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Massachusetts Health Insurance Responsibility Disclosure (HIRD) Form

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The Massachusetts Health Insurance Responsibility Disclosure (HIRD) form collects employer-level information about employer-sponsored insurance (ESI). This reporting is administered by MassHealth and the Department of Revenue (DOR) through the MassTaxConnect (MTC) web portal. Any employer who has (or had) six or more Massachusetts employees in any one of the 12 months preceding the filing deadline must report the required information to the state, whether or not they offer employer-sponsored insurance.

The deadline to file the HIRD form this year is December 15, 2023.

 

What information needs to be reported?

The HIRD form asks for information that pertains to the health insurance plan(s) your company offers. Information such as employee monthly contributions, deductibles, out-of-pocket maximums, waiting periods, etc., will all be requested. Much of the information you need can be found in the Summary of Benefits and Coverage (SBC) in your Justworks account under HR > Documents, and clicking on “Insurance Documents” or in your account under HR > Benefits.

 

How will this information be reported to the state?

You are required to have an MTC withholding tax account (active or inactive) to submit the required information. In order for Justworks to file the HIRD form on your behalf as your PEO, you will have to log into your MTC account to grant Justworks Third Party Access (TPA).

For Justworks customers who have never opened a MassTaxConnect (MTC) account, no action is needed from you at this time. Justworks will open the required accounts and grant third-party access on your behalf.

 

For Justworks customers who already have an open MassTaxConnect account, please ensure that the withholding account is open. If you haven’t established this account for the company, please review the instructions below.

 
How to add an account to an existing location? (adding a withholding account to an existing account).
  • Login to MassTaxConnect.
  • Click the more tab from the homepage.
  • From the Access tab, select ‘Add an account, New Location or New License’
  • From the Select all applicable account type(s) page, scroll down and select Withholding Account
  • Follow the on-screen prompts to open and register for the Withholding Account

Please let us know once you’ve confirmed this account has been opened so that Justworks can send a TPA request from our master account. Once we’ve sent the TPA request, please follow the directions below to approve the request.

 

To approve a Third Party Initiated Access Request from MassTaxConnect: For HIRD (withholding).

  • Login to MassTaxConnect.
  • Select the Manage My Profile hyperlink in the top right section of the panel.
  • Select the More…tab and then the View Access Requests From Third Parties hyperlink in the Third Party Access panel.
  • Select the Approve/Deny hyperlink for the request you want.
  • You will need to select the check box in the Give Rights column.

  • Select the access type in the Granted Rights column.

 

Looking for more info?

Check out this list of HIRD FAQs published by the state. For additional questions regarding the form, or if any technical difficulties arise while trying to complete the form, please contact the HIRD DOR call center at 617-466-3940.

 

Disclaimer

This material has been prepared for informational purposes only, and is not intended to provide, and should not be relied on for, legal or tax advice. If you have any legal or tax questions regarding this content or related issues, then you should consult with your professional legal or tax advisor.

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