The purpose of the board of the connector shall be to implement the commonwealth health insurance connector. The goal of the board is to facilitate the purchase of health care insurance products through the connector at an affordable price by eligible individuals and eligible small groups. For these purposes, the board is authorized and empowered as follows:—
(a) to develop a plan of operation for the connector, this shall include, but not be limited to, the following:—
- (1) establish procedures for operations of the connector;
- (2) establish procedures for communications with the executive director;
- (3) establish procedures for the selection of and the seal of approval certification for health benefit plans and stand-alone vision or stand-alone dental plans to be offered through the connector;
- (4) establish procedures for the enrollment of eligible individuals and eligible small groups;
- (5) establish procedures for granting an annual certification upon request of a resident who has sought health insurance coverage through the connector, attesting that, for the purposes of enforcing section 2 of chapter 111M, no health benefit plan which meets the definition of creditable coverage was deemed affordable by the connector for said individual. The connector shall maintain a list of individuals for whom such certificates have been granted;
- (6) establish procedures for appeals of eligibility decisions for premium assistance payments or cost-sharing subsidies;
- (7) establish appeals procedures for enforcement actions taken by the department of revenue under said chapter 111M, including standards to govern appeals based on the assertion that imposition of the penalty under said chapter 111M would create extreme hardship;
- (8) establish a plan for operating a health insurance service center to provide eligible individuals and eligible small groups, with information on the connector and manage connector enrollment;
- (9) establish and manage a system of collecting premium payments made by, or on behalf of, individuals obtaining health insurance coverage or stand-alone vision or stand-alone dental insurance coverage through the connector, including any premium payments made by enrollees, employees, unions or other organizations;
- (10) establish and manage a system of remitting premium assistance payments and point-of-service cost-sharing subsidies and, if applicable, federal advanced premium tax credits and federal point-of-service cost-sharing reductions to the carriers;
- (11) establish a plan for publicizing the existence of the connector and the connector's eligibility requirements and enrollment procedures;
- (12) develop criteria for determining that certain health benefit plans and stand-alone vision or stand-alone dental plans shall no longer be made available through the connector, and to develop a plan to decertify and remove the seal of approval from certain health benefit plans and stand-alone vision or stand-alone dental plans;
- (13) develop a standard application form for eligible individuals and eligible small groups seeking to purchase health insurance through the connector; and
- (14) develop criteria for plans sold through the connector that are eligible for premium assistance payments or cost sharing.
- (b) to determine each applicant's eligibility for purchasing insurance offered by the connector, including eligibility for premium assistance payments or point-of-service cost-sharing subsidies for applicants at or below 300 per cent of the federal poverty guidelines.
- (c) to seek and receive any grant funding from the federal government, departments or agencies of the commonwealth, and private foundations.
- (d) to contract with professional service firms as may be necessary in its judgment, and to fix their compensation.
- (e) to contract with companies which provide third-party administrative and billing services for insurance products.
- (f) to charge and equitably apportion among participating institutions its administrative costs and expenses incurred in the exercise of the powers and duties granted by this chapter.
- (g) to adopt by-laws for the regulation of its affairs and the conduct of its business.
- (h) to adopt an official seal and alter the same.
- (i) to maintain an office at such place or places in the commonwealth as it may designate.
- (j) to sue and be sued in its own name, plead and be impleaded.
- (k) to establish lines of credit, and establish one or more cash and investment accounts to receive payments for services rendered, appropriations from the commonwealth and for all other business activity granted by this chapter except to the extent otherwise limited by any applicable provision of the Employee Retirement Income Security Act of 1974.
- (l) to approve the use of its trademarks, brand names, seals, logos and similar instruments by participating carriers, employers or organizations.
- (m) to enter into interdepartmental agreements with the department of revenue, the executive office of health and human services, the division of insurance, the division of unemployment assistance and any other state agencies, departments, commissions, authorities or political subdivisions the board considers necessary or appropriate to implement chapters 6D, 12C, 15A, 111M, 118E and this chapter.
(n) to create and deliver to the department of revenue a form for the department to distribute to every person to whom it distributes information regarding personal income tax liability, including, without limitation, every person who filed a personal income tax return in the most recent calendar year, informing the recipient of the requirements to establish and maintain health care coverage.
[There is no clause (o).]