Massachusetts Healthcare Insurance laws & HR compliance analysis

Massachusetts Healthcare Insurance: What you need to know

Massachusetts adopted a broad healthcare reform package designed to cover most of the state's uninsured population. Since its initial adoption, Massachusetts has adapted the state reform program to meet the requirements of the federal Affordable Care Act (ACA). The following is a summary of the main provisions that affect employers.
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The ACA required the establishment of healthcare exchanges to provide individuals and small employers with access to affordable insurance coverage. States had the flexibility to design and operate exchanges that best met their unique needs while meeting the ACA’s statutory and regulatory standards.
Massachusetts has established its own state-based exchange called Massachusetts Health Connector: Massachusetts Health Connector offers individual and family plans, as well as the state’s Small Business Health Options Program (SHOP), where small businesses can purchase coverage for their employees.
Under Massachusetts law, all residents of the commonwealth who are 18 or older must obtain health insurance coverage. More specifically, to meet the state’s coverage requirements, the insurance must include certain basic benefits known as “Minimum Creditable Coverage” (MCC). To meet the standard, a plan must provide coverage of core services and a broad range of medical benefits in accordance with at least the minimum standards set by state and federal statutes and regulations governing the particular health benefit plan (956 CMR 5.03). Core services include physician services, ...

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