Sen. Christine Radogno

Filed: 4/24/2013





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2    AMENDMENT NO. ______. Amend Senate Bill 1245, AS AMENDED,
3by replacing the enacting clause with the following:
4    "Section 5. The Public Safety Employee Benefits Act is
5amended by changing Section 10 and adding Section 17 as
7    (820 ILCS 320/10)
8    Sec. 10. Required health coverage benefits.
9    (a) An employer who employs a full-time law enforcement,
10correctional or correctional probation officer, or firefighter
11(hereinafter referred to as "injured employee"), who, on or
12after the effective date of this Act suffers a catastrophic
13injury or is killed in the line of duty shall pay the entire
14premium of the employer's health insurance plan for the injured
15employee, the injured employee's spouse, and for each dependent
16child of the injured employee until the child reaches the age



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1of majority 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
7injured employee subsequently dies, the employer shall
8continue to pay the entire health insurance premium for the
9surviving spouse until remarried and for the dependent children
10under the conditions established in this Section. An employer
11shall not be required to pay the premium of the health
12insurance plan as provided in this Section if the employee or
13employee's spouse: (1) is granted disability income benefits
14under Title II (42 U.S.C. 401 et seq.) or supplemental security
15income benefits under Title XVI (42 U.S.C. 1381 et seq.) of the
16Social Security Act, (2) accepts health insurance benefits from
17another source, or (3) becomes eligible for federal Medicare
18benefits. However:
19        (1) Health insurance benefits payable from any other
20    source shall reduce benefits payable under this Section.
21        (2) It is unlawful for a person to willfully and
22    knowingly make, or cause to be made, or to assist, conspire
23    with, or urge another to make, or cause to be made, any
24    false, fraudulent, or misleading oral or written statement
25    to obtain health insurance coverage as provided under this
26    Section. A violation of this item is a Class A misdemeanor.



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1        (3) Upon conviction for a violation described in item
2    (2), a law enforcement, correctional or correctional
3    probation officer, or other beneficiary who receives or
4    seeks to receive health insurance benefits under this
5    Section shall forfeit the right to receive health insurance
6    benefits and shall reimburse the employer for all benefits
7    paid due to the fraud or other prohibited activity. For
8    purposes of this item, "conviction" means a determination
9    of guilt that is the result of a plea or trial, regardless
10    of whether adjudication is withheld.
11    (b) In order for the law enforcement, correctional or
12correctional probation officer, firefighter, spouse, or
13dependent children to be eligible for insurance coverage under
14this Act, the injury or death must have occurred as the result
15of the officer's response to fresh pursuit, the officer or
16firefighter's response to what is reasonably believed to be an
17emergency, an unlawful act perpetrated by another, or during
18the investigation of a criminal act. Nothing in this Section
19shall be construed to limit health insurance coverage or
20pension benefits for which the officer, firefighter, spouse, or
21dependent children may otherwise be eligible.
22    (c) "Catastrophic injury" means an injury that is one of
23the following:
24        (1) spinal cord injury involving severe paralysis of an
25    arm, a leg, or the trunk;
26        (2) any amputation of an arm, a hand, a foot, or a leg



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1    that involves the effective loss of use of that appendage;
2        (3) severe brain or closed head injury as evidenced by:
3            (A) severe sensory or motor disturbances;
4            (B) severe communication disturbances;
5            (C) severe complex integrated disturbances of
6        cerebral function;
7            (D) severe disturbances of consciousness;
8            (E) severe episodic neurological disorders; or
9            (F) other conditions at least as severe in nature
10        as any condition provided in items (A) through (E);
11        (4) second or third degree burns over 50% of the body
12    as a whole or third degree burns to 50% or more of the face
13    or hands;
14        (5) total vision loss; or
15        (6) any other injury, the direct and proximate cause of
16    which permanently prevents an individual from performing
17    any gainful work.
18    (d) An injured employee who on or after the effective date
19of this amendatory Act of the 98th General Assembly suffers an
20injury that is not considered catastrophic under subsection (c)
21of this Section, but would otherwise qualify the individual to
22receive a line-of-duty disability pension that was awarded as a
23consequence of the officer's response to fresh pursuit, the
24officer's or firefighter's response to what is reasonably
25believed to be an emergency, an unlawful act perpetrated by
26another, or during the investigation of a criminal act or under



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1Section 3-114.1 or 4-110 of the Illinois Pension Code or a duty
2death benefit under Section 3 of the Line of Duty Compensation
3Act, shall be considered to have suffered a qualifying
4disability and shall be entitled to receive health insurance
5benefits as provided in this subsection.
6    An injured employee who has suffered a qualifying
7disability is entitled to purchase or continue to purchase the
8same health insurance benefits provided by the unit of
9government at the time that the injured employee was injured
10for a period of 5 years following the qualifying disability.
11The employer shall pay not less than 50% of the total insurance
13    The injured employee is entitled to purchase or continue to
14purchase health insurance coverage until the earlier of: (1) a
15decision being rendered granting disability income benefits
16under Title II (42 U.S.C. 401 et seq.) or supplemental security
17income benefits under Title XVI (42 U.S.C. 1381 et seq.) of the
18Social Security Act, (2) the injured employee accepting health
19insurance benefits from another source, or (3) the date the
20injured employee becomes eligible for federal Medicare
22    (e) By July 1 of every year, a person receiving benefits
23under this Act shall be required to submit to the employer, on
24a form provided by the employer, a report that shall include
25the following:
26        (1) gainful employment by the beneficiary within the



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1    reporting period;
2        (2) compensation earned by the beneficiary as a result
3    of the employment;
4        (3) current annual household income;
5        (4) whether the injured employee, or his or her spouse,
6    has been offered any insurance from another source; and
7        (5) whether the injured employee, or his or her spouse,
8    is currently enrolled in any insurance plan from another
9    source.
10    Any information collected by the employer under this
11Section shall be exempt from the requirements of the Freedom of
12Information Act except data collected in the aggregate that
13does not reveal any personal information of the injured
15    (f) The employer may cancel benefits being provided under
16this Act for any beneficiary (1) whose household income exceeds
17800% of the poverty level; (2) who has rejected an offer of
18insurance coverage from another source; or (3) who is currently
19enrolled in an insurance plan from another source. Benefits may
20be denied any individual who fails to timely file a completed
21report under this Section. Not less than 60 days prior to July
221, an employer shall notify any employee receiving benefits
23under this Act of that employee's obligation to file a report
24under this Section. Any employee that fails to timely file a
25report under this Section by July 1 shall be notified that he
26or she has 30 days to submit the report. Any employee who fails



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1to file 30 days after receiving this notice may be denied
3(Source: P.A. 90-535, eff. 11-14-97.)
4    (820 ILCS 320/17 new)
5    Sec. 17. Claims report.
6    (a) An employer subject to this Act shall file a claims
7report with the Public Pension Division of the Department of
8Insurance in the format prepared by the Division. The Division
9shall design the form and prescribe the content of the report.
10At least 60 days before the filing deadline, the Division shall
11provide the form to the employers subject to this Act. The
12claims report shall be filed no later than December 31 of each
13year. The claims report shall set forth the required
14information for the 12-month period ending on June 30 preceding
15the deadline date for filing the report. The claims report
16shall, at a minimum, contain the following information:
17        (1) the number of claims filed under this Act during
18    the reporting period;
19        (2) the number of claims awarded under this Act during
20    the reporting period;
21        (3) the dollar amount of all claims awarded under this
22    Act during the reporting period;
23        (4) the number of claims paid under this Act during the
24    reporting period regardless of when the claim was awarded;
25        (5) the dollar amount of all claims paid under this Act



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1    during the reporting period regardless of when the claim
2    was awarded;
3        (6) the annual cost of the benefit and any available
4    long-term cost projections;
5        (7) the nature of the injury;
6        (8) any gainful employment during the annual reporting
7    period;
8        (9) the compensation earned as a result of that
9    employment; and
10        (10) any accessible insurance options.
11The claims report shall redact any information as required by
12the Health Insurance Portability and Accountability Act of 1996
14    (b) On or before July 1 of each year, the Public Pension
15Division of the Department of Insurance shall submit a report
16to the Governor and General Assembly setting forth the
17information received under subsection (a) with respect to the
18most recently completed reporting period. The requirement for
19reporting to the General Assembly shall be satisfied by filing
20copies of the report with the Speaker, Minority Leader, and
21Clerk of the House of Representatives, the President, Minority
22Leader, and Secretary of the Senate, the Legislative Research
23Unit as required under Section 3.1 of the General Assembly
24Organization Act, and the State Government Report Distribution
25Center for the General Assembly as required under paragraph (t)
26of Section 7 of the State Library Act. Upon request, the



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1Division shall provide copies of the report at no charge to
2employers subject to this Act, to public libraries, and to
3State agencies.
4    (c) By July 1 of every year, a person receiving benefits
5under this Act shall be required to file, on a form provided by
6the employer, a report that shall include the following:
7        (1) gainful employment by the beneficiary within the
8    reporting period;
9        (2) compensation earned by the beneficiary as a result
10    of the employment;
11        (3) current annual household income;
12        (4) whether the injured employee, or his or her spouse,
13    has been offered comparable insurance from another source;
14    and
15        (5) whether the injured employee, or his or her spouse,
16    is currently enrolled in a comparable insurance plan from
17    another source.
18    Benefits may be denied any individual who fails to timely
19file a report under this subsection.
20    Section 99. Effective date. This Act takes effect upon
21becoming law.".