Rep. Ann Williams

Filed: 5/28/2013

 

 


 

 


 
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1
AMENDMENT TO SENATE BILL 1245

2    AMENDMENT NO. ______. Amend Senate Bill 1245 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. The Public Safety Employee Benefits Act is
5amended by changing Section 10 as follows:
 
6    (820 ILCS 320/10)
7    Sec. 10. Required health coverage benefits.
8    (a) An employer who employs a full-time law enforcement,
9correctional or correctional probation officer, or firefighter
10(hereinafter referred to as "PSEBA recipient"), who, on or
11after the effective date of this Act suffers a catastrophic
12injury or is killed in the line of duty shall pay the entire
13premium of the employer's health insurance plan for the PSEBA
14recipient injured employee, the PSEBA recipient's injured
15employee's spouse, and for each dependent child of the PSEBA
16recipient injured employee until the child reaches the age of

 

 

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1majority or until the end of the calendar year in which the
2child reaches the age of 25 if the child continues to be
3dependent for support or the child is a full-time or part-time
4student and is dependent for support. The term "health
5insurance plan" does not include supplemental benefits that are
6not part of the basic group health insurance plan. If the PSEBA
7recipient injured employee subsequently dies, the employer
8shall continue to pay the entire health insurance premium for
9the surviving spouse until remarried and for the dependent
10children under the conditions established in this Section.
11However:
12        (1) Health insurance benefits payable from any other
13    source shall reduce benefits payable under this Section.
14        (2) It is unlawful for a person to willfully and
15    knowingly make, or cause to be made, or to assist, conspire
16    with, or urge another to make, or cause to be made, any
17    false, fraudulent, or misleading oral or written statement
18    to obtain health insurance coverage as provided under this
19    Section. A violation of this item is a Class A misdemeanor.
20        (3) Upon conviction for a violation described in item
21    (2), a law enforcement, correctional or correctional
22    probation officer, or other beneficiary who receives or
23    seeks to receive health insurance benefits under this
24    Section shall forfeit the right to receive health insurance
25    benefits and shall reimburse the employer for all benefits
26    paid due to the fraud or other prohibited activity. For

 

 

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1    purposes of this item, "conviction" means a determination
2    of guilt that is the result of a plea or trial, regardless
3    of whether adjudication is withheld.
4    (b) In order for the law enforcement, correctional or
5correctional probation officer, firefighter, spouse, or
6dependent children to be eligible for insurance coverage under
7this Act, the injury or death must have occurred as the result
8of the officer's response to fresh pursuit, the officer or
9firefighter's response to what is reasonably believed to be an
10emergency, an unlawful act perpetrated by another, or during
11the investigation of a criminal act. Nothing in this Section
12shall be construed to limit health insurance coverage or
13pension benefits for which the officer, firefighter, spouse, or
14dependent children may otherwise be eligible.
15    (c) A PSEBA benefit recipient who qualified for benefits
16under subsections (a) and (b) of this Section shall be required
17to file a form with his or her employer as prescribed in this
18Section. The Commission on Government Forecasting and
19Accountability (COGFA) shall use the form created in this Act
20and prescribe the content of the report in cooperation with one
21statewide labor organization representing police, one
22statewide law enforcement organization, one statewide labor
23organization representing firefighters employed by at least
24100 municipalities in this State that is affiliated with the
25Illinois State Federation of Labor, one statewide labor
26organization representing correctional officers and parole

 

 

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1agents, that is affiliated with the Illinois State Federation
2of Labor, one statewide labor organization representing
3correctional officers and parole agents that is affiliated with
4the Illinois State Federation of Labor, one statewide
5organization representing municipalities, and one regional
6organization representing municipalities. COGFA may accept
7comment from any source, but shall not be required to solicit
8public comment. Within 60 days after the effective date of this
9amendatory Act of the 98th General Assembly, COGFA shall remit
10a copy of the form contained in this subsection to all
11employers subject to this Act.
 
12        "PSEBA RECIPIENT REPORTING FORM:
13        Under Section 10 of the Public Safety Employee Benefits
14    Act (820 ILCS 320/10), the Commission on Government
15    Forecasting and Accountability (COGFA) is charged with
16    creating and submitting a report to the Governor and the
17    General Assembly setting forth information regarding
18    recipients and benefits payable under the Public Safety
19    Employee Benefits Act (Act). The Act requires employers
20    providing PSEBA benefits to distribute this form to any
21    former peace officer, firefighter, or correctional officer
22    currently in receipt of PSEBA benefits.
23        The responses to the questions below will be used by
24    COGFA to compile information regarding the PSEBA benefit
25    for its report. The Act prohibits the release of any

 

 

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1    personal information concerning the PSEBA recipient and
2    exempts the reported information from the requirements of
3    the Freedom of Information Act (FOIA).
4        The Act requires the PSEBA recipient to complete this
5    form and submit it to the employer providing PSEBA benefits
6    within 60 days of receipt. If the PSEBA recipient fails to
7    submit this form within 60 days of receipt, the employer is
8    required to notify the PSEBA recipient of non-compliance
9    and provide an additional 30 days to submit the required
10    form. Failure to submit the form in a timely manner will
11    result in the PSEBA recipient incurring responsibility for
12    reimbursing the employer for premiums paid during the
13    period the form is due and not filed.
14            (1) PSEBA recipient's name:
15            (2) PSEBA recipient's date of birth:
16            (3) Name of the employer providing PSEBA benefits:
17            (4) Date the PSEBA benefit first became payable:
18            (5) What was the medical diagnosis of the injury
19        that qualified you for the PSEBA benefit?
20            (6) Are you currently employed with compensation?
21            (7) If so, what is the name(s) of your current
22        employer(s)?
23            (8) Are you or your spouse enrolled in a health
24        insurance plan provided by your current employer or
25        another source?
26            (9) Have you or your spouse been offered or

 

 

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1        provided access to health insurance from your current
2        employer(s)?
3        If you answered yes to question 8 or 9, please provide
4    the name of the employer, the name of the insurance
5    provider(s), and a general description of the type(s) of
6    insurance offered (HMO, PPO, HSA, etc.):
7            (10) Are you or your spouse enrolled in a health
8        insurance plan provided by a current employer of your
9        spouse?
10            (11) Have you or your spouse been offered or
11        provided access to health insurance provided by a
12        current employer of your spouse?
13        If you answered yes to question 10 or 11, please
14    provide the name of the employer, the name of the insurance
15    provider, and a general description of the type of
16    insurance offered (HMO, PPO, HSA, etc.) by an employer of
17    your spouse:"
 
18    Within 30 days after receipt of this form, COFGA shall
19notify an employer of its obligation to notify any PSEBA
20recipient receiving benefits under this Act of that recipient's
21obligation to file a report under this Section. The employer
22shall include a copy of the form and a self-addressed stamped
23envelope for the form to be returned to the employer. A PSEBA
24recipient receiving benefits under this Act must complete and
25return this form to the employer within 60 days of receipt of

 

 

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1such form. Any PSEBA recipient who has been given notice as
2provided under this Section and who fails to timely file a
3report under this Section within 60 days after receipt of this
4form shall be notified by the employer that he or she has 30
5days to submit the report or risk incurring the cost of his or
6her benefits provided under this Act. An employer may seek
7reimbursement for premium payments for a PSEBA recipient who
8fails to file this report with the employer 30 days after
9receiving this notice. The PSEBA recipient is responsible for
10reimbursing the employer for premiums paid during the period
11the report is due and not filed. Employers shall return this
12form to COGFA within 30 days after receiving the form from the
13PSEBA recipient.
14    Any information collected by the employer under this
15Section shall be exempt from the requirements of the Freedom of
16Information Act except for data collected in the aggregate that
17does not reveal any personal information concerning the PSEBA
18recipient.
19    By July 1 of every odd-numbered year, beginning in 2015,
20employers subject to this Act must send the form contained in
21this subsection to all PSEBA recipients eligible for benefits
22under this Act. The PSEBA recipient must complete and return
23this form by September 1 of that year. Any PSEBA recipient who
24has been given notice as provided under this Section and who
25fails to timely file a completed form under this Section within
2660 days after receipt of this form shall be notified by the

 

 

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1employer that he or she has 30 days to submit the form or risk
2incurring the costs of his or her benefits provided under this
3Act. The PSEBA recipient is responsible for reimbursing the
4employer for premiums paid during the period the report is due
5and not filed. The employer shall resume premium payments upon
6receipt of the completed form. Employers shall return this form
7to COGFA within 30 days after receiving the form from the PSEBA
8recipient.
9    (d) An employer subject to this Act shall complete and file
10the form contained in this subsection.
 
11        "EMPLOYER SUBJECT TO PSEBA REPORTING FORM:
12        Under Section 10 of the Public Safety Employee Benefits
13    Act (820 ILCS 320/10), the Commission on Government
14    Forecasting and Accountability (COGFA) is charged with
15    creating and submitting a report to the Governor and
16    General Assembly setting forth information regarding
17    recipients and benefits payable under the Public Safety
18    Employee Benefits Act (Act).
19        The responses to the questions below will be used by
20    COGFA to compile information regarding the PSEBA benefit
21    for its report.
22        The Act requires all employers subject to the PSEBA Act
23    to submit the following information within 120 days after
24    receipt of this form.
25            (1) Name of the employer:

 

 

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1            (2) The number of PSEBA benefit applications filed
2        under the Act during the reporting period provided in
3        the aggregate and listed individually by name of
4        applicant and date of application:
5            (3) The number of PSEBA benefits and names of PSEBA
6        recipients receiving benefits awarded under the Act
7        during the reporting period provided in the aggregate
8        and listed individually by name of applicant and date
9        of application:
10            (4) The cost of the health insurance premiums paid
11        due to PSEBA benefits awarded under the Act during the
12        reporting period provided in the aggregate and listed
13        individually by name of PSEBA recipient:
14            (5) The number of PSEBA benefit applications filed
15        under the Act since the inception of the Act provided
16        in the aggregate and listed individually by name of
17        applicant and date of application:
18            (6) The number of PSEBA benefits awarded under the
19        Act since the inception of the Act provided in the
20        aggregate and listed individually by name of applicant
21        and date of application:
22            (7) The cost of health insurance premiums paid due
23        to PSEBA benefits awarded under the Act since the
24        inception of the Act provided in the aggregate and
25        listed individually by name of PSEBA recipient:
26            (8) The current annual cost of health insurance

 

 

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1        premiums paid for PSEBA benefits awarded under the Act
2        provided in the aggregate and listed individually by
3        name of PSEBA recipient:
4            (9) The annual cost of health insurance premiums
5        paid for PSEBA benefits awarded under the Act listed by
6        year since the inception of the Act provided in annual
7        aggregate amounts and listed individually by name of
8        PSEBA recipient:
9            (10) A description of health insurance benefit
10        levels currently provided by the employer to the PSEBA
11        recipient:
12            (11) The total cost of the monthly health insurance
13        premium currently provided to the PSEBA recipient:
14            (12) The other costs of the health insurance
15        benefit currently provided to the PSEBA recipient
16        including, but not limited to:
17                (i) the co-pay requirements of the health
18            insurance policy provided to the PSEBA recipient;
19                (ii) the out-of-pocket deductibles of the
20            health insurance policy provided to the PSEBA
21            recipient;
22                (iii) any pharmaceutical benefits and co-pays
23            provided in the insurance policy; and
24                (iv) any policy limits of the health insurance
25            policy provided to the PSEBA recipient."
 

 

 

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1    An employer covered under this Act shall file copies of the
2PSEBA Recipient Reporting Form and the Employer Subject to the
3PSEBA Act Reporting Form with COGFA within 120 days after
4receipt of the Employer Subject to the PSEBA Act Reporting
5Form.
6    The first form filed with COGFA under this Section shall
7contain all information required by this Section. All forms
8filed by the employer thereafter shall set forth the required
9information for the 24-month period ending on June 30 preceding
10the deadline date for filing the report.
11    Whenever possible, communication between COGFA and
12employers as required by this Act shall be through electronic
13means.
14    (e) For the purpose of creating the report required under
15subsection (f), upon receipt of each PSEBA Benefit Recipient
16Form, or as soon as reasonably practicable, COGFA shall make a
17determination of whether the PSEBA benefit recipient or the
18PSEBA benefit recipient's spouse meets one of the following
19criteria:
20        (1) the PSEBA benefit recipient or the PSEBA benefit
21    recipient's spouse is receiving health insurance from a
22    current employer, a current employer of his or her spouse,
23    or another source;
24        (2) the PSEBA benefit recipient or the PSEBA benefit
25    recipient's spouse has been offered or provided access to
26    health insurance from a current employer or employers.

 

 

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1    If one or both of the criteria are met, COGFA shall make
2the following determinations of the associated costs and
3benefit levels of health insurance provided or offered to the
4PSEBA benefit recipient or the PSEBA benefit recipient's
5spouse:
6        (A) a description of health insurance benefit levels
7    offered to or received by the PSEBA benefit recipient or
8    the PSEBA benefit recipient's spouse from a current
9    employer or a current employer of the PSEBA benefit
10    recipient's spouse;
11        (B) the monthly premium cost of health insurance
12    benefits offered to or received by the PSEBA benefit
13    recipient or the PSEBA benefit recipient's spouse from a
14    current employer or a current employer of the PSEBA benefit
15    recipient's spouse including, but not limited to:
16            (i) the total monthly cost of the health insurance
17        premium;
18            (ii) the monthly amount of the health insurance
19        premium to be paid by the employer;
20            (iii) the monthly amount of the health insurance
21        premium to be paid by the PSEBA benefit recipient or
22        the PSEBA benefit recipient's spouse;
23            (iv) the co-pay requirements of the health
24        insurance policy;
25            (v) the out-of-pocket deductibles of the health
26        insurance policy;

 

 

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1            (vi) any pharmaceutical benefits and co-pays
2        provided in the insurance policy;
3            (vii) any policy limits of the health insurance
4        policy.
5    COGFA shall summarize the related costs and benefit levels
6of health insurance provided or available to the PSEBA benefit
7recipient or the PSEBA benefit recipient's spouse and contrast
8the results to the cost and benefit levels of health insurance
9currently provided by the employer subject to this Act. This
10information shall be included in the report required in
11subsection (f).
12    (f) By June 1, 2014, and by January 1 of every
13even-numbered year thereafter beginning in 2016, COGFA shall
14submit a report to the Governor and the General Assembly
15setting forth the information received under subsections (c)
16and (d). The report shall aggregate data in such a way as to
17not reveal the identity of any single beneficiary. The
18requirement for reporting to the General Assembly shall be
19satisfied by filing copies of the report with the Speaker,
20Minority Leader, and Clerk of the House of Representatives, the
21President, Minority Leader, and Secretary of the Senate, the
22Legislative Research Unit as required under Section 3.1 of the
23General Assembly Organization Act, and the State Government
24Report Distribution Center for the General Assembly as required
25under paragraph (t) of Section 7 of the State Library Act.
26COGFA shall make this report available electronically on a

 

 

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1publicly accessible website.
2(Source: P.A. 90-535, eff. 11-14-97.)
 
3    Section 99. Effective date. This Act takes effect upon
4becoming law.".