Regulation

Regulation  211 CMR 152.00: Health benefit plans using limited, regional or tiered provider networks

211 CMR 152.00 applies to the design and Marketing of Insured Health Benefit Plans that make use of: (a) a Limited Provider Network that differs from the Carrier's General Provider Network; (b) a Regional Provider Network; or (c) a Tiered Provider Network in which the Health Benefit Plan copayments, coinsurance or deductibles are tied to the Health Care Provider's assigned benefit level tier. 211 CMR 152.00 also governs the offering by Carriers of at least one Health Benefit Plan with a Limited or Tiered network to Eligible Small Businesses or Eligible Individuals as defined in M.G.L. c. 176J

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