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Conditional Award of the 2021Seal of Approval (VOTE)
AUDREY MORSE GASTEIER
Chief of Policy & Strategy
MARIA JOY DAWLEY
Director of Plan Management & Product Strategy
SAMUEL ADAMS
Program Analyst, Health & Dental Plans
Board of Directors Meeting, July 9, 2020
2021 Conditional Seal of Approval
Today we ask the Board to allow further consideration of the proposed plans
we received in response to the Seal of Approval (SOA) Request for Responses
(RFR) issued in March.
▪ A vote today authorizing the Conditional SOA allows us to consider these plans for sale through the
Health Connector for the 2021 benefit year; it is not an indication of expected approval, but rather a
signal to the market of the types of plans we are considering for sale
▪ We will return to the Board in September seeking a final award of the 2021 SOA, after the Division of
Insurance (DOI) completes its form and rate filing review process and Health Connector staff
complete review of the value the plans offer to our Marketplace
2
Mar 2020 Apr May Jun Jul Aug Sept Oct Nov Dec 2020
3/20: Release Medical and Dental RFRs
5/22: RFR Responses Due
7/9: Conditional SOA – Board Meeting
9/10: Final SOA Awarded – Board Meeting
Review and Analysis of Responses
Review and Analysis of Rates
Analysis and Selection of ConnectorCare Plans
7/1: Rates Filed with DOI
2021 Product Goals and Strategies
The Health Connector designed its 2021 plan requirements with a focus on
improving affordability and predictability in standard plan designs while
maintaining a largely stable product shelf.
3
Goal Responsive Strategy
Affordability • Lowered deductibles, where needed, to align with an
indexed Minimum Creditable Coverage (MCC) deductible
• Continued carrier requirement to offer a low Gold plan, but
with new flexibility of design to promote competitive
offerings
• Member access to at least one of each major type of insulin
at a $30 copay (or lower) in all standard plans
Predictability • Standardized copay for ambulance transport
• Small group PPO from all relevant carriers, without exception
• Clarifications in online shopping experience
• Close review and monitoring of carrier changes impacting
the ConnectorCare program
Qualified Health Plan (QHP)Submissions
Qualified Health Plans:
Overview
Ten medical carriers responded to the 2021 Seal of Approval, submitting a total
of 63 non-group, and 77 small group, Qualified Health Plans (QHPs).
▪ As in Plan Years (PY) 2019 and 2020, carriers continue to be required to
offer standard platinum, high gold, high silver, low silver (small group only)
and bronze plans, and a PPO plan for small groups, as well as a low gold
plan newly non-standardized for PY 2021
• For PY 2021, the Health Connector no longer offered a standard plan
design for low gold but continues to require carriers offer a low gold
plan within the existing AV range requirement to encourage more
competition at this tier
▪ There is one new carrier entrant for PY 2021: AllWays Health Partners
Select
• Under the proposal, the current AllWays Health Partners carrier would
no longer participate in the ConnectorCare program beginning in PY
2021
• Instead, AllWays Health Partners Select, the smaller-network carrier,
submitted for consideration to participate in ConnectorCare in PY 2021
Platinum
High Gold
Low Gold
High Silver
Low Silver (SG)
Bronze
5
▪ There are no carrier departures for PY 2021
▪ As in PYs 2018, 2019, and 2020, ConnectorCare carriers will continue to “load” their silver tier non-group plans
with an additional percentage of premium to offset the loss of federal cost-sharing reductions
Qualified Health Plans:
Overview (Non-Group)
The chart below outlines the 63 non-group QHPs proposed for the Health
Connector’s consideration for 2021, a net increase of seven plans from 2020.
6
Non-Group 2021*
Issuers Platinum Gold Silver Bronze Catastrophic* Total 2021Total 2020 for
Comparison
AllWays Health Partners Inc. 1 2 1 1 0 5 5
AllWays Health Partners Select 1 2 1 1 0 5 0
Blue Cross Blue Shield 1 2 1 1 1 6 6
BMC HealthNet Plan 1 2 1 1 0 5 5
Fallon Health 2 4 3 2 1 12 13
Health New England 1 2 1 2 1 7 5
Harvard Pilgrim Health Care 1 2 1 2 0 6 5
Tufts Health Plan - Direct 1 2 1 2 1 7 7
Tufts Health Plan - Premier 1 2 1 1 0 5 5
United 1 2 1 1 0 5 5
Total 2021 11 22 12 14 4 63
Total 2020 for Comparison 10 21 11 11 3 56
*Excludes Catastrophic plans requested for withdrawal – subject to review and Board approval.
Qualified Health Plans:
Overview (Small Group)
7
The chart below outlines the 77 small group QHPs proposed for the Health
Connector’s consideration for 2021, a net increase of eight plans from 2020.
Small Group 2021
Issuers Platinum Gold Silver Bronze Catastrophic Total 2021Total 2020 for
Comparison
AllWays Health Partners Inc. 1 2 3 1 N/A 7 7
AllWays Health Partners Select 1 2 2 1 N/A 6 0
Blue Cross Blue Shield 1 2 3 1 N/A 7 7
BMC HealthNet Plan 1 2 3 1 N/A 7 7
Fallon Health 2 4 6 2 N/A 14 15
Health New England 1 3 2 2 N/A 8 7
Harvard Pilgrim Health Care 1 3 2 2 N/A 8 7
Tufts Health Plan - Direct 1 2 2 2 N/A 7 7
Tufts Health Plan - Premier 1 2 3 1 N/A 7 6
United 1 2 2 1 N/A 6 6
Total 2021 11 24 28 14 N/A 77
Total 2020 for Comparison 10 23 25 11 N/A 69
Qualified Health Plans:
New and Closing plansCarriers proposed nine new non-group plans, and ten new small group plans,
for consideration for 2021, and two plans will be closed.
Carrier# New
Non-GroupReason(s)
# New
Small GroupReason(s)
AllWays
Select5
New carrier, with one of each required
plan design6
New carrier, with one of each required
plan design
Fallon 1Low Gold design added on additional
network1
Low Gold design added on additional
network
HNE 2
One new non-standard bronze, and one
catastrophic (previously waived
catastrophic)
1 New non-standard bronze
HPHC 1 New non-standard bronze 1 New non-standard bronze
Tufts
PremierN/A N/A 1 New addition of PPO for PY 2021
TOTAL 9 10
8
▪ Health New England’s new offering of a catastrophic plan in 2021 would expand catastrophic plan
choice for members in the western portion of the Commonwealth
• Additionally, BCBS, Fallon, and Tufts Direct propose to continue offering catastrophic plans in 2021; the
remaining carriers submitted requests to waive their catastrophic plan offering
• Most members would have at least two catastrophic plan choices available
▪ Fallon intends to close two non-standard gold plans in 2021; the ~90 current members in these plans
would be mapped to Fallon gold plans with a similar plan design and same network
Affordability Initiatives: High-Value
MedicationsThe 2021 SOA requires low-cost access to insulin, in addition to the
continued requirement of zero cost-sharing opioid use disorder medication in
ConnectorCare.
▪ With clear data displaying cost barriers to care, and recent state-level initiatives aimed at limiting
enrollee cost-sharing for insulin, the Health Connector required carriers to include at least one of
each major type of insulin at a $30 copay (or lower) in all standard plans in their PY 2021 SOA
proposals
• All carriers’ SOA responses indicate this requirement will be met, and the Health Connector is
working with carriers to ensure proper display in formulary search tools
▪ Additionally, the Health Connector will continue to require ConnectorCare carriers to provide key
treatments for opioid use disorder at zero dollar cost sharing for ConnectorCare enrollees in PY 2021
9
Predictability Initiatives:
Standardization and TransparencyChanges for Plan Year 2021 also include standardization and transparency
initiatives to improve predictability in benefits and promote clarity in member plan
selection.
▪ The Health Connector newly required standardized ambulance cost-sharing for all standard plans, including
ConnectorCare plans, for PY 2021
• No member will see an increase in cost-sharing under this standardization compared to PY 2020, and
members in some carriers will see a decrease
• All carriers adhered to standardized ambulance cost-sharing in proposed 2021 plans
▪ Parity in small group PPO offerings
• Tufts Premier submitted a PPO for PY 2021, expanding small group PPO choice from all carriers offering
PPOs in the merged market
▪ Carrier clarifications in shopping experience
• Given ongoing member confusion between Tufts Direct and Tufts Premier, the carrier names in the online
shopping “filtering tool” will be updated for PY 2021 to clearly reflect “Direct” and “Premier”; plans are
currently grouped under one “Tufts Health Plan” filter
• AllWays Inc and AllWays Select will also clearly reflect two different entities in the filtering tool
• Additionally, Health Connector staff clarified the existing “network alert” language applied to plans with
smaller networks within the same carrier to promote member understanding of network differences
10
New Carrier:
AllWays Health Partners Select
AllWays Health Partners plans to operate under two different carrier licenses
for PY 2021: AllWays Health Partners Inc and a new narrower-network carrier,
AllWays Health Partners Select.
▪ Key differences between the two entities include:
11
PY 2021
Carrier ProposalAllWays Health Partners Inc AllWays Health Partners Select
Populations Served Unsubsidized, APTC-only, and small groupUnsubsidized, APTC-only, ConnectorCare, and
small group
Plans OfferedOne of each required plan design, including small
group PPO
One of each required plan design, without small
group PPO (not required as not offered in wider
market)
NetworkBroad network covering nearly all acute care
hospitals in the Commonwealth
• Narrower network focused in eastern portion
of the Commonwealth
• Maintains Partners HealthCare hospital
coverage
• No coverage of Children’s Hospital and Dana-
Farber Cancer Institute, of particular concern
for the ConnectorCare program
Service Area
Statewide for PY 2021, compared to a PY 2020
service area covering Worcester county through
the Eastern portion of the state
• Eastern portion of state only
• Excludes Worcester County
• Continues to include Islands coverage
ConnectorCare Participation
2021 ConnectorCare Participation
The SOA submissions reflect one proposed ConnectorCare carrier
participation change, and several geographic coverage changes, for 2021.
▪ AllWays Health Partners Select, BMC HealthNet Plan, Fallon Health, Health New England, and Tufts
Direct have proposed to offer ConnectorCare coverage in PY 2021
▪ AllWays Inc would no longer participate in the ConnectorCare program under the carrier’s proposal
• If approved for ConnectorCare participation, AllWays Select would take its place but with a smaller
geographic footprint with the removal of Worcester County, and participation in some areas to be
finalized related to ConnectorCare network adequacy as described in subsequent slides
▪ HNE proposed a larger geographic coverage area in PY 2021, newly entering Worcester County
• HNE currently offers unsubsidized and APTC-only coverage in Worcester County and meets
ConnectorCare network adequacy standards
▪ Tufts Direct proposed a larger footprint in PY 2021, newly entering Franklin County
• Tufts Direct’s signing of a hospital contract in Franklin County allows them to meet ConnectorCare
network adequacy standards for hospital coverage in the county, and ConnectorCare adequacy of
specialist coverage is under review with Health Connector staff
▪ While Health Connector staff are pleased to see expected ConnectorCare geographic coverage mostly
maintained or expanded for PY 2021, some proposed provider network changes signal possible
concerns regarding the stability of ConnectorCare networks in future years
13
AllWays Health Partners Select:
ConnectorCare ProposalHealth Connector staff are working with AllWays to determine whether the
AllWays Select provider network can sufficiently support ConnectorCare
membership in all geographic regions.
▪ Health Connector staff have expressed concerns about whether the initially proposed AllWays Select
provider network meets the Health Connector’s ConnectorCare-specific network adequacy standards,
and is currently working with the carrier to determine if those standards can be met in all proposed
ConnectorCare regions
▪ Hospital Coverage: The Health Connector allows a carrier to participate in the ConnectorCare program
in a given county only if the carrier contracts with at least one acute care hospital in the county and
that provides reasonable access to all county residents
• Health Connector staff identified areas of certain counties where access may not be reasonable
for all enrollees and therefore AllWays Select’s ConnectorCare participation in those areas remains
to be determined
• AllWays Select added two Massachusetts hospitals in response to Health Connector feedback, and
indicates it is continuing efforts to add to its hospital network in order to satisfy ConnectorCare
hospital standards in all proposed regions
14
AllWays Health Partners Select:
ConnectorCare Proposal (cont’d)The AllWays Select provider network, as initially proposed, represents a
smaller selection of primary care and specialty providers in comparison to the
AllWays Inc network.
▪ Primary Care Provider (PCP) and Specialist Coverage: The AllWays Select network is a narrower network
with a smaller portion of the PCPs and specialists available to members currently enrolled in AllWays Inc
plans, though the degree of provider attrition varies by region
• The Health Connector is reviewing AllWays Select PCP and specialist coverage with a focus on the
experience of current members accustomed to a wide array of available providers
▪ Based on preliminary data from AllWays, the difference in breadth between the two networks is more
acute in some counties than others
• For example, Health Connector staff are concerned about provider coverage in Bristol County, where
27% of PCPs, 40% of obstetricians/gynecologists, and 14% of cardiologists in the AllWays Inc network
are retained in the AllWays Select network
• Conversely, in Suffolk County, 65% of PCPs and cardiologists, and 79% of obstetricians/gynecologists,
remain in the Select network
▪ If the carrier is unable to sufficiently expand its network to ensure it can adequately serve ConnectorCare
members, Health Connector staff will return to the Board in September to recommend certain restrictions
on AllWays Select’s ConnectorCare participation, such as a smaller geographic coverage area
15
AllWays Health Partners Select:
Member ImpactIf the AllWays Select’s ConnectorCare submission proceeds as proposed,
ConnectorCare members would be impacted in several ways.
▪ While AllWays’ existing ~9,900 ConnectorCare members would maintain access to the Partners
hospital system under the proposed Select license, a portion would experience a disruption in
provider continuity if they enroll in the AllWays Select ConnectorCare plan
• Preliminary data from AllWays suggest approximately 23% of ConnectorCare members would
experience at least one disrupted relationship with a provider if they enroll in an AllWays Select
ConnectorCare plan in 2021*
▪ As with provider retention, the degree of provider disruption varies regionally with, for example, ~50%
of Bristol County ConnectorCare members experiencing at least one provider disruption, compared to
~18% in Suffolk County or ~13% in Essex County
▪ A ConnectorCare member would be able to select from BMCHP, Fallon, and Tufts Direct
ConnectorCare plans, depending on their region, if they did not wish to enroll in AllWays Select
• However, members may also experience provider disruption if they enroll in one of these other
carriers
• As AllWays is the only ConnectorCare carrier to offer coverage on the Islands, Islands residents
would need to remain with AllWays
• AllWays indicates there will be no change in Islands provider coverage under the Select license
16
*Data represent AllWays ConnectorCare members as of June 2020 who utilized at least one health service in 2019. As the data does
not include health services utilized in 2020 due to claims lag, the proportion of provider disruption is potentially an undercount.
Qualified Dental Plan (QDP)Submissions
Qualified Dental Plans:
Overview
The proposed 2021 dental shelf is unchanged from 2020.
▪ Two existing carriers proposed to offer plans to the non-group market: Altus Dental and Delta Dental
▪ Four existing carriers proposed to offer plans to the small group market: Altus Dental, Blue Cross Blue
Shield, Delta Dental and Guardian; however, BCBS and Guardian again requested to waive on-
exchange sale
▪ There are no new carriers exits or entrants
18
Plan Year 21 (No change from PY 20)
Carriers Non-GroupSmall
Group
Intent to sell on
exchangeHigh Low Pedi Total
Altus Dental ✓ ✓ ✓ 1 1 1 3
Blue Cross Blue
Shield of MA✓ 1 1 2 4
Delta Dental of MA ✓ ✓ ✓ 2 3 4 9
Guardian ✓ 1 1 1 3
TOTAL 5 6 8 19
Next Steps and Vote
2021 Seal of Approval: Next Steps
The Conditional Seal of Approval is an important step in the process,
but more data and analysis, particularly regarding premiums, is
required before the 2021 product shelves are finalized.
▪ We will work closely with the Board throughout the summer to develop recommendations for final
award of the Seal of Approval
• Carriers must demonstrate compliance with all DOI requirements, including completion of
premium rate review
• Our final recommendation will be based on confirmation that all SOA plans offer good value to our
consumers, meet ConnectorCare network adequacy standards in all proposed coverage areas, and
carrier readiness to enter a contract with the Health Connector
20
VOTE
The Health Connector recommends allowing the 2021 Conditional
Seal of Approval to enable consideration of all recommended
standardized and non-standardized QHPs and QDPs proposed by the
following carriers:
21
• AllWays Health Partners Inc
• AllWays Health Partners Select
• Altus Dental
• Blue Cross Blue Shield of MA
• Boston Medical Center HealthNet Plan
• Delta Dental of MA
• Fallon Health
• Guardian
• Harvard Pilgrim Health Care
• Health New England
• Tufts Health Plan Direct
• Tufts Health Plan Premier
• UnitedHealthcare
Appendix 1: PY 2021 Standard Plan Designs
23
2021 Standard Qualified Health Plan DesignsPlan Feature/ Service
Note: “Deductible then…” means the member must first meet the
plan’s deductible; then, the member pays only the copay as listed for
in-network services.
Platinum High Gold High SilverLow Silver
(HSA compatible,
Small Group Only)
Bronze #1 Bronze #2(HSA compatible)
Annual Deductible – Combined$0 $0 $2,000 $2,000 $2,700 $3,600
$0 $0 $4,000 $4,000 $5,400 $7,200
Annual Deductible – MedicalN/A N/A N/A N/A N/A N/A
N/A N/A N/A N/A N/A N/A
Annual Deductible – Prescription DrugsN/A N/A N/A N/A N/A N/A
N/A N/A N/A N/A N/A N/A
Annual Out-of-Pocket Maximum$3,000 $5,000 $8,550 $6,850 $8,550 $7,000
$6,000 $10,000 $17,100 $13,700 $17,100 $14,000
Primary Care Provider (PCP) Office Visits and
Mental/Behavioral Health Outpatient Services$20 $25 $25 Deductible then $30 Deductible then $40 Deductible then $100
Specialist Office Visits $40 $50 $50 Deductible then $60 Deductible then $90 Deductible then $150
Urgent Care $40 $50 $50 Deductible then $60 Deductible then $90 Deductible then $150
Emergency Room $150 $300 Deductible then $300 Deductible then $300 Deductible then $750 Deductible then $1,750
Emergency Transportation $0 $0 Deductible then $0 Deductible then $0 Deductible then $0 Deductible then $0
Inpatient Hospitalization $500 $750 Deductible then $1,000 Deductible then $750 Deductible then $1,200 Deductible then $2,000
Skilled Nursing Facility $500 $750 Deductible then $1,000 Deductible then $750 Deductible then $1,200 Deductible then $2,000
Durable Medical Equipment 20 percent 20 percentDeductible then 20
percent
Deductible then 20
percent
Deductible then 20
percent
Deductible then 20
percent
Rehabilitative Occupational and Rehabilitative Physical Therapy $40 $50 $50 Deductible then $60 Deductible then $90 Deductible then $150
Laboratory Outpatient and Professional Services $0 $50 Deductible then $50 Deductible then $60 Deductible then $75 Deductible then $55
X-rays and Diagnostic Imaging $0 $75 Deductible then $75 Deductible then $75 Deductible then $100 Deductible then $140
High-Cost Imaging $150 $400 Deductible then $400 Deductible then $500 Deductible then $1,000 Deductible then $1,000
Outpatient Surgery: Ambulatory Surgery Center $250 $500 Deductible then $500 Deductible then $500 Deductible then $500 Deductible then $500
Outpatient Surgery: Physician/Surgical Services $0 $0 Deductible then $0 Deductible then $0 Deductible then $0 Deductible then $0
Prescription Drug
Retail Tier 1 $10 $25 $25 Deductible then $30 $30 Deductible then $30
Retail Tier 2 $25 $50 $50 Deductible then $60 Deductible then $100 Deductible then $150
Retail Tier 3 $50 $75 Deductible then $75 Deductible then $105 Deductible then $150 Deductible then $225
Mail Tier 1 $20 $50 $50 Deductible then $60 $60 Deductible then $60
Mail Tier 2 $50 $100 $100 Deductible then $120 Deductible then $200 Deductible then $300
Mail Tier 3 $150 $225 Deductible then $225 Deductible then $315 Deductible then $450 Deductible then $675
Federal Actuarial Value Calculator 89.25 percent 81.40 percent 71.97 percent 69.10 percent 64.98 percent 64.98 percent
Bold indicates changes from 2020.
2021 Standard Qualified Dental Plan Designs
Plan Feature/ Service Family High Family Low Pediatric-only
Plan Year Deductible $50/$150 $50/$150 $50
Deductible Applies toMajor and Minor
Restorative
Major and Minor
Restorative
Major and Minor
Restorative
Plan Year Max (>=19 only) $1,250 $750 N/A
Plan Year MOOP <19 Only$350 (1 child)
$700 (2+ children)
$350 (1 child)
$700 (2+ children)$350 (1 child)
Preventive & Diagnostic Co-Insurance (In/out-of-
Network)0 percent/20 percent 0 percent/20 percent 0 percent/20 percent
Minor Restorative Co-Insurance (In/out-of-Network)25 percent/45
percent
25 percent/45
percent
25 percent/45
percent
Major Restorative Co-Insurance (In/out-of-Network)50 percent/70
percent
50 percent/70
percent
No Major Restorative
>=19
50 percent/70
percent
Medically Necessary Orthodontia, <19 only (In/out-of-
Network)
50 percent/70
percent
50 percent/70
percent
50 percent/70
percent
Non-Medically Necessary Orthodontia, <19 only (In/out-
of-Network)N/A N/A N/A
Note: Standard QDP designs are unchanged from 2020.
24
Appendix 2: ConnectorCare Membership
ConnectorCare Membership Summary
26
Membership by Plan Type*
Plan Type AllWays BMCHP FCHP HNETufts
Direct
PT 1 (<100% FPL)
334 9,680 372 <50 8,778
PT 2 (100-200%
FPL)
4,309 41,232 3,622 1,842 59,113
PT 3 (200-300%
FPL)
5,245 27,406 3,465 1,912 56,888
Proportion of Carrier Membership by
Plan Type*
Plan Type AllWays BMCHP FCHP HNETufts
Direct
PT 1 (<100% FPL)
3% 12% 5% 1% 7%
PT 2 (100-200%
FPL)
44% 53% 49% 48% 47%
PT 3 (200-300%
FPL)
53% 35% 46% 50% 46%
*Data as of 7/2/2020.
Appendix 3: PY 2020 Reference Material
Qualified Health Plans:
2020 Standardized Plan Designs
28
Plan Feature/ Service
A check mark (✓) indicates this benefit
is subject to the annual deductible
Platinum High Gold Low Gold High Silver Low Silver (HSA) Bronze #1 Bronze #2 (HSA)
Annual Deductible – Combined$0 N/A N/A $2,000 $2,000 $2,900 $3,500
$0 N/A N/A $4,000 $4,000 $5,800 $7,000
Annual Deductible – MedicalN/A $1,000 $2,000 N/A N/A N/A N/A
N/A $2,000 $4,000 N/A N/A N/A N/A
Annual Deductible – Prescription DrugsN/A $0 $250 N/A N/A N/A N/A
N/A $0 $500 N/A N/A N/A N/A
Annual Out-of-Pocket Maximum$3,000 $5,000 $5,600 $8,150 $6,850 $8,150 $6,850
$6,000 $10,000 $11,200 $16,300 $13,700 $16,300 $13,700
Primary Care Provider (PCP) Office Visits $20 $25 $30 $30 $30 $30 $45
Specialist Office Visits $40 $45 $55 $60 $60 $60 $75
Emergency Room $150 $150 $350 $350 $300 $350 $300
Urgent Care $40 $45 $55 $60 $60 $60 $75
Inpatient Hospitalization $500 $500 $750 $1,000 $750 $750 $750
Skilled Nursing Facility $500 $500 $750 $1,000 $750 $750 $750
Durable Medical Equipment 20 percent 20 percent 20 percent 20 percent 20 percent 20 percent 20 percent
Rehabilitative Occupational and
Rehabilitative Physical Therapy$40 $45 $55 $60 $60 $60 $75
Laboratory Outpatient and Professional
Services$0 $25 $50 $60 $60 $60 $60
X-rays and Diagnostic Imaging $0 $25 $75 $75 $75 $75 $75
High-Cost Imaging $150 $200 $300 $500 $500 $500 $500
Outpatient Surgery: Ambulatory Surgery
Center$250 $250 $500 $500 $500 $500 $500
Outpatient Surgery: Physician/Surgical
Services$0 $0 $0 $0 $0 $0 $0
Prescription Drug
Retail Tier 1 $10 $20 $25 $30 $30 $30 $35
Retail Tier 2 $25 $40 $50 $60 $60 $60 $75
Retail Tier 3 $50 $60 $125 $100 $105 $125 $150
Mail Tier 1 $20 $40 $50 $60 $60 $60 $70
Mail Tier 2 $50 $80 $100 $120 $120 $120 $150
Mail Tier 3 $150 $180 $375 $300 $315 $375 $450
Federal Actuarial Value Calculator 89.38 percent 81.30 percent 76.04 percent 71.94 percent 69.42 percent 64.96 percent 64.95 percent
Bold indicates changes from PY2019.
2020 ConnectorCare Enrollee Contributions
Region A1
Enrollee Premium Contribution By Plan Type
1<100
percentFPL
2A100-150
percent FPL
2B150-200
percent FPL
3A200-250
percent FPL
3B250-300
percent FPL
1 Tufts-Direct $0 $0 $45 $87 $130
2 BMC $0 $0 $45 $87 $130
3 HNE $104 $107 $156 $199 $246
4AllWays Health
Partners$155 $156 $206 $250 $299
Region A2Enrollee Premium Contribution By Plan Type
1 2A 2B 3A 3B
1 Tufts-Direct $0 $0 $45 $87 $130
2 BMC $0 $0 $45 $87 $130
3 HNE $104 $107 $156 $199 $246
Region A3Enrollee Premium Contribution By Plan Type
1 2A 2B 3A 3B
1 Tufts-Direct $0 $0 $45 $87 $130
2 HNE $37 $74 $130 $199 $246
Region A4Enrollee Premium Contribution By Plan Type
1 2A 2B 3A 3B
1 HNE $0 $0 $45 $87 $130
Region B1Enrollee Premium Contribution By Plan Type
1 2A 2B 3A 3B
1 Tufts-Direct $0 $0 $45 $87 $130
2 Fallon $0 $0 $45 $87 $130
3 BMC $0 $0 $45 $87 $130
4AllWays Health
Partners$147 $145 $194 $237 $282
Region C1Enrollee Premium Contribution By Plan Type
1 2A 2B 3A 3B
1 Tufts-Direct $0 $0 $45 $87 $130
2 BMC $0 $0 $45 $87 $130
3AllWays Health
Partners$191 $193 $243 $286 $331
Region D1Enrollee Premium Contribution By Plan Type
1 2A 2B 3A 3B
1 Tufts-Direct $0 $0 $45 $87 $130
2 BMC $0 $0 $45 $87 $130
3AllWays Health
Partners$161 $171 $221 $263 $307
Region E1Enrollee Premium Contribution By Plan Type
1 2A 2B 3A 3B
1 Tufts-Direct $0 $0 $45 $87 $130
2 BMC $0 $0 $45 $87 $130
3AllWays Health
Partners$217 $226 $276 $318 $360
Region F1Enrollee Premium Contribution By Plan Type
1 2A 2B 3A 3B
1 Tufts-Direct $0 $0 $45 $87 $130
2 BMC $0 $0 $45 $87 $130
3AllWays Health
Partners$206 $211 $263 $305 $352
Region
F2
Enrollee Premium Contribution By
Plan Type
1 2A 2B 3A 3B
1AllWays Health
Partners$0 $0 $45 $87 $130
Region
G1
Enrollee Premium Contribution By
Plan Type
1 2A 2B 3A 3B
1 Tufts-Direct $0 $0 $45 $87 $130
2 BMC $12 $50 $105 $151 $194
Region G2Enrollee Premium Contribution By Plan Type
1 2A 2B 3A 3B
1AllWays Health
Partners$0 $0 $45 $87 $130
Region C2Enrollee Premium Contribution By Plan Type
1 2A 2B 3A 3B
1 Tufts-Direct $0 $0 $45 $87 $130
2 BMC $0 $0 $45 $87 $130
3 Fallon $0 $0 $45 $87 $130
4AllWays Health
Partners$191 $193 $243 $286 $331
Region G3Enrollee Premium Contribution By Plan Type
1 2A 2B 3A 3B
1 Tufts-Direct $0 $0 $45 $87 $130
2 BMC $12 $50 $105 $151 $194
3AllWays Health
Partners$221 $266 $327 $375 $422
Region D2Enrollee Premium Contribution By Plan Type
1 2A 2B 3A 3B
1 Tufts-Direct $0 $0 $45 $87 $130
2 BMC $0 $0 $45 $87 $130
3AllWays Health
Partners$166 $172 $221 $263 $305
4 Fallon $216 $221 $271 $313 $355
29