the Illinois Pension Code, and part of each
12eligible member's and retired member's premiums for health
13insurance coverage for enrolled dependents as provided by
14Section 9. The State shall pay the cost of the basic program of
15group health benefits only after benefits are reduced by the
16amount of benefits covered by Medicare for all members and
17dependents who are eligible for benefits under Social Security
18or the Railroad Retirement system or who had sufficient
19Medicare-covered government employment, except that such
20reduction in benefits shall apply only to those members and
21dependents who (1) first become eligible for such Medicare
22coverage on or after July 1, 1992; or (2) are
23Medicare-eligible members or dependents of a local government
24unit which began participation in the program on or after July
251, 1992; or (3) remain eligible for, but no longer receive

 

 

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1Medicare coverage which they had been receiving on or after
2July 1, 1992. The Department may determine the aggregate level
3of the State's contribution on the basis of actual cost of
4medical services adjusted for age, sex or geographic or other
5demographic characteristics which affect the costs of such
6programs.
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
11and would be an annuitant but for the fact that he or she was
12made ineligible to participate in the State Universities
13Retirement System by clause (4) of subsection (a) of Section
1415-107 of the Illinois Pension Code shall not be greater than
15the cost of participation that would otherwise apply to that
16dependent or survivor if he or she were the dependent or
17survivor of an annuitant under the State Universities
18Retirement System.
19    (a-1) (Blank).
20    (a-2) (Blank).
21    (a-3) (Blank).
22    (a-4) (Blank).
23    (a-5) (Blank).
24    (a-6) (Blank).
25    (a-7) (Blank).
26    (a-8) Any annuitant, survivor, or retired employee may

 

 

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

 

 

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

 

 

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1certified by the Director of Central Management Services.
2    The Department of Central Management Services, or any
3successor agency designated to procure healthcare contracts
4pursuant to this Act, is authorized to establish funds,
5separate accounts provided by any bank or banks as defined by
6the Illinois Banking Act, or separate accounts provided by any
7savings and loan association or associations as defined by the
8Illinois Savings and Loan Act of 1985 to be held by the
9Director, outside the State treasury, for the purpose of
10receiving the transfer of moneys from the Local Government
11Health Insurance Reserve Fund. The Department may promulgate
12rules further defining the methodology for the transfers. Any
13interest earned by moneys in the funds or accounts shall inure
14to the Local Government Health Insurance Reserve Fund. The
15transferred moneys, and interest accrued thereon, shall be
16used exclusively for transfers to administrative service
17organizations or their financial institutions for payments of
18claims to claimants and providers under the self-insurance
19health plan. The transferred moneys, and interest accrued
20thereon, shall not be used for any other purpose including,
21but not limited to, reimbursement of administration fees due
22the administrative service organization pursuant to its
23contract or contracts with the Department.
24    (a-10) To the extent that participation, benefits, or
25premiums under this Act are based on a person's service credit
26under an Article of the Illinois Pension Code, service credit

 

 

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1terminated in exchange for an accelerated pension benefit
2payment under Section 14-147.5, 15-185.5, or 16-190.5 of that
3Code shall be included in determining a person's service
4credit for the purposes of this Act.
5    (b) State employees who become eligible for this program
6on or after January 1, 1980 in positions normally requiring
7actual performance of duty not less than 1/2 of a normal work
8period but not equal to that of a normal work period, shall be
9given the option of participating in the available program. If
10the employee elects coverage, the State shall contribute on
11behalf of such employee to the cost of the employee's benefit
12and any applicable dependent supplement, that sum which bears
13the same percentage as that percentage of time the employee
14regularly works when compared to normal work period.
15    (c) The basic non-contributory coverage from the basic
16program of group health benefits shall be continued for each
17employee not in pay status or on active service by reason of
18(1) leave of absence due to illness or injury, (2) authorized
19educational leave of absence or sabbatical leave, or (3)
20military leave. This coverage shall continue until expiration
21of authorized leave and return to active service, but not to
22exceed 24 months for leaves under item (1) or (2). This
2324-month limitation and the requirement of returning to active
24service shall not apply to persons receiving ordinary or
25accidental disability benefits or retirement benefits through
26the appropriate State retirement system or benefits under the

 

 

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1Workers' Compensation or Occupational Disease Act.
2    (d) The basic group life insurance coverage shall
3continue, with full State contribution, where such person is
4(1) absent from active service by reason of disability arising
5from any cause other than self-inflicted, (2) on authorized
6educational leave of absence or sabbatical leave, or (3) on
7military leave.
8    (e) Where the person is in non-pay status for a period in
9excess of 30 days or on leave of absence, other than by reason
10of disability, educational or sabbatical leave, or military
11leave, such person may continue coverage only by making
12personal payment equal to the amount normally contributed by
13the State on such person's behalf. Such payments and coverage
14may be continued: (1) until such time as the person returns to
15a status eligible for coverage at State expense, but not to
16exceed 24 months or (2) until such person's employment or
17annuitant status with the State is terminated (exclusive of
18any additional service imposed pursuant to law).
19    (f) The Department shall establish by rule the extent to
20which other employee benefits will continue for persons in
21non-pay status or who are not in active service.
22    (g) The State shall not pay the cost of the basic
23non-contributory group life insurance, program of health
24benefits and other employee benefits for members who are
25survivors as defined by paragraphs (1) and (2) of subsection
26(q) of Section 3 of this Act. The costs of benefits for these

 

 

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1survivors shall be paid by the survivors or by the University
2of Illinois Cooperative Extension Service, or any combination
3thereof. However, the State shall pay the amount of the
4reduction in the cost of participation, if any, resulting from
5the amendment to subsection (a) made by this amendatory Act of
6the 91st General Assembly.
7    (h) Those persons occupying positions with any department
8as a result of emergency appointments pursuant to Section 8b.8
9of the Personnel Code who are not considered employees under
10this Act shall be given the option of participating in the
11programs of group life insurance, health benefits and other
12employee benefits. Such persons electing coverage may
13participate only by making payment equal to the amount
14normally contributed by the State for similarly situated
15employees. Such amounts shall be determined by the Director.
16Such payments and coverage may be continued until such time as
17the person becomes an employee pursuant to this Act or such
18person's appointment is terminated.
19    (i) Any unit of local government within the State of
20Illinois may apply to the Director to have its employees,
21annuitants, and their dependents provided group health
22coverage under this Act on a non-insured basis. To
23participate, a unit of local government must agree to enroll
24all of its employees, who may select coverage under any either
25the State group health benefits plan made available by the
26Department under the health benefits program established under

 

 

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1this Section or a health maintenance organization that has
2contracted with the State to be available as a health care
3provider for employees as defined in this Act. A unit of local
4government must remit the entire cost of providing coverage
5under the health benefits program established under this
6Section the State group health benefits plan or, for coverage
7under a health maintenance organization, an amount determined
8by the Director based on an analysis of the sex, age,
9geographic location, or other relevant demographic variables
10for its employees, except that the unit of local government
11shall not be required to enroll those of its employees who are
12covered spouses or dependents under the State group health
13benefits this plan or another group policy or plan providing
14health benefits as long as (1) an appropriate official from
15the unit of local government attests that each employee not
16enrolled is a covered spouse or dependent under this plan or
17another group policy or plan, and (2) at least 50% of the
18employees are enrolled and the unit of local government remits
19the entire cost of providing coverage to those employees,
20except that a participating school district must have enrolled
21at least 50% of its full-time employees who have not waived
22coverage under the district's group health plan by
23participating in a component of the district's cafeteria plan.
24A participating school district is not required to enroll a
25full-time employee who has waived coverage under the
26district's health plan, provided that an appropriate official

 

 

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1from the participating school district attests that the
2full-time employee has waived coverage by participating in a
3component of the district's cafeteria plan. For the purposes
4of this subsection, "participating school district" includes a
5unit of local government whose primary purpose is education as
6defined by the Department's rules.
7    Employees of a participating unit of local government who
8are not enrolled due to coverage under another group health
9policy or plan may enroll in the event of a qualifying change
10in status, special enrollment, special circumstance as defined
11by the Director, or during the annual Benefit Choice Period. A
12participating unit of local government may also elect to cover
13its annuitants. Dependent coverage shall be offered on an
14optional basis, with the costs paid by the unit of local
15government, its employees, or some combination of the two as
16determined by the unit of local government. The unit of local
17government shall be responsible for timely collection and
18transmission of dependent premiums.
19    The Director shall annually determine monthly rates of
20payment, subject to the following constraints:
21        (1) In the first year of coverage, the rates shall be
22    equal to the amount normally charged to State employees
23    for elected optional coverages or for enrolled dependents
24    coverages or other contributory coverages, or contributed
25    by the State for basic insurance coverages on behalf of
26    its employees, adjusted for differences between State

 

 

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1    employees and employees of the local government in age,
2    sex, geographic location or other relevant demographic
3    variables, plus an amount sufficient to pay for the
4    additional administrative costs of providing coverage to
5    employees of the unit of local government and their
6    dependents.
7        (2) In subsequent years, a further adjustment shall be
8    made to reflect the actual prior years' claims experience
9    of the employees of the unit of local government.
10    In the case of coverage of local government employees
11under a health maintenance organization, the Director shall
12annually determine for each participating unit of local
13government the maximum monthly amount the unit may contribute
14toward that coverage, based on an analysis of (i) the age, sex,
15geographic location, and other relevant demographic variables
16of the unit's employees and (ii) the cost to cover those
17employees under the State group health benefits plan. The
18Director may similarly determine the maximum monthly amount
19each unit of local government may contribute toward coverage
20of its employees' dependents under a health maintenance
21organization.
22    Monthly payments by the unit of local government or its
23employees for group health benefits plan or health maintenance
24organization coverage shall be deposited in the Local
25Government Health Insurance Reserve Fund.
26    The Local Government Health Insurance Reserve Fund is

 

 

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1hereby created as a nonappropriated trust fund to be held
2outside the State Treasury, with the State Treasurer as
3custodian. The Local Government Health Insurance Reserve Fund
4shall be a continuing fund not subject to fiscal year
5limitations. The Local Government Health Insurance Reserve
6Fund is not subject to administrative charges or charge-backs,
7including but not limited to those authorized under Section 8h
8of the State Finance Act. All revenues arising from the
9administration of the health benefits program established
10under this Section shall be deposited into the Local
11Government Health Insurance Reserve Fund. Any interest earned
12on moneys in the Local Government Health Insurance Reserve
13Fund shall be deposited into the Fund. All expenditures from
14this Fund shall be used for payments for health care benefits
15for local government and rehabilitation facility employees,
16annuitants, and dependents, and to reimburse the Department or
17its administrative service organization for all expenses
18incurred in the administration of benefits. No other State
19funds may be used for these purposes.
20    A local government employer's participation or desire to
21participate in a program created under this subsection shall
22not limit that employer's duty to bargain with the
23representative of any collective bargaining unit of its
24employees.
25    (j) Any rehabilitation facility within the State of
26Illinois may apply to the Director to have its employees,

 

 

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

 

 

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1    The Director shall annually determine quarterly rates of
2payment, subject to the following constraints:
3        (1) In the first year of coverage, the rates shall be
4    equal to the amount normally charged to State employees
5    for elected optional coverages or for enrolled dependents
6    coverages or other contributory coverages on behalf of its
7    employees, adjusted for differences between State
8    employees and employees of the rehabilitation facility in
9    age, sex, geographic location or other relevant
10    demographic variables, plus an amount sufficient to pay
11    for the additional administrative costs of providing
12    coverage to employees of the rehabilitation facility and
13    their dependents.
14        (2) In subsequent years, a further adjustment shall be
15    made to reflect the actual prior years' claims experience
16    of the employees of the rehabilitation facility.
17    Monthly payments by the rehabilitation facility or its
18employees for group health benefits shall be deposited in the
19Local Government Health Insurance Reserve Fund.
20    (k) Any domestic violence shelter or service within the
21State of Illinois may apply to the Director to have its
22employees, annuitants, and their dependents provided group
23health coverage under this Act on a non-insured basis. To
24participate, a domestic violence shelter or service must agree
25to enroll all of its employees and pay the entire cost of
26providing such coverage for its employees. The domestic

 

 

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1violence shelter shall not be required to enroll those of its
2employees who are covered spouses or dependents under this
3plan or another group policy or plan providing health benefits
4as long as (1) an appropriate official from the domestic
5violence shelter attests that each employee not enrolled is a
6covered spouse or dependent under this plan or another group
7policy or plan and (2) at least 50% of the employees are
8enrolled and the domestic violence shelter remits the entire
9cost of providing coverage to those employees. Employees of a
10participating domestic violence shelter who are not enrolled
11due to coverage under another group health policy or plan may
12enroll in the event of a qualifying change in status, special
13enrollment, or special circumstance as defined by the Director
14or during the annual Benefit Choice Period. A participating
15domestic violence shelter may also elect to cover its
16annuitants. Dependent coverage shall be offered on an optional
17basis, with employees, or some combination of the 2 as
18determined by the domestic violence shelter or service. The
19domestic violence shelter or service shall be responsible for
20timely collection and transmission of dependent premiums.
21    The Director shall annually determine rates of payment,
22subject to the following constraints:
23        (1) In the first year of coverage, the rates shall be
24    equal to the amount normally charged to State employees
25    for elected optional coverages or for enrolled dependents
26    coverages or other contributory coverages on behalf of its

 

 

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1    employees, adjusted for differences between State
2    employees and employees of the domestic violence shelter
3    or service in age, sex, geographic location or other
4    relevant demographic variables, plus an amount sufficient
5    to pay for the additional administrative costs of
6    providing coverage to employees of the domestic violence
7    shelter or service and their dependents.
8        (2) In subsequent years, a further adjustment shall be
9    made to reflect the actual prior years' claims experience
10    of the employees of the domestic violence shelter or
11    service.
12    Monthly payments by the domestic violence shelter or
13service or its employees for group health insurance shall be
14deposited in the Local Government Health Insurance Reserve
15Fund.
16    (l) A public community college or entity organized
17pursuant to the Public Community College Act may apply to the
18Director initially to have only annuitants not covered prior
19to July 1, 1992 by the district's health plan provided health
20coverage under this Act on a non-insured basis. The community
21college must execute a 2-year contract to participate in the
22Local Government Health Plan. Any annuitant may enroll in the
23event of a qualifying change in status, special enrollment,
24special circumstance as defined by the Director, or during the
25annual Benefit Choice Period.
26    The Director shall annually determine monthly rates of

 

 

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1payment subject to the following constraints: for those
2community colleges with annuitants only enrolled, first year
3rates shall be equal to the average cost to cover claims for a
4State member adjusted for demographics, Medicare
5participation, and other factors; and in the second year, a
6further adjustment of rates shall be made to reflect the
7actual first year's claims experience of the covered
8annuitants.
9    (l-5) The provisions of subsection (l) become inoperative
10on July 1, 1999.
11    (m) The Director shall adopt any rules deemed necessary
12for implementation of this amendatory Act of 1989 (Public Act
1386-978).
14    (n) Any child advocacy center within the State of Illinois
15may apply to the Director to have its employees, annuitants,
16and their dependents provided group health coverage under this
17Act on a non-insured basis. To participate, a child advocacy
18center must agree to enroll all of its employees and pay the
19entire cost of providing coverage for its employees. The child
20advocacy center shall not be required to enroll those of its
21employees who are covered spouses or dependents under this
22plan or another group policy or plan providing health benefits
23as long as (1) an appropriate official from the child advocacy
24center attests that each employee not enrolled is a covered
25spouse or dependent under this plan or another group policy or
26plan and (2) at least 50% of the employees are enrolled and the

 

 

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

 

 

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1        (2) In subsequent years, a further adjustment shall be
2    made to reflect the actual prior years' claims experience
3    of the employees of the child advocacy center.
4    Monthly payments by the child advocacy center or its
5employees for group health insurance shall be deposited into
6the Local Government Health Insurance Reserve Fund.
7(Source: P.A. 100-587, eff. 6-4-18.)
 
8    (5 ILCS 375/13)  (from Ch. 127, par. 533)
9    Sec. 13. There is established a Group Insurance Premium
10Fund administered by the Director which shall include: (1)
11amounts paid by covered members for optional life insurance
12and (2) refunds which may be received from (a) the group
13carrier or carriers which may result from favorable experience
14as described in Section 12 herein or (b) from any other source
15from which the State is reasonably and properly entitled to
16refund as a result of the life insurance program. The Group
17Insurance Premium Fund shall be a continuing fund not subject
18to fiscal year limitations.
19    The State of Illinois shall at least once each month make
20payment on behalf of each member, except one who is a member by
21virtue of participation in a program created under subsection
22(i), (j), (k), or (l) of Section 10 of this Act, to the
23appropriate carrier or, if applicable, carriers insuring State
24members under the contracted group life insurance program
25authorized by this Act.

 

 

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1    Refunds to members for premiums paid for optional life
2insurance coverage may be paid from the Group Insurance
3Premium Fund without regard to the fact that the premium being
4refunded may have been paid in a different fiscal year.
5(Source: P.A. 95-632, eff. 9-25-07.)
 
6    (5 ILCS 375/13.1)  (from Ch. 127, par. 533.1)
7    Sec. 13.1. (a) All contributions, appropriations,
8interest, and dividend payments to fund the program of health
9benefits and other employee benefits, and all other revenues
10arising from the administration of any employee health
11benefits program, shall be deposited in a trust fund outside
12the State Treasury, with the State Treasurer as ex-officio
13custodian, to be known as the Health Insurance Reserve Fund.
14    (b) Upon the adoption of a self-insurance health plan, any
15monies attributable to the group health insurance program
16shall be deposited in or transferred to the Health Insurance
17Reserve Fund for use by the Department. As of the effective
18date of this amendatory Act of 1986, the Department shall
19certify to the Comptroller the amount of money in the Group
20Insurance Premium Fund attributable to the State group health
21insurance program and the Comptroller shall transfer such
22money from the Group Insurance Premium Fund to the Health
23Insurance Reserve Fund. Contributions by the State to the
24Health Insurance Reserve Fund to meet the requirements of this
25Act, as established by the Director, from the General Revenue

 

 

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1Fund and the Road Fund to the Health Insurance Reserve Fund
2shall be by annual appropriations, and all other contributions
3to meet the requirements of the programs of health benefits or
4other employee benefits shall be deposited in the Health
5Insurance Reserve Fund. The Department shall draw the
6appropriation from the General Revenue Fund and the Road Fund
7from time to time as necessary to make expenditures authorized
8under this Act.
9    The Director may employ such assistance and services and
10may purchase such goods as may be necessary for the proper
11development and administration of any of the benefit programs
12authorized by this Act. The Director may promulgate rules and
13regulations in regard to the administration of these programs.
14    All monies received by the Department for deposit in or
15transfer to the Health Insurance Reserve Fund, through
16appropriation or otherwise, shall be used to provide for the
17making of payments to claimants and providers and to reimburse
18the Department for all expenses directly incurred relating to
19Department development and administration of the program of
20health benefits and other employee benefits.
21    Any administrative service organization administering any
22self-insurance health plan and paying claims and benefits
23under authority of this Act may receive, pursuant to written
24authorization and direction of the Director, an initial
25transfer and periodic transfers of funds from the Health
26Insurance Reserve Fund in amounts determined by the Director

 

 

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1who may consider the amount recommended by the administrative
2service organization. Notwithstanding any other statute, such
3transferred funds shall be retained by the administrative
4service organization in a separate account provided by any
5bank as defined by the Illinois Banking Act. The Department
6may promulgate regulations further defining the banks
7authorized to accept such funds and all methodology for
8transfer of such funds. Any interest earned by monies in such
9account shall inure to the Health Insurance Reserve Fund,
10shall remain in such account and shall be used exclusively to
11pay claims and benefits under this Act. Such transferred funds
12shall be used exclusively for administrative service
13organization payment of claims to claimants and providers
14under the self-insurance health plan by the drawing of checks
15against such account. The administrative service organization
16may not use such transferred funds, or interest accrued
17thereon, for any other purpose including, but not limited to,
18reimbursement of administrative expenses or payments of
19administration fees due the organization pursuant to its
20contract or contracts with the Department of Central
21Management Services.
22    The account of the administrative service organization
23established under this Section, any transfers from the Health
24Insurance Reserve Fund to such account and the use of such
25account and funds shall be subject to (1) audit by the
26Department or private contractor authorized by the Department

 

 

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1to conduct audits, and (2) post audit pursuant to the Illinois
2State Auditing Act.
3    The Department of Central Management Services, or any
4successor agency designated to procure healthcare contracts
5pursuant to this Act, is authorized to establish funds,
6separate accounts provided by any bank or banks as defined by
7the Illinois Banking Act, or separate accounts provided by any
8savings and loan association or associations as defined by the
9Illinois Savings and Loan Act of 1985 to be held by the
10Director, outside the State treasury, for the purpose of
11receiving the transfer of moneys from the Health Insurance
12Reserve Fund. The Department may promulgate rules further
13defining the methodology for the transfers. Any interest
14earned by monies in the funds or accounts shall inure to the
15Health Insurance Reserve Fund. The transferred moneys, and
16interest accrued thereon, shall be used exclusively for
17transfers to administrative service organizations or their
18financial institutions for payments of claims to claimants and
19providers under the self-insurance health plan. The
20transferred moneys, and interest accrued thereon, shall not be
21used for any other purpose including, but not limited to,
22reimbursement of administration fees due the administrative
23service organization pursuant to its contract or contracts
24with the Department.
25    (c) The Director, with the advice and consent of the
26Commission, shall establish premiums for optional coverage for

 

 

HB0706- 35 -LRB102 11853 RJF 17189 b

1dependents of eligible members for the health plans. The
2eligible members shall be responsible for their portion of
3such optional premium. The State shall contribute an amount
4per month for each eligible member who has enrolled one or more
5dependents under the health plans. Such contribution shall be
6made directly to the Health Insurance Reserve Fund. Those
7employees described in subsection (b) of Section 9 of this Act
8shall be allowed to continue in the health plan by making
9personal payments with the premiums to be deposited in the
10Health Insurance Reserve Fund.
11    (d) The Health Insurance Reserve Fund shall be a
12continuing fund not subject to fiscal year limitations. All
13expenditures from that fund shall be at the direction of the
14Director and shall be only for the purpose of:
15        (1) the payment of administrative expenses incurred by
16    the Department for the program of health benefits or other
17    employee benefit programs, including but not limited to
18    the costs of audits or actuarial consultations,
19    professional and contractual services, electronic data
20    processing systems and services, and expenses in
21    connection with the development and administration of such
22    programs;
23        (2) the payment of administrative expenses incurred by
24    an the Administrative Service Organization;
25        (3) the payment of health benefits;
26        (3.5) the payment of medical expenses incurred by the

 

 

HB0706- 36 -LRB102 11853 RJF 17189 b

1    Department for the treatment of employees who suffer
2    accidental injury or death within the scope of their
3    employment;
4        (4) refunds to employees for erroneous payments of
5    their selected health insurance dependent coverage;
6        (5) payment of premium for stop-loss or re-insurance;
7        (6) payment of premium to health maintenance
8    organizations pursuant to Section 6.1 of this Act;
9        (7) payment of adoption program benefits; and
10        (8) payment of other benefits offered to members and
11    dependents under this Act.
12(Source: P.A. 98-488, eff. 8-16-13.)
 
13    Section 10. The Illinois Pension Code is amended by
14changing Section 15-158.3 as follows:
 
15    (40 ILCS 5/15-158.3)
16    Sec. 15-158.3. Reports on cost reduction; effect on
17retirement at any age with 30 years of service.
18    (a) On or before November 15, 2001 and on or before
19November 15th of each year thereafter, the Board shall have
20the System's actuary prepare a report showing, on a fiscal
21year by fiscal year basis, the actual rate of participation in
22the self-managed plan authorized by Section 15-158.2, (i) by
23employees of the System's covered higher educational
24institutions who were hired on or after the implementation

 

 

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1date of the self-managed plan and (ii) by other System
2participants.
3    (b) On or before November 15th of 2001 and on or before
4November 15th of each year thereafter, the Illinois Board of
5Higher Education, in conjunction with the Bureau of the Budget
6(now Governor's Office of Management and Budget) shall prepare
7a report showing, on a fiscal year by fiscal year basis, the
8amount by which the costs associated with compensable sick
9leave have been reduced as a result of the termination of
10compensable sick leave accrual on and after January 1, 1998 by
11employees of higher education institutions who are
12participants in the System.
13    (c) (Blank). On or before November 15 of 2001 and on or
14before November 15th of each year thereafter, the Department
15of Central Management Services shall prepare a report showing,
16on a fiscal year by fiscal year basis, the amount by which the
17State's cost for health insurance coverage under the State
18Employees Group Insurance Act of 1971 for retirees of the
19State's universities and their survivors has declined as a
20result of requiring some of those retirees and survivors to
21contribute to the cost of their basic health insurance. These
22year-by-year reductions in cost must be quantified both in
23dollars and as a level percentage of payroll covered by the
24System.
25    (d) The report reports required under subsection
26subsections (b) and (c) shall be disseminated to the Board,

 

 

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1the Pension Laws Commission (until it ceases to exist), the
2Commission on Government Forecasting and Accountability, the
3Illinois Board of Higher Education, and the Governor.
4    (e) The report reports required under subsection
5subsections (b) and (c) shall be taken into account by the
6Pension Laws Commission (or its successor, the Commission on
7Government Forecasting and Accountability) in making any
8recommendation to extend by legislation beyond December 31,
92002 the provision that allows a System participant to retire
10at any age with 30 or more years of service as authorized in
11Section 15-135.
12(Source: P.A. 95-83, eff. 8-13-07.)
 
13    Section 99. Effective date. This Act takes effect July 1,
142021.