1 of 1 SENATE DOCKET, NO. 1981 FILED ON: 1/17/2025 SENATE . . . . . . . . . . . . . . No. 745 The Commonwealth of Massachusetts _________________ PRESENTED BY: Paul R. Feeney _________________ To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General Court assembled: The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill: An Act limiting out of pocket health expenses. _______________ PETITION OF: NAME:DISTRICT/ADDRESS :Paul R. FeeneyBristol and NorfolkMichael J. BarrettThird Middlesex2/4/2025 1 of 3 SENATE DOCKET, NO. 1981 FILED ON: 1/17/2025 SENATE . . . . . . . . . . . . . . No. 745 By Mr. Feeney, a petition (accompanied by bill, Senate, No. 745) of Paul R. Feeney and Michael J. Barrett for legislation to limit out of pocket health expenses. Financial Services. [SIMILAR MATTER FILED IN PREVIOUS SESSION SEE SENATE, NO. 638 OF 2023-2024.] The Commonwealth of Massachusetts _______________ In the One Hundred and Ninety-Fourth General Court (2025-2026) _______________ An Act limiting out of pocket health expenses. Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows: 1 SECTION 1. Section 6 of chapter 32A of the General Laws, as appearing in the 2022 2Official Edition, is hereby amended by inserting after the fourth sentence thereof the following 3sentence:- 4 For active and retired employees, their dependents and the survivors of deceased 5employees, including municipal subscribers, the maximum amount of deductibles and 6copayments for covered services during an enrollment year in a plan shall not exceed $2,500 for 7individual coverage and $5,000 for family coverage. 8 SECTION 2. Subsection (b) Section 22 of Chapter 32B, as so appearing, is hereby 9amended by striking the first paragraph and inserting the following paragraph:- 2 of 3 10 (b) An appropriate public authority may increase the dollar amounts for copayments, 11deductibles, tiered provider network copayments and other cost-sharing plan design features; 12provided that, for subscribers enrolled in a non-Medicare plan, such features do not exceed plan 13design features offered by the commission pursuant to section 4 or 4A of chapter 32A in a non- 14Medicare plan with the largest subscriber enrollment and, for subscribers enrolled in a Medicare 15plan under section 18A, such features do not exceed plan design features offered by the 16commission pursuant to section 4 or 4A of chapter 32A in a Medicare plan with the largest 17subscriber enrollment; provided that for active and retired employees, their dependents and the 18survivors of deceased employees the maximum amount of health insurance deductibles and 19copayments for covered services during an enrollment year in a plan shall not exceed those 20offered by the commission; provided, however, that the public authority need only satisfy the 21requirements of subsection (a) of section 21 the first time changes are implemented pursuant to 22this section; and provided, further that the public authority meet its obligations under subsections 23(b) to (h), inclusive, of section 21 each time an increase to a plan design feature is proposed. 24 SECTION 3. Section 9 of Chapter 32A, as so appearing, is hereby amended by inserting 25after the word “credits,”, in line 2, the following words:- 26 “or excess premium payments made by the Commonwealth and or employees,” 27 SECTION 4. Section 9 of Chapter 32A, as so appearing, is hereby amended by inserting 28the following new paragraph and the end thereof:- 29 Any and all excess premium payments made by the Commonwealth and or its employees, 30shall remain in the trust fund, to be utilized for the purposes of paying the out of pocket costs in 31excess of the limitations established in Section 6, or reducing the employees share of the annual 3 of 3 32premium in the event of a deficiency. Premium payments pursuant to this section shall include 33sums appropriated by the General Court or paid by the insured for self-insured products offered 34by the group insurance commission.