Code of Massachusetts Regulations › 830 CMR - DEPARTMENT OF REVENUE › Title 830 CMR 111M.00 - INDIVIDUAL HEALTH COVERAGE › Section 111M.2.1 - Health Insurance Individual Mandate; Personal Income Tax Return Requirements

Current through Register 1525, July 5, 2024
(1)
Statement of Purpose; Application and Effective Date;
			 Organization
.
(a) The goal of
			 the Massachusetts Health Care Reform Act (St. 2006, c. 58), is to ensure that
			 virtually all Massachusetts residents have affordable, comprehensive health
			 insurance designated as "creditable coverage."
Under St. 2006, c. 58, a resident is required to indicate
				whether he or she has health insurance on his or her Massachusetts personal
				income tax return. A resident who has access to affordable coverage but who
				does not obtain the coverage, and to whom an exception does not apply, is
				subject to penalties under M.G.L. c. 111M, § 2 which will be imposed
				through the individual's personal income tax return. 830 CMR 111M.2.1 explains
				various aspects of the health insurance individual mandate, including the need
				to declare health insurance coverage on the income tax return, exceptions to
				the mandate, calculation of any applicable penalties, employer reporting
				responsibilities under M.G.L. c. 62C, § 8B, and appeal rights of taxpayers
				in connection with the penalty under M.G.L. c. 111M, § 2.
St. 2006, c. 58 creates a new independent authority, the
				Commonwealth Health Insurance Connector Authority, which is responsible, among
				other things, for setting standards to determine whether affordable health
				insurance is available to residents, based on the percentage of income
				available to obtain coverage and the price of coverage. The Connector is also
				responsible for reviewing appeals of the health care individual mandate due to
				hardship.
In general, the implementation of the health care law involves
				multiple agencies including the Connector and the Department of Revenue. The
				purpose of 830 CMR 111M.2.1 is to explain the role of the Department in
				implementing St. 2006, c. 58. 830 CMR 111M.2.1 must be read in conjunction with
				any pertinent regulations promulgated by the Connector or other applicable
				agencies.
For tax years beginning on or after January 1, 2014, the
				federal Affordable Care Act instituted a federal mandate on individuals to
				obtain and maintain health insurance. While both Massachusetts and federal
				health care reform include this individual responsibility requirement, the
				details associated with the respective mandates differ. Specifically, there are
				differences associated with the penalties imposed on those who are not exempt
				from the federal mandate and fail to comply with the mandate requirement, with
				the standards defining what constitutes affordable coverage, and with the
				standards defining the type of health insurance that satisfies the coverage
				requirement.
With respect to penalties, to ensure that no taxpayer is
				subject to the aggregation of both the state and federal penalties, this
				regulation provides an adjustment in the circumstance where an individual is
				subject to both the federal and the Massachusetts penalties.
(b) Effective beginning with taxable year
			 2007, 830 CMR 111M.2.1 applies to the penalty imposed under M.G.L. c. 111M,
			 § 2. Effective January 1, 2008, 830 CMR 111M.2.1 applies to the penalty
			 imposed under M.G.L. c. 62C, § 8B.
See
St. 2006, c.
			 58.
(c)830 CMR 111M.2.1, is
			 organized as follows:
1. Statement of
			 Purpose; Application and Effective Date; Organization
2. Definitions
3. Individual Mandate for Health Insurance
			 Coverage
4. Massachusetts Personal
			 Income Tax Return; Requirements Relating to Health Insurance Coverage
5. Penalty for Failure to Obtain Affordable
			 Health Insurance Coverage; Interaction with the Federal Affordable Care
			 Act
6. Exceptions to the Individual
			 Mandate for Health Insurance Coverage
7. Appeals; Abatement of Penalty for Failure
			 to Obtain Affordable Health Insurance
8. Employers and Other Persons Required to
			 Document Health Insurance Coverage
9. Penalty for Failure to Provide
			 Documentation of Health Insurance