SJC Decision Clarifies the Law Regarding a Retiree’s Entitlement to Group Health Insurance. The Retiree Had Resigned From Employment And Elected Not to Continue on the Group Plan Under the “Deferred Retirement” Rules But Chose Instead to Apply at the Time of Actual Retirement

In a decision issued on June 18, 2025 the Supreme Judicial Court has clarified a provision in the group health insurance law, G.L. chapter 32B. The relevant provision is G.L. c. 32B, § 9, which governs the group health insurance rights of retirees.

In Cannata v. Town of Mashpee, No. SJC-13637 (June 18, 2025), the court was asked to decide how section 9 applies to a retiree’s eligibility where the retiree had voluntarily left employment, did not continue on the group plan under the “deferred retirement” law, subsequently retired, and sought to enroll in the former employer’s group health plan.

Section 9, first paragraph, entitles an employee who retires while employed to continue on the plan provided that the employee pays the full premium.[1] At issue in Cannata was the third paragraph of §9. That paragraph allows an employee who voluntarily leaves employment and who defers retirement to continue on the group health plan by paying the full premium. In Cannata the employee had left his employment with the Town and had chosen not to continue on its plan. After retiring he sought to enroll but the former employer Town denied his application on the grounds that he was ineligible under its established unwritten practice where the retiree had not continued on the plan when leaving employment.

The retiree brought a lawsuit and the Superior Court dismissed his complaint for failure to state a claim because he had not alleged his compliance with the steps required to continue his coverage when he voluntarily resigned. After the retiree appealed to the Appeals Court, the SJC assumed jurisdiction of the appeal on its own initiative.

The court pointed out that the first paragraph of §9 requires that an employee on the group health plan at the time of retirement is entitled to remain on the plan by paying the applicable premium. The court held that this paragraph “imposes a requirement that the municipality’s group policy must be continued in retirement — not a requirement as to who is eligible for such coverage” [emphasis added]. It therefore ruled that a retiree who is not on the plan at the time of retirement “may be lawfully excluded under a reasonable municipal regulation, without running afoul of §9, first par.” [emphasis added].

Turning to the third paragraph of §9 covering deferral of retirement, the court observed that this paragraph “does not apply to Cannata because, at the time he sought to enroll in the town’s group health insurance plan, he had retired.” It held that the trial court’s dismissal therefore was error because Cannata’s failure to comply with the third paragraph’s steps are inapplicable to a retiree who applies for coverage at the time of retirement. The court decided that the retiree’s claim “depends entirely on the town’s regulations and policies”, noting that where the statute is silent “the issue is left to local discretion.”

The court then addressed what an applicant must allege in a complaint based on these circumstances. The court held that it is not enough for a retiree to allege the absence of a policy barring enrollment. It held, instead, that the complaint must allege “facts plausibly suggesting the existence of a policy permitting enrollment by a retiree following a deferred retirement during which the retiree was not enrolled” [emphasis in original]. Because the retiree had not made these allegations the court affirmed the dismissal, although it ordered that the retiree be given the opportunity to amend his complaint.

This case clarifies that §9 does not address the eligibility for group health insurance of a retiree who resigns before retirement and does not continue on the group health plan under the third paragraph. That, instead, is left to the rules and practices of the municipal employer. It should be noted that the allegations in Cannata indicated that the Town’s policy/practice was not “written”. Although the court did not explicitly address this factor, the better practice clearly is to establish the rules in writing. Among other advantages this gives all persons notice of the rules and also minimizes the sorts of conflicting reasons given for denial that were alleged in this case.[2]

We are pleased to provide advice to public employers regarding group health insurance and contributory retirement.

This update is provided for informational purposes only and should not be considered legal advice.

[1] Sections 9A and 9E are local acceptance laws that allow the employer to pay half or more than half the applicable premium, respectively. Nothing in the Cannata decision affects these provisions.

[2] In Cioch v. Treasurer of Ludlow, 449 Mass. 690 (2007), the court rejected a challenge to a municipal policy “first reduced to writing in 1999, [that] has the effect of denying enrollment to retirees who were not enrolled at the time of retirement.” As the court noted, these regulations must be “reasonable”. They also cannot conflict with the provisions in chapter 32B.

Summer To-Dos for School Districts

As our school districts prepare for the start of the 2025-2026 school year, the summer presents a great opportunity to review and revise district documents to comply with federal and state laws and regulations and to codify best practices going forward. Here are a few areas that typically warrant review:

Student Handbooks and Educational Service Plans

State law requires that school councils review student handbooks each year to consider changes in policies to take effect the following September. Additionally, all school buildings are required by law to have written educational service plans detailing available alternative educational services for students removed from school longer than ten (10) days. The attorneys in our office are available to review these documents and recommend changes for the 2025-2026 school year.

School Committee Policies

Depending on the issues your School Committee and district may have faced recently, as well as recent changes to federal regulations, the School Committee may want to consider reviewing and updating certain policies. School Committee policies that have required the most updates in the last year include:

  • Non-Discrimination on the Basis of Sex (Title IX)
  • Staff Conduct
  • Relations with Parent/Booster Organizations
  • English Learner Education
  • Library Materials Section and Adoption, Library Resources
  • Public Comment at School Committee meetings

Bullying Plans and Policies

State law requires that school districts review their bullying plans and policies every two years. If the 2025-2026 school year falls on your district’s year for review, our attorneys would be pleased to assist in the review of your current bullying plans and policies and recommend changes where needed.

Student Disciplinary Notices and Hearings

School districts must comply with federal and state laws and regulations in addressing student discipline. In the past year, school districts have experienced an increase in complaints with DESE’s Problem Resolution System (“PRS”), the Bureau for Special Education Appeals (“BSEA”) and federal and state courts regarding student discipline. The attorneys in our office are available to review and revise disciplinary notice templates for compliance with current legal requirements. In addition, we provide training for new and experienced administrators on the proper procedures and requirements for disciplining students, including students with IEPs.

Please contact us for administrator training, assistance in reviewing and revising current policies and procedures, and for assistance on other areas of school law in preparation for the 2025-2026 school year.

This update is provided for informational purposes only and should not be considered legal advice.

Liz Valerio and Nick Dominello Present at 2024 Massachusetts Association of School Committees (“MASC”) and Massachusetts Association of School Superintendents (“MASS”) Annual Joint Conference

On Thursday, November 7, 2024 Liz and Nick presented at the MASC/MASS Annual Joint Conference in Hyannis.  Liz and Nick discussed current trends in collective bargaining.

Liz Valerio and Nick Dominello Presented at 2024 MASC Summer Institute

On Friday, July 12th Liz presented at the 2024 Massachusetts Association of School Committees (MASC) Summer Institute. Liz hosted a workshop on preparing for collective bargaining. On Saturday, July 13, 2024 Nick hosted a workshop on challenges in collective bargaining.

Ann Marie Noonan Presents at MMHR HR101 Boot Camp

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Nick Dominello to Present at 2024 COSA School Law Seminar

On Thursday, April 4, 2024 Nick will present at the 2024 Council of School Attorneys (COSA) School Law Seminar in New Orleans. Nick will be presenting a workshop on collective bargaining.

Liz Valerio Presents at MMA Monthly Meeting

On Wednesday, March 27, 2024 Liz presented at the Massachusetts Mayor’s Association (MMA) Monthly Meeting. Liz will be hosting a workshop on collective bargaining.

Liz Valerio and Nick Dominello Present at MASPA Annual Law Day

On Friday, March 22, 2024 Liz and Nick presented at the Annual Massachusetts Association of School Personnel Administrators (MASPA) Annual Law Day. Liz and Nick hosted a collective bargaining workshop on employee speech and leaves and accommodations.

Liz Valerio and Ann Marie Noonan Present at MMAAA Annual Education Program

On Tuesday, March 19, 2024 Liz and Ann Marie presented at the Massachusetts Municipal Auditors’ & Accountants’ Association (MMAAA) Annual Education Program. Liz and Ann Marie presented a collective bargaining workshop on preparing for and trends in collective bargaining.

Liz Valerio To Present at the MMA Annual Meeting Workshop Series

On Friday, January 19, 2024 Liz will present at the Massachusetts Municipal Association (MMA) Annual Meeting. Liz will be hosting a collective bargaining workshop for the Massachusetts Municipal Human Resources (MMHR) on responding to grievances and navigating arbitration. For more information, please click here.