105 ILCS 55/ School Employee Benefit Act.
(105 ILCS 55/1)
Sec. 1. Short title. This Act may be cited as the School Employee Benefit Act.
(Source: P.A. 93‑1036, eff. 9‑14‑04.)
(105 ILCS 55/5)
Sec. 5. Purpose. The purpose of this Act is to require the Department of Central Management Services to establish and administer a prescription drug benefit program that will enable eligible school employees access to affordable prescription drugs.
(Source: P.A. 93‑1036, eff. 9‑14‑04.)
(105 ILCS 55/10)
Sec. 10. Definitions.
"Annuitant" means a retired school district employee entitled to receive retirement benefits, as defined by the school district.
"Department" means the Department of Central Management Services.
"Dependent" means a school district employee's dependent as defined by the school district.
"Director" means the Director of Central Management Services.
"Employee" means a school district employee who is entitled to benefits as defined by the school district.
"Rules" includes rules adopted and forms prescribed by the Department.
"School district" means a public school district in this State, including a vocational education district, a special education district, a program operated by an educational service region, and a joint agreement.
(Source: P.A. 93‑1036, eff. 9‑14‑04; 94‑227, eff. 1‑1‑06.)
(105 ILCS 55/15)
Sec. 15. Prescription drug benefits; contract.
(a) The Director shall, by contract, self‑insurance, or otherwise, make available a voluntary program of prescription drug benefits for school districts under Section 15 of this Act. The contract or other arrangement for the provision of the prescription drug benefits shall be on terms deemed by the Director to be in the best interest of the State of Illinois and school districts based on criteria set by the Department, which must include without limitation administrative cost, service capabilities of the carrier or other contractors, and premiums, fees, or charges as related to the costs of the benefits.
(b) The term of a contract under this Section may not extend beyond 5 fiscal years. The Director may exercise renewal options of the same contract for up to a period of 5 years. Any increases in premiums, fees, or charges requested by a contractor whose contract may be renewed pursuant to a renewal option contained in the contract must be justified on the basis of (1) audited experience data, (2) increases in the costs of prescription drug coverage provided under the contract, (3) contractor performance, (4) increases in contractor responsibilities, or (5) any combination of these bases.
(c) A contractor shall agree to abide by all requirements and rules of the prescription drug benefit program, to submit such information and data as may from time to time be deemed necessary by the Director for effective administration of the program, and to fully cooperate in any audit.
(Source: P.A. 93‑1036, eff. 9‑14‑04.)
(105 ILCS 55/20)
Sec. 20. Prescription drug benefits; program.
(a) Beginning July 1, 2005, the Department shall be responsible for administering the prescription drug benefit program established under this Act for employees, annuitants, and dependents on a non‑insured basis.
(b) For each program year, the Department shall set a date by which school districts must notify the Department of their election to participate in the prescription drug benefit program. The Department shall provide notification of the election date to school districts at least 45 days prior to the election date.
(c) Any school district may apply to the Director to have employees, annuitants, and dependents be provided a prescription drug benefit program under this Act. To participate, a school district must agree to enroll all of its employees. A participating school district is not required to enroll a full‑time employee who has waived coverage under the district's health plan.
(d) The Director shall determine the insurance rates and premiums for those employees, annuitants, and dependents participating in the prescription drug benefit program. Rates and premiums may be based in part on age and eligibility for federal Medicare coverage.
A school district must remit the entire cost of providing prescription drug coverage under this Section.
(e) All revenues arising from the administration of the prescription drug benefit program shall be deposited into the Illinois Prescription Drug Discount Program Fund.
(f) The prescription drug benefit program shall be maintained on an ongoing, affordable basis, and the cost to school districts shall not exceed the State's actual program costs. The prescription drug benefit program may be changed by the State and is not intended to be a pension or retirement benefit subject to protection under Section 5 of Article XIII of the Illinois Constitution.
(Source: P.A. 93‑1036, eff. 9‑14‑04; 94‑91, eff. 7‑1‑05.)
(105 ILCS 55/25)
Sec. 25. Pharmacy providers.
(a) The Department or its contractor may enter into a contract with a pharmacy registered or licensed under Section 16a of the Pharmacy Practice Act.
(b) Before entering into an agreement with other pharmacy providers, pursuant to Sections 15 and 20 of this Act, the Department or its contractor must by rule or contract establish terms or conditions that must be met by pharmacy providers desiring to contract with the Department or its contractor. If a pharmacy licensed under Section 15 of the Pharmacy Practice Act rejects the terms and conditions established, the Department or its contractor may offer other terms and conditions necessary to comply with the network adequacy requirements.
(c) Notwithstanding the provisions of subsection (a) of this Section, the Department or its contractor may not refuse to contract with a pharmacy licensed under Section 15 of the Pharmacy Practice Act that meets the terms and conditions established by the Department or its contractor under subsection (a) or (b) of this Section.
(Source: P.A. 95‑689, eff. 10‑29‑07.)
(105 ILCS 55/85)
Sec. 85. (Amendatory provisions; text omitted).
(Source: P.A. 93‑1036, eff. 9‑14‑04; text omitted.)
(105 ILCS 55/90)
Sec. 90. (Amendatory provisions; text omitted).
(Source: P.A. 93‑1036, eff. 9‑14‑04; text omitted.)
(105 ILCS 55/95)
Sec. 95. (Amendatory provisions; text omitted).
(Source: P.A. 93‑1036, eff. 9‑14‑04; text omitted.)
(105 ILCS 55/97)
Sec. 97. Severability. The provisions of this Act are severable under Section 1.31 of the Statute on Statutes.
(Source: P.A. 93‑1036, eff. 9‑14‑04.)
(105 ILCS 55/99)
Sec. 99. Effective date. This Act takes effect upon becoming law.
(Source: P.A. 93‑1036, eff. 9‑14‑04.)