(5 ILCS 375/15)
(from Ch. 127, par. 535)
Administration; rules; audit; review.
(a) The Director shall administer this Act and shall prescribe
such rules and regulations as are necessary to give full effect to the
purposes of this Act. To facilitate the maintenance of the program of group health benefits provided to annuitants, survivors, and retired employees under this Act, rules adopted by the Director to alter the contributions to be paid by the State, annuitants, survivors, retired employees, or any combination of those entities, for that program of group health benefits, shall be adopted as emergency rules in accordance with Section 5-45 of the Illinois Administrative Procedure Act.
(b) These rules may fix reasonable standards for the group life and
group health programs and other benefit programs offered under this
Act, and for the contractors providing them.
(c) These rules shall specify that covered and optional medical
services of the program are services provided within the scope of their
licenses by practitioners in all categories licensed under the Medical
Practice Act of 1987 and shall provide that all eligible persons be
fully informed of this specification.
(d) These rules shall establish eligibility requirements for
members and dependents as may be necessary to supplement
or clarify requirements contained in this Act.
(e) Each affected department of the State, the State Universities
Retirement System, the Teachers' Retirement System, and each qualified local
government, rehabilitation facility, domestic violence shelter or service,
or child advocacy center, shall keep such records, make such certifications, and furnish the Director
such information as may be necessary for the administration of this Act,
including information concerning number and total amounts of payroll of
employees of the department who are paid from trust funds or federal funds.
(f) Each member, each community college benefit recipient to whom this Act
applies, and each TRS benefit recipient to whom this Act applies shall
furnish the Director, in such form as may be required, any
information that may be necessary to enroll such member
or benefit recipient and, if applicable, his or her
dependents or dependent beneficiaries under the programs or
plan, including such data as may be required to allow the Director to
accumulate statistics on data normally considered in actuarial studies of
employee groups. Information about community college benefit recipients and
community college dependent beneficiaries shall be furnished through the State
Universities Retirement System. Information about TRS benefit recipients and
TRS dependent beneficiaries shall be furnished through the Teachers' Retirement
(g) There shall be audits and reports
on the programs authorized and established by this Act prepared by the Director
with the assistance of a qualified, independent accounting firm. The
reports shall provide information on the experience, and
and adequacy of the program including, when applicable, recommendations on
up-grading of benefits and improvement of the program.
(h) Any final order, decision or other determination made, issued or
executed by the Director under the provisions of this Act whereby any
contractor or person is aggrieved shall be subject to review in accordance
with the provisions of the Administrative Review Law and all amendments
and modifications thereof, and the rules adopted pursuant thereto, shall
apply to and govern all proceedings for the judicial review of final
administrative decisions of the Director.
(Source: P.A. 97-695, eff. 7-1-12.)