§ 1 Definitions
§ 2 Application of chapter
§ 3 Individual and small group plans; group base premium rate; filing plan with connector; investigation of deviations from group base premium rate
§ 4 Carriers to make health benefit plans available; renewal of plans
§ 5 Exclusion of eligible individuals
§ 6 Approval of health insurance policies; eligibility criteria; submission of information; approval of changes to small group product base rates or rating factors
§ 7 Disclosure by carriers
§ 8 Transitional reinsurance program
§ 9 Continuous coverage
§ 10 Young adult health benefit plans; coverage requirements; premiums
§ 11 Reduced or selective network plans; tiered network plans; smart tiering plans
§ 11A Continuing coverage for active course of treatment for serious disease begun prior to enrollment in reduced or selective network plan or tiered network plan
§ 12 Small business group purchasing cooperatives; regulations governing establishment, oversight and certification
§ 13 Filing of health benefit plan proposals for consideration upon request of group purchasing cooperative
§ 14 Coverage of medically necessary and covered services otherwise unavailable within carrier’s provider network
§ 15 Display by insurer offering tiered network plan of cost-sharing differences for enrollees in various tiers in promotional and agreement material
§ 16 Attribution of members to a primary care provider
§ 17 Disclosure of patient-level data and contracted prices of individual health care services by carriers to providers
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Terms Used In Massachusetts General Laws > Chapter 176J - Small Group Health Insurance

  • Advice and consent: Under the Constitution, presidential nominations for executive and judicial posts take effect only when confirmed by the Senate, and international treaties become effective only when the Senate approves them by a two-thirds vote.
  • Bankruptcy: Refers to statutes and judicial proceedings involving persons or businesses that cannot pay their debts and seek the assistance of the court in getting a fresh start. Under the protection of the bankruptcy court, debtors may discharge their debts, perhaps by paying a portion of each debt. Bankruptcy judges preside over these proceedings.
  • Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. Source: OCC
  • Contract: A legal written agreement that becomes binding when signed.
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
  • Dependent: A person dependent for support upon another.
  • Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
  • Fraud: Intentional deception resulting in injury to another.
  • Interests: includes any form of membership in a domestic or foreign nonprofit corporation. See Massachusetts General Laws ch. 156D sec. 11.01
  • Joint committee: Committees including membership from both houses of teh legislature. Joint committees are usually established with narrow jurisdictions and normally lack authority to report legislation.
  • Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
  • Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
  • Other entity: includes a domestic or foreign nonprofit corporation. See Massachusetts General Laws ch. 156D sec. 11.01
  • Oversight: Committee review of the activities of a Federal agency or program.
  • Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
  • Public law: A public bill or joint resolution that has passed both chambers and been enacted into law. Public laws have general applicability nationwide.
  • Statute: A law passed by a legislature.