093_HB2514eng

 
HB2514 Engrossed                     LRB093 08477 JLS 08701 b

 1        AN  ACT  concerning  health coverage under State employee
 2    programs.

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

 5        Section  5.  The  State  Employees Group Insurance Act of
 6    1971 is amended by changing Sections 2, 3, 10, 13.2,  and  15
 7    as follows:

 8        (5 ILCS 375/2) (from Ch. 127, par. 522)
 9        Sec. 2. Purpose.  The purpose of this Act is to provide a
10    program of group life insurance, a program of health benefits
11    and other employee benefits for persons in the service of the
12    State  of Illinois, employees of local governments, employees
13    of  rehabilitation  facilities  and  employees  of   domestic
14    violence   shelters   and  services,  and  certain  of  their
15    dependents.  It is also the purpose of this Act to provide  a
16    program of health benefits (i) for certain benefit recipients
17    of  the  Teachers' Retirement System of the State of Illinois
18    and  their  dependent  beneficiaries  and  (ii)  for  certain
19    eligible  retired  community  college  employees  and   their
20    dependent  beneficiaries.  It is also the purpose of this Act
21    to provide a  program  of  health  benefits  for  owners  and
22    employees of qualified small businesses and their dependents.
23    (Source: P.A. 89-25, eff. 6-21-95; 90-497, eff. 8-18-97.)

24        (5 ILCS 375/3) (from Ch. 127, par. 523)
25        Sec.   3.  Definitions.   Unless  the  context  otherwise
26    requires, the following words and phrases as used in this Act
27    shall have the following meanings.  The Department may define
28    these and other words and phrases separately for the  purpose
29    of  implementing  specific  programs providing benefits under
30    this Act.
 
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 1        (a)  "Administrative  service  organization"  means   any
 2    person,  firm  or  corporation experienced in the handling of
 3    claims  which  is  fully  qualified,  financially  sound  and
 4    capable of meeting the service requirements of a contract  of
 5    administration executed with the Department.
 6        (b)  "Annuitant"  means  (1)  an employee who retires, or
 7    has retired, on or after January  1,  1966  on  an  immediate
 8    annuity under the provisions of Articles 2, 14, 15 (including
 9    an  employee  who  has  retired under the optional retirement
10    program established under Section 15-158.2), paragraphs  (2),
11    (3),  or (5) of Section 16-106, or Article 18 of the Illinois
12    Pension  Code;  (2)  any  person  who  was  receiving   group
13    insurance  coverage  under  this  Act as of March 31, 1978 by
14    reason of his status as an annuitant, even though the annuity
15    in  relation  to  which  such  coverage  was  provided  is  a
16    proportional annuity based on less than the minimum period of
17    service required for  a  retirement  annuity  in  the  system
18    involved;  (3)  any  person not otherwise covered by this Act
19    who has retired as a participating member under Article 2  of
20    the   Illinois   Pension  Code  but  is  ineligible  for  the
21    retirement  annuity  under  Section  2-119  of  the  Illinois
22    Pension Code; (4) the spouse of any person who is receiving a
23    retirement annuity under Article 18 of the  Illinois  Pension
24    Code  and  who  is  covered  under  a  group health insurance
25    program sponsored by a governmental employer other  than  the
26    State  of  Illinois  and who has irrevocably elected to waive
27    his or her coverage under this Act and to  have  his  or  her
28    spouse  considered  as the "annuitant" under this Act and not
29    as a "dependent"; or (5) an  employee  who  retires,  or  has
30    retired,  from  a qualified position, as determined according
31    to rules promulgated by the Director, under a qualified local
32    government  or  a  qualified  rehabilitation  facility  or  a
33    qualified domestic violence shelter or  service;  or  (6)  an
34    owner  or  employee  who  retires,  or  has  retired,  from a
 
HB2514 Engrossed            -3-      LRB093 08477 JLS 08701 b
 1    qualified  position,  as  determined   according   to   rules
 2    promulgated by the Director, with a qualified small business.
 3    (For definition of "retired employee", see (p) post).
 4        (b-5)  "New  SERS  annuitant"  means  a person who, on or
 5    after January 1, 1998, becomes an annuitant,  as  defined  in
 6    subsection   (b),   by  virtue  of  beginning  to  receive  a
 7    retirement annuity under Article 14 of the  Illinois  Pension
 8    Code,  and is eligible to participate in the basic program of
 9    group health benefits provided for annuitants under this Act.
10        (b-6)  "New SURS annuitant" means a person who (1) on  or
11    after  January  1,  1998, becomes an annuitant, as defined in
12    subsection  (b),  by  virtue  of  beginning  to   receive   a
13    retirement  annuity  under Article 15 of the Illinois Pension
14    Code, (2) has not made the election authorized under  Section
15    15-135.1 of the Illinois Pension Code, and (3) is eligible to
16    participate  in  the  basic  program of group health benefits
17    provided for annuitants under this Act.
18        (b-7)  "New TRS State annuitant" means a person  who,  on
19    or  after  July  1, 1998, becomes an annuitant, as defined in
20    subsection  (b),  by  virtue  of  beginning  to   receive   a
21    retirement  annuity  under Article 16 of the Illinois Pension
22    Code based on service as a teacher as  defined  in  paragraph
23    (2),  (3),  or  (5)  of  Section  16-106 of that Code, and is
24    eligible to participate in the basic program of group  health
25    benefits provided for annuitants under this Act.
26        (c)  "Carrier"   means   (1)   an  insurance  company,  a
27    corporation  organized  under  the  Limited  Health   Service
28    Organization Act or the Voluntary Health Services Plan Act, a
29    partnership,  or other nongovernmental organization, which is
30    authorized  to  do  group  life  or  group  health  insurance
31    business in Illinois, or (2)  the  State  of  Illinois  as  a
32    self-insurer.
33        (d)  "Compensation"  means  salary  or wages payable on a
34    regular payroll by the State Treasurer on a  warrant  of  the
 
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 1    State Comptroller out of any State, trust or federal fund, or
 2    by  the Governor of the State through a disbursing officer of
 3    the State out of a trust or out of federal funds, or  by  any
 4    Department  out  of State, trust, federal or other funds held
 5    by the State Treasurer or the Department, to any  person  for
 6    personal   services  currently  performed,  and  ordinary  or
 7    accidental disability  benefits  under  Articles  2,  14,  15
 8    (including  ordinary  or accidental disability benefits under
 9    the optional retirement  program  established  under  Section
10    15-158.2),  paragraphs (2), (3), or (5) of Section 16-106, or
11    Article 18 of  the  Illinois  Pension  Code,  for  disability
12    incurred after January 1, 1966, or benefits payable under the
13    Workers'   Compensation   or  Occupational  Diseases  Act  or
14    benefits  payable  under  a  sick  pay  plan  established  in
15    accordance  with  Section  36  of  the  State  Finance   Act.
16    "Compensation" also means salary or wages paid to an employee
17    of any qualified local government or qualified rehabilitation
18    facility or a qualified domestic violence shelter or service.
19    "Compensation" also means salary or wages paid to an employee
20    or owner of a qualified small business.
21        (e)  "Commission"   means   the   State  Employees  Group
22    Insurance  Advisory  Commission  authorized  by   this   Act.
23    Commencing  July  1,  1984,  "Commission" as used in this Act
24    means  the  Illinois  Economic  and  Fiscal   Commission   as
25    established  by the Legislative Commission Reorganization Act
26    of 1984.
27        (f)  "Contributory", when  referred  to  as  contributory
28    coverage,  shall  mean optional coverages or benefits elected
29    by the member toward the cost  of  which  such  member  makes
30    contribution, or which are funded in whole or in part through
31    the acceptance of a reduction in earnings or the foregoing of
32    an increase in earnings by an employee, as distinguished from
33    noncontributory  coverage or benefits which are paid entirely
34    by the State of Illinois without reduction  of  the  member's
 
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 1    salary.
 2        (g)  "Department"   means  any  department,  institution,
 3    board, commission, officer, court or any agency of the  State
 4    government  receiving  appropriations  and  having  power  to
 5    certify  payrolls  to the Comptroller authorizing payments of
 6    salary and wages against such appropriations as are  made  by
 7    the  General  Assembly  from any State fund, or against trust
 8    funds held by the State  Treasurer  and  includes  boards  of
 9    trustees of the retirement systems created by Articles 2, 14,
10    15,  16  and  18  of the Illinois Pension Code.  "Department"
11    also includes the  Illinois  Comprehensive  Health  Insurance
12    Board,  the Board of Examiners established under the Illinois
13    Public Accounting Act, and the Illinois Rural Bond Bank.
14        (h)  "Dependent", when the term is used in the context of
15    the health and life plan, means a  member's  spouse  and  any
16    unmarried child (1) from birth to age 19 including an adopted
17    child, a child who lives with the member from the time of the
18    filing  of a petition for adoption until entry of an order of
19    adoption, a stepchild or recognized child who lives with  the
20    member  in  a parent-child relationship, or a child who lives
21    with the member if such member is a court appointed  guardian
22    of  the  child,  or  (2) age 19 to 23 enrolled as a full-time
23    student in any accredited school, financially dependent  upon
24    the  member,  and  eligible  to be claimed as a dependent for
25    income tax purposes, or (3) age 19 or over who is mentally or
26    physically handicapped. For the health plan  only,  the  term
27    "dependent"  also  includes  any person enrolled prior to the
28    effective date of this Section  who  is  dependent  upon  the
29    member to the extent that the member may claim such person as
30    a  dependent for income tax deduction purposes; no other such
31    person may be enrolled. For the health plan  only,  the  term
32    "dependent"  also  includes any person who has received after
33    June 30, 2000 an organ  transplant  and  who  is  financially
34    dependent  upon  the  member  and eligible to be claimed as a
 
HB2514 Engrossed            -6-      LRB093 08477 JLS 08701 b
 1    dependent for income tax purposes.
 2        (i)  "Director"  means  the  Director  of  the   Illinois
 3    Department of Central Management Services.
 4        (j)  "Eligibility  period"  means  the  period  of time a
 5    member has to elect  enrollment  in  programs  or  to  select
 6    benefits without regard to age, sex or health.
 7        (k)  "Employee"   means  and  includes  each  officer  or
 8    employee in the service of a department who (1) receives  his
 9    compensation  for  service  rendered  to  the department on a
10    warrant  issued  pursuant  to  a  payroll  certified   by   a
11    department  or  on  a  warrant or check issued and drawn by a
12    department upon a trust,  federal  or  other  fund  or  on  a
13    warrant  issued pursuant to a payroll certified by an elected
14    or duly appointed  officer  of  the  State  or  who  receives
15    payment  of the performance of personal services on a warrant
16    issued pursuant to a payroll certified by  a  Department  and
17    drawn  by  the  Comptroller  upon the State Treasurer against
18    appropriations made by the General Assembly from any fund  or
19    against  trust  funds held by the State Treasurer, and (2) is
20    employed  full-time  or  part-time  in  a  position  normally
21    requiring actual performance of duty during not less than 1/2
22    of a normal work period, as established by  the  Director  in
23    cooperation with each department, except that persons elected
24    by  popular  vote  will  be  considered  employees during the
25    entire term for which they are elected  regardless  of  hours
26    devoted  to  the  service  of  the State, and (3) except that
27    "employee" does not include any person who is not eligible by
28    reason of such person's employment to participate in  one  of
29    the State retirement systems under Articles 2, 14, 15 (either
30    the  regular  Article  15  system  or the optional retirement
31    program established under Section 15-158.2) or 18,  or  under
32    paragraph (2), (3), or (5) of Section 16-106, of the Illinois
33    Pension  Code,  but  such  term  does include persons who are
34    employed during the 6 month qualifying period  under  Article
 
HB2514 Engrossed            -7-      LRB093 08477 JLS 08701 b
 1    14 of the Illinois Pension Code.  Such term also includes any
 2    person  who  (1) after January 1, 1966, is receiving ordinary
 3    or accidental disability benefits under Articles  2,  14,  15
 4    (including  ordinary  or accidental disability benefits under
 5    the optional retirement  program  established  under  Section
 6    15-158.2),  paragraphs (2), (3), or (5) of Section 16-106, or
 7    Article 18 of  the  Illinois  Pension  Code,  for  disability
 8    incurred  after January 1, 1966, (2) receives total permanent
 9    or total temporary disability under the Workers' Compensation
10    Act or Occupational Disease  Act  as  a  result  of  injuries
11    sustained  or  illness contracted in the course of employment
12    with the State of Illinois, or (3) is not  otherwise  covered
13    under  this  Act  and  has  retired as a participating member
14    under  Article  2  of  the  Illinois  Pension  Code  but   is
15    ineligible  for the retirement annuity under Section 2-119 of
16    the Illinois Pension Code.  However, a person  who  satisfies
17    the criteria of the foregoing definition of "employee" except
18    that  such  person  is  made ineligible to participate in the
19    State  Universities  Retirement  System  by  clause  (4)   of
20    subsection (a) of Section 15-107 of the Illinois Pension Code
21    is   also  an  "employee"  for  the  purposes  of  this  Act.
22    "Employee" also includes any person receiving or eligible for
23    benefits under a sick pay plan established in accordance with
24    Section 36 of the State Finance Act. "Employee" also includes
25    each officer or employee in the service of a qualified  local
26    government,   including  persons  appointed  as  trustees  of
27    sanitary districts regardless of hours devoted to the service
28    of the sanitary district, and each employee in the service of
29    a  qualified  rehabilitation  facility  and  each   full-time
30    employee  in  the  service  of  a qualified domestic violence
31    shelter  or  service,  as  determined  according   to   rules
32    promulgated  by  the  Director.  "Employee"  also includes an
33    owner and a full-time employee in the service of a  qualified
34    small  business, as determined according to rules promulgated
 
HB2514 Engrossed            -8-      LRB093 08477 JLS 08701 b
 1    by the Director.
 2        (l)  "Member"  means  an  employee,  annuitant,   retired
 3    employee or survivor.
 4        (m)  "Optional   coverages   or   benefits"  means  those
 5    coverages or benefits available to the member on his  or  her
 6    voluntary election, and at his or her own expense.
 7        (n)  "Program"  means  the  group  life insurance, health
 8    benefits and other employee benefits designed and  contracted
 9    for by the Director under this Act.
10        (o)  "Health   plan"  means  a  health  benefits  program
11    offered by the State of Illinois for persons eligible for the
12    plan.
13        (p)  "Retired employee" means any person who would be  an
14    annuitant  as  that  term  is defined herein but for the fact
15    that such person retired prior to January 1, 1966.  Such term
16    also includes any person formerly employed by the  University
17    of Illinois in the Cooperative Extension Service who would be
18    an  annuitant  but  for  the  fact  that such person was made
19    ineligible  to  participate   in   the   State   Universities
20    Retirement  System by clause (4) of subsection (a) of Section
21    15-107 of the Illinois Pension Code.
22        (q)  "Survivor" means a person receiving an annuity as  a
23    survivor  of an employee or of an annuitant.  "Survivor" also
24    includes:  (1)  the  surviving  dependent  of  a  person  who
25    satisfies the  definition  of  "employee"  except  that  such
26    person  is  made  ineligible  to  participate  in  the  State
27    Universities  Retirement  System  by clause (4) of subsection
28    (a) of Section 15-107 of the Illinois Pension Code;  and  (2)
29    the  surviving  dependent  of any person formerly employed by
30    the University  of  Illinois  in  the  Cooperative  Extension
31    Service  who  would  be an annuitant except for the fact that
32    such person was made ineligible to participate in  the  State
33    Universities  Retirement  System  by clause (4) of subsection
34    (a) of Section 15-107 of the Illinois Pension Code.
 
HB2514 Engrossed            -9-      LRB093 08477 JLS 08701 b
 1        (q-5)  "New SERS survivor" means a survivor,  as  defined
 2    in  subsection (q), whose annuity is paid under Article 14 of
 3    the Illinois Pension Code and is based on the death of (i) an
 4    employee whose death occurs on or after January 1,  1998,  or
 5    (ii) a new SERS annuitant as defined in subsection (b-5).
 6        (q-6)  "New  SURS  survivor" means a survivor, as defined
 7    in subsection (q), whose annuity is paid under Article 15  of
 8    the Illinois Pension Code and is based on the death of (i) an
 9    employee  whose  death occurs on or after January 1, 1998, or
10    (ii) a new SURS annuitant as defined in subsection (b-6).
11        (q-7)  "New TRS State  survivor"  means  a  survivor,  as
12    defined  in  subsection  (q),  whose  annuity  is  paid under
13    Article 16 of the Illinois Pension Code and is based  on  the
14    death  of  (i)  an  employee  who  is a teacher as defined in
15    paragraph (2), (3), or (5) of Section 16-106 of that Code and
16    whose death occurs on or after July 1, 1998, or  (ii)  a  new
17    TRS State annuitant as defined in subsection (b-7).
18        (r)  "Medical   services"  means  the  services  provided
19    within the scope of their licenses by  practitioners  in  all
20    categories licensed under the Medical Practice Act of 1987.
21        (s)  "Unit   of   local  government"  means  any  county,
22    municipality,  township,   school   district   (including   a
23    combination  of  school districts under the Intergovernmental
24    Cooperation Act), special district or other unit,  designated
25    as a unit of local government by law, which exercises limited
26    governmental   powers   or   powers  in  respect  to  limited
27    governmental subjects, any not-for-profit association with  a
28    membership  that  primarily  includes  townships and township
29    officials, that has duties that include provision of research
30    service, dissemination of information, and other acts for the
31    purpose of improving township government, and that is  funded
32    wholly  or  partly  in  accordance  with Section 85-15 of the
33    Township Code; any not-for-profit corporation or association,
34    with a membership  consisting  primarily  of  municipalities,
 
HB2514 Engrossed            -10-     LRB093 08477 JLS 08701 b
 1    that  operates its own utility system, and provides research,
 2    training, dissemination of  information,  or  other  acts  to
 3    promote  cooperation  between  and  among municipalities that
 4    provide utility services and for the advancement of the goals
 5    and  purposes  of  its  membership;  the  Southern   Illinois
 6    Collegiate  Common  Market,  which  is a consortium of higher
 7    education institutions in Southern Illinois; and the Illinois
 8    Association of Park Districts.  "Qualified local  government"
 9    means a unit of local government approved by the Director and
10    participating  in  a  program created under subsection (i) of
11    Section 10 of this Act.
12        (t)  "Qualified  rehabilitation   facility"   means   any
13    not-for-profit   organization   that  is  accredited  by  the
14    Commission on Accreditation of Rehabilitation  Facilities  or
15    certified  by  the Department of Human Services (as successor
16    to  the  Department  of  Mental  Health   and   Developmental
17    Disabilities)   to   provide   services   to   persons   with
18    disabilities  and  which  receives  funds  from  the State of
19    Illinois  for  providing  those  services,  approved  by  the
20    Director  and  participating  in  a  program  created   under
21    subsection (j) of Section 10 of this Act.
22        (u)  "Qualified  domestic  violence  shelter  or service"
23    means any Illinois domestic violence shelter or  service  and
24    its  administrative offices funded by the Department of Human
25    Services (as successor to the Illinois Department  of  Public
26    Aid), approved by the Director and participating in a program
27    created under subsection (k) of Section 10.
28        (v)  "TRS benefit recipient" means a person who:
29             (1)  is  not  a "member" as defined in this Section;
30        and
31             (2)  is receiving a monthly  benefit  or  retirement
32        annuity  under  Article  16 of the Illinois Pension Code;
33        and
34             (3)  either (i) has at least 8 years  of  creditable
 
HB2514 Engrossed            -11-     LRB093 08477 JLS 08701 b
 1        service under Article 16 of the Illinois Pension Code, or
 2        (ii) was enrolled in the health insurance program offered
 3        under  that  Article  on January 1, 1996, or (iii) is the
 4        survivor of a benefit recipient who had at least 8  years
 5        of  creditable  service  under Article 16 of the Illinois
 6        Pension Code or was  enrolled  in  the  health  insurance
 7        program  offered under that Article on the effective date
 8        of this amendatory Act of 1995, or (iv) is a recipient or
 9        survivor of a recipient of  a  disability  benefit  under
10        Article 16 of the Illinois Pension Code.
11        (w)  "TRS dependent beneficiary" means a person who:
12             (1)  is  not a "member" or "dependent" as defined in
13        this Section; and
14             (2)  is a TRS benefit recipient's: (A)  spouse,  (B)
15        dependent parent who is receiving at least half of his or
16        her  support  from  the  TRS  benefit  recipient,  or (C)
17        unmarried natural or adopted child who is (i)  under  age
18        19,  or  (ii)  enrolled  as  a  full-time  student  in an
19        accredited school, financially  dependent  upon  the  TRS
20        benefit  recipient, eligible to be claimed as a dependent
21        for income tax purposes, and either is under  age  24  or
22        was,  on  January  1,  1996, participating as a dependent
23        beneficiary in the health insurance program offered under
24        Article 16 of the Illinois Pension Code, or (iii) age  19
25        or over who is mentally or physically handicapped.
26        (x)  "Military  leave  with  pay  and benefits" refers to
27    individuals in basic training for reserves,  special/advanced
28    training,  annual  training, emergency call up, or activation
29    by the President of the United States with approved  pay  and
30    benefits.
31        (y)  "Military  leave without pay and benefits" refers to
32    individuals who enlist for active duty in a regular component
33    of the U.S. Armed Forces  or  other  duty  not  specified  or
34    authorized under military leave with pay and benefits.
 
HB2514 Engrossed            -12-     LRB093 08477 JLS 08701 b
 1        (z)  "Community college benefit recipient" means a person
 2    who:
 3             (1)  is  not  a "member" as defined in this Section;
 4        and
 5             (2)  is receiving a monthly  survivor's  annuity  or
 6        retirement  annuity  under  Article  15  of  the Illinois
 7        Pension Code; and
 8             (3)  either  (i)  was  a  full-time  employee  of  a
 9        community college district or an association of community
10        college boards created under the Public Community College
11        Act (other than an employee  whose  last  employer  under
12        Article  15  of the Illinois Pension Code was a community
13        college district subject to Article  VII  of  the  Public
14        Community College Act) and was eligible to participate in
15        a  group  health  benefit  plan as an employee during the
16        time of employment  with  a  community  college  district
17        (other  than  a  community  college  district  subject to
18        Article VII of the Public Community College  Act)  or  an
19        association  of  community college boards, or (ii) is the
20        survivor of a person described in item (i).
21        (aa)  "Community college dependent beneficiary"  means  a
22    person who:
23             (1)  is  not a "member" or "dependent" as defined in
24        this Section; and
25             (2)  is a community college benefit recipient's: (A)
26        spouse, (B) dependent parent who is  receiving  at  least
27        half  of  his  or  her support from the community college
28        benefit recipient, or (C) unmarried  natural  or  adopted
29        child  who  is  (i)  under  age 19, or (ii) enrolled as a
30        full-time student in an  accredited  school,  financially
31        dependent  upon  the community college benefit recipient,
32        eligible to be claimed as  a  dependent  for  income  tax
33        purposes  and  under  age 23, or (iii) age 19 or over and
34        mentally or physically handicapped.
 
HB2514 Engrossed            -13-     LRB093 08477 JLS 08701 b
 1        (bb)  "Qualified  small  business"   means   a   business
 2    situated  in  Illinois having 50 or fewer employees, approved
 3    by the Director and participating in a program created  under
 4    subsection (k-5) of Section 10.
 5    (Source:  P.A.  91-390,  eff.  7-30-99; 91-395, eff. 7-30-99;
 6    91-617, eff.  8-19-99;  92-16,  eff.  6-28-01;  92-186,  eff.
 7    1-1-02; 92-204, eff. 8-1-01; 92-651, eff. 7-11-02.)

 8        (5 ILCS 375/10) (from Ch. 127, par. 530)
 9        Sec. 10. Payments by State; premiums.
10        (a)  The    State   shall   pay   the   cost   of   basic
11    non-contributory group life insurance and, subject to  member
12    paid  contributions set by the Department or required by this
13    Section, the basic program of group health benefits  on  each
14    eligible  member,  except  a member, not otherwise covered by
15    this Act, who has retired as  a  participating  member  under
16    Article  2 of the Illinois Pension Code but is ineligible for
17    the retirement annuity under Section 2-119  of  the  Illinois
18    Pension  Code, and part of each eligible member's and retired
19    member's premiums for health insurance coverage for  enrolled
20    dependents as provided by Section 9.  The State shall pay the
21    cost of the basic program of group health benefits only after
22    benefits  are  reduced  by  the amount of benefits covered by
23    Medicare for all members and dependents who are eligible  for
24    benefits  under  Social  Security  or the Railroad Retirement
25    system or  who  had  sufficient  Medicare-covered  government
26    employment,  except  that  such  reduction  in benefits shall
27    apply only to those members  and  dependents  who  (1)  first
28    become  eligible  for such Medicare coverage on or after July
29    1, 1992; or (2) are Medicare-eligible members  or  dependents
30    of  a  local government unit which began participation in the
31    program on or after July 1, 1992; or (3) remain eligible for,
32    but no longer receive Medicare coverage which they  had  been
33    receiving  on  or  after  July  1,  1992.  The Department may
 
HB2514 Engrossed            -14-     LRB093 08477 JLS 08701 b
 1    determine the aggregate level of the State's contribution  on
 2    the  basis  of  actual  cost of medical services adjusted for
 3    age, sex or geographic or other  demographic  characteristics
 4    which affect the costs of such programs.
 5        The  cost  of participation in the basic program of group
 6    health benefits for the dependent or survivor of a living  or
 7    deceased  retired  employee  who was formerly employed by the
 8    University of Illinois in the Cooperative  Extension  Service
 9    and would be an annuitant but for the fact that he or she was
10    made  ineligible  to  participate  in  the State Universities
11    Retirement System by clause (4) of subsection (a) of  Section
12    15-107 of the Illinois Pension Code shall not be greater than
13    the  cost of participation that would otherwise apply to that
14    dependent or survivor if he or  she  were  the  dependent  or
15    survivor   of  an  annuitant  under  the  State  Universities
16    Retirement System.
17        (a-1)  Beginning January 1, 1998,  for  each  person  who
18    becomes  a  new  SERS annuitant and participates in the basic
19    program of group health benefits, the State shall  contribute
20    toward  the  cost of the annuitant's coverage under the basic
21    program of group health benefits an amount  equal  to  5%  of
22    that cost for each full year of creditable service upon which
23    the  annuitant's retirement annuity is based, up to a maximum
24    of 100% for an annuitant with 20 or more years of  creditable
25    service.  The remainder of the cost of a new SERS annuitant's
26    coverage under the basic program  of  group  health  benefits
27    shall be the responsibility of the annuitant.
28        (a-2)  Beginning  January  1,  1998,  for each person who
29    becomes a new SERS survivor and  participates  in  the  basic
30    program  of group health benefits, the State shall contribute
31    toward the cost of the survivor's coverage  under  the  basic
32    program  of  group  health  benefits an amount equal to 5% of
33    that cost for each full year of the  deceased  employee's  or
34    deceased   annuitant's   creditable   service  in  the  State
 
HB2514 Engrossed            -15-     LRB093 08477 JLS 08701 b
 1    Employees' Retirement System  of  Illinois  on  the  date  of
 2    death,  up to a maximum of 100% for a survivor of an employee
 3    or annuitant with 20 or more  years  of  creditable  service.
 4    The remainder of the cost of the new SERS survivor's coverage
 5    under the basic program of group health benefits shall be the
 6    responsibility of the survivor.
 7        (a-3)  Beginning  January  1,  1998,  for each person who
 8    becomes a new SURS annuitant and participates  in  the  basic
 9    program  of group health benefits, the State shall contribute
10    toward the cost of the annuitant's coverage under  the  basic
11    program  of  group  health  benefits an amount equal to 5% of
12    that cost for each full year of creditable service upon which
13    the annuitant's retirement annuity is based, up to a  maximum
14    of  100% for an annuitant with 20 or more years of creditable
15    service. The remainder of the cost of a new SURS  annuitant's
16    coverage  under  the  basic  program of group health benefits
17    shall be the responsibility of the annuitant.
18        (a-4)  (Blank).
19        (a-5)  Beginning January 1, 1998,  for  each  person  who
20    becomes  a  new  SURS  survivor and participates in the basic
21    program of group health benefits, the State shall  contribute
22    toward  the  cost  of the survivor's coverage under the basic
23    program of group health benefits an amount  equal  to  5%  of
24    that  cost  for  each full year of the deceased employee's or
25    deceased  annuitant's  creditable  service   in   the   State
26    Universities  Retirement System on the date of death, up to a
27    maximum of 100% for a survivor of an  employee  or  annuitant
28    with  20  or more years of creditable service.  The remainder
29    of the cost of the new SURS  survivor's  coverage  under  the
30    basic   program   of  group  health  benefits  shall  be  the
31    responsibility of the survivor.
32        (a-6)  Beginning  July  1,  1998,  for  each  person  who
33    becomes a new TRS State annuitant  and  participates  in  the
34    basic  program  of  group  health  benefits,  the State shall
 
HB2514 Engrossed            -16-     LRB093 08477 JLS 08701 b
 1    contribute toward the cost of the annuitant's coverage  under
 2    the basic program of group health benefits an amount equal to
 3    5% of that cost for each full year of creditable service as a
 4    teacher  as  defined in paragraph (2), (3), or (5) of Section
 5    16-106  of  the  Illinois  Pension  Code   upon   which   the
 6    annuitant's  retirement  annuity is based, up to a maximum of
 7    100%; except that the State contribution shall be  12.5%  per
 8    year  (rather  than  5%)  for  each  full  year of creditable
 9    service as a regional superintendent  or  assistant  regional
10    superintendent  of  schools.   The remainder of the cost of a
11    new TRS State annuitant's coverage under the basic program of
12    group health benefits shall  be  the  responsibility  of  the
13    annuitant.
14        (a-7)  Beginning  July  1,  1998,  for  each  person  who
15    becomes  a  new  TRS  State  survivor and participates in the
16    basic program of  group  health  benefits,  the  State  shall
17    contribute  toward  the cost of the survivor's coverage under
18    the basic program of group health benefits an amount equal to
19    5% of that cost for each full year of the deceased employee's
20    or deceased annuitant's creditable service as  a  teacher  as
21    defined  in  paragraph  (2), (3), or (5) of Section 16-106 of
22    the Illinois Pension Code on the  date  of  death,  up  to  a
23    maximum  of 100%; except that the State contribution shall be
24    12.5% per year (rather than 5%) for each  full  year  of  the
25    deceased   employee's   or  deceased  annuitant's  creditable
26    service as a regional superintendent  or  assistant  regional
27    superintendent  of  schools. The remainder of the cost of the
28    new TRS State survivor's coverage under the basic program  of
29    group  health  benefits  shall  be  the responsibility of the
30    survivor.
31        (a-8)  A new SERS annuitant, new SERS survivor, new  SURS
32    annuitant, new SURS survivor, new TRS State annuitant, or new
33    TRS  State  survivor  may  waive or terminate coverage in the
34    program of group health  benefits.   Any  such  annuitant  or
 
HB2514 Engrossed            -17-     LRB093 08477 JLS 08701 b
 1    survivor  who has waived or terminated coverage may enroll or
 2    re-enroll in the program of group health benefits only during
 3    the annual  benefit  choice  period,  as  determined  by  the
 4    Director; except that in the event of termination of coverage
 5    due  to nonpayment of premiums, the annuitant or survivor may
 6    not re-enroll in the program.
 7        (a-9)  No later than May 1 of  each  calendar  year,  the
 8    Director  of  Central  Management  Services  shall certify in
 9    writing to the Executive Secretary of  the  State  Employees'
10    Retirement  System  of  Illinois  the amounts of the Medicare
11    supplement health care premiums and the amounts of the health
12    care premiums for all other retirees  who  are  not  Medicare
13    eligible.
14        A  separate  calculation  of  the premiums based upon the
15    actual cost of each health care plan shall be so certified.
16        The Director of Central Management Services shall provide
17    to the Executive Secretary of the State Employees' Retirement
18    System of Illinois such information,  statistics,  and  other
19    data  as  he or she may require to review the premium amounts
20    certified by the Director of Central Management Services.
21        (b)  State employees who become eligible for this program
22    on or after January 1, 1980 in positions  normally  requiring
23    actual performance of duty not less than 1/2 of a normal work
24    period  but  not equal to that of a normal work period, shall
25    be  given  the  option  of  participating  in  the  available
26    program. If the employee elects  coverage,  the  State  shall
27    contribute  on  behalf  of  such  employee to the cost of the
28    employee's benefit and any applicable  dependent  supplement,
29    that  sum  which bears the same percentage as that percentage
30    of time the employee regularly works when compared to  normal
31    work period.
32        (c)  The  basic  non-contributory coverage from the basic
33    program of group health benefits shall be continued for  each
34    employee  not in pay status or on active service by reason of
 
HB2514 Engrossed            -18-     LRB093 08477 JLS 08701 b
 1    (1) leave of absence due to illness or injury, (2) authorized
 2    educational leave of absence  or  sabbatical  leave,  or  (3)
 3    military  leave  with  pay  and benefits. This coverage shall
 4    continue until expiration of authorized leave and  return  to
 5    active  service, but not to exceed 24 months for leaves under
 6    item (1) or (2). This 24-month limitation and the requirement
 7    of returning to active service shall  not  apply  to  persons
 8    receiving  ordinary  or  accidental  disability  benefits  or
 9    retirement  benefits through the appropriate State retirement
10    system  or  benefits  under  the  Workers'  Compensation   or
11    Occupational Disease Act.
12        (d)  The   basic  group  life  insurance  coverage  shall
13    continue, with full State contribution, where such person  is
14    (1)  absent  from  active  service  by  reason  of disability
15    arising from any cause  other  than  self-inflicted,  (2)  on
16    authorized  educational leave of absence or sabbatical leave,
17    or (3) on military leave with pay and benefits.
18        (e)  Where the person is in non-pay status for  a  period
19    in  excess  of  30 days or on leave of absence, other than by
20    reason of disability, educational  or  sabbatical  leave,  or
21    military  leave  with  pay  and  benefits,  such  person  may
22    continue  coverage  only  by making personal payment equal to
23    the amount normally contributed by the State on such person's
24    behalf. Such payments and  coverage  may  be  continued:  (1)
25    until  such  time  as the person returns to a status eligible
26    for coverage at State expense, but not to exceed  24  months,
27    (2)  until  such person's employment or annuitant status with
28    the State is terminated, or (3) for a  maximum  period  of  4
29    years for members on military leave with pay and benefits and
30    military  leave  without  pay  and benefits (exclusive of any
31    additional service imposed pursuant to law).
32        (f)  The Department shall  establish by rule  the  extent
33    to which other employee benefits will continue for persons in
34    non-pay status or who are not in active service.
 
HB2514 Engrossed            -19-     LRB093 08477 JLS 08701 b
 1        (g)  The  State  shall  not  pay  the  cost  of the basic
 2    non-contributory group  life  insurance,  program  of  health
 3    benefits  and  other  employee  benefits  for members who are
 4    survivors as defined by paragraphs (1) and (2) of  subsection
 5    (q)  of  Section  3  of  this Act.  The costs of benefits for
 6    these survivors shall be paid by  the  survivors  or  by  the
 7    University  of Illinois Cooperative Extension Service, or any
 8    combination thereof. However, the State shall pay the  amount
 9    of  the  reduction  in  the  cost  of  participation, if any,
10    resulting from the amendment to subsection (a) made  by  this
11    amendatory Act of the 91st General Assembly.
12        (h)  Those   persons   occupying   positions   with   any
13    department  as a result of emergency appointments pursuant to
14    Section 8b.8 of the Personnel Code  who  are  not  considered
15    employees  under  this  Act  shall  be  given  the  option of
16    participating in the programs of group life insurance, health
17    benefits and other employee benefits.  Such persons  electing
18    coverage  may participate only by making payment equal to the
19    amount  normally  contributed  by  the  State  for  similarly
20    situated employees.  Such amounts shall be determined by  the
21    Director.   Such payments and coverage may be continued until
22    such time as the person becomes an employee pursuant to  this
23    Act or such person's appointment is terminated.
24        (i)  Any  unit  of  local  government within the State of
25    Illinois may apply to the Director  to  have  its  employees,
26    annuitants,   and  their  dependents  provided  group  health
27    coverage  under  this  Act  on  a  non-insured   basis.    To
28    participate,  a unit of local government must agree to enroll
29    all of its employees, who may select  coverage  under  either
30    the  State group health benefits plan or a health maintenance
31    organization  that  has  contracted  with  the  State  to  be
32    available as a health care provider for employees as  defined
33    in  this  Act.   A  unit  of  local government must remit the
34    entire cost of  providing  coverage  under  the  State  group
 
HB2514 Engrossed            -20-     LRB093 08477 JLS 08701 b
 1    health   benefits  plan  or,  for  coverage  under  a  health
 2    maintenance  organization,  an  amount  determined   by   the
 3    Director  based  on  an  analysis of the sex, age, geographic
 4    location, or other relevant  demographic  variables  for  its
 5    employees, except that the unit of local government shall not
 6    be  required to enroll those of its employees who are covered
 7    spouses or dependents under this plan or another group policy
 8    or  plan  providing  health  benefits  as  long  as  (1)   an
 9    appropriate  official  from  the  unit  of  local  government
10    attests  that  each employee not enrolled is a covered spouse
11    or dependent under this plan or another group policy or plan,
12    and (2) at least 85% of the employees are  enrolled  and  the
13    unit  of local government remits the entire cost of providing
14    coverage to those  employees,  except  that  a  participating
15    school  district  must  have  enrolled  at  least  85% of its
16    full-time employees who have not waived  coverage  under  the
17    district's  group health plan by participating in a component
18    of the district's cafeteria  plan.   A  participating  school
19    district  is  not required to enroll a full-time employee who
20    has  waived  coverage  under  the  district's  health   plan,
21    provided  that an appropriate official from the participating
22    school district  attests  that  the  full-time  employee  has
23    waived  coverage  by  participating  in  a  component  of the
24    district's  cafeteria  plan.   For  the  purposes   of   this
25    subsection,  "participating  school district" includes a unit
26    of local government whose primary  purpose  is  education  as
27    defined by the Department's rules.
28        Employees of a participating unit of local government who
29    are  not  enrolled due to coverage under another group health
30    policy or plan may enroll in the event of a qualifying change
31    in  status,  special  enrollment,  special  circumstance   as
32    defined  by the Director, or during the annual Benefit Choice
33    Period.  A participating unit of local  government  may  also
34    elect  to  cover its annuitants.  Dependent coverage shall be
 
HB2514 Engrossed            -21-     LRB093 08477 JLS 08701 b
 1    offered on an optional basis, with the costs paid by the unit
 2    of local government, its employees, or  some  combination  of
 3    the  two  as determined by the unit of local government.  The
 4    unit of local government  shall  be  responsible  for  timely
 5    collection and transmission of dependent premiums.
 6        The  Director  shall  annually determine monthly rates of
 7    payment, subject to the following constraints:
 8             (1)  In the first year of coverage, the rates  shall
 9        be   equal  to  the  amount  normally  charged  to  State
10        employees for elected optional coverages or for  enrolled
11        dependents  coverages or other contributory coverages, or
12        contributed by the State for basic insurance coverages on
13        behalf of its employees, adjusted for differences between
14        State employees and employees of the local government  in
15        age,   sex,   geographic   location   or  other  relevant
16        demographic variables, plus an amount sufficient  to  pay
17        for  the  additional  administrative  costs  of providing
18        coverage to employees of the unit of local government and
19        their dependents.
20             (2)  In subsequent years, a further adjustment shall
21        be  made  to  reflect  the  actual  prior  years'  claims
22        experience  of  the  employees  of  the  unit  of   local
23        government.
24        In  the  case  of  coverage of local government employees
25    under a health maintenance organization, the  Director  shall
26    annually  determine  for  each  participating  unit  of local
27    government the maximum monthly amount the unit may contribute
28    toward that coverage, based on an analysis of  (i)  the  age,
29    sex,  geographic  location,  and  other  relevant demographic
30    variables of the unit's employees and (ii) the cost to  cover
31    those  employees  under the State group health benefits plan.
32    The Director may  similarly  determine  the  maximum  monthly
33    amount  each  unit  of local government may contribute toward
34    coverage  of  its  employees'  dependents  under   a   health
 
HB2514 Engrossed            -22-     LRB093 08477 JLS 08701 b
 1    maintenance organization.
 2        Monthly  payments  by the unit of local government or its
 3    employees  for  group  health   benefits   plan   or   health
 4    maintenance  organization  coverage shall be deposited in the
 5    Local Government Health Insurance Reserve Fund.
 6        The Local Government Health Insurance Reserve Fund  shall
 7    be  a continuing fund not subject to fiscal year limitations.
 8    All expenditures from this Fund shall be  used  for  payments
 9    for  health  care  benefits  for  local  government, domestic
10    violence shelter  or  service,  and  rehabilitation  facility
11    employees,  annuitants,  and dependents, and to reimburse the
12    Department or its administrative service organization for all
13    expenses incurred in  the  administration  of  benefits.   No
14    other State funds may be used for these purposes.
15        A  local government employer's participation or desire to
16    participate in a program created under this subsection  shall
17    not   limit   that   employer's  duty  to  bargain  with  the
18    representative of  any  collective  bargaining  unit  of  its
19    employees.
20        (j)  Any  rehabilitation  facility  within  the  State of
21    Illinois may apply to the Director  to  have  its  employees,
22    annuitants,  and  their  eligible  dependents  provided group
23    health coverage under this Act on  a  non-insured  basis.  To
24    participate,  a  rehabilitation facility must agree to enroll
25    all of its employees and remit the entire cost  of  providing
26    such   coverage   for   its   employees,   except   that  the
27    rehabilitation facility shall not be required to enroll those
28    of its employees who are covered spouses or dependents  under
29    this  plan  or  another group policy or plan providing health
30    benefits as long as (1)  an  appropriate  official  from  the
31    rehabilitation   facility  attests  that  each  employee  not
32    enrolled is a covered spouse or dependent under this plan  or
33    another  group  policy  or  plan, and (2) at least 85% of the
34    employees are enrolled and the rehabilitation facility remits
 
HB2514 Engrossed            -23-     LRB093 08477 JLS 08701 b
 1    the entire cost of providing  coverage  to  those  employees.
 2    Employees  of a participating rehabilitation facility who are
 3    not enrolled due  to  coverage  under  another  group  health
 4    policy or plan may enroll in the event of a qualifying change
 5    in   status,  special  enrollment,  special  circumstance  as
 6    defined by the Director, or during the annual Benefit  Choice
 7    Period.   A  participating  rehabilitation  facility may also
 8    elect to cover its annuitants. Dependent  coverage  shall  be
 9    offered  on  an  optional  basis,  with the costs paid by the
10    rehabilitation facility, its employees, or  some  combination
11    of  the  2  as determined by the rehabilitation facility. The
12    rehabilitation  facility  shall  be  responsible  for  timely
13    collection and transmission of dependent premiums.
14        The Director shall annually determine quarterly rates  of
15    payment, subject to the following constraints:
16             (1)  In  the first year of coverage, the rates shall
17        be  equal  to  the  amount  normally  charged  to   State
18        employees  for elected optional coverages or for enrolled
19        dependents coverages or other contributory  coverages  on
20        behalf of its employees, adjusted for differences between
21        State  employees  and  employees  of  the  rehabilitation
22        facility  in  age,  sex,  geographic  location  or  other
23        relevant demographic variables, plus an amount sufficient
24        to   pay  for  the  additional  administrative  costs  of
25        providing coverage to  employees  of  the  rehabilitation
26        facility and their dependents.
27             (2)  In subsequent years, a further adjustment shall
28        be  made  to  reflect  the  actual  prior  years'  claims
29        experience   of   the  employees  of  the  rehabilitation
30        facility.
31        Monthly payments by the rehabilitation  facility  or  its
32    employees for group health benefits shall be deposited in the
33    Local Government Health Insurance Reserve Fund.
34        (k)  Any  domestic violence shelter or service within the
 
HB2514 Engrossed            -24-     LRB093 08477 JLS 08701 b
 1    State of Illinois may apply  to  the  Director  to  have  its
 2    employees,  annuitants,  and  their dependents provided group
 3    health coverage under this Act on a  non-insured  basis.   To
 4    participate,  a  domestic  violence  shelter  or service must
 5    agree to enroll all of its employees and pay the entire  cost
 6    of   providing   such   coverage   for   its   employees.   A
 7    participating domestic violence shelter  may  also  elect  to
 8    cover its annuitants.  Dependent coverage shall be offered on
 9    an  optional  basis,  with  the  costs  paid  by the domestic
10    violence  shelter  or  service,  its   employees,   or   some
11    combination  of  the 2 as determined by the domestic violence
12    shelter or service.  The domestic violence shelter or service
13    shall be responsible for timely collection  and  transmission
14    of dependent premiums.
15        The  Director  shall annually determine rates of payment,
16    subject to the following constraints:
17             (1)  In the first year of coverage, the rates  shall
18        be   equal  to  the  amount  normally  charged  to  State
19        employees for elected optional coverages or for  enrolled
20        dependents  coverages  or other contributory coverages on
21        behalf of its employees, adjusted for differences between
22        State employees and employees of  the  domestic  violence
23        shelter  or  service  in age, sex, geographic location or
24        other relevant  demographic  variables,  plus  an  amount
25        sufficient to pay for the additional administrative costs
26        of  providing  coverage  to  employees  of  the  domestic
27        violence shelter or service and their dependents.
28             (2)  In subsequent years, a further adjustment shall
29        be  made  to  reflect  the  actual  prior  years'  claims
30        experience  of  the  employees  of  the domestic violence
31        shelter or service.
32        Monthly payments by  the  domestic  violence  shelter  or
33    service  or its employees for group health insurance shall be
34    deposited in the Local Government  Health  Insurance  Reserve
 
HB2514 Engrossed            -25-     LRB093 08477 JLS 08701 b
 1    Fund.
 2        (k-5)  Any  qualified  small business within the State of
 3    Illinois may apply to the Director  to  have  its  employees,
 4    annuitants,   and  their  dependents  provided  group  health
 5    coverage  under  this  Act  on  a  non-insured  basis.    The
 6    Department  may  set a limit on the number of qualified small
 7    businesses that may receive group health coverage under  this
 8    subsection  (k-5).   In  order  to  control  its  costs,  the
 9    Department  may  designate  which  plans  it  will  offer  to
10    qualified small businesses under this subsection (k-5). Those
11    plans  may  include,  but  need  not  be limited to, minimum,
12    limited, or comprehensive coverage plans; Health  Maintenance
13    Organization  and  Preferred Provider Organization plans; and
14    medical savings plans. The plans may include the  utilization
15    of insurance producers in the marketing of coverage under the
16    plans.  In  offering  plans  under  this subsection (k-5) the
17    Department shall be subject to ratings and  minimum  coverage
18    in  the  same  manner  as a private insurer. Any plan offered
19    under  this  subsection  (k-5)  may  provide   for   employee
20    contributions  to  the  cost  of  the plan. A qualified small
21    business may select one or more of the plans offered  by  the
22    Department  to  offer  to  its  employees.  To participate, a
23    qualified small business must agree to offer to enroll all of
24    its employees and remit the entire  cost  of  providing  such
25    coverage  for  its employees, except that the qualified small
26    business shall  not  be  required  to  enroll  those  of  its
27    employees  who  waive  coverage  under  this subsection (k-5)
28    because they are covered spouses or dependents under  another
29    group policy or plan providing health benefits as long as (1)
30    an  appropriate  official  from  the qualified small business
31    attests that each employee not enrolled is a  covered  spouse
32    or  dependent  under  another group policy or plan and (2) at
33    least  75%  of  the  remaining  employees  are  enrolled.   A
34    participating qualified small  business  may  also  elect  to
 
HB2514 Engrossed            -26-     LRB093 08477 JLS 08701 b
 1    cover its annuitants.  Dependent coverage shall be offered on
 2    an optional basis, with the costs paid by the small business,
 3    its  employees, or some combination of the 2 as determined by
 4    the qualified small business.  The qualified  small  business
 5    shall  be  responsible for timely collection and transmission
 6    of all premiums.
 7        The Director shall annually determine  rates  of  payment
 8    taking into consideration, among other things, the following:
 9             (1)  In  the first year of coverage, the rates shall
10        be  equal  to  the  amount  normally  charged  to   State
11        employees  for elected optional coverages or for enrolled
12        dependents coverages or other contributory  coverages  on
13        behalf of its employees, adjusted for differences between
14        State  employees  and  employees  of  the qualified small
15        business  in  age,  sex,  geographic  location  or  other
16        relevant demographic variables, plus an amount sufficient
17        to  pay  for  the  additional  administrative  costs   of
18        providing  coverage  to  employees of the qualified small
19        business and their dependents.
20             (2)  In subsequent years, a further adjustment shall
21        be  made  to  reflect  the  actual  prior  years'  claims
22        experience  of  the  employees  of  the  qualified  small
23        business.
24        Monthly payments by  the  qualified  small  business  for
25    group  health  insurance  shall  be  deposited into the Small
26    Employers Health Insurance Reserve Fund.  The Small Employers
27    Health Insurance Reserve Fund shall be a continuing fund  not
28    subject  to  fiscal  year limitations.  All expenditures from
29    this fund shall be used for payments for health care benefits
30    for  employees  of  qualified  small  businesses  and   their
31    annuitants  and dependents and to reimburse the Department or
32    its administrative  service  organization  for  all  expenses
33    incurred  in the administration of benefits.  No State funds,
34    other than those specifically appropriated, may be  used  for
 
HB2514 Engrossed            -27-     LRB093 08477 JLS 08701 b
 1    these purposes.
 2        (l)  A  public  community  college  or  entity  organized
 3    pursuant to the Public Community College Act may apply to the
 4    Director  initially to have only annuitants not covered prior
 5    to July 1, 1992 by the district's health plan provided health
 6    coverage  under  this  Act  on  a  non-insured  basis.    The
 7    community   college   must   execute  a  2-year  contract  to
 8    participate  in  the  Local  Government  Health   Plan.   Any
 9    annuitant  may  enroll in the event of a qualifying change in
10    status, special enrollment, special circumstance  as  defined
11    by the Director, or during the annual Benefit Choice Period.
12        The  Director  shall  annually determine monthly rates of
13    payment subject to  the  following  constraints:   for  those
14    community  colleges with annuitants only enrolled, first year
15    rates shall be equal to the average cost to cover claims  for
16    a   State   member   adjusted   for   demographics,  Medicare
17    participation, and other factors; and in the second  year,  a
18    further  adjustment  of  rates  shall  be made to reflect the
19    actual  first  year's  claims  experience  of   the   covered
20    annuitants.
21        (l-5)  The    provisions   of   subsection   (l)   become
22    inoperative on July 1, 1999.
23        (m)  The Director shall adopt any rules deemed  necessary
24    for implementation of this amendatory Act of 1989 (Public Act
25    86-978).
26    (Source:  P.A.  91-280,  eff.  7-23-99; 91-311; eff. 7-29-99;
27    91-357, eff. 7-29-99;  91-390,  eff.  7-30-99;  91-395,  eff.
28    7-30-99;  91-617,  eff. 8-19-99; 92-16, eff. 6-28-01; revised
29    2-25-02.)

30        (5 ILCS 375/13.2) (from Ch. 127, par. 533.2)
31        Sec. 13.2.  Insurance reserve  funds;  investments.   All
32    amounts  held in the Health Insurance Reserve Fund, the Group
33    Insurance Premium Fund, the Small Employers Health  Insurance
 
HB2514 Engrossed            -28-     LRB093 08477 JLS 08701 b
 1    Reserve  Fund,  and  the  Local  Government  Health Insurance
 2    Reserve Fund shall be invested, at  interest,  by  the  State
 3    Treasurer.   The  investments  shall  be  subject  to  terms,
 4    conditions,  and  limitations imposed by the laws of Illinois
 5    on State funds.  All  income  derived  from  the  investments
 6    shall accrue and be deposited to the respective funds no less
 7    frequently  than  quarterly.   The  Health  Insurance Reserve
 8    Fund, the Small Employers Health Insurance Reserve Fund,  and
 9    the  Local  Government Health Insurance Reserve Fund shall be
10    administered by the Director.
11    (Source: P.A. 91-390, eff. 7-30-99.)

12        (5 ILCS 375/15) (from Ch. 127, par. 535)
13        Sec. 15. Administration; rules; audit; review.
14        (a)  The Director shall administer  this  Act  and  shall
15    prescribe such rules and regulations as are necessary to give
16    full effect to the purposes of this Act.
17        (b)  These  rules  may  fix  reasonable standards for the
18    group life  and  group  health  programs  and  other  benefit
19    programs  offered  under  this  Act,  and for the contractors
20    providing them.
21        (c)  These rules shall specify that covered and  optional
22    medical  services of the program are services provided within
23    the  scope  of  their  licenses  by  practitioners   in   all
24    categories  licensed  under  the Medical Practice Act of 1987
25    and shall provide that all eligible persons be fully informed
26    of this specification.
27        (d)  These rules shall establish eligibility requirements
28    for members and dependents as may be necessary to  supplement
29    or clarify requirements contained in this Act.
30        (e)  Each  affected  department  of  the State, the State
31    Universities  Retirement  System,  the  Teachers'  Retirement
32    System, and each qualified local  government,  rehabilitation
33    facility,  or  domestic violence shelter or service, or small
 
HB2514 Engrossed            -29-     LRB093 08477 JLS 08701 b
 1    business shall keep such records, make  such  certifications,
 2    and furnish the Director such information as may be necessary
 3    for  the  administration  of  this Act, including information
 4    concerning number and total amounts of payroll  of  employees
 5    of  the  department  who are paid from trust funds or federal
 6    funds.
 7        (f)  Each  member,   each   community   college   benefit
 8    recipient  to  whom  this  Act  applies, and each TRS benefit
 9    recipient  to  whom  this  Act  applies  shall  furnish   the
10    Director,  in  such  form as may be required, any information
11    that may be  necessary  to  enroll  such  member  or  benefit
12    recipient  and,  if  applicable,  his  or  her  dependents or
13    dependent beneficiaries under the programs or plan, including
14    such data as  may  be  required  to  allow  the  Director  to
15    accumulate   statistics   on   data  normally  considered  in
16    actuarial studies  of  employee  groups.   Information  about
17    community  college  benefit  recipients and community college
18    dependent beneficiaries shall be furnished through the  State
19    Universities   Retirement   System.   Information  about  TRS
20    benefit recipients and TRS dependent beneficiaries  shall  be
21    furnished through the Teachers' Retirement System.
22        (g)  There  shall  be  audits and reports on the programs
23    authorized and  established  by  this  Act  prepared  by  the
24    Director  with  the  assistance  of  a qualified, independent
25    accounting firm.  The reports shall  provide  information  on
26    the experience, and administrative effectiveness and adequacy
27    of the program including, when applicable, recommendations on
28    up-grading of benefits and improvement of the program.
29        (h)  Any  final  order,  decision  or other determination
30    made, issued or executed by the Director under the provisions
31    of this Act whereby any contractor  or  person  is  aggrieved
32    shall  be subject to review in accordance with the provisions
33    of the Administrative  Review  Law  and  all  amendments  and
34    modifications   thereof,   and  the  rules  adopted  pursuant
 
HB2514 Engrossed            -30-     LRB093 08477 JLS 08701 b
 1    thereto, shall apply to and govern all  proceedings  for  the
 2    judicial  review  of  final  administrative  decisions of the
 3    Director.
 4    (Source: P.A. 90-497, eff. 8-18-97; 91-390, eff. 7-30-99.)

 5        Section 10.  The State Finance Act is amended by changing
 6    Section 25 as follows:

 7        (30 ILCS 105/25) (from Ch. 127, par. 161)
 8        Sec. 25.  Fiscal year limitations.
 9        (a)  All   appropriations   shall   be   available    for
10    expenditure for the fiscal year or for a lesser period if the
11    Act  making that appropriation so specifies.  A deficiency or
12    emergency appropriation shall be  available  for  expenditure
13    only  through  June  30  of the year when the Act making that
14    appropriation is enacted unless that Act otherwise provides.
15        (b)  Outstanding liabilities as of June 30, payable  from
16    appropriations  which have otherwise expired, may be paid out
17    of the expiring  appropriations  during  the  2-month  period
18    ending  at  the  close of business on August 31.  Any service
19    involving professional or artistic  skills  or  any  personal
20    services  by  an  employee  whose  compensation is subject to
21    income tax withholding must be performed as of June 30 of the
22    fiscal  year  in  order  to  be  considered  an  "outstanding
23    liability as of June 30" that is thereby eligible for payment
24    out of the expiring appropriation.
25        However, payment of tuition  reimbursement  claims  under
26    Section 14-7.03 or 18-3 of the School Code may be made by the
27    State  Board  of  Education from its appropriations for those
28    respective purposes for any  fiscal  year,  even  though  the
29    claims  reimbursed  by the payment may be claims attributable
30    to a prior fiscal year, and  payments  may  be  made  at  the
31    direction  of  the State Superintendent of Education from the
32    fund from which the appropriation is made without  regard  to
 
HB2514 Engrossed            -31-     LRB093 08477 JLS 08701 b
 1    any fiscal year limitations.
 2        Medical  payments  may  be  made  by  the  Department  of
 3    Veterans'  Affairs from its appropriations for those purposes
 4    for any fiscal year, without regard  to  the  fact  that  the
 5    medical  services  being  compensated for by such payment may
 6    have been rendered in a prior fiscal year.
 7        Medical payments may be made by the Department of  Public
 8    Aid  and child care payments may be made by the Department of
 9    Human Services (as successor to the Department of Public Aid)
10    from appropriations for those purposes for any  fiscal  year,
11    without  regard  to  the  fact that the medical or child care
12    services being compensated for by such payment may have  been
13    rendered  in a prior fiscal year; and payments may be made at
14    the  direction  of  the  Department  of  Central   Management
15    Services  from  the  Health Insurance Reserve Fund, the Small
16    Employers  Health  Insurance  Reserve  Fund,  and  the  Local
17    Government Health Insurance Reserve Fund  without  regard  to
18    any fiscal year limitations.
19        Additionally,  payments  may be made by the Department of
20    Human Services from its appropriations, or  any  other  State
21    agency  from  its  appropriations  with  the  approval of the
22    Department of Human Services, from the Immigration Reform and
23    Control  Fund  for  purposes  authorized  pursuant   to   the
24    Immigration Reform and Control Act of 1986, without regard to
25    any fiscal year limitations.
26        Further,  with  respect to costs incurred in fiscal years
27    2002 and 2003  only,  payments  may  be  made  by  the  State
28    Treasurer from its appropriations from the Capital Litigation
29    Trust Fund without regard to any fiscal year limitations.
30        (c)  Further,  payments  may be made by the Department of
31    Public Health and the Department of Human Services (acting as
32    successor to  the  Department  of  Public  Health  under  the
33    Department  of  Human  Services  Act)  from  their respective
34    appropriations for grants for medical care to or on behalf of
 
HB2514 Engrossed            -32-     LRB093 08477 JLS 08701 b
 1    persons  suffering  from  chronic  renal   disease,   persons
 2    suffering  from  hemophilia,  rape victims, and premature and
 3    high-mortality risk infants and their mothers and for  grants
 4    for  supplemental  food  supplies  provided  under the United
 5    States Department of Agriculture Women, Infants and  Children
 6    Nutrition  Program, for any fiscal year without regard to the
 7    fact that the services being compensated for by such  payment
 8    may have been rendered in a prior fiscal year.
 9        (d)  The  Department  of Public Health and the Department
10    of Human Services (acting as successor to the  Department  of
11    Public  Health  under  the  Department of Human Services Act)
12    shall each annually submit to the State  Comptroller,  Senate
13    President,  Senate  Minority  Leader,  Speaker  of the House,
14    House  Minority  Leader,  and  the  respective  Chairmen  and
15    Minority Spokesmen of the Appropriations  Committees  of  the
16    Senate  and  the House, on or before December 31, a report of
17    fiscal year funds used to pay for services  provided  in  any
18    prior  fiscal year.  This report shall document by program or
19    service category those expenditures from  the  most  recently
20    completed  fiscal  year  used to pay for services provided in
21    prior fiscal years.
22        (e)  The Department of Public Aid and the  Department  of
23    Human  Services  (acting  as  successor  to the Department of
24    Public  Aid)  shall  each  annually  submit  to   the   State
25    Comptroller,   Senate   President,  Senate  Minority  Leader,
26    Speaker of the House, House Minority Leader,  the  respective
27    Chairmen   and   Minority  Spokesmen  of  the  Appropriations
28    Committees of the Senate and the House, on or before November
29    30, a report  that  shall  document  by  program  or  service
30    category  those expenditures from the most recently completed
31    fiscal year used to pay for (i) services  provided  in  prior
32    fiscal years and (ii) services for which claims were received
33    in prior fiscal years.
34        (f)  The  Department  of  Human Services (as successor to
 
HB2514 Engrossed            -33-     LRB093 08477 JLS 08701 b
 1    the Department of Public Aid) shall annually  submit  to  the
 2    State  Comptroller, Senate President, Senate Minority Leader,
 3    Speaker  of  the  House,  House  Minority  Leader,  and   the
 4    respective   Chairmen   and   Minority   Spokesmen   of   the
 5    Appropriations  Committees of the Senate and the House, on or
 6    before December 31, a report of fiscal year funds used to pay
 7    for services (other than medical care) provided in any  prior
 8    fiscal  year.   This  report  shall  document  by  program or
 9    service category those expenditures from  the  most  recently
10    completed  fiscal  year  used to pay for services provided in
11    prior fiscal years.
12        (g)  In addition,  each  annual  report  required  to  be
13    submitted  by  the  Department of Public Aid under subsection
14    (e) shall include the following information with  respect  to
15    the State's Medicaid program:
16             (1)  Explanations   of   the  exact  causes  of  the
17        variance between the previous year's estimated and actual
18        liabilities.
19             (2)  Factors  affecting  the  Department  of  Public
20        Aid's liabilities, including but not limited  to  numbers
21        of  aid recipients, levels of medical service utilization
22        by aid recipients, and inflation in the cost  of  medical
23        services.
24             (3)  The  results  of  the  Department's  efforts to
25        combat fraud and abuse.
26        (h)  As provided in Section 4  of  the  General  Assembly
27    Compensation  Act, any utility bill for service provided to a
28    General  Assembly  member's  district  office  for  a  period
29    including portions of 2 consecutive fiscal years may be  paid
30    from funds appropriated for such expenditure in either fiscal
31    year.
32        (i)  An agency which administers a fund classified by the
33    Comptroller as an internal service fund may issue rules for:
34             (1)  billing  user  agencies  in  advance  based  on
 
HB2514 Engrossed            -34-     LRB093 08477 JLS 08701 b
 1        estimated charges for goods or services;
 2             (2)  issuing  credits  during  the subsequent fiscal
 3        year for all user agency  payments  received  during  the
 4        prior  fiscal  year  which  were  in  excess of the final
 5        amounts owed by the user agency for that period; and
 6             (3)  issuing  catch-up  billings  to  user  agencies
 7        during the subsequent fiscal year for  amounts  remaining
 8        due  when  payments  received from the user agency during
 9        the prior fiscal year were less  than  the  total  amount
10        owed for that period.
11    User  agencies  are  authorized to reimburse internal service
12    funds for catch-up billings by vouchers drawn  against  their
13    respective  appropriations  for  the fiscal year in which the
14    catch-up billing was issued.
15    (Source: P.A. 92-885, eff. 1-13-03.)

16        Section 99.  Effective date.  This Act  takes  effect  on
17    January 1, 2004.