A Carrier may establish an area rate
adjustment for each different geographic region designated in 211 CMR 41.03
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
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.
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.