Section 45 (Part 6): Commonwealth Care Below-Poverty Benefits
Residents eligible for the Commonwealth Care program whose income is below 100% of the Federal Poverty Level will be enrolled in a special health plan with no premium or deductible.
Residents eligible for the Commonwealth Care program whose income is below 100% of the Federal Poverty Level will be enrolled in a special health plan with no premium or deductible.
Subsidies for the Commonwealth Care program will be paid based on a sliding scale for eligible plans that are procured by the Commonwealth Health Insurance Connector.
Provides that all residents of Massachusetts have the right to apply for the Commonwealth Care program, to receive written determinations, and to appeal an adverse decision.
Sets eligibility standards for the Commonwealth Care health insurance program, which provides subsidized insurance to people with incomes under 300% of the Federal Poverty Level who are not eligible for other publicly-funded programs. Subsidies will be paid based on a sliding scale for eligible plans that are procured by the Connector. Subsidies are not available to workers who are provided coverage by their employers; however, the Connector may waive that restriction.
Establishes the Commonwealth Care health insurance program, the sliding-scale subsidized health insurance program for low-income uninsured residents.
Provides Connector Commonwealth Care program definitions. Note: the definition of "resident" has been superseded by provisions in the FY 2011 budget and section 95 of chapter 359 of the Acts of 2010.
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.
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.
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.
Provides Health Care Quality and Cost Council - definitions of terms used in QCC statute.