There are several important regulatory hearings and meetings regarding small business health insurance that will be occurring in the upcoming weeks that will be of interest to small businesses in Massachusetts and their employees:
The Governor previously directed members of his cabinet to investigate potential solutions to escalating premiums. The recommendations, compiled by the secretaries of Housing and Economic Development, Health and Human Services and Administration and Finance, consisted of the following initiatives:
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The Division of Insurance will immediately hold hearings to examine small business premium increases, focusing specifically on work insurers are currently doing to reduce costs and future steps that may be necessary to eliminate the substantial increases impacting the small-group market.
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The administration will file legislation amending small-group rating rules, giving the Division of Insurance expanded power to annually eliminate any unnecessary administrative costs and align factors in ways that could reduce the premiums charged to most small businesses.
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The administration will file legislation to expand the Division of Insurance’s authority over health insurance premiums, ensuring that company rates are reviewed before going into effect and allowing the agency to disapprove rates if they are deemed unreasonable in relation to the benefits provided.
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The Division of Insurance will immediately conduct special sessions with stakeholders to plan the development of open-access purchasing cooperatives. The creation of group purchasing cooperatives will allow small businesses and individuals to combine their purchasing power and seek out lower premiums through a larger entity. The cooperatives will not have membership restrictions, and the cooperatives will be able to choose and sponsor their own health products and health promotion programs.
There are two notices-one regarding small group insurance premiums, the other regarding group purchasing cooperatives.
Special Sessions on Group Purchasing Cooperatives
Small Business Health Insurance Hearings
Additionally, the Joint Committee on Financial Services will be holding a hearing on SB 2170: An Act Relative to an Affordable Health Plan, which was introduced by Senator Richard Moore, on Monday, November 2, 2009 at 2:00PM at the State House, Room B-1.
The Affordable Health Plan, which would establish a new product for businesses with 50 or fewer employees and individuals, would contain the following elements:
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A new product with benefits actuarially equivalent to Commonwealth Choice Bronze Level coverage. The product would be available for purchase through or outside the Health Connector.
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Establishes a statutory rate cap on reimbursements to all providers at no more than 110 percent of Medicare (or a rate actuarially equivalent to 110 percent of Medicare) for all covered services other than outpatient pharmacy benefits.
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Limits post-tax underwriting surpluses to 2 percent and establishes a minimum medical loss ratio of 85 percent for products offered by carriers in the small group/nongroup market.
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Prohibits providers from billing patients in excess of the reimbursement amount and established co-payments, co-insurance or deductibles.
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Prohibits providers from shifting costs to other products and charges the Division of Health Care Finance and Policy with monitoring provider charges and reporting noncompliance to the Attorney General.
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Sunsets upon implementation of the Special Commission on the Health Care Payment System's recommendations and are deemed to generate comparable reductions in costs.
Click here for a full copy of the Bill.