State of Illinois
91st General Assembly
Legislation

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[ Introduced ][ Enrolled ][ House Amendment 002 ]

91_SB0251eng

 
SB251 Engrossed                                LRB9102764EGfg

 1        AN  ACT  to amend the State Employees Group Insurance Act
 2    of 1971 by changing Section 10.

 3        Be it enacted by the People of  the  State  of  Illinois,
 4    represented in the General Assembly:

 5        Section  5.   The  State Employees Group Insurance Act of
 6    1971 is amended by changing Section 10 as follows:

 7        (5 ILCS 375/10) (from Ch. 127, par. 530)
 8        Sec. 10. Payments by State; premiums.
 9        (a)  The   State   shall   pay   the   cost   of    basic
10    non-contributory  group life insurance and, subject to member
11    paid contributions set by the Department or required by  this
12    Section,  the  basic program of group health benefits on each
13    eligible member, except a member, not  otherwise  covered  by
14    this  Act,  who  has  retired as a participating member under
15    Article 2 of the Illinois Pension Code but is ineligible  for
16    the  retirement  annuity  under Section 2-119 of the Illinois
17    Pension Code, and part of each eligible member's and  retired
18    member's  premiums for health insurance coverage for enrolled
19    dependents as provided by Section 9.  The State shall pay the
20    cost of the basic program of group health benefits only after
21    benefits are reduced by the amount  of  benefits  covered  by
22    Medicare  for all retired members and retired dependents aged
23    65 years or older who are entitled to benefits  under  Social
24    Security  or  the  Railroad  Retirement  system  or  who  had
25    sufficient Medicare-covered government employment except that
26    such  reduction in benefits shall apply only to those retired
27    members or retired dependents who (1) first  become  eligible
28    for  such  Medicare coverage on or after July 1, 1992; or (2)
29    remain eligible for, but no longer receive Medicare  coverage
30    which  they  had been receiving on or after July 1, 1992. The
31    Department may determine the aggregate level of  the  State's
 
SB251 Engrossed             -2-                LRB9102764EGfg
 1    contribution  on the basis of actual cost of medical services
 2    adjusted for age, sex  or  geographic  or  other  demographic
 3    characteristics which affect the costs of such programs.
 4        The  cost  of participation in the basic program of group
 5    health benefits for the dependent or survivor of a living  or
 6    deceased  retired  employee  who was formerly employed by the
 7    University of Illinois in the Cooperative  Extension  Service
 8    and would be an annuitant but for the fact that he or she was
 9    made  ineligible  to  participate  in  the State Universities
10    Retirement System by clause (4) of subsection (a) of  Section
11    15-107 of the Illinois Pension Code shall not be greater than
12    the  cost of participation that would otherwise apply to that
13    dependent or survivor if he or  she  were  the  dependent  or
14    survivor   of  an  annuitant  under  the  State  Universities
15    Retirement System.
16        (a-1)  Beginning January 1, 1998,  for  each  person  who
17    becomes  a  new  SERS annuitant and participates in the basic
18    program of group health benefits, the State shall  contribute
19    toward  the  cost of the annuitant's coverage under the basic
20    program of group health benefits an amount  equal  to  5%  of
21    that cost for each full year of creditable service upon which
22    the  annuitant's retirement annuity is based, up to a maximum
23    of 100% for an annuitant with 20 or more years of  creditable
24    service.  The remainder of the cost of a new SERS annuitant's
25    coverage  under  the  basic  program of group health benefits
26    shall be the responsibility of the annuitant.
27        (a-2)  Beginning January 1, 1998,  for  each  person  who
28    becomes  a  new  SERS  survivor and participates in the basic
29    program of group health benefits, the State shall  contribute
30    toward  the  cost  of the survivor's coverage under the basic
31    program of group health benefits an amount  equal  to  5%  of
32    that  cost  for  each full year of the deceased employee's or
33    deceased  annuitant's  creditable  service   in   the   State
34    Employees'  Retirement  System  of  Illinois  on  the date of
 
SB251 Engrossed             -3-                LRB9102764EGfg
 1    death, up to a maximum of 100% for a survivor of an  employee
 2    or  annuitant  with  20  or more years of creditable service.
 3    The remainder of the cost of the new SERS survivor's coverage
 4    under the basic program of group health benefits shall be the
 5    responsibility of the survivor.
 6        (a-3)  Beginning January 1, 1998,  for  each  person  who
 7    becomes  a  new  SURS annuitant and participates in the basic
 8    program of group health benefits, the State shall  contribute
 9    toward  the  cost of the annuitant's coverage under the basic
10    program of group health benefits an amount  equal  to  5%  of
11    that cost for each full year of creditable service upon which
12    the  annuitant's retirement annuity is based, up to a maximum
13    of 100% for an annuitant with 20 or more years of  creditable
14    service.  The remainder of the cost of a new SURS annuitant's
15    coverage  under  the  basic  program of group health benefits
16    shall be the responsibility of the annuitant.
17        (a-4)  Beginning January 1, 1998,  for  each  person  who
18    becomes  a  new SURS retired employee and participates in the
19    basic program of  group  health  benefits,  the  State  shall
20    contribute toward the cost of the retired employee's coverage
21    under  the  basic  program of group health benefits an amount
22    equal to 5% of that cost for each full year that the  retired
23    employee  was  an  employee  as defined in Section 3, up to a
24    maximum of 100% for a retired employee who  was  an  employee
25    for  20  or  more  years.  The remainder of the cost of a new
26    SURS retired employee's coverage under the basic  program  of
27    group  health  benefits  shall  be  the responsibility of the
28    retired employee.
29        (a-5)  Beginning January 1, 1998,  for  each  person  who
30    becomes  a  new  SURS  survivor and participates in the basic
31    program of group health benefits, the State shall  contribute
32    toward  the  cost  of the survivor's coverage under the basic
33    program of group health benefits an amount  equal  to  5%  of
34    that  cost  for  each full year of the deceased employee's or
 
SB251 Engrossed             -4-                LRB9102764EGfg
 1    deceased  annuitant's  creditable  service   in   the   State
 2    Universities  Retirement System on the date of death, up to a
 3    maximum of 100% for a survivor of an  employee  or  annuitant
 4    with  20  or more years of creditable service.  The remainder
 5    of the cost of the new SURS  survivor's  coverage  under  the
 6    basic   program   of  group  health  benefits  shall  be  the
 7    responsibility of the survivor.
 8        (a-6)  Beginning  July  1,  1998,  for  each  person  who
 9    becomes a new TRS State annuitant  and  participates  in  the
10    basic  program  of  group  health  benefits,  the State shall
11    contribute toward the cost of the annuitant's coverage  under
12    the basic program of group health benefits an amount equal to
13    5% of that cost for each full year of creditable service as a
14    teacher  as  defined in paragraph (2), (3), or (5) of Section
15    16-106  of  the  Illinois  Pension  Code   upon   which   the
16    annuitant's  retirement  annuity is based, up to a maximum of
17    100%  for  an  annuitant  with  20  or  more  years  of  such
18    creditable service.  The remainder of the cost of a  new  TRS
19    State  annuitant's  coverage under the basic program of group
20    health benefits shall be the responsibility of the annuitant.
21        (a-7)  Beginning  July  1,  1998,  for  each  person  who
22    becomes a new TRS State  survivor  and  participates  in  the
23    basic  program  of  group  health  benefits,  the State shall
24    contribute toward the cost of the survivor's  coverage  under
25    the basic program of group health benefits an amount equal to
26    5% of that cost for each full year of the deceased employee's
27    or  deceased  annuitant's  creditable service as a teacher as
28    defined in paragraph (2), (3), or (5) of  Section  16-106  of
29    the  Illinois  Pension  Code  on  the  date of death, up to a
30    maximum of 100% for a survivor of an  employee  or  annuitant
31    with  20  or  more  years  of  such  creditable service.  The
32    remainder of  the  cost  of  the  new  TRS  State  survivor's
33    coverage  under  the  basic  program of group health benefits
34    shall be the responsibility of the survivor.
 
SB251 Engrossed             -5-                LRB9102764EGfg
 1        (a-8)  A new SERS annuitant, new SERS survivor, new  SURS
 2    annuitant,  new SURS retired employee, new SURS survivor, new
 3    TRS State annuitant, or new TRS State survivor may  waive  or
 4    terminate  coverage  in the program of group health benefits.
 5    Any such annuitant, survivor, or  retired  employee  who  has
 6    waived  or terminated coverage may enroll or re-enroll in the
 7    program of group  health  benefits  only  during  the  annual
 8    benefit  choice period, as determined by the Director; except
 9    that  in  the  event  of  termination  of  coverage  due   to
10    nonpayment  of  premiums, the annuitant, survivor, or retired
11    employee may not re-enroll in the program.
12        (a-9)  No later than May 1 of  each  calendar  year,  the
13    Director  of  Central  Management  Services  shall certify in
14    writing to the Executive Secretary of  the  State  Employees'
15    Retirement  System  of  Illinois  the amounts of the Medicare
16    supplement health care premiums and the amounts of the health
17    care premiums for all other retirees  who  are  not  Medicare
18    eligible.
19        A  separate  calculation  of  the premiums based upon the
20    actual cost of each health care plan shall be so certified.
21        The Director of Central Management Services shall provide
22    to the Executive Secretary of the State Employees' Retirement
23    System of Illinois such information,  statistics,  and  other
24    data  as  he or she may require to review the premium amounts
25    certified by the Director of Central Management Services.
26        (b)  State employees who become eligible for this program
27    on or after January 1, 1980 in positions  normally  requiring
28    actual performance of duty not less than 1/2 of a normal work
29    period  but  not equal to that of a normal work period, shall
30    be  given  the  option  of  participating  in  the  available
31    program. If the employee elects  coverage,  the  State  shall
32    contribute  on  behalf  of  such  employee to the cost of the
33    employee's benefit and any applicable  dependent  supplement,
34    that  sum  which bears the same percentage as that percentage
 
SB251 Engrossed             -6-                LRB9102764EGfg
 1    of time the employee regularly works when compared to  normal
 2    work period.
 3        (c)  The  basic  non-contributory coverage from the basic
 4    program of group health benefits shall be continued for  each
 5    employee  not in pay status or on active service by reason of
 6    (1) leave of absence due to illness or injury, (2) authorized
 7    educational leave of absence  or  sabbatical  leave,  or  (3)
 8    military  leave  with  pay  and benefits. This coverage shall
 9    continue until expiration of authorized leave and  return  to
10    active  service, but not to exceed 24 months for leaves under
11    item (1) or (2). This 24-month limitation and the requirement
12    of returning to active service shall  not  apply  to  persons
13    receiving  ordinary  or  accidental  disability  benefits  or
14    retirement  benefits through the appropriate State retirement
15    system  or  benefits  under  the  Workers'  Compensation   or
16    Occupational Disease Act.
17        (d)  The   basic  group  life  insurance  coverage  shall
18    continue, with full State contribution, where such person  is
19    (1)  absent  from  active  service  by  reason  of disability
20    arising from any cause  other  than  self-inflicted,  (2)  on
21    authorized  educational leave of absence or sabbatical leave,
22    or (3) on military leave with pay and benefits.
23        (e)  Where the person is in non-pay status for  a  period
24    in  excess  of  30 days or on leave of absence, other than by
25    reason of disability, educational  or  sabbatical  leave,  or
26    military  leave  with  pay  and  benefits,  such  person  may
27    continue  coverage  only  by making personal payment equal to
28    the amount normally contributed by the State on such person's
29    behalf. Such payments and  coverage  may  be  continued:  (1)
30    until  such  time  as the person returns to a status eligible
31    for coverage at State expense, but not to exceed  24  months,
32    (2)  until  such person's employment or annuitant status with
33    the State is terminated, or (3) for a  maximum  period  of  4
34    years for members on military leave with pay and benefits and
 
SB251 Engrossed             -7-                LRB9102764EGfg
 1    military  leave  without  pay  and benefits (exclusive of any
 2    additional service imposed pursuant to law).
 3        (f)  The Department shall  establish by rule  the  extent
 4    to which other employee benefits will continue for persons in
 5    non-pay status or who are not in active service.
 6        (g)  The  State  shall  not  pay  the  cost  of the basic
 7    non-contributory group  life  insurance,  program  of  health
 8    benefits  and  other  employee  benefits  for members who are
 9    survivors as defined by paragraphs (1) and (2) of  subsection
10    (q)  of  Section  3  of  this Act.  The costs of benefits for
11    these survivors shall be paid by  the  survivors  or  by  the
12    University  of Illinois Cooperative Extension Service, or any
13    combination thereof.  However, the State shall pay the amount
14    of the reduction  in  the  cost  of  participation,  if  any,
15    resulting  from  the amendment to subsection (a) made by this
16    amendatory Act of the 91st General Assembly.
17        (h)  Those   persons   occupying   positions   with   any
18    department as a result of emergency appointments pursuant  to
19    Section  8b.8  of  the  Personnel Code who are not considered
20    employees under  this  Act  shall  be  given  the  option  of
21    participating in the programs of group life insurance, health
22    benefits  and other employee benefits.  Such persons electing
23    coverage may participate only by making payment equal to  the
24    amount  normally  contributed  by  the  State  for  similarly
25    situated  employees.  Such amounts shall be determined by the
26    Director.  Such payments and coverage may be continued  until
27    such  time as the person becomes an employee pursuant to this
28    Act or such person's appointment is terminated.
29        (i)  Any unit of local government  within  the  State  of
30    Illinois  may  apply  to  the Director to have its employees,
31    annuitants,  and  their  dependents  provided  group   health
32    coverage   under   this  Act  on  a  non-insured  basis.   To
33    participate, a unit of local government must agree to  enroll
34    all  of  its  employees, who may select coverage under either
 
SB251 Engrossed             -8-                LRB9102764EGfg
 1    the State group health insurance plan or a health maintenance
 2    organization  that  has  contracted  with  the  State  to  be
 3    available as a health care provider for employees as  defined
 4    in  this  Act.   A  unit  of  local government must remit the
 5    entire cost of  providing  coverage  under  the  State  group
 6    health  insurance  plan  or,  for  coverage  under  a  health
 7    maintenance   organization,   an  amount  determined  by  the
 8    Director based on an analysis of  the  sex,  age,  geographic
 9    location,  or  other  relevant  demographic variables for its
10    employees, except that the unit of local government shall not
11    be required to enroll those of its employees who are  covered
12    spouses or dependents under this plan or another group policy
13    or   plan  providing  health  benefits  as  long  as  (1)  an
14    appropriate  official  from  the  unit  of  local  government
15    attests that each employee not enrolled is a  covered  spouse
16    or dependent under this plan or another group policy or plan,
17    and  (2)  at  least 85% of the employees are enrolled and the
18    unit of local government remits the entire cost of  providing
19    coverage  to  those  employees.  Employees of a participating
20    unit of local government who are not enrolled due to coverage
21    under another group health policy or plan  may  enroll  at  a
22    later  date subject to submission of satisfactory evidence of
23    insurability and provided that no benefits shall  be  payable
24    for  services  incurred during the first 6 months of coverage
25    to the extent  the  services  are   in  connection  with  any
26    pre-existing   condition.   A  participating  unit  of  local
27    government may also elect to cover its annuitants.  Dependent
28    coverage shall be offered on  an  optional  basis,  with  the
29    costs paid by the unit of local government, its employees, or
30    some  combination  of  the  two  as determined by the unit of
31    local government.  The unit  of  local  government  shall  be
32    responsible   for   timely  collection  and  transmission  of
33    dependent premiums.
34        The Director shall annually determine  monthly  rates  of
 
SB251 Engrossed             -9-                LRB9102764EGfg
 1    payment, subject to the following constraints:
 2             (1)  In  the first year of coverage, the rates shall
 3        be  equal  to  the  amount  normally  charged  to   State
 4        employees  for elected optional coverages or for enrolled
 5        dependents coverages or other contributory coverages,  or
 6        contributed by the State for basic insurance coverages on
 7        behalf of its employees, adjusted for differences between
 8        State  employees and employees of the local government in
 9        age,  sex,  geographic   location   or   other   relevant
10        demographic  variables,  plus an amount sufficient to pay
11        for the  additional  administrative  costs  of  providing
12        coverage to employees of the unit of local government and
13        their dependents.
14             (2)  In subsequent years, a further adjustment shall
15        be  made  to  reflect  the  actual  prior  years'  claims
16        experience   of  the  employees  of  the  unit  of  local
17        government.
18        In the case of coverage  of  local  government  employees
19    under  a  health maintenance organization, the Director shall
20    annually determine  for  each  participating  unit  of  local
21    government the maximum monthly amount the unit may contribute
22    toward  that  coverage,  based on an analysis of (i) the age,
23    sex, geographic  location,  and  other  relevant  demographic
24    variables  of the unit's employees and (ii) the cost to cover
25    those employees under the State group health insurance  plan.
26    The  Director  may  similarly  determine  the maximum monthly
27    amount each unit of local government  may  contribute  toward
28    coverage   of   its  employees'  dependents  under  a  health
29    maintenance organization.
30        Monthly payments by the unit of local government  or  its
31    employees  for  group  health insurance or health maintenance
32    organization  coverage  shall  be  deposited  in  the   Local
33    Government   Health   Insurance   Reserve  Fund.   The  Local
34    Government  Health  Insurance  Reserve  Fund   shall   be   a
 
SB251 Engrossed             -10-               LRB9102764EGfg
 1    continuing  fund not subject to fiscal year limitations.  All
 2    expenditures from this fund shall be used  for  payments  for
 3    health  care benefits for local government and rehabilitation
 4    facility  employees,  annuitants,  and  dependents,  and   to
 5    reimburse   the  Department  or  its  administrative  service
 6    organization for all expenses incurred in the  administration
 7    of  benefits.   No  other  State  funds may be used for these
 8    purposes.
 9        A local government employer's participation or desire  to
10    participate  in a program created under this subsection shall
11    not  limit  that  employer's  duty  to   bargain   with   the
12    representative  of  any  collective  bargaining  unit  of its
13    employees.
14        (j)  Any rehabilitation  facility  within  the  State  of
15    Illinois  may  apply  to  the Director to have its employees,
16    annuitants,  and  their  dependents  provided  group   health
17    coverage   under   this   Act  on  a  non-insured  basis.  To
18    participate, a rehabilitation facility must agree  to  enroll
19    all  of  its employees and remit the entire cost of providing
20    such  coverage   for   its   employees,   except   that   the
21    rehabilitation facility shall not be required to enroll those
22    of  its employees who are covered spouses or dependents under
23    this plan or another group policy or  plan  providing  health
24    benefits  as  long  as  (1)  an appropriate official from the
25    rehabilitation  facility  attests  that  each  employee   not
26    enrolled  is a covered spouse or dependent under this plan or
27    another group policy or plan, and (2) at  least  85%  of  the
28    employees are enrolled and the rehabilitation facility remits
29    the  entire  cost  of  providing coverage to those employees.
30    Employees of a participating rehabilitation facility who  are
31    not  enrolled  due  to  coverage  under  another group health
32    policy or  plan  may  enroll  at  a  later  date  subject  to
33    submission  of  satisfactory  evidence  of  insurability  and
34    provided  that  no  benefits  shall  be  payable for services
 
SB251 Engrossed             -11-               LRB9102764EGfg
 1    incurred during the first 6 months of coverage to the  extent
 2    the   services   are  in  connection  with  any  pre-existing
 3    condition. A participating rehabilitation facility  may  also
 4    elect  to  cover  its annuitants. Dependent coverage shall be
 5    offered on an optional basis, with  the  costs  paid  by  the
 6    rehabilitation  facility,  its employees, or some combination
 7    of the 2 as determined by the  rehabilitation  facility.  The
 8    rehabilitation  facility  shall  be  responsible  for  timely
 9    collection and transmission of dependent premiums.
10        The  Director shall annually determine quarterly rates of
11    payment, subject to the following constraints:
12             (1)  In the first year of coverage, the rates  shall
13        be   equal  to  the  amount  normally  charged  to  State
14        employees for elected optional coverages or for  enrolled
15        dependents  coverages  or other contributory coverages on
16        behalf of its employees, adjusted for differences between
17        State  employees  and  employees  of  the  rehabilitation
18        facility  in  age,  sex,  geographic  location  or  other
19        relevant demographic variables, plus an amount sufficient
20        to  pay  for  the  additional  administrative  costs   of
21        providing  coverage  to  employees  of the rehabilitation
22        facility and their dependents.
23             (2)  In subsequent years, a further adjustment shall
24        be  made  to  reflect  the  actual  prior  years'  claims
25        experience  of  the  employees  of   the   rehabilitation
26        facility.
27        Monthly  payments  by  the rehabilitation facility or its
28    employees for group health insurance shall  be  deposited  in
29    the Local Government Health Insurance Reserve Fund.
30        (k)  Any  domestic violence shelter or service within the
31    State of Illinois may apply  to  the  Director  to  have  its
32    employees,  annuitants,  and  their dependents provided group
33    health coverage under this Act on a  non-insured  basis.   To
34    participate,  a  domestic  violence  shelter  or service must
 
SB251 Engrossed             -12-               LRB9102764EGfg
 1    agree to enroll all of its employees and pay the entire  cost
 2    of   providing   such   coverage   for   its   employees.   A
 3    participating domestic violence shelter  may  also  elect  to
 4    cover its annuitants.  Dependent coverage shall be offered on
 5    an optional basis, with employees, or some combination of the
 6    2  as determined by the domestic violence shelter or service.
 7    The domestic violence shelter or service shall be responsible
 8    for timely collection and transmission of dependent premiums.
 9        The Director shall annually determine quarterly rates  of
10    payment, subject to the following constraints:
11             (1)  In  the first year of coverage, the rates shall
12        be  equal  to  the  amount  normally  charged  to   State
13        employees  for elected optional coverages or for enrolled
14        dependents coverages or other contributory  coverages  on
15        behalf of its employees, adjusted for differences between
16        State  employees  and  employees of the domestic violence
17        shelter or service in age, sex,  geographic  location  or
18        other  relevant  demographic  variables,  plus  an amount
19        sufficient to pay for the additional administrative costs
20        of  providing  coverage  to  employees  of  the  domestic
21        violence shelter or service and their dependents.
22             (2)  In subsequent years, a further adjustment shall
23        be  made  to  reflect  the  actual  prior  years'  claims
24        experience of the  employees  of  the  domestic  violence
25        shelter or service.
26             (3)  In  no  case  shall  the  rate be less than the
27        amount normally charged to State employees or contributed
28        by the State on behalf of its employees.
29        Monthly payments by  the  domestic  violence  shelter  or
30    service  or its employees for group health insurance shall be
31    deposited in the Local Government  Health  Insurance  Reserve
32    Fund.
33        (l)  A  public  community  college  or  entity  organized
34    pursuant to the Public Community College Act may apply to the
 
SB251 Engrossed             -13-               LRB9102764EGfg
 1    Director  initially to have only annuitants not covered prior
 2    to July 1, 1992 by the district's health plan provided health
 3    coverage  under  this  Act  on  a  non-insured  basis.    The
 4    community   college   must   execute  a  2-year  contract  to
 5    participate in  the  Local  Government  Health  Plan.   Those
 6    annuitants  enrolled initially under this contract shall have
 7    no benefits payable for services incurred during the first  6
 8    months  of  coverage  to  the  extent  the  services  are  in
 9    connection  with  any  pre-existing condition.  Any annuitant
10    who may enroll after this initial enrollment period shall  be
11    subject   to   submission   of   satisfactory   evidence   of
12    insurability and to the pre-existing conditions limitation.
13        The  Director  shall  annually determine monthly rates of
14    payment subject to  the  following  constraints:   for  those
15    community  colleges with annuitants only enrolled, first year
16    rates shall be equal to the average cost to cover claims  for
17    a   State   member   adjusted   for   demographics,  Medicare
18    participation, and other factors; and in the second  year,  a
19    further  adjustment  of  rates  shall  be made to reflect the
20    actual  first  year's  claims  experience  of   the   covered
21    annuitants.
22        (m)  The  Director shall adopt any rules deemed necessary
23    for implementation of this amendatory Act of 1989 (Public Act
24    86-978).
25    (Source:  P.A.  89-53,  eff.  7-1-95;  89-236,  eff.  8-4-95;
26    89-324,  eff.  8-13-95;  89-626,  eff.  8-9-96;  90-65,  eff.
27    7-7-97; 90-582, eff. 5-27-98; 90-655, eff.  7-30-98;  revised
28    8-3-98.)

29        Section  99.  Effective date.  This Act takes effect upon
30    becoming law.

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