805 CMR 9.07
Subsequent Determination of Ineligibility
If premiums have been paid and accepted on behalf of a person enrolled in Commission
coverage and the Commission later determines that the person was not eligible, Commission
coverage shall cease either as provided by law or as of the end of the period for which the
Commission last received premium payment. The ineligible person shall not be entitled to
continuation coverage except as required by federal law.
If an employee initially is eligible and insured under the Commission's programs but
thereafter becomes ineligible due to a change in employment or status in the service of the
Commonwealth or of one of its participating municipalities, his or her Commission coverage
shall terminate at the end of the month following the month in which the change that caused the
Employee's ineligibility occurs or a later date as determined by the Commission. Such
employees shall be entitled to Continuation Coverage, unless the ineligibility is due to termina
tion for gross misconduct.
If an employee or covered person becomes ineligible by operation of law, coverage shall
terminate on the date they become ineligible. The ineligible person shall be entitled to
continuation coverage only as required by state or federal law.