Related to:

805 CMR 7.00: Retired Municipal Teachers

Date: 11/14/2017
Organization: Group Insurance Commission
Regulatory Authority: Group Insurance Commission
Official Version: Published by the Massachusetts Register

This is an unofficial version of Commonwealth regulations and is posted here for the convenience of the public. It is not an official statement of the regulations.

These provisions regulate GIC coverage of certain Retired Municipal Teachers (“RMTs”) and their surviving spouses. Please note that not all retired teachers receiving benefits through the GIC are RMTs.

Contact for 805 CMR 7.00: Retired Municipal Teachers

Group Insurance Commission

7.01: General

(1) A Local Governmental Unit that accepts M.G.L. c. 32B, § 11E shall inform the Commission in writing of its decision to transfer its retired teachers to the Commission's Health Coverage for Retired Municipal Teachers.

(2) Upon receiving the Local Governmental Unit's acceptance notice, the Commission shall consider applications from the Local Governmental Unit and shall notify the Local Governmental Unit's treasurer that the Commission has approved the coverage transfer. Thereafter, the Local Governmental Unit shall promptly notify all teachers whom it employs that they must be enrolled in the Local Governmental Unit's basic life insurance upon retirement in order to be eligible for the Commission's life insurance and Retired Municipal Teacher health coverage.

(3) Eligible retiring teachers or their surviving spouses, as applicable, who apply when first eligible to be insured in the Retired Municipal Teachers' Program, must complete a Commission application in order to avoid a lapse in coverage. Teachers shall complete and submit their applications to the Commission approximately three months before their anticipated Coverage effective date determined by the Commission.

(4)(a) Retiring teachers whose Local Governmental Unit participates in the Commission's Retired Municipal Teacher program are required to be insured with the Local Governmental Unit upon Retirement in order to be eligible for Commission coverage.

(b) The Local Governmental Unit providing Retired Municipal Teacher coverage shall provide a notice to all newly hired teachers informing them that they must be enrolled in the Local Governmental Unit's life or life and health coverage at retirement in order to be eligible for Retired Municipal Teacher coverage. The Local Governmental Unit shall allow teachers who have a right to retire but defer their retirement to maintain their eligibility by continuing to be insured for Basic Life Insurance or Basic Life and Health Insurance.

(5) Teachers from a Local Governmental Unit that decides to join Health Coverage pursuant to M.G.L. c. 32B, § 19 are considered to be Retired Municipal Teachers only if their retirement date occurs before July 1st of the year in which the teachers' Local Governmental Unit joins Health Coverage.

(6) Retired teachers who decline Retired Municipal Teacher coverage when they are first eligible may later enroll only during annual enrollment or with satisfactory proof of loss of other health coverage. The Local Governmental Unit must certify to the Commission that the Retired Municipal Teacher was insured at retirement in the Local Governmental Unit's life or life and health coverage.

7.02: Transfer Procedures, Effective Date of Insurance

(1) The Commission shall contact retiring teachers about their applications for Retired Municipal Teacher coverage, and shall determine their effective dates of coverage. The Local Governmental Unit shall continue to be responsible for providing the retiring teachers' premium contributions to their Local Government Unit coverage until such time as their Retired Municipal Teacher coverage becomes effective.

(2) The Local Government Unit must process Retired Municipal Teacher coverage as follows:

(a) The Local Governmental Unit shall continue to collect premium payment from the retired teachers or their surviving spouses, as applicable, until the Commission sends notice that premium payment has been transferred to pension deduction.

(b) The Local Governmental Unit shall furnish Commission applications to all retiring teachers who, at the time of retirement, are enrolled in life insurance coverage or life and health insurance coverage, along with the notice described in 805 CMR 7.01(2), three months prior to their expected retirement date.

(c) The Local Governmental Unit shall continue to collect retiring teachers' premium for two Calendar Months following the month in which the teacher retires. The first day of the third Calendar Month following the month in which a teacher retires, or a date otherwise determined by the Commission, is the retired teacher's coverage effective date, provided that the retiree pays the required monthly premium for coverage. The Commission shall notify the Local Governmental Unit of all retirees' effective dates of Commission coverage.

7.03: Correction of Incorrect Premium Payment

(1) If a Local Governmental Unit continues to bill a retiring teacher and also receives premium payment after the retiring teacher's effective date of Commission coverage, the Local Governmental Unit shall refund the payment to the retiring teacher upon satisfactory proof of payment.

(2) If a Local Governmental Unit ceases billing a retiring teacher before his or her Retired Municipal Teacher's coverage effective date, creating a premium payment lapse, the Local Governmental Unit shall bill the teacher for past and current premium due until the Commission notifies the Local Governmental Unit to discontinue billing.

(3) If the Commission's premium is not deducted from the retiring teacher's pension or annuity, the Commission shall bill the teacher directly until the premium has been deducted. Failure to pay the required premium on time shall result in termination of coverage.

7.04: Coverage Options

The Commission shall determine the health coverage options available to Retired Municipal Teachers.

7.05: Termination of Retired Municipal Teacher Status

(1) If the Local Governmental Unit subsequently withdraws from Commission coverage, all Retired Municipal Teachers will cease to be eligible for the Commission's Retired Municipal Teacher coverage. The Commission and the Local Governmental Unit shall jointly determine the termination effective date.

(2) Retired Municipal Teachers whose Local Governmental Unit agrees to join the Commission's Health Coverage pursuant to M.G.L. c. 32B, § 19 cease to be Retired Municipal Teachers and, in so doing, their Commission's Basic Life Insurance and Retiree Dental Coverage ends on the date on which the Municipal Employer joins the Commission's Health Coverage.

(3) A Local Governmental Unit that decides to join Health Coverage pursuant to M.G.L. c. 32B, § 19 must continue to contribute its premium share to Retired Municipal Teacher coverage until the date that all of the Local Governmental Unit's insureds begin their Health Coverage.

Contact for 805 CMR 7.00: Retired Municipal Teachers

Feedback

Did you find the information you were looking for on this page? * required
We use your feedback to help us improve this site but we are not able to respond directly. Please do not include personal or contact information. If you need a response, please locate contact information elsewhere on this page or in the footer.
Tell us what you think