Commonwealth Health Insurance Connector Authority

Allows staff of the Connector to receive pension benefits.

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.

Establishes an exemption from the individual mandate for individuals whose religious beliefs prevent them from using medical health care.

Individuals may appeal an adverse decision of eligibility or affordability through an appeals process established by the Connector.

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.

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.

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 Note: the definition of "resident" has been superseded by provisions in the FY 2011 budget and section 95 of chapter 359 of the Acts of 2010.

Establishes the Commonwealth Care health insurance program, the sliding-scale subsidized health insurance program for low-income uninsured residents.

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.

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.

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.

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.

Provides definitions for General Law chapter 151F, which requires employers with 11 or more employees to maintain a "cafeteria plan" to provide health benefits to workers.

Establishes the requirement that all employers with more than 10 employees must maintain a "Section 125" cafeteria plan to give employees access to pre-tax health insurance payments.

Requires commercial insurers to provide written statements verifying that a health plan provides creditable coverage to both the insured and the Commissioner of Revenue.

Requires insurers to provide written statements verifying that a health plan provides creditable coverage to both the insured and to the commissioner of revenue.

An HMO can include a maximum deductible consistent with the maximum contribution requirements allowed for a federally-established Health Savings Account.

Provides that an HMO plan covering a young adult will be approved as a Young Adult Health Benefit Plan if it complies with young adults plan standards.

Requires HMO plan carriers to provide written statements verifying that a health plan provides creditable coverage to both the insured and to the commissioner of revenue.

Provides definitions pertaining to Connector Seal of Approval for private insurace plans.