Code of Massachusetts Regulations
956 CMR - COMMONWEALTH HEALTH INSURANCE CONNECTOR AUTHORITY
Title 956 CMR 7.00 - Small Group Wellness Incentive Program
Section 7.05 - Rebate Payment

Universal Citation: 956 MA Code of Regs 956.7

Current through Register 1531, September 27, 2024

(1) To qualify for a Rebate Payment, an Eligible Small Employer shall:

(a) provide to the Connector, or its designee, prior to the end of a Term, satisfactory documentation that the Eligible Small Employer and at least 33% of the Eligible Small Employer's Initially Enrolled Employees have met participation requirements for the Small Group Wellness Incentive Program as set by the Connector; and

(b) provide to the Connector the information needed to calculate the amount of the rebate, on a form and within a time period specified by the Connector.

(2) The Rebate Payment shall, subject to 956 CMR 7.05(5), equal up to 15% of the Eligible Small Employer's share of the amount paid to purchase a group health plan for Qualified Employees through the Connector.

(3) The failure of an Eligible Small Group to meet the requirements of 956 CMR 7.05(1) will result in the Eligible Small Group not receiving a Rebate Payment for that Term.

(4) A Rebate Payment shall be paid to an Eligible Small Employer by the Connector at least annually.

(5) Rebate Payments are contingent on available funding as determined by the Connector. In the event there are insufficient funds, the Director may impose a cap on the number of Eligible Small Employers that may qualify for a Rebate Payment.

(6) Rebate Payment is only available to an Eligible Small Employer for three Terms in which an Eligible Small Employer has qualified for a Rebate Payment in accordance with 956 CMR 7.05(1).

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