Healthcare Reform:  What Mass. Realtors Need to Know

With the onset of the Affordable Care Act requirements for health care coverage nationwide, readers may have questions in understanding the state insurance requirement that has been in place for several years and how it relates and compares to the national reform.  A primary clarifier in compliance with healthcare nationwide and including Massachusetts, is that all plans have to contain 10 Essential Health Benefits as contained in the 2014 health reform provisions.


The are:

1. Ambulatory services

2. emergency services

3. Hospitalization

4. Maternity and newborn care

5. Mental health and substance use disorder services, including behavioral health treatment

6. Prescription drugs

7. Rehabilitative and habilitative services and devices

8. Laboratory services

9. Preventive and wellness services and chronic disease management

10. Pediatric services, including oral and vision care (services for individuals under 19 years of age)

Review these several FAQs to help you determine how to search for healthcare provided by MAR's Health Insurance for Realtors program offered through Health Services Administrator who is available with advice and to help you access the health care coverage that best suits your needs.  Visit to find out more on the Affordable Care Act (ACA) and what MAR's Health Insurance for Realtors® has to offer or contact HSA at 781-228-2171 or


Q. Do I have to go to the Federal Exchange for a health insurance plan?

A. No, there are other options other than going to the exchange which is synonymous with ObamaCare or the provisions of the ACA.  States have had the option to create their own exchange, however Massachusetts is using the Federal Exchange for access to the ACA provision plan.

Q. Where else can I go to find an insurance plan that works for me or my small group?

A. MAR's Health Service Administrators ( can help you find plans and rates that are specific to your personal or group situation.  However, you have the option to go to a non group plan as well.  HSA is available to help you determine which would work best.

Q. Why should I go through the exchange for a health insurance plan instead of another plan?

A.  If you qualify for a subsidy (or payroll tax credit for a small group) to help pay for the monthly premium, going to the exchange is a good idea. Subsidies are based on your household annual income and are on a sliding scale. If your household income is less than 400% of the federal poverty line (based on the number of people in your household) you may qualify for a subsidy.

Q. Are there any subsidies or discounts given through other  group insurance plans?

A. No, there are no discounts or subsidies through anything but the exchange. 

Q. Are all plans on and off the exchange qualified insurance plans?

A. Yes, all plans offered through HSA Insurance and the exchange are qualified plans. 

Q. I have a pre-existing condition; does that exclude me from any insurance plans in 2014?

A. No, as of January 1, 2014, you cannot be turned down due to a pre-existing condition for any plans on or off the exchange. 

Q. Do plans offered through other groups such as the Chamber of Commerce or NAR eligible to meet the requirements?

A. All plans being offered in 2014 must have the Essential Health Benefits in order to be qualified. If someone finds a plan that isn’t qualified, I would not recommend it.

Q.  What can I expect when contacting the Federal Exchange

A. You will need to provide a lot of information, some of which you may not want to disclose to the government. Lots of this information isn’t generally required in order to get an insurance plan off-exchange so it just makes it more confusing when all of this stuff needs to be entered.

Q. Are all major health care carriers available on the Exchange?

A. Some carriers aren’t available on the exchange, only off-exchange/private.