By Mr. Roy of Franklin, a petition of Jeffrey N. Roy that the Division of Insurance be authorized to issue a report on the performance of the merged non-group and small-group health insurance market. The division of insurance, in consultation with the commonwealth health connector authority and the center for health information and analysis, shall issue a comprehensive report on or before October 1, 2020 and at least once every 5 years thereafter, analyzing the performance of the merged non-group and small-group health insurance market, as defined in chapter 176J of the General Laws. In the development of each 5 year report, the division may contract with an outside organization with expertise in fiscal analysis of the private insurance market. It shall be the responsibility of the division, in consultation with the commonwealth health insurance connector authority and the center for health information and analysis, to establish appropriate guidelines and assumptions regarding the health reforms authorized in this act prior to engaging an outside organization. Said organization shall study the impact of merging the non-group and small-group health insurance markets and make a report considering the impact on the uninsured, currently insured individuals, and employers in the commonwealth.

(b) The study shall consider: (i) trends in premiums, cost-sharing, and actuarial value for plans in for individuals and small groups; (ii) characteristics of individuals in the merged market in contrast with characteristics of small group members, including, but not limited to, age, risk score, geography, gender, family size, industry and income; (iii) utilization and spending trends for individual and small group members, sourced from the Massachusetts All-Payer Claims Database, including differences in hospital and primary care practice utilization; (iv) status of competition between carriers in the market, including migration of insureds to new plans, the number of employers offering 1 plan to employees, and the behavior of employees whose employers offer more than 1 plan; and (v) any additional subjects the division considers relevant. In conducting its examination, the organization shall, to the extent possible, obtain and use actual health plan data; provided, however, that such data shall be confidential and shall not be a public record. The division shall publish each report on its website and file the same with the clerks of the house of representatives and senate, the house and senate committee on ways and means, and the joint committee on health care financing.