Generate/ERILOGO1.gif About ERI Disclaimer

Illinois - Compensation & Benefit Legislation

ILLINOIS - AASHOWME

Demonstrates www.BenefitsReview.com™ site. Illustrates insurance carriers' coverages within the State.

 

ILLINOIS - ADOPTED CHILD HEALTH CARE MANDATE

OBRA 1993 (Federal) requires group health plans to honor medical and child support orders. Also, plans must treat adopted children like biological children covered by the plan, and plans are precluded from applying pre-existing condition exclusions to an adopted child where no such exclusion applies to a newborn biological child. Health plans that covered the cost of pediatric vaccines as of May 1, 1993, and fail to continue that level of coverage, will be subject to an excise tax penalty applicable to plans that fail to meet the health care continuation coverage requirements under OBRA 1993.

 

If policy covers family members, it must cover newborn and adopted children.

Preventive care for children: No.

 

(Illinois Ann. Stat. ch. 215, paragraphs 5/356(c), 5/356 (h), 5/356(m), 5/357.2, 5/367b, 5/367(5))

 

ILLINOIS - ALCOHOLISM & DRUG ABUSE

Mandatory coverage (alcoholism treatment only).

 

Minimum yearly inpatient coverage: No statutory requirements.

 

Minimum yearly outpatient coverage: No statutory requirements.

 

Minimum lifetime coverage: no statutory requirements.

 

(Illinois Ann. Stat. Ch. 215, paragraph 5/367(7))

 

ILLINOIS - CAFETERIA PLAN TAX LAWS

State income tax, unemployment insurance tax on salary reduction: State Unemployment Insurance law has no specific provision on cafeteria plans, but payments for health and accident and group term life insurance benefits are specifically excluded from wages under state Unemployment Insurance law and may be excluded even when provided through a cafeteria plan. Employee salary reductions for the purchase of group-term life insurance are not taxable.

 

ILLINOIS - CONTINUATION OF COVERAGE CONVERSIONS

Events Triggering Continuation of Coverage:

 

Death: Yes. For spouse under 55, 2 years minimum continuation coverage; for spouse 55 or older, continuation coverage until spouse is eligible for Medicare.

 

Job Termination: Yes, unless employee is convicted of or admits to felony or theft in connection with work; 9 months minimum continuation coverage.

 

Reduction of Hours: No.

 

Divorce or Legal Separation: Yes. For spouse under 55, 2 years minimum continuation coverage; for spouse 55 or older, continuation coverage until spouse is eligible for Medicare.

 

Medicare Eligibility: No.

 

Other Provisions: Termination of insured's membership in the group policy.

 

Early Termination of Continuation of Coverage: Becoming eligible for Medicare; coverage under another group policy; remarriage of former spouse; termination of group policy; failure to exercise conversion right; failure to make timely payment.

 

(Illinois Ann. Stat. ch. 2115, paragraphs 5/367, 5/36e, 5/367.2)

 

ILLINOIS - COORDINATION OF BENEFITS

Requires use of the birthday rule if coordinating benefits (effective March 22, 1988). Based on 1987 National Association of Insurance Commissioner Rules model. (Illinois Admin. Reg. tit. 50 Sections 2009.10 to 2009.60) Includes joint custody and COBRA provisions.

 

ILLINOIS - COST-OF-LIVING

ERI's Relocation Assessor™ is a recommended source for U.S./Canadian cost-of-living data and U.S. Automobile Cost Survey.

 

ILLINOIS - DRUG TESTING AND EMPLOYEE ASSISTANCE BENEFITS

Who is Covered by Statute: An individual performing services for an employer. An employer is any person employing 15 or more employees; any person employing one or more employees, when a complainant alleges civil rights violations due to discrimination; the state or any political subdivision; or any party to a public contract.

 

Applicant Testing: Applicant testing is allowed but not encouraged, prohibited, or restricted.

 

How Test Results are Used: Results can be used to remove persons from safety-sensitive duties.

 

Enforcement of Statutes: State has no statutory requirements.

 

Employee Remedies: State has no statutory requirements.

 

Employer Remedies: State has no statutory requirements.

 

Who Pays for Testing: State has no statutory requirements.

 

Employee Assistance Benefits: State has no statutory requirements.

 

Other Requirements: State has no statutory requirements.

 

(755 Illinois Comp. Stat. Ann. 5/2-101, 5/2-104.)

 

ILLINOIS - GROUP HEALTH CODE ADDITIONS (MANDATED)

Adopted Children: Accident and health policies providing family coverage must cover children adopted or placed for adoption or placed for adoption with the insured as described (215 Illinois Code Section 5/36h.)

 

Alcoholism Treatment: Group accident and health policies covering inpatient hospital care for sicknesses cannot exclude treatment for alcoholism. (215 Illinois Code Section 5/367(7).)

 

Blood Products: Group hospital policies must cover cost of processing and administering blood and its components. (215 Illinois Code Section 5/367(6).)

 

Breast Reconstruction and Prostheses: Accident and health policies covering surgical expenses for mastectomy must cover such costs. (215 Illinois Code Section 5/356g(b).)

 

Coverage Continuation and Conversion: Group accident and health policies must provide continuation and conversion rights for the insured and dependents upon termination of employment or membership by the insured under certain conditions. Continuation and conversion rights must be provided to spouses and dissolution of marriage, retirement, or death of the insured. (215 Illinois Code Sections 5/367e, 5/367.2, 5/356d.)

 

DES: Accident and health policies may not deny, cancel, or limit coverage solely because the mother of an insured took diethylstibestrol (DES). (215 Illinois Code Section 5/356f.)

 

Genetic Information: Results of genetic testing are confidential and may be released only to the tested individual and to persons who have written authorization to obtain such information. (H8, 1997) (215 Illinois Code Section 5/356t.)

 

Handicapped Dependents: Accident and health policies cannot terminate coverage for a dependent child while such a dependent is incapable of employment due to mental retardation or physical handicap and chiefly dependent on the insured. (Illinois Code Sections 5/356b, 5/367b.)

 

Infertility Coverage: Group policies of accident and health insurance providing coverage for more than 25 employees that provide pregnancy related benefits must contain coverage for the diagnosis and treatment of infertility. (215 Illinois Code Section 5/356m.)

 

Mammography Screening: Group policies, including HMOs, must provide coverage for screening by low dose mammography for detection of occult breast cancer. Coverage must include baseline mammograms for women 35 to 39 years of age and annual mammograms for women 40 years of age and over. (H1881, 1997) (215 Illinois Code Section 5/356g.)

 

Mastectomy: Health care insurers with provide benefits for mastectomy also must cover for prosthetic devices and for reconstructive surgery following a mastectomy in which no evidence of malignancy is found. Post Mastectomy Care: Group policies which provide surgical coverage must provide inpatient hospitalization coverage following mastectomies for a duration of time determined by an attending physician. (H1881, 1997) (215 Illinois Code Section 5/356g.)

 

Maternity: Health care providers (including HMOs) which cover maternity care also must provide benefits for inpatient hospital care for a mother and her newborn child for a minimum of 48 hours after a vaginal delivery and for a minimum of 96 hours after a Caesarean section. A mother an newborn child may be allowed an earlier discharge from a hospital if approved by an attending physician, and, in such cases, a newborn child must be monitored within 48 hours after discharge by a visit to a physician's office or by an in home visit from a nurse (H2557, 1996) (215 Illinois Code Section 5/356r.)

 

Mental Health: Insurers must offer applicants for group accident and health policies coverage for mental, emotional and nervous disorders or conditions; 50 percent co-payment with benefit limit the lesser of $10,000 or 25 percent of the lifetime policy limit. (215 Illinois Code Section 5/370c.)

 

Newborns: Accident and health policies providing family coverage must provide benefits for newborns from the moment of birth for illness, injury, congenital defects, birth abnormalities, and prematurity (215 Illinois Code Section 5/356c.)

 

Organ Transplant Procedures: Accident and health policies must reimburse for otherwise covered expense incurred for organ transplant procedure unless the National Institute of Health (NIH) deem the procedure experimental or investigational. (215 Illinois Code Sections 356c, 367(13).)

 

Pap Smears: Group policies which provide coverage for hospital and medical treatments or services must provide females with coverage for annual cervical smears or pap tests. (H1881, 1997) (215 Illinois Code Section 5/356b.)

 

Policies for Small Employers: Policies for employers with not more than 25 employees should cover breast reconstruction and prostheses, mammography screening, newborns, and adopted children. (215 Illinois Code Sections 5/356B to 5/356B.)

 

Pre-existing Conditions: Under pre-existing conditions provisions, health insurers may exclude coverage for conditions occurring during the first 6 months following an effective date of coverage; an exclusion is acceptable if coverage in such manner as would cause an ordinarily prudent person to seek diagnosis, care or treatment or medical advice, care of treatment was recommended or if medical advice, care or treatment was recommended or received during such time. (H1881, 1997) (215 Illinois Code Section 5/1308.)

 

Prostate Cancer Screening: Group policies which provide coverage for hospital and medical treatments or services must provide men with coverage for annual digital rectal examinations and for prostate specific antigen tests upon recommendation by a physician. Prostate cancer screening must be covered for symptomatic men age 50 and over and for those 40 and over who are African-American or who have a family history of prostate cancer. (H1881, 1997) (215 Illinois Code Section 3/356b.)

 

Providers: Optometrists, Podiatrists: Accident and health policies must cover costs if the provider is licensed, the service is within the providers' scope of services, and the service is covered by the policy. (Illinois Rev. Stat. ch. 73, parka. 976.1, 356b.) Psychiatric and rehabilitation hospitals: Accident and health policies may not deny claims for treatment or services for mental illness or rehabilitation following physical or mental illness rendered in a hospital solely because the hospital lacks surgical facilities. (215 Illinois Code Sections 5/356c, 5/356d.)

 

Sexual Assault or Abuse Treatment: Accident and health policies covering routine physical exams must cover costs of examining and testing victims of criminal sexual assault or abuse. (215 Illinois Code Section 5/367e.)

 

ILLINOIS - GROUP HEALTH FOR SMALL EMPLOYERS

For insurance plans offered to small employers:

 

ILLINOIS - GROUP LIFE CODE ADDITIONS

Employer required to pay part of premium: No.

 

Percent of employees who must elect coverage (if employees pay part of premium): No statutory requirements.

 

Percent of employees who must be covered if employer pays all of premium: 100%.

 

Minimum number of employees in group plan: No statutory requirements.

 

Employer prohibited as beneficiary: Yes.

 

Grace period (days): 31.

 

Mandatory conversion: Yes.

 

Other provisions: None.

 

(Illinois Ann. Stat. ch. 215 paragraphs 5/230.1, 5/231.1)

 

ILLINOIS - HOLIDAYS

January 1, Washington's Birthday (or 3rd Monday in February), Memorial Day (or last Monday in May), July 4, Labor Day (or 1st Monday in September), Veterans Day, and December 25 are state holidays in all 50 states and in the District of Columbia. Other holidays under State law include: Martin Luther King's birthday (or 3rd Monday in January), Lincoln's Birthday, Columbus Day (or 2nd Monday in October), Thanksgiving. Other: Days Proclaimed by the Governor as legal holidays. (Illinois Comp. Stat. Ann. Ch. 5, Sections 490/10 through 490/95)

 

ILLINOIS - IMMIGRATION (PREVAILING WAGE POLICY)

See U.S. Federal General Administrative Letter 1-2000

 

ILLINOIS - JURY DUTY & WITNESS TIME OFF

Employer Restriction For Discharging Employee For Taking Leave For Jury Service: Yes.

 

Remedies and Penalties: Violator may be charged with civil and criminal contempt of court and will be liable for damages, lost wages, reinstatement and reasonable attorney fees.

 

Other Requirements: Employee must give employer reasonable notice by delivering copy of summons within 10 days of date it was issued. Paid jury service is not required. (Illinois Ann. Stat. ch. 705, par. 305/4.1.)

 

Employer Restriction For Discharging Employee For Taking Leave to be a Witness: State reports no statutory requirements.

 

Remedies and Penalties: No, but witnesses to violent crimes have right to be provided with appropriate employment intercession services to ensure employers will cooperate with criminal justice system to minimize employee's loss of pay/absence from work.

 

Other Requirements: None reported.

 

ILLINOIS - LEAVES OF ABSENCE

Employers Subject to Leave Laws: Employers with at least 50 employees.

 

Criteria for Eligibility: Must be employed for at least 6 months and work an average number of hours per week equal to at least one half of the full time equivalent position.

 

Maximum length of leave: 8 hours during any school year.

 

Paid Leave: State does not require paid leave.

 

Acceptable Reasons for Leave: Child's school conferences and school activities.

 

Employment Guarantees After Leave: Not applicable.

 

Use of Vacation or other Time-off Benefits: Employee must first use other leave benefits, except for sick and disability leave benefits.

 

Certification Required: Employer may require documentation of school conference or activity.

 

Effect Of Leave on Other Benefits: Employee may not lose benefits for exercising right to take leave.

 

Effect of Seniority Accrual During Leave: Not applicable.

 

Minimum Requirements for Notification to Employer: Written notification at least 7 days in advance is required; except in emergencies.

 

Conditions for Denial of a Request For Leave: Request may be denied if the leave would result in 75% of work force or a shift taking leave at the same time. (Illinois Ann Stat. Ch. 820 Sections 147/10, 147/15, 147/30, 147/40.)

 

See U.S. Federal Family and Medical Leave Act

 

ILLINOIS - LONG TERM DISABILITY CODE ADDITIONS

State does not require employer to provide long term disability benefits; although many employers do in order to remain competitive in hiring/retention of employees.

 

See LEAVES OF ABSENCE (above), WORKERS' COMPENSATION (below) and U.S. Federal Americans With Disabilities Act

 

ILLINOIS - MANDATED PROVIDERS

Optometrists, psychologists, podiatrists, and social workers. If drug/alcohol abuse is covered, persons licensed by the State Department of Human Services to provide treatment for substance abuse must be covered. (Illinois Ann. Stat. Ch. 215, paragraph 5/364.1, 5/367d.1, 5/370b, 5/370c)

 

ILLINOIS - MENTAL HEALTH CARE

Employee option.

 

Minimum yearly inpatient coverage: Lesser of $10,000 for inpatient and outpatient combined or 25% of lifetime policy limits.

 

Minimum yearly outpatient coverage: Lesser of $10,000 for inpatient and outpatient combined or 25% of lifetime policy limits.

 

Minimum lifetime coverage: No less than lifetime maximum for physical illness. (Illinois Ann. Stat. ch. 215 paragraph 5/370C)

 

ILLINOIS - MINIMUM WAGE

Refer to the Federal minimum wage: $5.15 per hour (effective September 1, 1997).

 

Exemptions: Certain agriculture workers, domestics, outside sales, students, and apprentices (sub-minimum wage no less than 70% of minimum wage). Handicapped workers in special environments may be exempt by special license. (Illinois Comp. Stat. Ann. Ch. 820, Sections 105/2-105/6)

 

See U.S. Minimum Wage

 

ILLINOIS - NEW HIRE REPORTING

Who is required to report: All employers.

 

Who must be reported: All employees.

 

Exempt from reporting: No exemptions.

 

Form(s) to file: State form, W-4, or employer’s form if it contains all required information. May be submitted by mail, electronically, or magnetically.

 

Filing deadline: Within 20 days of hire.

 

Employer information to be included: Employer’s name, address, EIN and address to which child support orders should be sent if different from employer’s address.

 

Employee information to be included: Name, address, SSN, and date of hire.

 

Penalty for failure to report: Late fee of $15. Failure to report fee of $15; $500 if failure to report was intentional.

 

(Senate Bill 1024)

 

ILLINOIS - NEWBORN CARE MANDATE

If policy covers family members, it must cover newborn and adopted children.

 

Preventive care for children: No.

 

(Illinois Ann. Stat. ch. 215, paragraphs 5/356(c), 5/356 (h), 5/356(m), 5/357.2, 5/367b, 5/367(5))

 

ILLINOIS - PARENTAL LEAVE

See U.S. Federal Family and Medical Leave Act

 

ILLINOIS - PRE-EXISTING CONDITIONS

State reports no statutory requirements.

 

See U.S. Federal Health Insurance Portability & Accountability Act

 

ILLINOIS - PROTECTED CLASSIFICATIONS

Age:   Yes, age 40 and over.

Race:   Yes.

Color:  Yes.

National Origin:  Yes.

Ancestry:   Yes.

Religion:   Yes.

Sex:  Yes.

Pregnancy: No specific law. State has expressed policy against discrimination.

Sexual Harassment: Yes.

 

(775 ILCS Sections 5/1-101 et seq., 5/2-101 et seq.)

 

ILLINOIS - SALARY SURVEY

ERI's Relocation Assessor™ is a recommended source for U.S./Canadian wages & salaries (covering 3,000 positions).

 

ILLINOIS - SHORT TERM DISABILITY CODE ADDITIONS

State does not require employer or employee participation in short term disability plans.

 

ILLINOIS - TERMINATION & SEVERANCE PAY

Date pay is due if employee is discharged: As soon as possible, but not later than next payday.

 

Date due if employee resigns: As soon as possible, but not later than next payday.

 

Wages: Yes.

 

Vacation Pay: Yes.

 

Holiday: No.

 

Sick leave: No.

 

Severance: No.

 

(Illinois Ann. Stat. ch. 820, paragraph 115/5)

 

ILLINOIS - UNEMPLOYMENT TAX

Employer Contributions:

 

 

Voluntary Contribution Provision: No. State reports no statutory requirements.

 

(Illinois Comp. Stat. Ann. 405/1505, 405/1506.1, 405/1801.)

 

ILLINOIS - VACATION PAY

See TERMINATION & SEVERANCE PAY (above)

 

ILLINOIS - VOTING TIME OFF

2 hours. (Illinois Ann. Stat. ch. 10, par. 15/15 - 15.)

 

ILLINOIS - WORKERS' COMPENSATION

Private Employers: Mandatory as to enumerated "extra hazardous" employments (including occupational diseases). Elective as to partners and sole proprietors.

 

Public Employers: Mandatory as to all public employments except members of fire and police departments in cities over 200,000 in population (such firefighters covered to extend of burn-related disfigurement). (Note: Townships may elect coverage to participants in job training or work program.)

 

Exceptions: Certain farm labor, domestics, and persons not in usual course of employer's business; real estate brokers and salespersons paid by commission only.

 

Special Coverage Provisions: Voluntary as to excluded employments. (Note: The law is elective as to private employments of a non-hazardous nature, but it does not abrogate the employer's defenses if the employer does not accept the act, and thus is considered to be voluntary.) Corporate officers of small business may reject coverage. (U.S. Chamber of Commerce, 1994 Analysis of Workers' Compensation Laws.)