Section 114: Study Individual and Small Group Health Insurance Market Merger

(a) Notwithstanding any general or special laws to the contrary, there shall be a special commission to examine and study the impact of merging the non-group insurance market as defined in chapter 176M of the General Laws and small-group health insurance market as defined in chapter 176J of the General Laws.

(b) The commission shall consist of the commissioner of insurance, who shall serve as chair; the secretary of administration and finance; the commissioner of the division of health care finance and policy; 3 members appointed by the president of the senate, including an actuary in good standing with the American Society of Actuaries, a health economist, and a member of the senate; and 3 members appointed by the speaker of the house of representatives, including an actuary in good standing with the American Society of Actuaries, a health economist, and a member of the house of representatives.

(c) The commission shall conduct a study, which shall include examining the impact of merging the non-group and small-group health insurance markets on premiums charged to individuals and small groups. The report shall take into account the following factors:--
 

(1) the individual mandate, established by chapter 111M of the General Laws;
 

(2) the commonwealth care health insurance program, established by chapter 118H of the General Laws;

(3) health benefit plans authorized to be sold through the commonwealth health insurance connector, established by chapter 176Q of the General Laws, and the operation of the connector;

(4) the requirement in chapter 151F of the General Laws for employers to establish plans under 26 U.S.C. 125;

(5) the fair share employer assessment, established by section 188 of chapter 149 of the General Laws;

(6) the free rider surcharge, established by section 18B of chapter 118E of the General Laws; and

(7) appropriate use by insurance plans of standardized industry codes as used as a rating factor in section 1 of chapter 176J of the General Laws.

(d) The commission shall then direct that the results of the study shall be further studied to analyze the potential impact of reinsurance on the new merged market.

(e) For the purpose of conducting these studies, the commission may contract with an outside organization with expertise in fiscal analysis of the private insurance market. The commission shall establish appropriate guidelines and assumptions regarding the health reforms authorized in this act before engaging an outside organization. In conducting its examination, the organization shall, to the extent possible, obtain and use actual health plan data; but such data shall be confidential and shall not be a public record.

(f) The commission shall meet no later than May 1, 2006 and shall file a report with the clerks of the senate and house of representatives no later than December 31, 2006.