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April 26, 2024 Clouds | 55°F
The 193rd General Court of the Commonwealth of Massachusetts

Section 4: Automatic insurance of employees; election to forego coverage; notice; withdrawal

Section 4. Each employee shall be automatically insured for at least two thousand dollars of group life insurance and at least two thousand dollars of group accidental death and dismemberment insurance and group general or blanket insurance, providing hospital, surgical, medical, dental and other health insurance benefits provided under said policy or policies, commencing on the date he first becomes eligible or on the effective date of such coverage or coverages, including dependent benefits, whichever last occurs. Notwithstanding the foregoing, a collective bargaining agreement governing the terms and conditions of employment of persons who are employees under this chapter may provide that employees who are covered by a group or nongroup health insurance plan financed without any participation by the employer or by another employee's insurance under a group or nongroup health insurance plan offered by the employer may, at the employee's option, elect to forego coverage under the employer's group or nongroup health insurance plan. Any such collective bargaining agreement shall provide for benefits, monetary or otherwise, in lieu of such coverage for employees who were covered as of July first, nineteen hundred and ninety-two by the employer's group or nongroup health insurance plan pursuant to the provisions of this chapter. For employees whose terms and conditions of employment are not subject to collective bargaining, an employer may exclude from coverage under the employer's group or nongroup health insurance plan any such nonunit employee who, at the employee's option, elects to forego such coverage, upon a determination that such employee is covered by a group or nongroup health insurance plan financed without any participation by the employer or by another employee's insurance under a group or nongroup health insurance plan offered by the employer. The employer may offer nonunit employees who were covered as of July first, nineteen hundred and ninety-two under the employer's group or nongroup health insurance plan, alternative benefits in lieu of such coverage. Any employee electing to forego coverage under the employer's group or nongroup health insurance plan shall, on an appropriate form prescribed by the appropriate public authority, give written notice, in accordance with applicable rules prescribed by the appropriate public authority, to the treasurer of the governmental unit indicating that he is not to be insured for such coverages, including dependent benefits, provided under such policy or policies. If such notice is received before the employee shall have become insured under such policy, he shall not be so insured. Once an employee elects to terminate his insurance by withdrawing, such insurance benefits shall cease to be effective on the date up to which the premium has been paid. The employer shall provide that if an employee who elects withdrawal under the provisions of this section and under the relevant clauses of an applicable collective bargaining agreement, ceases to be covered by a group of nongroup health insurance plan financed without any participation by the employer, or by another employee's insurance under a group or nongroup health insurance plan offered by the employer, such employee shall thereupon be covered by the employer's group or nongroup health insurance plan pursuant to this chapter as of the date he informs the employer in writing of such termination of insurance coverage. Any benefits, monetary or otherwise, paid to such employee in accordance with this section, shall be ratably reduced, and any amounts paid hereunder which are allocable to periods of employment after such insurance coverage by the employer's group or nongroup health insurance plan are reinstated may be recovered by the employer under such terms and such conditions as shall be provided in a collective bargaining agreement, for employees whose terms and conditions of employment are so governed, or as determined by the employer, for employees whose terms and conditions of employment are not subject to collective bargaining. In determining said date, payroll deductions of the employee shall continue to be made until the expiration of fifteen days from the receipt of notice of withdrawal by the treasurer of the governmental unit. In the event an employee is not entitled to receive salary, wages or other compensation for a calendar month but may make direct payment of his required premium contribution, the appropriate public authority or administrator of the insurance plan shall provide for the giving of timely notice to the employee of his right to make payment of the required premium contribution.

When an employee insured under this section becomes eligible for health insurance coverage as provided in section eleven C, he may terminate by withdrawal notice, as aforesaid, his hospital, surgical, medical, dental and other health benefits provided herein, and retain his automatic group life insurance and automatic group accidental death and dismemberment insurance, as provided in this section.

Every policy, whether original or renewal, shall, in the case of employees who immediately prior to the effective date of such original or new policy were covered by group insurance benefits under this chapter, provide protection by continuing uninterrupted coverage without regard to waiting periods for benefits.