Connector Contracts with Insurers- Reform Starts Next Week

September 29, 2006

The Massachusetts Health Insurance Connector Authority yesterday entered a contract with four "affordable" health insurance providers. The Connector voted in favor of entering a two-year contract with four managed care organizations: Boston Medical Center Health Net, Fallon Community Health Plan, Network Health and Neighborhood Health Plan. The state´s monthly share ranges from $280 to $387 per person. The four providers cover the state´s 38 service areas and most of the enrollees will have the choice of two or three providers in the same coverage area.

"This is obviously a landmark meeting for us for our launch down the road,"said the board’s Executive Director Jon Kingsdale minutes before the meeting was adjourned.

The Commonwealth Care program, applies to those earning between 100 percent and 300 percent of the federal poverty level - for an adult the range is $9,800 a year to $26,400 per year, for a family of two adults it's $13,300 to $39,600 and for a family of two adults and one child it´s $16,600 a year to $49,800 per year. The proposed premium contributions for enrollees range from 1.7 percent (or $18 monthly) to 4.7 percent ($106 a month) of income for individuals and from 2.1 percent ($36 to $48 a month) to 6.3 percent ($240 a month) for families.

The board is struggling with premium waiver provisions and struck out language to the emergency regulations that define waiver eligibility due to "extreme financial hardship".

"We´re really pleased that Commonwealth Care will be up and running on October 1. This is an enormous step forward and will allow tens of thousands of uninsured residents of Massachusetts to get good quality healthcare," said Brian Rosman, research director from Health Care For All.

The board also voted in favor of entering into a two- year $9.6 million contract with Maximus, a publicly traded company of 5,000 employees, to establish a call center and a premium billing system for Commonwealth Care. This is the board´s second contract with Maximus. Earlier in the month, the Connector closed a $3.6 million deal with the company for customer services.

Click here for a chart of MMCO coverage areas and low cost plans.

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