Section 15. The commission may negotiate with and purchase on such terms as it deems to be in the best interest of the commonwealth and its active and retired employees and their dependents eligible under this chapter, from one or more insurance carriers authorized to sell health insurance in the commonwealth, a policy or policies providing basic and extended coverage for catastrophic illness such as cancer and other dread diseases as may be included from time to time by the commission. Such insurance shall provide basic and extended coverage including, but not limited to, ambulance services, in-patient and out-patient hospital services, blood and plasma, medicines and drugs, x-ray and other related treatments, nursing care, surgical, medical and other licensed practitioners' services, services of institutions providing rehabilitative care, or nursing or convalescent home care, and, for custodial care necessitated as a result of an illness covered under such policy or policies of insurance.
The commission shall negotiate a contract that assures sound financial stability consistent with insurance risks for long-term catastrophic illnesses, and shall be for a period of time and from time to time continuously without interruption of coverage; but any such contract with a carrier may be terminated by the commission provided that reasonable advance notice is given by the commission as provided in said policy or policies of insurance. The scope of insurance coverage under this section may relate to other health insurance coverages and experience accounting as provided in appropriate sections of this chapter, in order to attain the broadest possible basis of risk and protection.
Payment of premiums for catastrophic illness insurance provided in this section shall be made by the active and retired employee or surviving spouse thereof with no contribution by the commonwealth, and the method for such payments shall be as provided in sections eight, ten, ten B, ten C, eleven, twelve and fourteen, as may be applicable. Any dividend, refund or its equivalent accepted by the commission from the carrier or carriers shall be applied as provided in section nine.
Any policy or policies issued pursuant to this section shall provide that on termination of employment of an employee, or of coverage if a retiree, an employee or retiree shall be entitled, subject to the requirements of the commission, to convert his catastrophic illness coverage to a nongroup type of policy.
The commission may promulgate rules and regulations implementing and maintaining the provisions of this section, and such rules and regulations 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