HOUSE DOCKET, NO. 2587        FILED ON: 1/16/2025

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No.         

The Commonwealth of Massachusetts

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PRESENTED BY:

Mindy Domb

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To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:

The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:

An Act to increase health insurer reporting transparency.

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PETITION OF:

HOUSE DOCKET, NO. 2587        FILED ON: 1/16/2025

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No.         

The Commonwealth of Massachusetts

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In the One Hundred and Ninety-Fourth General Court
(2025-2026)

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An Act to increase health insurer reporting transparency.

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:
 

SECTION 1. Section 16 of chapter 12C of the General Laws is hereby amended by adding at the end thereof the following subsection:-

(d) The center shall evaluate and report on individual private and public health care payer data metrics submitted to the center pursuant to subsection (b), clauses (1) through (5) of section 10 of chapter 12C as well as data submitted to the Division of Insurance under section 6 of Chapter 176J and section 21 of chapter 176O. The center shall issue public reports on payer data periodically, including through its annual report. The information shall be reported on an industry-wide, payer-specific basis and shall include, but not be limited to: (1) operating margins, (2) total margins, (3) reserves in dollars and as a percent of risk-based capital, (4) enrollment, and member months (5) total premiums and premiums on a per member per month basis, (6) total medical expenses and medical expenses on a per member per month basis, and (7) total administrative expenses and administrative expenses on a per member per month basis. The center shall report this information by line of business, where possible.

SECTION 2. Section 6 of chapter 176J of the General Laws is hereby amended by inserting at the end of subsection (b) the following sentence:- 

The commissioner shall make all information submitted to the division pursuant to the provisions of this section available to the center for health information and analysis.

SECTION 3.  Section 21 of chapter 176O of the General Laws is hereby amended by adding at the end thereof the following subsection:- 

(f) The commissioner shall make all information submitted to the division pursuant to the provisions of this section available to the center for health information and analysis.