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Mass. agency OKs minimum required health cover


BOSTON--The board of directors of the Massachusetts agency charged with implementing key portions of the state's 2006 health care reform law Tuesday approved the minimum health care coverage required of state residents.

State residents, among other things, must be enrolled in plans with no annual limits on covered core services and annual deductibles for in-network services that are no greater than $2,000 for single coverage and $4,000 for family services.

Additionally, the maximum annual out-of-pocket limit could not exceed $5,000 for individuals and $10,000 for families.High-deductible health insurance plans linked to health savings accounts automatically would be considered creditable coverage.

The new requirements, approved unanimously by the board of the Health Insurance Connector Authority, will kick in Jan. 1, 2009.

State residents must--to avoid penalties--have coverage later this year, but they would not have to be enrolled in plans that meet such specific design criteria until 2009.

In the first year, the penalty would be relatively small, just over $200. But in succeeding years, state residents will be fined for each month they lack coverage. The fine is equal to 50% of the premium of the least costly health insurance plan that meets state coverage requirements.

The Connector board, though, temporarily delayed action on final rules that would exempt residents from the law's individual coverage mandate if they could prove, based on their income, that coverage was not affordable.