093_HB2514ham001











                                     LRB093 08477 JLS 14298 a

 1                    AMENDMENT TO HOUSE BILL 2514

 2        AMENDMENT NO.     .  Amend House Bill 2514  by  replacing
 3    the title with the following:
 4        "AN  ACT  concerning health coverage under State employee
 5    programs."; and

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

 8        "Section  5.  The  State Employees Group Insurance Act of
 9    1971 is amended by changing Sections 2, 3, 10, 13.2,  and  15
10    as follows:

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

 6        (5 ILCS 375/3) (from Ch. 127, par. 523)
 7        Sec.   3.  Definitions.   Unless  the  context  otherwise
 8    requires, the following words and phrases as used in this Act
 9    shall have the following meanings.  The Department may define
10    these and other words and phrases separately for the  purpose
11    of  implementing  specific  programs providing benefits under
12    this Act.
13        (a)  "Administrative  service  organization"  means   any
14    person,  firm  or  corporation experienced in the handling of
15    claims  which  is  fully  qualified,  financially  sound  and
16    capable of meeting the service requirements of a contract  of
17    administration executed with the Department.
18        (b)  "Annuitant"  means  (1)  an employee who retires, or
19    has retired, on or after January  1,  1966  on  an  immediate
20    annuity under the provisions of Articles 2, 14, 15 (including
21    an  employee  who  has  retired under the optional retirement
22    program established under Section 15-158.2), paragraphs  (2),
23    (3),  or (5) of Section 16-106, or Article 18 of the Illinois
24    Pension  Code;  (2)  any  person  who  was  receiving   group
25    insurance  coverage  under  this  Act as of March 31, 1978 by
26    reason of his status as an annuitant, even though the annuity
27    in  relation  to  which  such  coverage  was  provided  is  a
28    proportional annuity based on less than the minimum period of
29    service required for  a  retirement  annuity  in  the  system
30    involved;  (3)  any  person not otherwise covered by this Act
31    who has retired as a participating member under Article 2  of
32    the   Illinois   Pension  Code  but  is  ineligible  for  the
33    retirement  annuity  under  Section  2-119  of  the  Illinois
 
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 1    Pension Code; (4) the spouse of any person who is receiving a
 2    retirement annuity under Article 18 of the  Illinois  Pension
 3    Code  and  who  is  covered  under  a  group health insurance
 4    program sponsored by a governmental employer other  than  the
 5    State  of  Illinois  and who has irrevocably elected to waive
 6    his or her coverage under this Act and to  have  his  or  her
 7    spouse  considered  as the "annuitant" under this Act and not
 8    as a "dependent"; or (5) an  employee  who  retires,  or  has
 9    retired,  from  a qualified position, as determined according
10    to rules promulgated by the Director, under a qualified local
11    government  or  a  qualified  rehabilitation  facility  or  a
12    qualified domestic violence shelter or  service;  or  (6)  an
13    owner  or  employee  who  retires,  or  has  retired,  from a
14    qualified  position,  as  determined   according   to   rules
15    promulgated by the Director, with a qualified small business.
16    (For definition of "retired employee", see (p) post).
17        (b-5)  "New  SERS  annuitant"  means  a person who, on or
18    after January 1, 1998, becomes an annuitant,  as  defined  in
19    subsection   (b),   by  virtue  of  beginning  to  receive  a
20    retirement annuity under Article 14 of the  Illinois  Pension
21    Code,  and is eligible to participate in the basic program of
22    group health benefits provided for annuitants under this Act.
23        (b-6)  "New SURS annuitant" means a person who (1) on  or
24    after  January  1,  1998, becomes an annuitant, as defined in
25    subsection  (b),  by  virtue  of  beginning  to   receive   a
26    retirement  annuity  under Article 15 of the Illinois Pension
27    Code, (2) has not made the election authorized under  Section
28    15-135.1 of the Illinois Pension Code, and (3) is eligible to
29    participate  in  the  basic  program of group health benefits
30    provided for annuitants under this Act.
31        (b-7)  "New TRS State annuitant" means a person  who,  on
32    or  after  July  1, 1998, becomes an annuitant, as defined in
33    subsection  (b),  by  virtue  of  beginning  to   receive   a
34    retirement  annuity  under Article 16 of the Illinois Pension
 
                            -4-      LRB093 08477 JLS 14298 a
 1    Code based on service as a teacher as  defined  in  paragraph
 2    (2),  (3),  or  (5)  of  Section  16-106 of that Code, and is
 3    eligible to participate in the basic program of group  health
 4    benefits provided for annuitants under this Act.
 5        (c)  "Carrier"   means   (1)   an  insurance  company,  a
 6    corporation  organized  under  the  Limited  Health   Service
 7    Organization Act or the Voluntary Health Services Plan Act, a
 8    partnership,  or other nongovernmental organization, which is
 9    authorized  to  do  group  life  or  group  health  insurance
10    business in Illinois, or (2)  the  State  of  Illinois  as  a
11    self-insurer.
12        (d)  "Compensation"  means  salary  or wages payable on a
13    regular payroll by the State Treasurer on a  warrant  of  the
14    State Comptroller out of any State, trust or federal fund, or
15    by  the Governor of the State through a disbursing officer of
16    the State out of a trust or out of federal funds, or  by  any
17    Department  out  of State, trust, federal or other funds held
18    by the State Treasurer or the Department, to any  person  for
19    personal   services  currently  performed,  and  ordinary  or
20    accidental disability  benefits  under  Articles  2,  14,  15
21    (including  ordinary  or accidental disability benefits under
22    the optional retirement  program  established  under  Section
23    15-158.2),  paragraphs (2), (3), or (5) of Section 16-106, or
24    Article 18 of  the  Illinois  Pension  Code,  for  disability
25    incurred after January 1, 1966, or benefits payable under the
26    Workers'   Compensation   or  Occupational  Diseases  Act  or
27    benefits  payable  under  a  sick  pay  plan  established  in
28    accordance  with  Section  36  of  the  State  Finance   Act.
29    "Compensation" also means salary or wages paid to an employee
30    of any qualified local government or qualified rehabilitation
31    facility or a qualified domestic violence shelter or service.
32    "Compensation" also means salary or wages paid to an employee
33    or owner of a qualified small business.
34        (e)  "Commission"   means   the   State  Employees  Group
 
                            -5-      LRB093 08477 JLS 14298 a
 1    Insurance  Advisory  Commission  authorized  by   this   Act.
 2    Commencing  July  1,  1984,  "Commission" as used in this Act
 3    means  the  Illinois  Economic  and  Fiscal   Commission   as
 4    established  by the Legislative Commission Reorganization Act
 5    of 1984.
 6        (f)  "Contributory", when  referred  to  as  contributory
 7    coverage,  shall  mean optional coverages or benefits elected
 8    by the member toward the cost  of  which  such  member  makes
 9    contribution, or which are funded in whole or in part through
10    the acceptance of a reduction in earnings or the foregoing of
11    an increase in earnings by an employee, as distinguished from
12    noncontributory  coverage or benefits which are paid entirely
13    by the State of Illinois without reduction  of  the  member's
14    salary.
15        (g)  "Department"   means  any  department,  institution,
16    board, commission, officer, court or any agency of the  State
17    government  receiving  appropriations  and  having  power  to
18    certify  payrolls  to the Comptroller authorizing payments of
19    salary and wages against such appropriations as are  made  by
20    the  General  Assembly  from any State fund, or against trust
21    funds held by the State  Treasurer  and  includes  boards  of
22    trustees of the retirement systems created by Articles 2, 14,
23    15,  16  and  18  of the Illinois Pension Code.  "Department"
24    also includes the  Illinois  Comprehensive  Health  Insurance
25    Board,  the Board of Examiners established under the Illinois
26    Public Accounting Act, and the Illinois Rural Bond Bank.
27        (h)  "Dependent", when the term is used in the context of
28    the health and life plan, means a  member's  spouse  and  any
29    unmarried child (1) from birth to age 19 including an adopted
30    child, a child who lives with the member from the time of the
31    filing  of a petition for adoption until entry of an order of
32    adoption, a stepchild or recognized child who lives with  the
33    member  in  a parent-child relationship, or a child who lives
34    with the member if such member is a court appointed  guardian
 
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 1    of  the  child,  or  (2) age 19 to 23 enrolled as a full-time
 2    student in any accredited school, financially dependent  upon
 3    the  member,  and  eligible  to be claimed as a dependent for
 4    income tax purposes, or (3) age 19 or over who is mentally or
 5    physically handicapped. For the health plan  only,  the  term
 6    "dependent"  also  includes  any person enrolled prior to the
 7    effective date of this Section  who  is  dependent  upon  the
 8    member to the extent that the member may claim such person as
 9    a  dependent for income tax deduction purposes; no other such
10    person may be enrolled. For the health plan  only,  the  term
11    "dependent"  also  includes any person who has received after
12    June 30, 2000 an organ  transplant  and  who  is  financially
13    dependent  upon  the  member  and eligible to be claimed as a
14    dependent for income tax purposes.
15        (i)  "Director"  means  the  Director  of  the   Illinois
16    Department of Central Management Services.
17        (j)  "Eligibility  period"  means  the  period  of time a
18    member has to elect  enrollment  in  programs  or  to  select
19    benefits without regard to age, sex or health.
20        (k)  "Employee"   means  and  includes  each  officer  or
21    employee in the service of a department who (1) receives  his
22    compensation  for  service  rendered  to  the department on a
23    warrant  issued  pursuant  to  a  payroll  certified   by   a
24    department  or  on  a  warrant or check issued and drawn by a
25    department upon a trust,  federal  or  other  fund  or  on  a
26    warrant  issued pursuant to a payroll certified by an elected
27    or duly appointed  officer  of  the  State  or  who  receives
28    payment  of the performance of personal services on a warrant
29    issued pursuant to a payroll certified by  a  Department  and
30    drawn  by  the  Comptroller  upon the State Treasurer against
31    appropriations made by the General Assembly from any fund  or
32    against  trust  funds held by the State Treasurer, and (2) is
33    employed  full-time  or  part-time  in  a  position  normally
34    requiring actual performance of duty during not less than 1/2
 
                            -7-      LRB093 08477 JLS 14298 a
 1    of a normal work period, as established by  the  Director  in
 2    cooperation with each department, except that persons elected
 3    by  popular  vote  will  be  considered  employees during the
 4    entire term for which they are elected  regardless  of  hours
 5    devoted  to  the  service  of  the State, and (3) except that
 6    "employee" does not include any person who is not eligible by
 7    reason of such person's employment to participate in  one  of
 8    the State retirement systems under Articles 2, 14, 15 (either
 9    the  regular  Article  15  system  or the optional retirement
10    program established under Section 15-158.2) or 18,  or  under
11    paragraph (2), (3), or (5) of Section 16-106, of the Illinois
12    Pension  Code,  but  such  term  does include persons who are
13    employed during the 6 month qualifying period  under  Article
14    14 of the Illinois Pension Code.  Such term also includes any
15    person  who  (1) after January 1, 1966, is receiving ordinary
16    or accidental disability benefits under Articles  2,  14,  15
17    (including  ordinary  or accidental disability benefits under
18    the optional retirement  program  established  under  Section
19    15-158.2),  paragraphs (2), (3), or (5) of Section 16-106, or
20    Article 18 of  the  Illinois  Pension  Code,  for  disability
21    incurred  after January 1, 1966, (2) receives total permanent
22    or total temporary disability under the Workers' Compensation
23    Act or Occupational Disease  Act  as  a  result  of  injuries
24    sustained  or  illness contracted in the course of employment
25    with the State of Illinois, or (3) is not  otherwise  covered
26    under  this  Act  and  has  retired as a participating member
27    under  Article  2  of  the  Illinois  Pension  Code  but   is
28    ineligible  for the retirement annuity under Section 2-119 of
29    the Illinois Pension Code.  However, a person  who  satisfies
30    the criteria of the foregoing definition of "employee" except
31    that  such  person  is  made ineligible to participate in the
32    State  Universities  Retirement  System  by  clause  (4)   of
33    subsection (a) of Section 15-107 of the Illinois Pension Code
34    is   also  an  "employee"  for  the  purposes  of  this  Act.
 
                            -8-      LRB093 08477 JLS 14298 a
 1    "Employee" also includes any person receiving or eligible for
 2    benefits under a sick pay plan established in accordance with
 3    Section 36 of the State Finance Act. "Employee" also includes
 4    each officer or employee in the service of a qualified  local
 5    government,   including  persons  appointed  as  trustees  of
 6    sanitary districts regardless of hours devoted to the service
 7    of the sanitary district, and each employee in the service of
 8    a  qualified  rehabilitation  facility  and  each   full-time
 9    employee  in  the  service  of  a qualified domestic violence
10    shelter  or  service,  as  determined  according   to   rules
11    promulgated  by  the  Director.  "Employee"  also includes an
12    owner and a full-time employee in the service of a  qualified
13    small  business, as determined according to rules promulgated
14    by the Director.
15        (l)  "Member"  means  an  employee,  annuitant,   retired
16    employee or survivor.
17        (m)  "Optional   coverages   or   benefits"  means  those
18    coverages or benefits available to the member on his  or  her
19    voluntary election, and at his or her own expense.
20        (n)  "Program"  means  the  group  life insurance, health
21    benefits and other employee benefits designed and  contracted
22    for by the Director under this Act.
23        (o)  "Health   plan"  means  a  health  benefits  program
24    offered by the State of Illinois for persons eligible for the
25    plan.
26        (p)  "Retired employee" means any person who would be  an
27    annuitant  as  that  term  is defined herein but for the fact
28    that such person retired prior to January 1, 1966.  Such term
29    also includes any person formerly employed by the  University
30    of Illinois in the Cooperative Extension Service who would be
31    an  annuitant  but  for  the  fact  that such person was made
32    ineligible  to  participate   in   the   State   Universities
33    Retirement  System by clause (4) of subsection (a) of Section
34    15-107 of the Illinois Pension Code.
 
                            -9-      LRB093 08477 JLS 14298 a
 1        (q)  "Survivor" means a person receiving an annuity as  a
 2    survivor  of an employee or of an annuitant.  "Survivor" also
 3    includes:  (1)  the  surviving  dependent  of  a  person  who
 4    satisfies the  definition  of  "employee"  except  that  such
 5    person  is  made  ineligible  to  participate  in  the  State
 6    Universities  Retirement  System  by clause (4) of subsection
 7    (a) of Section 15-107 of the Illinois Pension Code;  and  (2)
 8    the  surviving  dependent  of any person formerly employed by
 9    the University  of  Illinois  in  the  Cooperative  Extension
10    Service  who  would  be an annuitant except for the fact that
11    such person was made ineligible to participate in  the  State
12    Universities  Retirement  System  by clause (4) of subsection
13    (a) of Section 15-107 of the Illinois Pension Code.
14        (q-5)  "New SERS survivor" means a survivor,  as  defined
15    in  subsection (q), whose annuity is paid under Article 14 of
16    the Illinois Pension Code and is based on the death of (i) an
17    employee whose death occurs on or after January 1,  1998,  or
18    (ii) a new SERS annuitant as defined in subsection (b-5).
19        (q-6)  "New  SURS  survivor" means a survivor, as defined
20    in subsection (q), whose annuity is paid under Article 15  of
21    the Illinois Pension Code and is based on the death of (i) an
22    employee  whose  death occurs on or after January 1, 1998, or
23    (ii) a new SURS annuitant as defined in subsection (b-6).
24        (q-7)  "New TRS State  survivor"  means  a  survivor,  as
25    defined  in  subsection  (q),  whose  annuity  is  paid under
26    Article 16 of the Illinois Pension Code and is based  on  the
27    death  of  (i)  an  employee  who  is a teacher as defined in
28    paragraph (2), (3), or (5) of Section 16-106 of that Code and
29    whose death occurs on or after July 1, 1998, or  (ii)  a  new
30    TRS State annuitant as defined in subsection (b-7).
31        (r)  "Medical   services"  means  the  services  provided
32    within the scope of their licenses by  practitioners  in  all
33    categories licensed under the Medical Practice Act of 1987.
34        (s)  "Unit   of   local  government"  means  any  county,
 
                            -10-     LRB093 08477 JLS 14298 a
 1    municipality,  township,   school   district   (including   a
 2    combination  of  school districts under the Intergovernmental
 3    Cooperation Act), special district or other unit,  designated
 4    as a unit of local government by law, which exercises limited
 5    governmental   powers   or   powers  in  respect  to  limited
 6    governmental subjects, any not-for-profit association with  a
 7    membership  that  primarily  includes  townships and township
 8    officials, that has duties that include provision of research
 9    service, dissemination of information, and other acts for the
10    purpose of improving township government, and that is  funded
11    wholly  or  partly  in  accordance  with Section 85-15 of the
12    Township Code; any not-for-profit corporation or association,
13    with a membership  consisting  primarily  of  municipalities,
14    that  operates its own utility system, and provides research,
15    training, dissemination of  information,  or  other  acts  to
16    promote  cooperation  between  and  among municipalities that
17    provide utility services and for the advancement of the goals
18    and  purposes  of  its  membership;  the  Southern   Illinois
19    Collegiate  Common  Market,  which  is a consortium of higher
20    education institutions in Southern Illinois; and the Illinois
21    Association of Park Districts.  "Qualified local  government"
22    means a unit of local government approved by the Director and
23    participating  in  a  program created under subsection (i) of
24    Section 10 of this Act.
25        (t)  "Qualified  rehabilitation   facility"   means   any
26    not-for-profit   organization   that  is  accredited  by  the
27    Commission on Accreditation of Rehabilitation  Facilities  or
28    certified  by  the Department of Human Services (as successor
29    to  the  Department  of  Mental  Health   and   Developmental
30    Disabilities)   to   provide   services   to   persons   with
31    disabilities  and  which  receives  funds  from  the State of
32    Illinois  for  providing  those  services,  approved  by  the
33    Director  and  participating  in  a  program  created   under
34    subsection (j) of Section 10 of this Act.
 
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 1        (u)  "Qualified  domestic  violence  shelter  or service"
 2    means any Illinois domestic violence shelter or  service  and
 3    its  administrative offices funded by the Department of Human
 4    Services (as successor to the Illinois Department  of  Public
 5    Aid), approved by the Director and participating in a program
 6    created under subsection (k) of Section 10.
 7        (v)  "TRS benefit recipient" means a person who:
 8             (1)  is  not  a "member" as defined in this Section;
 9        and
10             (2)  is receiving a monthly  benefit  or  retirement
11        annuity  under  Article  16 of the Illinois Pension Code;
12        and
13             (3)  either (i) has at least 8 years  of  creditable
14        service under Article 16 of the Illinois Pension Code, or
15        (ii) was enrolled in the health insurance program offered
16        under  that  Article  on January 1, 1996, or (iii) is the
17        survivor of a benefit recipient who had at least 8  years
18        of  creditable  service  under Article 16 of the Illinois
19        Pension Code or was  enrolled  in  the  health  insurance
20        program  offered under that Article on the effective date
21        of this amendatory Act of 1995, or (iv) is a recipient or
22        survivor of a recipient of  a  disability  benefit  under
23        Article 16 of the Illinois Pension Code.
24        (w)  "TRS dependent beneficiary" means a person who:
25             (1)  is  not a "member" or "dependent" as defined in
26        this Section; and
27             (2)  is a TRS benefit recipient's: (A)  spouse,  (B)
28        dependent parent who is receiving at least half of his or
29        her  support  from  the  TRS  benefit  recipient,  or (C)
30        unmarried natural or adopted child who is (i)  under  age
31        19,  or  (ii)  enrolled  as  a  full-time  student  in an
32        accredited school, financially  dependent  upon  the  TRS
33        benefit  recipient, eligible to be claimed as a dependent
34        for income tax purposes, and either is under  age  24  or
 
                            -12-     LRB093 08477 JLS 14298 a
 1        was,  on  January  1,  1996, participating as a dependent
 2        beneficiary in the health insurance program offered under
 3        Article 16 of the Illinois Pension Code, or (iii) age  19
 4        or over who is mentally or physically handicapped.
 5        (x)  "Military  leave  with  pay  and benefits" refers to
 6    individuals in basic training for reserves,  special/advanced
 7    training,  annual  training, emergency call up, or activation
 8    by the President of the United States with approved  pay  and
 9    benefits.
10        (y)  "Military  leave without pay and benefits" refers to
11    individuals who enlist for active duty in a regular component
12    of the U.S. Armed Forces  or  other  duty  not  specified  or
13    authorized under military leave with pay and benefits.
14        (z)  "Community college benefit recipient" means a person
15    who:
16             (1)  is  not  a "member" as defined in this Section;
17        and
18             (2)  is receiving a monthly  survivor's  annuity  or
19        retirement  annuity  under  Article  15  of  the Illinois
20        Pension Code; and
21             (3)  either  (i)  was  a  full-time  employee  of  a
22        community college district or an association of community
23        college boards created under the Public Community College
24        Act (other than an employee  whose  last  employer  under
25        Article  15  of the Illinois Pension Code was a community
26        college district subject to Article  VII  of  the  Public
27        Community College Act) and was eligible to participate in
28        a  group  health  benefit  plan as an employee during the
29        time of employment  with  a  community  college  district
30        (other  than  a  community  college  district  subject to
31        Article VII of the Public Community College  Act)  or  an
32        association  of  community college boards, or (ii) is the
33        survivor of a person described in item (i).
34        (aa)  "Community college dependent beneficiary"  means  a
 
                            -13-     LRB093 08477 JLS 14298 a
 1    person who:
 2             (1)  is  not a "member" or "dependent" as defined in
 3        this Section; and
 4             (2)  is a community college benefit recipient's: (A)
 5        spouse, (B) dependent parent who is  receiving  at  least
 6        half  of  his  or  her support from the community college
 7        benefit recipient, or (C) unmarried  natural  or  adopted
 8        child  who  is  (i)  under  age 19, or (ii) enrolled as a
 9        full-time student in an  accredited  school,  financially
10        dependent  upon  the community college benefit recipient,
11        eligible to be claimed as  a  dependent  for  income  tax
12        purposes  and  under  age 23, or (iii) age 19 or over and
13        mentally or physically handicapped.
14        (bb)  "Qualified  small  business"   means   a   business
15    situated  in  Illinois having 50 or fewer employees, approved
16    by the Director and participating in a program created  under
17    subsection (k-5) of Section 10.
18    (Source:  P.A.  91-390,  eff.  7-30-99; 91-395, eff. 7-30-99;
19    91-617, eff.  8-19-99;  92-16,  eff.  6-28-01;  92-186,  eff.
20    1-1-02; 92-204, eff. 8-1-01; 92-651, eff. 7-11-02.)

21        (5 ILCS 375/10) (from Ch. 127, par. 530)
22        Sec. 10. Payments by State; premiums.
23        (a)  The    State   shall   pay   the   cost   of   basic
24    non-contributory group life insurance and, subject to  member
25    paid  contributions set by the Department or required by this
26    Section, the basic program of group health benefits  on  each
27    eligible  member,  except  a member, not otherwise covered by
28    this Act, who has retired as  a  participating  member  under
29    Article  2 of the Illinois Pension Code but is ineligible for
30    the retirement annuity under Section 2-119  of  the  Illinois
31    Pension  Code, and part of each eligible member's and retired
32    member's premiums for health insurance coverage for  enrolled
33    dependents as provided by Section 9.  The State shall pay the
 
                            -14-     LRB093 08477 JLS 14298 a
 1    cost of the basic program of group health benefits only after
 2    benefits  are  reduced  by  the amount of benefits covered by
 3    Medicare for all members and dependents who are eligible  for
 4    benefits  under  Social  Security  or the Railroad Retirement
 5    system or  who  had  sufficient  Medicare-covered  government
 6    employment,  except  that  such  reduction  in benefits shall
 7    apply only to those members  and  dependents  who  (1)  first
 8    become  eligible  for such Medicare coverage on or after July
 9    1, 1992; or (2) are Medicare-eligible members  or  dependents
10    of  a  local government unit which began participation in the
11    program on or after July 1, 1992; or (3) remain eligible for,
12    but no longer receive Medicare coverage which they  had  been
13    receiving  on  or  after  July  1,  1992.  The Department may
14    determine the aggregate level of the State's contribution  on
15    the  basis  of  actual  cost of medical services adjusted for
16    age, sex or geographic or other  demographic  characteristics
17    which affect the costs of such programs.
18        The  cost  of participation in the basic program of group
19    health benefits for the dependent or survivor of a living  or
20    deceased  retired  employee  who was formerly employed by the
21    University of Illinois in the Cooperative  Extension  Service
22    and would be an annuitant but for the fact that he or she was
23    made  ineligible  to  participate  in  the State Universities
24    Retirement System by clause (4) of subsection (a) of  Section
25    15-107 of the Illinois Pension Code shall not be greater than
26    the  cost of participation that would otherwise apply to that
27    dependent or survivor if he or  she  were  the  dependent  or
28    survivor   of  an  annuitant  under  the  State  Universities
29    Retirement System.
30        (a-1)  Beginning January 1, 1998,  for  each  person  who
31    becomes  a  new  SERS annuitant and participates in the basic
32    program of group health benefits, the State shall  contribute
33    toward  the  cost of the annuitant's coverage under the basic
34    program of group health benefits an amount  equal  to  5%  of
 
                            -15-     LRB093 08477 JLS 14298 a
 1    that cost for each full year of creditable service upon which
 2    the  annuitant's retirement annuity is based, up to a maximum
 3    of 100% for an annuitant with 20 or more years of  creditable
 4    service.  The remainder of the cost of a new SERS annuitant's
 5    coverage under the basic program  of  group  health  benefits
 6    shall be the responsibility of the annuitant.
 7        (a-2)  Beginning  January  1,  1998,  for each person who
 8    becomes a new SERS survivor and  participates  in  the  basic
 9    program  of group health benefits, the State shall contribute
10    toward the cost of the survivor'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 the  deceased  employee's  or
13    deceased   annuitant's   creditable   service  in  the  State
14    Employees' Retirement System  of  Illinois  on  the  date  of
15    death,  up to a maximum of 100% for a survivor of an employee
16    or annuitant with 20 or more  years  of  creditable  service.
17    The remainder of the cost of the new SERS survivor's coverage
18    under the basic program of group health benefits shall be the
19    responsibility of the survivor.
20        (a-3)  Beginning  January  1,  1998,  for each person who
21    becomes a new SURS annuitant and participates  in  the  basic
22    program  of group health benefits, the State shall contribute
23    toward the cost of the annuitant's coverage under  the  basic
24    program  of  group  health  benefits an amount equal to 5% of
25    that cost for each full year of creditable service upon which
26    the annuitant's retirement annuity is based, up to a  maximum
27    of  100% for an annuitant with 20 or more years of creditable
28    service. The remainder of the cost of a new SURS  annuitant's
29    coverage  under  the  basic  program of group health benefits
30    shall be the responsibility of the annuitant.
31        (a-4)  (Blank).
32        (a-5)  Beginning January 1, 1998,  for  each  person  who
33    becomes  a  new  SURS  survivor and participates in the basic
34    program of group health benefits, the State shall  contribute
 
                            -16-     LRB093 08477 JLS 14298 a
 1    toward  the  cost  of the survivor's coverage under the basic
 2    program of group health benefits an amount  equal  to  5%  of
 3    that  cost  for  each full year of the deceased employee's or
 4    deceased  annuitant's  creditable  service   in   the   State
 5    Universities  Retirement System on the date of death, up to a
 6    maximum of 100% for a survivor of an  employee  or  annuitant
 7    with  20  or more years of creditable service.  The remainder
 8    of the cost of the new SURS  survivor's  coverage  under  the
 9    basic   program   of  group  health  benefits  shall  be  the
10    responsibility of the survivor.
11        (a-6)  Beginning  July  1,  1998,  for  each  person  who
12    becomes a new TRS State annuitant  and  participates  in  the
13    basic  program  of  group  health  benefits,  the State shall
14    contribute toward the cost of the annuitant's coverage  under
15    the basic program of group health benefits an amount equal to
16    5% of that cost for each full year of creditable service as a
17    teacher  as  defined in paragraph (2), (3), or (5) of Section
18    16-106  of  the  Illinois  Pension  Code   upon   which   the
19    annuitant's  retirement  annuity is based, up to a maximum of
20    100%; except that the State contribution shall be  12.5%  per
21    year  (rather  than  5%)  for  each  full  year of creditable
22    service as a regional superintendent  or  assistant  regional
23    superintendent  of  schools.   The remainder of the cost of a
24    new TRS State annuitant's coverage under the basic program of
25    group health benefits shall  be  the  responsibility  of  the
26    annuitant.
27        (a-7)  Beginning  July  1,  1998,  for  each  person  who
28    becomes  a  new  TRS  State  survivor and participates in the
29    basic program of  group  health  benefits,  the  State  shall
30    contribute  toward  the cost of the survivor's coverage under
31    the basic program of group health benefits an amount equal to
32    5% of that cost for each full year of the deceased employee's
33    or deceased annuitant's creditable service as  a  teacher  as
34    defined  in  paragraph  (2), (3), or (5) of Section 16-106 of
 
                            -17-     LRB093 08477 JLS 14298 a
 1    the Illinois Pension Code on the  date  of  death,  up  to  a
 2    maximum  of 100%; except that the State contribution shall be
 3    12.5% per year (rather than 5%) for each  full  year  of  the
 4    deceased   employee's   or  deceased  annuitant's  creditable
 5    service as a regional superintendent  or  assistant  regional
 6    superintendent  of  schools. The remainder of the cost of the
 7    new TRS State survivor's coverage under the basic program  of
 8    group  health  benefits  shall  be  the responsibility of the
 9    survivor.
10        (a-8)  A new SERS annuitant, new SERS survivor, new  SURS
11    annuitant, new SURS survivor, new TRS State annuitant, or new
12    TRS  State  survivor  may  waive or terminate coverage in the
13    program of group health  benefits.   Any  such  annuitant  or
14    survivor  who has waived or terminated coverage may enroll or
15    re-enroll in the program of group health benefits only during
16    the annual  benefit  choice  period,  as  determined  by  the
17    Director; except that in the event of termination of coverage
18    due  to nonpayment of premiums, the annuitant or survivor may
19    not re-enroll in the program.
20        (a-9)  No later than May 1 of  each  calendar  year,  the
21    Director  of  Central  Management  Services  shall certify in
22    writing to the Executive Secretary of  the  State  Employees'
23    Retirement  System  of  Illinois  the amounts of the Medicare
24    supplement health care premiums and the amounts of the health
25    care premiums for all other retirees  who  are  not  Medicare
26    eligible.
27        A  separate  calculation  of  the premiums based upon the
28    actual cost of each health care plan shall be so certified.
29        The Director of Central Management Services shall provide
30    to the Executive Secretary of the State Employees' Retirement
31    System of Illinois such information,  statistics,  and  other
32    data  as  he or she may require to review the premium amounts
33    certified by the Director of Central Management Services.
34        (b)  State employees who become eligible for this program
 
                            -18-     LRB093 08477 JLS 14298 a
 1    on or after January 1, 1980 in positions  normally  requiring
 2    actual performance of duty not less than 1/2 of a normal work
 3    period  but  not equal to that of a normal work period, shall
 4    be  given  the  option  of  participating  in  the  available
 5    program. If the employee elects  coverage,  the  State  shall
 6    contribute  on  behalf  of  such  employee to the cost of the
 7    employee's benefit and any applicable  dependent  supplement,
 8    that  sum  which bears the same percentage as that percentage
 9    of time the employee regularly works when compared to  normal
10    work period.
11        (c)  The  basic  non-contributory coverage from the basic
12    program of group health benefits shall be continued for  each
13    employee  not in pay status or on active service by reason of
14    (1) leave of absence due to illness or injury, (2) authorized
15    educational leave of absence  or  sabbatical  leave,  or  (3)
16    military  leave  with  pay  and benefits. This coverage shall
17    continue until expiration of authorized leave and  return  to
18    active  service, but not to exceed 24 months for leaves under
19    item (1) or (2). This 24-month limitation and the requirement
20    of returning to active service shall  not  apply  to  persons
21    receiving  ordinary  or  accidental  disability  benefits  or
22    retirement  benefits through the appropriate State retirement
23    system  or  benefits  under  the  Workers'  Compensation   or
24    Occupational Disease Act.
25        (d)  The   basic  group  life  insurance  coverage  shall
26    continue, with full State contribution, where such person  is
27    (1)  absent  from  active  service  by  reason  of disability
28    arising from any cause  other  than  self-inflicted,  (2)  on
29    authorized  educational leave of absence or sabbatical leave,
30    or (3) on military leave with pay and benefits.
31        (e)  Where the person is in non-pay status for  a  period
32    in  excess  of  30 days or on leave of absence, other than by
33    reason of disability, educational  or  sabbatical  leave,  or
34    military  leave  with  pay  and  benefits,  such  person  may
 
                            -19-     LRB093 08477 JLS 14298 a
 1    continue  coverage  only  by making personal payment equal to
 2    the amount normally contributed by the State on such person's
 3    behalf. Such payments and  coverage  may  be  continued:  (1)
 4    until  such  time  as the person returns to a status eligible
 5    for coverage at State expense, but not to exceed  24  months,
 6    (2)  until  such person's employment or annuitant status with
 7    the State is terminated, or (3) for a  maximum  period  of  4
 8    years for members on military leave with pay and benefits and
 9    military  leave  without  pay  and benefits (exclusive of any
10    additional service imposed pursuant to law).
11        (f)  The Department shall  establish by rule  the  extent
12    to which other employee benefits will continue for persons in
13    non-pay status or who are not in active service.
14        (g)  The  State  shall  not  pay  the  cost  of the basic
15    non-contributory group  life  insurance,  program  of  health
16    benefits  and  other  employee  benefits  for members who are
17    survivors as defined by paragraphs (1) and (2) of  subsection
18    (q)  of  Section  3  of  this Act.  The costs of benefits for
19    these survivors shall be paid by  the  survivors  or  by  the
20    University  of Illinois Cooperative Extension Service, or any
21    combination thereof. However, the State shall pay the  amount
22    of  the  reduction  in  the  cost  of  participation, if any,
23    resulting from the amendment to subsection (a) made  by  this
24    amendatory Act of the 91st General Assembly.
25        (h)  Those   persons   occupying   positions   with   any
26    department  as a result of emergency appointments pursuant to
27    Section 8b.8 of the Personnel Code  who  are  not  considered
28    employees  under  this  Act  shall  be  given  the  option of
29    participating in the programs of group life insurance, health
30    benefits and other employee benefits.  Such persons  electing
31    coverage  may participate only by making payment equal to the
32    amount  normally  contributed  by  the  State  for  similarly
33    situated employees.  Such amounts shall be determined by  the
34    Director.   Such payments and coverage may be continued until
 
                            -20-     LRB093 08477 JLS 14298 a
 1    such time as the person becomes an employee pursuant to  this
 2    Act or such person's appointment is terminated.
 3        (i)  Any  unit  of  local  government within the State of
 4    Illinois may apply to the Director  to  have  its  employees,
 5    annuitants,   and  their  dependents  provided  group  health
 6    coverage  under  this  Act  on  a  non-insured   basis.    To
 7    participate,  a unit of local government must agree to enroll
 8    all of its employees, who may select  coverage  under  either
 9    the  State group health benefits plan or a health maintenance
10    organization  that  has  contracted  with  the  State  to  be
11    available as a health care provider for employees as  defined
12    in  this  Act.   A  unit  of  local government must remit the
13    entire cost of  providing  coverage  under  the  State  group
14    health   benefits  plan  or,  for  coverage  under  a  health
15    maintenance  organization,  an  amount  determined   by   the
16    Director  based  on  an  analysis of the sex, age, geographic
17    location, or other relevant  demographic  variables  for  its
18    employees, except that the unit of local government shall not
19    be  required to enroll those of its employees who are covered
20    spouses or dependents under this plan or another group policy
21    or  plan  providing  health  benefits  as  long  as  (1)   an
22    appropriate  official  from  the  unit  of  local  government
23    attests  that  each employee not enrolled is a covered spouse
24    or dependent under this plan or another group policy or plan,
25    and (2) at least 85% of the employees are  enrolled  and  the
26    unit  of local government remits the entire cost of providing
27    coverage to those  employees,  except  that  a  participating
28    school  district  must  have  enrolled  at  least  85% of its
29    full-time employees who have not waived  coverage  under  the
30    district's  group health plan by participating in a component
31    of the district's cafeteria  plan.   A  participating  school
32    district  is  not required to enroll a full-time employee who
33    has  waived  coverage  under  the  district's  health   plan,
34    provided  that an appropriate official from the participating
 
                            -21-     LRB093 08477 JLS 14298 a
 1    school district  attests  that  the  full-time  employee  has
 2    waived  coverage  by  participating  in  a  component  of the
 3    district's  cafeteria  plan.   For  the  purposes   of   this
 4    subsection,  "participating  school district" includes a unit
 5    of local government whose primary  purpose  is  education  as
 6    defined by the Department's rules.
 7        Employees of a participating unit of local government who
 8    are  not  enrolled due to coverage under another group health
 9    policy or plan may enroll in the event of a qualifying change
10    in  status,  special  enrollment,  special  circumstance   as
11    defined  by the Director, or during the annual Benefit Choice
12    Period.  A participating unit of local  government  may  also
13    elect  to  cover its annuitants.  Dependent coverage shall be
14    offered on an optional basis, with the costs paid by the unit
15    of local government, its employees, or  some  combination  of
16    the  two  as determined by the unit of local government.  The
17    unit of local government  shall  be  responsible  for  timely
18    collection and transmission of dependent premiums.
19        The  Director  shall  annually determine monthly rates of
20    payment, subject to the following constraints:
21             (1)  In the first year of coverage, the rates  shall
22        be   equal  to  the  amount  normally  charged  to  State
23        employees for elected optional coverages or for  enrolled
24        dependents  coverages or other contributory coverages, or
25        contributed by the State for basic insurance coverages on
26        behalf of its employees, adjusted for differences between
27        State employees and employees of the local government  in
28        age,   sex,   geographic   location   or  other  relevant
29        demographic variables, plus an amount sufficient  to  pay
30        for  the  additional  administrative  costs  of providing
31        coverage to employees of the unit of local government and
32        their dependents.
33             (2)  In subsequent years, a further adjustment shall
34        be  made  to  reflect  the  actual  prior  years'  claims
 
                            -22-     LRB093 08477 JLS 14298 a
 1        experience  of  the  employees  of  the  unit  of   local
 2        government.
 3        In  the  case  of  coverage of local government employees
 4    under a health maintenance organization, the  Director  shall
 5    annually  determine  for  each  participating  unit  of local
 6    government the maximum monthly amount the unit may contribute
 7    toward that coverage, based on an analysis of  (i)  the  age,
 8    sex,  geographic  location,  and  other  relevant demographic
 9    variables of the unit's employees and (ii) the cost to  cover
10    those  employees  under the State group health benefits plan.
11    The Director may  similarly  determine  the  maximum  monthly
12    amount  each  unit  of local government may contribute toward
13    coverage  of  its  employees'  dependents  under   a   health
14    maintenance organization.
15        Monthly  payments  by the unit of local government or its
16    employees  for  group  health   benefits   plan   or   health
17    maintenance  organization  coverage shall be deposited in the
18    Local Government Health Insurance Reserve Fund.
19        The Local Government Health Insurance Reserve Fund  shall
20    be  a continuing fund not subject to fiscal year limitations.
21    All expenditures from this Fund shall be  used  for  payments
22    for  health  care  benefits  for  local  government, domestic
23    violence shelter  or  service,  and  rehabilitation  facility
24    employees,  annuitants,  and dependents, and to reimburse the
25    Department or its administrative service organization for all
26    expenses incurred in  the  administration  of  benefits.   No
27    other State funds may be used for these purposes.
28        A  local government employer's participation or desire to
29    participate in a program created under this subsection  shall
30    not   limit   that   employer's  duty  to  bargain  with  the
31    representative of  any  collective  bargaining  unit  of  its
32    employees.
33        (j)  Any  rehabilitation  facility  within  the  State of
34    Illinois may apply to the Director  to  have  its  employees,
 
                            -23-     LRB093 08477 JLS 14298 a
 1    annuitants,  and  their  eligible  dependents  provided group
 2    health coverage under this Act on  a  non-insured  basis.  To
 3    participate,  a  rehabilitation facility must agree to enroll
 4    all of its employees and remit the entire cost  of  providing
 5    such   coverage   for   its   employees,   except   that  the
 6    rehabilitation facility shall not be required to enroll those
 7    of its employees who are covered spouses or dependents  under
 8    this  plan  or  another group policy or plan providing health
 9    benefits as long as (1)  an  appropriate  official  from  the
10    rehabilitation   facility  attests  that  each  employee  not
11    enrolled is a covered spouse or dependent under this plan  or
12    another  group  policy  or  plan, and (2) at least 85% of the
13    employees are enrolled and the rehabilitation facility remits
14    the entire cost of providing  coverage  to  those  employees.
15    Employees  of a participating rehabilitation facility who are
16    not enrolled due  to  coverage  under  another  group  health
17    policy or plan may enroll in the event of a qualifying change
18    in   status,  special  enrollment,  special  circumstance  as
19    defined by the Director, or during the annual Benefit  Choice
20    Period.   A  participating  rehabilitation  facility may also
21    elect to cover its annuitants. Dependent  coverage  shall  be
22    offered  on  an  optional  basis,  with the costs paid by the
23    rehabilitation facility, its employees, or  some  combination
24    of  the  2  as determined by the rehabilitation facility. The
25    rehabilitation  facility  shall  be  responsible  for  timely
26    collection and transmission of dependent premiums.
27        The Director shall annually determine quarterly rates  of
28    payment, subject to the following constraints:
29             (1)  In  the first year of coverage, the rates shall
30        be  equal  to  the  amount  normally  charged  to   State
31        employees  for elected optional coverages or for enrolled
32        dependents coverages or other contributory  coverages  on
33        behalf of its employees, adjusted for differences between
34        State  employees  and  employees  of  the  rehabilitation
 
                            -24-     LRB093 08477 JLS 14298 a
 1        facility  in  age,  sex,  geographic  location  or  other
 2        relevant demographic variables, plus an amount sufficient
 3        to   pay  for  the  additional  administrative  costs  of
 4        providing coverage to  employees  of  the  rehabilitation
 5        facility and their dependents.
 6             (2)  In subsequent years, a further adjustment shall
 7        be  made  to  reflect  the  actual  prior  years'  claims
 8        experience   of   the  employees  of  the  rehabilitation
 9        facility.
10        Monthly payments by the rehabilitation  facility  or  its
11    employees for group health benefits shall be deposited in the
12    Local Government Health Insurance Reserve Fund.
13        (k)  Any  domestic violence shelter or service within the
14    State of Illinois may apply  to  the  Director  to  have  its
15    employees,  annuitants,  and  their dependents provided group
16    health coverage under this Act on a  non-insured  basis.   To
17    participate,  a  domestic  violence  shelter  or service must
18    agree to enroll all of its employees and pay the entire  cost
19    of   providing   such   coverage   for   its   employees.   A
20    participating domestic violence shelter  may  also  elect  to
21    cover its annuitants.  Dependent coverage shall be offered on
22    an  optional  basis,  with  the  costs  paid  by the domestic
23    violence  shelter  or  service,  its   employees,   or   some
24    combination  of  the 2 as determined by the domestic violence
25    shelter or service.  The domestic violence shelter or service
26    shall be responsible for timely collection  and  transmission
27    of dependent premiums.
28        The  Director  shall annually determine rates of payment,
29    subject to the following constraints:
30             (1)  In the first year of coverage, the rates  shall
31        be   equal  to  the  amount  normally  charged  to  State
32        employees for elected optional coverages or for  enrolled
33        dependents  coverages  or other contributory coverages on
34        behalf of its employees, adjusted for differences between
 
                            -25-     LRB093 08477 JLS 14298 a
 1        State employees and employees of  the  domestic  violence
 2        shelter  or  service  in age, sex, geographic location or
 3        other relevant  demographic  variables,  plus  an  amount
 4        sufficient to pay for the additional administrative costs
 5        of  providing  coverage  to  employees  of  the  domestic
 6        violence shelter or service and their dependents.
 7             (2)  In subsequent years, a further adjustment shall
 8        be  made  to  reflect  the  actual  prior  years'  claims
 9        experience  of  the  employees  of  the domestic violence
10        shelter or service.
11        Monthly payments by  the  domestic  violence  shelter  or
12    service  or its employees for group health insurance shall be
13    deposited in the Local Government  Health  Insurance  Reserve
14    Fund.
15        (k-5)  Any  qualified  small business within the State of
16    Illinois may apply to the Director  to  have  its  employees,
17    annuitants,   and  their  dependents  provided  group  health
18    coverage  under  this  Act  on  a  non-insured  basis.    The
19    Department  may  set a limit on the number of qualified small
20    businesses that may receive group health coverage under  this
21    subsection  (k-5).   In  order  to  control  its  costs,  the
22    Department  may  designate  which  plans  it  will  offer  to
23    qualified small businesses under this subsection (k-5). Those
24    plans  may  include,  but  need  not  be limited to, minimum,
25    limited, or comprehensive coverage plans; Health  Maintenance
26    Organization  and  Preferred Provider Organization plans; and
27    medical savings plans. The plans may include the  utilization
28    of insurance producers in the marketing of coverage under the
29    plans.  In  offering  plans  under  this subsection (k-5) the
30    Department shall be subject to ratings and  minimum  coverage
31    in  the  same  manner  as a private insurer. Any plan offered
32    under  this  subsection  (k-5)  may  provide   for   employee
33    contributions  to  the  cost  of  the plan. A qualified small
34    business may select one or more of the plans offered  by  the
 
                            -26-     LRB093 08477 JLS 14298 a
 1    Department  to  offer  to  its  employees.  To participate, a
 2    qualified small business must agree to offer to enroll all of
 3    its employees and remit the entire  cost  of  providing  such
 4    coverage  for  its employees, except that the qualified small
 5    business shall  not  be  required  to  enroll  those  of  its
 6    employees  who  waive  coverage  under  this subsection (k-5)
 7    because they are covered spouses or dependents under  another
 8    group policy or plan providing health benefits as long as (1)
 9    an  appropriate  official  from  the qualified small business
10    attests that each employee not enrolled is a  covered  spouse
11    or  dependent  under  another group policy or plan and (2) at
12    least  75%  of  the  remaining  employees  are  enrolled.   A
13    participating qualified small  business  may  also  elect  to
14    cover its annuitants.  Dependent coverage shall be offered on
15    an optional basis, with the costs paid by the small business,
16    its  employees, or some combination of the 2 as determined by
17    the qualified small business.  The qualified  small  business
18    shall  be  responsible for timely collection and transmission
19    of all premiums.
20        The Director shall annually determine  rates  of  payment
21    taking into consideration, among other things, the following:
22             (1)  In  the first year of coverage, the rates shall
23        be  equal  to  the  amount  normally  charged  to   State
24        employees  for elected optional coverages or for enrolled
25        dependents coverages or other contributory  coverages  on
26        behalf of its employees, adjusted for differences between
27        State  employees  and  employees  of  the qualified small
28        business  in  age,  sex,  geographic  location  or  other
29        relevant demographic variables, plus an amount sufficient
30        to  pay  for  the  additional  administrative  costs   of
31        providing  coverage  to  employees of the qualified small
32        business and their dependents.
33             (2)  In subsequent years, a further adjustment shall
34        be  made  to  reflect  the  actual  prior  years'  claims
 
                            -27-     LRB093 08477 JLS 14298 a
 1        experience  of  the  employees  of  the  qualified  small
 2        business.
 3        Monthly payments by  the  qualified  small  business  for
 4    group  health  insurance  shall  be  deposited into the Small
 5    Employers Health Insurance Reserve Fund.  The Small Employers
 6    Health Insurance Reserve Fund shall be a continuing fund  not
 7    subject  to  fiscal  year limitations.  All expenditures from
 8    this fund shall be used for payments for health care benefits
 9    for  employees  of  qualified  small  businesses  and   their
10    annuitants  and dependents and to reimburse the Department or
11    its administrative  service  organization  for  all  expenses
12    incurred  in the administration of benefits.  No State funds,
13    other than those specifically appropriated, may be  used  for
14    these purposes.
15        (l)  A  public  community  college  or  entity  organized
16    pursuant to the Public Community College Act may apply to the
17    Director  initially to have only annuitants not covered prior
18    to July 1, 1992 by the district's health plan provided health
19    coverage  under  this  Act  on  a  non-insured  basis.    The
20    community   college   must   execute  a  2-year  contract  to
21    participate  in  the  Local  Government  Health   Plan.   Any
22    annuitant  may  enroll in the event of a qualifying change in
23    status, special enrollment, special circumstance  as  defined
24    by the Director, or during the annual Benefit Choice Period.
25        The  Director  shall  annually determine monthly rates of
26    payment subject to  the  following  constraints:   for  those
27    community  colleges with annuitants only enrolled, first year
28    rates shall be equal to the average cost to cover claims  for
29    a   State   member   adjusted   for   demographics,  Medicare
30    participation, and other factors; and in the second  year,  a
31    further  adjustment  of  rates  shall  be made to reflect the
32    actual  first  year's  claims  experience  of   the   covered
33    annuitants.
34        (l-5)  The    provisions   of   subsection   (l)   become
 
                            -28-     LRB093 08477 JLS 14298 a
 1    inoperative on July 1, 1999.
 2        (m)  The Director shall adopt any rules deemed  necessary
 3    for implementation of this amendatory Act of 1989 (Public Act
 4    86-978).
 5    (Source:  P.A.  91-280,  eff.  7-23-99; 91-311; eff. 7-29-99;
 6    91-357, eff. 7-29-99;  91-390,  eff.  7-30-99;  91-395,  eff.
 7    7-30-99;  91-617,  eff. 8-19-99; 92-16, eff. 6-28-01; revised
 8    2-25-02.)

 9        (5 ILCS 375/13.2) (from Ch. 127, par. 533.2)
10        Sec. 13.2.  Insurance reserve  funds;  investments.   All
11    amounts  held in the Health Insurance Reserve Fund, the Group
12    Insurance Premium Fund, the Small Employers Health  Insurance
13    Reserve  Fund,  and  the  Local  Government  Health Insurance
14    Reserve Fund shall be invested, at  interest,  by  the  State
15    Treasurer.   The  investments  shall  be  subject  to  terms,
16    conditions,  and  limitations imposed by the laws of Illinois
17    on State funds.  All  income  derived  from  the  investments
18    shall accrue and be deposited to the respective funds no less
19    frequently  than  quarterly.   The  Health  Insurance Reserve
20    Fund, the Small Employers Health Insurance Reserve Fund,  and
21    the  Local  Government Health Insurance Reserve Fund shall be
22    administered by the Director.
23    (Source: P.A. 91-390, eff. 7-30-99.)

24        (5 ILCS 375/15) (from Ch. 127, par. 535)
25        Sec. 15. Administration; rules; audit; review.
26        (a)  The Director shall administer  this  Act  and  shall
27    prescribe such rules and regulations as are necessary to give
28    full effect to the purposes of this Act.
29        (b)  These  rules  may  fix  reasonable standards for the
30    group life  and  group  health  programs  and  other  benefit
31    programs  offered  under  this  Act,  and for the contractors
32    providing them.
 
                            -29-     LRB093 08477 JLS 14298 a
 1        (c)  These rules shall specify that covered and  optional
 2    medical  services of the program are services provided within
 3    the  scope  of  their  licenses  by  practitioners   in   all
 4    categories  licensed  under  the Medical Practice Act of 1987
 5    and shall provide that all eligible persons be fully informed
 6    of this specification.
 7        (d)  These rules shall establish eligibility requirements
 8    for members and dependents as may be necessary to  supplement
 9    or clarify requirements contained in this Act.
10        (e)  Each  affected  department  of  the State, the State
11    Universities  Retirement  System,  the  Teachers'  Retirement
12    System, and each qualified local  government,  rehabilitation
13    facility,  or  domestic violence shelter or service, or small
14    business shall keep such records, make  such  certifications,
15    and furnish the Director such information as may be necessary
16    for  the  administration  of  this Act, including information
17    concerning number and total amounts of payroll  of  employees
18    of  the  department  who are paid from trust funds or federal
19    funds.
20        (f)  Each  member,   each   community   college   benefit
21    recipient  to  whom  this  Act  applies, and each TRS benefit
22    recipient  to  whom  this  Act  applies  shall  furnish   the
23    Director,  in  such  form as may be required, any information
24    that may be  necessary  to  enroll  such  member  or  benefit
25    recipient  and,  if  applicable,  his  or  her  dependents or
26    dependent beneficiaries under the programs or plan, including
27    such data as  may  be  required  to  allow  the  Director  to
28    accumulate   statistics   on   data  normally  considered  in
29    actuarial studies  of  employee  groups.   Information  about
30    community  college  benefit  recipients and community college
31    dependent beneficiaries shall be furnished through the  State
32    Universities   Retirement   System.   Information  about  TRS
33    benefit recipients and TRS dependent beneficiaries  shall  be
34    furnished through the Teachers' Retirement System.
 
                            -30-     LRB093 08477 JLS 14298 a
 1        (g)  There  shall  be  audits and reports on the programs
 2    authorized and  established  by  this  Act  prepared  by  the
 3    Director  with  the  assistance  of  a qualified, independent
 4    accounting firm.  The reports shall  provide  information  on
 5    the experience, and administrative effectiveness and adequacy
 6    of the program including, when applicable, recommendations on
 7    up-grading of benefits and improvement of the program.
 8        (h)  Any  final  order,  decision  or other determination
 9    made, issued or executed by the Director under the provisions
10    of this Act whereby any contractor  or  person  is  aggrieved
11    shall  be subject to review in accordance with the provisions
12    of the Administrative  Review  Law  and  all  amendments  and
13    modifications   thereof,   and  the  rules  adopted  pursuant
14    thereto, shall apply to and govern all  proceedings  for  the
15    judicial  review  of  final  administrative  decisions of the
16    Director.
17    (Source: P.A. 90-497, eff. 8-18-97; 91-390, eff. 7-30-99.)

18        Section 10.  The State Finance Act is amended by changing
19    Section 25 as follows:

20        (30 ILCS 105/25) (from Ch. 127, par. 161)
21        Sec. 25.  Fiscal year limitations.
22        (a)  All   appropriations   shall   be   available    for
23    expenditure for the fiscal year or for a lesser period if the
24    Act  making that appropriation so specifies.  A deficiency or
25    emergency appropriation shall be  available  for  expenditure
26    only  through  June  30  of the year when the Act making that
27    appropriation is enacted unless that Act otherwise provides.
28        (b)  Outstanding liabilities as of June 30, payable  from
29    appropriations  which have otherwise expired, may be paid out
30    of the expiring  appropriations  during  the  2-month  period
31    ending  at  the  close of business on August 31.  Any service
32    involving professional or artistic  skills  or  any  personal
 
                            -31-     LRB093 08477 JLS 14298 a
 1    services  by  an  employee  whose  compensation is subject to
 2    income tax withholding must be performed as of June 30 of the
 3    fiscal  year  in  order  to  be  considered  an  "outstanding
 4    liability as of June 30" that is thereby eligible for payment
 5    out of the expiring appropriation.
 6        However, payment of tuition  reimbursement  claims  under
 7    Section 14-7.03 or 18-3 of the School Code may be made by the
 8    State  Board  of  Education from its appropriations for those
 9    respective purposes for any  fiscal  year,  even  though  the
10    claims  reimbursed  by the payment may be claims attributable
11    to a prior fiscal year, and  payments  may  be  made  at  the
12    direction  of  the State Superintendent of Education from the
13    fund from which the appropriation is made without  regard  to
14    any fiscal year limitations.
15        Medical  payments  may  be  made  by  the  Department  of
16    Veterans'  Affairs from its appropriations for those purposes
17    for any fiscal year, without regard  to  the  fact  that  the
18    medical  services  being  compensated for by such payment may
19    have been rendered in a prior fiscal year.
20        Medical payments may be made by the Department of  Public
21    Aid  and child care payments may be made by the Department of
22    Human Services (as successor to the Department of Public Aid)
23    from appropriations for those purposes for any  fiscal  year,
24    without  regard  to  the  fact that the medical or child care
25    services being compensated for by such payment may have  been
26    rendered  in a prior fiscal year; and payments may be made at
27    the  direction  of  the  Department  of  Central   Management
28    Services  from  the  Health Insurance Reserve Fund, the Small
29    Employers  Health  Insurance  Reserve  Fund,  and  the  Local
30    Government Health Insurance Reserve Fund  without  regard  to
31    any fiscal year limitations.
32        Additionally,  payments  may be made by the Department of
33    Human Services from its appropriations, or  any  other  State
34    agency  from  its  appropriations  with  the  approval of the
 
                            -32-     LRB093 08477 JLS 14298 a
 1    Department of Human Services, from the Immigration Reform and
 2    Control  Fund  for  purposes  authorized  pursuant   to   the
 3    Immigration Reform and Control Act of 1986, without regard to
 4    any fiscal year limitations.
 5        Further,  with  respect to costs incurred in fiscal years
 6    2002 and 2003  only,  payments  may  be  made  by  the  State
 7    Treasurer from its appropriations from the Capital Litigation
 8    Trust Fund without regard to any fiscal year limitations.
 9        (c)  Further,  payments  may be made by the Department of
10    Public Health and the Department of Human Services (acting as
11    successor to  the  Department  of  Public  Health  under  the
12    Department  of  Human  Services  Act)  from  their respective
13    appropriations for grants for medical care to or on behalf of
14    persons  suffering  from  chronic  renal   disease,   persons
15    suffering  from  hemophilia,  rape victims, and premature and
16    high-mortality risk infants and their mothers and for  grants
17    for  supplemental  food  supplies  provided  under the United
18    States Department of Agriculture Women, Infants and  Children
19    Nutrition  Program, for any fiscal year without regard to the
20    fact that the services being compensated for by such  payment
21    may have been rendered in a prior fiscal year.
22        (d)  The  Department  of Public Health and the Department
23    of Human Services (acting as successor to the  Department  of
24    Public  Health  under  the  Department of Human Services Act)
25    shall each annually submit to the State  Comptroller,  Senate
26    President,  Senate  Minority  Leader,  Speaker  of the House,
27    House  Minority  Leader,  and  the  respective  Chairmen  and
28    Minority Spokesmen of the Appropriations  Committees  of  the
29    Senate  and  the House, on or before December 31, a report of
30    fiscal year funds used to pay for services  provided  in  any
31    prior  fiscal year.  This report shall document by program or
32    service category those expenditures from  the  most  recently
33    completed  fiscal  year  used to pay for services provided in
34    prior fiscal years.
 
                            -33-     LRB093 08477 JLS 14298 a
 1        (e)  The Department of Public Aid and the  Department  of
 2    Human  Services  (acting  as  successor  to the Department of
 3    Public  Aid)  shall  each  annually  submit  to   the   State
 4    Comptroller,   Senate   President,  Senate  Minority  Leader,
 5    Speaker of the House, House Minority Leader,  the  respective
 6    Chairmen   and   Minority  Spokesmen  of  the  Appropriations
 7    Committees of the Senate and the House, on or before November
 8    30, a report  that  shall  document  by  program  or  service
 9    category  those expenditures from the most recently completed
10    fiscal year used to pay for (i) services  provided  in  prior
11    fiscal years and (ii) services for which claims were received
12    in prior fiscal years.
13        (f)  The  Department  of  Human Services (as successor to
14    the Department of Public Aid) shall annually  submit  to  the
15    State  Comptroller, Senate President, Senate Minority Leader,
16    Speaker  of  the  House,  House  Minority  Leader,  and   the
17    respective   Chairmen   and   Minority   Spokesmen   of   the
18    Appropriations  Committees of the Senate and the House, on or
19    before December 31, a report of fiscal year funds used to pay
20    for services (other than medical care) provided in any  prior
21    fiscal  year.   This  report  shall  document  by  program or
22    service category those expenditures from  the  most  recently
23    completed  fiscal  year  used to pay for services provided in
24    prior fiscal years.
25        (g)  In addition,  each  annual  report  required  to  be
26    submitted  by  the  Department of Public Aid under subsection
27    (e) shall include the following information with  respect  to
28    the State's Medicaid program:
29             (1)  Explanations   of   the  exact  causes  of  the
30        variance between the previous year's estimated and actual
31        liabilities.
32             (2)  Factors  affecting  the  Department  of  Public
33        Aid's liabilities, including but not limited  to  numbers
34        of  aid recipients, levels of medical service utilization
 
                            -34-     LRB093 08477 JLS 14298 a
 1        by aid recipients, and inflation in the cost  of  medical
 2        services.
 3             (3)  The  results  of  the  Department's  efforts to
 4        combat fraud and abuse.
 5        (h)  As provided in Section 4  of  the  General  Assembly
 6    Compensation  Act, any utility bill for service provided to a
 7    General  Assembly  member's  district  office  for  a  period
 8    including portions of 2 consecutive fiscal years may be  paid
 9    from funds appropriated for such expenditure in either fiscal
10    year.
11        (i)  An agency which administers a fund classified by the
12    Comptroller as an internal service fund may issue rules for:
13             (1)  billing  user  agencies  in  advance  based  on
14        estimated charges for goods or services;
15             (2)  issuing  credits  during  the subsequent fiscal
16        year for all user agency  payments  received  during  the
17        prior  fiscal  year  which  were  in  excess of the final
18        amounts owed by the user agency for that period; and
19             (3)  issuing  catch-up  billings  to  user  agencies
20        during the subsequent fiscal year for  amounts  remaining
21        due  when  payments  received from the user agency during
22        the prior fiscal year were less  than  the  total  amount
23        owed for that period.
24    User  agencies  are  authorized to reimburse internal service
25    funds for catch-up billings by vouchers drawn  against  their
26    respective  appropriations  for  the fiscal year in which the
27    catch-up billing was issued.
28    (Source: P.A. 92-885, eff. 1-13-03.)

29        Section 99.  Effective date.  This Act  takes  effect  on
30    January 1, 2004.".