Massachusetts Group Health Insurance & Employee Benefits Plans

Massachusetts Group Health Insurance & Employee Benefit Plans

Massachusetts Large Group Health Insurance Plans

As in other states, insurers providing coverage in Massachusetts must comply with the Affordable Care Act provisions. Massachusetts, however, is known for its progressive healthcare approach. There are two significant instances where state law is more restrictive than the ACA. Only one applies to large group plans.

Massachusetts caps the age rating ratio for premiums at two to one, compared with the ACA’s allowable three to one. That means that while in other states, older enrollees can pay as much as three times more than younger adults, in Massachusetts, the limit is held to twice as much.

As is the case elsewhere, preferred provider organizations, health maintenance organizations, and point-of-service structures comprise the bulk of offerings in the state. Large companies may give workers a choice between two or more to allow for individual preferences. Major employers typically provide comprehensive large group health insurance coverage that exceeds the ACA minimum essential coverage, which consists of these components:

  1. Ambulatory patient services (outpatient care)
  2. Emergency services
  3. Hospitalization, including surgical and medical
  4. Maternity and newborn care, including delivery
  5. Mental health and substance use disorder services
  6. Prescription drugs
  7. Rehabilitative services and devices
  8. Laboratory services
  9. Preventative and wellness services, including chronic disease management
  10. Pediatric services, including dental and vision care for children under the age of 19

Massachusetts Small Business Health Insurance Plans

Another place where Massachusetts’ rules differ from the ACA is the medical loss ratio requirement for individual and small business plans. While the ACA requires health plans to send rebates to enrollees if their medical loss ratios are under 80 percent, the ratio is set at 88 percent in Massachusetts.

Also, unlike the ACA exemption for employers with fifty or fewer workers, Massachusetts imposes a penalty on small companies if any of their employees enroll in either Medicaid (MassHealth) or ConnectorCare, which is the state-subsidized program available on the Massachusetts marketplace. The penalty is calculated by a line item on an employer’s unemployment reporting and applies to Massachusetts businesses with as few as six full-time employees. The fine is the lesser of five percent of the individual’s pay or $750.

Small companies in Massachusetts may want to consult a broker like Taylor Benefits Insurance to evaluate their options before choosing the right plan. Small businesses have access to SHOP plans through the federal platform but also through a dedicated enrollment option partnership between Massachusetts Health Connector and DC Health Link.

Massachusetts Employee Benefit Plans and Employee Benefit Packages

Massachusetts is home to a spectrum of companies, from Route 128 tech startups to behemoths like General Electric and Dunkin Brands. Most large employers offer employees a traditional range of benefits, including health insurance, dental and vision coverage, disability insurance, life insurance and retirement plans. Companies with more than eleven workers must provide paid sick leave according to state law. Other time off does not have to be paid, although workers must be granted unpaid time off for various reasons. If employers offer paid vacation, workers who terminate employment must receive payment for accrued but unused time.

With over 25 years of experience, Taylor Benefits Insurance is Massachusetts’ industry leader in providing comprehensive and affordable health insurance policies.  Serving small and large businesses alike, Taylor Benefits has been there through the health care reform law passed back in 2006 and continues to aid Massachusetts’ companies today. Both our long-term and new clients rave about the exceptional service we provide, which guarantees immediate access to an agent 24 hours a day if needed.

Our expert services include the following:

Here at Taylor Benefits, we operate as an independent agent, allowing us to pick and choose components from a variety of traditional insurance providers. That means we guarantee you will get the best deal available. Our customized approach to the health insurance policy and package creation for your group ensures that you can benefit from a comprehensive and affordable health plan.

Ready to enroll? Call our support team today using the number on the top of the page for a FREE estimate and available group benefits options in Massachusetts, or complete the simple form on the right for a no-obligation, customized proposal for your Massachusetts-based business.

How does the Affordable Care Act affect my small business?

The Affordable Care Act, perhaps better known as Obamacare, made it easier and more affordable for uninsured Americans everywhere to purchase or qualify for low-cost healthcare.  Of course, with this health plan introduction, businesses of all sizes were affected, especially those that did not previously offer low-cost employee benefits packages.

Taylor Benefits Insurance was there for those who needed assistance in making the transition and is still available today for help with all your group policy needs. Although Massachusetts tended to be less affected by the introduction of the ACA due to their statewide healthcare reform already in place, there were still adaptations required to achieve Obamacare compliance.

If you are operating a Massachusetts-based business and need this type of attentive insurance assistance when dealing with the health insurance company, please complete the form on the right or call the number at the top of the page for a FREE, customized proposal guaranteed to meet your needs exactly.

Frequently Asked Questions About Health Insurance And Employee Benefit Plans in Massachusetts

In Massachusetts, What Is Considered a Large Group for Health Insurance Plans?

Large group health insurance plans cover companies with 50 or more eligible employees. These Massachusetts health plans can be purchased by small businesses as well as large corporations. A large group health insurance plan does not have a maximum number of participants. All employees can be covered under large-group health insurance plans, which simplifies the enrollment and administration procedures for the employer.

In Massachusetts, What Is Considered a Small Business Group for Health Insurance Plans?

Most business owners don’t realize how low the employee threshold for a group health insurance plan is. As a small business owner, you must only employ one person to be eligible for a group health insurance package. Small group coverage is appropriate for up to 50 workers. If your workforce is larger, you may be better off with a large employer health plan.

What Are the Different Types of Benefits Offered in Massachusetts?

You can retain old employees and attract new ones by offering excellent employee benefits. Whether a small or large business, employers can select an employee benefits plan that meets their needs. Depending on the organization, employee benefits in Massachusetts may include health coverage, vision and dental insurance, retirement plans, life insurance and 401k plans.

What Should Employee Benefits Packages Include in Massachusetts?

Generally, employee benefits packages include benefits mandated by law and some optional items selected by the employer. Massachusetts employee benefits packages vary depending on the company you work for. Unemployment benefits, minimum wages, and overtime are some of the mandatory ones.
In addition, your employer may provide some or all of the following important benefits to foster recruiting and retention: health insurance, dental insurance, vision insurance, 401(k) plan, short- and long-term disability insurance, retirement and pension benefits, and life insurance.

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