Bill > S564

This bill amends Chapter 176O of the General Laws to require health insurance carriers to submit annual comprehensive financial statements to the Division of Insurance. The statements must include detailed information on the carriers' costs, membership, medical loss ratios, reserves, administrative expenses, and other financial data, itemized by market group size and line of business. The bill also requires carriers that provide administrative services to self-insured groups to include additional information about those groups in the financial statements. The Division of Insurance is required to establish a formula to determine the amount of reserves that carriers must allocate to certified risk-bearing provider organizations with which they have alternative payment contracts. Additionally, the bill mandates a public hearing for any carrier with a risk-based capital ratio exceeding 600%, during which the carrier must provide testimony on its financial condition and plans to use surplus funds to reduce health plan costs.

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https://malegislature.gov/Bills/191/S564