The new Massachusetts health insurance market change laws probably will increase prices slightly for small groups but lead to substantial savings for individuals and families.
Consultants make those predictions in a report on the impact of merging the Massachusetts non-group and small group health insurance markets. The consultants work for Gorman Actuarial L.L.C., Marlborough, Mass.; DeWeese Consulting Inc., Canton, Conn.; and Hinckley, Allen & Tringale L.P., Boston.
They prepared the report for the Massachusetts Division of Insurance and a market merger special commission to help Bay State policymakers implement the state’s new health market change laws.
One provision of the laws calls for the state to require many large employers to provide health coverage for employees or make special payments to the state, and another provision could require many residents with moderate or relatively high incomes to buy their own individual coverage through a new organization called “the Connector” that would be allowed to base rates on insureds’ demographic characteristics.
Another provision would merge the non-group market, which provides coverage for individuals and families, and the small group market, which provides coverage for employers with 1 to 50 eligible employees.
Insurers in the non-group market follow community rating rules. Insurers in the group market can charge some customers twice as much as others based on factors such as age, group size and geography.