(1) The Commission shall determine the full cost rates for Health Coverage, to be shared by the Municipal Employer and Municipal Insureds. The full cost rates shall consist of a premium cost and an administrative fee determined by the Commission. The administrative fee shall not exceed 1 percent of the premium cost.
(2) The Municipal Employer shall arrange for all Municipal Insureds' premium contributions to be deducted from their paychecks or retirement allowance one month in advance of coverage.
(3) No later than March 1, the Municipal Employer shall notify the Commission of any change to Municipal Insureds' premium contribution ratios. Changes to contribution ratios shall be effective July 1st.
(4) The Municipal Employer shall transmit monthly to the Commission the full cost of Municipal Insureds' Health Coverage, including the applicable administrative fee. Payment of Municipal Insureds' Health Coverage is due on a date determined by the Commission. The Commission shall invoice the Municipal Employer on a monthly billing cycle for the full cost health insurance premium liability and administrative fee. Invoices will be sent electronically, via secure email, to each Municipal Employer each month; any adjustments will be separately noted on the following month’s invoice.
(a) In the event that a Municipal Employer fails to pay the cost of its Insureds' Health Coverage within 30 days of the premium due date, the Commission shall send an overdue notice to the Municipal Employer. Payments not received after 30 days' delinquency will be subject to interest charges and further action.
(b) The Commission shall notify the Public Employee Committee, the Municipal Employer, and the Executive Office for Administration and Finance of the delinquency and the Commission's intention to cancel coverage if the Municipal Employer fails to pay the full amount in arrears for more than 60 days from the invoice due date.
(c) As to remaining arrearages, the Commission may inform the state treasurer who shall issue a warrant in the manner provided by M.G.L. c. 59, § 20 requiring the Municipal Employer to pay into the treasury, as prescribed by the Commission, the amount of the premium and administrative expenses attributable to the political subdivision, see M.G.L. c. 58, § 20A.
(d) If any amount remains in arrears at the end of a 90-day period, the Commission may begin termination proceedings of the Municipal Employer's health coverage, and the Municipal Employer may be responsible for all claims incurred during the period in which the full premium was not paid.
(5) If a Municipal Employer fails repeatedly or egregiously to notify the Commission within 60 days of a termination or other loss of eligibility due to a change in employment status, the Commission may assess against the Municipal Employer a financial penalty of $100 per ineligible person per month, or the amount by which actual claims for any ineligible person exceeded premiums paid by the Municipal Employer for that person, whichever is greater.
This information provided by the Group Insurance Commission .
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