Appendix 3 AFSCME Contract 2023-2027 App A and B.pdf

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Appendix A.

Effective July 1, 2023 through June 30, 2027

All benefits in this Appendix are effective July 1, 2023, unless otherwise noted. Prior Appendix A benefit levels apply to all services received through June 30, 2023.

Section 1. SUMMARY OF BENEFITS The State shall maintain a program of benefits that shall include health, dental, vision, and life coverage. The health plan shall include medical, prescription and behavioral health coverage. Any and all services covered by the Plan must be medically necessary as determined by the Plan.

Eligible dependents of members shall have available benefits. All dependents enrolled in the Plan must be enrolled in the same health and dental plan as the member.

Section 2. CONTRIBUTION AMOUNTS

Employee Contributions for the Quality Care Health Plan (QCHP)

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Employee Contributions for the Consumer Driven Health Plan (CDHP)

Employee Contributions for the Managed Care Health Plans (MCHP)

Employee Contribution Increases for QCHP, CDHP, and MCHP

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Member Contribution Increases for Dependent Coverage for QCHP, CDHP, and MCHP

Dental Contributions for the Quality Care Dental Plan (QCDP)

Section 3. HEALTH PLAN COVERAGE

THE QUALITY CARE HEALTH PLAN (QCHP)

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Management (DM) Program

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HEALTH MAINTENANCE ORGANIZTIONS (HMOs)

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OPEN ACCESS PLANS (OAPs)

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Section 4. DENTAL PLAN COVERAGE The State may offer a managed care dental plan during the term of this Agreement.

Quality Care Dental Plan (QCDP)

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Section 5. VISION PLAN COVERAGE A vision benefit shall be made available to all members and dependents enrolled in a health plan offered pursuant to the State Employees Group Insurance Act of 1971.

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dependent co-payment shall not exceed the following:

not exceed the following:

Section 6. DISPUTE RESOLUTION The Parties to this Agreement shall negotiate over the terms of an appeals process that is in conformance with the Affordable Care Act.

Section 7. JOINT LABOR/MANAGEMENT ADVISORY

COMMITTEE ON HEALTHCARE BENEFITS

The Joint Labor/ Management Advisory Committee (JLMAC) on health care benefits shall provide for the development and introduction of value-based benefit design changes for all health plans, with the goal of improving the health of the covered population.

The State agrees to provide a funded position(s) and to budget appropriately to carry out the initiatives of the Committee. The parties will explore the feasibility of jointly determining potential candidates for such position.

The Committee will be composed of an even number of members, half selected by the State and half selected by AFSCME.

The Committee shall:

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Section 8. WELLNESS

Section 9. TERM LIFE INSURANCE The State shall provide basic term life insurance equal to 100% of the employee’s salary, at premiums to be paid by the State, unless the employee is on a leave of absence as enumerated in the State of Illinois Benefits Handbook.

Employees may purchase, subject to medical underwriting requirements of the Life Insurance Administrator, up to eight (8) times their annual salary for optional (member paid) term life insurance and $10,000.00 in term life

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Section 10. COMMUNICABLE DISEASES Department of Children and Family Services (DCFS) employees shall have access to TB (tuberculosis) testing and hepatitis B vaccine at no cost to the employee. employee.

The method for administration of this benefit shall be determined jointly by the Department of Central Management Services (DCMS) and DCFS.

Section 11. LAID OFF AND FURLOUGHED EMPLOYEES

Section 12. COMMUTER SAVINGS BENEFIT PROGRAM The employer shall provide a pre-tax payroll deduction program for transportation expenses in accordance with and to the extent permitted by the Transportation Equity Act for the 21st Century (TEA-21).

Section 13. PAID LEAVE FOR ORGAN TRANSPLANT DONOR The employer shall grant up to six (6) weeks of leave with pay for living donors of organs including, but not limited to, kidneys, bone marrow, or any other organ that may be transplanted.

Section 14. HEARING BENEFITS The Employer shall provide benefits for hearing exams and hearing aids, up to a maximum of $150.00 for audiologist fee(s) and up to a maximum of $600.00 for hearing aid(s), limited to once every three years.

Section 15. SAME SEX DOMESTIC PARTNERS A domestic partner of the same sex, enrolled prior to June 11, 2011, shall be considered eligible for coverage under the health, dental and vision plans. The State shall require reasonable proof of the domestic partnership.

For purposes of this Section, a domestic partner is defined as an unrelated person of the same sex who has resided in the employee’s household and has had a financial and motional interdependence with the employee, consistent with that of a married couple for a period of not less than one (1) year, and continues to maintain such arrangement consistent with that of a married

[288] couple. The benefit shall be administered in accordance with all applicable state and federal laws. The parties recognize and agree that persons who have entered into a civil union in accordance with the Illinois Religious Freedom and Civil Union Act, 750 ILCS 75/1 et seq. (PA 096-1513) and the children of those who have entered into such a civil union shall be entitled to coverage under the health, dental and vision plans as well as to other benefits conferred by the Act. In the event the Illinois Religious Freedom and Civil Union Act, 750 ILCS 75/1 et seq. (PA 096-1513) is repealed or otherwise rendered invalid, the civil union partner and children who were eligible to receive and who were receiving health, dental and/or vision benefits at the effective date of the repeal or invalidity shall continue to receive such benefits and coverages, and the limiting enrollment date of June 1, 2011, shall be null and void and the provisions of this section of Appendix A shall be made applicable to all same sex domestic partners who meet the definition of domestic partner contained herein.

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Appendix B

Section 1. SUMMARY OF BENEFITS The State shall maintain a program of group health benefits in which eligible annuitants of SERS and TRS may participate. For purposes of this section, annuitant includes retired employee, annuitant and survivor.

Specific benefits, including those benefits outside of the basic program of group health benefits, as well as relevant plan design elements, are as outlined in Appendix A.

Nothing contained in this Appendix or in this Agreement prohibits the Director of CMS from establishing or accessing Medicare Advantage program of health benefits specifically designed for Medicare-eligible annuitants.

Such program of health benefits may differ from that outlined in Appendix A as long as the benefits and design, including participant responsibility for out-of-pocket costs and provider networks are at least comparable to those benefits provided through the State’s supplementary Medicare program. For a Medicare eligible annuitant with covered dependents, the dependents must be covered by Medicare in order for the annuitant to participate in Medicare Advantage. The Joint Labor Management Advisory Committee shall work to ensure a smooth transition to a Medicare Advantage Program that conforms to the collective bargaining agreement, including this Appendix. The State will, to the extent practicable, permit separate plan enrollment for members and dependents for Medicare primary annuitants.

Section 2. CONTRIBUTION AMOUNTS

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Section 3. CERTIFICATION OF PREMIUM

Section 4. NON-MEDICARE OPT-OUT Non-Medicare Retirees with twenty (20) years of creditable service who provide proof of other comprehensive medical coverage will be allowed to Opt Out of the health, dental and vision coverage provided by the State of Illinois Insurance Program and receive a financial incentive payment of $500 per month. In addition, the Employer may establish a prorated incentive for retirees with fewer than twenty (20) years of creditable service.

To qualify for this Financial Incentive Program, a retiree must be non- Medicare-eligible and able to provide proof of enrollment in another health benefit plan, either comprehensive major medical or comprehensive managed care, from a source other than one funded through the Illinois Department of Central Management Services (DCMS). If a retiree chooses to opt-out and receive the financial incentive, the retiree cannot enroll as a dependent of a state employee or retired spouse under the State of Illinois Group Insurance Program.

and receive a financial incentive may re-enroll within 60 days of becoming Medicare primary, either due to age or disability. Retirees may also re-enroll during a Benefits Choice Period or within 60 days of experiencing a Qualifying Change in Status, such as divorce, marriage or loss of other coverage.