State RegulationsMA specificDifficulty 2/5
Under the Massachusetts individual mandate, which body establishes the standards for minimum creditable coverage?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
The Massachusetts Health Connector sets the minimum creditable coverage standards that determine whether a resident satisfies the individual mandate of M.G.L. c. 111M, and it does so through its regulations at 956 CMR 5.00. The standards define the benefit floor a policy must meet to count as qualifying coverage. Producers therefore need to recognize that coverage sufficiency is a Connector determination, not a matter of insurer preference or federal substitution.
Why the other options are wrong
- B) Federal frameworks operate alongside state law, but the minimum creditable coverage standard is set by the Massachusetts Health Connector under 956 CMR 5.00.
- C) Insurers design products to meet the standard; they do not define it, because the authority rests with the Massachusetts Health Connector.
- D) A producer sells coverage that meets the standard but has no authority to decide what qualifies under 956 CMR 5.00.
Memory hook
The Connector writes the checklist: 956 CMR 5.00 defines creditable coverage.