CONTRIBUTORY GROUP GENERAL OR BLANKET INSURANCE FOR PERSONS IN THE SERVICE OF COUNTIES, CITIES, TOWNS AND DISTRICTS, AND THEIR DEPENDENTS

M.G.L. pt. Part I, tit. Title IV, ch. c. 32B

in effect

M.G.L. c. 32B, § 1 Purpose of chapter

c. 32B, § 1. Purpose of chapter Section 1. The purpose of this chapter is to provide a plan of group life insurance, group accidental death and dismemberment insurance and group general or blanket hospital, surgical, medical, dental and other health insurance for certain persons in the service of counties, except Worcester county, cities, towns and districts and their dependents.

M.G.L. c. 32B, § 2 Definitions

c. 32B, § 2. Definitions Section 2. As used in this chapter the following words shall, unless the context clearly requires otherwise, have the following meanings:— ''Appropriate public authority'', as to a county, except Worcester county, the county commissioners; as to a city, the mayor; as to a town, the selectmen; as to a district, the governing board of the district and for the purposes of this chapter if a collective bargaining agreement is in place, as to a commonwealth charter school as defined by section 89 of chapter 71, the board of trustees; and as to an education collaborative, as defined by section 4E of chapter 40, the board of directors. ''Commission'', the group insurance commission established by section 3 of chapter 32A. ''Dependent'', an employee's spouse, an employee's unmarried children under 19 years of age and any child 19 years of age or over who is mentally or physically incapable of earning the child's own living; provided, however, that any additional premium which may be required shall be paid for the coverage of such child 19 years of age or over; provided further, that ''dependent'' shall also include an unmarried child 19 years of age or over who is a full-time student in an educational or vocational institution and whose program of education has not been substantially interrupted by full-time gainful employment, excluding service in the armed forces; provided further, that any additional premium which may be required for the coverage of such student shall be paid in full by the employee. The standards for such full-time instruction and the time required to complete such a program of education shall be determined by the appropriate public authority. ''District'', any water, sewer, light, fire, veterans' services or other improvement district or public unit created within 1 or more political subdivisions of the commonwealth to provide public services or conveniences. ''Employee'', any person in the service of a governmental unit or whose services are divided between 2 or more governmental units or between a governmental unit and the commonwealth, and who receives compensation for any such service, whether such person is employed, appointed or elected by popular vote, and any employee of a free public library maintained in a city or town to the support of which that city or town annually contributes not less than one-half of the cost; provided, however, that the duties of such person require not less than 20 hours, regularly, in the service of the governmental unit during the regular work week of permanent or temporary employment; provided further, that no seasonal employee or emergency employees shall be included, except that persons elected by popular vote may be considered eligible employees during the entire term for which they are elected regardless of the number of hours devoted to the service of the governmental unit. A member of a call fire department or other volunteer emergency service agency serving a municipality shall be considered an employee, if approved by vote of the municipal legislative body, and the municipality shall charge such individual 100 per cent of the premium. If an employee's services are divided between governmental units, the employee shall, for the purposes of this chapter, be considered an employee of the governmental unit which pays more than 50 per cent of the employee's salary. But, if no one governmental units pays more than 50 per cent of that employee's salary, the governmental unit paying the largest share of the salary shall consider the employee as its own for membership purposes, and that governmental unit shall contribute 50 per cent of the cost of the premium. If the payment of an employee's salary is equally divided between governmental units, the governmental unit having the largest population shall contribute 50 per cent of the cost of the premium. If an employee's salary is divided in any manner between a governmental unit and the commonwealth, the governmental unit shall contribute 50 per cent of the cost of the premium. An employee eligible for coverage under this chapter shall not be eligible for coverage as an employee under chapter 32A. Teachers and all other public school employees shall be deemed to be employees during the months of July and August under this chapter; provided, however, that employee contributions for such health insurance for those 2 months are deducted from the compensation paid for services rendered during the previous school year. A determination by the appropriate public authority that a person is eligible for participation in the plan of insurance shall be final. Nothing in this paragraph shall apply to Worcester county or its employees. ''Employer'', the governmental unit. ''Governmental unit'', any political subdivision of the commonwealth. ''Health care flexible spending account'', a federally-recognized tax-exempt health benefit program that allows an employee to set aside a portion of earnings to pay for qualified expenses as established in an employer's benefit plan. ''Health care organization'', an organization for the group practice of medicine, with or without hospital or other medical institutional affiliations, which furnishes to the patient a specified or unlimited range of medical, surgical, dental, hospital and other types of health care services. ''Health reimbursement arrangement'', a federally-recognized tax-exempt health benefit program funded solely by an employer to reimburse subscribers for qualified medical expenses. ''Optional Medicare extension'', a program of hospital, surgical, medical, dental and other health insurance for such active employees and their dependents and such retired employees and their dependents, except elderly governmental retirees insured under section 11B, as are eligible or insured under the federal health insurance for the aged act, as may be amended from time to time. ''Political subdivision'', any county, except Worcester county, city, town or district. ''Savings'', for the purposes of sections 21, 22 and 23, shall mean the difference between the total projected premium costs for health insurance benefits provided by a political subdivision with changes made to health insurance benefits under section 22 or 23 for the first 12 months after the implementation of such changes and the total projected premium costs for health insurance benefits provided by that subdivision without such changes for the same 12 month period. ''Subscribers'', employees, retirees, surviving spouses and dependents of the political subdivision and may include employees, retirees, surviving spouses and dependents of a district who previously received health insurance benefits through the political subdivision.

M.G.L. c. 32B, § 2A Traffic supervisors as employees

c. 32B, § 2A. Traffic supervisors as employees Section 2A. In cities and towns which accept the provisions of this section, traffic supervisors shall be considered employees under this chapter, notwithstanding the definition of ''Employee'' in section two.

M.G.L. c. 32B, § 2B Reserve, permanent-intermittent or call firefighters as employees

c. 32B, § 2B. Reserve, permanent-intermittent or call firefighters as employees Section 2B. In governmental units which accept the provisions of this section, reserve, permanent-intermittent or call firefighters shall be considered employees under this chapter, notwithstanding the definition of ''Employee'' in section two, and upon retirement shall be considered retirees under this chapter.

M.G.L. c. 32B, § 3 Purchase of group life, accidental death, etc., insurance policies; reinsurance agreements

c. 32B, § 3. Purchase of group life, accidental death, etc., insurance policies; reinsurance agreements Section 3. Upon acceptance of this chapter as hereinafter provided, the appropriate public authority of the governmental unit shall negotiate with and purchase, on such terms as it deems to be in the best interest of the governmental unit and its employees, from one or more insurance companies, savings banks or non-profit hospital, medical, dental or other, service corporations, a policy or policies of group life and accidental death and dismemberment insurance covering employees, and group general or blanket insurance providing hospital, surgical, medical and dental benefits covering employees and their dependents as provided under section eleven and section eleven A if applicable and shall execute all agreements or contracts pertaining to said policies or any amendments thereto for and on behalf and in the name of such governmental unit. Said policy, or policies, including policies purchased under authority of sections three A and sixteen, shall contain a requirement that the insurance company, savings bank, nonprofit hospital, medical, dental or other service corporations, other intermediary or health care organizations, shall furnish the governmental unit, or its designee, all nonconfidential claims without diagnosis on a form satisfactory to the governmental unit including, but not limited to, computer tape, disc or unlined paper reports. Said insurer may, pursuant to a contract between said insurer and said governmental unit, charge the governmental unit a reasonable fee to cover the costs of providing the nonconfidential claims in the form requested by the governmental unit. Prior to the purchase of said insurance, and execution of all such agreements or contracts within the limits established by said sections, the appropriate public authority shall consult with an advisory committee for the purpose of securing the written recommendations of a majority of the membership of said committee. Said committee shall consist of eight members as follows: seven persons to be duly elected or appointed to membership on such committee by organizations of the employees affected, and one person who shall be a retiree of a governmental unit who shall be duly appointed to membership on said committee by the appropriate public authority. If the appropriate public authority finds that the committee's recommendations in whole or in part cannot be included within the aforementioned agreements or contracts, at the written request of any member of said committee within thirty days from the effective date of the agreements or contracts, the appropriate public authority shall submit to said member, in writing, the reasons for the rejection of any or all of the recommendations and a copy shall be filed with the commission. The appropriate public authority may execute said agreements or contracts for a period not exceeding five years; provided, however, that the portion of the cost of the premium per month to be borne by the governmental unit shall not exceed the estimated monthly cost for which funds have been appropriated for the then current fiscal year. If a town or district having accepted the provisions of section ten accepts any other section of this chapter but fails to appropriate the funds necessary to implement said provisions, the selectmen, in the case of a town, or the prudential committee or district commissioner, in the case of a district, shall certify the cost to the town or district, as the case may be, in carrying out the provisions of this chapter to the board of assessors who shall include the amount so certified in the determination of the tax rate of that year. If a city accepts the provisions of this chapter as provided under section ten and as further provided under sections seven A and nine E, the annual budget shall include sums necessary to implement said provisions. Arrangements may be made with the carrier or carriers issuing such policy or policies purchased under this chapter to reinsure, by reinsurance agreement, under conditions approved by the appropriate public authority, portions of the total amount of such insurance with such other carriers as may elect to participate in such insurance. For the purposes of this chapter, any non-profit hospital service corporation or non-profit medical corporation organized under chapter one hundred and seventy-six A or one hundred and seventy-six B and any dental service corporation organized under chapter one hundred and seventy-six E shall be and is hereby authorized to enter into a reinsurance agreement as herein provided in the same manner as any other insurance company.

M.G.L. c. 32B, § 3A Administrative services contract for payment of claims by political subdivision; claims trust fund; annual audit

c. 32B, § 3A. Administrative services contract for payment of claims by political subdivision; claims trust fund; annual audit Section 3A. A city, town, county, except Worcester county, or other subdivision of the commonwealth, when providing hospital, surgical, medical, dental and other health care coverage as authorized by this chapter, and subject to the adequacy of a claims trust fund as hereinafter described, may, in lieu of or in addition to entering into the insurance policies, agreements, or contracts described in this chapter, enter into an administrative services or other contract with one or more insurance companies, nonprofit hospital, medical or dental service corporations organized under chapter one hundred and seventy-six A, chapter one hundred and seventy-six B, or chapter one hundred and seventy-six E, or with one or more health care organizations, or with one or more third-party administrators or other entities to organize, arrange, or provide for the delivery or payment of health care coverage or services, whereby the funds for the payment of claims of eligible persons, including appropriate service charges of the insurance carrier, third party administrator or other intermediary, shall be furnished by the respective subdivision from the claims trust fund for the payment by such intermediary to the health care vendors or persons entitled to such payment in accordance with the terms and provisions of said contract. Subject to the adequacy of a claims trust fund, as hereinafter described, a city, town, county, except Worcester county, or other subdivision of the commonwealth may itself provide all or a portion of the administrative services authorized by this section without contracting with an insurance company, third party administrator or other intermediary for such services. If deemed by the city, town, county, except Worcester county, or other subdivision to be in the best interests of the subdivision and its active and retired employees and their eligible dependents, the respective subdivision may enter into such service type contracts for a period not to exceed five years. Funds made available by appropriations by the city, town, county except Worcester county, or other subdivision of the commonwealth for purposes of this chapter on the basis of the contributory share of the subdivision as set forth and applicable therein shall, upon authorization by the subdivision, be transferred from said appropriation account by the treasurer and shall be deposited from time to time by the treasurer in a separate fund to be known as the claims trust fund. Notwithstanding the provisions of section fifty-five of chapter forty-four, the treasurer shall be the custodian of said fund and may deposit the proceeds in national banks or invest the proceeds by deposit in savings banks, cooperative banks or trust companies organized under the laws of the commonwealth, or invest the same in such securities as are legal for the investment of funds of savings banks under the laws of the commonwealth or in federal savings and loan associations situated in the commonwealth. Any interest or return of premium or claims advance, excluding dividends applicable to section eight or eight A, shall be added to and become part of the fund. The treasurer shall invest and reinvest as aforesaid such funds to the extent not required for current disbursement as determined by the subdivision. Any interest liability incurred as the result of processing a tax anticipation loan authorized by section four of chapter forty-four, and directly related to the establishment or the continuance of the aforesaid claims trust fund, shall be chargeable to said fund. The treasurer shall take measures that will assure a sufficient balance at all times in said fund to make prompt payment for incurred and unpaid claims and other related liabilities. The subdivision insofar as practicable shall prepare annually or sooner a schedule for the treasurer which shall be an estimate of the amounts of anticipated monthly disbursements to be made from said fund and shall as frequently as necessary authorize disbursements therefrom in accordance with the terms and conditions of the contracts authorized by this section. Where an annual or earlier accounting of administrative service charges, claims paid, and claims incurred and unpaid, under a contract authorized by this section to the subdivision, discloses that payment from the fund has resulted in the contributions of the subdivision and its employees and retirees toward a previously established total monthly premium or rate has been shared on a ratio inconsistent with the share of the contributions as provided from time to time by applicable sections of this chapter, the subdivision shall adjust future contributions toward the total monthly premium or rate to compensate for the inconsistency. Payment to the subdivision by the employees, retirees and surviving spouses of their contribution toward the total monthly premium or rate shall be to the extent and manner as required in the applicable sections of this chapter. Any city, town, county, or other political subdivision of the commonwealth maintaining a claim trust fund under this section shall cause an audit of that fund to be made annually. The audit shall determine whether the accounting for the fund is in accordance with generally accepted accounting principles, including accrual for claims that have been incurred but not paid as of the conclusion of the fiscal year. The audit may be performed as part of the annual audit of the city, town, county, or other political subdivision. The amount of any deficit in a claims trust fund, if not otherwise provided for, shall be raised in the next fiscal year's tax rate for a city or town, or be provided in the next fiscal year's budget for any other political subdivision and credited to the claims trust fund. Nothing in this paragraph shall eliminate the requirement of the preceding paragraph with respect to adjusting the future ratio of monthly premium contributions of the subdivision and its employees and retirees to achieve a previously established ratio or ratios of monthly premium contributions.

M.G.L. c. 32B, § 4 Automatic insurance of employees; election to forego coverage; notice; withdrawal

c. 32B, § 4. Automatic insurance of employees; election to forego coverage; notice; withdrawal Section 4. Each employee shall be automatically insured for at least two thousand dollars of group life insurance and at least two thousand dollars of group accidental death and dismemberment insurance and group general or blanket insurance, providing hospital, surgical, medical, dental and other health insurance benefits provided under said policy or policies, commencing on the date he first becomes eligible or on the effective date of such coverage or coverages, including dependent benefits, whichever last occurs. Notwithstanding the foregoing, a collective bargaining agreement governing the terms and conditions of employment of persons who are employees under this chapter may provide that employees who are covered by a group or nongroup health insurance plan financed without any participation by the employer or by another employee's insurance under a group or nongroup health insurance plan offered by the employer may, at the employee's option, elect to forego coverage under the employer's group or nongroup health insurance plan. Any such collective bargaining agreement shall provide for benefits, monetary or otherwise, in lieu of such coverage for employees who were covered as of July first, nineteen hundred and ninety-two by the employer's group or nongroup health insurance plan pursuant to the provisions of this chapter. For employees whose terms and conditions of employment are not subject to collective bargaining, an employer may exclude from coverage under the employer's group or nongroup health insurance plan any such nonunit employee who, at the employee's option, elects to forego such coverage, upon a determination that such employee is covered by a group or nongroup health insurance plan financed without any participation by the employer or by another employee's insurance under a group or nongroup health insurance plan offered by the employer. The employer may offer nonunit employees who were covered as of July first, nineteen hundred and ninety-two under the employer's group or nongroup health insurance plan, alternative benefits in lieu of such coverage. Any employee electing to forego coverage under the employer's group or nongroup health insurance plan shall, on an appropriate form prescribed by the appropriate public authority, give written notice, in accordance with applicable rules prescribed by the appropriate public authority, to the treasurer of the governmental unit indicating that he is not to be insured for such coverages, including dependent benefits, provided under such policy or policies. If such notice is received before the employee shall have become insured under such policy, he shall not be so insured. Once an employee elects to terminate his insurance by withdrawing, such insurance benefits shall cease to be effective on the date up to which the premium has been paid. The employer shall provide that if an employee who elects withdrawal under the provisions of this section and under the relevant clauses of an applicable collective bargaining agreement, ceases to be covered by a group of nongroup health insurance plan financed without any participation by the employer, or by another employee's insurance under a group or nongroup health insurance plan offered by the employer, such employee shall thereupon be covered by the employer's group or nongroup health insurance plan pursuant to this chapter as of the date he informs the employer in writing of such termination of insurance coverage. Any benefits, monetary or otherwise, paid to such employee in accordance with this section, shall be ratably reduced, and any amounts paid hereunder which are allocable to periods of employment after such insurance coverage by the employer's group or nongroup health insurance plan are reinstated may be recovered by the employer under such terms and such conditions as shall be provided in a collective bargaining agreement, for employees whose terms and conditions of employment are so governed, or as determined by the employer, for employees whose terms and conditions of employment are not subject to collective bargaining. In determining said date, payroll deductions of the employee shall continue to be made until the expiration of fifteen days from the receipt of notice of withdrawal by the treasurer of the governmental unit. In the event an employee is not entitled to receive salary, wages or other compensation for a calendar month but may make direct payment of his required premium contribution, the appropriate public authority or administrator of the insurance plan shall provide for the giving of timely notice to the employee of his right to make payment of the required premium contribution. When an employee insured under this section becomes eligible for health insurance coverage as provided in section eleven C, he may terminate by withdrawal notice, as aforesaid, his hospital, surgical, medical, dental and other health benefits provided herein, and retain his automatic group life insurance and automatic group accidental death and dismemberment insurance, as provided in this section. Every policy, whether original or renewal, shall, in the case of employees who immediately prior to the effective date of such original or new policy were covered by group insurance benefits under this chapter, provide protection by continuing uninterrupted coverage without regard to waiting periods for benefits.

M.G.L. c. 32B, § 5 Amount of employee insurance coverage; schedules of benefits; determination; excess coverage, withholding of premium

c. 32B, § 5. Amount of employee insurance coverage; schedules of benefits; determination; excess coverage, withholding of premium Section 5. The amount of group life insurance on each employee and the amount of group accident death and dismemberment insurance on each employee shall be established by the appropriate public authority and shall be not less than two thousand dollars except that those employees desiring to elect optional coverage in excess of the amount or amounts so established may do so as provided in section eleven A. The schedules of hospital, surgical, medical, dental and other health insurance benefits and the amount to be provided each employee and his dependents shall be determined by the appropriate public authority subject to the amount of the appropriation made available for such purpose, provided, however, that to the extent such schedules exceed the schedule of benefits established under section eleven of this chapter, the premium applicable to such excess coverage shall be withheld from each payment of salary or wages of such employee and the governmental unit shall make no contribution applicable to such excess coverage. As determined by the rules and regulations of the appropriate public authority all insurance coverages authorized by this chapter may be considered as separable for any employee, retired employee or deferred retiree who applies for any part of such coverage.

M.G.L. c. 32B, § 6 Employees to furnish information; certificate or booklet of coverage

c. 32B, § 6. Employees to furnish information; certificate or booklet of coverage Section 6. Each employee to whom this chapter applies shall furnish the treasurer of the governmental unit, in such form as he shall prescribe, such information as is necessary to enroll himself alone, or himself and his dependents, under the policy or policies of insurance. Each employee shall receive a certificate or booklet from the insurance company, savings bank or non-profit hospital, medical, or other service corporation describing the coverage for which the employee has enrolled. The certificate or booklet shall be printed at the expense of such insurance company, savings bank or nonprofit hospital, medical, dental, or other service corporation which has issued the policy or policies of insurance, and shall be approved by the appropriate public authority prior to distribution.

M.G.L. c. 32B, § 7 Premiums; withholding, contribution; direct payment

c. 32B, § 7. Premiums; withholding, contribution; direct payment Section 7. (a) With respect to any period of insurance which is in effect for an active or retired employee and dependent there shall be withheld from each payment of salary, wages, other compensation, pension or retirement allowance, subject to the provisions of section nine A, fifty per cent of the premium for the insurance of the employee and his dependents and the governmental unit shall contribute the remaining fifty per cent of such premium. The governmental unit shall also contribute fifty per cent of any additional premium which may be required for coverage of an employee's dependent child who is nineteen years of age or over and mentally or physically incapable of earning his own living. (b) If an employee is entitled to receive, during a calendar month, salary, wages or other compensation, and the premium has not been withheld from said salary, wages or other compensation, he may continue his insurance in effect by paying directly to the governmental unit the premium which would otherwise have been deducted from his salary or wages and said governmental unit shall contribute the remaining fifty per cent of the cost of the premium. If an employee is not entitled to receive salary, wages or other compensation for a calendar month, for purposes of this chapter, he shall be deemed to have been granted a leave of absence without pay, and shall make payment for the entire cost of his insurance to the governmental unit as aforesaid, and there shall be no contribution by the governmental unit for such employee's insurance. If an employee is not entitled to receive salary, wages or other compensation for any calendar month, due to illness of such employee and not because of illness of his immediate family, for purposes of this chapter he shall be deemed to have been granted sick leave without pay, and subject to the rules and regulations of the appropriate public authority, said employee shall make payment for fifty per cent of the cost of his insurance to the treasurer of the governmental unit, and such governmental unit shall contribute the remaining fifty per cent of said premium. (c) All amounts withheld from an employee's salary, wages or other compensation as provided in paragraph (a) of this section and all amounts paid by an employee as provided in paragraph (b) of this section and all amounts withheld from retired employees as retirement allowances under the provisions of section nineteen A of chapter thirty-two together with the contribution of the governmental unit as provided in paragraph (a) shall be paid by the treasurer of the governmental unit to the carrier or carriers entitled to the premium.

M.G.L. c. 32B, § 7A Contribution and withholding for premiums; subsidiary or additional rate; payments in lieu of withholding; acceptance of section

c. 32B, § 7A. Contribution and withholding for premiums; subsidiary or additional rate; payments in lieu of withholding; acceptance of section Section 7A. A governmental unit which has accepted the provisions of section ten and which accepts the provisions of this section may, as a part of the total monthly cost of contracts of insurance authorized by sections three and eleven C, with contributions as required by section seven, make payment of a subsidiary or additional rate which may be lower or higher than a premium determined by the governmental unit to be paid by the insured, the combination of which shall result in the governmental unit making payment of more, but not less, than fifty per cent of the total monthly cost for such insurance. No governmental unit, however, shall provide different subsidiary or additional rates to any group or class within that unit. (a) With respect to any period of insurance which is in effect for an active or retired employee and dependent, there shall be withheld from each payment of salary, wages, other compensation, pension or retirement allowance, subject to the provisions of section nine E, fifty per cent of a premium for the insurance of the employee and his dependents and the governmental unit shall contribute the remaining fifty per cent of such premium together with any subsidiary or additional rate. The governmental unit shall also contribute fifty per cent of a premium together with any subsidiary or additional rate which may be required of an employee's dependent child who is nineteen years of age or over and mentally or physically incapable of earning his own living. (b) If an active or retired employee is entitled to receive, during a calendar month, salary, wages, other compensation, pension or retirement allowance, and the premium has not been withheld from said salary, wages, other compensation, pension or retirement allowance, he may continue his insurance in effect by paying directly to the governmental unit the premium which would otherwise have been deducted from his salary or pension and said governmental unit shall contribute the remaining fifty per cent of the premium together with any subsidiary or additional rate. If an employee is not entitled to receive salary, wages or other compensation for a calendar month, for purposes of this chapter, he shall be deemed to have been granted a leave of absence without pay, and he shall make payment for the entire cost of his insurance to the governmental unit as aforesaid, and there shall be no contribution by the governmental unit for such employee's insurance. If an employee is not entitled to receive salary, wages or other compensation for any calendar month, due to illness of such employee and not because of illness of his immediate family, for purposes of this section he shall be deemed to have been granted sick leave without pay, and subject to the rules and regulations of the appropriate public authority, said employee shall make payment of fifty per cent of the premium for his insurance to the treasurer of the governmental unit, and such governmental unit shall contribute the remaining fifty per cent of such premium together with any subsidiary or additional rate. (c) All amounts withheld from an employee's salary, wages or other compensation as provided in paragraph (a) of this section and all amounts paid by an employee as provided in paragraph (b) of this section and all amounts withheld from retired employees as retirement allowances under the provisions of section nineteen A of chapter thirty-two together with the contribution of the governmental unit as provided in paragraph (a) shall be paid by the treasurer of the governmental unit to the carrier or carriers entitled to the total premium and subsidiary or additional rate, if any. (d) This section shall take effect in a county, except Worcester county, city, town or district upon its acceptance in the following manner:—In a county by vote of the county commissioners; in a city having a Plan D or Plan E charter by majority vote of its city council; in any other city by vote of its city council, approved by the mayor; in a district, except as hereinafter provided, by vote of the registered voters of the district at a district meeting; in a regional school district by vote of the regional district school committee; in a veterans' services district by vote of the district board; in a welfare district by vote of the district welfare committee; in a health district established under section twenty-seven A of chapter one hundred and eleven by vote of the joint committee; and in a town either by vote of the town or by a majority of affirmative votes cast in answer to the following question which shall be printed upon the official ballot to be used at an election in said town:—''Shall the town, in addition to the payment of fifty per cent of a premium for contributory group life and health insurance for employees in the service of the town and their dependents, pay a subsidiary or additional rate?'' Section seven shall not apply in any governmental unit which accepts the provisions of this section.

M.G.L. c. 32B, § 8 Dividends, refunds and rate credits to inure to benefit of governmental unit

c. 32B, § 8. Dividends, refunds and rate credits to inure to benefit of governmental unit Section 8. Any dividend or other refund or rate credit shall inure to the benefit of the governmental unit or to the governmental units participating under section eleven in proportion to the gross premiums paid by each governmental unit.

M.G.L. c. 32B, § 8A Dividends and refunds; deposit in employees' group insurance trust fund; administrative costs; effective date

c. 32B, § 8A. Dividends and refunds; deposit in employees' group insurance trust fund; administrative costs; effective date Section 8A. In any governmental unit which accepts the provisions of this section, all dividends, their equivalent and other such refunds accepted by the governmental unit from the carrier or carriers as a result of any policy or policies entered into under the authority of this chapter shall be deposited by the treasurer thereof in a separate fund to be known as the employees' group insurance trust fund. Prior to the distribution of all such dividends or refunds, the appropriate public authority shall determine the total administrative cost of all policies of insurance entered into under authority of this chapter for the calendar year preceding the date of receipt of the dividend, and shall notify the treasurer to transfer the amount of said total administrative cost from the said trust fund to the appropriate general revenue accounts of the governmental unit. If the said total administrative cost exceeds the dividend receipts, the entire dividend shall be so transferred; if the dividend receipts exceed the said total administrative cost, the appropriate public authority shall notify the treasurer to transfer to the appropriate revenue accounts that portion of the remaining balance which represents the governmental units' proportionate share of the premium cost of the policy year to which the dividend or refund is attributable. The balance of said dividend remaining in the trust fund shall represent the employees' and retirees' proportionate share of the premium cost. The appropriate public authority at a date deemed practicable shall then authorize the treasurer to expend the remaining balance of the trust fund on behalf of the insured employees and retired employees to reduce the insured employees' and retired employees' share of future premium costs or by a proportionate refund to insured members. The reduction of such costs shall be determined by using the ratio of the dividends received to the insured employees' and retired employees' share of the total premiums which yielded the dividend. In the event two or more governmental units are participating in accordance with section eleven, all dividends or their equivalent or other such refunds shall first be allocated to the respective governmental units in proportion to the gross premiums paid by each governmental unit to the respective carrier or carriers. This section shall take effect in a county, except Worcester county, city, town or district upon its acceptance in the following manner:—In a county by vote of the county commissioners; in a city having a Plan D or Plan E charter by majority vote of its city council; in any other city by vote of its city council, approved by the mayor; in a district by vote of the district at a district meeting; and in a town if a majority of the votes cast in answer to the following question, which shall be printed on the official ballot to be used at an election in said town, is in the affirmative:—''Shall the town distribute to its insured employees, after deducting the town's total administrative cost, the balance of any group insurance dividend which shall be based upon the employees' proportionate share of the total premiums paid for all insurance coverages?'' Section eight shall not apply in any governmental unit which accepts the provisions of this section.

M.G.L. c. 32B, § 9 Policy provisions

c. 32B, § 9. Policy provisions Section 9. The policy or policies of insurance shall provide that upon retirement of an employee, the policy or policies providing at least two thousand dollars of group life insurance and at least two thousand dollars of group accidental death and dismemberment insurance as set forth in section five, except the optional coverage referred to therein, shall be reduced to one thousand dollars of group life insurance, unless the governmental unit has accepted section nine F, and the retired employee shall make payment of the full premium cost, subject to the provisions of section nine A or nine E, whichever may be applicable, of the average group premium as determined by the appropriate public authority for such insurance; and the group general or blanket insurance providing hospital, surgical, medical, dental and other health insurance, as provided under sections four, eleven C, and sixteen as may be applicable, shall be continued and the retired employee shall pay the full premium cost, subject to the provisions of section nine A or section nine E whichever may be applicable of the average group premium as determined by the appropriate public authority for such hospital, surgical, medical, dental and other health insurance. The policy or policies may provide for group life insurance not to exceed one thousand dollars on the lives of retired employees who, up to the effective date of such policy or policies, were insured under a group life policy purchased pursuant to the provisions of clause (44) of section five of chapter forty. Prior to retirement, an insured employee who terminates his services with the governmental unit and who has a right to retire but whose retirement is deferred under any applicable law shall for the purpose of this chapter only be deemed to have been granted a leave of absence without pay and may continue all insurance coverages to which he would have been entitled if he had not terminated his services; provided he files an application therefor with the treasurer of the governmental unit and makes payment for the full premium cost of his insurance with no contribution by the governmental unit notwithstanding the provisions of sections nine A or nine E. The policy or policies shall also provide that upon termination of employment an employee shall be entitled to convert his insurance to an individual type of policy, subject to the provisions of section one hundred and thirty-four of chapter one hundred and seventy-five with respect to life insurance, and subject to the requirements of the appropriate public authority with respect to health insurance coverages provided in this chapter which shall not be less than the minimum hospital, medical, surgical, dental and other health benefits provided in an individual policy regularly issued by the insurance carrier at the time of conversion, except that with respect to the services of a health care organization, the contract made under section sixteen may provide for extension or continuation of coverage in lieu of the right to convert. No employee will be permitted to convert his insurance or extend or continue coverage for services of a health care organization on separation from service more than one time, if such converted or extended insurance would result in a greater amount of insurance than is provided in sections three, five, eleven C or twelve, as the case may be.

M.G.L. c. 32B, § 9A Political subdivision; contribution for insurance premiums of retired employees

c. 32B, § 9A. Political subdivision; contribution for insurance premiums of retired employees Section 9A. A county, except Worcester county, by vote of the county commissioners, a city having a Plan D or a Plan E charter by majority vote of its city council, any other city by vote of its city council, approved by the mayor, a regional school district by vote of the regional district school committee and a district by vote of the district at a district meeting, may provide that it will pay one-half of the amount of the premium to be paid by a retired employee under the first sentence of section 9. A town shall provide for the payment by vote of the town at a town meeting or if a majority of the votes cast in answer to the following question which shall be printed on the official ballot to be used at an election in said town is in the affirmative:— ''Shall the town pay one-half the premium costs payable by a retired employee for group life insurance and for group general or blanket hospital, surgical, medical, dental and other health insurance?''

M.G.L. c. 32B, § 9B Death of employee or retired employee; continuation of insurance coverage by spouse

c. 32B, § 9B. Death of employee or retired employee; continuation of insurance coverage by spouse Section 9B. Upon the death of an employee or a retired employee, his surviving spouse may continue the group general or blanket insurance coverage for himself or his dependents providing hospital, surgical, medical, dental and other health benefits, until the remarriage or death of said surviving spouse; provided, that application for such insurance coverage shall be filed with the appropriate public authority and a method for the payment of premiums shall be determined in accordance with its rules and regulations; and provided, further, that said surviving spouse shall pay the entire cost of such premiums without any contribution by the governmental unit. Said appropriate public authority shall determine the amount of said premium which may be the entire average group premium for hospital, surgical, medical, dental and other health benefits applicable to an employee, an employee and his dependents, or a premium computed on a basis considered by said authority to be equitable in relation to all insured employees and all former employees who have retired and who have continued such coverage.

M.G.L. c. 32B, § 9C Death of fire fighter; continuation of insurance coverage by spouse; contribution by governmental unit; acceptance of provisions

c. 32B, § 9C. Death of fire fighter; continuation of insurance coverage by spouse; contribution by governmental unit; acceptance of provisions Section 9C. Upon the death of an insured employee who was killed, or who died from injuries received, in the performance of his duty as a fire fighter his surviving spouse may continue the group hospital, surgical, medical, dental and other health insurance for herself and her dependents under age nineteen, until the remarriage or death of said surviving spouse; provided that application for such insurance shall be filed with the appropriate public authority and a method for the payment of premiums shall be determined in accordance with its rules and regulations; and provided, further that said surviving spouse shall pay fifty per cent of a premium the amount of which may be changed by the governmental unit from time to time as part of the total cost for such hospital, surgical, medical, dental and other health insurance. The governmental unit shall contribute the remaining fifty per cent of said premium together with payment in full of a subsidiary or additional rate which rate may be lower or higher than the governmental unit's share of the aforesaid premium. This section shall take effect in a county, except Worcester county, city, town or district upon its acceptance in the following manner:—In a county by vote of the county commissioners; in a city having a Plan D or Plan E charter by majority vote of its city council; in any other city by vote of its city council, approved by the mayor; in a district by vote of the registered voters of the district at a district meeting; and in a town by submission for acceptance to the registered voters in the form of the following question which shall be printed upon the official ballot to be used at an election:—''Shall the town pay one half of a premium for group hospital, surgical, medical, dental and other health insurance for the surviving widow and dependents of an insured fire fighter who was killed or who died from injuries received in the performance of his duty, with the survivor paying the remaining one half, and shall the town also pay a subsidiary or additional rate?'' Section nine B shall not apply in any governmental unit which accepts the provisions of this section.

M.G.L. c. 32B, § 9C1/2 Death of call, volunteer, intermittent, part-time or reserve firefighter, emergency medical services provider or police officer; continuation of insurance coverage by spouse and dependents

c. 32B, § 9C1/2. Death of call, volunteer, intermittent, part-time or reserve firefighter, emergency medical services provider or police officer; continuation of insurance coverage by spouse and dependents Section 9C1/2. Upon the death of a call, volunteer, intermittent, part-time or reserve firefighter, emergency medical services provider or police officer who, while in the performance of duties and as a result of an incident, accident or violence, is killed or sustains injuries which are the direct and proximate cause of death, the surviving spouse and dependents, including children under the age of 26, may continue to participate in group hospital, surgical, medical, dental and other health insurance until the remarriage or death of the surviving spouse. Application for such insurance shall be filed with the appropriate public authority and a method for the payment of premiums shall be determined in accordance with its rules and regulations. The surviving spouse shall also file in the office of the city auditor, town accountant or officer having similar duties, a copy of the marriage certificate of the surviving spouse. The municipality shall charge the surviving spouse 100 per cent of the premium for such hospital, surgical, medical, dental and other health insurance. This section shall take effect in a city, town or district upon its acceptance in the following manner: in a city having a Plan D or Plan E charter, by a majority vote of its city council; in any other city, by a vote of the city council and approval by the mayor; in a district, by a vote of the registered voters of the district at a district meeting; and in a town, by a vote of the registered voters at a town meeting.

M.G.L. c. 32B, § 9D Insurance premium payable by surviving spouse; contribution by political subdivisions

c. 32B, § 9D. Insurance premium payable by surviving spouse; contribution by political subdivisions Section 9D. A county, except Worcester county, by vote of the county commissioners; a city having a Plan D or Plan E charter by majority vote of its city council, any other city by vote of its city council, approved by the mayor; a district, except as hereinafter provided, by vote of the registered voters of the district at a district meeting; a regional school district by vote of the regional district school committee; a veterans' services district by vote of the district board; a welfare district by vote of the district welfare committee; a district established under the provisions of section twenty-seven A of chapter one hundred and eleven by vote of the joint committee; may provide that it will pay one-half of the amount of the premium to be paid by the surviving spouse of an insured employee or a retired employee for hospital, surgical, medical, dental and other health insurance continued as provided in section nine B. A town shall provide for such payment either by a vote of the town, or by a majority of affirmative votes cast in answer to the following question which shall be printed upon the official ballot to be used at an election in said town:—''Shall the town pay one-half of the premium costs payable by the surviving spouse of an employee or retired employee for group general, or blanket hospital, surgical, medical, dental or other health insurance?'' Payment of the entire premium by the surviving spouse as required by section nine B shall not apply in any governmental unit which accepts the provisions of this section.

M.G.L. c. 32B, § 9D1/2 Insurance premium payable by surviving spouse; additional contribution by political subdivisions

c. 32B, § 9D1/2. Insurance premium payable by surviving spouse; additional contribution by political subdivisions Section 9D1/2. A county, except Worcester county, by vote of the county commissioners; a city having a Plan D or Plan E charter by majority vote of its city council, any other city by vote of its city council, approved by the mayor; a district, except as hereinafter provided, by vote of the registered voters of the district at a district meeting; a regional school district by vote of the regional district school committee; a veterans' services district by vote of the district board; a welfare district by vote of the district welfare committee; a district established under the provisions of section twenty-seven A of chapter one hundred and eleven by vote of the joint committee; may provide that it will pay in addition to fifty per cent of a stated monthly payment, as described in section nine D, a subsidiary or additional amount, with a correspondingly lesser amount to be paid by the surviving spouse of an insured or retired employee. A town may provide for such payment by vote of the town or if a majority of the votes cast in answer to the following question which shall be printed on the official ballot to be used at an election in said town is in the affirmative:—''Shall the town, in addition to the payment of fifty per cent of premium costs payable by the surviving spouse of an employee or retired employee for group general or blanket hospital, surgical, medical and other health insurance pay an additional or subsidiary rate?'' Section nine D shall not apply in any governmental unit which accepts the provisions of this section.

M.G.L. c. 32B, § 9D3/4 Insurance premium payable by surviving spouse; additional contribution by political subdivisions not accepting provisions of Secs. 9D or 9D1/2

c. 32B, § 9D3/4. Insurance premium payable by surviving spouse; additional contribution by political subdivisions not accepting provisions of Secs. 9D or 9D1/2 Section 9D3/4. A county, except Worcester county, by vote of the county commissioners; a city having a Plan D or Plan E charter by majority vote of its city council, and any other city by vote of its city council, approved by the mayor; a district, except as hereinafter provided, by vote of the registered voters of the district at a district meeting; a regional school district by vote of the regional district school committee; a veterans' services district by vote of the district board; a welfare district by vote of the district welfare committee; a district established under the provisions of section twenty-seven A of chapter one hundred and eleven by vote of the joint committee; may if such county, city or district has not accepted the provisions of sections nine D or nine D1/2, provide that it will pay an amount less than one-half the amount of the premium to be paid by the surviving spouse of an insured employee or a retired employee for hospital, surgical, medical, dental and other health insurance continued as provided in section nine B. A town which has not accepted the provisions of section nine D or nine D1/2 shall provide for such payment either by vote of the town, or by a majority of affirmative votes cast in answer to the following question which shall be printed upon the official ballot to be used at an election in said town: ''Shall the town pay an amount up to one-half of the premium costs payable by the surviving spouse of an employee or retired employee for group general or blanket hospital, surgical, medical, dental or other health insurance?'' Payment of the entire premium by the surviving spouse as required by section nine B shall not apply in any governmental unit which accepts the provisions of this section.

M.G.L. c. 32B, § 9E Subsidiary or additional rate; payment by political subdivisions; premium payment by retired employee; acceptance of section

c. 32B, § 9E. Subsidiary or additional rate; payment by political subdivisions; premium payment by retired employee; acceptance of section Section 9E. A county, except Worcester county, by vote of the county commissioners; a city having a Plan D or Plan E charter by majority vote of its city council; in any other city by vote of its city council, approved by the mayor; a district, except as hereinafter provided, by vote of the registered voters of the district at a district meeting; a regional school district by vote of the regional district school committee; a veterans' services district by vote of the district board; a welfare district by vote of the district welfare committee; a health district established under section twenty-seven A of chapter one hundred and eleven by vote of the joint committee may provide that it will pay in addition to fifty per cent of a stated monthly premium as described in section seven A for contracts of insurance authorized by sections three and eleven C, a subsidiary or additional rate which may be lower or higher than the aforesaid premium and the remaining fifty per cent of said premium is to be paid by a retired employee under the provisions of the first sentence of section nine. A town shall provide for such payment by vote of the town or if a majority of the votes cast in answer to the following question which shall be printed on the official ballot to be used at an election in said town is in the affirmative:—''Shall the town, in addition to the payment of fifty per cent of a premium for contributory group life, hospital, surgical, medical, dental and other health insurance for employees retired from the service of the town, and their dependents, pay a subsidiary or additional rate?'' Section nine A shall not apply in any governmental unit which accepts the provisions of this section. No governmental unit, however, shall provide different subsidiary or additional rates to any group or class within that unit.

M.G.L. c. 32B, § 9F Retired local employees; life, accidental death and dismemberment coverage; acceptance of section

c. 32B, § 9F. Retired local employees; life, accidental death and dismemberment coverage; acceptance of section Section 9F. A county, except Worcester county, by vote of the county commissioners; a city having a Plan D or Plan E charter by majority vote of its city council; in any other city by vote of its city council, approved by the mayor; a district, except as herein provided, by vote of the registered voters of the district at a district meeting; a regional school district by vote of the regional district school committee; a veterans' service district by vote of the district board; a health district established under section twenty-seven A of chapter one hundred and eleven by vote of the joint committee, shall provide that an employee receiving a pension or annuity allowance having retired from the governmental unit may be insured for such greater amount of group life insurance and for such greater amount of group accidental death and dismemberment insurance as determined by the governmental unit, in lieu of the one thousand dollars of group life insurance as provided in section nine. A town shall provide such insurance coverage if approved by vote of the board of selectmen, or by a majority of the votes cast if in the affirmative in answer to the following question which shall be printed on the official ballot: ''Shall the town provide (X) thousand dollars of group life insurance and (X) thousand dollars of accidental death and dismemberment insurance for a retired employee in lieu of one thousand dollars of group life insurance?'' Acceptance of this section as aforesaid by a governmental unit having accepted section eleven E shall hereby authorize the commission to provide such greater amount of group life insurance and of such greater amount of group accidental death and dismemberment insurance, in lieu of one thousand dollars of group life insurance, to retired teachers insured under section twelve of chapter thirty-two A.

M.G.L. c. 32B, § 9G Surviving spouse of police officer killed in line of duty; continuation of group coverage; payment of premiums; acceptance of section

c. 32B, § 9G. Surviving spouse of police officer killed in line of duty; continuation of group coverage; payment of premiums; acceptance of section Section 9G. Upon the death of an insured employee who was killed, or who died from injuries received, in the performance of his duty as a police officer, a surviving spouse may continue the group health and dental insurance for the benefit of such spouse and any dependents under age nineteen, until the remarriage or death of said surviving spouse; provided that application for such insurance shall be filed with the appropriate public authority and a method for the payment of premiums shall be determined in accordance with its rules and regulations; and provided, further, that said surviving spouse shall pay fifty per cent of a premium the amount of which may be changed by the governmental unit from time to time as part of the total cost for such health and dental insurance. The governmental unit shall contribute the remaining fifty per cent of said premium together with payment in full of a subsidiary or additional rate which rate may be lower or higher than the governmental unit's share of the aforesaid premium. This section shall take effect in a county, except Worcester county, city, town or district upon its acceptance in the following manner:—In a county by vote of the county commissioners; in a city having a Plan D or Plan E charter by majority vote of its city council; in any other city by vote of its city council, approved by the mayor; in a district by vote of the registered voters of the district at a district meeting; and in a town by submission for acceptance to the registered voters in the form of the following question which shall be printed upon the official ballot to be used at an election:—''Shall the town pay one half of a premium for group health and dental insurance for the surviving spouse and dependents of an insured police officer who was killed or who died from injuries received in the performance of duty, with the surviving spouse paying the remaining one half, and shall the town also pay a subsidiary or additional rate?'' Section nine B shall not apply in any governmental unit which accepts the provisions of this section.

M.G.L. c. 32B, § 9H Divorced or separated spouses; continuation of group coverage

c. 32B, § 9H. Divorced or separated spouses; continuation of group coverage Section 9H. (a) In the event of the granting of a judgment absolute of divorce or of separate support to which a member or subscriber of a group hospital, surgical, medical, or dental insurance plan, a group nonprofit hospital service contract, a group nonprofit medical service plan or a group health maintenance contract authorized by this chapter is a party, the person who was the spouse of said member or subscriber prior to the issuance of such judgment shall be and remain eligible for benefits under said plan or contract, whether or not said judgment was entered prior to the effective date of said plan or contract, without additional premium or examination therefor, as if said judgment had not been entered; provided, however, that such eligibility shall not be required if said judgment so provides. Such eligibility shall continue through the member's or subscriber's participation in the plan or contract until the remarriage of either the member or subscriber or such spouse, or until such time as provided by said judgment, whichever is earlier. (b) In the event of the remarriage of the group plan member or subscriber referred to in paragraph (a), the former spouse thereafter shall have the right, if so provided in said judgment, to continue to receive benefits as are available to the member or subscriber, by means of the addition of a rider to the family plan or contract or the issuance of an individual plan or contract, either of which may be at additional premium rates determined by the appropriate public authority to be just and reasonable in accordance with the additional insuring risks involved. (c) The name, address, and policy number of a person eligible for health insurance coverage pursuant to paragraph (a) or (b), if available, shall be forwarded by such insurance company, nonprofit hospital service corporation, nonprofit medical service corporation or health maintenance organization whichever is applicable to the department of public welfare within thirty days of the date when coverage of said person under said paragraph (a) or (b) is commenced. (d) Notice of cancellation of coverage of the divorced or separated spouse of a member shall be mailed to such divorced or separated spouse at such person's last known address, together with notice of the right to reinstate coverage retroactively to the date of cancellation. (e) Claims paid on behalf of a divorced or separated spouse or on behalf of a dependent who is not residing with the member shall be paid to the physician, hospital or other provider of covered services or to the person on whose behalf such services were performed, unless the person is a minor child. In the event the person on whose behalf such services were performed is a minor, payment shall be made to the physician, hospital or other provider of such services or to the parent or custodian with whom the child resides.

M.G.L. c. 32B, § 9I Employees on military leave of absence for active service; payment of premiums; acceptance of section

c. 32B, § 9I. Employees on military leave of absence for active service; payment of premiums; acceptance of section Section 9I. A governmental unit which has accepted the provisions of section ten and which accepts the provisions of this section as hereinafter provided, shall consider an employee on a military leave of absence because said employee is a member of the army national guard or air national guard or a reservist in the armed forces of the United States called to active service in the armed forces of the United States, for the purposes of this chapter, to be deemed to have been granted leave without pay, and subject to the rules and regulations of the appropriate public authority, said employee shall make payment of the portion of the total monthly premium or rate that would have otherwise been deducted from his salary, wages or other compensation. For purposes of this section, the term ''active service'' shall not include active duty for training in the army national guard or air national guard or as a reservist in the armed forces of the United States. This section shall take effect in a county, except Worcester county, city, town or district upon its acceptance in the following manner:— in a county by vote of the county commissioners; in a city having a Plan D or Plan E charter by majority vote of its city council; in any other city by vote of its city council, approved by the mayor; in a district, except as hereinafter provided, by vote of the registered voters of the district at a district meeting; in a regional school district by vote of the regional district school committee; in a veterans' services district by vote of the district board; in a health district established under section twenty-seven A of chapter one hundred and eleven by vote of the joint committee; and in a town by vote of the town meeting or town council.

M.G.L. c. 32B, § 10 Acceptance of chapter by county, city, town, municipality or district

c. 32B, § 10. Acceptance of chapter by county, city, town, municipality or district Section 10. This chapter, except sections seven A, eight A, nine A, nine C, nine D, nine E, nine F, eleven A, eleven B, eleven D, eleven E, eleven F and sixteen, may be accepted in a county, except Worcester county, by vote of the county commissioners; in a city having a Plan D or Plan E charter by majority vote of its city council, in any other city by vote of its city council, approved by the mayor, in a municipality having a town council form of government, by vote of the town council, subject to the provisions of the charter of such municipality; in a district, except as hereinafter provided, by vote of the registered voters of the district at a district meeting; in a regional school district by vote of the regional district school committee; in a veterans' services district by vote of the district board; in a welfare district by vote of the district welfare committee; in a health district established under section twenty-seven A of chapter one hundred and eleven by vote of the joint committee; and in a town by submission for acceptance to the registered voters in the form of the following question which shall be printed upon the official ballot to be used at an election:—''Shall certain provisions of chapter thirty-two B of the General Laws, authorizing any county, except Worcester county, city, town or district to provide a plan of contributory group life insurance, group accidental death and dismemberment insurance, and group general or blanket hospital, surgical, medical, dental and other health insurance for certain persons in the service of such county, city, town or district and their dependents, be accepted by this town?'' If a majority of the voters voting on the question shall vote in the affirmative, this chapter, except sections seven A, eight A, nine A, nine C, nine D, nine E, nine F, eleven A, eleven B, eleven D, eleven E, eleven F and sixteen, shall take effect in such town. Notwithstanding the provisions of any general law to the contrary, neither the acceptance of this chapter nor the acceptance of any individual section thereof by a governmental unit shall be revoked or rescinded. This chapter shall not apply to Worcester county nor to its employees, and they shall be eligible for coverage under the provisions of chapter thirty-two A. This action shall be a transferral and not a revocation or rescission.

M.G.L. c. 32B, § 10A Purchase of insurance by public authority following acceptance of chapter

c. 32B, § 10A. Purchase of insurance by public authority following acceptance of chapter Section 10A. The appropriate public authority shall provide for the purchase of insurance, or include the cost thereof, for dental expenses under those sections of this chapter which provide for the purchase of hospital, surgical, medical, dental and other health insurance benefits but only upon the acceptance of this section in the following manner:—in a city having a Plan D or Plan E charter by majority vote of its city council; in any other city by vote of its city council, approved by the mayor; in a district, except as hereinafter provided, by vote of the registered voters of the district at a district meeting; in a regional school district by vote of the regional district school committee; in a veterans' services district by vote of the district board; in a health district established under section twenty-seven A of chapter one hundred and eleven by vote of the joint committee; and in a town by vote of the board of selectmen or, by vote of the town at a town meeting or, by submission for acceptance to the registered voters in the form of the following question which shall be printed upon the official ballot to be used at an election:—''Shall certain provisions of chapter thirty-two B of the General Laws, authorizing any county, except Worcester county, city or town or district to provide dental benefits as part of group general or blanket insurance providing hospital, surgical, medical, and other health insurance benefits for certain persons in the service of such county, town or district and their dependents, be accepted by this town?'' If a majority of the voters voting on the question shall vote in the affirmative, the chapter shall take effect in such town. Any town which is a member of the Cape Cod municipal health group which does not provide dental benefits under this chapter may provide that any general, group or blanket insurance policy it purchases makes dental benefits available to employees at said employees' expense. Notwithstanding the provisions of any general law to the contrary, acceptance of this section shall not be revoked or rescinded. This section shall not apply to Worcester county nor its employees, and they shall be eligible for coverage under the provisions of chapter thirty-two A. This action shall be a transferral and not a revocation or rescission.

M.G.L. c. 32B, § 11 Schedules of insurance benefits; establishment; joint participation; administration

c. 32B, § 11. Schedules of insurance benefits; establishment; joint participation; administration Section 11. The appropriate public authority in each county, except Worcester county, city, town or district which has accepted this chapter shall from time to time issue rules and regulations establishing a schedule of group life, accidental death and dismemberment insurance for each employee and a schedule of hospital, surgical, medical, dental and other health insurance benefits for active and retired employees and their dependents which schedules shall be the maximum schedules of insurance coverage to be made available for active and retired employees and their dependents of the governmental unit. The appropriate public authority in each city, town or district which has accepted this chapter may notify the county commissioners of its election to participate in the schedule of benefits made available by said county, except Worcester county, for its employees; and subject to the approval of said commissioners the employees of the city, town or district so applying will become insured at the earliest practicable date, but in no event later than the commencement of the next policy anniversary date. Such coverage shall be furnished at uniform premium rates to all participating counties, except Worcester county, cities, towns and districts. Two or more counties establishing identical benefit schedules may join under one such policy or policies and may be considered as one governmental unit. The county commissioners may at their discretion establish a central administrative office and employ such personnel as may be necessary to carry out the provisions of this chapter. Notwithstanding any charter or ordinance to the contrary, the appropriate public authority of the cities of Cambridge, Chelsea, Everett, Malden, Medford, Melrose, Quincy, Revere and Somerville may notify the appropriate public authority of the city of Boston of its election to participate in the schedule of benefits made available by the city of Boston for its employees and, subject to the approval of the appropriate public authority of the city of Boston and under such terms and conditions and rules and regulations as may be prescribed from time to time by the appropriate public authority of the city of Boston, the employees of the city so applying shall become insured at the earliest practicable date as participants in a city of Boston group health or life benefit plan. The withdrawal of each individual city's employees from each individual city's group health or life benefit plan and the subsequent inclusion of that city's employees in the city of Boston's group health life benefit plan shall coincide with annual open enrollment periods. Nothing in this paragraph shall prohibit the appropriate public authority of the city of Boston from prohibiting participation by applying cities in certain benefit programs made available by the city of Boston for its employees. Nothing in this paragraph shall prevent a participating city from withdrawing from participation upon reasonable notice provided by the appropriate public authority of the participating city to the appropriate public authority of the city of Boston. A city granted approval to participate in the city of Boston's schedule of benefits that incurs costs by so joining or exiting including, but not limited to, paying for claims which have been incurred but not yet paid may amortize such costs over a period of not more that 10 years from the date of such approval or exit. Nothing in this section shall abrogate any provision of chapter 150E or any collective bargaining agreement with respect to health benefits or impact adversely the rights and benefits of public employees pursuant to any collective bargaining agreement. Upon request, the commission shall furnish information and advisory rulings in accordance with the provisions of section eight of chapter thirty A.

M.G.L. c. 32B, § 11A Additional insurance; application; cancellation; conversion

c. 32B, § 11A. Additional insurance; application; cancellation; conversion Section 11A. Each employee insured for the minimum amounts of group life and group accidental death and dismemberment insurance provided in section 5, subject to such conditions as the appropriate public authority shall approve, may be insured for amounts of group life insurance and group accidental death and dismemberment insurance in addition to the minimum amounts provided for in said section 5 in an amount not greater than $150,000. Such additional insurance shall be issued by the carrier or carriers as determined by the appropriate public authority without regard to a minimum number of eligible employees or to the provisions of chapter one hundred and seventy-five. Each employee entitled to additional insurance under this section shall file an application therefor with the treasurer of the governmental unit on an appropriate form prescribed by said treasurer, except that an employee having such additional insurance who becomes entitled to further additional insurance hereunder by reason of an increase in annual salary shall automatically be insured for the amount of such further additional insurance, to become effective on the first day of the second month following the month in which the increase was authorized, unless the employee notifies the treasurer of the governmental unit in writing on a form prescribed by it that he is not to be so insured; and provided, that such increase in salary has been authorized for a period of time in excess of one year. No reduction in the amount of insurance shall be required on account of a reduction in compensation. For purposes of this additional insurance, yearly gross salary or compensation shall not include any overtime pay and in the case of hourly workers shall be computed on the basis of scheduled required work-hours. With respect to any additional insurance which is in effect for an employee, there shall be withheld from each payment of salary or wages of such employee the premium for such insurance and, notwithstanding the provisions of any collective bargaining agreement to the contrary, the governmental unit shall make no contribution to said premium. If an employee is not entitled to receive salary, wages or other compensation for a calendar month, he shall make payment directly to the treasurer of the governmental unit and, notwithstanding the provisions of any collective bargaining agreement to the contrary, there shall be no contribution by the governmental unit for such payment. An employee insured under this section may by written notice on a form prescribed by the treasurer cancel such insurance, and such insurance shall require no further premium payment the first day of the month following the expiration of fifteen days from the receipt of notice of cancellation. Insurance coverage will therefore terminate at the end of the month for which premium has been paid. If an employee withdraws as provided in section four, such withdrawal shall automatically effect a cessation of the additional insurance under this section as of the date of cessation of his minimum insurance. Upon retirement of an employee eligible for pension allowances under any general or special law, that portion of his additional insurance under this section which is not paid-up shall terminate upon attainment of the age of seventy-five, and he shall be afforded the privilege of converting such term insurance in accordance with the rules and regulations issued under section fourteen. A person who has retired and whose insurance under this section has been terminated may be reinstated for the amount of insurance in force at the time of retirement provided the retiree has not attained the age of seventy-five and provided further that he submits proof of his physical condition satisfactory to the appropriate public authority. The appropriate public authority is hereby authorized to negotiate for and purchase the additional insurance on the basis of group renewable term insurance. This section shall not apply to Worcester county nor to its employees. This section shall take effect in a county, except Worcester county, city, town or district upon its acceptance in the following manner:—In a county, except Worcester county by vote of the county commissioners; in a city having a Plan D or Plan E charter by majority vote of its city council; in any other city by vote of its city council, approved by the mayor; in a district by vote of the district at a district meeting; and in a town if a majority of the votes cast in answer to the following question, which shall be printed on the official ballot to be used at an election in said town, is in the affirmative:—''Shall the town purchase additional group life and group accidental death and dismemberment insurance for employees in accordance with the provisions of chapter thirty-two B of the General Laws with no premium contribution by the town?''

M.G.L. c. 32B, § 11B Insurance for elderly government retirees

c. 32B, § 11B. Insurance for elderly government retirees Section 11B. Any political subdivision, subject to the provisions of section ten B of chapter thirty-two A, shall appropriate funds or apply therefor for the payment of group general or blanket insurance providing hospital, surgical, chiropractic, medical, dental and other health insurance for elderly governmental retirees as defined in paragraph (f) of section two of said chapter thirty-two A, and for the payment of the surcharge or subsidiary rate required to be paid by paragraph (c) of section ten B of chapter thirty-two A if accepted in a county, city, town or district in the following manner:—In a county, by vote of the county commissioners; in a city having a Plan D or Plan E charter by majority vote of its city council; in any other city by vote of its city council, approved by the mayor; in a district by vote of the voters of the district at a district meeting; and in a town by vote of the town or if a majority of the votes cast in answer to the following question, which shall be printed on the official ballot to be used at an election in said town, is in the affirmative:—''Shall the town extend contributory group hospital, surgical, medical, dental and other health insurance to elderly persons retired from the service of the town?''.

M.G.L. c. 32B, § 11C Optional medicare extension

c. 32B, § 11C. Optional medicare extension Section 11C. Upon acceptance of this chapter as provided in section ten, the appropriate public authority of the governmental unit shall negotiate with and purchase on such terms as it deems to be in the best interest of the governmental unit and its active and retired employees and their dependents insured or eligible to be insured under this chapter including the surviving spouse of said employees, who are eligible for coverage under the federal health insurance for the aged act, from one or more insurance companies or nonprofit hospital, medical or other service corporations, a policy or policies of group general or blanket insurance providing hospital, surgical, medical, dental and other health insurance, to be known as optional medicare extension. Said policy or policies shall consist of one or more schedules of benefits which, as determined by the appropriate public authority, may be related to the schedule of benefits purchased under the provisions of sections three and five. Such schedule of benefits may include on behalf of any person insured under this section the payment of any premium which may be required by the federal health insurance for the aged act, to be paid by any enrollee thereof. The claim experience of persons insured for optional medicare extension may, as determined by the appropriate public authority, be maintained apart from, or made a part of, the claim experience applicable to the schedules of benefits provided under sections three and five. The appropriate public authority, after receiving the recommendations if any from the advisory committee as provided in section three, shall execute all agreements or contracts pertaining to said policy or policies or any amendment thereto for a period, not exceeding five years, as it may deem the most advantageous to the governmental unit; provided, however, that the portion of the cost of the premium to be borne by the governmental unit shall not exceed the estimated monthly cost for which funds have been appropriated for the then current fiscal year. Every policy whether original or renewal shall, in the case of all persons insured under this section who immediately prior to the effective date of such original or new policy were covered by group insurance benefits under this chapter, provide protection by continuing uninterrupted coverage without regard to waiting periods for benefits. (a) Each person or his dependent to which this section applies shall furnish the treasurer of the governmental unit or the appropriate retirement authority in such form as he or they may prescribe, such information as is necessary to be insured for optional medicare extension, and shall authorize the withholding of the appropriate premium from salary, wages, other compensation, pension, annuity or retirement allowance. Each person may also authorize the withholding of any premium which may be required by the federal health insurance for the aged act, to be paid by any enrollee thereof, or to make direct payment to the treasurer as he may determine, and he shall transmit all such amounts to the appropriate federal agency on behalf of such enrollee in a manner prescribed by said agency. (b) With respect to any period of insurance authorized by this section which is in effect for an active employee or a retired employee and his dependent, payment for such insurance shall be made as provided in section seven. (c) Upon the death of an active or retired employee insured under this section, the surviving spouse may continue the insurance under this section, or the group hospital, surgical, medical, dental and other health insurance benefits provided under section three, whichever may be applicable, and the duration of such insurance, the determination and the amount of premium to be paid will be in accordance with section nine B. (d) If it is determined by the appropriate public authority to be in the best interests of the governmental unit and its active and retired employees and dependents eligible for optional medicare extension under this section that the optional medicare extension program administered by the commission under section ten C of chapter thirty-two A would be less costly to the governmental unit and the employees as well as being administratively advantageous to the governmental unit, the appropriate public authority may make application to the commission in accordance with the procedure the commission may establish and upon approval by the commission the employees of the governmental unit shall become so insured. (e) The medicare extension coverage permitted by this section shall be mandatory, rather than optional, for any governmental unit that accepts section eighteen.

M.G.L. c. 32B, § 11D Accidental insurance for policemen and firefighters; payment of portion of premiums by municipalities

c. 32B, § 11D. Accidental insurance for policemen and firefighters; payment of portion of premiums by municipalities Section 11D. Upon acceptance of this section as hereinafter provided, the appropriate public authority of the governmental unit shall negotiate with insurance companies or savings banks and purchase on such terms as it deems to be in the best interest of the governmental unit and those persons employed as police officers and firefighters and defined as employees in section two a policy or policies of group accidental death insurance payable on behalf of a police officer or firefighter who dies as the natural and proximate result of a bodily injury accidentally sustained or a hazard undergone as a result of and while in the performance of his official duties as an employee of the governmental unit and not as an employee of a private organization, at some definite place and at some definite time on and after the date of his becoming insured hereunder, and without serious and wilful misconduct on his part. The appropriate public authority shall incorporate this accidental death insurance as an integral part of the coverage provided under section eleven A, or, provide a policy of accidental death insurance for said employees with the claim experience and retention costs maintained unrelated to the claim experience and retention costs applicable to any policy or policies of group life and accidental death and dismemberment insurance in effect as provided under said section eleven A, but, in either event, the aforementioned employees shall be insured for group accidental death insurance authorized by this section for twice the maximum amount to which the policeman or fireman would be entitled if insured for the maximum amount of group accidental death and dismemberment insurance provided under section eleven A whether or not said employee is insured for such maximum amount under said section eleven A. Such accidental death insurance shall be issued by the carrier or carriers as determined by the appropriate public authority for a period not exceeding five years, and such insurance shall be issued without regard to a minimum number of eligible policemen or firemen or to the provisions of chapter one hundred and seventy-five. Each policeman and fireman entitled to be insured under this section shall file an application therefor with the treasurer of the governmental unit on an appropriate form prescribed by said treasurer, except that a policeman or fireman having such accidental death insurance who becomes entitled to further accidental death insurance hereunder by reason of an increase in annual salary shall automatically be insured for the amount of such further accidental death insurance to become effective on the first day of the second month following the month in which the increase was granted provided that such increase in salary has been authorized for a period of time in excess of one year. No reduction in the amount of accidental death insurance shall be required on account of a reduction in salary or compensation. For purposes of this accidental death insurance, yearly gross salary or compensation shall not include any overtime pay. With respect to any accidental death insurance which is in effect for a policeman or fireman there shall be withheld from each payment of salary, wages or compensation fifty per cent of a premium the amount of which may be changed by the governmental unit from time to time as part of the total cost for such accidental death insurance. The governmental unit shall contribute the remaining fifty per cent of said premium together with payment in full of a subsidiary or additional rate which rate may be lower or higher than the governmental unit's share of the aforesaid premium. If a policeman or fireman is not entitled to receive salary, wages or other compensation for a calendar or premium month while in the status of leave of absence without pay, he shall make payment directly to the treasurer of the governmental unit and there shall be no contribution by the governmental unit for such payment. A policeman or fireman insured under this section may by written notice on a form provided by the treasurer cancel such accidental death insurance and such insurance shall require no further premium payment the first day of the premium month following the expiration of fifteen days from the receipt of notice of cancellation. Accidental death insurance coverage will therefore terminate at the end of the month for which premium has been paid. Upon retirement of a policeman or fireman eligible for pension allowances under any general or special law the accidental death insurance provided under this section shall terminate. Any dividend or refund applicable to the accidental death insurance provided under this section shall be paid by the insurance carrier or carriers to the governmental unit and shall then be distributed in accordance with the provisions of section eight or eight A whichever may be applicable. The appropriate public authorities of two or more governmental units, irrespective of the county, may join together in negotiating and purchasing one or more policies of accidental death insurance as prescribed in section twelve. This section shall take effect in a county, except Worcester county, city, town or district upon its acceptance in the following manner:—In a county, except Worcester county by vote of the county commissioners; in a city having a Plan D or Plan E charter by a majority vote of its city council; in any other city by vote of its city council, approved by the mayor; in a district by vote of the governing board of the district; and in a town by submission for acceptance to the registered voters in the form of the following question which shall be printed upon the official ballot to be used at an election:—''Shall the town pay one half of a premium for group accidental death insurance for policemen and firemen who are killed or who die from accidental injuries received in the performance of their duties with such employee paying the remaining one half, and shall the town also pay a subsidiary or additional rate?''

M.G.L. c. 32B, § 11E Life and health insurance for retired teachers; appropriation of funds authorized; acceptance of section by political subdivisions

c. 32B, § 11E. Life and health insurance for retired teachers; appropriation of funds authorized; acceptance of section by political subdivisions Section 11E. Upon acceptance of this section as hereinafter provided, any political subdivision, subject to the provisions of section twelve of chapter thirty-two A, shall appropriate funds or apply therefor for the payment of certain costs for group life and health insurance coverages for teachers retired from the service of the political subdivision, and for health insurance coverages for their surviving spouses and dependents provided such teachers receive a pension or annuity allowance from the teachers' retirement system, and for the payment of premiums, subsidiary or additional rates and administrative expenses required to be paid by paragraph (d) of section twelve of chapter thirty-two A. This section shall take effect in a county, except Worcester county, city, town or district upon its acceptance in the following manner:—in a county, except Worcester county, by vote of the county commissioners; in a city having a Plan D or Plan E charter by majority vote of its city council, in any other city by vote of its city council, approved by the mayor; in a district, except as hereinafter provided, by vote of the registered voters of the district at a district meeting; in a regional school district by vote of the regional district school committee; and in a town either by vote of the board of selectmen or by a majority of affirmative votes cast in answer to the following question which shall be printed upon the official ballot to be used at an election in said town:—''Shall the town authorize all teachers insured for group life and health insurance, and their dependents, upon receiving a pension or annuity allowance from the teachers' retirement system, to have such insurance transferred to the state for convenience of premium withholdings, with the town making payment of fifty per cent of the premium, a portion of the administrative expense and the payment of a subsidiary or additional rate to be paid by the town?'' A political subdivision that has accepted this section and whose application has been approved by the commission as provided in section thirteen of chapter thirty-two A may thereafter terminate its acceptance of this section. Any political subdivision, before voting to terminate its acceptance of this section, shall notify the commission of its intent to submit such termination to a vote, and shall provide for a public hearing for the purpose of informing affected retired teachers and the public. All such affected retired teachers shall be notified at least thirty days prior to such public hearing. After such public hearing, a vote shall be taken of affected retired teachers in attendance. A simple majority shall determine the will of such majority. Such termination shall take effect by a vote obtained in the same manner as that required for an acceptance of this section except as heretofore mentioned. Such political subdivision shall thereafter furnish notice of termination to the commission.

M.G.L. c. 32B, § 11F Disability income insurance for nonoccupational injury or disease; premiums; cancellation; dividends or refunds; acceptance of this section

c. 32B, § 11F. Disability income insurance for nonoccupational injury or disease; premiums; cancellation; dividends or refunds; acceptance of this section Section 11F. Upon acceptance of this section as hereinafter provided, the appropriate public authority of the governmental unit shall negotiate with one or more insurance companies and purchase on such terms as it deems to be in the best interest of the governmental unit and its employees a policy or policies of group disability income insurance covering nonoccupational injury or disease. Such insurance shall be issued in accordance with the eligibility requirements as provided in chapter one hundred and seventy-five. The appropriate public authority shall incorporate this disability income insurance as an integral part of the group life and accidental death and dismemberment insurance provided under section five or eleven A with the claim experience and retention costs combined, or the claims experience and retention costs of said disability income insurance may be maintained separately from the claims experience and retention costs of the group life and accidental death and dismemberment insurance provided under sections five and eleven A. The appropriate public authority may execute policies or contracts for said disability income insurance for a period not exceeding five years; provided, however, that the portion of the cost of the premium per month to be borne by the governmental unit shall not exceed the estimated monthly cost for which funds have been appropriated for the then current fiscal year. A copy of said policies or contracts shall be filed with the commission no later than thirty days after their effective date and the commission shall in its discretion include pertinent data regarding such insurance in its annual report. Each employee entitled to be insured under this section shall file an application therefor with the treasurer of the governmental unit on a form prescribed by said treasurer. Such application shall be the property of the governmental unit. With respect to any disability income insurance which is in effect for an employee there shall be withheld from payment of salary, wages or other compensation fifty per cent of a total monthly premium or rate and the governmental unit shall contribute the remaining fifty per cent. If an employee is not entitled to receive salary, wages or other compensation for a calendar or premium month while in the status of a leave of absence without pay and not because of sickness or injury, he shall make payment directly to the treasurer of the governmental unit and there shall be no contribution by the governmental unit for such payment. If an employee is entitled to receive, during a calendar month, salary, wages or other compensation, and the premium has not been withheld from said salary, wages or other compensation, he may continue his insurance in effect by paying directly to the governmental unit, which would otherwise have been deducted from his salary or wages, and said governmental unit shall contribute the remaining fifty per cent of the cost of the monthly premium. If an employee is not entitled to receive salary, wages or other compensation for any calendar month, due to illness of such employee and not because of illness of his immediate family, for purposes of this section he shall be deemed to have been granted sick leave without pay, and, subject to the rules and regulations of the appropriate public authority, said employee shall make payment for fifty per cent of the cost of such insurance to the treasurer of the governmental unit, and such governmental unit shall contribute the remaining fifty per cent of said premium. All amounts withheld from an employee's salary, wages or other compensation and all amounts paid by an employee together with the contribution of the governmental unit as hereinbefore described shall be paid by the treasurer of the governmental unit to the carrier or carriers entitled to the premium. An employee insured under this section may by written notice on a form provided by the treasurer cancel such disability income insurance and such insurance shall require no further premium payment the first day of the premium month following the expiration of fifteen days from the receipt of notice of cancellation. Any dividend or refund applicable to disability income insurance provided under this section shall be paid by the insurance carrier or carriers to the governmental unit and shall be distributed in accordance with the provisions of section eight or eight A whichever may be applicable. This section shall take effect in a county, except Worcester county, city, town or district upon its acceptance in the following manner:—in a county, except Worcester county, by vote of the county commissioners; in a city having a Plan D or Plan E charter by majority vote of its city council; in any other city by vote of its city council, approved by the mayor; in a district, except as hereinafter provided, by vote of the registered voters of the district at a district meeting; in a regional school district by vote of the regional district school committee; and in a town either by vote of the board of selectmen, or by a majority of affirmative votes cast in answer to the following question which shall be printed upon the official ballot to be used at an election in said town:—''Shall the town pay one half of a premium for disability income insurance for its employees?'' The appropriate public authority shall notify the commission of the acceptance of this section as soon thereafter as practicable.

M.G.L. c. 32B, § 12 Joint negotiation and purchase of insurance by governmental units; trusts or joint purchase agreements for health care coverage

c. 32B, § 12. Joint negotiation and purchase of insurance by governmental units; trusts or joint purchase agreements for health care coverage Section 12. Upon acceptance of this chapter as herein provided, the appropriate public authorities of two or more governmental units may join together in negotiating and purchasing, as provided in section three, one or more policies of insurance providing the benefits set forth herein for the employees of all said governmental units. At their discretion said public authorities may establish a central administrative office and employ such personnel as may be necessary to carry out the provisions of this chapter. The requirements of clause (h) of subdivision (A) of section one hundred and ten and clause (e) of section one hundred and thirty-three of chapter one hundred and seventy-five that the policy be issued to the trustees of a fund shall not apply to the issuance of a policy insuring the employees of two or more governmental units pursuant to sections eleven and twelve of this chapter. Two or more governmental units may also join together, by means of a trust or joint purchase agreement, when providing hospital, surgical, medical, dental and other health care coverage as authorized by this chapter. In lieu of or in addition to entering into the insurance policies, agreements or contracts described in this chapter, a trust or joint purchase group may enter into an administrative services or other contract with one or more insurance companies, nonprofit hospital, medical or dental service corporations organized under chapter one hundred and seventy-six A, chapter one hundred and seventy-six B or chapter one hundred and seventy-six E, or with one or more health care organizations, or with one or more third party administrators or other entities to organize, arrange or provide for the delivery or payment of health care coverage or services, as provided in section three A. In such case, the trust or joint purchase agreement shall make provisions for the allocation of the claims, administrative and other expenses of the trust or joint purchase group among the participating governmental units, and shall set forth a schedule pursuant to which the treasurer of each participating governmental unit shall forward to the treasurer of the trust or joint purchase group, from the governmental unit's claims trust fund, that governmental unit's allocation of the trust or joint purchase group's claims, administrative or other expenses. The requirements of section three A shall apply to any governmental unit which participates in any such trust or joint purchase agreement, except to the extent that those requirements would conflict with the provisions of this paragraph. Nothing in this section shall be construed to prevent two or more governmental units pursuant to a joint purchase or trust agreement from jointly negotiating and purchasing other coverage as authorized by this section. The board of a trust or joint purchase group established by 2 or more governmental units may vote to implement changes to co-payments, deductibles, tiered provider network copayments and other cost-sharing plan design features which do not exceed those which an appropriate public authority may offer under section 22; provided, however, that each governmental unit that is a member of a trust or group shall comply with the requirements set forth in section 21 before any such changes may be applied to the health insurance coverage of such governmental unit's subscribers. If such changes to the dollar amounts for copayments, deductibles, tiered provider network copayments and other cost-sharing plan design features do not exceed those permitted under section 22, such changes shall be approved in accordance with the provisions of section 21.

M.G.L. c. 32B, § 14 Rules and regulations

c. 32B, § 14. Rules and regulations Section 14. The appropriate public authority in each governmental unit shall adopt such rules and regulations, not inconsistent with this chapter, as may be necessary for the administration of this chapter. At the option of the appropriate public authority, a copy of any such proposed agreement or contract may be submitted to the commission for review and comment by it upon all or such portions thereof as the appropriate public authority may request.

M.G.L. c. 32B, § 15 Insurance coverage for employees of governmental units; appropriation or expenditure of public funds for payment of premiums

c. 32B, § 15. Insurance coverage for employees of governmental units; appropriation or expenditure of public funds for payment of premiums Section 15. (a) Upon acceptance of this subsection by its appropriate public authority and subject to any necessary appropriation, a governmental unit, acting by and through its appropriate public authority, may offer its employees a policy or policies of group long-term disability insurance, group dental insurance or group vision care insurance. A governmental unit may contract for such insurance coverage individually or through its membership in a trust or joint purchase group as provided in section twelve of this chapter. A governmental unit may elect to pay any part or none of the premium cost for such insurance coverage for its employees, and may bargain for such insurance coverage collectively. (b) No governmental unit may appropriate or expend public funds for the payment of premiums for group life insurance, group accidental death and dismemberment insurance and group general or blanket hospital, surgical, medical, dental and other health insurance for its active or retired employees, or their dependents, unless such insurance is procured pursuant to the provisions of this chapter, or unless such payments are authorized by section five of chapter forty, or unless such payments are made, pursuant to an agreement of an employer and an employee organization, to a health and welfare trust fund agreement for the purposes of (i) providing health benefits not otherwise provided to such employees by said governmental unit under the provisions of this chapter or (ii) paying contributions by said governmental unit toward premium costs or rates in excess of the level of such premium cost or rate contributions otherwise provided for under the provisions of this chapter or (iii) providing health benefits required under this chapter. This subsection shall not apply to the county of Worcester.

M.G.L. c. 32B, § 16 Optional insurance for services of health care organizations

c. 32B, § 16. Optional insurance for services of health care organizations Section 16. Upon acceptance of this section as hereinafter provided, the appropriate public authority of the governmental unit shall enter into a contract, hereinafter described, to make available the services of a health care organization to certain eligible and retired employees and dependents, including the surviving spouse and dependents of such active and retired employees, on a voluntary and optional basis, as it deems to be in the best interest of the governmental unit and such eligible persons as aforesaid, provided:— (1) that the total monthly premium cost to be paid by the governmental unit is to be paid under the terms of a contract to a carrier and not paid directly to a health care organization. For purposes of this chapter such a contract shall be deemed to be a contract of insurance; (2) that the health care organization maintains fair and non-discriminatory formulas for the payment of all vendor's services and that such formulas result in the same relative charges to all fiscal intermediaries or carriers with whom the health care organization has an agreement; provided, however, that any difference in relative charges which may result from the application of a rate of payment approved under section five of chapter one hundred and seventy-six A shall be deemed to comply herewith. The appropriate public authority shall negotiate such a contract of insurance for and on behalf and in the name of the governmental unit for such a period of time not exceeding five years as it may in its discretion, deem to be the most advantageous to the governmental unit and the persons insured hereunder. All persons eligible for the insurance provided under section five shall have the option to be insured for the services of a health care organization under this section but shall not be insured for both. Eligible persons, having elected coverage under this section by making application as provided in section six, shall pay a minimum of ten percent of the total monthly premium cost or rate for coverage under this section, and the governmental unit shall pay the remainder of the total monthly premium cost or rate; provided, however, that nothing in this chapter shall preclude the parties to a collective bargaining agreement under chapter one hundred and fifty E from agreeing that such eligible persons shall pay a percent share of such total monthly premium cost or rate which is higher than said ten percent; provided, further, that such eligible persons shall in no event be required to pay more than fifty percent of such total monthly premium cost or rate. Such payment by the insured shall be made to the governmental unit as provided in sections seven, seven A, nine A, nine B, nine C, nine D and nine E, as may be applicable. The governmental unit shall require under the terms and provisions of such insurance contracts an accounting at least annually of the payments made to providers of services on behalf of each person so insured; and, the extent and range of health care services shall be a matter of continuing analysis and study by the governmental unit for the purpose of maintaining a reasonable relationship between the total monthly premium cost or rate and the schedule of health care services provided. Any dividend or its equivalent derived from insurance contracts issued pursuant to this section shall be applied as provided in sections eight or eight A whichever may be applicable. The appropriate public authority may adopt such rules and regulations as may be necessary for the administration of this section. This section shall take effect in a county, except Worcester county, city, town or district upon its acceptance in the following manner:—in a county, except Worcester county, by vote of the county commissioners; in a city having a Plan D or Plan E charter by majority vote of its city council, in any other city by vote of its city council approved by the mayor; in a town by vote of the board of selectmen; in a regional school district by vote of the regional district school committee and in all other districts by vote of the registered voters of the district at a district meeting.

M.G.L. c. 32B, § 17 Election to continue insurance coverages; notice

c. 32B, § 17. Election to continue insurance coverages; notice Section 17. (a) In any city or town which accepts the provisions of this section, an employee, in addition to the right of a deferred retiree status, or, conversion of insurance coverages to a non-group policy as provided in this chapter, and upon his involuntary termination of employment due to lack of funds, lack of work, or abolition of the position, may elect to continue all or a part of his insurance coverages including membership in a health maintenance organization, until such employee and dependents have become eligible and insured under another group plan of health insurance but in no event shall such extension of coverages exceed a period of thirty-nine weeks computed from the date of termination of employment or the date to which insurance premiums have been regularly paid, whichever is the later. (b) Upon determination by the employer of the termination of employment as described in this section, the employer shall notify in writing the employee of the right to elect to continue coverages under this section and a copy of such notification shall be sent to the treasurer or department charged with the responsibility to administer the group insurance plans for payroll deduction, and direct payment purposes, at least fifteen working days if possible, prior to the date of termination of employment. (c) The involuntarily terminated insured employee and on behalf of his dependents shall, upon election to continue insurance coverages under this section, give at least a thirty day written notice thereof to the employer. Such employee shall be responsible for making payment to the treasurer of the governmental unit of the total monthly premiums or rates, with no contribution by the governmental unit. The treasurer of the governmental unit, or his authorized designee, shall send a written notice by regular mail of the monthly premiums when due to the last known address of the terminated employee, who, upon making timely monthly payments to the treasurer shall be required to certify under the penalty of perjury that the employee is not eligible or insured under another group policy or plan. Failure on the part of the treasurer to transmit the terminated employee's premiums to the governmental unit's insurance carriers in a timely manner shall nevertheless render the insurance carrier and the governmental unit liable under its policy or contracts for payment of claims to the same extent as if the treasurer had transmitted the employee's premiums in a timely manner to the insurance carriers or plans. Section twenty-seven C of chapter twenty-nine shall not apply to this paragraph. (d) Upon expiration of the period of the extension as provided in this section the governmental unit shall provide to the terminated employee and dependents conversion rights to non-group coverages to the extent that such rights had not been exercised heretofore during the latest period of employment. (e) If it is determined by the appropriate public authority to be in the best interests of the governmental unit and its formerly insured employees whose employment has been terminated as described in this section that the extension of the insurance coverages would be less costly to the local governmental unit by transferring the eligibility for similar coverages, as provided by the commonwealth for its employees, to the commission for the centralization and maintenance during this temporary extension period and without loss of other rights to the terminated employee, application in writing may be made to the commission for approval. The appropriate public authority shall be notified within five working days of the commission's decision.

M.G.L. c. 32B, § 18A Transfer of retiree, spouse or dependent to Medicare health plan

c. 32B, § 18A. Transfer of retiree, spouse or dependent to Medicare health plan Section 18A. (a) A retiree, spouse or dependent insured or eligible to be insured under this chapter, if enrolled in Medicare Part A at no cost to the retiree, spouse or dependent or eligible for coverage under Medicare Part A at no cost to the retiree, spouse or dependent, shall be required to transfer to a Medicare health plan offered by the governmental unit under section 11C or section 16, if the benefits under the plan and Medicare Part A and Part B together shall be of comparable actuarial value to those under the retiree's existing coverage, but a retiree or spouse who has a dependent who is not enrolled or eligible to be enrolled in Medicare Part A at no cost shall not be required to transfer to a Medicare health plan if a transfer requires the retiree or spouse to continue the existing family coverage for the dependent in a plan other than a Medicare health plan offered by the governmental unit. (b) Each retiree shall provide the governmental unit, in such form as the governmental unit shall prescribe, such information as is necessary to transfer to a Medicare health plan. If a retiree does not submit the information required, the retiree shall no longer be eligible for the retiree's existing health coverage. The governmental unit may, from time to time, request from a retiree, a retiree's spouse or a retiree's dependent, proof certified by the federal government, of eligibility or ineligibility for Medicare Part A and Part B coverage. (c) The governmental unit shall pay any Medicare Part B premium penalty assessed by the federal government on the retiree, spouse or dependent as a result of enrollment in Medicare Part B at the time of transfer.

M.G.L. c. 32B, § 19 Health carriers; contracts; public employee committees; agreements with public authorities; transfer of subscribers to commission

c. 32B, § 19. Health carriers; contracts; public employee committees; agreements with public authorities; transfer of subscribers to commission Section 19. (a) Notwithstanding any other provision of this chapter, the appropriate public authority of a political subdivision which has undertaken to provide health insurance coverage to its subscribers by acceptance of any other section of this chapter may instead elect to provide health insurance coverage to all its subscribers pursuant to this section by entering into contracts with health insurance carriers or by transferring its subscribers to the commission under subsection (e). For the purposes of this section, the term ''subscribers'' shall mean employees, retirees, surviving spouses and dependents of the political subdivision and may include employees, retirees, surviving spouses and dependents of a district who previously received health insurance benefits through the political subdivision accepting this section. This section shall take effect in a political subdivision upon its acceptance in the following manner: in a county, except Worcester county, by a vote of the county commissioners; in a city having Plan D or a Plan E charter, by majority vote of the city council and approval by the manager; in any other city, by majority vote of the city council and approval by the mayor; in a town, by vote of the board of selectmen; in a regional school district, by vote of the regional district school committee; and in all other districts, by vote of the registered voters of the district at a district meeting. Acceptance of this section shall not take effect until a written agreement has been reached between the appropriate public authority and the public employee committee, but the written agreement may condition acceptance of this section upon the transferring of subscribers into the commission under subsection (e). A written agreement to transfer subscribers to the commission under this section shall be the sole means by which the subscribers of a political subdivision may be transferred to commission coverage. Notwithstanding subsection (c) of section 4B of chapter 4, the acceptance of this section may be revoked in the same manner it was accepted in accordance with all other subsections of section 4B of said chapter 4, subject to the requirements of any written agreements as provided in this section and chapter 150E. The revocation of this section shall not take effect until a written agreement providing for revocation is reached between the appropriate public authority and the employee committee established herein. Nothing in this section shall preclude an appropriate public authority from agreeing to establish a health and welfare trust fund under section 15. Except as otherwise provided in subsection (e), a contract with a health insurance carrier shall be in conformity with an agreement reached by an appropriate public authority and a public employee committee. The election by the appropriate public authority may be renewed in conformity with any successor agreement reached with a public employee committee. The public employee committee shall include a representative of each collective bargaining unit with which the political subdivision negotiates under chapter 150E and a retiree representative. Either the public employee committee or the appropriate public authority may convene the initial meeting of the committee at any time upon 7 days notice. Either the public employee committee or the appropriate public authority may convene any subsequent meeting with notice of not less than 3 business days. The retiree representative shall be designated by the Retired State, County and Municipal Employees Association. The retiree representative shall have a 10 per cent vote. The remaining 90 per cent vote shall be divided so that each collective bargaining unit represented on the public employee committee shall have a weighted vote equal to the proportion which the number of employees eligible for health insurance under this chapter employed in the bargaining unit he represents bears to the total number of employees eligible for health insurance in all bargaining units of the political subdivision. An agreement with the appropriate public authority shall be approved by a majority of the weighted votes of the representatives on the public employee committee and shall be binding on all subscribers and their representatives. For the purposes of this section, a health insurance carrier shall include any insurance company organized pursuant to chapter 175, hospital service corporation organized pursuant to chapter 176A, medical service corporation organized pursuant to chapter 176B, health maintenance organization organized pursuant to chapter 176G, preferred provider organization organized pursuant to chapter 176I and, in the case of a political subdivision which is partially or fully self-insured with respect to health insurance coverage, any third party administrator selected by the political subdivision, which may include, but shall not be limited to, a health insurance carrier. An agreement approved under this section shall be binding on all active and retired employees for whom health insurance coverage is being purchased, shall supersede any conflicting provision of a collective bargaining agreement and shall not be superseded in a statutory impasse proceeding under chapter 150E, but the agreement may include procedures for resolving an impasse in negotiations for a successor agreement. A dispute arising over the interpretation or application of the public employee committee agreement under this section may be submitted to binding arbitration under the labor arbitration provisions of the American Arbitration Association upon request of the public employee committee or the appropriate public authority, except as otherwise provided in subsection (f). A request shall be approved by 70 per cent of the weighted votes of the representatives on the public employee committee as set forth in this section or, where applicable, by a majority vote of the appropriate public authority. A political subdivision which elects to provide health insurance coverage to subscribers under this section shall be deemed in full compliance with this chapter regulating the procurement of health insurance. A political subdivision which elects to provide health insurance coverage under this section pursuant to an agreement approved by a public employee committee, may provide such coverage either as a single political subdivision or, under section 12, through joint purchase with other political subdivisions or, with multiple political subdivisions, through a risk-sharing pool, trust or health insurance carrier or third party administrator, or by making payments to a health and welfare trust fund to provide health insurance coverage under this section either as a single political subdivision or with multiple political subdivisions. The appropriate public authority may contract with a health insurance carrier for direct coverage of subscribers for whom the carrier's geographic service area provides appropriate access and coverage for other subscribers in accordance with subsection (d). (b) Nothing in this section shall require, preclude or permit a change in any aspect of health insurance coverage for subscribers authorized by this section except where an agreement to provide for such change is reached by an appropriate public authority and a public employee committee in an agreement entered into or modified after the effective date of this subsection except as otherwise provided in subsection (e). In the absence of a successor agreement approved under this section, the prior agreement of the public employee committee and the appropriate public authority regarding the provision of health insurance shall remain in effect. (c) Nothing in this section shall relieve a political subdivision from providing health insurance coverage to an employee, retiree, surviving spouse or dependent to whom it has an obligation to provide coverage under any other provision of this chapter. (d) The agreement reached between an appropriate public authority and the public employee committee shall provide for those subscribers who, by reason of residence or domicile, cannot be appropriately served within the service area of the health insurance carrier included in the agreement, subject to this subsection. Coverage for subscribers under this subsection shall be pursuant to and in conformity with the agreement required by this section and shall conform to all requirements of this section. The agreement reached between an appropriate public authority and the public employee committee shall provide that a subscriber who for reasons of residency is not eligible for enrollment in any such plan offered by a political subdivision shall be covered under a plan offered under chapter 176I, if any such plan is provided for under the agreement, but a subscriber who lives 10 miles or more from the nearest primary care physician providing care under the plan shall have out-of-pocket payments and medical deductibles limited to the amount that he would have paid had he utilized the network of medical services of the plan offered under chapter 176I. If the agreement reached between the appropriate public authority and the public employee committee provides for only health maintenance organizations or other health insurance carriers that limit enrollment to a particular geographic area, then notwithstanding any general or special law to the contrary, health maintenance organizations or other health insurance carriers shall provide for the coverage of services provided or arranged for all subscribers who do not reside within the geographic service area by providing the same benefit schedule and premium contribution provided to subscribers residing within the carrier's geographic service area including, but not limited to, covered services, out-of-pocket payments and medical deductibles for all medical services provided for or arranged under the agreement. (e) Where an agreement, either executed or modified, reached by an appropriate public authority and the public employee so provides, the appropriate public authority shall notify the commission that it will transfer all subscribers for whom it provides health insurance coverage to the commission. The notice shall be provided to the commission by the appropriate public authority on or before December 1 of each year for the transfer of subscribers to the commission effective the following July 1, or on or before July 1 of each year for the transfer of subscribers to the commission effective the following January 1. On the effective date of the transfer, the health insurance of all subscribers, including elderly governmental retirees previously governed by section 10B of chapter 32A and retired municipal teachers previously governed by section 12 of chapter 32A, shall be provided through the commission for all purposes and governed under this section. As of the effective date and for the duration of this transfer, subscribers transferred to the commission's health insurance coverage shall receive group health insurance benefits determined exclusively by the commission and the coverage shall not be subject to collective bargaining, except for contribution ratios which shall be determined by the written agreement. Subscribers transferred to the commission who are eligible or become eligible for Medicare coverage shall transfer to Medicare coverage, as prescribed by the commission. In the event of transfer to Medicare, the political subdivision shall pay any Medicare part B premium penalty assessed by the federal government on retirees, spouses and dependents as a result of enrollment in Medicare part B at the time of transfer into the Medicare health benefits supplement plan. For each subscriber's premium and the political subdivision's share of that premium, the subscriber and the political subdivision shall furnish to the commission, in such form and content as the commission shall prescribe, all information the commission deems necessary to maintain subscribers' and covered dependents' health insurance coverage. The appropriate public authority of the political subdivision shall perform such administrative functions and process such information as the commission deems necessary to maintain those subscribers' health insurance coverage including, but not limited to, family and personnel status changes, and shall report all changes monthly to the commission. In the event that a political subdivision transfers subscribers to the commission under this section, subscribers may be withdrawn from commission coverage after an initial 3–year period from the date of transfer of subscribers to the commission, at whole-year intervals determined by the written agreement which shall specify the withdrawal interval and withdrawal procedures; provided, however, that such whole-year intervals shall not be less than 2 years in length. The written agreement may specify the procedures for resolving an impasse in negotiations over whether to withdraw from commission coverage and for determining health insurance coverage and contribution ratios for subscribers for the year following withdrawal from the commission. In the event that binding arbitration is included in the written agreement, the agreement shall provide that the dispute shall be submitted to arbitration and, if no method is provided of arbitration is provided in the agreement, then the dispute shall be administered by the American Arbitration Association under the procedures set forth in its Labor Arbitration Rules. The decision and notice to withdraw shall be made by December 1 of the year prior to the effective date of withdrawal. All withdrawals shall be effective on July 1 following the political subdivision's notice to the commission. Except as otherwise provided in the written agreement, withdrawal from commission coverage shall revoke acceptance of this section and any written agreements related to the implementation of this section as of the effective date of withdrawal. In the event that the acceptance of this section is revoked, the appropriate public authority of the political subdivision shall abide by all commission requirements for effectuating such withdrawal, including the notice requirements in this subsection. In the event a political subdivision withdraws from commission coverage under this section, such withdrawal shall be binding on all subscribers, including those subscribers who, prior to the transfer to the commission, received coverage from the commission under sections 10B and 12 of chapter 32A and, after withdrawal from the commission, those subscribers who received coverage from the commission under said sections 10B and 12 of said chapter 32A shall not pay more than 25 per cent of the cost of their health insurance premiums. In the event of revocation of acceptance of this section, the political subdivision and public employee unions shall return to governance of negotiations of health insurance under chapter 150E and this chapter on the effective date of withdrawal from commission coverage, to negotiate healthcare coverage for subscribers thereafter. (f) To the extent authorized under chapter 32A, the commission shall provide group coverage of subscribers' health claims incurred after transfer to the commission. The claim experience of those subscribers shall be maintained by the commission in a single pool and combined with the claim experience of all covered state employees and retirees and their covered dependents, including those subscribers who previously received coverage under sections 10B and 12 of chapter 32A. Upon a written request by the mayor, town manager or the public employee committee of a political subdivision, the commission shall provide the political subdivision with its claims history from the previous year, which shall include, but not be limited to, the following information: (i) subscriber count; (ii) covered lives count; (iii) total paid medical claims; and (iv) total paid prescription drug claims. The commission may charge a fee for providing the data in an amount determined by the executive director, which shall not be greater than $1,000. The commission shall provide a detailed data response to such request within 60 days. Notwithstanding any general or special law to the contrary, a political subdivision that self-insures its group health insurance plan under section 3A and has a deficit in its claims trust fund at the time of transferring its subscribers to the commission and the deficit is attributable to a failure to accrue claims which had been incurred but not paid may capitalize the deficit and amortize the amount over 10 fiscal years in 10 equal amounts, or on a schedule providing for a more rapid amortization. Except as provided otherwise herein, subscribers eligible for health insurance coverage under subsection (e) shall be subject to all of the terms, conditions, schedule of benefits and health insurance carriers as employees and dependents as defined by section 2 and commission regulations. The commission shall determine all matters relating to subscribers' group health insurance rights, responsibilities, costs and payments, excluding contribution ratios, and obligations, including but not limited to, the manner and method of payment, schedule of benefits, eligibility requirements and choice of health insurance carriers and these matters shall be determined exclusively by the commission and shall not be subject to collective bargaining, the written agreement under subsection (a) or to arbitration under the agreement. The commission may issue rules and regulations consistent with this section and shall provide public notice of any proposed rules and regulations and notice of thereof at the request of interested parties, together with an opportunity to review those rules and regulations and an opportunity to comment on those proposed rules and regulations in writing and at a public hearing, but the commission shall not be subject to chapter 30A. The commission shall negotiate and purchase health insurance coverage for subscribers transferred under subsection (e) and shall promulgate regulations, policies and procedures for coverage of the transferred subscribers. The schedule of benefits available to transferred subscribers shall be determined by the commission pursuant to chapter 32A. The commission shall offer those subscribers the same choice as to health insurance carriers and benefits as those provided to state employees and retirees. The political subdivision's contribution to the cost of health insurance coverage for transferred subscribers shall be as determined under this section, and shall not be subject to the provisions on contributions in said chapter 32A. Any change to the premium contribution ratios shall become effective on July 1 of each year, with notice to the commission of such change not later than January 15 of the same year. A political subdivision that transfers subscribers to the commission shall pay the commission for all costs of its subscribers' coverage, including administrative expenses, and the governmental unit's cost of subscribers' premium. The commission shall determine on a periodic basis the amount of premium which the political subdivision shall pay to the commission. If the political subdivision unit fails to pay all or a portion of these costs according to the timetable determined by the commission, the commission may inform the state treasurer who shall issue a warrant in the manner provided by section 20 of chapter 59 requiring the respective political subdivision to pay into the treasury of the commonwealth as prescribed by the commission the amount of the premium and administrative expenses attributable to the political subdivision. The state treasurer shall recoup any past due costs from the political subdivision's cherry sheet under section 20A of chapter 58 and transfer that money to the commission. If a governmental unit fails to pay to the commission the costs of coverage for more than 90 days and the cherry sheet provides an inadequate source of payment, the commission may, at its discretion, cancel the coverage of subscribers of the political subdivision. If the cancellation of coverage is for nonpayment, the political subdivision shall provide all subscribers health insurance coverage under plans which are the actuarial equivalent of plans offered by the commission in the preceding year until there is an agreement with the public employee committee providing for replacement coverage. The commission may charge the political subdivision an administrative fee, which shall not be more than 1 per cent of the cost of total premiums for the political subdivision, to be determined by the commission which shall be considered as part of the cost of coverage for purposes of determining the contributions of the political subdivision and its employees to the cost of health insurance coverage by the commission. (g) Any agreement reached between the political subdivision and the public employee committee, including an agreement to transfer subscribers to the group insurance commission, shall provide that within the same health insurance coverage plan the percentage contributed by the political subdivision to the premium or cost of health insurance coverage shall be the same for all subscribers covered under this section. These payments shall differ only by the type of coverage elected under the plan, including individual, family, optional Medicare extension or other coverage selections; but the percentage contributed by the political subdivision may vary among the different health insurance coverage plans offered under the agreement reached between the political subdivision and the public employee committee. The agreement reached shall provide that the percentage contributed by the political subdivision to the premium or cost of at least 1 Medicare extension plan available to all eligible subscribers shall be not less than the minimum percentage contributed by the political subdivision to any other health insurance coverage plan offered under the agreement reached. Any political subdivision that accepts this section shall establish by agreement with the public employee committee a contribution by the political subdivision to the premium or cost of health insurance coverage that provides for at east 50 per cent but not more than 99 per cent. Notwithstanding this subsection, where there is an agreement to transfer subscribers to the commission, subscribers whose coverage was governed by section 10B or 12 of chapter 32A before the date that the written agreement is executed, shall not be required to contribute more than 25 per cent of their health insurance premiums, but the written agreement may provide for a premium contribution paid by these subscribers of less than 25 per cent. (h) If there is a revocation of acceptance or a withdrawal from the commission under this section, all retirees, their spouses and dependents insured or eligible to be insured by the political subdivision, if enrolled in Medicare part A at no cost to the retiree, spouse or dependents, shall be required to be insured by a Medicare extension plan offered by the political subdivision under section 11C or section 16. A retiree shall provide the political subdivision, in such form as the political subdivision shall prescribe, such information as is necessary to transfer to a Medicare extension plan. If a retiree does not submit the information required, he shall no longer be eligible for his existing health insurance coverage. The political subdivision may from time to time request from a retiree, a retiree's spouse and dependents, proof certified by the federal government of his eligibility or ineligibility for Medicare part A and part B coverage. The political subdivision shall pay the Medicare part B premium penalty assessed by the federal government on those retirees, spouses and dependents as a result of enrollment in Medicare part B at the time of transfer into the Medicare health benefits supplement plan. (i) In the absence of a public collective bargaining unit, the chief executive officer of a municipality may authorize the transfer of subscribers to the commission. (j) Notwithstanding any other general or special law to the contrary, in the event that an agreement, either executed or modified, was reached by an appropriate public authority and the public employee committee to transfer all subscribers, for whom the authority provides health insurance coverage, to the commission under subsections (e) and (f), its retirees, surviving spouses and their dependents may enroll in the dental insurance plan provided by the commission to retirees, surviving spouses and their dependents insured under chapter 32A, at premium contribution ratios that requires retirees, surviving spouses and their dependents to contribute 100 per cent of the dental insurance premium and administrative fee. The commission shall provide dental insurance coverage, under its plan for retirees, surviving spouses and their dependents insured under chapter 32A, to retirees, surviving spouses and their dependents who elect the coverage under this subsection, as it so provides health insurance coverage under subsections (e) and (f). The commission may charge an administrative fee, which shall not be more than 1 per cent of the cost of total dental insurance premiums for the retirees, surviving spouses and their dependents who enroll in the dental insurance plan under this section, to be determined by the commission which shall be considered as part of the cost of coverage for purposes of determining the contributions of the political subdivision and its retirees, surviving spouses and their dependents to the cost of insurance coverage by the commission.

M.G.L. c. 32B, § 20 Other Post–Employment Benefits Liability Trust Fund; sources of funding; custodian; trustees; separate OPEB Fund board of trustees as investing authority; expenditures and investments

c. 32B, § 20. Other Post–Employment Benefits Liability Trust Fund; sources of funding; custodian; trustees; separate OPEB Fund board of trustees as investing authority; expenditures and investments [Text of section applicable as provided by 2016, 218, Sec. 238.] Section 20. (a) As used in this section, and section 20A, the following words shall have the following meanings unless the context clearly requires otherwise: ''Chief executive officer'', the mayor in a city or the board of selectmen in a town, unless some other municipal office is designated to be the chief executive officer pursuant to a local charter, the county commissioners in a county and the governing board, commission or committee in a district or other governmental unit. ''Commission'' or ''PERAC'', the public employee retirement administration commission established pursuant to section 49 of chapter 7. ''GASB'', the Governmental Accounting Standards Board. ''Governing body'', the legislative body in a city or town, the county commissioners in a county, the regional district school committee in a regional school district, or the district meeting or other appropriating body in any other governmental unit. ''Governmental unit'' or ''unit'', any political subdivision of the commonwealth, including a municipal lighting plant, local housing or redevelopment authority, regional council of government established pursuant to section 20 of chapter 34B and educational collaborative, as defined in section 4E of chapter 40. ''State Retiree Benefits Trust Fund board of trustees'', the board of trustees established by section 24A of chapter 32A. ''Other Post–Employment Benefits Liability Trust Fund'' or ''OPEB Fund''; a trust fund established by a governmental unit pursuant to this section for the deposit of gifts, grants, appropriations and other funds for the: (1) benefit of retired employees and their dependents, (2) payment of required contributions by the unit to the group health insurance benefits provided to employees and their dependents after retirement and (3) reduction and elimination of the unfunded liability of the unit for such benefits. ''OPEB Fund board of trustees''; an independent board of trustees selected by the governmental unit with investing authority for the OPEB Fund. ''OPEB investing authority'' or ''investing authority''; the trustee or board of trustees designated by the governmental unity to invest and reinvest the OPEB Fund using the investment standard or investment vehicle established pursuant to this section. (b) A governmental unit that accepts this section shall establish on its books and accounts the Other Post–Employment Benefits Liability Trust Fund, the assets of which shall be held solely to meet the current and future liabilities of the governmental unit for group health insurance benefits for retirees and their dependents. The governmental unit may appropriate amounts to be credited to the fund and the treasurer of the governmental unit may accept gifts, grants and other contributions to the fund. The fund shall be an expendable trust subject to appropriation and shall be managed by a trustee or a board of trustees as provided in subsection (d). Any interest or other income generated by the fund shall be added to and become part of the fund. Amounts that a governmental unit receives as a sponsor of a qualified retiree prescription drug plan pursuant to 42 U.S.C. section 1395w–132 may be dedicated to and become part of the fund by vote of the governing body of the governmental unit. All monies held in the fund shall be accounted for separately from other funds of the governmental unit and shall not be subject to the claims of any general creditor of the governmental unit. (c) The treasurer of the governmental unit shall be the custodian of the OPEB Fund and shall be bonded in any additional amounts necessary to protect fund assets. (d) The governing body of the governmental unit shall designate a trustee or board of trustees, which shall have general supervision of the management, investment and reinvestment of the OPEB Fund. The governing body may designate as the trustee or board of trustees: (i) the custodian; (ii) the governmental unit's retirement board as the board of trustees; or (iii) an OPEB Fund board of trustees established by the governmental unit pursuant to subsection (e). If no designation is made, the custodian of the fund shall be the trustee and shall manage and invest the fund. The duties and obligations of the trustee or board of trustees with respect to the fund shall be set forth in a declaration of trust to be adopted by the trustee or board, but shall not be inconsistent with this section. The declaration of trust and any amendments thereto shall be filed with the chief executive officer and the clerk of the governing body of the governmental unit and take effect 90 days after the date filed, unless the governing body votes to disapprove the declaration or amendment within that period. The trustee or board of trustees may employ reputable and knowledgeable investment consultants to assist in determining appropriate investments and pay for those services from the fund, if authorized by the governing body of the governmental unit. The trustee or board of trustees may, with the approval of the State Retiree Benefits Trust Fund board of trustees, invest the OPEB Fund in the State Retiree Benefits Trust Fund established in section 24 of chapter 32A. (e) The governing body of the governmental unit may vote to establish a separate OPEB Fund board of trustees to be the investing authority. The board of trustees shall consist of 5 to 13 individuals, including a person or persons with the investment experience desired by the governmental unit, a citizen or citizens of the governmental unit, an employee of the governmental unit, a retiree or retirees of the governmental unit, and a governmental unit officer or officers. The governmental unit employee trustee shall be selected by current employees of the unit by ballot, and the retiree trustee or trustees shall be selected by current retirees of the unit by ballot. The remainder of the trustees shall be appointed by the chief executive officer of the governmental unit. The trustees will serve for terms of 3 or 5 years, as determined by the governing body of the governmental unit, and if a vacancy occurs, a trustee may be elected or selected in the same manner to serve for the remainder of the term. Trustees shall be eligible for reappointment. (f) The trustee or board of trustees shall: (i) act in a fiduciary capacity, (ii) discharge its duties for the primary purpose of enhancing the value of the OPEB Fund, (iii) act with the care, skill, prudence and diligence under the circumstances then prevailing that a prudent person acting in a like capacity and familiar with such matters would use in the conduct of an enterprise with like character and with like aims and (iv) diversify the investments in the fund to minimize the risk of large losses, unless under the circumstances it is clearly prudent not to do so. In any civil action brought against a trustee, the board of trustees, acting within the scope of official duties, the defense or settlement of which is made by legal counsel for the governmental unit, the trustee or employee shall be indemnified from the OPEB Fund for all expenses incurred in the defense thereof and for damages to the same extent as provided for public employees in chapter 258. No trustee or employee shall be indemnified for expenses in an action or damages awarded in such action in which there is: (i) a breach of fiduciary duty, (ii) an act of willful dishonesty or (iii) an intentional violation of law by the trustee or employee. (g) Monies in the OPEB Fund not required for expenditures or anticipated expenditures within the investment period, shall be invested and reinvested by the custodian as directed by the investing authority from time to time; provided such investment or reinvestment is made in accordance with: (i) section 54 of chapter 44, if the treasurer or OPEB Fund board of trustees is the investing authority, unless the governing body of the governmental unit authorizes investment under the prudent investor rule established in chapter 203C; (ii) section 23 of chapter 32, if the retirement board is the investing authority; or (iii) sections 24 and 24A of chapter 32A, if the OPEB Fund is invested in the State Retiree Benefits Trust Fund. (h) Amounts in the OPEB Fund may be appropriated by a two-thirds vote of the governing body of the governmental unit to pay the unit's share of health insurance benefits for retirees and their dependents upon certification by the trustee or board of trustees that such amounts are available in the fund. The treasurer of the governmental unit after consulting with the chief executive officer of the unit shall determine the amount to be appropriated from the fund to the annual budget for retiree health insurance and notify the trustee or board of trustees of that amount at the earliest possible opportunity in the annual budget cycle. Upon notification, the trustee or board of trustees shall take diligent steps to certify those funds as available for appropriation by the governmental unit, or will be available by the time the appropriation would become effective or provide an explanation why the funds are or will not be available or should not be made available. (i) In a regional school district, appropriations of amounts to the OPEB Fund may be made only in the annual budget submitted to the member cities and towns for approval. The annual report submitted to the member cities and towns pursuant to clause (k) of section 16 of chapter 71 shall include a statement of the balance in the fund and all additions to and appropriations from the fund during the period covered by such report. (j) A municipal lighting plant that establishes an OPEB fund shall pay the premiums and assume the liability for the municipal share of retiree healthcare benefits attributable to lighting plant employees and their dependents. (k) A governmental unit that accepts this section may participate in the OPEB Fund established by another governmental unit pursuant to this section upon authorization of the governing boards of both units and in accordance with the procedures and criteria established by the trustee or board of trustees of the fund. Each governmental unit shall remain responsible for all costs attributable for the health care and other post-employment obligations for its retired employees and their dependents and for completing an actuarial valuation of its liabilities and funding schedule that conforms to GASB requirements. The participating governmental unit may appropriate or otherwise contribute amounts to the OPEB Fund as provided in subsection (b). Amounts from the fund may be appropriated by the participating unit for its retiree health insurance expenses in the manner authorized in subsection (h) upon a determination by the treasurer of the unit, after consulting with the chief executive officer of the unit, of the necessary amount and notification of the treasurer of the governmental unit maintaining the fund and the trustee or board of trustees of that amount. The trustee or board of trustees shall certify those funds available for appropriation, as provided in subsection (h), and the treasurer of the governmental unit maintaining the fund shall transfer the amounts certified to the participating governmental unit. The participating governmental unit shall be separately credited for any contributions made to and appropriations from the OPEB Fund, and interest or other income generated by the fund, in the accounting of the relative liabilities of each governmental unit for its retirees and their dependents. (l) This section may be accepted in a city or town in the manner provided in section 4 of chapter 4; in a county, by vote of the county commissioners; in a regional school district, by vote of the regional school committee; and in a district or other governmental unit, by vote of the district meeting or other appropriating body. (m) This section shall also apply to the OPEB Fund established by a governmental unit under a special law, notwithstanding any provision to the contrary, upon the acceptance of this section by the governmental unit.

M.G.L. c. 32B, § 20A Actuarial valuation report on liabilities for health care and other post-employment benefits for retired employees; summary report

c. 32B, § 20A. Actuarial valuation report on liabilities for health care and other post-employment benefits for retired employees; summary report Section 20A. When a governmental unit obtains an actuarial valuation report in accordance with GASB containing statements of the liabilities of the unit for health care and other post-employment benefits for its retired employees and their dependents, it shall submit a copy to PERAC no later than 90 days after receipt of such report. PERAC may require that the governmental unit provide additional information related to such liabilities, normal cost and benefit payments, as specified by the executive office for administration and finance, in consultation with PERAC. The governmental unit shall file the report and additional information with PERAC and the division of local services in the department of revenue. PERAC shall file a summary report of the information received pursuant to this section with the chairs of the house and senate committees on ways and means, the secretary of administration and finance and the board of trustees of the State Retiree Benefits Trust Fund established pursuant to section 24A of chapter 32A.

M.G.L. c. 32B, § 21 Manner of changing health insurance benefits; estimation of savings; approval of agreement; immediate implementation; time for review; distribution of savings; regulations

c. 32B, § 21. Manner of changing health insurance benefits; estimation of savings; approval of agreement; immediate implementation; time for review; distribution of savings; regulations Section 21. (a) Any political subdivision electing to change health insurance benefits under sections 22 or 23 shall do so in the following manner: in a county, except Worcester county, by a vote of the county commissioners; in a city having Plan D or a Plan E charter, by majority vote of the city council and approval by the manager; in any other city, by majority vote of the city council and approval by the mayor; in a town, by vote of the board of selectmen; in a regional school district, by vote of the regional district school committee; and in all other districts, by vote of the registered voters of the district at a district meeting or by vote of the district's governing board. This section shall be binding on any political subdivision that implements changes to health insurance benefits pursuant to section 22 or 23. (b) Prior to implementing any changes authorized under sections 22 or 23, the appropriate public authority shall evaluate its health insurance coverage and determine the savings that may be realized after the first 12 months of implementation of plan design changes or upon transfer of its subscribers to the commission. The appropriate public authority shall then notify its insurance advisory committee, or such committee's regional or district equivalent, of the estimated savings and provide any reports or other documentation with respect to the determination of estimated savings as requested by the insurance advisory committee. After discussion with the insurance advisory committee as to the estimated savings, the appropriate public authority shall give notice to each of its collective bargaining units to which the authority provides health insurance benefits and a retiree representative, hereafter called the public employee committee, of its intention to enter into negotiations to implement changes to health insurance benefits provided by the appropriate public authority. The retiree representative shall be designated by the Retired State, County and Municipal Employees Association. A political subdivision which has previously established a public employee committee under section 19 may implement changes to its health insurance benefits pursuant to this section and sections 22 and 23. Notice to the collective bargaining units and retirees shall be provided in the same manner as prescribed in section 19. The notice shall detail the proposed changes, the appropriate public authority's analysis and estimate of its anticipated savings from such changes and a proposal to mitigate, moderate or cap the impact of these changes for subscribers, including retirees, low-income subscribers and subscribers with high out-of-pocket health care costs, who would otherwise be disproportionately affected. (c) The appropriate public authority and the public employee committee shall have not more than 30 days from the point at which the public employee committee receives the notice as provided in subsection (b) to negotiate all aspects of the proposal. An agreement with the appropriate public authority shall be approved by a majority vote of the public employee committee; provided, however, that the retiree representative shall have a 10 per cent vote. If after 30 days the appropriate public authority and public employee committee are unable to enter into a written agreement to implement changes under section 22 or 23, the matter shall be submitted to a municipal health insurance review panel. The panel shall be comprised of 3 members, 1 of whom shall be appointed by the public employee committee, 1 of whom shall be appointed by the public authority and 1 of whom shall be selected through the secretary of administration and finance who shall forward to the appropriate public authority and the public employee committee a list of 3 impartial potential members, each of whom shall have professional experience in dispute mediation and municipal finance or municipal health benefits, from which the appropriate public authority and the public employee committee may jointly select the third member; provided, however, that if the appropriate public authority and the public employee committee cannot agree within 3 business days upon which person to select as the third member of the panel, the secretary of administration and finance shall select the final member of the panel. Any fee or compensation provided to a member for service on the panel shall be shared equally between the public employee committee and the appropriate public authority. (d) The municipal health insurance review panel shall approve the appropriate public authority's immediate implementation of the proposed changes under section 22; provided, however, that any increases to plan design features have been made in accordance with the provisions of section 22. The municipal health insurance review panel shall approve the appropriate public authority's immediate implementation of the proposed changes under section 23; provided, that the panel confirms that the anticipated savings under those changes would be at least 5 per cent greater than the maximum possible savings under section 22. If the panel does not approve implementation of changes made pursuant to section 22 or section 23, the public authority may submit a new proposal to the public employee committee for consideration and confirmation under this section. (e) Within 10 days of receiving any proposed changes under sections 22 or 23, the municipal health insurance review panel shall: (i) confirm the appropriate public authority's estimated monetary savings due to the proposed changes under section 22 or 23 and ensure that the savings is substantiated by documentation provided by the appropriate public authority; provided, however, that if the panel determines the savings estimate to be unsubstantiated, the panel may require the public authority to submit a new estimate or provide additional information to substantiate the estimate; (ii) review the proposal submitted by the appropriate public authority to mitigate, moderate or cap the impact of these changes for subscribers, including retirees, low-income subscribers and subscribers with high out-of-pocket health care costs, who would otherwise be disproportionately affected; and (iii) concur with the appropriate public authority that the proposal is sufficient to mitigate, moderate or cap the impact of these changes for subscribers, including retirees, low-income subscribers and subscribers with high out-of-pocket health care costs, who would otherwise be disproportionately affected or revise the proposal pursuant to subsection (f). (f) The municipal health insurance review panel may determine the proposal to be insufficient and may require additional savings to be shared with subscribers, particularly those who would be disproportionately affected by changes made pursuant to sections 22 or 23, including retirees, low-income subscribers and subscribers with high out-of-pocket costs. In evaluating the distribution of savings to retirees, the panel may consider any discrepancy between the percentage contributed by retirees, surviving spouses and their dependents to plans offered by the public authority as compared to other subscribers. In reaching a decision on the proposal under this subsection, the municipal health insurance review panel may consider an alternative proposal, with supporting documentation, from the public employee committee to mitigate, moderate or cap the impact of these changes for subscribers. The panel may require the appropriate public authority to distribute additional savings to subscribers in the form of health reimbursement arrangements, wellness programs, health care trust funds for emergency medical care or inpatient hospital care, out-of-pocket caps, Medicare Part B reimbursements or reimbursements for other qualified medical expenses; provided, however that in no case shall the municipal health insurance review panel designate more than 25 per cent of the estimated savings to subscribers. The municipal health insurance review panel shall not require a municipality to implement a proposal to mitigate, moderate or cap the impact of changes authorized under section 22 or 23 which has a total multi-year cost that exceeds 25 per cent of the estimated savings. All obligations on behalf of the appropriate public authority related to the proposal shall expire after the initial amount of estimated savings designated by the panel to be distributed to employees and retirees has been expended. The panel shall not impose any change to contribution ratios. (g) The decision of the municipal health insurance review panel shall be binding upon all parties. (h) The secretary of administration and finance shall promulgate regulations establishing administrative procedures for the negotiations with the public employee committee and the municipal health insurance review panel, and issue guidelines to be utilized by the appropriate public authority and the municipal health insurance review panel in evaluating which subscribers are disproportionately affected, subscriber income and subscriber out-of-pocket costs associated with health insurance benefits.

M.G.L. c. 32B, § 22 Copayments, deductibles, tiered provider network copayments and other cost-sharing plan design features; increases

c. 32B, § 22. Copayments, deductibles, tiered provider network copayments and other cost-sharing plan design features; increases Section 22. (a) Upon meeting the requirements of section 21, an appropriate public authority of a political subdivision which has undertaken to provide health insurance coverage to its subscribers by acceptance of any other section of this chapter may include, as part of the health plans that it offers to its subscribers not enrolled in a Medicare plan under section 18A, copayments, deductibles, tiered provider network copayments and other cost-sharing plan design features that are no greater in dollar amount than the copayments, deductibles, tiered provider network copayments and other cost-sharing plan design features offered by the commission pursuant to section 4 or 4A of chapter 32A in a non-Medicare plan with the largest subscriber enrollment; provided, however, that for subscribers enrolled in a Medicare plan pursuant to section 18A the appropriate public authority may include, as part of the health plans that it offers to its subscribers, copayments, deductibles, tiered provider network copayments and other cost-sharing plan design features that are no greater in dollar amount than the copayments, deductibles, tiered provider network copayments and other cost-sharing plan design features offered by the commission pursuant to section 4 or 4A of chapter 32A in a Medicare plan with the largest subscriber enrollment. The appropriate public authority shall not include a plan design feature which seeks to achieve premium savings by offering a health benefit plan with a reduced or selective network or providers unless the appropriate public authority also offers a health benefit plan to all subscribers that does not contain a reduced or selective network of providers. (b) An appropriate public authority may increase the dollar amounts for copayments, deductibles, tiered provider network copayments and other cost-sharing plan design features; provided that, for subscribers enrolled in a non-Medicare plan, such features do not exceed plan design features offered by the commission pursuant to section 4 or 4A of chapter 32A in a non-Medicare plan with the largest subscriber enrollment and, for subscribers enrolled in a Medicare plan under section 18A, such features do not exceed plan design features offered by the commission pursuant to section 4 or 4A of chapter 32A in a Medicare plan with the largest subscriber enrollment; provided, however, that the public authority need only satisfy the requirements of subsection (a) of section 21 the first time changes are implemented pursuant to this section; and provided, further that the public authority meet its obligations under subsections (b) to (h), inclusive, of section 21 each time an increase to a plan design feature is proposed. Nothing herein shall prohibit an appropriate public authority from including in its health plans higher copayments, deductibles or tiered provider network copayments or other plan design features than those authorized by this section; provided, however, such higher copayments, deductibles, tiered provider network copayments and other plan design features may be included only after the governmental unit has satisfied any bargaining obligations pursuant to section 19 or chapter 150E. (c) The decision to accept and implement this section shall not be subject to bargaining pursuant to chapter 150E or section 19. Nothing in this section shall preclude the implementation of plan design changes pursuant to this section in communities that have adopted section 19 of this chapter or by the governing board of a joint purchasing group established pursuant to section 12. (d) Nothing in this section shall relieve an appropriate public authority from providing health insurance coverage to a subscriber to whom it has an obligation to provide coverage under any other provision of this chapter. (e) The first time a public authority implements plan design changes under this section or section 23, the public authority shall not increase before July 1, 2018, the percentage contributed by retirees, surviving spouses and their dependents to their health insurance premiums from the percentage that was approved by the public authority prior to and in effect on May 1, 2014; provided however, that if a public authority approved of an increase in said percentage contributed by retirees before May 1, 2014, but to take effect on a date after May 1, 2014, said percentage increase may take effect upon the approval of the secretary of administration and finance based on documented evidence satisfactory to the secretary that the public authority approved the increase prior to May 1, 2014.

M.G.L. c. 32B, § 23 Transfer of subscribers to commission; notice; transfer to Medicare of eligible subscribers; withdrawal from commission coverage; group coverage provided by commission; deficit in claims trust fund by self-insured political subdivision; administration of coverage for transferred subscribers by commission; reimbursement of commission for coverage costs; withdrawal from commission

c. 32B, § 23. Transfer of subscribers to commission; notice; transfer to Medicare of eligible subscribers; withdrawal from commission coverage; group coverage provided by commission; deficit in claims trust fund by self-insured political subdivision; administration of coverage for transferred subscribers by commission; reimbursement of commission for coverage costs; withdrawal from commission Section 23. (a) Upon meeting the requirements of section 21, an appropriate public authority which has undertaken to provide health insurance coverage to its subscribers may elect to provide health insurance coverage to its subscribers by transferring its subscribers to the commission and shall notify the commission of such transfer. The notice shall be provided to the commission by the appropriate public authority on or before December 1 of each year for the transfer of subscribers to the commission effective the following July 1, or on or before July 1 of each year for the transfer of subscribers to the commission effective the following January 1. On the effective date of the transfer, the health insurance of all subscribers, including elderly governmental retirees previously governed by section 10B of chapter 32A and retired municipal teachers previously governed by section 12 of chapter 32A, shall be provided through the commission for all purposes and governed under this section. As of the effective date and for the duration of this transfer, subscribers transferred to the commission's health insurance coverage shall receive group health insurance benefits determined exclusively by the commission and the coverage shall not be subject to collective bargaining, except for contribution ratios. Subscribers transferred to the commission who are eligible or become eligible for Medicare coverage shall transfer to Medicare coverage, as prescribed by the commission. In the event of transfer to Medicare, the political subdivision shall pay any Medicare part B premium penalty assessed by the federal government on retirees, spouses and dependents as a result of enrollment in Medicare part B at the time of transfer into the Medicare health benefits supplement plan. For each subscriber's premium and the political subdivision's share of that premium, the subscriber and the political subdivision shall furnish to the commission, in such form and content as the commission shall prescribe, all information the commission deems necessary to maintain subscribers' and covered dependents' health insurance coverage. The appropriate public authority of the political subdivision shall perform such administrative functions and process such information as the commission deems necessary to maintain those subscribers' health insurance coverage including, but not limited to, family and personnel status changes, and shall report all changes to the commission. In the event that a political subdivision transfers subscribers to the commission under this section, subscribers may be withdrawn from commission coverage after an initial 3–year period from the date of transfer of subscribers to the commission, at whole-year intervals; provided, however, that such whole-year intervals shall not be less than 2 years in length as determined by the written agreement established in subsection (c) of section 21. The appropriate public authority shall provide notice of any withdrawal by December 1 of the year prior to the effective date of withdrawal. All withdrawals shall be effective on July 1 following the political subdivision's notice to the commission and the political subdivision shall abide by all commission requirements for effectuating such withdrawal, including the notice requirements in this subsection. In the event a political subdivision withdraws from commission coverage under this section, such withdrawal shall be binding on all subscribers, including those subscribers who, prior to the transfer to the commission, received coverage from the commission under sections 10B and 12 of chapter 32A and, after withdrawal from the commission, those subscribers who received coverage from the commission under said sections 10B and 12 of said chapter 32A shall not pay more than 25 per cent of the cost of their health insurance premiums. In the event of withdrawal from the commission, the political subdivision and public employee unions shall return to governance of negotiations of health insurance under chapter 150E and this chapter; provided, however, that the political subdivision may transfer coverage to the commission again after complying with the requirements of subsections (b) to (h), inclusive, of section 21. The commission shall issue rules and regulations consistent with this section related to the process by which subscribers shall be transferred to the commission. (b) To the extent authorized under chapter 32A, the commission shall provide group coverage of subscribers' health claims incurred after transfer to the commission. The claim experience of those subscribers shall be maintained by the commission in a single pool and combined with the claim experience of all covered state employees and retirees and their covered dependents, including those subscribers who previously received coverage under sections 10B and 12 of chapter 32A. Upon a written request by the mayor, town manager or the public employee committee of a political subdivision, the commission shall provide the political subdivision with its claims history from the previous year, which shall include, but not be limited to, the following information: (i) subscriber count; (ii) covered lives count; (iii) total paid medical claims; and (iv) total paid prescription drug claims. The commission may charge a fee for providing the data in an amount determined by the executive director, which shall not be greater than $1,000. The commission shall provide a detailed data response to such request within 60 days. (c) A political subdivision that self-insures its group health insurance plan under section 3A and has a deficit in its claims trust fund at the time of transferring its subscribers to the commission and the deficit is attributable to a failure to accrue claims which had been incurred but not paid may capitalize the deficit and amortize the amount over 10 fiscal years in 10 equal amounts or on a schedule providing for a more rapid amortization. Except as provided otherwise herein, subscribers eligible for health insurance coverage pursuant to this section shall be subject to all of the terms, conditions, schedule of benefits and health insurance carriers as employees and dependents as defined by section 2 and commission regulations. The commission shall, exclusively and not subject to collective bargaining under chapter 150E, determine all matters relating to subscribers' group health insurance rights, responsibilities, costs and payments and obligations excluding contribution ratios, including, but not limited to, the manner and method of payment, schedule of benefits, eligibility requirements and choice of health insurance carriers. The commission may issue rules and regulations consistent with this section and shall provide public notice, and notice at the request of the interested parties, of any proposed rules and regulations and provide an opportunity to review and an opportunity to comment on those proposed rules and regulations in writing and at a public hearing; provided, however, that the commission shall not be subject to chapter 30A. (d) The commission shall negotiate and purchase health insurance coverage for subscribers transferred under this section and shall promulgate regulations, policies and procedures for coverage of the transferred subscribers. The schedule of benefits available to transferred subscribers shall be determined by the commission pursuant to chapter 32A. The commission shall offer those subscribers the same choice as to health insurance carriers and benefits as those provided to state employees and retirees. The political subdivision's contribution to the cost of health insurance coverage for transferred subscribers shall be as determined under this section, and shall not be subject to the provisions on contributions in said chapter 32A. Any change to the premium contribution ratios shall become effective on July 1 of each year, with notice to the commission of such change not later than January 15 of the same year. (e) A political subdivision that transfers subscribers to the commission shall pay the commission for all costs of its subscribers' coverage, including administrative expenses and the governmental unit's cost of subscribers' premium. The commission shall determine on a periodic basis the amount of premium which the political subdivision shall pay to the commission. If the political subdivision unit fails to pay all or a portion of these costs according to the timetable determined by the commission, the commission may inform the state treasurer who shall issue a warrant in the manner provided by section 20 of chapter 59 requiring the respective political subdivision to pay into the treasury of the commonwealth as prescribed by the commission the amount of the premium and administrative expenses attributable to the political subdivision. The state treasurer shall recoup any past due costs from the political subdivision's cherry sheet under section 20A of chapter 58 and transfer that money to the commission. If a governmental unit fails to pay to the commission the costs of coverage for more than 90 days and the cherry sheet provides an inadequate source of payment, the commission may, at its discretion, cancel the coverage of subscribers of the political subdivision. If the cancellation of coverage is for nonpayment, the political subdivision shall provide all subscribers health insurance coverage under plans which are the actuarial equivalent of plans offered by the commission in the preceding year until there is an agreement with the public employee committee providing for replacement coverage. The commission may charge the political subdivision an administrative fee, which shall not be more than 1 per cent of the cost of total premiums for the political subdivision, to be determined by the commission which shall be considered as part of the cost of coverage to determine the contributions of the political subdivision and its employees to the cost of health insurance coverage by the commission. (f) If there is a withdrawal from the commission under this section, all retirees, their spouses and dependents insured or eligible to be insured by the political subdivision, if enrolled in Medicare part A at no cost to the retiree, spouse or dependents, shall be required to be insured by a Medicare extension plan offered by the political subdivision under section 11C or section 16. A retiree shall provide the political subdivision, in such form as the political subdivision shall prescribe, such information as is necessary to transfer to a Medicare extension plan. If a retiree does not submit the information required, the retiree shall no longer be eligible for the retiree's existing health insurance coverage. The political subdivision may from time to time request from a retiree, a retiree's spouse and dependents, proof certified by the federal government of the retiree's eligibility or ineligibility for Medicare part A and part B coverage. The political subdivision shall pay the Medicare part B premium penalty assessed by the federal government on those retirees, spouses and dependents as a result of enrollment in Medicare part B at the time of transfer into the Medicare health benefits supplement plan. (g) The decision to implement this section shall not be subject to collective bargaining pursuant to chapter 150E or section 19. (h) Nothing in this section shall relieve a political subdivision from providing health insurance coverage to a subscriber to whom it has an obligation to provide coverage under any other provision of this chapter or change eligibility standards for health insurance under the definition of ''employee'' in section 2. (i) Notwithstanding any other general or special law to the contrary, in the event that an agreement, either executed or modified, was reached by an appropriate public authority and the public employee committee to transfer all subscribers, for whom the authority provides health insurance coverage, to the commission under this section, its retirees, surviving spouses and their dependents may enroll in the dental insurance plan provided by the commission to retirees, surviving spouses and their dependents insured under chapter 32A, at premium contribution ratios that requires retirees, surviving spouses and their dependents to contribute 100 per cent of the dental insurance premium and administrative fee. The commission shall provide dental insurance coverage, under its plan for retirees, surviving spouses and their dependents insured under chapter 32A, to retirees, surviving spouses and their dependents who elect the coverage under this subsection, as it so provides health insurance coverage under this section. The commission may charge an administrative fee, which shall not be more than 1 per cent of the cost of total dental insurance premiums for the retirees, surviving spouses and their dependents who enroll in the dental insurance plan under this subsection, to be determined by the commission which shall be considered as part of the cost of coverage for purposes of determining the contributions of the political subdivision and its retirees, surviving spouses and their dependents to the cost of insurance coverage by the commission.

M.G.L. c. 32B, § 24 Health care flexible spending accounts

c. 32B, § 24. Health care flexible spending accounts Section 24. An appropriate public authority of a political subdivision which has undertaken to provide health insurance coverage to its subscribers under this chapter may provide health care flexible spending accounts to allow certain subscribers, as determined by the appropriate public authority, to set aside a portion of earnings to pay for qualified expenses which may include, but shall not be limited to, out-of-pocket costs such as inpatient and outpatient copayments, calendar year deductibles, office visit copayments and prescription drug copayments.

M.G.L. c. 32B, § 25 Health reimbursement arrangements

c. 32B, § 25. Health reimbursement arrangements Section 25. Notwithstanding any general or special law or regulation to the contrary, the appropriate public authority of a political subdivision which has undertaken to provide health insurance coverage to its subscribers under this chapter or transfer its subscribers to the commission under this chapter may provide health reimbursement arrangements to reimburse subscribers for qualified medical expenses which may include, but shall not be limited to, out-of-pocket costs such as inpatient and outpatient copayments, calendar year deductibles, office visit copayments and prescription drug copayments.

M.G.L. c. 32B, § 26 Enrollment audit

c. 32B, § 26. Enrollment audit Section 26. An appropriate public authority of a political subdivision which has undertaken to provide health insurance coverage to its subscribers under this chapter shall conduct an enrollment audit not less than once every 2 years. The audit shall be completed in order to ensure that members are appropriately eligible for coverage.

M.G.L. c. 32B, § 27 Historical claims data

c. 32B, § 27. Historical claims data Section 27. An insurance carrier, third party purchasing group or administrator or the commission in the case of a governmental unit, which has undertaken to provide health insurance coverage to its subscribers by acceptance of sections 19 or 23, shall, upon written request, provide the governmental unit or public employee committee with its historical claims data within 45 days of such request; provided, that all personally identifying information within such claims shall be redacted and released in a form and manner compliant with all applicable state and federal privacy statutes and regulations including, but not limited to, the federal Health Insurance Portability and Accountability Act of 1996.

M.G.L. c. 32B, § 28 Joint negotiation and purchase of coverage

c. 32B, § 28. Joint negotiation and purchase of coverage Section 28. Nothing in section 21, 22 or 23 shall be construed to prevent 2 or more governmental units under a joint purchase or trust agreement from jointly negotiating and purchasing coverage as authorized in section 12.

M.G.L. c. 32B, § 29 Annual report on non-Medicare and Medicare plans with largest subscriber enrollments

c. 32B, § 29. Annual report on non-Medicare and Medicare plans with largest subscriber enrollments Section 29. Each fiscal year, the commission shall prepare and place on its website a report delineating the dollar amount of the copayments, deductibles, tiered provider network co-payments and other design features offered by the commission in the non-Medicare plan with the largest subscriber enrollment and the dollar amount of the copayments, deductibles, tiered provider network copayments and other design features offered by the commission in the Medicare extension plan with the largest subscriber enrollment. The commission shall also provide information on its plans with the largest subscriber enrollment upon request of any appropriate public authority or political subdivision.

Source: Massachusetts General Court (malegislature.gov)URL: https://malegislature.gov/Laws/GeneralLaws/PartI/TitleIV/Chapter32BFetched: 10/20/2026