Rep. Chapin Rose

Filed: 11/7/2011

 

 


 

 


 
09700SB1538ham002LRB097 07771 JDS 58805 a

1
AMENDMENT TO SENATE BILL 1538

2    AMENDMENT NO. ______. Amend Senate Bill 1538 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. The State Employees Group Insurance Act of 1971
5is amended by changing Sections 3 and 8 as follows:
 
6    (5 ILCS 375/3)  (from Ch. 127, par. 523)
7    Sec. 3. Definitions. Unless the context otherwise
8requires, the following words and phrases as used in this Act
9shall have the following meanings. The Department may define
10these and other words and phrases separately for the purpose of
11implementing specific programs providing benefits under this
12Act.
13    (a) "Administrative service organization" means any
14person, firm or corporation experienced in the handling of
15claims which is fully qualified, financially sound and capable
16of meeting the service requirements of a contract of

 

 

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1administration executed with the Department.
2    (b) "Annuitant" means (1) an employee who retires, or has
3retired, on or after January 1, 1966 on an immediate annuity
4under the provisions of Articles 2, 14 (including an employee
5who has elected to receive an alternative retirement
6cancellation payment under Section 14-108.5 of the Illinois
7Pension Code in lieu of an annuity), 15 (including an employee
8who has retired under the optional retirement program
9established under Section 15-158.2), paragraphs (2), (3), or
10(5) of Section 16-106, or Article 18 of the Illinois Pension
11Code; (2) any person who was receiving group insurance coverage
12under this Act as of March 31, 1978 by reason of his status as
13an annuitant, even though the annuity in relation to which such
14coverage was provided is a proportional annuity based on less
15than the minimum period of service required for a retirement
16annuity in the system involved; (3) any person not otherwise
17covered by this Act who has retired as a participating member
18under Article 2 of the Illinois Pension Code but is ineligible
19for the retirement annuity under Section 2-119 of the Illinois
20Pension Code; (4) the spouse of any person who is receiving a
21retirement annuity under Article 18 of the Illinois Pension
22Code and who is covered under a group health insurance program
23sponsored by a governmental employer other than the State of
24Illinois and who has irrevocably elected to waive his or her
25coverage under this Act and to have his or her spouse
26considered as the "annuitant" under this Act and not as a

 

 

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1"dependent"; or (5) an employee who retires, or has retired,
2from a qualified position, as determined according to rules
3promulgated by the Director, under a qualified local
4government, a qualified rehabilitation facility, a qualified
5domestic violence shelter or service, or a qualified child
6advocacy center. (For definition of "retired employee", see (p)
7post).
8    (b-5) "New SERS annuitant" means a person who, on or after
9January 1, 1998, becomes an annuitant, as defined in subsection
10(b), by virtue of beginning to receive a retirement annuity
11under Article 14 of the Illinois Pension Code (including an
12employee who has elected to receive an alternative retirement
13cancellation payment under Section 14-108.5 of that Code in
14lieu of an annuity), and is eligible to participate in the
15basic program of group health benefits provided for annuitants
16under this Act.
17    (b-6) "New SURS annuitant" means a person who (1) on or
18after January 1, 1998, becomes an annuitant, as defined in
19subsection (b), by virtue of beginning to receive a retirement
20annuity under Article 15 of the Illinois Pension Code, (2) has
21not made the election authorized under Section 15-135.1 of the
22Illinois Pension Code, and (3) is eligible to participate in
23the basic program of group health benefits provided for
24annuitants under this Act.
25    (b-7) "New TRS State annuitant" means a person who, on or
26after July 1, 1998, becomes an annuitant, as defined in

 

 

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1subsection (b), by virtue of beginning to receive a retirement
2annuity under Article 16 of the Illinois Pension Code based on
3service as a teacher as defined in paragraph (2), (3), or (5)
4of Section 16-106 of that Code, and is eligible to participate
5in the basic program of group health benefits provided for
6annuitants under this Act.
7    (c) "Carrier" means (1) an insurance company, a corporation
8organized under the Limited Health Service Organization Act or
9the Voluntary Health Services Plan Act, a partnership, or other
10nongovernmental organization, which is authorized to do group
11life or group health insurance business in Illinois, or (2) the
12State of Illinois as a self-insurer.
13    (d) "Compensation" means salary or wages payable on a
14regular payroll by the State Treasurer on a warrant of the
15State Comptroller out of any State, trust or federal fund, or
16by the Governor of the State through a disbursing officer of
17the State out of a trust or out of federal funds, or by any
18Department out of State, trust, federal or other funds held by
19the State Treasurer or the Department, to any person for
20personal services currently performed, and ordinary or
21accidental disability benefits under Articles 2, 14, 15
22(including ordinary or accidental disability benefits under
23the optional retirement program established under Section
2415-158.2), paragraphs (2), (3), or (5) of Section 16-106, or
25Article 18 of the Illinois Pension Code, for disability
26incurred after January 1, 1966, or benefits payable under the

 

 

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1Workers' Compensation or Occupational Diseases Act or benefits
2payable under a sick pay plan established in accordance with
3Section 36 of the State Finance Act. "Compensation" also means
4salary or wages paid to an employee of any qualified local
5government, qualified rehabilitation facility, qualified
6domestic violence shelter or service, or qualified child
7advocacy center.
8    (e) "Commission" means the State Employees Group Insurance
9Advisory Commission authorized by this Act. Commencing July 1,
101984, "Commission" as used in this Act means the Commission on
11Government Forecasting and Accountability as established by
12the Legislative Commission Reorganization Act of 1984.
13    (f) "Contributory", when referred to as contributory
14coverage, shall mean optional coverages or benefits elected by
15the member toward the cost of which such member makes
16contribution, or which are funded in whole or in part through
17the acceptance of a reduction in earnings or the foregoing of
18an increase in earnings by an employee, as distinguished from
19noncontributory coverage or benefits which are paid entirely by
20the State of Illinois without reduction of the member's salary.
21    (g) "Department" means any department, institution, board,
22commission, officer, court or any agency of the State
23government receiving appropriations and having power to
24certify payrolls to the Comptroller authorizing payments of
25salary and wages against such appropriations as are made by the
26General Assembly from any State fund, or against trust funds

 

 

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1held by the State Treasurer and includes boards of trustees of
2the retirement systems created by Articles 2, 14, 15, 16 and 18
3of the Illinois Pension Code. "Department" also includes the
4Illinois Comprehensive Health Insurance Board, the Board of
5Examiners established under the Illinois Public Accounting
6Act, and the Illinois Finance Authority.
7    (h) "Dependent", when the term is used in the context of
8the health and life plan, means a member's spouse and any child
9(1) from birth to age 26 including an adopted child, a child
10who lives with the member from the time of the filing of a
11petition for adoption until entry of an order of adoption, a
12stepchild or adjudicated child, or a child who lives with the
13member if such member is a court appointed guardian of the
14child or (2) age 19 or over who is mentally or physically
15disabled from a cause originating prior to the age of 19 (age
1626 if enrolled as an adult child dependent). For the health
17plan only, the term "dependent" also includes (1) any person
18enrolled prior to the effective date of this Section who is
19dependent upon the member to the extent that the member may
20claim such person as a dependent for income tax deduction
21purposes and (2) any person who has received after June 30,
222000 an organ transplant and who is financially dependent upon
23the member and eligible to be claimed as a dependent for income
24tax purposes. A member requesting to cover any dependent must
25provide documentation as requested by the Department of Central
26Management Services and file with the Department any and all

 

 

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1forms required by the Department.
2    (i) "Director" means the Director of the Illinois
3Department of Central Management Services or of any successor
4agency designated to administer this Act.
5    (j) "Eligibility period" means the period of time a member
6has to elect enrollment in programs or to select benefits
7without regard to age, sex or health.
8    (k) "Employee" means and includes each officer or employee
9in the service of a department who (1) receives his
10compensation for service rendered to the department on a
11warrant issued pursuant to a payroll certified by a department
12or on a warrant or check issued and drawn by a department upon
13a trust, federal or other fund or on a warrant issued pursuant
14to a payroll certified by an elected or duly appointed officer
15of the State or who receives payment of the performance of
16personal services on a warrant issued pursuant to a payroll
17certified by a Department and drawn by the Comptroller upon the
18State Treasurer against appropriations made by the General
19Assembly from any fund or against trust funds held by the State
20Treasurer, and (2) is employed full-time or part-time in a
21position normally requiring actual performance of duty during
22not less than 1/2 of a normal work period, as established by
23the Director in cooperation with each department, except that
24persons elected by popular vote will be considered employees
25during the entire term for which they are elected regardless of
26hours devoted to the service of the State, and (3) except that

 

 

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1"employee" does not include any person who is not eligible by
2reason of such person's employment to participate in one of the
3State retirement systems under Articles 2, 14, 15 (either the
4regular Article 15 system or the optional retirement program
5established under Section 15-158.2) or 18, or under paragraph
6(2), (3), or (5) of Section 16-106, of the Illinois Pension
7Code, but such term does include persons who are employed
8during the 6 month qualifying period under Article 14 of the
9Illinois Pension Code. Such term also includes any person who
10(1) after January 1, 1966, is receiving ordinary or accidental
11disability benefits under Articles 2, 14, 15 (including
12ordinary or accidental disability benefits under the optional
13retirement program established under Section 15-158.2),
14paragraphs (2), (3), or (5) of Section 16-106, or Article 18 of
15the Illinois Pension Code, for disability incurred after
16January 1, 1966, (2) receives total permanent or total
17temporary disability under the Workers' Compensation Act or
18Occupational Disease Act as a result of injuries sustained or
19illness contracted in the course of employment with the State
20of Illinois, or (3) is not otherwise covered under this Act and
21has retired as a participating member under Article 2 of the
22Illinois Pension Code but is ineligible for the retirement
23annuity under Section 2-119 of the Illinois Pension Code.
24However, a person who satisfies the criteria of the foregoing
25definition of "employee" except that such person is made
26ineligible to participate in the State Universities Retirement

 

 

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1System by clause (4) of subsection (a) of Section 15-107 of the
2Illinois Pension Code is also an "employee" for the purposes of
3this Act. "Employee" also includes any person receiving or
4eligible for benefits under a sick pay plan established in
5accordance with Section 36 of the State Finance Act. "Employee"
6also includes (i) each officer or employee in the service of a
7qualified local government, including persons appointed as
8trustees of sanitary districts regardless of hours devoted to
9the service of the sanitary district, (ii) each employee in the
10service of a qualified rehabilitation facility, (iii) each
11full-time employee in the service of a qualified domestic
12violence shelter or service, and (iv) each full-time employee
13in the service of a qualified child advocacy center, as
14determined according to rules promulgated by the Director.
15    (l) "Member" means an employee, annuitant, retired
16employee or survivor. In the case of an annuitant or retired
17employee who first becomes an annuitant or retired employee on
18or after the effective date of this amendatory Act of the 97th
19General Assembly, the individual must meet the minimum vesting
20requirements of the applicable retirement system in order to be
21eligible for group insurance benefits under that system. In the
22case of a survivor who first becomes a survivor on or after the
23effective date of this amendatory Act of the 97th General
24Assembly, the deceased employee, annuitant, or retired
25employee upon whom the annuity is based must have been eligible
26to participate in the group insurance system under the

 

 

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1applicable retirement system in order for the survivor to be
2eligible for group insurance benefits under that system.
3    (m) "Optional coverages or benefits" means those coverages
4or benefits available to the member on his or her voluntary
5election, and at his or her own expense.
6    (n) "Program" means the group life insurance, health
7benefits and other employee benefits designed and contracted
8for by the Director under this Act.
9    (o) "Health plan" means a health benefits program offered
10by the State of Illinois for persons eligible for the plan.
11    (p) "Retired employee" means any person who would be an
12annuitant as that term is defined herein but for the fact that
13such person retired prior to January 1, 1966. Such term also
14includes any person formerly employed by the University of
15Illinois in the Cooperative Extension Service who would be an
16annuitant but for the fact that such person was made ineligible
17to participate in the State Universities Retirement System by
18clause (4) of subsection (a) of Section 15-107 of the Illinois
19Pension Code.
20    (q) "Survivor" means a person receiving an annuity as a
21survivor of an employee or of an annuitant. "Survivor" also
22includes: (1) the surviving dependent of a person who satisfies
23the definition of "employee" except that such person is made
24ineligible to participate in the State Universities Retirement
25System by clause (4) of subsection (a) of Section 15-107 of the
26Illinois Pension Code; (2) the surviving dependent of any

 

 

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1person formerly employed by the University of Illinois in the
2Cooperative Extension Service who would be an annuitant except
3for the fact that such person was made ineligible to
4participate in the State Universities Retirement System by
5clause (4) of subsection (a) of Section 15-107 of the Illinois
6Pension Code; and (3) the surviving dependent of a person who
7was an annuitant under this Act by virtue of receiving an
8alternative retirement cancellation payment under Section
914-108.5 of the Illinois Pension Code.
10    (q-2) "SERS" means the State Employees' Retirement System
11of Illinois, created under Article 14 of the Illinois Pension
12Code.
13    (q-3) "SURS" means the State Universities Retirement
14System, created under Article 15 of the Illinois Pension Code.
15    (q-4) "TRS" means the Teachers' Retirement System of the
16State of Illinois, created under Article 16 of the Illinois
17Pension Code.
18    (q-5) "New SERS survivor" means a survivor, as defined in
19subsection (q), whose annuity is paid under Article 14 of the
20Illinois Pension Code and is based on the death of (i) an
21employee whose death occurs on or after January 1, 1998, or
22(ii) a new SERS annuitant as defined in subsection (b-5). "New
23SERS survivor" includes the surviving dependent of a person who
24was an annuitant under this Act by virtue of receiving an
25alternative retirement cancellation payment under Section
2614-108.5 of the Illinois Pension Code.

 

 

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1    (q-6) "New SURS survivor" means a survivor, as defined in
2subsection (q), whose annuity is paid under Article 15 of the
3Illinois Pension Code and is based on the death of (i) an
4employee whose death occurs on or after January 1, 1998, or
5(ii) a new SURS annuitant as defined in subsection (b-6).
6    (q-7) "New TRS State survivor" means a survivor, as defined
7in subsection (q), whose annuity is paid under Article 16 of
8the Illinois Pension Code and is based on the death of (i) an
9employee who is a teacher as defined in paragraph (2), (3), or
10(5) of Section 16-106 of that Code and whose death occurs on or
11after July 1, 1998, or (ii) a new TRS State annuitant as
12defined in subsection (b-7).
13    (r) "Medical services" means the services provided within
14the scope of their licenses by practitioners in all categories
15licensed under the Medical Practice Act of 1987.
16    (s) "Unit of local government" means any county,
17municipality, township, school district (including a
18combination of school districts under the Intergovernmental
19Cooperation Act), special district or other unit, designated as
20a unit of local government by law, which exercises limited
21governmental powers or powers in respect to limited
22governmental subjects, any not-for-profit association with a
23membership that primarily includes townships and township
24officials, that has duties that include provision of research
25service, dissemination of information, and other acts for the
26purpose of improving township government, and that is funded

 

 

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1wholly or partly in accordance with Section 85-15 of the
2Township Code; any not-for-profit corporation or association,
3with a membership consisting primarily of municipalities, that
4operates its own utility system, and provides research,
5training, dissemination of information, or other acts to
6promote cooperation between and among municipalities that
7provide utility services and for the advancement of the goals
8and purposes of its membership; the Southern Illinois
9Collegiate Common Market, which is a consortium of higher
10education institutions in Southern Illinois; the Illinois
11Association of Park Districts; and any hospital provider that
12is owned by a county that has 100 or fewer hospital beds and
13has not already joined the program. "Qualified local
14government" means a unit of local government approved by the
15Director and participating in a program created under
16subsection (i) of Section 10 of this Act.
17    (t) "Qualified rehabilitation facility" means any
18not-for-profit organization that is accredited by the
19Commission on Accreditation of Rehabilitation Facilities or
20certified by the Department of Human Services (as successor to
21the Department of Mental Health and Developmental
22Disabilities) to provide services to persons with disabilities
23and which receives funds from the State of Illinois for
24providing those services, approved by the Director and
25participating in a program created under subsection (j) of
26Section 10 of this Act.

 

 

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1    (u) "Qualified domestic violence shelter or service" means
2any Illinois domestic violence shelter or service and its
3administrative offices funded by the Department of Human
4Services (as successor to the Illinois Department of Public
5Aid), approved by the Director and participating in a program
6created 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; and
9        (2) is receiving a monthly benefit or retirement
10    annuity under Article 16 of the Illinois Pension Code; and
11        (3) either (i) has at least 8 years of creditable
12    service under Article 16 of the Illinois Pension Code, or
13    (ii) was enrolled in the health insurance program offered
14    under that Article on January 1, 1996, or (iii) is the
15    survivor of a benefit recipient who had at least 8 years of
16    creditable service under Article 16 of the Illinois Pension
17    Code or was enrolled in the health insurance program
18    offered under that Article on the effective date of this
19    amendatory Act of 1995, or (iv) is a recipient or survivor
20    of a recipient of a disability benefit under Article 16 of
21    the Illinois Pension Code.
22    (w) "TRS dependent beneficiary" means a person who:
23        (1) is not a "member" or "dependent" as defined in this
24    Section; and
25        (2) is a TRS benefit recipient's: (A) spouse, (B)
26    dependent parent who is receiving at least half of his or

 

 

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1    her support from the TRS benefit recipient, or (C) natural,
2    step, adjudicated, or adopted child who is (i) under age
3    26, (ii) was, on January 1, 1996, participating as a
4    dependent beneficiary in the health insurance program
5    offered under Article 16 of the Illinois Pension Code, or
6    (iii) age 19 or over who is mentally or physically disabled
7    from a cause originating prior to the age of 19 (age 26 if
8    enrolled as an adult child).
9    "TRS dependent beneficiary" does not include, as indicated
10under paragraph (2) of this subsection (w), a dependent of the
11survivor of a TRS benefit recipient who first becomes a
12dependent of a survivor of a TRS benefit recipient on or after
13the effective date of this amendatory Act of the 97th General
14Assembly unless that dependent would have been eligible for
15coverage as a dependent of the deceased TRS benefit recipient
16upon whom the survivor benefit is based.
17    (x) "Military leave" refers to individuals in basic
18training for reserves, special/advanced training, annual
19training, emergency call up, activation by the President of the
20United States, or any other training or duty in service to the
21United States Armed Forces.
22    (y) (Blank).
23    (z) "Community college benefit recipient" means a person
24who:
25        (1) is not a "member" as defined in this Section; and
26        (2) is receiving a monthly survivor's annuity or

 

 

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1    retirement annuity under Article 15 of the Illinois Pension
2    Code; and
3        (3) either (i) was a full-time employee of a community
4    college district or an association of community college
5    boards created under the Public Community College Act
6    (other than an employee whose last employer under Article
7    15 of the Illinois Pension Code was a community college
8    district subject to Article VII of the Public Community
9    College Act) and was eligible to participate in a group
10    health benefit plan as an employee during the time of
11    employment with a community college district (other than a
12    community college district subject to Article VII of the
13    Public Community College Act) or an association of
14    community college boards, or (ii) is the survivor of a
15    person described in item (i).
16    (aa) "Community college dependent beneficiary" means a
17person who:
18        (1) is not a "member" or "dependent" as defined in this
19    Section; and
20        (2) is a community college benefit recipient's: (A)
21    spouse, (B) dependent parent who is receiving at least half
22    of his or her support from the community college benefit
23    recipient, or (C) natural, step, adjudicated, or adopted
24    child who is (i) under age 26, or (ii) age 19 or over and
25    mentally or physically disabled from a cause originating
26    prior to the age of 19 (age 26 if enrolled as an adult

 

 

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1    child).
2    "Community college dependent beneficiary" does not
3include, as indicated under paragraph (2) of this subsection
4(aa), a dependent of the survivor of a community college
5benefit recipient who first becomes a dependent of a survivor
6of a community college benefit recipient on or after the
7effective date of this amendatory Act of the 97th General
8Assembly unless that dependent would have been eligible for
9coverage as a dependent of the deceased community college
10benefit recipient upon whom the survivor annuity is based.
11    (bb) "Qualified child advocacy center" means any Illinois
12child advocacy center and its administrative offices funded by
13the Department of Children and Family Services, as defined by
14the Children's Advocacy Center Act (55 ILCS 80/), approved by
15the Director and participating in a program created under
16subsection (n) of Section 10.
17(Source: P.A. 95-331, eff. 8-21-07; 95-632, eff. 9-25-07;
1896-756, eff. 1-1-10; 96-1519, eff. 2-4-11.)
 
19    (5 ILCS 375/8)  (from Ch. 127, par. 528)
20    Sec. 8. Eligibility.
21    (a) Each employee member eligible under the provisions of
22this Act and any rules and regulations promulgated and adopted
23hereunder by the Director shall become immediately eligible and
24covered for all benefits available under the programs.
25Employees Members electing coverage for eligible dependents

 

 

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

 

 

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

 

 

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1retired Retired employees may elect coverage for eligible
2dependents and shall have the coverage effective immediately,
3provided that the election is properly filed in accordance with
4required filing dates and procedures specified by the Director,
5except that, for a survivor, the dependent sought to be added
6on or after the effective date of this amendatory Act of the
797th General Assembly must have been eligible for coverage as a
8dependent under the deceased member upon whom the survivor's
9annuity is based in order to be eligible for coverage under the
10survivor.
11    Except as otherwise provided in this Act, where husband and
12wife are both eligible members, each shall be enrolled as a
13member and coverage on their eligible dependent children, if
14any, may be under the enrollment and election of either.
15    Regardless of other provisions herein regarding late
16enrollment or other qualifications, as appropriate, the
17Director may periodically authorize open enrollment periods
18for each of the benefit programs at which time each member may
19elect enrollment or change of enrollment without regard to age,
20sex, health, or other qualification under the conditions as may
21be prescribed in rules and regulations supplementing this Act.
22Special open enrollment periods may be declared by the Director
23for certain members only when special circumstances occur that
24affect only those members.
25    (d) Beginning with fiscal year 2003 and for all subsequent
26years, eligible members may elect not to participate in the

 

 

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

 

 

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1program of financial incentives to encourage annuitants
2receiving a retirement annuity from the State Employees
3Retirement System, but who are not eligible for benefits under
4the federal Medicare health insurance program (Title XVIII of
5the Social Security Act, as added by Public Law 89-97) to elect
6not to participate in the program of health benefits provided
7under this Act. The election by an annuitant not to participate
8under this program must be made in accordance with the
9requirements set forth under subsection (d). The financial
10incentives provided to these annuitants under the program may
11not exceed $150 per month for each annuitant electing not to
12participate in the program of health benefits provided under
13this Act.
14    (e) Notwithstanding any other provision of this Act or the
15rules adopted under this Act, if a person participating in the
16program of health benefits as the dependent spouse of an
17eligible member becomes an annuitant, the person may elect, at
18the time of becoming an annuitant or during any subsequent
19annual benefit choice period, to continue participation as a
20dependent rather than as an eligible member for as long as the
21person continues to be an eligible dependent. In order to be
22eligible to make such an election, the person must have been
23enrolled as a dependent under the program of health benefits
24for no less than one year prior to becoming an annuitant.
25    An eligible member who has elected to participate as a
26dependent may re-enroll in the program of health benefits as an

 

 

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1eligible member (i) during any subsequent annual benefit choice
2period or (ii) upon showing a qualifying change in status, as
3defined in the U.S. Internal Revenue Code, without evidence of
4insurability and with no limitations on coverage for
5pre-existing conditions.
6    A person who elects to participate in the program of health
7benefits as a dependent rather than as an eligible member shall
8be furnished a written explanation of the consequences of
9electing to participate as a dependent and the conditions and
10procedures for re-enrolling as an eligible member. The
11explanation shall also be included in the annual benefit choice
12options booklet furnished to members.
13(Source: P.A. 94-95, eff. 7-1-05; 94-109, eff. 7-1-05; 95-331,
14eff. 8-21-07.)
 
15    Section 99. Effective date. This Act takes effect upon
16becoming law.".