Massachusetts regulators plan to clarify final rules soon on the design
requirements of health plans state residents must be enrolled in to avoid
financial penalties.
On January 1, 2009, under the state’s landmark health care reform law, most
state residents will have to be covered in plans that meet minimum “creditable
coverage criteria.”
Under rules finalized last June by the Commonwealth Health Insurance
Connector Authority—the state agency in charge in implementing key portions of
the 2006 reform law—plans considered offering minimum coverage can’t, among
other things, have annual deductibles greater than $2,000 for individual
coverage or $4,000 for family coverage.
Additionally, in order for the enrollees to have creditable coverage, a plan
cannot impose an overall annual benefit limit or a per illness annual maximum
benefit for covered core services. The bulletin will provide more clarification
of what are considered covered core services, a spokesman for the Connector
Authority said.
The bulletin itself will be issued in about a week, said Jon Kingsdale,
executive director of the Connector Authority, who spoke Monday at a briefing in
Washington sponsored by the Alliance for Health Reform and the Kaiser Family
Foundation.
Since enactment of the Massachusetts law, about 340,000 previously uninsured
state residents have obtained coverage, with the largest number of the newly
insured enrolled in a program whose premiums are heavily subsidized by the
state.
Filed by Jerry Geisel of
Business
Insurance, a sister publication of Workforce Management. To comment,
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