Massachusetts Statutes

Section 4A. For the purposes of this section the following words shall have the following meanings:— ''Genetic information'', a written recorded individually identifiable result of a genetic test as defined by this section or explanation of such a result. ''Genetic test'', a test…

Section 5. An organization shall maintain financial and utilization records for its preferred provider arrangements and activities in a form separate or separable from the financial and utilization records of other operations and activities carried on by the organization.

Section 6. An organization shall furnish to the commissioner evidence of a surety bond, reinsurance or other financial resources in an amount satisfactory to the commissioner as a guarantee that obligations to covered persons will be performed.

Section 7. An organization which enters into a preferred provider arrangement shall file annually with the commissioner, within one hundred and twenty days of the close of its fiscal year, a report covering its prior fiscal year. The report shall include: (a) the number of covere…

Section 8. In addition to other powers specified in this chapter, the commissioner may, after due hearing: (a) promulgate appropriate rules and regulations necessary to the administration and enforcement of this chapter; (b) issue an order requiring any person or organization to …

Section 9. An organization which offers or administers a health benefit plan or furnishes workers' compensation, under a preferred provider arrangement shall be subject to all of the provisions of its enabling or licensing statute and of any other provisions of the general laws a…

Section 1. As used in this chapter the following words shall have the following meanings, unless the context clearly requires otherwise:— ''Actuarial opinion'', a signed written statement by a member of the American Academy of Actuaries based upon the person's examination, includ…

Section 10. The division of insurance, with the advice and consent of the director of the connector, shall issue regulations to define coverage for young adult health benefit plans, and to implement this section. Eligibility for enrollment in a qualifying young adult health insur…

Section 11. (a) A carrier that offers a health benefit plan that: (i) provides or arranges for the delivery of health care services through a closed network of health care providers; and (ii) as of the close of any preceding calendar year, has a combined total of 5,000 or more el…

Section 11A. (a) For an insured member who (1) is receiving an active course of medical treatment from a health care provider for a serious disease, including but not limited to cancer or cystic fibrosis, that if disrupted in the course of medical treatment would pose an undue ha…

Section 12. (a) The commissioner shall promulgate regulations governing the establishment and oversight of small business group purchasing cooperatives. The regulations shall require: (i) that all state-mandated benefits are required under plans procured by approved small busines…

Section 13. (a) As a condition of continued offer of small group health, a carrier that, as of the close of a preceding calendar year, has a combined total of at least 5,000 eligible individuals, eligible employees and eligible dependents who are enrolled in health benefit plans …

Section 14. If a medically necessary and covered service is not available to a member within the carrier's provider network, the carrier shall cover the services out-of-network, for as long as the service is unavailable in-network.

Section 15. An insurer offering a tiered network plan shall clearly and conspicuously indicate, in all promotional and agreement materials, the cost-sharing differences for enrollees in the various tiers. The commissioner shall adopt regulations to carry out this section.

Section 16. To the maximum extent possible, carriers shall attribute every member to a primary care provider. Members may change their primary care provider, provided that the member gives notice to the carrier.

Section 17. To the extent permissible under applicable state and federal privacy laws, every carrier shall disclose patient-level data to providers in their network solely for the purpose of carrying out treatment, coordinating care among providers and managing the care of their …

Section 2. Except as otherwise provided, this chapter applies to all health benefit plans issued, made effective, delivered or renewed to any eligible small business after April 1, 1992, and all health benefit plans issued, made effective, delivered or renewed to any eligible ind…

Section 3. (a) (1) For every health benefit plan issued or renewed to eligible individuals and eligible small groups, including a certificate issued to an eligible individual or eligible small group that evidences coverage under a policy or contract issued or renewed to a trust, …

Section 4. (a)(1) Every carrier shall make available to every eligible individual and every small business, including an eligible small group or eligible individual, a certificate that evidences coverage under a policy or contract issued or renewed to a trust, association or othe…

Section 5. No policy shall exclude an eligible individual, eligible employee or eligible dependent on the basis of age, occupation, actual or expected health condition, claims experience, duration of coverage or medical condition.

Section 6. (a) Notwithstanding any general or special law to the contrary, the commissioner may approve health insurance policies submitted to the division of insurance for the purpose of being provided to eligible individuals or eligible small businesses. These health insurance …

Section 7. (a) Every carrier shall make reasonable disclosure to prospective small business insureds, as part of its solicitation and sales material of:— (1) the surcharge, if any, which shall be applied to a group's premium if one or more members are covered in the plan set fort…

Section 8. The commissioner may study the implementation of, establish, if warranted, and supervise a transitional reinsurance program pursuant to section 1341 of the federal Affordable Care Act or, if the commissioner believes that such program is not appropriate for the commonw…

Section 9. (a) Subject to the limitations set forth in this section, every carrier shall offer continuation coverage under a health benefit plan issued under this chapter to any qualified beneficiary who would lose coverage under that health benefit plan as the result of a qualif…

Section 1. As used in this chapter the following words shall have the following meanings, unless the context clearly requires otherwise: ''Actuarial opinion'', a signed written statement by a member of the American Academy of Actuaries based upon the person's examination, includi…

Section 2. (a) Notwithstanding the provisions of any other law to the contrary, and subject to the provisions of OBRA 90 and Section 1882 of the federal Social Security Act (42 U.S.C. Section 1395 et seq.), any policy for medicare supplement insurance or medicare select insurance…

Section 3. (a) No carrier participating in the market shall, at any time, deny or condition the issuance of any policy for medicare supplement insurance or medicare select insurance or a policy issued pursuant to a risk or cost contract available for sale in the commonwealth, nor…

Section 4. (a) The commissioner shall, to the extent permitted by OBRA 90, promulgate by regulation the plans for medicare supplement insurance and medicare select insurance, and the benefits for those plans, which may be offered, sold, issued, or delivered, or renewed by a carri…

Section 5. Any eligible person who applies on or after a date set by the commissioner pursuant to regulation for a policy for medicare supplement insurance or medicare select insurance or a policy issued pursuant to a risk or cost contract from any carrier participating in the ma…

Section 6. A carrier shall not participate in the market unless the policy form or certificate form has been filed with and approved by the commissioner.

Section 7. (a) Any policy for medicare supplement insurance or medicare select insurance or a policy issued pursuant to a cost contract offered, sold, issued, delivered, or otherwise made effective, or renewed, on or after a date established by the commissioner, by any carrier in…

Section 8. This chapter shall not apply to a policy or contract of one or more employers' or labor organizations, or of the trustees of a fund established by one or more employers' or labor organizations, or a combination thereof, covering employees or former employees, or a comb…

Section 9. Nothing contained herein shall affect, in any way, binding contracts, including the existence, validity or operation of such contracts in existence in the commonwealth prior to the effective date of this chapter.

Section 1. As used in this chapter the following words shall, unless the context clearly requires otherwise, have the following meanings:— ''Authorized insurer'', an insurer licensed by or admitted to do business in the commonwealth or a surplus lines carrier approved to do busin…

Section 10. Nothing in this chapter shall be construed to exempt a risk retention group or purchasing group from the policy form or coverage requirements of any motor vehicle no-fault or motor vehicle financial responsibility law of the commonwealth.

Section 11. The commissioner is authorized to make use of any of the powers established under the laws governing insurance to enforce those laws not specifically preempted by the Risk Retention Act of 1986 including the commissioner's administrative authority to investigate, issu…

Section 12. (A) No person, firm, association or corporation shall act or aid in any manner in soliciting, negotiating or procuring liability insurance in the commonwealth from a risk retention group unless such person, firm, association or corporation is licensed in accordance wi…

Section 13. An order issued by any district court of the United States enjoining a risk retention group from soliciting or selling insurance, or operating in any state, or in all states or in any territory or possession of the United States, upon a finding that such a group is in…

Section 14. The commissioner may in accordance with provisions of chapter thirty A, after notice of hearing, promulgate rules and regulations as are necessary or proper to carry out the provisions of this chapter.

Section 2. (A) A risk retention group shall be chartered and licensed under the laws of the commonwealth to write only liability insurance pursuant to the provisions of this chapter and, except as provided elsewhere in this chapter, must comply with (1) all of the laws, rules, re…

Section 3. A risk retention group chartered and licensed in another state which seeks to do business as a risk retention group in the commonwealth shall comply with the laws of the commonwealth, and shall satisfy the following requirements: (A) Before offering insurance in the co…

Section 4. (A) No risk retention group shall be required or permitted to join or contribute financially to any insurance insolvency guaranty fund, or similar mechanism, in the commonwealth, nor shall any risk retention group, or its insureds or claimants against its insurers, rec…

Section 6. A purchasing group and its insurer or insurers shall be subject to all applicable laws of the commonwealth except that a purchasing group and its insurer or insurers shall be exempt, in regard to liability insurance for the purchasing group, from any law that would: (A…

Section 7. (A) A purchasing group which intends to do business in the commonwealth shall, prior to doing business, submit to the commissioner a statement which shall: (1) identify the state in which the group is domiciled; (2) identify all other states in which the group does or …

Section 8. (A) A purchasing group may not purchase insurance from a risk retention group that is not chartered in a state or from an insurer not admitted in the state in which the purchasing group is located, unless the purchase is effected through a licensed agent or broker acti…

Section 9. Premium taxes and taxes on premiums paid for coverage of residents or risks located in the commonwealth by a purchasing group or any members of a purchasing group shall be: (A) imposed at the same rate and subject to the same interest, fines and penalties as are applic…