211 CMR 41.03 - Geographic Regions for Area Rate Adjustments

Current through Register 1466, April 1, 2022

(1) A Carrier may establish an area rate adjustment for each different geographic region designated in 211 CMR 41.03(2), which must range from .80 to 1.20. If a Carrier chooses to establish area rate adjustments, it shall apply the adjustments to every eligible individual within each region.
(2) The regions of Massachusetts described below are established for use in making area rate adjustments. The regions are based on zip code groupings which refer to the first three digits of the zip code for each eligible individual.
(a) 010 through 013;
(b) 014 through 016;
(c) 017 and 020;
(d) 018 through 019;
(e) 021 through 022 and 024;
(f) 023 and 027; and
(g) 025 through 026.
(3) A Carrier may combine the zip code groupings outlined in 211 CMR 41.03(2)(c) and (d) into one region or combine the zip code groupings outlined in 211 CMR 41.03(2)(c), (d) and (e) into one region for all of its Closed Guaranteed Issue Health Plans or use regions based on groupings for counties that approximate the zip code groupings.


211 CMR 41.03

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