Massachusetts Releases 2025 MCC Amounts

The Commonwealth Health Insurance Connector Authority (“Health Connector”) recently published Administrative Bulletin 02-24 to provide annual guidance regarding certain provisions of the Minimum Creditable Coverage (“MCC”) regulation. Specifically, this Bulletin describes the calculation of the deductible limits and out-of-pocket maximums for 2025 and provides those respective dollar amounts.

Deductible Limits

The 2007 regulations mandated a $2,000/$4,000 deductible limit and a separate prescription deductible limit of up to $250/$500 for in-network covered services. Subsequent regulations required indexing the deductible limits to the annual out of-pocket maximum (“OOPM”) adjustment percentage under federal law, rounded down to the next $50. Administrative Bulletin 02-24 sets the 2025 maximum MCC deductibles as $2,950/$5,900. If the plan has a separate prescription drug deductible, the amounts cannot exceed $360/$720 and the total maximum deductible applies. These deductible limits are unchanged from 2024.

OOPMs

In 2017, the Health Connector published Administrative Bulletin 02-17, tying the indexed OOPMs under MCC to the federally indexed OOPMs that apply to non-grandfathered plans. For 2025, the OOPMs under MCC will be $9,200/$18,400. It should be noted that the 2005 federally indexed OOPMs that apply to non-grandfathered plans have not been released

Effective Dates

Administrative Bulletin 02-24 takes effect immediately; the changes applicable to employer-sponsored plans will be incorporated with plan years beginning on or after January 1, 2025.