Proposed Amendments and Public Hearings

Public hearing notices provide the date of the public hearing, the changes to the regulation, the fiscal impact of those changes, and instructions on how to submit comments and/or to testify public hearings. Contact information.

PUBLIC HEARINGS

June 2006

Pursuant to the provisions of M.G.L. c. 118G and in accordance with M.G.L. c. 30A, as amended, the Division of Health Care Finance and Policy will hold a public hearing on August 8, 2006 from 9:00 am to 12:00 pm at the Campus Center of the University of Massachusetts at Boston, relative to the adoption of the following regulation:

The proposed regulation implements Section 47 of Chapter 58 of the Acts of 2006, An Act Providing Access to Affordable, Quality, Accountable Health Care. Section 47 requires that each Massachusetts employer of eleven or more full time equivalent employees that does not make a fair and reasonable premium contribution toward the health insurance costs of its employees pay a per-employee Fair Share Contribution. The Department of Labor is required to collect the fair share contribution under M.G.L. c. 149, �� 188(a) and to assess each employer subject to the contribution requirement according to a formula set forth in M.G.L. c. 149, �� 188(b). The Division and the Department are also required to calculate the amount of the fair share employer contribution annually, not to exceed $295 per employee. The proposed regulation also sets forth the methodology for calculating the annual contribution amount, in accordance with the formula specified by the statute.

Under the proposed regulation, an employer would be determined to make a fair and reasonable premium contribution if at least 25% of its full time employees are enrolled in a health plan sponsored by said employer. Each employer will be required to calculate its percentage of enrolled employees by dividing the total annual payroll hours of full time employees enrolled in one of its health plans by the total annual payroll hours of all full time employees. If this percentage is less than 25%, but the employer offered to pay at least 33% of the premium cost toward an individual health plan for full time employees employed at least 90 days during the year, the employer will be exempt from the fair share contribution.

The proposed regulations would be effective October 1, 2006. Administrative procedures for collection of the Fair Share Contribution will be established by the Department of Labor. Based on currently available data, it is estimated that employers subject to the fair share contribution requirement will pay approximately $25.99 million for the period from October 1, 2006 to September 30, 2007. The fiscal impact on cities and towns will depend on each municipality's percentage of enrolled employees and premium contribution percentage.

Interested parties are encouraged to submit comments on these amendments. All persons desiring to be heard on this matter are hereby notified to appear at the designated time and place. Persons intending to speak will be afforded an early opportunity to testify if the Division receives notice by 5pm on August 7, 2006. All others will be heard subsequently. Written comments may be sent to Two Boylston Street, Boston MA 02116. Copies of the regulation are available for inspection and/or purchase at the Division of Health Care Finance and Policy, Two Boylston Street, Boston MA 02116 or you can access them free of charge in the Regulations section of the Division�fs web site located at www.mass.gov/dhcfp.

Pursuant to the provisions of M.G.L. c. 118G and in accordance with M.G.L. c. 30A, as amended, the Division of Health Care Finance and Policy will hold a public hearing on August 8, 2006 from 1:00 PM to 4:00 PM at the Campus Center of the University of Massachusetts at Boston, relative to the adoption of the following regulation:

The proposed regulation implements Section 44 of Chapter 58 of the Acts of 2006, An Act Providing Access to Affordable, Quality, Accountable Health Care. Section 44 adds section 18B to M.G.L. c. 118G and requires the Division to assess a surcharge on Massachusetts employers for state-funded health costs incurred for its employees and employee dependents for whom the employer has not offered to contribute toward or arrange for the purchase of health insurance.

Under the regulation, the surcharge is assessed on each "non providing employer" defined as an employer (1) of more than ten employees (2) of a state-funded employee as defined by the regulation; and (3) that does not offer to contribute toward, or arrange for the purchase of health insurance for the state-funded employee or maintain a cafeteria plan under M.G.L. c. 151F and the rules of the Connector. An employer is exempt if it is a signatory to a collective bargaining agreement or participates in the Insurance Partnership Program. A "state-funded employee" is an employee or dependent that receives services paid from the Uncompensated Care Pool during the fiscal year with more than three admissions or visits funded by the Pool during the year, or is employed by an employer with more than five aggregate Uncompensated Care Pool admissions or visits by employees or employee dependents during the year. The regulation sets forth the methodology for determining the amount of state-funded health costs for which an employer is to be assessed a surcharge, and the percentage of total state-funded health costs to be assessed. The surcharge percentage amount will be determined based on the number of employees, the number of state-funded admissions and visits; the percentage of employees for whom the employer provides health insurance, and the employer's compliance with the Health Insurance Responsibility Disclosure Requirement under 114.5 CMR 18.00. The regulation provides for an appeal process and penalties for non-compliance in accordance with M.G.L. c. 118G, �� 18B.

The proposed amendments will be effective on October 1, 2006. The fiscal impact of this proposal on employers and cities and towns depends on the rate of employer compliance with the requirement to offer employer sponsored health insurance or maintain a cafeteria plan under M.G.L. c. 151F, �� 2 and the rules of the Connector.

Copies of the regulation are available for inspection and/or purchase at the Division of Health Care Finance and Policy, Two Boylston Street, Boston MA 02116 or you can access them free of charge in the Regulations section of the Division�fs web site located at www.state.ma.us/dhcfp.

Pursuant to the provisions of M.G.L. c. 118G and in accordance with M.G.L. c. 30A, as amended, the Division of Health Care Finance and Policy will hold a public hearing on August 15, 2006 at 10:00 AM at Two Boylston Street, Boston, MA 02116 relative to the adoption of the following regulation:

The proposed regulation implements Section 42 of Chapter 58 of the Acts of 2006, An Act Providing Access to Affordable, Quality, Accountable Health Care. Section 42 of the Act adds section 6C to M.G.L. c. 118G and requires the Division to promulgate a "Health Insurance Responsibility Disclosure" form to be submitted by Massachusetts employers and employees. The information in the HIRD Form will be used to administer and enforce the Individual Insurance Mandate under M.G.L. c. 111M, the Employer Fair Share Contribution under M.G.L. c. 149, �� 188 and the Employer Surcharge for State-Funded Health Costs under M.G.L. c. 118G, �� 18B.

Every Massachusetts employer will be required to file an Initial HIRD Form with general information about the employer, including its Division of Unemployment Assistance account number, FEIN, number of employees, whether it offers access to employer-sponsored insurance, whether it offers to arrange for the purchase of health insurance, including maintenance of a cafeteria plan under M.G.L. c. 151F, �� 2 and the rules of the Commonwealth Health Insurance Connector; and whether the employer's health insurance plan is a self-insured plan. In the Initial Form, employers will also be required to submit employee names, social security numbers, whether the employee was offered employer sponsored health insurance, whether the employee accepted or declined, if employee accepted, whether enrolled in an individual or family plan, if employee declined, whether the employee claimed access to alternative coverage, whether employer offered to arrange for the purchase of health insurance including maintenance of a cafeteria plan under M.G.L. c. 151F, �� 2 and the rules of the Connector, and whether the employee accepted or declined such arrangement. Employers will be required to submit the Initial HIRD Form based on employees employed as of April 15, 2007, and the form will be due on May 15, 2007. Following the filing of the Initial HIRD, employers will be required to submit updates concerning changes to general employer information, and information about new and terminated employees. Employers with 50 or more employees will be required to submit quarterly updates. All employers will be required to update the HIRD annually by May 15 of each year.

Employees that either are not offered or decline employer-sponsored insurance or the employer's offer to arrange for the purchase of health insurance will be required to sign an Employee HIRD Form. The form contains the following information: name, social security number, name of employer, whether the employer offered health insurance or offered to arrange for the purchase of health insurance, whether the employee declined, and if the employee declined, whether the employee has alternative insurance coverage. The form will contain an acknowledgement that the employee is aware of the individual mandate under M.G.L. c. 11M and the penalties for failure to comply. If the employer did not offer health insurance or offer to arrange for the purchase of health insurance, the employee must sign an authorization for the Division to notify the employer if the employee or an employee dependent receives services funded by the Uncompensated Care Pool. Employers will be required to distribute, collect and file the Employee forms with the Division.

The proposed regulations will be effective October 1, 2006. Employers will incur administrative costs to comply with the new reporting requirement.

Most public hearings are held at the Division of Health Care Finance and Policy, Two Boylston Street, Boston, MA, 02116-4704.

Directions

If you wish to testify at an upcoming public hearing, please contact:

Corine Peach
Division of Health Care Finance and Policy
Two Boylston Street, 5th floor
Boston, MA 02116-4704
corine.peach@hcf.state.ma.us

Public Hearing:	Regulation Name and Number	Notice and Regulation
AUGUST
Tuesday August 8, 2006 9:00 a.m. - 12:00 p.m.	114.5 CMR 16.00 Determination of the Employer Fair Share Contribution	Notice Regulation
Tuesday August 8, 2006 1:00 p.m. - 4:00 p.m.	114.5 CMR 17.00 Employer Surcharge for State-Funded Health Costs	Notice Regulation
Tuesday August 15, 2006 10:00 a.m.	114.5 CMR 18.00 Health Insurance Responsibility Disclosure	Notice Regulation