Commonwealth of Massachusetts
Citizens' Guide to State Services

Published by
William Francis Galvin
Secretary of the Commonwealth
Citizen Information Service

Consumer: Insurance

D14 Division of Insurance

D15 Bureau of Managed Care

D16 Office of Patient Protection

D17 Insurance Fraud Bureau of Massachusetts

D18 Board of Appeal on Motor Vehicle Liability, Policies and Bonds

D19 Commonwealth Health Insurance Connector Authority


D14 Division of Insurance
Office of Consumer Affairs and Business Regulations
1000 Washington Street, 8th Floor
Boston, MA 02118-2218
Administration: (617) 521-7794
Consumer Line: (617) 521-7777
Western Massachusetts Communities Tel: (413) 785-5526
TTY: (617) 521-7490
Fax: (617) 521-7575
www.mass.gov/doi/

The Division of Insurance regulates all aspects of the insurance business in the Commonwealth including licensing of agents, brokers, and companies, examination of domestic and foreign insurance companies, and oversight of sales, marketing and claim practices. Consumers may address questions about all aspects of insurance to this office between 8:45 a.m. and 5:00 p.m. Consumer complaints must be made in person at the office during those hours or submitted in writing.


D15 Bureau of Managed Care
Division of Insurance
Office of Consumer Affairs and Business Regulations
1000 Washington Street, Suite 810
Boston, MA 02118
Tel: (617) 521-7372
Fax: (617) 521-7773
www.mass.gov/doi/
E-mail: bmc.mailbox@state.ma.us 

The Bureau of Managed Care was created by Chapter 131 of the Acts of 2000, in conjunction with the Department of Public Health's Office of Patient Protection, (see next entry) to oversee and enforce compliance of health insurance carriers, insurers, and HMOs operating in the state. Contact this office to file a complaint phone, fax, or e-mail.


D16 Office of Patient Protection
Department of Public Health
250 Washington Street, 2nd Floor
Boston, MA 02108
Toll Free: 1-800-436-7757 (within Mass. only)
Fax: (617) 624-5046
www.mass.gov/dph/opp

The Office of Patient Protection, created by Chapter 141 of the Acts of 2000 and in operation since January 1, 2001, is charged with developing regulations and implementing new statutory provisions of M.G.L. Chapter 1760 for residents covered by a state carrier, insurer or HMO regarding their rights to understanding their health coverage’s internal grievance procedures, as well as establishing a process for obtaining an independent external review where coverage is denied based upon a medical necessity determination. An insured individual who receives an adverse determination of an internal grievance has the right to an external review of a covered benefit within 45 days, and may obtain the necessary forms by calling this office or by accessing the department’s website for a form. To file a complaint, contact the Division of Insurance’s new Bureau of Managed Care (see previous entry).


D17 Insurance Fraud Bureau of Massachusetts
101 Arch Street
Boston MA 02110
Tel: (617) 439-0439
Fax: (617) 439-0404
Toll Free: 1-800-32-FRAUD (3-7283, 24-hours)
www.ifb.org/

The Insurance Fraud Bureau is a private entity licensed by the state under MGL Ch. 175A:8, was mandated by MGL Ch.266:111B (Ch. 338 of the Acts of 1990). Its purpose is to prevent and investigate fraudulent insurance transactions by insured individuals against their insurance company. These illegal transactions can be criminally prosecuted.


D18 Board of Appeal on Motor Vehicle Liability, Policies and Bonds
Division of Insurance
1000 Washington Street, 8th Floor
Boston, MA 02118
Tel: (617) 521-7478
Fax: (617) 521-7772
www.mass.gov/doi/

Accident surcharges may be appealed to the Board of Appeals within 30 days of receipt of the Merit Rating Surcharge Notice. Convictions of moving violations are considered surchargeable incidents and are not appealable to the board. Any action of the Registry of Motor Vehicles and automobile insurance cancellations may also be appealed to this board.


D19 Commonwealth Health Insurance Connector Authority
100 City Hall Plaza 6th Floor
Boston, MA 02108
Tel: (617) 933-3140
Toll Free: 1-877-MA ENROLL (623-6765)
TTY Commonwealth Care: 1-877-623-7773
TTY Commonwealth Choice: 1-888-213-8163
www.MahealthConnector.org/
E-mail: Connector@state.ma.us

The Commonwealth Health Insurance Connector Authority created by Chapter 58 of the Acts of 2006 and signed into law on April 12th, 2006 requires citizens on Massachusetts to have health insurance. Based upon income eligibility, those at or below 300% of the federal poverty level enroll in a Commonwealth Care plan while those individuals and eligible small employers above the federal poverty level may enroll with a Commonwealth Choice plan.


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