211 CMR 66.09 - Eligibility Criteria: Exclusion/Limitation of Mandated Benefits in Health Benefit Plans

Current through Register 1466, April 1, 2022

(1) Notwithstanding any law to the contrary, Carriers may offer, as permitted under M.G.L. c. 176J, § 6, to Eligible Small Businesses Health Benefit Plans that exclude some or all Mandated Benefits, provided, however, that Carriers offer such Health Benefit Plans only to Eligible Small Businesses which did not provide health insurance to their employees as of April 1, 1992 and that such Health Benefit Plans shall not exclude or limit Mandated Benefits for more than a five-year period. An Eligible Small Business must have existed in 1992 in order to be subject to 211 CMR 66.09(1).
(2) Notwithstanding 211 CMR 66.09(1), all health benefit plans offered to eligible small businesses must include the following:
(a) dependent coverage for newborn infants, adoptive children and newborn infants of a dependent as described in M.G.L. chs. 175, § 47C; 176A, § 8B; 176B, § 4C and 176G, § 4;
(b) continued health care coverage for divorced or separated spouses as described in M.G.L. chs. 175, § 110I; 176A, § 8F; 176B, § 6B and 176G, § 5A; and
(c) coverage for a certain period after an insured leaves insured group/limited extension of benefits as described in M.G.L. chs. 175, §§ 110D and 110G; 176A, § 8D; 176B, § 6A and 176G, § 4A.


211 CMR 66.09
Amended by Mass Register Issue 1349, eff. 10/6/2017.

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