Massachusetts has sent letters to four large firms urging them to offer low-cost medical plans for small businesses or face legal sanctions. In letters to the chief executives of the state's dominant health insurers, Glen M. Shor, executive director of the Massachusetts Health Insurance Connector Authority, pressed the companies to participate in the state's small-business program. If they don't, he wrote, "we will consider any and all legal avenues available to us to ensure that contractual obligations are met."
