Compliance Corner

FAQs

FAQ: How do employers comply with the Massachusetts Minimum Creditable Coverage (MCC) and Health Insurance Responsibility Disclosure (HIRD) requirements?

November 08, 2022

Employers with employees in Massachusetts should be aware of MCC and HIRD requirements and take necessary actions even when their primary business is located outside of the state. These two requirements are outlined below.

Health Insurance Responsibility Disclosure (HIRD)

About HIRD: The HIRD form is a state annual reporting requirement in Massachusetts. The HIRD form collects employer-level information about employer-sponsored health insurance plans to assist MassHealth (the state’s Marketplace) in identifying members who can participate in and who may be eligible for premium assistance from MassHealth.

Covered employers: An employer who has (or had) six or more employees in Massachusetts any month during the past 12 months prior to the HIRD due date must comply with the HIRD form requirement.

Due date: December 15 of the reporting year annually (the form is available on the MassTaxConnect website starting November 15).

Information reported on HIRD: Covered employers must report a separate HIRD form for each FEIN. Further, employers that maintain multiple plan options must file a separate HIRD form for each plan.

The HIRD form(s) should include information on the plan(s) offered to Massachusetts employees for the employer’s upcoming plan year. If plan information for the upcoming plan year is not available, then employers must provide information only for a plan or plans offered to Massachusetts employees for the current plan year. If the employer’s current plan year ends on or before December 31 (e.g., a calendar year plan), an employer must report plan information for the upcoming plan year.

Though the employer is ultimately responsible for ensuring the information is provided in a timely and accurate manner, the form may be completed by its payroll vendor.

Filing method: The HIRD reporting is filed through the MassTaxConnect (MTC) web portal electronically only, and paper forms are not accepted.

MA HIRD Form FAQs »
MassTaxConnect (MTC) »
MA HIRD Form Instructions »

MA Individual Mandate — Minimum Credible Coverage (MCC) and Form MA 1099-HC

About MCC and Form MA 1099-HC: Massachusetts requires its residents (over the age of 18) to carry minimum creditable coverage (MCC) or pay a penalty. It is a similar requirement to the now repealed ACA Individual Mandate; however, a MCC determination involves a more in-depth review. Employers that provide MCC to Massachusetts residents are required to distribute Form MA 1099-HC to those residents and submit reporting electronically to the Department of Revenue (DOR) by January 31, following the end of the medical plan year. However, employers are not required to offer MCC, and there's no penalty if the coverage the employer offers does not meet the MCC standard. For fully insured plans issued in MA, the insurers generally administer these requirements on behalf of the employers.

Covered employers: All employers with at least one Massachusetts resident employee must comply with the Form MA 1099-HC requirement. For fully insured plans sitused in the state, insurers generally prepare and provide Form MA 1099-HC to the state resident employees and report to the DOR on behalf of employers. It is recommended that employers that sponsor fully insured group health plans confirm with their carriers accordingly. For self-insured plans and non-Massachusetts employers, employers are required to distribute Form MA 1099-HC with their Massachusetts resident employees and file with the DOR by January 31. Employers can obtain draft copies of Form 1099-HC on the DOR website.

If an employer is unsure if its plan is considered MCC, the employer can request the Health Connector to make the determination.

Due date: January 31, following the end of the medical plan year.

Information reported on MA Form 1099-HC: A Form 1099-HC indicates the months that the employees and any dependents had MCC in the previous year.

Filing method: Employers must submit Form MA 1099-HC information to DOR electronically in properly formatted XML through MassTaxConnect. For additional information about how to file Form MA 1099-HC information, please refer to the state site, “Submitting Information to DOR.”

The Form MA 1099-HC needs to be sent only to the primary subscriber.

Mass Healthcare – Frequently Asked Questions for Employers »
Health Connector – Employer Advisory »
Health Connector – HDHPs and MCC Requirements »