Amendment vs bill House Amendment 001 vs Engrossed

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HB4972 Engrossed LRB103 37243 MXP 67363 b AN ACT concerning State government.
*LRB10337243RPS71852a* Rep.
Be it enacted by the People of the State of Illinois, represented in the General Assembly:
Brandun Schweizer Filed:
Section 5.
4/11/2024 10300HB4972ham001 LRB103 37243 RPS 71852 a AMENDMENT TO HOUSE BILL 4972 AMENDMENT NO.
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Amend House Bill 4972 by replacing everything after the enacting clause with the following:
"Section 5.
The Board of Trustees of the Teachers' Retirement System shall continue to administer the health benefit program established under Article 16 of the Illinois Pension Code through December 31, 1995.
The Board of Trustees of the Teachers' Retirement System shall continue to administer the health benefit program established under Article 16 of the 10300HB4972ham001 -2- LRB103 37243 RPS 71852 a Illinois Pension Code through December 31, 1995.
The Department of Central Management Services and the Teachers' Retirement System shall cooperate in this endeavor and shall coordinate their HB4972 Engrossed - 2 - LRB103 37243 MXP 67363 b activities so as to ensure a smooth transition and uninterrupted health benefit coverage.
The Department of Central Management Services and the Teachers' Retirement System shall cooperate in this endeavor and shall coordinate their activities so as to ensure a smooth transition and uninterrupted health benefit coverage.
A TRS dependent beneficiary who is a child age 19 or over and mentally or physically disabled does not become ineligible to participate by reason of (i) becoming ineligible to be claimed as a dependent for Illinois or federal income tax purposes or (ii) receiving earned income, so long as those earnings are insufficient for the child to be fully self-sufficient.
10300HB4972ham001 -3- LRB103 37243 RPS 71852 a A TRS dependent beneficiary who is a child age 19 or over and mentally or physically disabled does not become ineligible to participate by reason of (i) becoming ineligible to be claimed as a dependent for Illinois or federal income tax purposes or (ii) receiving earned income, so long as those earnings are insufficient for the child to be fully self-sufficient.
HB4972 Engrossed - 3 - LRB103 37243 MXP 67363 b (d) Coverage.
(d) Coverage.
The Director shall determine the insurance rates and premiums for TRS benefit recipients and TRS dependent beneficiaries, and shall present to the Teachers' Retirement System of the State of Illinois, by April 15 of each calendar year, the rate-setting methodology (including but not limited to utilization levels and costs) used to determine the amount of the health care premiums.
The Director shall determine the insurance rates and premiums for TRS benefit recipients and TRS dependent beneficiaries, and shall present to the Teachers' Retirement System of the State of Illinois, by April 15 of each calendar year, the rate-setting methodology (including but not limited to utilization levels 10300HB4972ham001 -4- LRB103 37243 RPS 71852 a and costs) used to determine the amount of the health care premiums.
For Fiscal Year 2003, the premium shall not exceed HB4972 Engrossed - 4 - LRB103 37243 MXP 67363 b 110% of the premium actually charged in Fiscal Year 2002.
For Fiscal Year 2003, the premium shall not exceed 110% of the premium actually charged in Fiscal Year 2002.
However, the cost of participation for a TRS dependent beneficiary who is an unmarried child age 19 or over and mentally or physically disabled shall not exceed the cost for a TRS dependent beneficiary who is an unmarried child under age 19 and participates in the same major medical or managed care program.
However, the cost of participation for a TRS dependent beneficiary who is an unmarried child age 19 or over and mentally or physically 10300HB4972ham001 -5- LRB103 37243 RPS 71852 a disabled shall not exceed the cost for a TRS dependent beneficiary who is an unmarried child under age 19 and participates in the same major medical or managed care program.
(1) For a TRS benefit recipient selecting a managed HB4972 Engrossed - 5 - LRB103 37243 MXP 67363 b care program, up to 75% of the total insurance rate shall be paid from the Teacher Health Insurance Security Fund.
(1) For a TRS benefit recipient selecting a managed care program, up to 75% of the total insurance rate shall be paid from the Teacher Health Insurance Security Fund.
(3) For a TRS benefit recipient selecting the major medical coverage program, up to 75% of the total insurance rate shall be paid from the Teacher Health Insurance Security Fund if a managed care program is not accessible, as determined by the Teachers' Retirement System.
(3) For a TRS benefit recipient selecting the major medical coverage program, up to 75% of the total insurance 10300HB4972ham001 -6- LRB103 37243 RPS 71852 a rate shall be paid from the Teacher Health Insurance Security Fund if a managed care program is not accessible, as determined by the Teachers' Retirement System.
Effective with Fiscal Year 2007 and thereafter, for a TRS benefit recipient selecting the major medical coverage program, 75% of the total insurance rate shall be paid from the Teacher Health Insurance Security Fund if a HB4972 Engrossed - 6 - LRB103 37243 MXP 67363 b managed care program is not accessible, as determined by the Department of Central Management Services.
Effective with Fiscal Year 2007 and thereafter, for a TRS benefit recipient selecting the major medical coverage program, 75% of the total insurance rate shall be paid from the Teacher Health Insurance Security Fund if a managed care program is not accessible, as determined by the Department of Central Management Services.
except that (i) if the balance of the cost of coverage exceeds the amount of the monthly annuity or benefit payment, the difference shall be paid directly to the Teachers' Retirement System by the TRS benefit recipient, and (ii) all or part of the balance of the cost of coverage may, at the school board's option, be paid to the Teachers' Retirement System by the school board of the school district from which the TRS benefit recipient retired, in accordance with Section 10-22.3b of HB4972 Engrossed - 7 - LRB103 37243 MXP 67363 b the School Code.
except that (i) if the balance of the cost of coverage exceeds the amount of the 10300HB4972ham001 -7- LRB103 37243 RPS 71852 a monthly annuity or benefit payment, the difference shall be paid directly to the Teachers' Retirement System by the TRS benefit recipient, and (ii) all or part of the balance of the cost of coverage may, at the school board's option, be paid to the Teachers' Retirement System by the school board of the school district from which the TRS benefit recipient retired, in accordance with Section 10-22.3b of the School Code.
To receive a refund pursuant to this subsection, the TRS benefit recipient or TRS dependent beneficiary must provide documentation to the Department of Central Management Services evidencing the TRS benefit recipient's or TRS dependent beneficiary's Medicare coverage and the amount paid by the TRS benefit recipient or TRS dependent beneficiary during the applicable time period.
To receive a refund pursuant to this subsection, the TRS benefit recipient or TRS dependent beneficiary must provide documentation to the Department of Central 10300HB4972ham001 -8- LRB103 37243 RPS 71852 a Management Services evidencing the TRS benefit recipient's or TRS dependent beneficiary's Medicare coverage and the amount paid by the TRS benefit recipient or TRS dependent beneficiary during the applicable time period.
Beginning July 1, 1995, all revenues arising from the administration of the health benefit programs established under Article 16 of the Illinois Pension Code or HB4972 Engrossed - 8 - LRB103 37243 MXP 67363 b this Section shall be deposited into the Teacher Health Insurance Security Fund, which is hereby created as a nonappropriated trust fund to be held outside the State Treasury, with the State Treasurer as custodian.
Beginning July 1, 1995, all revenues arising from the administration of the health benefit programs established under Article 16 of the Illinois Pension Code or this Section shall be deposited into the Teacher Health Insurance Security Fund, which is hereby created as a nonappropriated trust fund to be held outside the State Treasury, with the State Treasurer as custodian.
After other funds authorized for the payment of the costs of the health benefit program established under Article 16 of the Illinois Pension Code are exhausted and until January 1, 1996 (or such later date as may be agreed upon by the Director of Central Management Services and the Secretary of the Teachers' Retirement System), the Secretary of the Teachers' Retirement System may make expenditures from the Teacher Health Insurance Security Fund as necessary to pay up to 75% of the cost of providing health coverage to eligible benefit recipients (as defined in Sections 16-153.1 and 16-153.3 of the Illinois Pension Code) who are enrolled in the Article 16 HB4972 Engrossed - 9 - LRB103 37243 MXP 67363 b health benefit program and to facilitate the transfer of administration of the health benefit program to the Department of Central Management Services.
After other funds authorized for the payment of the costs of the health benefit program established under Article 16 of the Illinois Pension Code are exhausted and until January 1, 1996 (or such later date as may be agreed upon by the Director 10300HB4972ham001 -9- LRB103 37243 RPS 71852 a of Central Management Services and the Secretary of the Teachers' Retirement System), the Secretary of the Teachers' Retirement System may make expenditures from the Teacher Health Insurance Security Fund as necessary to pay up to 75% of the cost of providing health coverage to eligible benefit recipients (as defined in Sections 16-153.1 and 16-153.3 of the Illinois Pension Code) who are enrolled in the Article 16 health benefit program and to facilitate the transfer of administration of the health benefit program to the Department of Central Management Services.
The transferred moneys, and interest accrued thereon, shall be used exclusively for transfers to administrative service organizations or their financial institutions for payments of claims to claimants and providers under the self-insurance health plan.
The transferred moneys, and interest accrued thereon, shall be used exclusively for transfers to administrative service organizations or their financial institutions for payments of 10300HB4972ham001 -10- LRB103 37243 RPS 71852 a claims to claimants and providers under the self-insurance health plan.
The Director shall by contract, HB4972 Engrossed - 10 - LRB103 37243 MXP 67363 b self-insurance, or otherwise make available the program of health benefits for TRS benefit recipients and their TRS dependent beneficiaries that is provided for in this Section.
The Director shall by contract, self-insurance, or otherwise make available the program of health benefits for TRS benefit recipients and their TRS dependent beneficiaries that is provided for in this Section.
If the Teacher Health Insurance Security Fund experiences a deficit balance based upon the contribution and subsidy rates established in this Section and Section 6.6 for Fiscal Year 2008 or thereafter, the Committee shall make recommendations for adjustments to the funding sources established under these Sections.
If the Teacher Health Insurance Security Fund experiences a deficit balance based upon the contribution and subsidy 10300HB4972ham001 -11- LRB103 37243 RPS 71852 a rates established in this Section and Section 6.6 for Fiscal Year 2008 or thereafter, the Committee shall make recommendations for adjustments to the funding sources established under these Sections.
In addition, the Committee shall identify proposed solutions to the funding shortfalls that are affecting the Teacher Health Insurance Security Fund, and it shall report HB4972 Engrossed - 11 - LRB103 37243 MXP 67363 b those solutions to the Governor and the General Assembly within 6 months after August 15, 2011 (the effective date of Public Act 97-386).
In addition, the Committee shall identify proposed solutions to the funding shortfalls that are affecting the Teacher Health Insurance Security Fund, and it shall report those solutions to the Governor and the General Assembly within 6 months after August 15, 2011 (the effective date of Public Act 97-386).
7-30-21.)
7-30-21.)".