Frequently Asked Questions Regarding Massachusetts Health Care Reform Act

What is the Massachusetts Health Care Reform Act?

Passed into law on April 12, 2006, the Health Care Reform Act is Massachusetts’ plan to reduce the number of people in the state who have no health insurance. 

What is required of individuals and families?

By July 1, 2007, Massachusetts residents age 18 or older must carry health insurance that meets the minimum standards set by the state. All WHOI’s medical plans exceed the minimum standards.  Individuals who do not get insurance by December 31, 2007 will lose their state personal income tax exemption (approximately $210) when filing their 2007 state taxes.  The penalty will be more severe for 2008.

I’m not enrolled in health insurance, what do I do?

If you are not enrolled in a health insurance program and you are not eligible for one of WHOI’s health insurance plans, you will need to enroll in a health insurance plan effective July 1, 2007 to avoid the state penalty. The Commonwealth Health Connector may be able to help you or your other family members find the right health plan. To learn more, visit www.mahealthconnector.org.

If you are eligible but are not currently enrolled in one of WHOI’s medical plans and do not have coverage elsewhere, our Annual Open Enrollment will be your next opportunity to enroll in one of WHOI’s health plans. WHOI’s Annual Open Enrollment occurs once a year in the fall with an effective date of January 1st of every year.  Employees will be receiving Annual Open Enrollment information at that time.  If you experience a qualifying life status change, such as marriage, divorce, birth of a child, etc., please contact your benefit specialist, Linda Snow at lsnow@whoi.edu or Donna Hyman at dhyman@whoi.edu as you may be able to make a change outside of our Annual Open Enrollment.

I am enrolled in health insurance; do I need to do anything?

If you are currently enrolled in one of WHOI’s health plans or a qualified health insurance plan through another company, you do not need to do anything.  This coverage will meet the requirements determined by the state.

Please note that you are only able to add, change or drop coverage during our Annual Open Enrollment or if you have a qualifying life status change, such as marriage, divorce, birth or a child etc.  In addition, WHOI will require each employee who has declined to enroll in WHOI’s sponsored health insurance to sign a Health Insurance Responsibility Disclosure (HIRD) Form indicating that you are aware of the individual mandate to have health insurance and the penalties that go along with not having health insurance.

How long can my dependent children be covered under the new law?

Effective January 1, 2007, WHOI’s medical and dental insurance plans covered dependents up to age 26, or for two calendar years past the loss of dependent status under the Internal Revenue Code, whichever comes first.  Dependents that were previously ineligible for medical and dental coverage were able to be enrolled during the month of January 2007 if they met the new dependent status definition.  The next opportunity you will have to enroll your eligible dependents is during our Annual Open Enrollment that occurs in the fall with an effective date of January 1st of every year or within 31 days of your dependents loss of coverage.

For additional information on the Massachusetts Health Care Reform Act, please visit the website at www.mahealthconnector.org or contact your Benefits Specialist.