Known as "Section 18" of MGL Chapter 32B, several communities have adopted the state law that requires Medicare eligible retirees to join the federal insurance program. Under this system, Medicare becomes the primary insurer, while the community provides the supplemental coverage.

Communities can only require retirees to join Medicare after first adopting Section 18 by a vote of the local legislative body. The legislative body is either the city council or town meeting.

In order to be eligible for Medicare, Parts A&B, the retiree must be at least 65 years of age and qualify for Social Security. If a retiree has passed the age of 65 when they join Medicare, the federal government levies a penalty that Section 18 requires the municipality to pay.

"Section 18 came into play in the early 90s when the state implemented mandatory Medicare for its own retirees. All eligible retirees insured through the Group Insurance Commission are enrolled in Medicare," explains Association President Ralph White. "If implemented correctly, retirees will see no disruption in coverage. In some cases, being on Medicare offers better coverage at a lower cost to the retiree."

As a means of countering the expected increase in health care premiums for the coming fiscal year ('03), several communities have begun to explore the Medicare option. On the South Shore, the town of Plymouth and the city of Brockton have adopted Section 18 in recent months.

While both communities made the move to Medicare as a cost saving measure, the approach used in each case was remarkably different. Both serve as models as to the right and wrong way to implement such a change.

In the case of Plymouth, the adoption of Section 18 at a special town meeting in May was the end result of more than six years of work. Action at town meeting followed many months of meetings between town officials, retirees, the insurance advisory committee and insurance representatives.

The hands-on involvement of the insurance advisory committee (IAC) was crucial to the ultimate success of implementing Section 18. Members should note that under the municipal health insurance law (MGL Chapter 32B), every municipality that adopts the law must create a committee to advise on health insurance matters. It is also mandated that one retiree must serve on the committee.

Plymouth's open process not only included the IAC, but also the local retiree association. Representatives of the Plymouth Retired Employees Association (PREA) attended every meeting and were included in all decisions throughout the process.

Retirement Board member Tom Kelley, who is also a member of the IAC, was instrumental in helping to bridge the gap between the retirees and town management. Kelley, retiree representative Warren Ottino, and local AFSME President Dale Webber did a fine job watching out for retiree interests.

By adopting Section 18, the town will save over $600,000 in the coming fiscal year alone. In return, the town is reimbursing retirees and survivors for the Part B premium at the same contribution rate as the insurance is provided (85-90% depending on retirement date). In addition, the town has agreed to begin to offer retiree dental coverage in July.

"We felt that the only way this could be done successfully was to fully involve the retirees in the decision making process. Requiring enrollment in Medicare does not take anything away from our retirees, but it does save the town a considerable amount of money," explained Plymouth Town Manager Eleanor Beth. "Once the retirees were comfortable with what we wanted to do and understood that benefits were not changing, it was a very smooth process."

Unfortunately, the city of Brockton did not take the same approach as Plymouth. Late last year, the city announced that it would adopt Section 18 shortly after the first of the year.

The news of mandatory Medicare came as a complete shock to Brockton retirees and active employees. This was due to a lack of public discussion that should have taken place months prior to any decision having been reached.

Brockton officials had not previously placed the issue before the IAC, had not met with retiree representatives, and had not educated the retirees as to what type of changes were taking place.

With the Brockton City Council poised to enact Section 18, an emergency meeting for retirees was called by the city's insurance officials. In early December, over 600 angry and concerned Brockton retirees met with city officials to discuss the transition to Medicare.

Despite the best efforts of the city to explain how Medicare would be implemented, many retirees remained suspicious of the program. Just days before Christmas and over the objections of retirees, the Brockton City Council voted to adopt Section 18.

Even though the city has agreed to reimburse the Part B premium and retirees should see no change in their coverage, an air of resentment remains. Like Plymouth, Brockton is set to begin mandatory Medicare this July 1.

"Obviously there is a right way and a wrong way to make a change of this magnitude. By involving the retirees in the process, Plymouth was able to avoid needless confusion," says Association General Counsel Bill Rehrey. "If Brockton had used the process correctly and gone through the IAC, the transition to Medicare would have been a lot smoother.

"The Association is not opposed to Section 18. However, we would hope that other municipalities would look at these two examples (see related Northhampton story above) and choose the route that involves an open process. Let's face it, retirees depend heavily on their insurance and deserve to be fully involved in any process that would alter that coverage."