State Council formed to Investigate Merged Market & Small Business Premiums

Last Fall, Governor Charlie Baker established the Merged Market Advisory Council in an effort to examine the individual and small group insurance market, or “merged market,” and underlying trends that have driven insurance costs up for small and mid-size employers. This group is comprised of 13 appointed members and chaired by Gary Anderson, the Commissioner of Insurance. Its membership includes various experts with knowledge of the insurance industry, including actuaries, brokers, insurance carriers and representatives from employers and the small business community.

The creation of this market can be traced to the Commonwealth’s enactment of RomneyCare in 2006. The reforms included merging the “non-group” risk pool, comprised of individuals, with the “small group” risk pool, comprised of small business with 50 or less employees (including the self-employed). This was intended to reduce premiums for those in the non-group market- which faced elevated costs due to a higher utilization on services – by spreading the risk over a larger population. The Chamber and many business groups were opposed at the time, fearing that rates would increase for small businesses. Vermont is the only other state where the individual and small group risk pools were merged into a single merged market.

While it is true that the merged market has led to premium reductions for individuals, it has also resulted in dramatic increases for small businesses and their employees. According to the Center for Insurance Information and Analysis, Massachusetts has amongst the highest small business health care premiums in the country. Unfortunately, this comes as no surprise to the Chamber or our members who have struggled with increasing premiums for years.

The Governor’s Merged Market Advisory Council is expected to make recommendations to the Baker Administration, which may include separating the merged groups as a way to reduce costs for small businesses. Some have argued that since passage of the national Affordable Care Act, the merged market is no longer necessary due to the incentives and subsidies provided to individuals.

The Advisory Council has scheduled a series of sessions where the public may share their input and concerns. The closest session to North Central Massachusetts is scheduled for Wednesday, February 26, 2020 from 6:30 p.m. to 8:30 p.m. in Room S-1-123 at UMass Medical Center, 55 Lake Avenue North in Worcester. The Chamber will be in attendance and encourages its members to participate and share any concerns they have as well. If you are unable to attend, please consider submitting written comments to the Merged Market Advisory Council via email at

For more information, please feel free to contact Christopher McDermott, Public Affairs Manager at 978.353.7600 ext. 224 or via email at