In a series of recent posts (available here and here), we discussed the expanded Massachusetts Employer Medical Assistance Contribution (EMAC) requirements, including the adoption of a new EMAC supplemental contribution. Among other things, we explained that the EMAC rules operate in a manner that is fundamentally different from the now repealed “fair share employer contribution” requirement under the 2006 Massachusetts health care reform law. Under that law, employers were obligated to (among other things) obtain signed forms—referred to as Health Insurance Responsibility Disclosure (or “HIRD”) forms. While the HIRD form requirements were repealed effective July 1, 2013, there is now a new HIRD form requirement with which employers will need to contend.

Continue Reading Revenge of the HIRDs—The New Massachusetts Employer Healthcare Coverage Form

The Massachusetts Department of Unemployment Assistance (DUA) has begun assessing Employer Medical Assistance Contribution (EMAC) supplemental payments for the first quarter. This post proposes a grounds for appealing DUA determinations that would serve employers well: employers that offer affordable, major medical coverage to their employees should not be assessed an EMAC supplement for any full-time employee who has coverage under ConnectorCare. The Affordable Care Act (ACA) makes these employees ineligible for subsidized coverage.

Continue Reading Appealing Massachusetts Employer Medical Assistance Contribution (EMAC) Supplement Determinations Based on ConnectorCare Coverage

Massachusetts employers with 6 or more employees will soon be required to prepare and file a new health care reporting form referred to as the “healthcare coverage form.” While reminiscent of the now repealed “Health Insurance Responsibility Disclosure” or “HIRD” form requirement, the new form differs significantly. This post explains this new reporting rule.

Continue Reading Massachusetts to (Again) Require Health Care Reporting by Employers

In a November 20, 2017 post, we reported on Massachusetts’ passage of H. 3822, “An Act Further Regulating Employer Contributions to Health Care,” (the “Act”), the purpose of which is to shore up the finances of the Commonwealth’s Medicaid program and its Children’s Health Insurance Program (CHIP). The law has two components or tiers.

Continue Reading Memo to Massachusetts Employers for 2018 and 2019: How Not to Comply with the EMAC New Rules

In an earlier post, we reported on the passage of H. 3822, “An Act Further Regulating Employer Contributions to Health Care,” (the “Act”), the purpose of which is to shore up the finances of the Commonwealth’s Medicaid program and its Children’s Health Insurance Program (CHIP). The law, which is a temporary measure, has two components or tiers.

Continue Reading Proposed Regulations Issued Implementing Massachusetts Employer Medical Assistance Contribution (EMAC) Supplemental Contribution

In an effort to make up for a funding shortfall in the Commonwealth of Massachusetts’ Medicaid program, state policymakers have proposed solutions that include a “play-or-pay” option under which employers who fail to offer major medical coverage, or who offer coverage but have low take-up rates, would be required to pay an additional “employer contribution” to the Commonwealth based on multiple factors and complex computations. Another option would make up the shortfall with an across-the-board increase, similar to a payroll tax increase, in the Employer Medical Assistance Contribution (or “EMAC”), which helps defray Medicaid financing.

This post argues in favor of the latter option. We are of the view that an across-the-board increase in EMAC payments, would be vastly preferable because of its simplicity and ease of administration. The “play-or-pay” option would not only be extremely complicated to comply with and enforce, but, as we explain below, it may be preempted by federal law, i.e., the Employee Retirement Income Security Act of 1974 (ERISA).

Continue Reading Efforts to Shore up MassHealth Should Favor Simplicity and Avoid Potential Conflict with Federal Law