Bill > S622

This bill amends existing Massachusetts law to require private health care payers offering small or large group health plans to submit a comprehensive set of data and information to the division of insurance. This includes details on average premiums for popular and lowest-cost plans, actuarial assumptions, plan designs, medical and administrative expenses (including medical loss ratios, which represent the percentage of premium revenue spent on medical claims and quality improvements), payer reserves and surpluses, provider payment methods and levels, adjusted medical expenses by provider group, relative prices paid to various healthcare providers, and hospital costs. The bill clarifies that certain supplemental insurance products, such as accident-only, credit-only, limited vision or dental benefits, hospital indemnity policies not exceeding $500 per day, disability income insurance, and coverage supplemental to liability or workers' compensation, are excluded from these data submission requirements. The intent is to provide greater transparency and oversight in the health insurance market.