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MA Health Care Reform Law
On April 12, 2006, the Commonwealth of Massachusetts ('Commonwealth') enacted legislation requiring most state residents to carry health insurance either through their employers or individually. The goal of the legislation is to 'provide access to affordable, quality, accountable healthcare' to everyone in the state, while reducing the percentage of uninsured residents to as close to 0% as possible. The reform law maintains employer-sponsored health insurance as the primary source of coverage for Commonwealth residents. While beneficial to employees, employers are faced with new obligations and the financial burdens of providing health benefits to employees. Employers that fail to provide health insurance to their employees may be subject to a surcharge of $295 annually per employee plus additional penalties.
The new law imposes several obligations on employers, even if they are already offering health insurance coverage to their employees. The five most significant obligations are:
- Adopting and maintaining a compliant premium conversion plan;
- Demonstrating the employer's Fair Share Contribution;
- Filing Employer Health Insurance Responsibility Disclosure ('Employer HIRD') Forms with the Division of Health Care Finance and Policy;
- Collecting Employee Health Insurance Responsibility Disclosure ('Employee HIRD') Forms; and
- Providing Certificates of Creditable Coverage.
Adopting and Maintaining a Compliant Premium Conversion Plan
By July 1, 2007, all employers doing business in the Commonwealth were required to adopt and maintain a premium conversion (also known as a Code '125 or Cafeteria) plan that allows employees to pay their share of health care premiums with pre-tax dollars. Such premium conversion plans also must allow employees who obtain health insurance through the Commonwealth's newly created Health Insurance Connector Plan ('Connector') to pay their Connector Plan premiums with pre-tax contributions. Employers will be required to file a copy of their premium conversion plans with the Commonwealth when regulations are issued. In response to the new premium conversion plan obligations, covered employers will need to amend their '125 or Cafeteria plans to include the Connector Plan option or adopt a separate Connector Plan to comply with the new law.
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