Massachusetts General Laws
Chapter 176a - Non-Profit Hospital Service Corporations
Section 8d - Limited Extension of Benefits

Section 8D. Whenever a subscriber of a group non-profit hospital service contract, other than one authorized under the provisions of chapter thirty-two A or chapter thirty-two B, becomes ineligible for continued participation in such group contract because of involuntary lay-off or death, the coverage originally provided by such contract for the subscriber and his dependents shall be continued as provided herein for a period of thirty-nine weeks from the date of such ineligibility or until such subscriber and his dependents become eligible for benefits under another group plan, whichever occurs first but in no event shall such continuation period exceed the period during which the member was most recently covered under such group plan. The employer or policyholder shall notify the involuntary laid-off member, surviving spouse of a deceased member and dependents of their eligibility to participate in such plans. The involuntary laid-off member, surviving spouse of a deceased member and dependents may elect to continue participation in such plan by giving at least thirty days written notice thereof to the employer or policyholder. Such member or surviving spouse or dependents, as the case may be, shall be responsible for the payment of the whole premium due for such coverage, including any and all amounts normally paid by the employer as employee's benefits, to the employer or policyholder throughout the extension period. After timely receipt of the premium payment from the responsible individual, if the employer or policyholder fails to make payment to the insurer or hospital or medical service corporation with the result that coverage is terminated, the employer or policyholder shall be liable for benefits to the same extent as the insurer or hospital or medical service corporation would have been liable if coverage had not been terminated. Timely receipt of premium payment shall mean the employer's or policyholder's receipt of the premium or subscription fee for the extended coverage from such member or his dependents within the dates or by the date indicated by the employer or policyholder at the time of the election of extended coverage. Failure to give notice or to make premium payments as hereinabove provided shall constitute a waiver of the option to have such extended coverage.
In addition, whenever such group non-profit hospital service contract is issued or subsequently renewed by agreement between the insurer and the policyholder, within or without the commonwealth, during the period this provision is effective, such plan shall include coverage such that when a subscriber of such group contract becomes ineligible for continued participation in such contract because he is an employee whose employment is terminated due to a plant closing or covered partial closing, as those terms are defined in section seventy-one A of chapter one hundred and fifty-one A, the coverage originally provided by such contract for the subscriber and his dependents shall continue as provided herein, for a period of ninety days from the date of ineligibility or until such subscriber and his dependents become eligible for benefits under another group plan, whichever comes first. Such subscriber and such employer or policyholder shall be responsible for the payment of their respective shares of the premium due as provided in said group plan. In the event that said employer or policyholder closed under the provisions of the Federal Bankruptcy Act, 11 USC sec. 101 et seq. except for employers or policyholders in reorganization proceedings, such employer's or policyholder's share of the premium shall be paid from the Health Insurance Benefits Fund established pursuant to section seventy-one E of said chapter one hundred and fifty-one A. The employer or policyholder shall notify the terminated member of their eligibility to participate in such plans. The terminated member may elect to continue participation in such plan by giving written notice thereof to the employer or policyholder. The member whose employment has been terminated shall be responsible for the payment of whatever part of the premium, if any, normally paid by such terminated employee as originally provided in such plan, throughout the ninety day period. If applicable, after timely receipt of the premium payment from the individual, if the employer or policyholder fails to make payment to the insurer or hospital or medical service corporation with the result that the coverage is terminated, the employer or policyholder shall be liable for the benefits to the same extent as the insurer or hospital or medical service corporation would have been liable if coverage had not been terminated. Timely receipt of payment shall mean the employer's or policyholder's receipt of the premium or subscription fee for extended coverage from such member within the dates or by the date indicated by the employer or policyholder at the time of the election of extended coverage. Failure to give notice or to make premium payments as hereinabove provided shall constitute a waiver of the option to have such extended coverage. Notwithstanding the provisions of this paragraph, any contractual agreement arrived at by a collective bargaining process that contains provisions requiring an employer to pay for the continuation of such insurance for employees whose employment is terminated by a plant closing or covered partial closing shall supercede the requirements of this paragraph when said contractual agreement provides at least three months or ninety days continuation of such insurance. Otherwise, the requirements of this paragraph shall be deemed to be controlling.

Structure Massachusetts General Laws

Massachusetts General Laws

Part I - Administration of the Government

Title XXII - Corporations

Chapter 176a - Non-Profit Hospital Service Corporations

Section 1 - Corporations Governed by Chapter; Services Received in Nonparticipating Hospital; Substitution of Benefits in Nursing Homes

Section 1a - Right to Become Subscriber; Open Enrollment Periods

Section 1b - Medicare Supplemental Group Coverage; Medical Assistance Recipients

Section 1c - Retroactive Premium Rate Increase

Section 1d - Contracts of Reinsurance

Section 2 - Incorporators; Directors; Certificate of Organization; Commissioner's Examination Report

Section 3 - Certificate of Compliance; Examination by Commissioner

Section 3a - Discrimination Against Abuse Victims in Terms of Hospital Service Plans

Section 3b - Medical Service Plans; Genetic Tests; Discrimination Based on Genetic Information

Section 4 - Accounting System; Accountant, Claim Manager, Underwriter and Actuary

Section 5 - Joint Administration With Certain Corporations

Section 6 - Approval of Nongroup Contracts

Section 7 - Information Gathering Authority of Commissioner; Confidentiality and Privilege

Section 8 - Conditions to Issuance or Delivery of Contract

Section 81/2 - Sale of Group Non-Profit Hospital Service Contracts

Section 8a - Mental Illness Expenses; Inclusion in Contracts as Benefits; Biologically-Based Mental Disorders; Rape-Related Mental Disorders; Non-Biologically-Based Mental Disorders for Children and Adolescents Under Age 19

Section 8a3/4 - Retroactive Claims Denials for Behavioral Health Services

Section 8b - Dependent Coverage for Newborn Infants or Adoptive Children; Inclusion in Contracts

Section 8c - Refusal to Contract With Blind or Deaf Persons; Prohibition

Section 8d - Limited Extension of Benefits

Section 8e - Diethylstilbestrol Exposure; Discrimination

Section 8f - Divorced or Separated Spouses; Continuation of Eligibility for Benefits

Section 8g - Cardiac Rehabilitation Expense Benefits

Section 8h - Prenatal, Childbirth and Postpartum Care Benefits; Minimum Coverage for In-Patient Care

Section 8i - Home Care Benefits

Section 8j - Minimum Requirements for Cytologic Screening and Mammographic Examination Expense Benefits

Section 8k - Infertility Diagnosis and Treatment Benefits

Section 8l - Nonprescription Enteral Formulas for Home Use

Section 8m - Standardized Claim Form

Section 8n - Off-Label Drug Use; Cancer

Section 8o - Hospital Service Plan Benefits for Bone Marrow Transplants

Section 8p - Items Medically Necessary for Diagnosis and Treatment of Diabetes

Section 8q - HIV/AIDS Treatment; Off-Label Prescription Drug Coverage

Section 8r - Coverage of Hospice Services for Terminally Ill Patients

Section 8s - Nurse Anesthetist and Nurse Practitioner Services

Section 8t - Scalp Hair Prostheses Necessary Due to Cancer or Leukemia Treatment

Section 8u - Emergency Services Provided to Insureds for Emergency Medical Conditions

Section 8v - Coverage for Human Leukocyte or Histocompatibility Locus Antigen Testing

Section 8w - Outpatient Services; Hormone Replacement Therapy for Peri and Post Menopausal Women; Contraceptive Services; Approved Prescription Contraceptive Drugs and Devices; Exception

Section 8x - Coverage for Patient Care Services Under Qualified Clinical Trials

Section 8y - Diagnosis and Treatment of Speech, Hearing and Language Disorders

Section 8aa - Coverage of Prosthetic Devices and Repairs

Section 8bb - Coverage for Eligible Dependents Under 26 Years of Age

Section 8cc - Coverage for Medically Necessary Hypodermic Syringes or Needles

Section 8dd - Coverage for Diagnosis and Treatment of Autism Spectrum Disorder

Section 8ee - Coverage for Children Under Age 18 for Cleft Lip and Cleft Palate

Section 8ff - Coverage for Orally Administered Anticancer Medications

Section 8gg - Coverage for Abuse Deterrent Opioid Drug Products

Section 8hh - Preauthorization for Substance Abuse Treatment Not to Be Required

Section 8ii - Coverage for Medically Necessary Acute Treatment or Clinical Stabilization Services

Section 8jj - Coverage for Long-Term Antibiotic Therapy for Patients With Lyme Disease

Section 8kk - Coverage for Medical or Drug Treatments to Correct or Repair Disturbances of Body Composition Caused by HIV Associated Lipodystrophy Syndrome

Section 8ll - Filling of Remaining Portion of Prescription for Covered Drug That Is a Narcotic Substance Earlier Filled in Lesser Quantity

Section 8mm - Pain Management Access Plans

Section 8nn - Coverage for Tobacco Use Cessation Counseling and Tobacco Cessation Products

Section 8oo - Coverage for Treatment of Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections and Pediatric Acute-Onset Neuropsychiatric Syndrome

Section 8pp - Coverage for Long-Term Antibiotic Therapy for Lyme Disease; Experimental Drugs

Section 8qq - Coverage for Prescription Eye Drops

Section 10 - Group Hospital Service Plan; Approval or Disapproval of Contracts and Rates; Filing

Section 10a - Preferred Provider Arrangements

Section 11 - Officers; Duties

Section 12 - Publication of Assets and Liabilities

Section 13 - Hospitalization and Medical Service for Officers and Employees of Corporation

Section 14 - Misrepresentation of Terms of Subscriber's Contract

Section 14b - Disclosure of Information; Mental or Nervous Conditions; Exceptions

Section 15 - Costs of Solicitation of Subscribers and Administration

Section 16 - Acquisition of Real Estate; Leases; Tax Exemption; Limit; Approval of Investments, Sales, Loans and Places of Deposit

Section 17 - Submission of Disputes and Controversies

Section 18 - Annual Statement of Condition; Verification, Filing, Form, Violations; Applicability of Chapters 176v and 176w

Section 18a - Financial Statements; Inclusion of Electronic Data Processing Equipment as Asset

Section 19 - Tax Exemption

Section 20 - Filing of Amendment of By-Laws

Section 21 - Submission of Advertising Matter to Commissioner

Section 22 - Filing of Riders, Endorsements and Applications With Commissioner

Section 23 - Grounds for Enjoining Transaction of Business; Rehabilitation Proceedings; Duties of Receiver; Distribution of Assets

Section 24 - Special Contingent Reserve Fund

Section 25 - Licensing of Agents

Section 26 - Salaries, Compensation or Emoluments Paid by Corporation

Section 27 - Payroll Deductions for Governmental Employees

Section 28 - Violations; Penalties

Section 29 - Application

Section 30 - Savings Clause

Section 31 - Contracts for Administrative or Other Services; Loans and Investments

Section 32 - Payment of Sums Owed to Subscriber's Estate

Section 33 - Insolvency of Health Maintenance Organization; Replacement Coverage

Section 34 - Report of Individuals Provided With Creditable Coverage

Section 36 - Attribution of Members to a Primary Care Provider

Section 37 - Disclosure of Patient-Level Data and Contracted Prices of Individual Health Care Services by Carriers to Providers

Section 38 - Coverage for Health Care Services Delivered via Telehealth by a Contracted Health Care Provider