Employers/Employees

Provides Health Care Quality and Cost Council - definitions of terms used in QCC statute.

Creates the Health Care Quality and Cost Council that will promote health care quality improvement and cost containment.

M.G.L. c. 6A, § 6J-L: Creates a Health Care Quality and Cost Council to promote health care quality improvement and cost containment.

Creates a MassHealth Payment Policy Advisory Board to review and evaluate Medicaid rates and rate methodologies, especially rates paid to Community Health Centers.

Creates a special commission to study reducing or eliminating the payor assessment paid by insurers and self-insured employers for the Health Safety Net.

Creates a Health Disparities Council within EOHHS to make recommendations to reduce racial and ethnic health disparities in the Commonwealth and to increase diversity among healthcare workers.

Creates a Commonwealth Care Trust Fund that will receive revenue generated from the Fair Share Contribution, the Free Rider Surcharge, and other revenue that will be used to pay for subsidized health insurance and Medicaid rate increases.

Changes current tax law definition of "Code" so that it includes section 223 of the Internal Revenue Code, which creates a deduction for health savings accounts.

Expands employee eligibility for participation in the Insurance Partnership Program to 300% of the Federal Poverty Level. • Ensures that Insurance Partnership subsidies are consistent with those provided under the Commonwealth Care program. • Specifies that self-employed individuals enrolled in the Insurance Partnership Program are eligible for employee subsidies only.

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.

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.

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.

Creates the Fair Share Contribution, to be paid by employers who do not provide or make a reasonable contribution to health insurance for their employees. The contribution requirement applies to employers with 11 or more employees and is capped at $295 annually per employee.

Provides definitions for General Law chapter 151F, which requires employers with 11 or more employees to maintain a "cafeteria plan" to provide health benefits to workers.

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.

Authorizes the attorney general to enforce the cafeteria plan regulations of employer sponsored health insurance provisions.

Provides that Blue Cross plans may only offer policies to employers if the insurance is offered to all full-time employees. The employer must offer to cover the same premium contribution percentage for each employee but may allow greater contribution percentages to lower paid employees and separate percentages for employees with collective bargaining agreements.

Blue Cross Blue Shield may only offer coverage to employers if the insurance is offered to all full-time employees. The employer must offer to cover the same premium contribution percentage for each employee but may allow greater contribution percentages to lower paid employees and separate percentages for employees with collective bargaining agreements.

Requires HMO family policies to extend coverage to children up to 26 years of age or for 2 years after "loss of dependent status," whichever occurs first.

Provides that an HMO may only sell a group health plan to employers if the insurance is offered to all full-time employees. The employer must offer to cover the same premium contribution percentage for each employee but may allow greater contribution percentages to lower paid employees and separate percentages for employees with collective bargaining agreements.