Section 12. The commission shall negotiate with and purchase on such terms as it deems to be in the best interests of the commonwealth, the political subdivisions that have accepted the provisions of this section as of April 1, 2018 and teachers retired from such political subdivision who are receiving a pension, annuity or retirement allowance from the state teachers' retirement system, as provided in chapter thirty-two, a policy or policies of group life insurance in the amount of one thousand dollars and such greater amount of group life insurance and two thousand dollars of group accidental death and dismemberment insurance for teachers retired from governmental units having accepted section nine F of chapter thirty-two B, and, a policy or policies of group hospital, surgical, medical, dental and other health insurance including optional medicare extension from one or more insurance companies, savings banks or non-profit hospital, medical or dental service corporations for such retired teachers and their dependents and the surviving spouse and dependents of such retired teachers. Said policy or policies shall consist of hospital, surgical, medical and other health insurance coverage for said retired teachers, their surviving spouse and dependents which may be related to the health insurance coverages purchased by the commonwealth under the provisions of sections four, four A and ten C or the health insurance coverages purchased by counties, cities, towns and districts under the provisions of sections three and eleven C of chapter thirty-two B. The claim experience of said retired teachers, or their surviving spouses and dependents may be maintained by the commission unrelated to the claim experience applicable to the aforementioned life and health insurance coverages. 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 to exceed five years; provided, however, that the portion of the total monthly cost to be borne initially by the commonwealth shall not exceed the estimated total monthly cost for which funds have been appropriated or otherwise made available by the general court for the then current fiscal year. The commission, subject to a subsidiary rate as hereinafter provided, may change the amount of the payment to be made by the retired teacher or surviving spouse and dependents which payment shall be fifty per cent of a monthly premium determined from time to time by the commission as part of a total monthly cost for all insurance purchased by the commission under this section and the commonwealth shall contribute the remaining fifty per cent. In addition to the contribution of fifty per cent of the aforesaid premium, the commonwealth, where necessary, shall make payment in full of a subsidiary or additional rate as determined by the commission which rate may be lower or higher than the commonwealth's fifty per cent contribution of said premium. The combination of payment of premium, subsidiary or additional rate by the commonwealth will accordingly exceed fifty per cent of the total monthly cost for such insurance but in no event shall such combination of payment by the commonwealth equal the total monthly cost for all insurance purchased as aforesaid.
Every agreement or contract 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 agreement or contract were insured for group life and health insurance coverages under chapter thirty-two B, provide protection by continuing uninterrupted coverage without regard to the number of months such prior insurance coverages were in force.
(a) Each retired teacher or insured surviving spouse to whom this section 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 applicable insurance coverages described herein, and shall authorize the withholding of the appropriate premium from his pension, annuity or retirement allowance by the teachers' retirement board established by chapter fifteen. Such authorization may include 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.
(b) With respect to any period of insurance which is in effect for a retired teacher or surviving spouse, and dependents, 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 teachers' retirement board the appropriate premium to be paid by said teacher or surviving spouse for such insurance and the commonwealth shall make primary payment of the remaining premium together with the subsidiary or additional rate if any, subject to reimbursement as outlined in paragraph (d).
(c) The teachers' retirement board shall transmit the premiums withheld as provided in paragraph (b) to the commission in accordance with the rules and regulations of the commission.
(d) The commission shall determine at least annually, or sooner, the amount of premiums and subsidiary or additional rates which shall be reimbursed to the commonwealth by counties, cities, towns and districts having retired teachers, surviving spouses and dependents insured under this section. The commission shall also determine, at least annually, the portion of the commission's expense of administering these life and health insurance coverages for retired teachers and their dependents applicable to the 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, towns and districts concerned to pay into the treasury of the commonwealth the amounts of such premium, subsidiary or additional rate and administrative expenses attributable to such cities, towns and districts. In the case of counties, the commission on or before December the fifteenth in each year shall notify the county commissioners of each county of the amount of premium, subsidiary or additional 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.
(e) Any dividend or refund accepted by the commission from the carrier or carriers as a result of the agreements or contracts 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 retired teachers insured hereunder and, in the case of a city, town or district, shall notify the state treasurer to reduce the premium, subsidiary rate and administrative expenses attributable to each such city, town or district by the amount of dividend or refund attributable thereto. In the case of counties, the commission shall notify the county commissioners of each county of the amount of dividend or 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 dividend or 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 dividend or refund to the political subdivision entitled thereto.
(f) Upon the death of a retired teacher insured under this section, the surviving spouse may continue the health insurance coverage upon the payment of the appropriate premium and in a manner prescribed by the commission.
(f1/2) No political subdivision may accept the provisions of this section after April 1, 2018.
(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