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 1525, July 5, 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).
(a) Employed and reemployed members
			 of the uniformed services who are absent from employment by reason of service
			 may elect to continue their Commission coverage up to the lesser of either 24
			 months from the date their absence begins or the day after the date on which
			 they fail to apply for or return to their employment positions. Members who
			 elect to continue their Commission coverage are required to pay the full
			 premium cost; however, members who perform service for fewer than 31 days are
			 not required to pay more than the Employee's share, if any, for such
			 coverage.
(b) Members who do not
			 elect to continue Commission coverage or do not pay for it in a timely manner
			 may, upon the members' departure for service, have their coverage terminated
			 unless their failure to elect was excused because continued payment was
			 impossible, unreasonable, or precluded by military necessity. The Commission
			 shall reinstate such member's health coverage retroactively if they elect to
			 continue coverage and pay all unpaid amounts due.
(c) Reemployed members, except in the case of
			 those who elect continuing coverage, will not have a waiting period if such a
			 waiting period would not have been imposed for reasons other than uniformed
			 service.