The Massachusetts Individual Mandate requires each Massachusetts resident to have health coverage that meets the Minimum Creditable Coverage (MCC) standards set by the Commonwealth Health Insurance Connector (Connector) or pay a penalty through their state tax returns. The Connector has announced the 2023 deductibles and out-of-pocket maximum limits for minimum creditable coverage (MCC). The 2021, 2022 and 2023 limits are summarized below.
Although employers are not required to provide MCC for their Massachusetts employees, insurers, or in some cases employers, are required to complete Form 1099-HC that indicates whether a plan is MCC or not and distribute the form to their Massachusetts employees. The same form must then be submitted to the state Department of Revenue (DOR) by January 31, following the plan year.
Additionally, employers with six or more employees who work in Massachusetts are required to submit an annual report, entitled the Health Insurance Responsibility Disclosure (HIRD) form, where MCC status is also reported, by December 15. You can find additional information in the FAQ section of this Compliance Corner.
Therefore, employers who have employees in Massachusetts should be aware of the 2023 MCC limits.
| Deductible Limits | 2023 | 2022 | 2021 |
| Employee-only tier deductible | $2,850 | $2,750 | $2,700 |
| Employee-only tier separate Rx deductible | $350 | $340 | $300 |
| Family tier deductible | $5,700 | $5,500 | $5,400 |
| Family tier Rx deductible | $700 | $680 | $660 |
| Maximum Out-of-Pocket (OOP) Limits | 2023 | 2022 | 2021 |
| Employee-only tier OOP max | $9,100 | $8,700 | $8,550 |
| Family tier OOP max | $18,200 | $17,400 | $17,100 |