805 CMR, § 8.04 - Coverage Continuation and Termination, Notice Deadline

(1) A Municipal Employer that transfers to Health Coverage due to a Fiscal Emergency declared by the Legislature may continue Health Coverage for its insureds after the governing finance control board or receiver determines that a Fiscal Emergency no longer exists or otherwise ends its oversight of the Municipal Employer. If a Municipal Employer remains in Health Coverage after release from finance control board oversight, the Municipal Insureds' Health Coverage shall be subject to the same Commission rules and regulations that apply to Municipal Employers whose Insureds have joined Health Coverage pursuant to M.G.L. c. 32B, § 19.

(2) If a Municipal Employer terminates Commission coverage without giving notice by the deadline, the Municipal Insureds' Health Coverage shall be cancelled for nonpayment retroactive to the last month for which the Municipal Employer paid its share of the premium.

(3) A Municipal Employer transferring out of the Commission's coverage pursuant to M.G.L. c. 32B, § 19 or 23 shall provide the Commission with notice on or before December 1^st for transfer on July 1^st of the following year. The effective date for a Municipal Employer to withdraw from Commission coverage shall be on July 1^st of the expiration year as specified in a municipal entity's bargained agreement or Order of the Panel, and Commission coverage shall end on June 30^th.

(4) A Municipal Employer that withdraws from Commission coverage and does not immediately transfer its Insureds to the Commission pursuant to a different section of M.G.L. c. 32B may not transfer its Insureds to the Commission for three years. For example, a Municipal Employer may withdraw from Commission coverage pursuant to M.G.L. c. 32B, § 19 effective July 1^st and transfer its Insureds to Commission coverage pursuant to M.G.L. c. 32B, § 23, as of the same July 1^st. However, if it does not do so, but instead withdraws from all Commission coverage, it may transfer its Insureds once again to the Commission no earlier than July 1^st, three years after the effective date of the earlier withdrawal.

(5) A Municipal Employer that fails to notify the Commission of its transfer decision as specified in 805 CMR 8.04(3) and fails to provide the Commission with a new PEC agreement by the expiration of its then current PEC agreement shall be re-enrolled for the minimum renewal period specified in M.G.L. c. 32B, § 19 or 23. The contribution ratios specified in M.G.L. c. 32B, § 19 expiring PEC agreement will continue until a successor agreement is provided to the Commission.

Notes

805 CMR, § 8.04

Amended by Mass Register Issue 1310, eff. 4/8/2016.