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Massachusettes - Compensation & Benefit Legislation

MASSACHUSETTS - AASHOWME

Demonstrates www.BenefitsReview.com™ site. Illustrates insurance carriers' coverages within the State.

 

MASSACHUSETTS - ADOPTED CHILD HEALTH CARE MANDATE

OBRA 1993 (Federal) requires group health plans to honor medical and child support orders. Also, plans must treat adopted children like biological children covered by the plan, and plans are precluded from applying pre-existing condition exclusions to an adopted child where no such exclusion applies to a newborn biological child. Health plans that covered the cost of pediatric vaccines as of May 1, 1993, and fail to continue that level of coverage, will be subject to an excise tax penalty applicable to plans that fail to meet the health care continuation coverage requirements under OBRA 1993.

 

Mandatory coverage of birth of adopted children is included in state's newborn health care mandate.

 

Preventive care for children: Yes, to age 6.

 

(Massachusetts Gen. Laws Ann. ch. 175 Sections 47C, 47F, 47H, 110E.)

 

MASSACHUSETTS - ALCOHOLISM & DRUG ABUSE

Mandatory coverage (alcoholism treatment only).

 

Minimum yearly inpatient coverage: 30 days.

 

Minimum annual outpatient coverage: $500.

 

Minimum lifetime coverage: no statutory requirements.

 

(Massachusetts Gen. Law. Ann. ch. 175, Section 110(H))

 

MASSACHUSETTS - CAFETERIA PLAN TAX LAWS

State income tax, unemployment insurance tax on salary reduction: State Unemployment Insurance law has no specific provision on cafeteria plans, but employer payments for health and accident and group term life insurance benefits are specifically excluded from wages under state Unemployment Insurance law and may be excluded even when provided through a cafeteria plan. However, employee salary reductions or cash elections for such benefits still must be counted as wages for Unemployment Insurance taxes.

 

MASSACHUSETTS - CONTINUATION OF COVERAGE CONVERSIONS

Events Triggering Continuation of Coverage:

 

MASSACHUSETTS - COORDINATION OF BENEFITS

Requires use of the birthday rule if coordinating benefits. Based on 1986 National Association of Insurance Commissioner Rules model. (Massachusetts Regs. Code tit. 211, Sections 38.01 et al)

 

MASSACHUSETTS - COST-OF-LIVING

ERI's Relocation Assessor™ is a recommended source for U.S./Canadian cost-of-living data and U.S. Automobile Cost Survey.

 

MASSACHUSETTS - DRUG TESTING AND EMPLOYEE ASSISTANCE BENEFITS

State has no statutory requirements.

 

MASSACHUSETTS - GROUP HEALTH CODE ADDITIONS (MANDATED)

Adopted Children: Policies providing family coverage must cover adopted children from the date of filing of a petition to adopt. (Massachusetts Ann. Laws ch. 175, Sections 47C, 47F, 47H, 110E.)

 

Alcoholism Treatment: General or blanket policies must cover at least 30 days of inpatient care for detoxification or rehabilitation and at least $500 in outpatient care per year. (Massachusetts Ann. Laws ch. 175, Section 110(H).)

 

Cardiac Rehabilitation: Policies must cover costs of cardiac rehabilitation, as defined. (Massachusetts Ann. Laws ch. 175, Section 47D.)

 

Coverage Continuation: Group policies must provide continuation rights to members who become ineligible due to involuntary layoff or death of the insured for up to 39 weeks; to members who become ineligible due to plant closing for up to 90 days; and to divorced or separated spouses until remarriage. (Massachusetts Ann. Laws ch. 175, Sections 110G,I.)

 

Cytologic and Mammography Screening: Policies covering hospital or surgical expenses must cover such screening as described. (Massachusetts Ann. Laws ch. 175, Sections 47G, 110(L).)

 

DES: Insurers cannot deny coverage or charge higher rates for persons exposed to DES. (Massachusetts Ann. Laws ch. 175, Section 108C.)

 

Enteral Formula: Accident and sickness policies must cover non-prescription enteral formulas for home use when deemed medically necessary to treat malabsorption. (Massachusetts Ann. Laws ch. 175, Section 471.)

 

Handicapped Dependents: Coverage for dependent children cannot be terminated while a person is incapable of employment due to mental retardation or physical handicap and chiefly dependent on the insured. (Massachusetts Ann. Laws ch. 175, Section 108 2(a)(3).)

 

Home Health Care: Group policies must cover such services, as defined, when physician approved. (Massachusetts Ann. Laws ch. 175, Section 110(K).)

 

Infertility: Hospital and surgical expense policies providing pregnancy related benefits must cover medically necessary expenses of diagnosis and treatment of infertility to the same extent as pregnancy related conditions are covered. (Massachusetts Ann. Laws ch. 175, Section 47H.)

 

Mental Health: Policies covering hospital and surgical expenses must cover at least 60 days of inpatient care per year, with no lifetime limits except those applied for other illnesses, and $500 of outpatient services per year. (Massachusetts Ann. Laws ch. 175, Section 47B.)

 

Newborns: Policies providing family coverage must provide benefits for newborns from the moment of birth for injury or sickness, including treatment of medically diagnosed congenital defects, birth abnormalities, or prematurity and including medical formulas to treat certain conditions. (Massachusetts Ann. Laws ch. 175 Section 47C. Medical service corporations must cover preventive child care. (Massachusetts Ann. Laws ch. 176B Section 4L.) Prenatal Care, Childbirth, and Postpartum Care: Policies must cover such costs to the same extend as provided for medical conditions not related to pregnancy. (Massachusetts Ann. Laws ch. 175, Section 47F.)

 

Providers: Certified nurse midwives, dentists, chiropractors, optometrists, and podiatrists: Costs for services must be covered if the provider is licensed, the service is within the provider's scope of services, and the service is covered by the policy. (Massachusetts An. Laws ch. 175 Sections 47E, 108D, 110(F), 110(I).)

 

MASSACHUSETTS - GROUP HEALTH FOR SMALL EMPLOYERS

For insurance plans offered to small employers:

 

MASSACHUSETTS - GROUP LIFE CODE ADDITIONS

Employer required to pay part of premium: Yes.

 

Percent of employees who must elect coverage (if employees pay part of premium): 75% (or 40% if each employee in group has been medically examined and found acceptable for ordinary insurance by an individual policy).

 

Percent of employees who must be covered if employer pays all of premium: No statutory requirements.

 

Minimum number of employees in group plan: 10.

 

Employer prohibited as beneficiary: Yes.

 

Grace period (days): 31.

 

Mandatory conversion: Yes.

 

Other provisions: None.

 

(Massachusetts Gen. Laws Ann. ch. 175, Sections 133, 134, 134A)

 

MASSACHUSETTS - HOLIDAYS

January 1, Washington's Birthday (or 3rd Monday in February), Memorial Day (or last Monday in May), July 4, Labor Day (or 1st Monday in September), Veterans Day, and December 25 are state holidays in all 50 states and in the District of Columbia. Other holidays under State law include: Martin Luther King's birthday (or 3rd Monday in January), Columbus Day (or 2nd Monday in October), Thanksgiving. Other: If January 1, July 4, November 11, or December 25 fall on Sunday, following Monday is a holiday. (Massachusetts Gen. Laws Ann. ch. 4 Sections 12A-15RRR)

 

MASSACHUSETTS - IMMIGRATION (PREVAILING WAGE POLICY)

See U.S. Federal General Administrative Letter 1-2000

 

MASSACHUSETTS - JURY DUTY & WITNESS TIME OFF

Employer Restriction For Discharging Employee For Taking Leave For Jury Service: Yes.

 

Remedies and Penalties: Violator is guilty of contempt of court.

 

Other Requirements: None reported. (Massachusetts Gen. Laws Ann. ch. 268, Sections 14A and 14B.)

 

Employer Restriction For Discharging Employee For Taking Leave to be a Witness: Yes.

 

Remedies and Penalties: Violator may be fined up to $200, imprisoned for up to 1 month, or both.

 

Other Requirements: Employee must notify employer of subpoena before the day of court appearance.

 

MASSACHUSETTS - LEAVES OF ABSENCE

Employers Subject to Leave Laws: Employers with at least 6 employees.

 

Criteria for Eligibility: Employed full time for at least 3 consecutive months and have completed probationary period.

 

Maximum length of leave: 8 weeks.

 

Paid Leave: Employer discretion.

 

Acceptable Reasons for Leave: Birth/adoption of child.

 

Employment Guarantees After Leave: Entitled to reinstatement in the same or equivalent position held prior to the leave, unless a layoff during the leave would have applied to the employee.

 

Use of Vacation or other Time-off Benefits: Employee may use accrued vacation and sick leave benefits to extend family leave.

 

Certification Required: State reports no statutory requirements.

 

Effect Of Leave on Other Benefits: All benefits to which employee was entitled prior to leave continues in effect. The employer is not obligated to pay for the cost of benefits unless it does so for all employees on all types of leave.

 

Effect of Seniority Accrual During Leave: Does not accrue during leave.

 

Minimum Requirements for Notification to Employer: At least 2 weeks notice of anticipated absence is required.

 

Conditions for Denial of a Request For Leave: State reports no statutory requirements.

 

(Massachusetts Gen. Laws Ann. ch. 149, Section 105D.)

 

See U.S. Federal Family and Medical Leave Act

 

MASSACHUSETTS - LONG TERM DISABILITY CODE ADDITIONS

State does not require employer to provide long term disability benefits; although many employers do in order to remain competitive in hiring/retention of employees.

 

See LEAVES OF ABSENCE (above), WORKERS' COMPENSATION (below) and U.S. Federal Americans With Disabilities Act

 

MASSACHUSETTS - MANDATED PROVIDERS

Optometrists, chiropractors, dentists, psychologists, podiatrists, social workers, nurse practitioners and midwives. Mandatory coverage certified nurse anesthetists. (Massachusetts Gen. Laws Ann. Ch. 175, Sections 47B, 47E, 47Q, 108B, 108D, 110)

 

MASSACHUSETTS - MENTAL HEALTH CARE

Mandatory coverage.

 

Minimum yearly inpatient coverage: 60 days.

 

Minimum yearly outpatient coverage: $500.

 

Minimum lifetime coverage: No statutory requirements.

 

(Massachusetts Gen. Laws Ann. ch. 175, Section 47B)

 

MASSACHUSETTS - MINIMUM WAGE

$6.75 per hour (effective January 1, 2001). Furthermore, the state minimum wage now may not be less than the federal minimum wage plus $0.10.

 

Exemptions: Certain learners and apprentices (80% of minimum wage), and handicapped workers in special environments with permit. (Massachusetts General Laws Ann. Ch. 151, Sections 1, 1a, 2, 7)

 

See U.S. Minimum Wage

 

MASSACHUSETTS - NEW HIRE REPORTING

Who is required to report: All employers.

 

Who must be reported: All new employees and rehires.

 

Exempt from reporting: No exemptions.

 

Form(s) to file: W-4 form.

 

Filing deadline: Within 14 days of hire.

 

Employer information to be included: Name, address, and federal EIN.

 

Employee information to be included: Name, address, and SSN.

 

Penalty for failure to report: Fines may be imposed.

 

(Massachusetts Gen. Laws Ann. ch. 30A, Section 6)

 

MASSACHUSETTS - NEWBORN CARE MANDATE

Mandated coverage.

 

Preventive care for children: Yes, to age 6. (Massachusetts Gen. Laws Ann. ch. 175 Sections 47C, 47F, 47H, 110E.)

 

MASSACHUSETTS - PARENTAL LEAVE

See U.S. Federal Family and Medical Leave Act

 

MASSACHUSETTS - PRE-EXISTING CONDITIONS

For insurance plans offered to small employers, six month waiting period. Otherwise, no other exclusion for pre-existing conditions. (Massachusetts Gen. Laws Ann. ch. 176J Section 1 et seq.)

 

See U.S. Federal Health Insurance Portability & Accountability Act

 

MASSACHUSETTS - PROTECTED CLASSIFICATIONS

Age: Yes.

Race:  Yes.

Color:   Yes.

National Origin: Yes.

Ancestry:  Yes.

Religion: Yes.

Sex: Yes.

Pregnancy: Yes.

Sexual Harassment: Yes.

 

(Mass. Gen. Laws ch. 151B, Sections 1, 4, ch. 272, Section 98B.)

 

MASSACHUSETTS - SALARY SURVEY

ERI's Relocation Assessor™ is a recommended source for U.S./Canadian wages & salaries (covering 3,000 positions).

 

MASSACHUSETTS - SHORT TERM DISABILITY CODE ADDITIONS

State does not require employer or employee participation in short term disability plans.

 

MASSACHUSETTS - TERMINATION & SEVERANCE PAY

Date pay is due if employee is discharged: Immediately

 

Date due if employee resigns: Payday.

 

Wages: Yes.

 

Vacation Pay: Yes.

 

Holiday: Yes.

 

Sick leave: No.

 

Severance: Yes. (Buyer of company must pay 2 weeks pay for each year of service to employees with 3 or more years of service who are terminated within 2 years of the transfer of control.

 

(Massachusetts Gen. Laws Ann. ch. 149 Sections 148, 183. NOTE: U.S. Court of Appeals, 1st Circuit, has held that state statute on severance pay is preempted by ERISA. Simas v. Quaker Fabric Corporation of Fall River, 6f.3d 849(1st cir. 1993))

 

MASSACHUSETTS - UNEMPLOYMENT TAX

Employer Contributions:

 

 

Voluntary Contribution Provision: No. State reports no statutory requirements.

 

(Massachusetts Gen. Laws Ann. ch. 151A Sections 14, 14c, 38, 39.)

 

MASSACHUSETTS - VACATION PAY

See TERMINATION & SEVERANCE PAY (above)

 

MASSACHUSETTS - VOTING TIME OFF

2 hours after the polls open, if employee applies for leave to vote. (Massachusetts Gen. Laws Ann. ch. 56 Section 33; ch. 149 Section 178.)

 

MASSACHUSETTS - WORKERS' COMPENSATION

Private Employers: Mandatory as to all employments.

 

Public Employers: Mandatory as to state; elective as to counties, cities, and districts having power of taxation. Municipalities required to indemnify police and firefighters. Cities and towns may cover certain elected or appointed officials.

 

Exceptions: Masters and seamen in interstate commerce covered by federal law; athletes whose contracts provide wages during job disability; commission-paid salespersons; independent taxi cab drivers.

 

Special Coverage Provisions: Voluntary as to domestic servants hired casually or on a seasonal basis.

 

(U.S. Chamber of Commerce, 1994 Analysis of Workers' Compensation Laws.)