Individual Mandate Enforcement

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 101 (Part 3): Connector Board Authority

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.