1. Has the Health Care 1099-HC schema been finalized?
  2. Does DOR require one large file from carriers? Or can it be split between multiple files?
  3. If there is an error with the file, does the entire file have to be re-sent, or just the records that failed?
  4. If we can't create an XML file, can we just send paper copies of the Form MA 1099-HC to DOR?
  5. Does our file have to match the sample with respect to formatting, indentation, etc?
  6. Should data be "padded" out to the Max Length for a field?
  7. What is the .XSD file, and how is it used?
  8. What are documentCount and documentId? How are they used?
  9. Will the documentName always be the same when the insurance carrier sends a file, or does each file need to have a different name?
  10. Is there any restriction as to the number of dependents that can be listed in the XML file?
  11. Does the subscriber number in the XML report have to match the paper Form MA 1099-HC exactly?
  12. Should dependents use the same subscriber number of the primary subscriber?
  13. Do birth dates have to be a valid values?
  14. If a subscriber has been covered since 1/1/2000, what should be reported for their Coverage Effective Date? What about their Coverage Through Date if their coverage extends beyond the end of the year?
  15. How do we report non-custodial parents who are the primary subscriber but don't actually have coverage themselves?
  16. For a retroactive termination where the individual's coverage was terminated for the entire year, what should be reported in the Coverage Dates?
  17. Should the Delete Flag be used to remove one coverage span during the year?
  18. What should the Corrected flag be set to for the initial record sent to DOR?
  19. If updating, do we report Corrected tag as true?
  20. When correcting or deleting a single dependent, does the whole family have to be re-sent?
  21. If we have a span that starts in 1/1/2005 and has an end date of 12/31/9999 would we report as 1/1/2005 or 1/1/2009?
  22. How should we report gaps in coverage?
  23. Is there a cut-off date for a carrier's responsibility to send updated files to DOR for either a retroactive termination or addition in cases where the carrier is required to automatically issue a Form MA 1099-HC?
  24. Does DOR have an example XML document that contains multiple insurance companies?
  25. Can an insurance provider include data for different calendar years on the same file sent to DOR?
  26. Are there any changes to the 1099-HC XML file layout for 2009?
  27. When a carrier or third party administrator issues 1099-HC's and submits the XML data to DOR on behalf of a plan sponsor, is it important to have unique files if the carrier uses the FID number but different company names?
  28. If a subscriber is not MCC Compliant, is there a preference by the DOR as to what the DOR would like to have reported in the DOR XML File Extract ? Should the Carrier either end no record as part of the XML File Extract or include the subscriber and member's name, address, DOB, ID #, but pass no Coverage dates as part of the XML File Extract?
  29. If a member is on a plan that is not MCC compliant then should the carrier submit to DOR on the XML file?
  30. If a member is on a plan that is not MCC compliant for some portion of the year and on a MCC compliant plan for the rest of the year, should the carrier not send the dates for the duration of the year where they are on the non MCC compliant plan?
  31. If a MA member does not meet all minimum creditable coverage requirements, but they do have health care coverage, is the member included in the XML file?
  32. If a MA member does meet all minimum creditable coverage requirements for specific times, but they do have health care coverage for the full year, is the member included in the XML file for only the dates with creditable coverage?
  33. If a MA member meets all minimum creditable coverage requirements, but they do have multiple health care coverage dates, is the member included in the XML file multiple times or one time with multiple dates? If it is in the file multiple time what impact will this have?
  34. If a MA member meets all minimum creditable coverage requirements, but they do have multiple health care coverage dates and belong to multiple groups (change jobs), is the member included in the XML file multiple times or one time with multiple dates?

1. Has the Health Care 1099-HC schema been finalized?

The XML schema is final and available on the DOR website.

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2. Does DOR require one large file from carriers? Or can it be split between multiple files?

Data can be split into multiple transmissions. There is no limit to the number of files.

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3. If there is an error with the file, does the entire file have to be re-sent, or just the records that failed?

Any file that has XML syntax errors must be corrected by the transmitter. The entire file should then be re-sent.

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4 . If we can't create an XML file, can we just send paper copies of the Form MA 1099-HC to DOR?

No. DOR will not accept paper copies of the Form MA 1099-HC.

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5. Does our file have to match the sample with respect to formatting, indentation, etc?

In XML "white space" characters between elements are ignored. This includes spaces, tabs and carriage returns.

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6. Should data be "padded" out to the Max Length for a field?

No. Do not pad fields with extra spaces.

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7 . What is the .XSD file, and how is it used?

The XSD file is the XML Schema Definition. It is the blueprint for the XML file, and can be used by programming tools to validate the XML file. The XSD file can be viewed in any text editor.

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8 . What are documentCount and documentId? How are they used?

The documentCount is the count of all the <SubscriberInformation> elements. The documentId of each subscriber is any value that can uniquely identify the record within the transmission. Carriers are free to choose a suitable naming or numbering scheme of their own.

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9 . Will the documentName always be the same when the insurance carrier sends a file, or does each file need to have a different name?

The documentName should be a unique value that identifies the XML document within the transmission. DOR does not currently use this value, since there is currently never more than one XML document allowed per file.

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10. Is there any restriction as to the number of dependents that can be listed in the XML file?

No. There is no limit.

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11. Does the subscriber number in the XML report have to match the paper Form MA 1099-HC exactly?

It is critical that what is reported to DOR electronically and what is sent to the taxpayer on the Form MA 1099-HC matches exactly. Especially for the subscriber number.

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12. Should dependents use the same subscriber number of the primary subscriber?

DOR assumes that each person can be uniquely identified by their subscriber number. If that is not the case then DOR would prefer the subscriber number be concatenated with a prefix or suffix to make it unique, and reported as such on both the paper Form MA 1099-HC and the electronic file.

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13. Do birth dates have to be a valid values?

DOR would prefer that legitimate dates be used. If a carrier does not have an actual date of birth for a subscriber, then it is okay to use a default value as long as it is a valid XML date.

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14. If a subscriber has been covered since 1/1/2000, what should be reported for their Coverage Effective Date? What about their Coverage Through Date if their coverage extends beyond the end of the year?

Coverage dates should be reported relative to the tax year.

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15. How do we report non-custodial parents who are the primary subscriber but don't actually have coverage themselves?

In the XML schema Coverage Dates are optional for cases such as this. Records with no coverage dates will just be ignored, unless they are marked as a Correction or Deletion.

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16. For a retroactive termination where the individual's coverage was terminated for the entire year, what should be reported in the Coverage Dates?

In the XML schema Coverage Dates are optional for cases such as this. The record should be marked as a deletion.

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17. Should the Delete Flag be used to remove one coverage span during the year?

No. Unless coverage for the entire tax year is being terminated, it would be considered a correction, not a deletion. The Coverage Dates from the corrected record will completely overwrite the original record.

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18. What should the Corrected flag be set to for the initial record sent to DOR?

Either omit the flag entirely, or set it to false.

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19 . If updating, do we report Corrected tag as true?

Yes.

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20. When correcting or deleting a single dependent, does the whole family have to be re-sent?

Additions, corrections and deletions can come by themselves, without re-sending the entire family.

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21. If we have a span that starts in 1/1/2005 and has an end date of 12/31/9999 would we report as 1/1/2005 or 1/1/2009?

If you have dates in your system like 12/31/9999, make sure those are valid XML date values. Otherwise you are going to get schema failures. We expect transmitters to programmatically validate against the XML schema before transmission.

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22. How should we report gaps in coverage?

The subscriber would have multiple Coverage Dates, each with it's own start and end date. The gaps would be the periods between each start and end date.

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23. Is there a cut-off date for a carrier's responsibility to send updated files to DOR for either a retroactive termination or addition in cases where the carrier is required to automatically issue a Form MA 1099-HC?

There is currently no cut-off date defined. DOR will accept corrections indefinitely.

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24. Does DOR have an example XML document that contains multiple insurance companies?

The XML schema only supports one carrier per file. If reporting needs to be done on behalf of multiple carriers, it would require multiple transmissions.

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25. Can an insurance provider include data for different calendar years on the same file sent to DOR?

No. The XML schema only supports one tax year per file. If reporting needs to be done for multiple tax years, it would require multiple transmissions.

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26. Are there any changes to the 1099-HC XML file layout for 2009?

There were no major changes from 2008 (other than the version number and tax year). Click here for the latest version of the 1099-HC XML.

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27. When a carrier or third party administrator issues 1099-HC's and submits the XML data to DOR on behalf of a plan sponsor, is it important to have unique files if the carrier uses the FID number but different company names?

No, provided you break out each unique combination of FID & company name into its own file (and the printed 1099-HC's match of course). You can also vary the company name for a given FID without having to split the file into multiple parts. It would be advisable to make the names consistent. If the Company Name is totally different, or represents a different insurance product for marketing purposes, for example, then you might want to split it up.

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28. If a subscriber is not MCC Compliant, is there a preference by the DOR as to what the DOR would like to have reported in the DOR XML File Extract ? Should the Carrier either end no record as part of the XML File Extract or include the subscriber and member's name, address, DOB, ID #, but pass no Coverage dates as part of the XML File Extract?

We have no preference. Member data without coverage dates is ignored by us, so those two ways are exactly the same for our system.

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29. If a member is on a plan that is not MCC compliant then should the carrier submit to DOR on the XML file?

No, you can either leave them out of the file entirely or if they are included, the coverage start date and coverage end date fields should be blank.

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30. If a member is on a plan that is not MCC compliant for some portion of the year and on a MCC compliant plan for the rest of the year, should the carrier not send the dates for the duration of the year where they are on the non MCC compliant plan?

Carriers should not include the time that the subscriber's plan is not MCC compliant. Only report the time that the subscriber is compliant.

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31. If a MA member does not meet all minimum creditable coverage requirements, but they do have health care coverage, is the member included in the XML file?

We do not have a preference if the member is included in the XML file. However, if they are included they should have no <CoverageDates>. We will just skip the records without Coverage Date completely. We chose offering both options (omitting the member or omitting Coverage Date) to give the Carriers more flexibility.

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32. If a MA member does meet all minimum creditable coverage requirements for specific times, but they do have health care coverage for the full year, is the member included in the XML file for only the dates with creditable coverage?

Yes. The only <CoverageDates> should be the creditable periods.

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33. If a MA member meets all minimum creditable coverage requirements, but they do have multiple health care coverage dates, is the member included in the XML file multiple times or one time with multiple dates? If it is in the file multiple time what impact will this have?

One time with multiple dates. Otherwise each subsequent record will completely overwrite the previous one, as if it were a "corrected" record.

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34. If a MA member meets all minimum creditable coverage requirements, but they do have multiple health care coverage dates and belong to multiple groups (change jobs), is the member included in the XML file multiple times or one time with multiple dates?

It depends on whether the Subscriber Number changes. If it's the same Subscriber Number, then it has to be one time with multiple dates. If it's a different Subscriber Number, then it has to be multiple records.

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