Section 10B. The commission shall negotiate with and purchase on such terms as it deems to be in the best interest of the commonwealth, certain political subdivisions that have accepted the provisions of this section, and the elderly governmental retirees and their dependents, from one or more insurance companies or non-profit 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 benefits for said retirees and their dependents. Such policy or policies shall consist of a schedule of hospital, surgical, medical, dental and other health insurance benefits for elderly governmental retirees and their surviving spouses which may be related to the schedule of hospital, surgical, medical, dental and other health insurance benefits purchased by the commonwealth under the provisions of sections 4, 4A and 10C, or the schedule of hospital, surgical, medical, dental and other health insurance benefits purchased by counties, cities, towns and districts under the provisions of section three of chapter thirty-two B. Such schedule of benefits for elderly governmental retirees may include the payment of any premium which may be required by the federal health insurance for the aged act to be paid by the enrollee thereof. The agreement between the carrier and the commission for said policy or policies may provide in addition to agreed, set, or stated monthly premium applicable to the aforementioned schedule a surcharge or subsidiary rate. The commission shall execute all agreements or contracts pertaining to said policy or policies or any amendment thereto for and on behalf and in the name of the commonwealth, for a period not exceeding five years; provided, however, that the portion of the cost of the monthly premium, and surcharge or subsidiary rate applicable to employees retired from the service of the commonwealth as enumerated in paragraph (b) of section two to be borne by the commonwealth shall not exceed the estimated monthly cost for which funds have been appropriated or otherwise made available by the general court for the then current fiscal year.
(a) With respect to any period of insurance which is in effect for the elderly governmental retiree, notwithstanding the provisions of section nineteen of chapter thirty-two or any other general or special law to the contrary, there shall be withheld from each monthly payment of pension, annuity or retirement allowance by the respective retirement system or by the appropriate retiring authority, fifty per cent of the premium for such insurance, and the commonwealth shall make primary payment of the remaining fifty per cent of said premium subject to reimbursement as outlined in (c) below.
(b) The retiree's fifty per cent share of the premium shall be withheld by the appropriate authority from the retiree's pension, annuity or allowance under the state employees' retirement system, the teachers' retirement system, the retirement system established in the county, city, town or district, and under any non-contributory pension or annuity, and shall be forwarded by the responsible governmental official to the commission in accordance with its rules and regulations. The commission shall make primary payment of the remaining fifty per cent of said premium together with the surcharge or subsidiary rate, subject to reimbursement as outlined in paragraph (c).
(c) The commission shall determine at least annually, or sooner, the amount of premiums and surcharge or subsidiary rates which shall be reimbursed to the commonwealth by agencies thereof, by housing and redevelopment authorities and counties, cities, towns and districts, having elderly governmental retirees insured under this section. The commission shall also determine, at least annually, the portion of the commission's expense of administering this hospital, surgical, medical, dental and other health insurance coverage for elderly governmental retirees applicable to the agency, authority or political subdivision from which they retired. After such determinations, the commission shall certify the amounts determined as aforesaid to the state treasurer for assessment. The state treasurer shall issue his warrant in the manner provided by section twenty of chapter fifty-nine requiring the cities and towns concerned to pay into the treasury of the commonwealth the amounts of such premium, surcharge or subsidiary rate and administrative expenses attributable to such cities and towns. In the case of counties, the commission on or before December fifteenth in each year shall notify the county commissioners of each county of the amount of premium, surcharge or subsidiary rate and the administrative expenses attributable to such county, and said amounts shall be included in the estimate of county receipts and expenses of said county; and reimbursement for said amounts shall be made to the state treasurer as prescribed by the commission.
(d) Any dividend or refund accepted by the commission from the carrier as a result of the contract negotiated under this section, shall be deposited by the commission with the state treasurer as provided in section nine. The commission shall determine the amount of dividend or refund apportionable to the various counties, cities, towns and districts having elderly governmental retirees insured hereunder, and in the case of a city, town or district shall notify the state treasurer to reduce the premium charges and administrative expenses attributable to each such city, town or district by the amount of refund attributable thereto. In the case of counties, the commission shall notify the county commissioner of each county of the amount of refund attributable thereto and the estimate of receipts and expenditures for the ensuing year in each such county shall be reduced by the amount of such refund. If no premium is to be payable by a county, city, town or district for the succeeding year the commission shall certify the same to the state treasurer who shall pay over the amount of such refund to the political subdivision entitled thereto. The remaining portion of the dividend or refund apportionable to the commonwealth shall be applied as provided in section nine.
(e) Each elderly governmental retiree to whom this chapter applies shall furnish the commission, in such form as it shall prescribe, such information as is necessary to insure himself or himself and his dependents under the hospital, surgical, medical, dental and other health insurance herein provided, and shall authorize the withholding of the appropriate premium from his pension, annuity or retirement allowance by the appropriate governmental authority. Each such retiree or his dependent 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 make direct payment to the commission as it may determine, and the commission shall transmit all such amounts to the appropriate federal agency on behalf of such enrollee in a manner prescribed by said agency.
(f) Upon the death of an elderly governmental retiree, the surviving spouse may continue the group hospital, surgical, medical, dental and other health insurance as provided under section eleven.
(g) The rules and regulations of the commission which govern the administration of this section shall not be subject to the provisions of chapter thirty A.
Structure Massachusetts General Laws
Part I - Administration of the Government
Title IV - Civil Service, Retirements and Pensions
Section 1 - Purpose of Chapter
Section 3 - Group Insurance Commission
Section 3a - Employees' Advisory Committee
Section 3b - Applicability of Chapter to Commonwealth Charter Schools and Education Collaboratives
Section 4 - Purchase of Insurance Policies by Commission
Section 4a - Administrative Services Contracts
Section 4b - Retroactive Claims Denials for Behavioral Health Services
Section 5 - Insurance and Medicare Benefits of State Employees
Section 7 - Information Furnished Commission by Employees
Section 9 - Dividends, Refunds, Rate Credits; Deposit in Special Funds; Transfer of Reserves
Section 9a - Investment Committee; Investment and Deposit of Funds by State Treasurer
Section 10 - Retirement or Termination of Employment; Effect on Policy; Conversion of Insurance
Section 10a - Additional Insurance
Section 10b - Insurance for Elderly Government Retirees and Their Dependents
Section 10c - Optional Medicare Extension
Section 10d - Disability Insurance; Withholding Payment of Premiums
Section 10e - Insurance for Commonwealth Employee Granted Leave to Care for Dependent Child
Section 11 - Death of Employee or Retired Employee; Continuation of Insurance by Spouse or Dependent
Section 11a - Divorced or Separated Spouses; Continuation of Insurance Coverage
Section 14 - Optional Insurance for Services of Health Care Organizations
Section 16 - Election to Continue Insurance Coverages; Notice
Section 17 - Dental and Vision Expenses; Reimbursement of Employees
Section 17a - Coverage for Nonprescription Enteral Formulas for Home Use
Section 17b - Hospice Services for Commonwealth Employees Insured Under Group Insurance Commission
Section 17c - Required Coverage for Prenatal Care, Childbirth, and Postpartum Care
Section 17d - Coverage for Bone Marrow Transplants
Section 17e - Scalp Hair Prostheses Necessary Due to Cancer or Leukemia Treatment
Section 17f - Newborn Hearing Screening Test; Group Insurance Commission Coverage
Section 17h - Coverage for Human Leukocyte or Histocompatibility Locus Antigen Testing
Section 17i - Prosthetic Devices and Repairs; Group Insurance Commission Coverage
Section 17j - Coverage for Children Under Age 18 for Cleft Lip and Cleft Palate
Section 17k - Coverage for Orally Administered Anticancer Medications
Section 17l - Coverage for Abuse Deterrent Opioid Drug Products
Section 17m - Preauthorization for Substance Abuse Treatment Not to Be Required
Section 17q - Pain Management Access Plan
Section 18 - Medicare Health Benefits Supplement Plan, Mandatory Transfer; Payment of Penalty
Section 19 - Release From Insurance Coverage; Payment; Reinstatement of Coverage
Section 20 - Charges or Collections of Excess Compensation
Section 21 - Health Care Services Evaluation; Vendor Quality Improvement Program; Annual Report
Section 23 - Coverage for Speech, Hearing and Language Disorders
Section 24 - State Retiree Benefits Trust Fund
Section 24a - State Retiree Benefits Trust Fund Board of Trustees; Membership; Powers and Duties
Section 25 - Insurance Coverage for Diagnosis and Treatment of Autism Spectrum Disorder
Section 28 - Coverage for Certain Services and Contraceptive Methods