Bill Text: IL SB2248 | 2023-2024 | 103rd General Assembly | Introduced

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Bill Title: Amends the State Employees Group Insurance Act of 1971. Provides that beginning January 1, 2024, the Director of Central Management Services shall establish a program of financial incentives to encourage Medicare-primary members to elect not to participate in the group health benefits program for Medicare-primary members and their Medicare-primary dependents. Provides that the program of financial incentives shall include a monthly voucher in the amount that the State would have contributed toward that member's monthly premium if the Medicare-primary member elected to participate in the group health benefits program. Provides that the voucher shall be used by the Medicare-primary member to pay the monthly premium cost of an individual Medicare Advantage plan of his or her choosing. Effective immediately.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Failed) 2025-01-07 - Session Sine Die [SB2248 Detail]

Download: Illinois-2023-SB2248-Introduced.html

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103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB2248 Introduced 2/10/2023, by Sen. Chapin Rose SYNOPSIS AS INTRODUCED:
5 ILCS 375/8 from Ch. 127, par. 528
Amends the State Employees Group Insurance Act of 1971. Provides that beginning January 1, 2024, the Director of Central Management Services shall establish a program of financial incentives to encourage Medicare-primary members to elect not to participate in the group health benefits program for Medicare-primary members and their Medicare-primary dependents. Provides that the program of financial incentives shall include a monthly voucher in the amount that the State would have contributed toward that member's monthly premium if the Medicare-primary member elected to participate in the group health benefits program. Provides that the voucher shall be used by the Medicare-primary member to pay the monthly premium cost of an individual Medicare Advantage plan of his or her choosing. Effective immediately.
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A BILL FOR
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AN ACT concerning State government.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The State Employees Group Insurance Act of 1971
is amended by changing Section 8 as follows:
(5 ILCS 375/8) (from Ch. 127, par. 528)
Sec. 8. Eligibility.
(a) Each employee eligible under the provisions of this
Act and any rules and regulations promulgated and adopted
hereunder by the Director shall become immediately eligible
and covered for all benefits available under the programs.
Employees electing coverage for eligible dependents shall have
the coverage effective immediately, provided that the election
is properly filed in accordance with required filing dates and
procedures specified by the Director, including the completion
and submission of all documentation and forms required by the
Director.
(1) Every member originally eligible to elect
dependent coverage, but not electing it during the
original eligibility period, may subsequently obtain
dependent coverage only in the event of a qualifying
change in status, special enrollment, special circumstance
as defined by the Director, or during the annual Benefit

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Choice Period.
(2) Members described above being transferred from
previous coverage towards which the State has been
contributing shall be transferred regardless of
preexisting conditions, waiting periods, or other
requirements that might jeopardize claim payments to which
they would otherwise have been entitled.
(3) Eligible and covered members that are eligible for
coverage as dependents except for the fact of being
members shall be transferred to, and covered under,
dependent status regardless of preexisting conditions,
waiting periods, or other requirements that might
jeopardize claim payments to which they would otherwise
have been entitled upon cessation of member status and the
election of dependent coverage by a member eligible to
elect that coverage.
(b) New employees shall be immediately insured for the
basic group life insurance and covered by the program of
health benefits on the first day of active State service.
Optional life insurance coverage one to 4 times the basic
amount, if elected during the relevant eligibility period,
will become effective on the date of employment. Optional life
insurance coverage exceeding 4 times the basic amount and all
life insurance amounts applied for after the eligibility
period will be effective, subject to satisfactory evidence of
insurability when applicable, or other necessary

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qualifications, pursuant to the requirements of the applicable
benefit program, unless there is a change in status that would
confer new eligibility for change of enrollment under rules
established supplementing this Act, in which event application
must be made within the new eligibility period.
(c) As to the group health benefits program contracted to
begin or continue after June 30, 1973, each annuitant,
survivor, and retired employee shall become immediately
eligible for all benefits available under that program. Each
annuitant, survivor, and retired employee shall have coverage
effective immediately, provided that the election is properly
filed in accordance with the required filing dates and
procedures specified by the Director, including the completion
and submission of all documentation and forms required by the
Director. Annuitants, survivors, and retired employees may
elect coverage for eligible dependents and shall have the
coverage effective immediately, provided that the election is
properly filed in accordance with required filing dates and
procedures specified by the Director, except that, for a
survivor, the dependent sought to be added on or after the
effective date of this amendatory Act of the 97th General
Assembly must have been eligible for coverage as a dependent
under the deceased member upon whom the survivor's annuity is
based in order to be eligible for coverage under the survivor.
Except as otherwise provided in this Act, where husband
and wife are both eligible members, each shall be enrolled as a

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member and coverage on their eligible dependent children, if
any, may be under the enrollment and election of either.
Regardless of other provisions herein regarding late
enrollment or other qualifications, as appropriate, the
Director may periodically authorize open enrollment periods
for each of the benefit programs at which time each member may
elect enrollment or change of enrollment without regard to
age, sex, health, or other qualification under the conditions
as may be prescribed in rules and regulations supplementing
this Act. Special open enrollment periods may be declared by
the Director for certain members only when special
circumstances occur that affect only those members.
(d) Eligible members may elect not to participate in the
program of health benefits as defined in this Act. The
election must be made during the annual benefit choice period
or upon showing a qualifying change in status as defined in the
U.S. Internal Revenue Code, subject to the conditions in this
subsection.
(1) (Blank).
(2) Members may re-enroll in the Department of Central
Management Services program of health benefits upon
showing a qualifying change in status, as defined in the
U.S. Internal Revenue Code, without evidence of
insurability and with no limitations on coverage for
pre-existing conditions.
(3) Members may also re-enroll in the program of

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health benefits during any annual benefit choice period,
without evidence of insurability.
(4) Members who elect not to participate in the
program of health benefits shall be furnished a written
explanation of the requirements and limitations for the
election not to participate in the program and for
re-enrolling in the program. The explanation shall also be
included in the annual benefit choice options booklets
furnished to members.
(d-5) Beginning July 1, 2005, the Director may establish a
program of financial incentives to encourage annuitants
receiving a retirement annuity, but who are not eligible for
benefits under the federal Medicare health insurance program
(Title XVIII of the Social Security Act, as added by Public Law
89-97) to elect not to participate in the program of health
benefits provided under this Act. The election by an annuitant
not to participate under this program must be made in
accordance with the requirements set forth under subsection
(d). The financial incentives provided to these annuitants
under the program may not exceed $150 per month for each
annuitant electing not to participate in the program of health
benefits provided under this Act.
(d-6) Beginning July 1, 2013, the Director may establish a
program of financial incentives to encourage annuitants with
20 or more years of creditable service but who are not eligible
for benefits under the federal Medicare health insurance

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program (Title XVIII of the Social Security Act, as added by
Public Law 89-97) to elect not to participate in the program of
health benefits provided under this Act. The election by an
annuitant not to participate under this program must be made
in accordance with the requirements set forth under subsection
(d). The program established under this subsection (d-6) may
include a prorated incentive for annuitants with fewer than 20
years of creditable service, as determined by the Director.
The financial incentives provided to these annuitants under
this program may not exceed $500 per month for each annuitant
electing not to participate in the program of health benefits
provided under this Act.
(d-7) Beginning January 1, 2024, the Director shall
establish a program of financial incentives to encourage
Medicare-primary members to elect not to participate in the
group health benefits program for Medicare-primary members and
their Medicare-primary dependents provided under this Act. The
program of financial incentives established under this
subsection (d-7) shall include a voucher, to be issued
monthly, in the amount that the State would have contributed
toward that member's monthly premium if the Medicare-primary
member elected to participate in the group health benefits
program for Medicare-primary members and their
Medicare-primary dependents provided under this Act. The
voucher shall be used by the Medicare-primary member to pay
the monthly premium cost of an individual Medicare Advantage

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plan of his or her choosing. Any amount of premium cost in
excess of the amount of the voucher is the Medicare-primary
member's responsibility.
(e) Notwithstanding any other provision of this Act or the
rules adopted under this Act, if a person participating in the
program of health benefits as the dependent spouse of an
eligible member becomes an annuitant, the person may elect, at
the time of becoming an annuitant or during any subsequent
annual benefit choice period, to continue participation as a
dependent rather than as an eligible member for as long as the
person continues to be an eligible dependent. In order to be
eligible to make such an election, the person must have been
enrolled as a dependent under the program of health benefits
for no less than one year prior to becoming an annuitant.
An eligible member who has elected to participate as a
dependent may re-enroll in the program of health benefits as
an eligible member (i) during any subsequent annual benefit
choice period or (ii) upon showing a qualifying change in
status, as defined in the U.S. Internal Revenue Code, without
evidence of insurability and with no limitations on coverage
for pre-existing conditions.
A person who elects to participate in the program of
health benefits as a dependent rather than as an eligible
member shall be furnished a written explanation of the
consequences of electing to participate as a dependent and the
conditions and procedures for re-enrolling as an eligible

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member. The explanation shall also be included in the annual
benefit choice options booklet furnished to members.
(Source: P.A. 102-19, eff. 7-1-21.)
Section 99. Effective date. This Act takes effect upon
becoming law.