940 CMR, § 26.05

Current through Register 1538, January 3, 2025
Section 26.05 - Misrepresentations Prohibited

It is an unfair and deceptive act in violation of MGL c. 93A s. 2(a) for a Discount Health Plan or Discount Health Plan Organization to:

(1) use or cause to be used in advertisements, marketing material, brochures and discount health plan cards the term "insurance" except as specifically provided in section 26.04(1)(a) or as a disclaimer of any relationship between the discount health plan and insurance;
(2) use or cause to be used in advertisements, marketing material, brochures and discount health plan cards, the following terms:

"health plan" without the term "discount" used before the words "health plan," "coverage," "copay," "copayments," "deductible," "preexisting conditions," "guaranteed issue," "premium," "PPO," "preferred provider organization," "open enrollment" or other terms in a manner that has the capacity to mislead a person into believing that the plan is a type of health insurance;

(3) except as specifically provided in the general laws, use or cause to be used in advertisements, marketing material, brochures and discount health plan cards language indicating that the discount health plan is an insurance product "licensed" by the Division of Insurance or the term "license" or "licensed" in a manner that could reasonably mislead an individual into believing that the discount health plan is insurance;
(4) make or cause to be made any representation that has the capacity to mislead a person into believing that the discount health plan has been authorized, approved or endorsed by the Commonwealth, including the Division of Insurance or the Commonwealth Connector Authority;
(5) make or cause to be made misleading, deceptive or fraudulent representations concerning the discount or range of discounts offered by the discount health plan or the access to any range of discounts offered by the discount health plan; and
(6) make or cause to be made misleading, deceptive or fraudulent representations concerning providers who agree to offer discounts on their services with the discount health plan.

940 CMR, § 26.05