Section 45 (Part 3): Commonwealth Care Eligibility

Sets eligibility standards for the Commonwealth Care health insurance program, which provides subsidized insurance to people with incomes under 300% of the Federal Poverty Level who are not eligible for other publicly-funded programs. Subsidies will be paid based on a sliding scale for eligible plans that are procured by the Connector. Subsidies are not available to workers who are provided coverage by their employers; however, the Connector may waive that restriction.

Section 44: Employer Free Rider Surcharge

Sets out provisions governing assessment of Free Rider surcharge on certain employers who do not offer health benefits to their employees based on the number of employees, the use of the Free Care Pool, total state-funded costs, and the percentage of employees enrolled in the employer’s health plan.

Section 42 (Part 1): Health Safety Net Eligibility

Requires applicants for the Health Safety Net to be enrolled in other publicly-funded health programs, if eligible. Applicants deemed ineligible for such programs are required to provide the name and address of their employer and their own identifying information, including social security number.

Section 41: Hospital Cost and Utilization Reports

Requires hospitals to conduct uniform reports to the Division of Health Care Finance and Policy, which must include the names and addresses of employers whose employees receive free care at the hospitals. Amended in 2010 to also require public and private insurance providers to submit to the Division of Health Care Finance and Policy an explanation of charges and costs associated with group and individual insurance plans.