Commonwealth Health Insurance Connector Authority

Section 12 (Part 1): Individual Mandate Definitions

Chapter 111M provides for the individual mandate to have health insurance coverage. Section 1 provides definitions of "creditable coverage," which also provides that the board of the Connector has authority to further determine "minimum creditable coverage" standards for individual and group health plans; and defines "resident" for purposes of the individual mandate.

Sections 12 & 13: Individual Mandate Requirement

Establishes the procedure for implementation of the individual mandate. Qualifying individuals for whom "creditable coverage" is deemed affordable must have "creditable coverage" in place. Individuals must include information about health insurance status on their tax forms. Failure to meet the insurance requirement will result in a penalty, assessed by the department of revenue. All penalties will be deposited in the Commonwealth Care Trust Fund that will contribute to state subsidies for the Commonwealth Care program. • Creates a penalty for non-compliance with the individual mandate as equal to 50% of the lowest premium available for each month the individual did not have creditable insurance, as determined by the Connector.

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.