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1		AN ACT concerning government.
2		Be it enacted by the People of the State of Illinois,
3		represented in the General Assembly:
4		Section 5. The State Employees Group Insurance Act of 1971
5		is amended by changing Sections 9 and 10 as follows:
6		(5 ILCS 375/9) (from Ch. 127, par. 529)
7		Sec. 9. (a) The eligible member shall be responsible for
8		his or her portion of the premiums, charges or other fees for
9		all elected coverages or benefits, which shall be paid by means
10		of the acceptance of a reduction in earnings or the foregoing
11		of an increase in earnings by an employee; provided, however,
12		subject to rules and regulations promulgated by the Department,
13		the eligible member may make personal payment of the premium,
14		charge or fee for any wellness programs implemented under the
15		program of health benefits. All contributions and payments by
16		the eligible members and the State for all elected coverages
17		and benefits shall be deposited in the Health Insurance Reserve
18		Fund. Except as otherwise provided in subsection (a-5), the The
19		Department may determine the aggregate level of contribution
20		required under this Section on the basis of actual cost of
21		services adjusted for age, sex or the geographical or other
22		demographic characteristics which affect costs of the benefit.
23		(a-5) Notwithstanding any provision of law to the contrary,

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1		any member of the General Assembly sworn into office on and
2		after the second Wednesday in January of 2019, and who retires
3		a participating member under Article 2 of the Illinois Pension
4		Code, shall be responsible for exactly 50% of the applicable
5		premiums, charges, or other fees for the basic program of group
6		health benefits. The provisions of this subsection (a-5) do not
7		apply to any person who previously served as a member of the
8		General Assembly in either house prior to the second Wednesday
9		of January of 2019. However, a current or retired member of the
10		General Assembly who was sworn into or retired from office
11		prior to the second Wednesday of January of 2019 may elect to
12		be responsible for the applicable premiums, charges, or other
13		fees for the basic program of group health benefits in
14		accordance with this subsection (a-5).
15		(b) If a member is not entitled to receive any salary,
16		wages or other compensation during a period in which premiums,
17		charges or other fees are due or does not receive compensation
18		sufficient to allow deduction of the required payment of the
19		premium, charge or other fee, such member may continue the
20		contributory benefit in effect by making personal payment of
21		the premium, charge or other fee for the period in such manner,
22		in such amount, and for such duration, as may be prescribed in
23		rules and regulations promulgated for the administration of
24		this Act.
25		(Source: P.A. 91-390, eff. 7-30-99.)

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1		(5 ILCS 375/10) (from Ch. 127, par. 530)
2		Sec. 10. Contributions by the State and members.
3		(a) The State shall pay the cost of basic non-contributory
4		group life insurance and, subject to member paid contributions
5		set by the Department or required by this Section and except as
6		provided in this Section, the basic program of group health
7		benefits on each eligible member, except a member, not
8		otherwise covered by this Act, who has retired as a
9		participating member under Article 2 of the Illinois Pension
10		Code but is ineligible for the retirement annuity under Section
11		2-119 of the Illinois Pension Code, and part of each eligible
12		member's and retired member's premiums for health insurance
13		coverage for enrolled dependents as provided by Section 9. The
14		State shall pay the cost of the basic program of group health
15		benefits only after benefits are reduced by the amount of
16		benefits covered by Medicare for all members and dependents who
17		are eligible for benefits under Social Security or the Railroad
18		Retirement system or who had sufficient Medicare-covered
19		government employment, except that such reduction in benefits
20		shall apply only to those members and dependents who (1) first
21		become eligible for such Medicare coverage on or after July 1,
22		1992; or (2) are Medicare-eligible members or dependents of a
23		local government unit which began participation in the program
24		on or after July 1, 1992; or (3) remain eligible for, but no
25		longer receive Medicare coverage which they had been receiving
26		on or after July 1, 1992. The Department may determine the

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1		aggregate level of the State's contribution on the basis of
2		actual cost of medical services adjusted for age, sex or
3		geographic or other demographic characteristics which affect
4		the costs of such programs, except that, subject to a reduction
5		based upon Medicare coverage, the State's contribution towards
6		the basic program of group health benefits provided to members
7		specified under subsection (a-5) of Section 9 shall be exactly
8		50% of the applicable premiums, charges, or other fees owed.
9		The cost of participation in the basic program of group
10		health benefits for the dependent or survivor of a living or
11		deceased retired employee who was formerly employed by the
12		University of Illinois in the Cooperative Extension Service and
13		would be an annuitant but for the fact that he or she was made
14		ineligible to participate in the State Universities Retirement
15		System by clause (4) of subsection (a) of Section 15-107 of the
16		Illinois Pension Code shall not be greater than the cost of
17		participation that would otherwise apply to that dependent or
18		survivor if he or she were the dependent or survivor of an
19		annuitant under the State Universities Retirement System.
20		(a-1) (Blank).
21		(a-2) (Blank).
22		(a-3) (Blank).
23		(a-4) (Blank).
24		(a-5) (Blank).
25		(a-6) (Blank).
26		(a-7) (Blank).

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1		(a-8) Any annuitant, survivor, or retired employee may
2		waive or terminate coverage in the program of group health
3		benefits. Any such annuitant, survivor, or retired employee who
4		has waived or terminated coverage may enroll or re-enroll in
5		the program of group health benefits only during the annual
6		benefit choice period, as determined by the Director; except
7		that in the event of termination of coverage due to nonpayment
8		of premiums, the annuitant, survivor, or retired employee may
9		not re-enroll in the program.
10		(a-8.5) Beginning on the effective date of this amendatory
11		Act of the 97th General Assembly, and except as otherwise
12		provided under subsection (a) of this Section and subsection
13		(a-5) of Section 9, the Director of Central Management Services
14		shall, on an annual basis, determine the amount that the State
15		shall contribute toward the basic program of group health
16		benefits on behalf of annuitants (including individuals who (i)
17		participated in the General Assembly Retirement System, the
18		State Employees' Retirement System of Illinois, the State
19		Universities Retirement System, the Teachers' Retirement
20		System of the State of Illinois, or the Judges Retirement
21		System of Illinois and (ii) qualify as annuitants under
22		subsection (b) of Section 3 of this Act), survivors (including
23		individuals who (i) receive an annuity as a survivor of an
24		individual who participated in the General Assembly Retirement
25		System, the State Employees' Retirement System of Illinois, the
26		State Universities Retirement System, the Teachers' Retirement

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1		System of the State of Illinois, or the Judges Retirement
2		System of Illinois and (ii) qualify as survivors under
3		subsection (q) of Section 3 of this Act), and retired employees
4		(as defined in subsection (p) of Section 3 of this Act). The
5		remainder of the cost of coverage for each annuitant, survivor,
6		or retired employee, as determined by the Director of Central
7		Management Services, shall be the responsibility of that
8		annuitant, survivor, or retired employee.
9		Contributions required of annuitants, survivors, and
10		retired employees shall be the same for all retirement systems
11		and shall also be based on whether an individual has made an
12		election under Section 15-135.1 of the Illinois Pension Code.
13		Contributions may be based on annuitants', survivors', or
14		retired employees' Medicare eligibility, but may not be based
15		on Social Security eligibility.
16		(a-9) No later than May 1 of each calendar year, the
17		Director of Central Management Services shall certify in
18		writing to the Executive Secretary of the State Employees'
19		Retirement System of Illinois the amounts of the Medicare
20		supplement health care premiums and the amounts of the health
21		care premiums for all other retirees who are not Medicare
22		eligible.
23		A separate calculation of the premiums based upon the
24		actual cost of each health care plan shall be so certified.
25		The Director of Central Management Services shall provide
26		to the Executive Secretary of the State Employees' Retirement

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1		System of Illinois such information, statistics, and other data
2		as he or she may require to review the premium amounts
3		certified by the Director of Central Management Services.
4		The Department of Central Management Services, or any
5		successor agency designated to procure healthcare contracts
6		pursuant to this Act, is authorized to establish funds,
7		separate accounts provided by any bank or banks as defined by
8		the Illinois Banking Act, or separate accounts provided by any
9		savings and loan association or associations as defined by the
10		Illinois Savings and Loan Act of 1985 to be held by the
11		Director, outside the State treasury, for the purpose of
12		receiving the transfer of moneys from the Local Government
13		Health Insurance Reserve Fund. The Department may promulgate
14		rules further defining the methodology for the transfers. Any
15		interest earned by moneys in the funds or accounts shall inure
16		to the Local Government Health Insurance Reserve Fund. The
17		transferred moneys, and interest accrued thereon, shall be used
18		exclusively for transfers to administrative service
19		organizations or their financial institutions for payments of
20		claims to claimants and providers under the self-insurance
21		health plan. The transferred moneys, and interest accrued
22		thereon, shall not be used for any other purpose including, but
23		not limited to, reimbursement of administration fees due the
24		administrative service organization pursuant to its contract
25		or contracts with the Department.
26		(b) State employees who become eligible for this program on

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1		or after January 1, 1980 in positions normally requiring actual
2		performance of duty not less than 1/2 of a normal work period
3		but not equal to that of a normal work period, shall be given
4		the option of participating in the available program. If the
5		employee elects coverage, the State shall contribute on behalf
6		of such employee to the cost of the employee's benefit and any
7		applicable dependent supplement, that sum which bears the same
8		percentage as that percentage of time the employee regularly
9		works when compared to normal work period.
10		(c) The basic non-contributory coverage from the basic
11		program of group health benefits shall be continued for each
12		employee not in pay status or on active service by reason of
13		(1) leave of absence due to illness or injury, (2) authorized
14		educational leave of absence or sabbatical leave, or (3)
15		military leave. This coverage shall continue until expiration
16		of authorized leave and return to active service, but not to
17		exceed 24 months for leaves under item (1) or (2). This
18		24-month limitation and the requirement of returning to active
19		service shall not apply to persons receiving ordinary or
20		accidental disability benefits or retirement benefits through
21		the appropriate State retirement system or benefits under the
22		Workers' Compensation or Occupational Disease Act.
23		(d) The basic group life insurance coverage shall continue,
24		with full State contribution, where such person is (1) absent
25		from active service by reason of disability arising from any
26		cause other than self-inflicted, (2) on authorized educational

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1		leave of absence or sabbatical leave, or (3) on military leave.
2		(e) Where the person is in non-pay status for a period in
3		excess of 30 days or on leave of absence, other than by reason
4		of disability, educational or sabbatical leave, or military
5		leave, such person may continue coverage only by making
6		personal payment equal to the amount normally contributed by
7		the State on such person's behalf. Such payments and coverage
8		may be continued: (1) until such time as the person returns to
9		a status eligible for coverage at State expense, but not to
10		exceed 24 months or (2) until such person's employment or
11		annuitant status with the State is terminated (exclusive of any
12		additional service imposed pursuant to law).
13		(f) The Department shall establish by rule the extent to
14		which other employee benefits will continue for persons in
15		non-pay status or who are not in active service.
16		(g) The State shall not pay the cost of the basic
17		non-contributory group life insurance, program of health
18		benefits and other employee benefits for members who are
19		survivors as defined by paragraphs (1) and (2) of subsection
20		(q) of Section 3 of this Act. The costs of benefits for these
21		survivors shall be paid by the survivors or by the University
22		of Illinois Cooperative Extension Service, or any combination
23		thereof. However, the State shall pay the amount of the
24		reduction in the cost of participation, if any, resulting from
25		the amendment to subsection (a) made by this amendatory Act of
26		the 91st General Assembly.

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1		(h) Those persons occupying positions with any department
2		as a result of emergency appointments pursuant to Section 8b.8
3		of the Personnel Code who are not considered employees under
4		this Act shall be given the option of participating in the
5		programs of group life insurance, health benefits and other
6		employee benefits. Such persons electing coverage may
7		participate only by making payment equal to the amount normally
8		contributed by the State for similarly situated employees. Such
9		amounts shall be determined by the Director. Such payments and
10		coverage may be continued until such time as the person becomes
11		an employee pursuant to this Act or such person's appointment
12		is terminated.
13		(i) Any unit of local government within the State of
14		Illinois may apply to the Director to have its employees,
15		annuitants, and their dependents provided group health
16		coverage under this Act on a non-insured basis. To participate,
17		a unit of local government must agree to enroll all of its
18		employees, who may select coverage under either the State group
19		health benefits plan or a health maintenance organization that
20		has contracted with the State to be available as a health care
21		provider for employees as defined in this Act. A unit of local
22		government must remit the entire cost of providing coverage
23		under the State group health benefits plan or, for coverage
24		under a health maintenance organization, an amount determined
25		by the Director based on an analysis of the sex, age,
26		geographic location, or other relevant demographic variables

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1		for its employees, except that the unit of local government
2		shall not be required to enroll those of its employees who are
3		covered spouses or dependents under this plan or another group
4		policy or plan providing health benefits as long as (1) an
5		appropriate official from the unit of local government attests
6		that each employee not enrolled is a covered spouse or
7		dependent under this plan or another group policy or plan, and
8		(2) at least 50% of the employees are enrolled and the unit of
9		local government remits the entire cost of providing coverage
10		to those employees, except that a participating school district
11		must have enrolled at least 50% of its full-time employees who
12		have not waived coverage under the district's group health plan
13		by participating in a component of the district's cafeteria
14		plan. A participating school district is not required to enroll
15		a full-time employee who has waived coverage under the
16		district's health plan, provided that an appropriate official
17		from the participating school district attests that the
18		full-time employee has waived coverage by participating in a
19		component of the district's cafeteria plan. For the purposes of
20		this subsection, "participating school district" includes a
21		unit of local government whose primary purpose is education as
22		defined by the Department's rules.
23		Employees of a participating unit of local government who
24		are not enrolled due to coverage under another group health
25		policy or plan may enroll in the event of a qualifying change
26		in status, special enrollment, special circumstance as defined

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1		by the Director, or during the annual Benefit Choice Period. A
2		participating unit of local government may also elect to cover
3		its annuitants. Dependent coverage shall be offered on an
4		optional basis, with the costs paid by the unit of local
5		government, its employees, or some combination of the two as
6		determined by the unit of local government. The unit of local
7		government shall be responsible for timely collection and
8		transmission of dependent premiums.
9		The Director shall annually determine monthly rates of
10		payment, subject to the following constraints:
11		(1) In the first year of coverage, the rates shall be
12		equal to the amount normally charged to State employees for
13		elected optional coverages or for enrolled dependents
14		coverages or other contributory coverages, or contributed
15		by the State for basic insurance coverages on behalf of its
16		employees, adjusted for differences between State
17		employees and employees of the local government in age,
18		sex, geographic location or other relevant demographic
19		variables, plus an amount sufficient to pay for the
20		additional administrative costs of providing coverage to
21		employees of the unit of local government and their
22		dependents.
23		(2) In subsequent years, a further adjustment shall be
24		made to reflect the actual prior years' claims experience
25		of the employees of the unit of local government.
26		In the case of coverage of local government employees under

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1		a health maintenance organization, the Director shall annually
2		determine for each participating unit of local government the
3		maximum monthly amount the unit may contribute toward that
4		coverage, based on an analysis of (i) the age, sex, geographic
5		location, and other relevant demographic variables of the
6		unit's employees and (ii) the cost to cover those employees
7		under the State group health benefits plan. The Director may
8		similarly determine the maximum monthly amount each unit of
9		local government may contribute toward coverage of its
10		employees' dependents under a health maintenance organization.
11		Monthly payments by the unit of local government or its
12		employees for group health benefits plan or health maintenance
13		organization coverage shall be deposited in the Local
14		Government Health Insurance Reserve Fund.
15		The Local Government Health Insurance Reserve Fund is
16		hereby created as a nonappropriated trust fund to be held
17		outside the State Treasury, with the State Treasurer as
18		custodian. The Local Government Health Insurance Reserve Fund
19		shall be a continuing fund not subject to fiscal year
20		limitations. The Local Government Health Insurance Reserve
21		Fund is not subject to administrative charges or charge-backs,
22		including but not limited to those authorized under Section 8h
23		of the State Finance Act. All revenues arising from the
24		administration of the health benefits program established
25		under this Section shall be deposited into the Local Government
26		Health Insurance Reserve Fund. Any interest earned on moneys in

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1		the Local Government Health Insurance Reserve Fund shall be
2		deposited into the Fund. All expenditures from this Fund shall
3		be used for payments for health care benefits for local
4		government and rehabilitation facility employees, annuitants,
5		and dependents, and to reimburse the Department or its
6		administrative service organization for all expenses incurred
7		in the administration of benefits. No other State funds may be
8		used for these 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 eligible dependents provided group
17		health coverage under this Act on a non-insured basis. To
18		participate, a rehabilitation facility must agree to enroll all
19		of its employees and remit the entire cost of providing such
20		coverage for its employees, except that the rehabilitation
21		facility shall not be required to enroll those of its employees
22		who are covered spouses or dependents under this plan or
23		another group policy or plan providing health benefits as long
24		as (1) an appropriate official from the rehabilitation facility
25		attests that each employee not enrolled is a covered spouse or
26		dependent under this plan or another group policy or plan, and

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1		(2) at least 50% of the employees are enrolled and the
2		rehabilitation facility remits the entire cost of providing
3		coverage to those employees. Employees of a participating
4		rehabilitation facility who are not enrolled due to coverage
5		under another group health policy or plan may enroll in the
6		event of a qualifying change in status, special enrollment,
7		special circumstance as defined by the Director, or during the
8		annual Benefit Choice Period. A participating rehabilitation
9		facility may also elect to cover its annuitants. Dependent
10		coverage shall be offered on an optional basis, with the costs
11		paid by the rehabilitation facility, its employees, or some
12		combination of the 2 as determined by the rehabilitation
13		facility. The rehabilitation facility shall be responsible for
14		timely collection and transmission of dependent premiums.
15		The Director shall annually determine quarterly rates of
16		payment, subject to the following constraints:
17		(1) In the first year of coverage, the rates shall be
18		equal to the amount normally charged to State employees for
19		elected optional coverages or for enrolled dependents
20		coverages or other contributory coverages on behalf of its
21		employees, adjusted for differences between State
22		employees and employees of the rehabilitation facility in
23		age, sex, geographic location or other relevant
24		demographic variables, plus an amount sufficient to pay for
25		the additional administrative costs of providing coverage
26		to employees of the rehabilitation facility and their

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1		dependents.
2		(2) In subsequent years, a further adjustment shall be
3		made to reflect the actual prior years' claims experience
4		of the employees of the rehabilitation facility.
5		Monthly payments by the rehabilitation facility or its
6		employees for group health benefits shall be deposited in the
7		Local Government Health Insurance Reserve Fund.
8		(k) Any domestic violence shelter or service within the
9		State of Illinois may apply to the Director to have its
10		employees, annuitants, and their dependents provided group
11		health coverage under this Act on a non-insured basis. To
12		participate, a domestic violence shelter or service must agree
13		to enroll all of its employees and pay the entire cost of
14		providing such coverage for its employees. The domestic
15		violence shelter shall not be required to enroll those of its
16		employees who are covered spouses or dependents under this plan
17		or another group policy or plan providing health benefits as
18		long as (1) an appropriate official from the domestic violence
19		shelter attests that each employee not enrolled is a covered
20		spouse or dependent under this plan or another group policy or
21		plan and (2) at least 50% of the employees are enrolled and the
22		domestic violence shelter remits the entire cost of providing
23		coverage to those employees. Employees of a participating
24		domestic violence shelter who are not enrolled due to coverage
25		under another group health policy or plan may enroll in the
26		event of a qualifying change in status, special enrollment, or

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1		special circumstance as defined by the Director or during the
2		annual Benefit Choice Period. A participating domestic
3		violence shelter may also elect to cover its annuitants.
4		Dependent coverage shall be offered on an optional basis, with
5		employees, or some combination of the 2 as determined by the
6		domestic violence shelter or service. The domestic violence
7		shelter or service shall be responsible for timely collection
8		and transmission of dependent premiums.
9		The Director shall annually determine rates of payment,
10		subject to the following constraints:
11		(1) In the first year of coverage, the rates shall be
12		equal to the amount normally charged to State employees for
13		elected optional coverages or for enrolled dependents
14		coverages or other contributory coverages on behalf of its
15		employees, adjusted for differences between State
16		employees and employees of the domestic violence shelter or
17		service in age, sex, geographic location or other relevant
18		demographic variables, plus an amount sufficient to pay for
19		the additional administrative costs of providing coverage
20		to employees of the domestic violence shelter or service
21		and their dependents.
22		(2) In subsequent years, a further adjustment shall be
23		made to reflect the actual prior years' claims experience
24		of the employees of the domestic violence shelter or
25		service.
26		Monthly payments by the domestic violence shelter or

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1		service or its employees for group health insurance shall be
2		deposited in the Local Government Health Insurance Reserve
3		Fund.
4		(l) A public community college or entity organized pursuant
5		to the Public Community College Act may apply to the Director
6		initially to have only annuitants not covered prior to July 1,
7		1992 by the district's health plan provided health coverage
8		under this Act on a non-insured basis. The community college
9		must execute a 2-year contract to participate in the Local
10		Government Health Plan. Any annuitant may enroll in the event
11		of a qualifying change in status, special enrollment, special
12		circumstance as defined by the Director, or during the annual
13		Benefit Choice Period.
14		The Director shall annually determine monthly rates of
15		payment subject to the following constraints: for those
16		community colleges with annuitants only enrolled, first year
17		rates shall be equal to the average cost to cover claims for a
18		State member adjusted for demographics, Medicare
19		participation, and other factors; and in the second year, a
20		further adjustment of rates shall be made to reflect the actual
21		first year's claims experience of the covered annuitants.
22		(l-5) The provisions of subsection (l) become inoperative
23		on July 1, 1999.
24		(m) The Director shall adopt any rules deemed necessary for
25		implementation of this amendatory Act of 1989 (Public Act
26		86-978).

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1		(n) Any child advocacy center within the State of Illinois
2		may apply to the Director to have its employees, annuitants,
3		and their dependents provided group health coverage under this
4		Act on a non-insured basis. To participate, a child advocacy
5		center must agree to enroll all of its employees and pay the
6		entire cost of providing coverage for its employees. The child
7		advocacy center shall not be required to enroll those of its
8		employees who are covered spouses or dependents under this plan
9		or another group policy or plan providing health benefits as
10		long as (1) an appropriate official from the child advocacy
11		center attests that each employee not enrolled is a covered
12		spouse or dependent under this plan or another group policy or
13		plan and (2) at least 50% of the employees are enrolled and the
14		child advocacy center remits the entire cost of providing
15		coverage to those employees. Employees of a participating child
16		advocacy center who are not enrolled due to coverage under
17		another group health policy or plan may enroll in the event of
18		a qualifying change in status, special enrollment, or special
19		circumstance as defined by the Director or during the annual
20		Benefit Choice Period. A participating child advocacy center
21		may also elect to cover its annuitants. Dependent coverage
22		shall be offered on an optional basis, with the costs paid by
23		the child advocacy center, its employees, or some combination
24		of the 2 as determined by the child advocacy center. The child
25		advocacy center shall be responsible for timely collection and
26		transmission of dependent premiums.

SB2292 Engrossed - 20 - LRB100 16179 RJF 31300 b
1		The Director shall annually determine rates of payment,
2		subject to the following constraints:
3		(1) In the first year of coverage, the rates shall be
4		equal to the amount normally charged to State employees for
5		elected optional coverages or for enrolled dependents
6		coverages or other contributory coverages on behalf of its
7		employees, adjusted for differences between State
8		employees and employees of the child advocacy center in
9		age, sex, geographic location, or other relevant
10		demographic variables, plus an amount sufficient to pay for
11		the additional administrative costs of providing coverage
12		to employees of the child advocacy center and their
13		dependents.
14		(2) In subsequent years, a further adjustment shall be
15		made to reflect the actual prior years' claims experience
16		of the employees of the child advocacy center.
17		Monthly payments by the child advocacy center or its
18		employees for group health insurance shall be deposited into
19		the Local Government Health Insurance Reserve Fund.
20		(Source: P.A. 97-695, eff. 7-1-12; 98-488, eff. 8-16-13.)
21		Section 99. Effective date. This Act takes effect upon
22		becoming law.