Frequently Asked Questions for Massachusetts Health Care Reform

1. Can groups under 50 eligibles access the connector instead of their employer offered health benefit?

Groups less than or equal to 50 eligible employees are eligible to go through the connector and NOT take the health insurance offered by their employer. However, the employer will have to set up an additional Section 125 for this group of people and is not liable to contribute any money towards that plan.

2. Does the employer collect the premium for the Connector elected coverage for part time employees?

Yes, the employer is required to withhold payroll deductions and submit them to the connector. The Employer will receive a monthly statement for all part time employees who have access the connector through that particular employer. The employer is then responsible to deduct the money for the part time employees' health plan and report the amount paid by each employee back to the connector each month. If the employee does not make enough money to cover the premiums, the connector will contact the employee directly for the balance of the health insurance premium.

3. What happens if the employee does not work every week? How will the employer collect premium?

The employer will only collect premiums when it can. Otherwise the connector will reach out to the insured. The employer is responsible to report all information back to the connector. This includes new eligibles for the section 1 25 and those who have terminated employment with the employee.

4. After the employer registers the Section 1 25 with the connector, enters information for the PT/non eligible employee, how long does it take to get a username and password?

The employer does not ''register" the section 1 25 with the connector. They complete their application/census off of the connector website and fax it into the connector or call 1 877 MA ENROLL. They are then responsible for deducting the premiums on a pre-tax basis for the employee. If they provide an email address for each employee, the connector will reach out to the employers via email with the username and password. If they do not provide an email, the connector will provide this information to the employer. The employer is responsible for getting this information out to their employees. The connector is currently unsure of the turnaround time at this point.

5. Does a self-funded employer whose contract is delivered in NH, and the admin/stop loss is Anthem, need to comply with the part time 1 25 Plan feature of this legislation?

If there is a Massachusetts location of the group, then yes.

6. If an employer withholds contributions, but they are not enough to cover the monthly premium, should the partial contribution be returned to the employee, or forwarded to the connector?

They are to be forwarded to the connector. Employers should let the connector know what has been collected for whom so that the connector will contact those individuals directly for the remainder of the premium.

7. What is the process for "filing" the 125 Plan SPD's for existing benefit eligible groups?

As of right now the employer is supposed to create the SPD for the 125, deduct the premiums pre-tax and file it away. They should be able to produce when asked. There is no process yet, but keep checking back for changes at the connector website (www.mahealthconnector.org)

8. If an employer chooses not to offer an off-cycle open enrollment between 7/1/07 and 10/1/07 (their normal renewal date), will they be subject to the free rider surcharge if the employee accesses ''fee care" during that three month period? This employee would have had the option to sign up for a pre-tax benefit during the prior open enrollment on 1 0/1.

No, technically the employee was offered the coverage and in the past declined.

9. When an employee has two part time jobs and purchases a health plan through the connector, does the employee receive two sets of log-in information? How does the employee purchase the plan with two employers?

According to the Tricia Bull, who works for the connector, and the connector Section 125 Plan - Handbook for Employers, employees may only participate in one Section 1 25 plan. Employees working for two or more employers must select one employer's plan. They may receive log-in information for both, but should be careful to use the employer of their choice to log-in and shop for their health insurance plan and sign up.

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