PETITION OF:

Rachel Kaprielian

Richard T. Moore

Jay R. Kaufman

Christopher N. Speranzo

Richard J. Ross

Steven M. Walsh

Mary E. Grant

Michael A. Costello

Ellen Story

Joyce A. Spiliotis

Matthew C. Patrick

Brian S. Dempsey

Paul C. Casey

William G. Greene, Jr.

Louis L. Kafka

Michael E. Festa

David Paul Linsky

William C. Galvin

Denis E. Guyer

Barbara A. L'Italien

Jennifer L. Flanagan

Stephen Kulik

John W. Scibak

Susan Williams Gifford

Douglas W. Petersen

Robert S. Hargraves

Stephen R. Canessa

Ruth B. Balser

Charles A. Murphy

Mark V. Falzone

Patricia A. Haddad

Paul J. Donato

Rosemary Sandlin

Frank M. Hynes

David M. Torrisi

Anthony J. Verga

William N. Brownsberger

Lewis G. Evangelidis

Stephen L. DiNatale

John D. Keenan

Mary S. Rogeness

Peter V. Kocot

John J. Binienda

F. Jay Barrows

John V. Fernandes

Robert K. Coughlin

Pam Richardson

James B. Eldridge

Alice K. Wolf

Tom Sannicandro

Colleen M. Garry

Elizabeth A. Malia

Martha M. Walz

Frank I. Smizik

Jennifer M. Callahan

Timothy J. Toomey, Jr.

Denise Provost

Cory Atkins

Steven J. D'Amico

Theodore C. Speliotis

Eugene L. O'Flaherty

Stephen P. LeDuc

John A. Lepper

William Smitty Pignatelli

John F. Quinn

Anne M. Gobi

Bradley H. Jones, Jr.

Antonio F. D. Cabral

Carl M. Sciortino, Jr.

Alice Hanlon Peisch

Donald F. Humason, Jr.

Robert P. Spellane

Michael J. Rodrigues

Bradford Hill

Barry R. Finegold

Geraldo Alicea

Kay Khan

Harriett L. Stanley

Joseph R. Driscoll

Angelo J. Puppolo, Jr.

Thomas P. Conroy

Stephen Stat Smith

A. Stephen Tobin

John P. Fresolo

Cheryl A. Coakley-Rivera

Elizabeth A. Poirier

William Lantigua

J. James Marzilli, Jr.

Karyn E. Polito

John H. Rogers

Paul J. P. Loscocco

James T. Welch

Sarah K. Peake

Peter J. Koutoujian

Michael W. Morrissey

Linda Dean Campbell

Allen J. McCarthy

SECTION 1. Chapter 32B of the General Laws is hereby amended by striking out section 19, as appearing in the 2004 Official Edition, and inserting in place thereof the following section:-

Section 19. (a) Notwithstanding the provisions of any other section in this chapter, the appropriate public authority of any governmental unit which has undertaken to provide health coverage to its subscribers by acceptance of any other section of this chapter may instead elect to provide health coverage to all such subscribers pursuant to the provisions of this section, by entering into a contract or contracts with any one or more health carriers, or by transferring such subscribers to the group insurance commission established in chapter 32A, pursuant to subsection (e) herein. For the purposes of this section, subscribers shall be defined as employees, retirees, surviving spouses, and dependents of the governmental unit, and may include any employees, retirees, surviving spouses and dependents of a district as defined in section two herein that previously received health insurance benefits through the governmental unit accepting this section. This section shall take effect in a county, except in Worcester county, city, town or district upon its acceptance in the following manner: in a county except in Worcester county, by a vote of the county commissioners; in a city having Plan D or a Plan E charter, by majority vote of its city council and approved by the manager; in any other city by majority vote of the city council and approved by the mayor; in a town, by vote of the board of selectmen; in a regional school district, by vote of the regional district school committee; and in all other districts, by vote of the registered voters of the district at a district meeting.

Acceptance of this section shall not take effect until a written agreement is reached between the appropriate public authority and the public employee committee established herein, and such written agreement may condition acceptance of this section upon transferring of subscribers into the group insurance commission pursuant to subsection (e) herein.

A written agreement to transfer subscribers to the commission pursuant to this section shall be the sole means by which the subscribers of a governmental unit may be transferred to group insurance commission coverage.

Notwithstanding the provisions of subsection (c) of section 4 of chapter 4, the acceptance of this designation may be revoked in the same manner it was accepted in accordance with all other subsections of section 4B of chapter 4, subject to the requirements of any public employee committee agreements as provided in this section and chapter 150E; provided, that revocation of this section shall not take effect until a written agreement providing for such revocation is reached between the appropriate public authority and the employee committee established herein. Nothing in this section shall preclude an appropriate public authority from agreeing to establish a health and welfare trust fund under section 15.

Except as otherwise provided in subsection (e) of this section, any such contract or contracts with any one or more health insurance carriers shall be in conformity with an agreement reached by an appropriate public authority and a public employee committee. Such election by the appropriate public authority may be renewed in conformity with any successor agreement reached with a public employee committee.

The public employee committee shall be composed of a representative of each collective bargaining unit with which the governmental unit negotiates under chapter 150E of the Massachusetts General Laws, and a retiree. Either the public employee committee or the appropriate public authority may convene the initial meeting of said committee at any time upon 30 days notice. The retiree representative shall be a designee of the Retired State, County and Municipal Employees Association. The retiree representative shall have a 10 per cent vote. The remaining 90 per cent vote shall be divided as follows: each collective bargaining unit represented on the public employee committee shall have a weighted vote equal to the proportion which the number of employees eligible for health insurance under this chapter employed in the bargaining unit he represents bears to the total number of employees eligible for health insurance in all bargaining units of the governmental unit. Any agreement with the public authority must be approved by 70 per cent of the weighted votes of the representatives on the public employee committee as set forth in this section, and shall be binding on all subscribers and their representatives.

For the purposes of this section, a health carrier shall include any insurance company organized pursuant to chapter 175, hospital service corporation organized pursuant to chapter 176A, medical service corporation organized pursuant to chapter 176B, a health maintenance organization organized pursuant to chapter 176G, a preferred provider organization organized pursuant to chapter 176I, or, in the case of a governmental unit which is partially or fully self-insured with respect to health coverage, any third party administrator selected by the governmental unit, which may include but is not limited to any health carrier.

An agreement so approved under this section shall be binding on all active and retired employees for whom health coverage is being purchased; shall supersede any conflicting provisions of all collective bargaining agreements and shall itself not be subject to supercedence in any statutory impasse proceeding under chapter 150E, provided, however, that the agreement may include procedures for resolving an impasse in negotiations for a successor agreement. Any dispute arising over the interpretation or application of the public employee committee agreement under this section may be submitted to binding arbitration under the labor arbitration provisions of the American Arbitration Association upon request of the public employee committee or the appropriate public authority, except as otherwise provided in subsection (f) herein. Any request must be approved by 70 per cent of weighted votes of the representatives on the public employee committee as set forth in this section, or where applicable by a majority vote of the appropriate public authority.

A governmental unit which elects to provide health coverage to subscribers under this section shall be deemed in full compliance with any other provisions of this chapter regulating the procurement of health insurance.

A governmental unit which elects to provide health coverage under this section pursuant to an agreement approved by a public employee committee, may provide such coverage either as a single governmental unit or, pursuant to section 12, through joint purchase with other governmental units or, with multiple governmental units, through a risk-sharing pool, trust or health carrier or third party administrator, or by making payments to a health and welfare trust fund to provide health coverage under this section either as a single governmental unit or together with multiple governmental units.

The appropriate public authority may contract with a health carrier for direct coverage of subscribers for whom the carrier’s geographic service area provides appropriate access and coverage for other subscribers in accordance with subsection (d) herein.

(b) Nothing in this section shall be deemed to require, preclude or permit any change in any aspect of health coverage for subscribers authorized by this section except where an agreement to provide for such change is reached by an appropriate public authority and a public employee committee in an agreement entered into or modified subsequent to the effective date of this subsection except as otherwise provided in subsection (e) of this section.

In the absence of a successor agreement approved under this section the prior agreement of the public employee committee and the appropriate public authority regarding the provision of health insurance shall remain in effect.

(c) Nothing in this section shall be construed so as to relieve any governmental unit from providing health coverage to any employee, retiree, surviving spouse or dependent to whom it has an obligation to provide coverage under any other provision of this chapter.

(d) The agreement reached between an appropriate public authority and the public employee committee shall provide for those subscribers who, by reason of residence or domicile, cannot be appropriately served within the service area of the health carrier or carriers included in said agreement, subject to the provisions set forth in this subsection.

Coverage for subscribers under this subsection shall be pursuant to and in conformity with the agreement required by this section and shall conform to all requirements of this section. The agreement reached between an appropriate public authority and the public employee committee shall provide that any subscriber who for reasons of residency is not eligible for enrollment in any such plan offered by a governmental unit shall be covered under a plan offered pursuant to chapter 176I, if any such plan is provided for under said agreement; provided, that any such subscriber who lives 10 miles or more from the nearest primary care physician providing care under said plan shall have out-of-pocket payments and medical deductibles limited to the amount that he would have paid had he utilized the network of medical services of the plan offered pursuant to chapter 176I. If the agreement reached between the appropriate public authority and the public employee committee provides for only health maintenance organizations or other health carriers that limit enrollment to a particular geographic area, then, notwithstanding any general or special law to the contrary, health maintenance organizations or other health carriers shall provide for the coverage of services provided or arranged for all subscribers who do not reside within the geographic service area of said carriers in the following manner: Any subscriber not eligible for direct coverage due to his residency shall have the same benefit schedule and premium contribution provided to subscribers residing within the carrier’s geographic service area, including but not limited to covered services, out-of-pocket payments and medical deductibles for any and all medical services provided for or arranged pursuant to such agreement.

(e) Where an agreement is reached by an appropriate public authority and the public employee committee covering the public employee committee of the governmental unit executed or modified so provides, the appropriate public authority shall notify the group insurance commission that it will transfer to said commission all subscribers for whom it provides health coverage. Such notice shall be provided to the commission by the appropriate public authority no later than October 1 and the transfer of subscribers to the commission shall take effect as of the following July 1. On the effective date of the transfer, the health insurance of all subscribers, including elderly governmental retirees previously governed by section 10B of chapter 32A and retired municipal teachers previously governed by section 12 of chapter 32A, shall be provided through the group insurance commission for all purposes and governed pursuant to this section. As of the effective date and for the duration of said transfer, subscribers transferred to the commission’s health coverage shall receive group health insurance benefits determined exclusively by the group insurance commission, which coverage shall not be subject to collective bargaining with the exception of contribution ratios which shall be determined by the written agreement.

All subscribers transferred to said commission who are eligible or become eligible for Medicare coverage shall be required to transfer to Medicare coverage, as prescribed by the group insurance commission. In the event of transfer to Medicare, the governmental unit shall pay any Medicare part B premium penalty assessed by the federal government on said retirees, spouses and dependents as a result of enrollment in Medicare part B at the time of transfer into the Medicare health benefits supplement plan.

For each subscriber’s premium and the governmental unit's share of said premium, said subscriber and the governmental unit shall furnish to the commission, in such form and content as the commission shall prescribe, all such information it determines to be necessary to maintain subscribers’ and covered dependents’ health coverage. The appropriate public authority of the governmental unit shall perform such administrative functions and process such information as the commission deems necessary to maintain said subscribers’ health coverage, including but not limited to, family and personnel status changes, and shall report all such changes monthly to the commission. In the event that a governmental unit transfers subscribers to the group insurance commission under this section, subscribers may be withdrawn from commission coverage at either 3 or 6 year intervals from the date of transfer of subscribers to the commission, as determined by the written agreement which shall specify the withdrawal interval and withdrawal procedures. The written agreement may specify the procedures for resolving an impasse in negotiations over whether to withdraw from commission coverage and for determining health coverage and contribution ratios for subscribers for the year following withdrawal from the commission, provided, that in the event binding arbitration is included in the written agreement, the agreement shall provide that the dispute shall be submitted to arbitration administered by the American Arbitration Association under the procedures set forth in its Labor Arbitration Rules, unless the written agreement provides for a different method of arbitration.

The decision and notice to withdraw must be made by October 1 of the year prior to the effective date of withdrawal. All withdrawals shall be effective on July 1 following the governmental unit’s notice to the commission. Except as otherwise provided in the written agreement, withdrawal from commission coverage shall revoke adoption of this section and any written agreements related to the implementation of this section as of the effective date of withdrawal. In the event that the acceptance of this section is revoked, the appropriate public authority of the governmental unit shall abide by all commission requirements for effectuating such withdrawal, including the notice requirements in this subsection. In the event a governmental unit withdraws from group insurance commission coverage pursuant to this section, such withdrawal shall be binding on all subscribers, including those subscribers who, prior to the transfer to the commission, received coverage from the commission under sections 10B and 12 of chapter 32, provided that, after withdrawal from the commission, those subscribers shall under no circumstances pay greater than 25 per cent of the cost of their health insurance premiums.

In the event of revocation from this section, the governmental unit and public employee unions shall return to governance of negotiations of health insurance under chapter 150E and chapter 32B on the effective date of withdrawal from commission coverage, to negotiate healthcare coverage for subscribers thereafter.

(f) To the extent authorized under chapter 32A, the commission shall provide group coverage of subscribers’ health claims incurred after transfer to said commission. The claim experience of said subscribers shall be maintained by the commission in a single pool and combined with the claim experience of all covered state employees and retirees and their covered dependents, including those subscribers that previously received coverage under section 10B of chapter 32A and section 12 of chapter 32A.

Notwithstanding any general or special law to the contrary, any governmental unit that self-insures its group health plan pursuant to the provisions of section 3A of this chapter which has a deficit in its claims trust fund at the time of transferring its subscribers to the group insurance commission attributable to failure to accrue claims which had been incurred but not paid is authorized to capitalize the deficit and amortize the amount over 10 fiscal years in 10 equal amounts, or on a schedule providing for a more rapid amortization.

Except as provided otherwise herein, subscribers eligible for health coverage under subsection (e) of this section shall be subject to all of the terms, conditions, schedule of benefits, and health carriers as employees and dependents defined by chapter 32A and commission regulations. The commission shall determine all matters relating to subscribers’ group health insurance rights, responsibilities, costs and payments excluding contribution ratios, and obligations, including but not limited to, the manner and method of payment, schedule of benefits, eligibility requirements, and choice of health carriers provided that these matters shall be determined exclusively by the commission and shall not be subject to collective bargaining, the written agreement or to arbitration under the agreement. The commission may issue rules and regulations consistent with this section, and shall provide public notice of proposed rules and regulations promulgated pursuant to this section and notice of said rules and regulations at the request of interested parties, opportunity to review said rules and regulations, and opportunity to comment on said rules and regulations in writing and at a public hearing, but under no circumstances shall the commission be subject to the provisions of chapter 30A.

Said commission shall negotiate and purchase health coverage for subscribers transferred pursuant to subsection (e) and shall promulgate regulations, policies, and procedures for coverage of such subscribers so transferred. The schedule of benefits available to such transferred subscribers shall be determined by said commission in accordance with chapter 32A. Said commission shall offer such subscribers the same choice as to health carriers and benefits as those provided to state employees and retirees.  The governmental unit’s contribution to the cost of health coverage for such subscribers, shall be as determined under this section, and shall not be subject to the provisions on contributions in said chapter 32A. Any change to such premium contribution ratios shall become effective as of July 1 of each year, with notice to the commission of such change no later than January 15 of the same year.

Any governmental unit that transfers subscribers to the group insurance commission shall pay the commonwealth for all costs of its subscribers' coverage, including the entire cost of applicable administrative expenses and the governmental unit's proportional cost of subscribers' premium. The commission shall determine on a periodic basis the amount of premium and administrative expenses which the governmental units shall pay to the state treasurer, and shall certify the amounts determined as aforesaid to the state treasurer for assessment.  The state treasurer shall issue a warrant in the manner provided by section 20 of chapter 59 requiring the governmental units concerned to pay into the treasury of the commonwealth as prescribed by the commission the amounts of such premium and administrative expenses attributable to such governmental units. The treasurer shall bill the participating governmental unit for the full cost of coverage, including said administrative fee, in accordance with policies and procedures established by said commission and the treasurer.  The commission may, at its option, recoup any past due costs from the governmental unit’s so-called cherry sheet pursuant to section 20A of chapter 58. In the event that a governmental unit fails to pay to the treasurer the costs of coverage for more than 90 days and the so-called cherry sheet provides an inadequate source of payment, the commission may, at its discretion, cancel the coverage of subscribers of said governmental unit.  In the event of cancellation due to nonpayment, the governmental unit shall provide all subscribers health coverage under plans which are the actuarial equivalent of plans offered by the commission in the preceding year  until there is an agreement with the public employee committee providing for replacement coverage.

Said commission may also charge the governmental unit an administrative fee, which shall not be more than 1 per cent of the cost of total premiums for the governmental unit, to be determined by said commission which shall be considered as part of the cost of coverage for purposes of determining the contributions of the governmental unit and its employees to the cost of health coverage by the commission. Any such administrative fee charged hereunder shall be placed in a retained revenue account and used by said commission to pay any personnel or other costs associated with the administration of municipal insurance health coverage.

(g) Any agreement reached between the governmental unit and the public employee committee, including an agreement to transfer subscribers to the group insurance commission, shall provide that within the same health coverage plan the percentage contributed by the governmental unit to the premium or cost of health coverage shall be the same for all subscribers covered under this section. Said payments shall differ only by the type of coverage elected under the plan, individual, family, optional Medicare extension or other; provided, however, that the percentage contributed by the governmental unit may vary among the different health coverage plans offered under the agreement reached between the governmental unit and the public employee committee. The agreement reached hereunder shall provide that the percentage contributed by said governmental unit to the premium or cost of at least 1 Medicare extension plan available to all eligible subscribers shall be no less than the minimum percentage contributed by said governmental unit to any other health coverage plan offered pursuant to the agreement reached hereunder. Any governmental unit that accepts this section shall establish by agreement with the public employee committee a contribution by said governmental unit to said premium or cost of health coverage that provides for a minimum of 50 per cent but not more than 99 per cent. Notwithstanding the provisions of this subsection, where there is an agreement to transfer subscribers to the group insurance commission, subscribers whose coverage was governed by section 10 B of chapter 32A or section 12 of chapter 32A prior to the date that the written agreement is signed, shall not be required to contribute more than 25 per cent of their health insurance premiums, provided, however, that the written agreement may provide for a premium contribution paid by such subscribers of less than 25 per cent.

(h) In the event of revocation of or withdrawal from the group insurance commission under section 19, all retirees, their spouses and dependents insured or eligible to be insured by the governmental unit, if enrolled in Medicare part A at no cost to the retiree, spouse or dependents, shall be required to be insured by a Medicare extension plan offered by the governmental unit under section 11C or section 16. Each retiree shall provide the governmental unit, in such form as the governmental unit shall prescribe such information as is necessary to transfer to a Medicare extension plan. If a retiree does not submit the information required, he shall no longer be eligible for his existing health coverage. The governmental unit may from time to time request from any retiree, a retiree’s spouse and dependents, proof certified by the federal government of his or her eligibility or ineligibility for Medicare part A and part B coverage. The governmental unit shall pay any Medicare part B premium penalty assessed by the federal government on said retirees, spouses and dependents as a result of enrollment in Medicare part B at the time of transfer into the Medicare health benefits supplement plan.

(i) Where a public employee committee and governmental entity have in existence an agreement pursuant to section 19 of this chapter as of July 31, 2006, such agreement shall remain in full force and effect and shall henceforth be governed by this chapter, as amended; provided, however, that if such agreement provides for the transfer of subscribers to the group insurance commission, the public employee committee and the governmental unit shall amend the agreement, as needed, to be consistent with state law.

SECTION 2. Section 3 of chapter 32A of the General Laws, as appearing in the 2004 Official Edition, is hereby amended by inserting in line13 after the word “CIO” the following:-

“In addition, there shall be at least 2 but not more than 4 municipal representatives that shall be members of the group insurance commission. One management representative shall be appointed by the governor from a list of 3 representatives provided by the Massachusetts Municipal Association, and 1 labor representative shall be appointed by the governor from a list of 3 representatives provided by the president of the teachers’ union with the greatest amount of active and retired members enrolled in commission health plans. In addition, upon the transfer of 25,000 subscribers from municipal governmental units to the group insurance commission pursuant to section 19 of chapter 32B, there shall be a second management representative appointed by the governor from a list of 3 representatives provided by the Massachusetts Municipal Association and a second labor representative by the governor from a list of 3 representatives of municipal public safety employees provided by the president of the Massachusetts Chapter of the AFL-CIO. In the event that the governor fails to take action within 180 days to appoint any of said representatives to the commission, a representative from the list for which no action has been taken shall be appointed to the commission by the relevant organization.”

SECTION 3. Section 3 of chapter 32A of the General Laws, as appearing in the 2004 Official Edition, is hereby amended in line 13 by striking the word ”five” and inserting in place thereof the following:-

“55 per cent of the”

SECTION 4: Section 19 of chapter 32 of the General Laws, as appearing in the 2004 Official Edition, is hereby amended by inserting at the end thereof the following paragraph:-

“A retirement board in the case of a retiree is authorized to deduct the per cent contribution of health insurance premiums for all retired members receiving group life insurance, group accidental death and dismemberment insurance, group general or blanket hospital, surgical, medical, dental or other health insurance coverage pursuant to Chapter 32B from the respective retiree pension check. In the event that that the amount of a retired member’s pension check is insufficient to accommodate the entire deduction, upon notice from the retirement board, the employer for whom the member last worked and from whom the member is retired shall bill the retired member for the employee share of the premiums.”