Massachusetts 2023-2024 Regular Session

Massachusetts Senate Bill S776 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	1 of 1
2	2	SENATE DOCKET, NO. 1858 FILED ON: 1/20/2023
3	3	SENATE . . . . . . . . . . . . . . No. 776
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Paul W. Mark
8	8	_________________
9	9	To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
10	10	Court assembled:
11	11	The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
12	12	An Act limiting out of pocket expenses.
13	13	_______________
14	14	PETITION OF:
15	15	NAME:DISTRICT/ADDRESS :Paul W. MarkBerkshire, Hampden, Franklin and
16	16	Hampshire 1 of 2
17	17	SENATE DOCKET, NO. 1858 FILED ON: 1/20/2023
18	18	SENATE . . . . . . . . . . . . . . No. 776
19	19	By Mr. Mark, a petition (accompanied by bill, Senate, No. 776) of Paul W. Mark for legislation
20	20	to limit out of pocket expenses. Health Care Financing.
21	21	[SIMILAR MATTER FILED IN PREVIOUS SESSION
22	22	SEE HOUSE, NO. 1295 OF 2021-2022.]
23	23	The Commonwealth of Massachusetts
24	24	_______________
25	25	In the One Hundred and Ninety-Third General Court
26	26	(2023-2024)
27	27	_______________
28	28	An Act limiting out of pocket expenses.
29	29	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
30	30	of the same, as follows:
31	31	1 SECTION 1. Section 6 of chapter 32A of the General Laws is hereby amended by
32	32	2inserting after the fourth sentence thereof the following new sentence: -
33	33	3 For active and retired employees, their dependents and the survivors of deceased
34	34	4employees, including municipal subscribers, the maximum amount of deductibles and
35	35	5copayments for covered services during an enrollment year in a plan shall not exceed $2,500 for
36	36	6individual coverage and $5,000 for family coverage.
37	37	7 SECTION 2. Subsection (b) Section 22 of Chapter 32B is hereby amended by striking the
38	38	8first paragraph and inserting the following new paragraph:-
39	39	9 (b) An appropriate public authority may increase the dollar amounts for copayments,
40	40	10deductibles, tiered provider network copayments and other cost-sharing plan design features; 2 of 2
41	41	11provided that, for subscribers enrolled in a non-Medicare plan, such features do not exceed plan
42	42	12design features offered by the commission pursuant to section 4 or 4A of chapter 32A in a non-
43	43	13Medicare plan with the largest subscriber enrollment and, for subscribers enrolled in a Medicare
44	44	14plan under section 18A, such features do not exceed plan design features offered by the
45	45	15commission pursuant to section 4 or 4A of chapter 32A in a Medicare plan with the largest
46	46	16subscriber enrollment; provided that for active and retired employees, their dependents and the
47	47	17survivors of deceased employees the maximum amount of health insurance deductibles and
48	48	18copayments for covered services during an enrollment year in a plan shall not exceed those
49	49	19offered by the commission; provided, however, that the public authority need only satisfy the
50	50	20requirements of subsection (a) of section 21 the first time changes are implemented pursuant to
51	51	21this section; and provided, further that the public authority meet its obligations under subsections
52	52	22(b) to (h), inclusive, of section 21 each time an increase to a plan design feature is proposed.
53	53	23 SECTION 3. Section 9 of Chapter 32A is hereby amended by inserting the following new
54	54	24paragraph at the end thereof:-
55	55	25 Any and all excess premium payments made by the Commonwealth and or its employees
56	56	26and retirees shall remain in the trust fund, to be utilized for the purposes of paying the out of
57	57	27pocket expenses in excess of the limitations established in Section 6 up to the combined medical
58	58	28and pharmaceutical maximums established pursuant to the Patient Protection and Affordable
59	59	29Care Act , 42 U.S.C. §18001 et seq. (2010) or improving insurance benefits for its employees
60	60	30and retirees. Premium payments pursuant to this section shall include sums appropriated by the
61	61	31General Court or paid by the insured for self-insured products offered by the group insurance
62	62	32commission.