Current through Register 1531, September 27, 2024
(1)
General. An Employer is subject to surcharge if:
(a) it is a Non-providing Employer determined
in accordance with 956 CMR 9.03(2); and
(b) any of its Employees are State funded
Employees determined in accordance with 956 CMR 9.03(3); and
(c) its State funded Employees receive State
funded Health Services that total at least $50,000 in a fiscal year as
determined in accordance with 956 CMR 9.03(4).
(2)
Non-providing
Employer. A Non-providing Employer is an Employer of a State
funded Employee as defined in 956 CMR 9.03(3) that employs eleven or more full
time equivalent Employees and is not in compliance with the requirement to
adopt and maintain a Section 125 Cafeteria Plan for such State funded Employee.
(a)
Number of
Employees. An Employer has eleven or more full time equivalent
Employees if the sum of total payroll hours for all Employees for the Fiscal
Year divided by 2,000 is greater than or equal to 11. In calculating total
payroll hours:
1. For each Employee with more
than 2,000 payroll hours for the Employer, the Employer shall include 2,000
payroll hours.
2. Payroll hours
include all hours for which an Employer paid wages to an Employee including,
but not limited to, regular, vacation, sick, Federal Medical Leave of Absence,
short term disability, long term disability, overtime and holiday payroll
hours.
3. An Employer that is
determined to be a successor under M.G.L. c. 151A shall include the payroll
hours of the precessor's Employees during the applicable Fiscal Year.
(b)
Certain Permitted
Section 125 Cafeteria Plan Exclusions. An Employer is not a
Non-providing Employer with respect to a State funded Employee to the extent
the Employee is excluded from eligibility to participate in the Employer's
Section 125 Cafeteria Plan in accordance with 956 CMR 4.00: Employer
Sponsored Health Insurance Access.
(c)
Exemptions. An
Employer is not a Non-Providing Employer if it is a signatory to or obligated
under a negotiated, bona fide collective bargaining agreement that governs the
employment conditions of the State funded Employee; or participates in the
Insurance Partnership Program.
(d)
Employee Leasing Company Arrangements. If and to the
extent there is an arrangement between Client Company and an Employee Leasing
Company, the Client Company is the Employer for purposes of M.G.L. c. 118G and
the determination of the Employer Surcharge under
956 CMR 9.00 with respect to
itself and its Employees covered by the arrangement.
(3)
State funded
Employee. A State funded Employee is:
(a) an Employee or Dependent of such Employee
with more than three State funded admissions or visits during a Fiscal Year,
or
(b) an Employee or Dependent of
an Employee of an Employer whose Employees or Dependents make five or more
State funded admissions or visits during a Fiscal Year.
(4)
Determination of State funded
Health Costs. The Connector will determine the State funded Health
Costs for a State funded Employee as follows:
(a) The Connector will review all claims for
State funded Health Services submitted for payment by hospitals and community
health centers during a Fiscal Year.
(b) The Connector will match claims to
Employers, using all available data sources, including, but not limited to, the
Employee's application form, the provider claim or Emergency Room Bad Debt
Form, the HIRD form, Office of Medicaid data, and data from the Department of
Revenue and Division of Unemployment Assistance.
(c) For each Fiscal Year, the Connector will
determine State funded Health Costs by multiplying each provider's claims for
State funded Health Services by its percentage of total Uncompensated Care Pool
or Safety Net Care payments divided by its total charges for all State funded
Health Services.
(d) The Connector
will determine the Employers of State funded Employee(s) as set forth in 956
CMR 9.03(3) and with $50,000 or more in aggregate State funded Health
Services.
(e) The Connector will
determine if an Employer identified in 956 CMR 9.03(2) is a Non-providing
Employer. The Connector will make this determination using data from the HIRD
form, the Connector, and data matches undertaken pursuant to an Interagency
Service Agreement to the extent permitted by law with the Department of Revenue
and the Division of Unemployment Assistance.
(f)
FY2007. For
FY2007, the Connector will determine State funded Health Costs only for the
period from July 1, 2007 through September 30, 2007.
(5)
Monitoring. The
Connector may use data submitted by hospitals and community health centers to
monitor uncompensated care usage during the fiscal year and may inform
Employers if it determines that its State funded Employees have incurred State
funded Health Costs in a fiscal year.