Your State Government's Oversight of Health Insurance in Massachusetts
The State Government of Massachusetts has a role in developing and overseeing insurance statutes and regulations for the state. In fulfilling this goal, the State Government usually tries to balance consumer rights within a supportive business environment that promotes strong economic growth. In the area of health care insurance, a State Government oversees the needs of three major constituents: health insurance consumers, insurance providers, and licensed brokers.
The State Government's main process for assuring a legitimate health insurance market is based on the periodic licensing of insurance companies and insurance brokers. For insurance companies, the State Government works to develop minimum requirements for health insurance products and performs periodic audits of financial records, to assure that taxation requirements are satisfied. For independent insurance brokers, the Government establishes licensing requirements and qualifications, manages license testing and license issuance for brokers, sets and administers continuing education criteria, and performs collections on broker license fees. The State Government is also in charge of researching and investigating insurance-related fraud, particularly when it may be harmful to consumers or when harmful to the local business environment.
For consumers, the State Government has developed and published public information guidelines to help residents identify their best insurance options. The State Government also helps resident consumers file insurance appeals with their health insurance company when a dispute is raised by a resident over the insurance policy coverage. Finally, the State Government is charged with overseeing the implementation of Medicare within the state where Federally funded health insurance is offered to lower income individuals, families or children without insurance, senior citizens, or the self-employed.