Massachusetts: @HealthConnector Gets All 9 #ACA Carriers To Agree To Let Enrollees Carry Accrued Deductibles When moving from off-exchange to on-exchange plans during #ARP SEP!

MA Health Connector

Massachusetts Health Connector and member carriers agree to carry over out-of-pocket costs for mid-year moves to access new lower premiums on-exchange

  • Agreement allows carrier members to access to lower Health Connector premiums as a result of the American Rescue Plan without resetting deductibles in 2021

May 20, 2021 – All nine health insurance carriers who participate in the Massachusetts Health Connector have agreed to let their off-exchange members move from an off-exchange plan to an exchange-based plan mid-year without losing spent out-of-pocket costs in 2021. This flexibility can help Massachusetts residents access new lower-cost plans through the Health Connector.

The federal American Rescue Plan, which was signed into law in March 2021, creates new premium subsidies for many people who earn more than 400 percent of the federal poverty level (about $51,000), creating lower premiums for plans available through the Health Connector. Someone who currently buys their plan directly through the carrier can seek out the new premium help available only through the Health Connector. If they purchase a plan with the same carrier, the money they have spent on their deductible and other out-of-pocket costs will be credited for money spent so far this year.

The Health Connector recently completed a redetermination of more than 11,000 current members who were not receiving subsidy previously. A majority of those people are now eligible for help paying for their health insurance, with average monthly premiums for those eligible dropping 27 percent thanks to savings of $217 per month – or $2,600 a year.

“This agreement to carry over out-of-pocket costs for people moving into Health Connector plans will allow thousands of Massachusetts residents to fully realize the financial benefits of the new, lower premiums available through the exchange,” said Louis Gutierrez, the Executive Director of the Massachusetts Health Connector. “We thank our carriers for their rapid collaboration as we work together to bring this new help to as many residents as possible, and encourage people who buy their health insurance directly from their carrier to check and see if they can take advantage of the new help offered by the Health Connector.”

Carriers have also collaborated with the Health Connector to conduct outreach and raise awareness about the new law and new savings opportunities to off-Exchange enrollees, as well as to people who have lost coverage over the last year and may be in need of new affordable coverage options.

“Health plans in Massachusetts are committed to finding ways to lower costs for our members. We're excited about the opportunity for more individuals and families to enroll into affordable plans through the Health Connector,” said Lora Pellegrini, President and CEO of the Massachusetts Association of Health Plans.

“Blue Cross Blue Shield of Massachusetts is proud to support the collective effort to get more people covered,” said Michael T. Caljouw, Vice President of State Government & Regulatory Affairs at Blue Cross Blue Shield of Massachusetts. “We hope that by allowing individuals to carry over their accrued cost sharing amounts, more residents will take advantage of the expanded premium subsidies available through the Health Connector, making coverage more affordable.”

In addition to small business offerings, the Health Connector provides health insurance to people who buy coverage on their own, and offers state and federal subsidies to help make coverage more affordable. The Health Connector offers a total of 59 plans from nine carriers: AllWays Health Partners, Blue Cross Blue Shield of Massachusetts, BMC HealthNet Plan, Fallon Health, Health New England, Harvard Pilgrim Health Care, Tufts Health Plan Direct and Premier, and United.

Massachusetts residents can visit MAhealthconnector.org, complete an application, and find out if they qualify for new lower premiums through the exchange. The deadline for coverage starting June 1 is May 23. Extended enrollment, which allows anyone to come into the Health Connector for coverage, runs through July 23 to ensure residents have ample opportunity to get lower-cost plans through the exchange.

About the Massachusetts Health Connector

The Massachusetts Health Connector is the Commonwealth’s health insurance exchange, and currently serves 300,000 individuals and small-employer members with health and dental insurance. Massachusetts residents who do not have health insurance from an employer or other entity can use the exchange to gain coverage. Through the ConnectorCare program, income-qualifying residents can access coverage that includes low-cost premiums and co-pays, and no deductibles. Access to health coverage for individuals and small businesses can be found at the Health Connector’s website, MAhealthconnector.org.