Code of Massachusetts Regulations
801 CMR - EXECUTIVE OFFICE FOR ADMINISTRATION AND FINANCE
Title 801 CMR 52.00 - Municipal Health Insurance
Section 52.05 - Health Insurance Review Panel

Universal Citation: 801 MA Code of Regs 801.52

Current through Register 1531, September 27, 2024

(1) Creation of the Panel.

(a) The appropriate public authority shall notify the Secretary by email within three business days after the beginning of the 30-day negotiation period under 801 CMR 52.04. The notice shall include the start and end dates of the 30-day negotiation period, and the name and contact information of the public authority's representative for the health insurance review panel. The appropriate public authority shall provide each member of the public employee committee with a copy of the notice to the Secretary.

(b) Within three business days after receiving copies of notice to the Secretary under 801 CMR 52.05(1)(a), the public employee committee shall select one representative for the panel and give notice to the appropriate public authority and the Secretary. If the public employee committee does not select a representative within three days, the representative shall be deemed to be the member of the public employee committee who represents the collective bargaining unit with the largest number of subscribers. Within ten days after receiving notice from the public employee committee, or, if no such notice is received, within 13 days of receiving notice from the appropriate public authority, the Secretary shall provide the appropriate public authority, the public employee committee, and the designated panel representatives (the parties) with a list (the list) of three qualified, impartial potential members available to serve on the review panel. Impartial members shall have professional experience in dispute mediation and professional experience in municipal finance or municipal health benefits. The Secretary shall also provide the parties with the name of an actuary selected by the Commission to assist the panel in verifying the savings calculations if no agreement is reached within the 30-day period and a panel is convened.

(c) Within three business days after receiving the list, the appropriate public authority and the public employee committee shall jointly select the third member for the panel from the list and shall notify the Secretary of their joint selection.

(d) If the appropriate public authority and the public employee committee cannot agree within three business days on which person from the list to select as the third member of the review panel, the notice by the public authority to the Secretary shall include notification that the parties have been unable to reach agreement on the selection of a name from the list of potential impartial panel members. If the public authority and the public employee committee cannot agree, the Secretary shall appoint the impartial member from the list and notify the parties not later than the end of the 30-day negotiation period.

(2) If the appropriate public authority and the public employee committee are unable to reach a written agreement on the public authority's proposal within 30 calendar days, the matter shall be submitted to the municipal health insurance review panel. The appropriate public authority shall submit its original proposal to the panel within three business days after the end of the 30-day negotiation period, with a copy sent to the Secretary and each member of the public employee committee. The appropriate public authority shall submit to the panel the same proposal that it made to the public employee committee. If the proposal includes the introduction of a limited network plan, the appropriate public authority shall provide an enrollment survey, a determination of which subscribers would enroll in a broad plan and which subscribers would enroll in a limited network plan, and the effect that the addition of a limited network plan would have on total premium costs and on disproportionately affected subscribers. The results of the enrollment survey shall be considered in the savings analysis.

(3) The public employee committee shall also submit any alternate mitigation proposal to the panel and any other information the public employee committee wants the panel to consider with respect to any other matters before them within three business days after the end of the 30-day negotiation period, with a copy sent to the Secretary and the other parties.

(4) Any fee or compensation provided to the impartial panel member for service on the panel shall be shared equally between the public employee committee and the appropriate public authority. The impartial members selected from the lists provided by the Secretary will be reimbursed only for reasonable travel expenses.

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