Requires creation of a form for employers to verify that they provide section 125 plans. Also requires creation of a form for employers to verify that employees who declined employer sponsored coverage have alternative coverage. Creates fine for employers who falsify or fail to submit forms.
Connector and Health Plans General
Provides Connector Commonwealth Care program definitions. Note: the definition of "resident" has been superseded by provisions in the FY 2011 budget and section 95 of chapter 359 of the Acts of 2010.
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.
Provides that all residents of Massachusetts have the right to apply for the Commonwealth Care program, to receive written determinations, and to appeal an adverse decision.
Subsidies for the Commonwealth Care program will be paid based on a sliding scale for eligible plans that are procured by the Commonwealth Health Insurance Connector.
Residents eligible for the Commonwealth Care program whose income is below 100% of the Federal Poverty Level will be enrolled in a special health plan with no premium or deductible.
Establishes the requirement that all employers with more than 10 employees must maintain a "Section 125" cafeteria plan to give employees access to pre-tax health insurance payments.
Allows individuals to purchase coverage through the small group insurance market, and provides that the small group insurance law provisions apply to all small business and individual plans issued by an insurance carrier, by the Connector, or through an intermediary.
Establishes insurance plan coverage criteria for Young Adults to be set by Division of Insurance. Only individuals between 19 & 26 who do not have employer-sponsored coverage are eligible for these products. Only insurance carriers with 5,000 or more enrollees may offer Young Adult plans, and the plans must be offered through the Connector.
Directs a study to examine the Connector use of brokers.
Authorizes the Connector Board to offer insurance products to individuals and small businesses, publish a schedule for premiums at which individuals of varying ages are eligible, and establish a schedule for affordability to be used in enforcing the individual mandate based upon percentage of income eligible to be spent on health care.
Specifies that the Connector will offer products to eligible individuals and small groups.
Establishes the criteria that health insurance plans must meet to receive the Seal of Approval and be offered through the Connector.
Outlines small business compliance requirements to participate in Connector health plans.
Authorizes the Connector to administer the Commonwealth Care health insurance program beginning October 1, 2006.
Establishes an open enrollment period for individuals into new plans from May 1, 2007 through July 31, 2007.
Allows individuals to purchase coverage through the small group insurance market starting July 1, 2007.