reglab/housing_qa huggingface dataset:
MA Gen L ch 176a § 1 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176a - Non-Profit Hospital Service Corporations|Section 1 - Corporations Governed by Chapter; Services Received in Nonparticipating Hospital; Substitution of Benefits in Nursing Homes

Section 1. Any corporation organized under the laws of the commonwealth for the purpose of establishing, maintaining and operating a non-profit hospital service plan whereby hospital care and reimbursement for other health services may be provided by such corporation, or by a hospital with which it has a contract for such care and which is maintained by the commonwealth or a political subdivision thereof, or maintained by a corporation organized for hospital purposes under the laws of the commonwealth, or such other hospitals as shall be approved by the commissioner of public health, to such of the public who become subscribers to said plan under a contract which entitles each subscriber or his dependents, or employees or dependents of employees of employers who contribute the subscription fees in whole or in part to certain hospital care and reimbursement for other health services, shall be governed by this chapter.  Nothing in this chapter shall prevent such a corporation from reimbursing a subscriber for services received in a non-participating hospital within or outside the commonwealth in the event of accident, illness or maternity or, upon the written direction of the subscriber, from making payment to said hospital for such services; provided, however, that the amount of such reimbursement and payment to any such hospital within the commonwealth shall conform with such method of payment and guarantee of benefits as shall have been in effect pursuant to section five of this chapter immediately prior to the expiration of the then most recent contract between said hospital and said corporation and shall be based upon the charges of the hospital in effect on such date.  Nothing in this section shall prevent any such corporation, with the approval of the commissioner of public health, from entering into contracts with the Soldiers' Home in Massachusetts and the Soldiers' Home in Holyoke, whereby in consideration of a contract fee, said soldiers' homes shall provide such care for non-service connected causes as would be provided in participating hospitals under contracts with subscribers.  Nothing in this section shall prevent any such corporation, with the approval of said commissioner, from entering into contracts with the Lemuel Shattuck Hospital whereby, in consideration of a contract fee, said hospital shall provide such hospitalization and such other care as would be provided in participating hospitals under contracts with subscribers, subject to such restrictions as to nature of disease and length of stay as may be specified from time to time in said contracts.
MA Gen L ch 176a § 1a (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176a - Non-Profit Hospital Service Corporations|Section 1a - Right to Become Subscriber; Open Enrollment Periods

Section 1A. Any person residing in the commonwealth shall have the right to become a subscriber of a nonprofit hospital service corporation if the qualifications of such person meet those specified in the by-laws of such corporation; provided, however, that such corporation may, in its discretion, refuse to issue a subscription certificate to, or upon due notice, cancel the subscription certificate of any person who has made any fraudulent claim or representation to such corporation, or has been guilty of uncooperative or unethical dealings with such corporation, or has failed to pay dues and assessments seasonably and promptly, or for any other cause which may be approved by the commissioner. Any such corporation shall provide for annual open enrollment periods of not less than two months' duration. Proper notification shall be given to prospective subscribers in a form subject to approval by the commissioner.  All nonprofit hospital service corporations governed by this chapter which offer supplemental coverage to medicare, shall provide open enrollment for nongroup subscribers to medicare supplemental coverage, commencing on February first and ending March thirty-first of each year, for coverage to be effective June first of that year; provided, however, that nothing contained herein shall preclude additional periods of open enrollment for subscribers to medicare supplemental coverage.  Any person who is eligible for Medicare coverage for both hospital and physician services due to age or disability, other than end-stage renal disease, shall be eligible for supplemental coverage to Medicare ninety days before and after the month of such person's Medicare effective date or of the month of such person's loss of group or individual health coverage resulting from such person's retirement. Such supplemental coverage shall be effective no earlier than the effective date of Medicare coverage.
MA Gen L ch 176a § 1b (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176a - Non-Profit Hospital Service Corporations|Section 1b - Medicare Supplemental Group Coverage; Medical Assistance Recipients

Section 1B. A nonprofit hospital service corporation governed by this chapter shall offer medicare supplemental group coverage to that group of medical assistance recipients designated from time to time by the department of public welfare. Such coverage shall be provided at a rate based on the projected experience of said group of recipients.
MA Gen L ch 176a § 1c (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176a - Non-Profit Hospital Service Corporations|Section 1c - Retroactive Premium Rate Increase

Section 1C. For purposes of this section, retroactive premium rate increase shall mean any premium rate increase based upon an actual approved rate which is assessed to a subscriber after any payment has been made by said subscriber based upon an estimated premium rate for such period of coverage.  A nonprofit hospital service corporation governed by this chapter which offers medicare supplemental individual or group coverage shall, in the event of a retroactive premium rate increase for such coverage, allocate such increase among the remaining outstanding premium payments due; provided, however, that no finance charge or additional cost may be charged as a result of such allocation.
MA Gen L ch 176a § 1d (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176a - Non-Profit Hospital Service Corporations|Section 1d - Contracts of Reinsurance

Section 1D. Any corporation subject to this chapter may make contracts of reinsurance relating to the providing of medical or other health services or reimbursement thereof, but the costs of such reinsurance shall not inure to or otherwise affect the premiums charged for any policy offered, sold, issued or delivered by the corporation pursuant to chapter 176K or for any nongroup health plan offered, sold, issued or delivered by the corporation pursuant to chapter 176M.
MA Gen L ch 176a § 2 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176a - Non-Profit Hospital Service Corporations|Section 2 - Incorporators; Directors; Certificate of Organization; Commissioner's Examination Report

Section 2. Persons desiring to form such a non-profit hospital service corporation shall incorporate as provided in section three of chapter one hundred and eighty.  The board of directors of each such corporation shall consist of thirty-one members, three of whom shall be officers or agents of contributing employers who are not identified with a hospital as officers, directors or employees, and two of whom shall be representatives of labor. The said directors shall be elected for terms of three years.  Every certificate of organization of a corporation subject to this chapter filed under said chapter one hundred and eighty shall have endorsed thereon or attached thereto the consent of the commissioner of insurance. The recommendations and criticisms of the latest report of each examination made by the commissioner of insurance shall be read at the next annual or special meeting of every non-profit hospital service corporation, and at the next meeting of the board of directors and thereafter a copy thereof shall be filed at the home office of the corporation and shall be made available for inspection by any member upon request.
MA Gen L ch 176a § 3 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176a - Non-Profit Hospital Service Corporations|Section 3 - Certificate of Compliance; Examination by Commissioner

Section 3. No non-profit hospital service corporation shall make or issue any contract to provide hospital care and reimbursement for other health services until it has obtained from the commissioner of insurance, in this section called the commissioner, a certificate, in such form as he may prescribe, stating that the corporation has complied with the conditions set forth in this chapter and all other provisions of law authorizing it to make or issue such contract. No such certificate shall be issued until the commissioner is satisfied, by such examination as he may make and such evidence as he may require, that the corporation has complied with the laws of the commonwealth, adopted a proper system of accounting, and employed either full time or on a consulting basis a competent accountant, a competent claim manager, a competent and experienced underwriter, and a competent and experienced actuary; nor, until the commissioner is satisfied, by such examination as he may make and by an affidavit filed with him, and by such evidence as he may require, that the corporation is without liabilities, except such organization expenses as the commissioner shall approve as reasonable; nor until he is satisfied that its officers and directors are of good repute and competent to manage a non-profit hospital service corporation.
MA Gen L ch 176a § 3a (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176a - Non-Profit Hospital Service Corporations|Section 3a - Discrimination Against Abuse Victims in Terms of Hospital Service Plans

Section 3A. No corporation subject to this chapter, and no officer or agent thereof, shall cancel, refuse to issue or renew, or in any way make or permit any distinction or discrimination in the amount or payment of premiums or rates charged, in the length of coverage, or in any other of the terms and conditions of a hospital service plan based on information that an individual has been a victim of abuse, as defined by section one of chapter two hundred and nine A. No corporation subject to this chapter, and no officer or agent thereof, shall seek information that such person has been a victim of abuse as defined by said section one of said chapter two hundred and nine A. The practices prohibited under this section shall include not only those overtly discriminatory but also practices and devices which are fair in form but discriminatory in practice. Nothing in this section shall be construed as creating a special class of insureds who have been victims of abuse as defined by said section one of said chapter two hundred and nine A. Any violation of this section shall constitute an unfair method of competition or an unfair or deceptive act or practice in violation of chapters ninety-three A and one hundred and seventy-six D.
MA Gen L ch 176a § 3b (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176a - Non-Profit Hospital Service Corporations|Section 3b - Medical Service Plans; Genetic Tests; Discrimination Based on Genetic Information

Section 3B. For the purposes of this section the following words shall have the following meanings:—  ''Genetic information'', a written recorded individually identifiable result of a genetic test as defined by this section or explanation of such a result.  ''Genetic test'', a test of human DNA, RNA, mitochondrial DNA, chromosomes or proteins for the purpose of identifying the genes, or genetic abnormalities, or the presence or absence of inherited or acquired characteristics in genetic material.  No corporation subject to this chapter and no officer or agent thereof, shall cancel, refuse to issue or renew, or in any way make or permit any distinction or discrimination in the amount of payment of premiums or rates charged, in the length of coverage, or in any other of the terms and conditions of a medical service plan based on genetic information as defined in this section. No corporation subject to the provisions of this chapter and no officer or agent thereof, shall require genetic tests or private genetic information, as defined in this section, as a condition of the issuance or renewal of a hospital service plan. Any violation of this section shall constitute an unfair method of competition or unfair or deceptive act or practice in violation of chapters 93A and 176D.
MA Gen L ch 176a § 4 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176a - Non-Profit Hospital Service Corporations|Section 4 - Accounting System; Accountant, Claim Manager, Underwriter and Actuary

Section 4. Every non-profit hospital service corporation shall use a proper system of accounting, and employ either full time, or on a consulting basis, a competent accountant, a competent claim manager, a competent and experienced underwriter, and a competent and experienced actuary.
MA Gen L ch 176a § 6 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176a - Non-Profit Hospital Service Corporations|Section 6 - Approval of Nongroup Contracts

Section 6. Nongroup contracts, except contracts providing supplemental coverage to medicare subject to the provisions of chapter one hundred and seventy-six K, issued and rates charged by nonprofit hospital service corporations to its subscribers for hospital care and reimbursement for other health services shall be subject to the provisions of chapter one hundred and seventy-six M, and any regulations promulgated thereunder.  No such contracts shall be approved if the benefits provided therein are unreasonable in relation to the rate charged, nor if the rates are excessive, inadequate or unfairly discriminatory.  The commissioner shall require every such corporation to keep its books, records, statistics, accounts and vouchers in such manner that he or his authorized representatives may readily verify its annual statements and ascertain whether the corporation has complied with the law.  At least once in three years, and whenever he determines it to be prudent, he shall personally, or by his deputy or examiner, visit each non-profit hospital service corporation and thoroughly inspect and examine its affairs to ascertain its financial condition, its ability to fulfill its obligations, whether it has complied with the law, and any other facts relating to its business methods and management, and the equity of its dealings with its subscribers.  A report of examination of any corporation made under this section shall as far as material and relevant be admitted in the discretion of the court in any judicial proceedings brought by or in behalf of the commissioner or any subscriber, non-profit hospital service corporation or other person as evidence tending to prove the facts stated in such report, but nothing in this paragraph shall be construed to require the commissioner to make an examination under this section before bringing such a proceeding.  The commissioner may investigate, in such manner and to such extent as he may deem expedient, any complaint under any subscriber's contract.
MA Gen L ch 176a § 81/2 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176a - Non-Profit Hospital Service Corporations|Section 81/2 - Sale of Group Non-Profit Hospital Service Contracts

Section 81/2. A corporation organized under this chapter may only contract to sell a group non-profit hospital service contract to an employer if the group non-profit hospital service contract is offered by that employer to all full-time employees who live in the commonwealth; provided, however, the employer shall not make a smaller health insurance premium contribution percentage amount to an employee than the employer makes to any other employee who receives an equal or greater total hourly or annual salary for each specific or general blanket policy of insurance for all employees. Notwithstanding the foregoing, a carrier may enter into a contract to sell a group non-profit hospital service contract with an employer that establishes separate contribution percentages for employees covered by collective bargaining agreements.
MA Gen L ch 176a § 8a3/4 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176a - Non-Profit Hospital Service Corporations|Section 8a3/4 - Retroactive Claims Denials for Behavioral Health Services

Section 8A3/4. (a) For the purposes of this section, the following words shall have the following meanings unless the context clearly requires otherwise:  ''Behavioral health services'', as defined in section 1 of chapter 175, or ''services''.  ''Provider'', (i) a mental health clinic or substance use disorder treatment program licensed by the department of public health under chapters 17, 111, 111B or 111E; or (ii) a behavioral, substance use disorder or mental health professional who is licensed under chapter 112 and accredited or certified to provide services and who has provided services under an express or implied contract or with the expectation of receiving payment, other than co-payment, deductible or co-insurance, directly or indirectly from the commission or other entity.  ''Retroactive claims denial'', as defined in section 1 of chapter 175.  (b) The corporation shall not impose a retroactive claims denial for behavioral health services on a provider unless: (i) less than 12 months have elapsed from the time of submission of the claim by the provider to the corporation; (ii) the corporation has furnished the provider with a written explanation of the reason for the retroactive claims denial and, where applicable, a description of additional documentation or any other corrective action required for payment of the claim; and (iii) where applicable, the corporation allows the provider 30 days to submit additional documentation or to take any other corrective action required for payment of the claim.  (c) Notwithstanding subsection (b), a retroactive claims denial may be allowed after 12 months if: (i) the claim was submitted fraudulently; (ii) the claim, or services for which the claim was submitted, is the subject of legal action; (iii) the claim payment was incorrect because the provider was paid or the insured has already paid for the services identified in the claim; or (iv) the services identified in the claim were not delivered by the provider.  (d) If a retroactive claims denial is imposed because the claim payment is subject to adjustment due to expected payment from a payer other than the corporation or an entity with which the insurer contracts to provide or manage health care services, including mental health and substance use disorder services, the corporation shall notify the provider not less than 15 days before imposing the retroactive claims denial. The provider shall have 12 months from the date of denial to determine whether the claim is subject to payment by a secondary insurer; provided, however, that if the claim is denied by the secondary insurer due to the insured's transfer or termination of coverage, the corporation shall allow for resubmission of the claim.
MA Gen L ch 176a § 8c (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176a - Non-Profit Hospital Service Corporations|Section 8c - Refusal to Contract With Blind or Deaf Persons; Prohibition

Section 8C. No corporation subject to this chapter shall refuse for the reason of blindness or deafness, to contract with a subscriber an individual hospital service plan.
MA Gen L ch 176a § 8e (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176a - Non-Profit Hospital Service Corporations|Section 8e - Diethylstilbestrol Exposure; Discrimination

Section 8E. No contract between a subscriber and the corporation under an individual or group hospital service plan which shall be delivered or issued in the commonwealth shall be denied, cancelled or fail to be renewed, nor shall any excessive rates be charged or restrictions on the length of coverage be imposed, nor shall any other factor be altered in such a way as to constitute discrimination primarily because the insured person has had a suspected, alleged or confirmed exposure to the potential hazards and afflictions of diethylstilbestrol or compounds commonly referred to as DES. The practices prohibited under this section shall include not only those overtly discriminatory but also practices and devices which are fair in form but discriminatory in practice.