1099-HC and health care reform - tax year 2014

Health care reform legislation requires Massachusetts state residents age 18 and over to have health care coverage. Residents whose coverage does not meet the state's minimum creditable coverage (MCC) standards, or who have a lapse in coverage more than 3 consecutive months, may be subject to a penalty for each month of non-compliant coverage during the year. The following are frequently asked questions designed to explain how the law affects state tax filings.

Am I required by the state to have health insurance?

Most Massachusetts residents who are 18 years or older are required to have health insurance that meets minimum creditable coverage standards, and not have a lapse in coverage of more than 3 consecutive months, or they may be subject to a penalty for each month of non-compliance. You can see the penalty amounts for tax year 2014 at http://www.mass.gov/dor/businesses/help-and-resources/legal-library/tirs/tirs-by-years/2014-releases/tir-14-1.html.

What is minimum creditable coverage?

Minimum creditable coverage (MCC) is the least amount of coverage that an individual must obtain to be in compliance with the health care reform individual mandate. 

What if I have a plan that does not meet minimum creditable coverage requirements?

The requirement to meet MCC guidelines may not apply to all individuals. For information on MCC, affordability or waivers, the Commonwealth Connector Public Information Line is available at 1-877-MA-ENROLL
(1-877-623-6765) or visit the Connector via their website at www.mahealthconnector.org.

What if I had coverage for non-consecutive months?

Gaps in health care coverage may exist without a penalty providing they are no more than 3 consecutive months, according to legislation. If you are enrolled in health insurance that meets minimum creditable coverage standards anytime during the year, you will receive a 1099-HC form indicating full year coverage, or, if there are gaps in coverage, showing each month you had health insurance that meets minimum creditable coverage standards for at least 15 days or greater.

How do I prove that I have obtained health insurance?

If you are enrolled in health insurance that meets minimum creditable coverage standards anytime during the year, you will receive a 1099-HC form in the mail in January from your health insurance company. The form is proof of coverage and can be used to help fill out the Schedule HC form, which is a required part of the Massachusetts income tax return.

You can also download a copy of your 1099-HC. Just log into myFallon, go to the “My Benefits” page, and click on the “1099-HC” link at the top right of the screen. 1099-HCs for the 2014 tax year will be available for download in January, 2015.

I am an employer that offers health benefits through Fallon Health and pharmacy benefits through a separate pharmacy benefits manager. How will Fallon know if I meet minimum creditable coverage standards?

Fallon Health will mail an attestation form to employers whose Fallon plan does not meet minimum creditable coverage standards. Employers receiving the form are required to complete and mail it back to Fallon attesting to meeting minimum creditable coverage standards. Fallon will then send 1099-HC forms to employees by January 31, 2015. 

What if I had coverage from different insurers?

If you have coverage from different health care insurers during 2014, you will receive a 1099-HC from each health insurance provider from which you had coverage.

What if I live outside of Massachusetts but have a dependent that lives in Massachusetts?

Fallon Health subscribers living in or outside of Massachusetts will be sent a 1099-HC form. Subscribers and dependents can use the form to obtain information needed to complete their Massachusetts Schedule HC filing. Subscribers that are not filing Massachusetts state income taxes may disregard the form.

How do I obtain a form if I am a dependent?

Fallon Health will send a 1099-HC form to each subscriber who has health coverage that meets minimum creditable coverage standards in 2014. Dependents can use the subscriber form to obtain information needed to complete their Massachusetts Schedule HC filing.

What if I am on a government-subsidized health plan(Medicare/MassHealth/Commonwealth Care)?

Individuals on a Medicare/MassHealth/Commonwealth Care plan at any time during 2014 will receive 1099-HC information from the state showing proof of coverage. The form is proof of coverage and can be used to help fill out the Schedule HC form, which is a required part of the Massachusetts income tax return.

What information does the 1099-HC form contain?

The 1099-HC indicates:

  • Name of insurance company or administrator, and its Federal Identification Number (FID) number (or, Employer Identification Number)
  • Subscriber’s name, address, member number and date of birth
  • Whether an individual had full-year coverage that meets minimum creditable coverage standards, or, if not full-year coverage, the number of months covered (a month of coverage is any month in which you had 15 or greater days of coverage)
  • Dependents’ names, dates of birth, member numbers and coverage data

What if my address or name is incorrect on my form?

If the 1099-HC has an incorrect address and you received the form, please let Fallon Health know your new or correct address. If you received a 1099-HC form, you will not need another one. If your name changed in 2014 or is incorrect on the 1099-HC form, please let Fallon know right away and we will make the correction for you and send you a corrected form.

How do I obtain a 1099-HC form?

Fallon Health subscribers over the age of 18 that have health insurance that meets minimum creditable coverage standards will be mailed a 1099-HC form from Fallon by January 31. If you, as a subscriber, misplace or don’t receive a form, please call the Customer Service phone number on the back of your member ID card to request a new one. (TTY users, please call TRS 711.)

You can also download a copy of your 1099-HC. Just log into myFallon, go to the “My Benefits” page, and click on the “1099-HC” link at the top right of the screen. 1099-HCs for the 2014 tax year will be available for download in January, 2015.

If you are a dependent over the age of 18 and filing separately, you can use the information from the subscriber’s 1099-HC form to complete your state tax filing.

Why did I receive more than one 1099-HC form?

If you have coverage from different health care providers during 2014, you will receive a 1099-HC form from each health insurance provider from which you obtained coverage. 

When will subscribers receive a 1099-HC form?

Fallon Health will mail 1099-HC forms to subscribers by January 31, 2015, for the 2014 state tax filing.

You can also download a copy of your 1099-HC. Just log into myFallon, go to the “My Benefits” page, and click on the “1099-HC” link at the top right of the screen. 1099-HCs for the 2014 tax year will be available for download in January, 2015.

If I receive health care coverage through my employer, will the employer send me a 1099-HC form?

In most cases, health insurers, not employers, will send out 1099-HC forms. Fallon Health will send 1099-HC forms to our members.

You can also download a copy of your 1099-HC. Just log into myFallon, go to the “My Benefits” page, and click on the “1099-HC” link at the top right of the screen. 1099-HCs for the 2014 tax year will be available for download in January, 2015.

If I do not receive the 1099-HC form or if I misplace the one that I did receive, can I obtain another form?

You can download a copy of your 1099-HC. Just log into myFallon, go to the “My Benefits” page, and click on the “1099-HC” link at the top right of the screen. 1099-HCs for the 2014 tax year will be available for download in January, 2015.

Additional copies of a subscriber’s 1099-HC form issued by Fallon can also be obtained by calling the Customer Service phone number on the back of your member ID card Monday, Tuesday, Thursday, and Friday from 8 a.m. to 6 p.m. and Wednesday from 10 a.m. to 6 p.m. (TTY users, please call TRS 711.) Customer Service can mail, email or fax a copy of your 1099-HC to you. Due to HIPAA privacy regulations, forms can only be requested by the subscriber. The caller may be asked certain questions to confirm that he or she is the actual subscriber.

Do I need more than one 1099-HC form if I am married but my spouse and I file separate tax returns?

No, you will only need one form. Health insurance companies will issue one 1099-HC per subscriber. If you need more than one form, you may make a copy of the original document.

Do I need to attach the 1099-HC form to my state income tax filing?

If you are filing your state income tax electronically, you do not need to submit a copy of your 1099-HC form. If you are filing a paper return, please attach a copy of your 1099-HC form to your tax return. If you need more than one form, you may make a copy of the original document. If you have not received a copy of your 1099-HC form by January 31, please call the Customer Service phone number on the back of your member ID card, Monday, Tuesday, Thursday, and Friday from 8 a.m. to 6 p.m. and Wednesday from 10 a.m. to 6 p.m. (TTY users, please call TRS 711.) You may submit your return without the form attached; however, 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 the Department of Revenue.

What is the Schedule HC tax form?

The Schedule HC form is a required part of your Massachusetts income tax filing which indicates whether or not you had health insurance that meets minimum creditable coverage standards at any time during 2014.

Where can I get a copy of the Schedule HC tax form?

The Massachusetts Department of Revenue will have the Schedule HC tax form available on their website, www.mass.gov/dor. Forms should also be available anywhere you obtain your state income tax forms or through your tax preparer.

More information can be found on the Massachusetts Department of Revenue (DOR) website at www.mass.gov/dor or by phone at 1-617-887-6367 (toll-free at 1-800-392-6089).

Updated on November 18, 2014