- How many employees does an employer need to offer health insurance?
- What happens if an employer offers medical coverage and an employee refuses it and can afford it?
- What if a person is self-employed and has no insurance? How is that handled on the tax return and what are the consequences?
- What are the employer obligations under the new health care mandate?
- Are employees required to complete a HIRD form if they choose health insurance coverage through a Section 125 Plan, but elect to have zero dollars withheld for the Flexible Spending Account?
- I am an employer with a self-insured health care plan and need to provide Form MA 1099-HC to my employees. Where can I obtain blank copies of the Form MA 1099-HC?
- Are residents required to submit Forms MA 1099-HC when filing their income tax returns?
- Is there a standard format for the Form MA 1099-HC?
- If an individual calls a carrier/employer to request a copy of a prior year Form MA 1099-HC, does a report need to be sent to DOR the prior year's Form MA 1099-HC?
- If a subscriber has a mailing address (eg., a Florida mailing address for the winter months and a default address (e.g, Massachusetts address for the rest of the year, what address should be sent to DOR and used on the Form MA 1099-HC?
- What if a dependent has a different mailing address? Should the dependent receive a separate Form MA 1099-HC?
- If a parent company will be sending out Forms MA 1099-HC for its operating companies, what should appear in Line 1, the parent company name or the individual business entity's name?
- How many attempts do carriers/employers have to make to deliver letters that are sent back as "undeliverable" via U.S. mail?
- Are carriers/employers required to mail Forms MA 1099-HC to Medicare subscribers?
- What is the penalty for a health insurance carrier or employer that is obligated to issue Form MA 1099-HC but does not to comply?
- My insurance company is not filing the Form MA 1099-HC report on my behalf, how do I file the report with DOR?
- Can employers file Form MA 1099-HC information with DOR in paper format?
- Is there a particular software that is required for filing electronically?
- I am small business and our out of state Carrier has informed us that they are not filing Healthcare information to DOR on our behalf. Do I need to submit data through the same process that is used by the large Carriers?
Businesses with 11 or more full-time-equivalent employees must offer Section 125 plans to enable their employees, including employees who may not be eligible for the employers' group health plan, to purchase health coverage on a pre-tax basis. Those who do not may be required to pay a surcharge if their employees (or dependents of their employees) make significant use of the state's Health Safety Net, formerly the Uncompensated Care Pool. This is called the Free Rider Surcharge.
2. What happens if an employer offers medical coverage and an employee refuses it and can afford it?
In short, employers subject to the mandate must make a fair and reasonable contribution to their employees' health insurance. (Please visit the Division of Unemployment Assistance for information about the Fair Share Contribution (FSC).) If the employer offers and the employee refuses, the employer has the employee sign a HIRD form that shows what the minimum monthly premium on the least expensive plan would have cost that the employee turned down. If the employee is not covered under a spouse's plan, and can afford to purchase insurance and doesn't, the employee will be subject to a penalty for each month he or she lacks health insurance.
3. What if a person is self-employed and has no insurance? How is that handled on the tax return and what are the consequences?
If a person is self-employed and can afford to purchase a health insurance but doesn't, he or she will be subject to a penalty for each month without insurance. However, the individual could appeal the imposition of the penalty to the Health Connector if a hardship prevented him or her from purchasing insurance.
For purposes of the new law, the only employer reporting requirement to the Department of Revenue relates to the Form MA 1099-HC. In Massachusetts, most insurance carriers will issue this form on behalf of employers; however, you should verify this with your particular carrier. Carriers will then send a report to DOR listing all Form MA 1099-HCs they issued. If an employer is issuing the Form MA 1099-HC to employees, a report will need to be filed with DOR. For information on this requirement, please see the Instructions for Electronic Filing Form 1099-HC .
5. Are employees required to complete a HIRD form if they choose health insurance coverage through a Section 125 Plan, but elect to have zero dollars withheld for the Flexible Spending Account?
No. Employees do not have to complete a HIRD form if they accept a Section 125 insurance plan offered by the employer, or if they decline the Flexible Spending Account offering.
6. I am an employer with a self-insured health care plan and need to provide Form MA 1099-HC to my employees. Where can I obtain draft copies of the Form MA 1099-HC?
The Form MA 1099-HC is available on the DOR website.
If you are filing a paper return, please attach a copy of your Form MA 1099-HC form to your tax return. If you have not received a copy of your 1099-HC form, please attempt to obtain one from your insurance carrier. If you are unable to obtain a copy of your 1099-HC form, you may submit your return without the form attached. Please be advised that this could delay the processing of your tax return. As always, electronic filing is the quickest and most efficient way to file your tax return with DOR.
No. There is no standardized format. The Form MA 1099-HC may vary depending upon each carrier; however the information fields must be consistent and must convey the information to the taxpayer that they need to transcribe over to the Schedule HC. A sample form is available on the DOR website.
3. If an individual calls a carrier/employer to request a copy of a prior year Form MA 1099-HC, does a report need to be sent to DOR for the prior year's Form MA 1099-HC?
To clarify: You can't commingle Tax Years, and we even designed the XML schema to make sure of that. But you do need to be able to send data for prior tax years, if it wasn't actually sent that year. So, let's say in 2012 a former customer asks you to generate a Form MA 1099-HC for 2007. If the carrier had already sent it in 2007, send DOR nothing new - that data from 2007 will still be here in our database. If you didn't send anything to us electronically in 2007 for some reason, it should come in its own transmission/file, with the Tax Year element set accordingly. Carriers may also use the 1099-HC Mapped Data Upload utility to send additions to prior years' data.
4. If a subscriber has a mailing address (eg., a Florida mailing address for the winter months and a default address (e.g, Massachusetts address for the rest of the year, what address should be sent to DOR and used on the Form MA 1099-HC?
It doesn't really matter. Just make sure what is sent to DOR and what is sent to the taxpayer is consistent.
5 . What if a dependent has a different mailing address? Should the dependent receive a separate Form MA 1099-HC?
The only requirement is that the Form MA 1099-HC be sent to the primary subscriber. Dependents are not required to receive Form MA 1099-HC; however, carriers may send separate Forms MA 1099-HC to dependents if they so choose. If a dependent needs to file a Schedule HC, he or she can obtain the necessary information from the subscriber's Form MA 1099-HC, or request a separate Form MA 1099-HC from the carrier.
6 . If a parent company will be sending out Forms MA 1099-HC for its operating companies, what should appear in Line 1, the parent company name or the individual business entity's name?
It does not matter. You can list either the parent company's name or the individual business entity's name, so long as what is reported to DOR electronically and what is sent to the taxpayer on the Form MA 1099-HC are consistent and the FID numbers are the same.
7 . How many attempts do carriers/employers have to make to deliver letters that are sent back as "undeliverable" via U.S. mail?
This is an internal decision of the carrier. There is no tax information on the Form MA 1099-HC and therefore DOR has no position on mail returned from the post office.
No. DOR will not require carriers to send Form MA 1099-HC to their Medicare members. This applies to both Supplemental or Replacement plans.
9 . What is the penalty for a health insurance carrier or employer that is obligated to issue Form MA 1099-HC but does not to comply?
The 1099 HC is a tax document like any other tax document required to be submitted to the Massachusetts Department of Revenue by law or regulation. Failure to do so could subject the employer or carrier to a host of penalties, as provided under M.G.L. Ch. 62C § 8B. Below is the language contained in DOR's regulation.
(9) Penalty for Failure to Provide Documentation of Health Insurance
(a) Pursuant to M.G.L. c. 62C, § 8B, carriers, employers or other sponsors of employment-sponsored health plans that fail to provide written statements to covered individuals or to report to the Commissioner in violation of this section shall be punishable by a penalty of $50 per individual to which the failure relates, not to exceed $50,000 per year per violator.
(b) The Commissioner shall assess the penalties under M.G.L. c. 62C, § 8B as a tax subject to chapter 62C.
1. My insurance company is not filing the Form MA 1099-HC report on my behalf, how do I file the report with DOR?
This year DOR offers two methods for health insurance carriers or employers to send health care data to DOR; XML or through the 1099HC Mapped Data Upload.
XML Data. The first method is the same as last year and requires carriers or employers to transmit XML data to DOR via an SSH connection with DOR. Data must be in good XML format. These XML files are uploaded to DOR through a secure application called .
Information relating to the filing requirements and methodology is located on the Health Care FAQs for Insurance Carriers page on the DOR website. Filers also can find registration and file upload information in the TY2009 Bulk E-Filer Registration and Transmission Guide, as well as important instructions relating to the XML file format and the XML schema information. Additionally sample 1099HC and Schedule HC and Instructions may be found at this location.
Mapped Data Upload. This year DOR has developed the 1099HC Mapped Data Upload, which allows 500 records or less of health care information to be transmitted to DOR through a new cut and paste upload to DOR. This new application is located in Webfile for Business. Registered users of Webfile for Business will see a new Health care reporting option displayed on the WFB home page. Through this link users will be lead to the new 1099HC Mapped Data upload.
An overview of the 1099HC Mapped Data Upload can be found in the information for Health care software developers section file size 1MB of the DOR Website.
Check out more information about the 1099HC Mapped Data Upload utility by viewing the tutorial Video.
No. Employers must submit 1099-HC information to DOR electronically in properly formatted XML through the ssh connections or through the 1099-MDU for files less than 500 records.
No. The electronic document is in XML format, which is a standard electronic document format used by many companies, including the IRS, for many initiatives. Various XML development tools are available to help in the development of the XML file if the insurance carrier/employer is developing the file in-house. Commercial vendors also exist in the market place that could assist if needed. DOR does not recommend any one tool or vendor or another.
4. I am small business and our out of state Carrier has informed us that they are not filing Healthcare information to DOR on our behalf. Do I need to submit data through the same process that is used by the large Carriers?
No. This year the Department developed a new and easier method for business and carriers with less then 500 health care records to submit data to DOR. The new method is called the 1099HC Mapped Data Upload and allows companies to cut and paste data from spreadsheet software into a web page and submit the data to DOR. As the name suggests, the data in each column is "mapped" in the process before it is sent to DOR.
Check out more information about the 1099HC Mapped Data Upload utility by viewing the tutorial Video.
Please contact us if you have any additional questions.
For a more detailed explanation of the personal income tax treatment of employer-provided health insurance coverage for an employee's child please see TIR 07-16.
For information about individual mandate penalties for Tax Year 2009, please see TIR 09-1.
For information about overall individual mandate enforcement, please see DOR Regulation 830 CMR 111M.2.1.