Massachusetts Group Health Insurance & Employee Benefit Plans

Massachusetts Group Health Insurance & Employee Benefit Plans

Massachusetts Large Group Health Insurance Plans

Like 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 differences 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 benefits, which consist 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 companies with as few as six full-time equivalent workers. 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. 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 hosts 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, and retirement plans. Companies with more than eleven workers must provide paid sick leave by state law. Other time off does not have to be paid, although workers must be granted unpaid time off for various reasons. If companies 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 insurance policies.  Serving both 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 as well.  Both our long-term and new clients will rave about the exceptional service we provide, guaranteeing 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 which means we guarantee you will get the best deal available.  Our customized approach to insurance policy and package creation for your group ensures that you can benefit from the most comprehensive coverage at the most affordable price point.

Call us today at the number on the top of the page for a FREE estimate and available group benefit 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 program introduction, businesses of all sizes were affected, especially those who 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 insurance needs.  Although Massachusetts tended to be less affected by the introduction of the ACA due to their statewide healthcare reform already in play, there were still adaptations required to meet Obamacare compliance.

If you need this type of attentive insurance assistance and are operating a Massachusetts-based business, please complete the form on the right or call the number at the top of the pae 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 groups of 50 or more employees. It 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 are covered under large group health insurance plans, making them straightforward to manage and easy to enroll. Individual insurance plans may be preferred by employees with special health care needs.

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

Most business owners don’t realize that the employee threshold for a group health insurance plan is lower than they think. As a small business owner, you must employ at least one employee to be eligible for a group health insurance package. You may not qualify for Medicaid health coverage if your company has more than 50 employees. If your company has more than the maximum number of employees, you may want to consider a large group health insurance plan.

What Are the Different Types of Benefits Offered in Massachusetts?

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

What Should Employee Benefits Packages Include in Massachusetts?

Generally, employee benefits packages include compensation provided by the employer as well as benefits mandated by law. 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 benefits to attract new employers or keep old ones: health insurance, dental insurance, vision insurance, 401Ks, short- and long-term disability insurance, retirement and pension benefits, and life insurance.

We’re ready to help! Call today: 800-903-6066