Design of the
Massachusetts Premium Assistance Program
The following is summarized from the Premium Assistance Toolbox for States, a project
of the National Academy for State Health Policy.
The Massachusetts premium assistance program for non-Medicaid eligible persons is
called Insurance Partnership.
The program subsidizes a share of health insurance premiums paid by small employers
on behalf of families
Employers must offer the basic benefit level mandated by state insurance law
Employers must pay at least 50% of the total premium
Employers must employ 50 or fewer workers
Subsidy amounts for employers are established by the state legislature
$400 annually for a single employee
$800 for a couple
$1000 for a family policy
Direct deposits are available to employers to pay the subsidy and more than half use this
Enrollees also are paid the premiums- Massachusetts only sees a very small error rate in
this form of payment.
Four Billing and enrollment intermediaries who are paid a fee, market the program to
State legislation requires health insurers to provide information to Medicaid about
medical assistance participants enrolled in group health insurance, and monthly files are
received from large commercial insurers to match against Medicaid.
Lessons learned are summarized from Expanding Employment-Based Health Coverage:
Lessons from Six State and Local Programs” by Sharon Silow-Carroll, Emily K.
Waldman, and Jack A. Meyer, Economic and Social Research Institute, February 2001
Lessons learned include;
Communication with various businesses and service agencies is necessary.
It was important to be flexible when deciding to whom subsidy payments should
be made and the frequency.
Prepared January 2006