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2024 Individual Mandate Coverage OOP and Deductible Minimum Creditable Coverage (MCC) Limits

September 28, 2023

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 2024 deductibles and out-of-pocket maximum limits for MCC. The 2022, 2023, and 2024 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, which indicates whether a plan provides 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: How do employers comply with the Massachusetts Minimum Creditable Coverage (MCC) and Health Insurance Responsibility Disclosure (HIRD) requirements? of the November 10, 2022, edition of Compliance Corner.

Therefore, employers who have employees in Massachusetts should be aware of the 2024 MCC limits.

Deductible Limits 2024 2023 2022
Employee-only tier deductible $2,950 $2,850 $2,750
Employee-only tier separate Rx deductible $360 $350 $340
Family tier deductible $5,900 $5,700 $5,500
Family tier Rx deductible $720 $700 $680
Maximum Out-of-Pocket (OOP) Limits 2024 2023 2022
Employee-only tier OOP max $9,450 $9,100 $8,700
Family tier OOP max $18,900 $18,200 $17,400

PPI Benefit Solutions does not provide legal or tax advice. Compliance, regulatory and related content is for general informational purposes and is not guaranteed to be accurate or complete. You should consult an attorney or tax professional regarding the application or potential implications of laws, regulations or policies to your specific circumstances.

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