Group Insurance Commission
Administrative Bulletin FY13-02: Guidance Regarding
Implementation of Regulatory Changes to Eligibility for Health Insurance
April 17, 2013
In regulations approved by the Commission on April 12, 2013, the Group Insurance Commission (GIC) revised its interpretation of c. 32B, §§ 19 and 23, with respect to the eligibility for health insurance through the GIC of municipal elected officials and certain other classes of employees. As soon as they are published by the Secretary of the Commonwealth, the regulations will become final. The GIC anticipates they will be published on May 10, and so will be in effect for the plan year starting July 1, 2013. The purpose of this bulletin is to inform interested parties how the GIC will implement this change.
The GIC administers benefits for employees, retirees, survivors, and dependents of municipal entities that have accepted chapter 32B, § 19 or §23, and have met other transfer requirements of the relevant section (“participating municipalities”). Since chapter 67 of the acts of 2007 rewrote G.L. c. 32B, § 19, the GIC has understood eligibility for health benefits to be generally subject to c. 32A, not chapter 32B, eligibility rules.
Of particular note here are elected officials: per chapter 32A, § 2(b), persons elected by popular vote are eligible for insurance without regard to hours worked. In chapter 32B, §2 (“Employee”), the rule is somewhat different: elected official who work less than half-time may be eligible for health insurance, at local option. Other classes of employees are subject to special rules in chapter 32B that lack any c. 32A counterpart: in c. 32B, certain firefighters and other emergency service workers as well as traffic supervisors are eligible at local option without regard to hours worked. See c. 32B, §§ 2 (“Employee”), 2B, and 3A.
As stated above, to date, the GIC has interpreted G.L. c. 32B, §§ 19 and 23 to permit the GIC to rely on c. 32A eligibility rules to govern eligibility in participating municipalities, even where c. 32A and c. 32B differ from each other. In the regulations finalized on April 12, the GIC is revising that interpretation. Prospectively, the GIC’s interpretation of c. 32B, §§ 19 and 23, is that in the limited circumstances in which c. 32A and c. 32B eligibility requirements vary, c. 32B rules will apply to participating municipalities. See 805 C.M.R. § 8.03(2) and (3). Transitionally, this change creates the challenge of determining how to re-establish local option components of c. 32B.
GIC will presume that present practices reflect local option
In the interests of a smooth transition, by default, the GIC will assume that current practices reflect local option preferences, unless and until the GIC is advised otherwise by the municipality.
Municipalities may exercise local options, with notice to the GIC
Prospectively, municipalities may inform the GIC that they intend to change their local option elections. They must comply with applicable local options laws, where applicable. Additionally, participating municipalities must inform the GIC by May 8, 2013, if they intend to change local option elections for coverage effective July 1, 2013. Prospectively, participating municipalities must notify the GIC three months in advance of the effective date of any change in eligibility related to a change in local option.
This information provided by the Group Insurance Commission .