Massachusetts 2025-2026 Regular Session

Massachusetts Senate Bill S745 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. 1981 FILED ON: 1/17/2025
3	3	SENATE . . . . . . . . . . . . . . No. 745
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Paul R. Feeney
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 health expenses.
13	13	_______________
14	14	PETITION OF:
15	15	NAME:DISTRICT/ADDRESS :Paul R. FeeneyBristol and NorfolkMichael J. BarrettThird Middlesex2/4/2025 1 of 3
16	16	SENATE DOCKET, NO. 1981 FILED ON: 1/17/2025
17	17	SENATE . . . . . . . . . . . . . . No. 745
18	18	By Mr. Feeney, a petition (accompanied by bill, Senate, No. 745) of Paul R. Feeney and Michael
19	19	J. Barrett for legislation to limit out of pocket health expenses. Financial Services.
20	20	[SIMILAR MATTER FILED IN PREVIOUS SESSION
21	21	SEE SENATE, NO. 638 OF 2023-2024.]
22	22	The Commonwealth of Massachusetts
23	23	_______________
24	24	In the One Hundred and Ninety-Fourth General Court
25	25	(2025-2026)
26	26	_______________
27	27	An Act limiting out of pocket health expenses.
28	28	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
29	29	of the same, as follows:
30	30	1 SECTION 1. Section 6 of chapter 32A of the General Laws, as appearing in the 2022
31	31	2Official Edition, is hereby amended by inserting after the fourth sentence thereof the following
32	32	3sentence:-
33	33	4 For active and retired employees, their dependents and the survivors of deceased
34	34	5employees, including municipal subscribers, the maximum amount of deductibles and
35	35	6copayments for covered services during an enrollment year in a plan shall not exceed $2,500 for
36	36	7individual coverage and $5,000 for family coverage.
37	37	8 SECTION 2. Subsection (b) Section 22 of Chapter 32B, as so appearing, is hereby
38	38	9amended by striking the first paragraph and inserting the following paragraph:- 2 of 3
39	39	10 (b) An appropriate public authority may increase the dollar amounts for copayments,
40	40	11deductibles, tiered provider network copayments and other cost-sharing plan design features;
41	41	12provided that, for subscribers enrolled in a non-Medicare plan, such features do not exceed plan
42	42	13design features offered by the commission pursuant to section 4 or 4A of chapter 32A in a non-
43	43	14Medicare plan with the largest subscriber enrollment and, for subscribers enrolled in a Medicare
44	44	15plan under section 18A, such features do not exceed plan design features offered by the
45	45	16commission pursuant to section 4 or 4A of chapter 32A in a Medicare plan with the largest
46	46	17subscriber enrollment; provided that for active and retired employees, their dependents and the
47	47	18survivors of deceased employees the maximum amount of health insurance deductibles and
48	48	19copayments for covered services during an enrollment year in a plan shall not exceed those
49	49	20offered by the commission; provided, however, that the public authority need only satisfy the
50	50	21requirements of subsection (a) of section 21 the first time changes are implemented pursuant to
51	51	22this section; and provided, further that the public authority meet its obligations under subsections
52	52	23(b) to (h), inclusive, of section 21 each time an increase to a plan design feature is proposed.
53	53	24 SECTION 3. Section 9 of Chapter 32A, as so appearing, is hereby amended by inserting
54	54	25after the word “credits,”, in line 2, the following words:-
55	55	26 “or excess premium payments made by the Commonwealth and or employees,”
56	56	27 SECTION 4. Section 9 of Chapter 32A, as so appearing, is hereby amended by inserting
57	57	28the following new paragraph and the end thereof:-
58	58	29 Any and all excess premium payments made by the Commonwealth and or its employees,
59	59	30shall remain in the trust fund, to be utilized for the purposes of paying the out of pocket costs in
60	60	31excess of the limitations established in Section 6, or reducing the employees share of the annual 3 of 3
61	61	32premium in the event of a deficiency. Premium payments pursuant to this section shall include
62	62	33sums appropriated by the General Court or paid by the insured for self-insured products offered
63	63	34by the group insurance commission.