Code of Massachusetts Regulations
805 CMR - GROUP INSURANCE COMMISSION
Title 805 CMR 9.00 - ELIGIBILITY AND PARTICIPATION
Section 9.06 - Leaves of Absence
Current through Register 1531, September 27, 2024
(1) Employees may continue their Commission coverage while on an authorized leave of absence without pay for reasons other than personal illness or injury. Such Employees are responsible for the entire premium cost; no Employer contribution shall be made, except as otherwise provided in 805 CMR 9.06.
(2) Employees who are absent from work due to personal illness or injury, for which they are receiving Workers' Compensation benefits pursuant to M.G.L. c. 152 or any similar law or regulation, and whose salary ceases due to lack of sick leave credits, may continue their benefits by paying the employee's share of the premiums with authorization by the employee's agency. The authorizing agency is responsible for updating its payroll system with the leave of absence (LOA) information and notifying the Commission via the proscribed form so that it can initiate monthly billing to the employee on leave. If the employee on LOA is terminated for failure to make premium payments, said employee will not be eligible for reinstatement of coverage until the next open enrollment.
(3) Employees who are not entitled to receive salary or wages while awaiting a determination of eligibility for Workers' Compensation benefits shall be deemed to have been granted a leave of absence without pay, and may continue their existing coverage by paying the entire monthly premium cost with no contribution made by the Employer. Employees approved for Worker's Compensation may apply for a reduction of premium, which the Commission will review and may refund the amount for which the employer is properly responsible.
(4) Entitlement to Workers' Compensation benefits does not entitle a terminated Employee to continue Commission life or health coverage.
(5) Employees on a leave of absence for one year who pay the Employee's share of premium may thereafter continue to receive their Health Coverage if they continue to pay the Employee's share of the premium cost and the Employee's agency pays the Commonwealth's share of the premium cost.
(6) Employees on a medical leave of absence (excluding worker's compensation, industrial accident or parental leave) may continue to receive their Health Coverage by paying the Employees' share of the premium cost only after they have exhausted their accrued sick and vacation time.
(7) Employed and Reemployed Members of the Uniformed Services are subject to the requirements of the Uniformed Services Employment and Re-employment Rights Act (USERRA).
(8) Employees who are absent from work for 30 consecutive calendar days or more are considered to be on leave of absence for the purpose of Commission coverage.
(9) Employees resuming employment following an approved leave of absence, who terminated coverage during said leave, may resume coverage in accordance with the Commission's Section 125 Cafeteria Plan or at Annual Enrollment.
(10) When an employee terminates state or municipal employment, coverage will continue to the end of the next month following the effective date of the termination.