Bill > H2157

This bill aims to alleviate health care burdens for Massachusetts employers by demerging the individual and small group markets. The key provisions of the bill include: 1. Eliminating the concept of "eligible individuals" and focusing solely on "eligible small groups" for the purposes of health insurance coverage. 2. Requiring carriers with 5,000 or more enrollees in small group plans to file plans for the health connector's consideration annually. 3. Modifying the rules around carriers' ability to deny enrollment to eligible small groups, including allowing denials in certain circumstances like a group's failure to pay premiums. 4. Striking provisions related to the merged individual and small group market rate setting, essentially separating the individual and small group markets. 5. Adding new sections to Chapter 176M to address issues like coverage for out-of-network services, transparency in tiered network plans, assignment of primary care providers, and data sharing between carriers and providers. The overall goal of the bill is to alleviate the health insurance burdens faced by small employers in Massachusetts by delineating the individual and small group insurance markets.

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https://malegislature.gov/Bills/190/H2157