Code of Massachusetts Regulations 805 CMR - GROUP INSURANCE COMMISSION
Here’s an enhanced breakdown of 805 CMR – Group Insurance Commission (GIC), outlining its structure, key topics, and how to access full details:
📘 Structure of 805 CMR
The Code is divided into several key parts governing the GIC’s operations:
805 CMR 1.00 – General Provisions
Defines administrative authority, rule interpretation, and the GIC’s issuance of informational bulletins. (mass.gov)
805 CMR 5.00 – Miscellaneous
Covers various administrative operational policies (not all parts are detailed on public site).
805 CMR 7.00 – Retired Municipal Teachers
Addresses benefits and coverage rules for municipal teachers in retirement (via GIC). (mass.gov)
805 CMR 8.00 – Municipal Health Coverage
Governs eligibility, enrollment, payments, portability, and communication protocols for municipal employees and other public entities. (mass.gov)
805 CMR 9.00 – Eligibility and Participation
The most detailed section, covering:
9.01 – New Employees: Defines eligibility criteria, enrollment timelines, waiting periods, retroactive coverage rules, employer and employee notification duties, and premium payment schedules. Effective coverage begins the first of the month after hire, with exceptions for same‑day starts. It also outlines rules for retroactive coverage in urgent medical need situations. (regulations.justia.com)
Additional sub‑sections (9.02–9.19) cover elected officials, re‑employment, qualifying life‑events, COBRA continuation, dependent enrollment, and mid‑year changes.
🧾 Highlights of 805 CMR 9.01 (New Hires)
Authority: The department/agency head determines eligibility; final authority rests with the GIC. (casetext.com, regulations.justia.com)
Enrollment Timing: Must apply during initial hire period; coverage starts the following month or same day if hired on the first. Premiums are billed until payroll deductions begin.
Retroactive Coverage: Available if employee/dependent incurs urgent unplanned medical expenses before coverage begins, subject to documentation and premium payment. (regulations.justia.com)
Notifications and Premiums: Employers must notify new hires of coverage eligibility and payment timing; employees must respond and pay premiums upfront if necessary. (regulations.justia.com)
📥 Accessing the Full Regulations
Mass.gov GIC Regulations portal: Offers PDFs for each part (1.00, 5.00, 7.00, 8.00, 9.00), last updated June 26, 2024 (mass.gov)
Trial Court Law Libraries: Host official print versions and downloadable PDFs (e.g., 9.00 Eligibility & Participation pdf: June 21, 2024) (mass.gov)
State Bookstore: Sells combined 805 CMR volumes (Parts 2.00–9.00) for purchase. (sec.state.ma.us)
✅ Why This Matters
Helps HR professionals and benefits coordinators determine eligibility and enrollment deadlines.
Guides new hires on when health, dental, or life insurance starts—and under what conditions retroactive coverage is possible.
Ensures compliance with payment and notification rules.
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