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.

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.

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 Note: the definition of "resident" has been superseded by provisions in the FY 2011 budget and section 95 of chapter 359 of the Acts of 2010.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 pertaining to Connector Seal of Approval for private insurace plans.

Allows individuals to purchase coverage through the small group insurance market, and provides that the small group insurance law provisions apply to all small business and individual plans issued by an insurance carrier, by the Connector, or through an intermediary.

Establishes insurance plan coverage criteria for Young Adults to be set by Division of Insurance. Only individuals between 19 & 26 who do not have employer-sponsored coverage are eligible for these products. Only insurance carriers with 5,000 or more enrollees may offer Young Adult plans, and the plans must be offered through the Connector.

Provides definitions for statute establishing the Connector.

Establishes criteria for Connector Seal of Approval product specifications.

Establishes financial liability of the Connector.

Establishes reporting requirements for the Connector.

Establishes a requirement that the Connector must conduct a study and report on its progress to the Massachusetts Legislature 2 years after operation and every year thereafter.

Authorizes the Connector to adopt implementation regulations.

Establishes the Connector as an authority within the Executive Office of Administration and Finance. Establishes the governance of the Connector by the 10-member board, chaired by the Secretary of Administration and Finance. The board is made up of 4 state officials and 6 citizens.