Illinois 2023-2024 Regular Session

Illinois House Bill HB4972 Compare Versions

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1+103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB4972 Introduced 2/7/2024, by Rep. Brandun Schweizer SYNOPSIS AS INTRODUCED: 5 ILCS 375/6.55 ILCS 375/6.6 Amends the State Employees Group Insurance Act of 1971. Provides that, at least 120 days prior to making any changes to the health benefits for TRS benefit recipients, the Department of Central Management Services shall post those changes on its website and shall submit the planned changes to the Commission on Government Forecasting and Accountability. Provides that at least 120 days prior to making any changes to funding for the Teacher Health Insurance Security Fund, the Department shall post those changes on its website and shall submit the planned changes to the Commission on Government Forecasting and Accountability. LRB103 37243 MXP 67363 b A BILL FOR 103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB4972 Introduced 2/7/2024, by Rep. Brandun Schweizer SYNOPSIS AS INTRODUCED: 5 ILCS 375/6.55 ILCS 375/6.6 5 ILCS 375/6.5 5 ILCS 375/6.6 Amends the State Employees Group Insurance Act of 1971. Provides that, at least 120 days prior to making any changes to the health benefits for TRS benefit recipients, the Department of Central Management Services shall post those changes on its website and shall submit the planned changes to the Commission on Government Forecasting and Accountability. Provides that at least 120 days prior to making any changes to funding for the Teacher Health Insurance Security Fund, the Department shall post those changes on its website and shall submit the planned changes to the Commission on Government Forecasting and Accountability. LRB103 37243 MXP 67363 b LRB103 37243 MXP 67363 b A BILL FOR
2+103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB4972 Introduced 2/7/2024, by Rep. Brandun Schweizer SYNOPSIS AS INTRODUCED:
3+5 ILCS 375/6.55 ILCS 375/6.6 5 ILCS 375/6.5 5 ILCS 375/6.6
4+5 ILCS 375/6.5
5+5 ILCS 375/6.6
6+Amends the State Employees Group Insurance Act of 1971. Provides that, at least 120 days prior to making any changes to the health benefits for TRS benefit recipients, the Department of Central Management Services shall post those changes on its website and shall submit the planned changes to the Commission on Government Forecasting and Accountability. Provides that at least 120 days prior to making any changes to funding for the Teacher Health Insurance Security Fund, the Department shall post those changes on its website and shall submit the planned changes to the Commission on Government Forecasting and Accountability.
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312 1 AN ACT concerning State government.
413 2 Be it enacted by the People of the State of Illinois,
514 3 represented in the General Assembly:
615 4 Section 5. The State Employees Group Insurance Act of 1971
7-5 is amended by changing Section 6.5 as follows:
16+5 is amended by changing Sections 6.5 and 6.6 as follows:
817 6 (5 ILCS 375/6.5)
918 7 Sec. 6.5. Health benefits for TRS benefit recipients and
1019 8 TRS dependent beneficiaries.
1120 9 (a) Purpose. It is the purpose of this amendatory Act of
1221 10 1995 to transfer the administration of the program of health
1322 11 benefits established for benefit recipients and their
1423 12 dependent beneficiaries under Article 16 of the Illinois
1524 13 Pension Code to the Department of Central Management Services.
1625 14 (b) Transition provisions. The Board of Trustees of the
1726 15 Teachers' Retirement System shall continue to administer the
1827 16 health benefit program established under Article 16 of the
1928 17 Illinois Pension Code through December 31, 1995. Beginning
2029 18 January 1, 1996, the Department of Central Management Services
2130 19 shall be responsible for administering a program of health
2231 20 benefits for TRS benefit recipients and TRS dependent
2332 21 beneficiaries under this Section. The Department of Central
2433 22 Management Services and the Teachers' Retirement System shall
2534 23 cooperate in this endeavor and shall coordinate their
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38+103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB4972 Introduced 2/7/2024, by Rep. Brandun Schweizer SYNOPSIS AS INTRODUCED:
39+5 ILCS 375/6.55 ILCS 375/6.6 5 ILCS 375/6.5 5 ILCS 375/6.6
40+5 ILCS 375/6.5
41+5 ILCS 375/6.6
42+Amends the State Employees Group Insurance Act of 1971. Provides that, at least 120 days prior to making any changes to the health benefits for TRS benefit recipients, the Department of Central Management Services shall post those changes on its website and shall submit the planned changes to the Commission on Government Forecasting and Accountability. Provides that at least 120 days prior to making any changes to funding for the Teacher Health Insurance Security Fund, the Department shall post those changes on its website and shall submit the planned changes to the Commission on Government Forecasting and Accountability.
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3471 1 activities so as to ensure a smooth transition and
3572 2 uninterrupted health benefit coverage.
3673 3 (c) Eligibility. All persons who were enrolled in the
3774 4 Article 16 program at the time of the transfer shall be
3875 5 eligible to participate in the program established under this
3976 6 Section without any interruption or delay in coverage or
4077 7 limitation as to pre-existing medical conditions. Eligibility
4178 8 to participate shall be determined by the Teachers' Retirement
4279 9 System. Eligibility information shall be communicated to the
4380 10 Department of Central Management Services in a format
4481 11 acceptable to the Department.
4582 12 Eligible TRS benefit recipients may enroll or re-enroll in
4683 13 the program of health benefits established under this Section
4784 14 during any applicable annual open enrollment period and as
4885 15 otherwise permitted by the Department of Central Management
4986 16 Services. A TRS benefit recipient shall not be deemed
5087 17 ineligible to participate solely by reason of the TRS benefit
5188 18 recipient having made a previous election to disenroll or
5289 19 otherwise not participate in the program of health benefits.
5390 20 A TRS dependent beneficiary who is a child age 19 or over
5491 21 and mentally or physically disabled does not become ineligible
5592 22 to participate by reason of (i) becoming ineligible to be
5693 23 claimed as a dependent for Illinois or federal income tax
5794 24 purposes or (ii) receiving earned income, so long as those
5895 25 earnings are insufficient for the child to be fully
5996 26 self-sufficient.
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70107 1 (d) Coverage. The level of health benefits provided under
71108 2 this Section shall be similar to the level of benefits
72109 3 provided by the program previously established under Article
73110 4 16 of the Illinois Pension Code.
74111 5 Group life insurance benefits are not included in the
75112 6 benefits to be provided to TRS benefit recipients and TRS
76113 7 dependent beneficiaries under this Act.
77114 8 The program of health benefits under this Section may
78115 9 include any or all of the benefit limitations, including but
79116 10 not limited to a reduction in benefits based on eligibility
80117 11 for federal Medicare benefits, that are provided under
81118 12 subsection (a) of Section 6 of this Act for other health
82119 13 benefit programs under this Act.
83120 14 (e) Insurance rates and premiums. The Director shall
84121 15 determine the insurance rates and premiums for TRS benefit
85122 16 recipients and TRS dependent beneficiaries, and shall present
86123 17 to the Teachers' Retirement System of the State of Illinois,
87124 18 by April 15 of each calendar year, the rate-setting
88125 19 methodology (including but not limited to utilization levels
89126 20 and costs) used to determine the amount of the health care
90127 21 premiums.
91128 22 For Fiscal Year 1996, the premium shall be equal to
92129 23 the premium actually charged in Fiscal Year 1995; in
93130 24 subsequent years, the premium shall never be lower than
94131 25 the premium charged in Fiscal Year 1995.
95132 26 For Fiscal Year 2003, the premium shall not exceed
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106143 1 110% of the premium actually charged in Fiscal Year 2002.
107144 2 For Fiscal Year 2004, the premium shall not exceed
108145 3 112% of the premium actually charged in Fiscal Year 2003.
109146 4 For Fiscal Year 2005, the premium shall not exceed a
110147 5 weighted average of 106.6% of the premium actually charged
111148 6 in Fiscal Year 2004.
112149 7 For Fiscal Year 2006, the premium shall not exceed a
113150 8 weighted average of 109.1% of the premium actually charged
114151 9 in Fiscal Year 2005.
115152 10 For Fiscal Year 2007, the premium shall not exceed a
116153 11 weighted average of 103.9% of the premium actually charged
117154 12 in Fiscal Year 2006.
118155 13 For Fiscal Year 2008 and thereafter, the premium in
119156 14 each fiscal year shall not exceed 105% of the premium
120157 15 actually charged in the previous fiscal year.
121158 16 Rates and premiums may be based in part on age and
122159 17 eligibility for federal medicare coverage. However, the cost
123160 18 of participation for a TRS dependent beneficiary who is an
124161 19 unmarried child age 19 or over and mentally or physically
125162 20 disabled shall not exceed the cost for a TRS dependent
126163 21 beneficiary who is an unmarried child under age 19 and
127164 22 participates in the same major medical or managed care
128165 23 program.
129166 24 The cost of health benefits under the program shall be
130167 25 paid as follows:
131168 26 (1) For a TRS benefit recipient selecting a managed
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142179 1 care program, up to 75% of the total insurance rate shall
143180 2 be paid from the Teacher Health Insurance Security Fund.
144181 3 Effective with Fiscal Year 2007 and thereafter, for a TRS
145182 4 benefit recipient selecting a managed care program, 75% of
146183 5 the total insurance rate shall be paid from the Teacher
147184 6 Health Insurance Security Fund.
148185 7 (2) For a TRS benefit recipient selecting the major
149186 8 medical coverage program, up to 50% of the total insurance
150187 9 rate shall be paid from the Teacher Health Insurance
151188 10 Security Fund if a managed care program is accessible, as
152189 11 determined by the Teachers' Retirement System. Effective
153190 12 with Fiscal Year 2007 and thereafter, for a TRS benefit
154191 13 recipient selecting the major medical coverage program,
155192 14 50% of the total insurance rate shall be paid from the
156193 15 Teacher Health Insurance Security Fund if a managed care
157194 16 program is accessible, as determined by the Department of
158195 17 Central Management Services.
159196 18 (3) For a TRS benefit recipient selecting the major
160197 19 medical coverage program, up to 75% of the total insurance
161198 20 rate shall be paid from the Teacher Health Insurance
162199 21 Security Fund if a managed care program is not accessible,
163200 22 as determined by the Teachers' Retirement System.
164201 23 Effective with Fiscal Year 2007 and thereafter, for a TRS
165202 24 benefit recipient selecting the major medical coverage
166203 25 program, 75% of the total insurance rate shall be paid
167204 26 from the Teacher Health Insurance Security Fund if a
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178215 1 managed care program is not accessible, as determined by
179216 2 the Department of Central Management Services.
180217 3 (3.1) For a TRS dependent beneficiary who is Medicare
181218 4 primary and enrolled in a managed care plan, or the major
182219 5 medical coverage program if a managed care plan is not
183220 6 available, 25% of the total insurance rate shall be paid
184221 7 from the Teacher Health Security Fund as determined by the
185222 8 Department of Central Management Services. For the purpose
186223 9 of this item (3.1), the term "TRS dependent beneficiary
187224 10 who is Medicare primary" means a TRS dependent beneficiary
188225 11 who is participating in Medicare Parts A and B.
189226 12 (4) Except as otherwise provided in item (3.1), the
190227 13 balance of the rate of insurance, including the entire
191228 14 premium of any coverage for TRS dependent beneficiaries
192229 15 that has been elected, shall be paid by deductions
193230 16 authorized by the TRS benefit recipient to be withheld
194231 17 from his or her monthly annuity or benefit payment from
195232 18 the Teachers' Retirement System; except that (i) if the
196233 19 balance of the cost of coverage exceeds the amount of the
197234 20 monthly annuity or benefit payment, the difference shall
198235 21 be paid directly to the Teachers' Retirement System by the
199236 22 TRS benefit recipient, and (ii) all or part of the balance
200237 23 of the cost of coverage may, at the school board's option,
201238 24 be paid to the Teachers' Retirement System by the school
202239 25 board of the school district from which the TRS benefit
203240 26 recipient retired, in accordance with Section 10-22.3b of
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214251 1 the School Code. The Teachers' Retirement System shall
215252 2 promptly deposit all moneys withheld by or paid to it
216253 3 under this subdivision (e)(4) into the Teacher Health
217254 4 Insurance Security Fund. These moneys shall not be
218255 5 considered assets of the Retirement System.
219256 6 (5) If, for any month beginning on or after January 1,
220257 7 2013, a TRS benefit recipient or TRS dependent beneficiary
221258 8 was enrolled in Medicare Parts A and B and such Medicare
222259 9 coverage was primary to coverage under this Section but
223260 10 payment for coverage under this Section was made at a rate
224261 11 greater than the Medicare primary rate published by the
225262 12 Department of Central Management Services, the TRS benefit
226263 13 recipient or TRS dependent beneficiary shall be eligible
227264 14 for a refund equal to the difference between the amount
228265 15 paid by the TRS benefit recipient or TRS dependent
229266 16 beneficiary and the published Medicare primary rate. To
230267 17 receive a refund pursuant to this subsection, the TRS
231268 18 benefit recipient or TRS dependent beneficiary must
232269 19 provide documentation to the Department of Central
233270 20 Management Services evidencing the TRS benefit recipient's
234271 21 or TRS dependent beneficiary's Medicare coverage and the
235272 22 amount paid by the TRS benefit recipient or TRS dependent
236273 23 beneficiary during the applicable time period.
237274 24 (f) Financing. Beginning July 1, 1995, all revenues
238275 25 arising from the administration of the health benefit programs
239276 26 established under Article 16 of the Illinois Pension Code or
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250287 1 this Section shall be deposited into the Teacher Health
251288 2 Insurance Security Fund, which is hereby created as a
252289 3 nonappropriated trust fund to be held outside the State
253290 4 Treasury, with the State Treasurer as custodian. Any interest
254291 5 earned on moneys in the Teacher Health Insurance Security Fund
255292 6 shall be deposited into the Fund.
256293 7 Moneys in the Teacher Health Insurance Security Fund shall
257294 8 be used only to pay the costs of the health benefit program
258295 9 established under this Section, including associated
259296 10 administrative costs, and the costs associated with the health
260297 11 benefit program established under Article 16 of the Illinois
261298 12 Pension Code, as authorized in this Section. Beginning July 1,
262299 13 1995, the Department of Central Management Services may make
263300 14 expenditures from the Teacher Health Insurance Security Fund
264301 15 for those costs.
265302 16 After other funds authorized for the payment of the costs
266303 17 of the health benefit program established under Article 16 of
267304 18 the Illinois Pension Code are exhausted and until January 1,
268305 19 1996 (or such later date as may be agreed upon by the Director
269306 20 of Central Management Services and the Secretary of the
270307 21 Teachers' Retirement System), the Secretary of the Teachers'
271308 22 Retirement System may make expenditures from the Teacher
272309 23 Health Insurance Security Fund as necessary to pay up to 75% of
273310 24 the cost of providing health coverage to eligible benefit
274311 25 recipients (as defined in Sections 16-153.1 and 16-153.3 of
275312 26 the Illinois Pension Code) who are enrolled in the Article 16
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286323 1 health benefit program and to facilitate the transfer of
287324 2 administration of the health benefit program to the Department
288325 3 of Central Management Services.
289326 4 The Department of Central Management Services, or any
290327 5 successor agency designated to procure healthcare contracts
291328 6 pursuant to this Act, is authorized to establish funds,
292329 7 separate accounts provided by any bank or banks as defined by
293330 8 the Illinois Banking Act, or separate accounts provided by any
294331 9 savings and loan association or associations as defined by the
295332 10 Illinois Savings and Loan Act of 1985 to be held by the
296333 11 Director, outside the State treasury, for the purpose of
297334 12 receiving the transfer of moneys from the Teacher Health
298335 13 Insurance Security Fund. The Department may promulgate rules
299336 14 further defining the methodology for the transfers. Any
300337 15 interest earned by moneys in the funds or accounts shall inure
301338 16 to the Teacher Health Insurance Security Fund. The transferred
302339 17 moneys, and interest accrued thereon, shall be used
303340 18 exclusively for transfers to administrative service
304341 19 organizations or their financial institutions for payments of
305342 20 claims to claimants and providers under the self-insurance
306343 21 health plan. The transferred moneys, and interest accrued
307344 22 thereon, shall not be used for any other purpose including,
308345 23 but not limited to, reimbursement of administration fees due
309346 24 the administrative service organization pursuant to its
310347 25 contract or contracts with the Department.
311348 26 (g) Contract for benefits. The Director shall by contract,
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322359 1 self-insurance, or otherwise make available the program of
323360 2 health benefits for TRS benefit recipients and their TRS
324361 3 dependent beneficiaries that is provided for in this Section.
325362 4 The contract or other arrangement for the provision of these
326363 5 health benefits shall be on terms deemed by the Director to be
327364 6 in the best interest of the State of Illinois and the TRS
328365 7 benefit recipients based on, but not limited to, such criteria
329366 8 as administrative cost, service capabilities of the carrier or
330367 9 other contractor, and the costs of the benefits.
331368 10 (g-5) Committee. A Teacher Retirement Insurance Program
332369 11 Committee shall be established, to consist of 10 persons
333370 12 appointed by the Governor.
334371 13 The Committee shall convene at least 4 times each year,
335372 14 and shall consider and make recommendations on issues
336373 15 affecting the program of health benefits provided under this
337374 16 Section. Recommendations of the Committee shall be based on a
338375 17 consensus of the members of the Committee.
339376 18 If the Teacher Health Insurance Security Fund experiences
340377 19 a deficit balance based upon the contribution and subsidy
341378 20 rates established in this Section and Section 6.6 for Fiscal
342379 21 Year 2008 or thereafter, the Committee shall make
343380 22 recommendations for adjustments to the funding sources
344381 23 established under these Sections.
345382 24 In addition, the Committee shall identify proposed
346383 25 solutions to the funding shortfalls that are affecting the
347384 26 Teacher Health Insurance Security Fund, and it shall report
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395+1 those solutions to the Governor and the General Assembly
396+2 within 6 months after August 15, 2011 (the effective date of
397+3 Public Act 97-386).
398+4 (h) Continuation of program. It is the intention of the
399+5 General Assembly that the program of health benefits provided
400+6 under this Section be maintained on an ongoing, affordable
401+7 basis.
402+8 The program of health benefits provided under this Section
403+9 may be amended by the State and is not intended to be a pension
404+10 or retirement benefit subject to protection under Article
405+11 XIII, Section 5 of the Illinois Constitution.
406+12 (i) Repeal. (Blank).
407+13 (j) At least 120 days prior to making any changes to the
408+14 benefits allowed under this Section, the Department shall post
409+15 those changes on its website and shall submit the planned
410+16 changes to the Commission on Government Forecasting and
411+17 Accountability.
412+18 (Source: P.A. 101-483, eff. 1-1-20; 102-210, eff. 7-30-21.)
413+19 (5 ILCS 375/6.6)
414+20 Sec. 6.6. Contributions to the Teacher Health Insurance
415+21 Security Fund.
416+22 (a) Beginning July 1, 1995, all active contributors of the
417+23 Teachers' Retirement System (established under Article 16 of
418+24 the Illinois Pension Code) who are not employees of a
419+25 department as defined in Section 3 of this Act shall make
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430+1 contributions toward the cost of annuitant and survivor health
431+2 benefits. These contributions shall be at the following rates:
432+3 until January 1, 2002, 0.5% of salary; beginning January 1,
433+4 2002, 0.65% of salary; beginning July 1, 2003, 0.75% of
434+5 salary; beginning July 1, 2005, 0.80% of salary; beginning
435+6 July 1, 2007, a percentage of salary to be determined by the
436+7 Department of Central Management Services by rule, which in
437+8 each fiscal year shall not exceed 105% of the percentage of
438+9 salary actually required to be paid in the previous fiscal
439+10 year.
440+11 These contributions shall be deducted by the employer and
441+12 paid to the System as service agent for the Department of
442+13 Central Management Services. The System may use the same
443+14 processes for collecting the contributions required by this
444+15 subsection that it uses to collect contributions received from
445+16 school districts and other covered employers under Sections
446+17 16-154 and 16-155 of the Illinois Pension Code.
447+18 An employer may agree to pick up or pay the contributions
448+19 required under this subsection on behalf of the teacher; such
449+20 contributions shall be deemed to have to have been paid by the
450+21 teacher. Beginning January 1, 2002, if the employer does not
451+22 directly pay the required member contribution, then the
452+23 employer shall reduce the member's salary by an amount equal
453+24 to the required contribution and shall then pay the
454+25 contribution on behalf of the member. This reduction shall not
455+26 change the amounts reported as creditable earnings to the
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466+1 Teachers' Retirement System.
467+2 A person who purchases optional service credit under
468+3 Article 16 of the Illinois Pension Code for a period after June
469+4 30, 1995 must also make a contribution under this subsection
470+5 for that optional credit, at the rate provided in subsection
471+6 (a), based on the salary used in computing the optional
472+7 service credit, plus interest on this employee contribution.
473+8 This contribution shall be collected by the System as service
474+9 agent for the Department of Central Management Services. The
475+10 contribution required under this subsection for the optional
476+11 service credit must be paid in full before any annuity based on
477+12 that credit begins.
478+13 (a-5) Beginning January 1, 2002, every employer of a
479+14 teacher (other than an employer that is a department as
480+15 defined in Section 3 of this Act) shall pay an employer
481+16 contribution toward the cost of annuitant and survivor health
482+17 benefits. These contributions shall be computed as follows:
483+18 (1) Beginning January 1, 2002 through June 30, 2003,
484+19 the employer contribution shall be equal to 0.4% of each
485+20 teacher's salary.
486+21 (2) Beginning July 1, 2003, the employer contribution
487+22 shall be equal to 0.5% of each teacher's salary.
488+23 (3) Beginning July 1, 2005, the employer contribution
489+24 shall be equal to 0.6% of each teacher's salary.
490+25 (4) Beginning July 1, 2007, the employer contribution
491+26 shall be a percentage of each teacher's salary to be
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502+1 determined by the Department of Central Management
503+2 Services by rule, which in each fiscal year shall not
504+3 exceed 105% of the percentage of each teacher's salary
505+4 actually required to be paid in the previous fiscal year.
506+5 These contributions shall be paid by the employer to the
507+6 System as service agent for the Department of Central
508+7 Management Services. The System may use the same processes for
509+8 collecting the contributions required by this subsection that
510+9 it uses to collect contributions received from school
511+10 districts and other covered employers under the Illinois
512+11 Pension Code.
513+12 The school district or other employing unit may pay these
514+13 employer contributions out of any source of funding available
515+14 for that purpose and shall forward the contributions to the
516+15 System on the schedule established for the payment of member
517+16 contributions.
518+17 (b) The Teachers' Retirement System shall promptly deposit
519+18 all moneys collected under subsections (a) and (a-5) of this
520+19 Section into the Teacher Health Insurance Security Fund
521+20 created in Section 6.5 of this Act. The moneys collected under
522+21 this Section shall be used only for the purposes authorized in
523+22 Section 6.5 of this Act and shall not be considered to be
524+23 assets of the Teachers' Retirement System. Contributions made
525+24 under this Section are not transferable to other pension funds
526+25 or retirement systems and are not refundable upon termination
527+26 of service.
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538+1 (c) On or before November 15 of each year, the Board of
539+2 Trustees of the Teachers' Retirement System shall certify to
540+3 the Governor, the Director of Central Management Services, and
541+4 the State Comptroller its estimate of the total amount of
542+5 contributions to be paid under subsection (a) of this Section
543+6 6.6 for the next fiscal year. The amount certified shall be
544+7 decreased or increased each year by the amount that the actual
545+8 active teacher contributions either fell short of or exceeded
546+9 the estimate used by the Board in making the certification for
547+10 the previous fiscal year. The certification shall include a
548+11 detailed explanation of the methods and information that the
549+12 Board relied upon in preparing its estimate. As soon as
550+13 possible after the effective date of this amendatory Act of
551+14 the 92nd General Assembly, the Board shall recalculate and
552+15 recertify its certifications for fiscal years 2002 and 2003.
553+16 (d) Beginning in fiscal year 1996, on the first day of each
554+17 month, or as soon thereafter as may be practical, the State
555+18 Treasurer and the State Comptroller shall transfer from the
556+19 General Revenue Fund to the Teacher Health Insurance Security
557+20 Fund 1/12 of the annual amount appropriated for that fiscal
558+21 year to the State Comptroller for deposit into the Teacher
559+22 Health Insurance Security Fund under Section 1.3 of the State
560+23 Pension Funds Continuing Appropriation Act.
561+24 (e) Except where otherwise specified in this Section, the
562+25 definitions that apply to Article 16 of the Illinois Pension
563+26 Code apply to this Section.
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