Employer Health Care Not MCC Compliant

Submitted by SoPoOneO t3_11bp1ze in massachusetts

I’m curious if anyone else is getting hit with a Mass tax penalty even though you had coverage. Turns out for 2022 the national ACA requirements diverged from Massachusetts MCC requirements.

So my employer plan stayed in line with national standards, but not Mass and, having no clue this was a risk, now I owe a penalty of almost $1,000 on my Mass income taxes.

I feel like the spirit of the regulation is to ensure all families in Mass were covered, which mine was. But because my deductible limits were off by a couple hundred dollars I’m monetarily penalized as though I didn’t sign up at all.

Anyone else with experience or advice?

https://www.sequoia.com/2021/08/2022-rates-released-for-required-coverage-under-the-massachusetts-individual-mandate/

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erin816e t1_j9zjgn3 wrote

I would appeal the tax penalty, they might give you an exemption as you really have no choice but to enroll in your company plan. I had to appeal a penalty a couple years ago and the process was actually not that bad to navigate.

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SoPoOneO OP t1_j9zkao6 wrote

Thank you. I’m hoping to that and found relevant appeals forms online. Did you have to do an in person hearing?

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SoPoOneO OP t1_j9zlnzy wrote

Another question: did you go ahead and pay the penalty then file an appeal after the fact and get the money back? Or did you appeal ahead of time and avoid paying to begin with?

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erin816e t1_ja0efsb wrote

Mine was over the phone because it was during Covid, not sure how they do it now. I did not pay, I appealed first.

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Icy-Neck-2422 t1_j9yzw1s wrote

HR

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SoPoOneO OP t1_j9z4s84 wrote

Yeah I hear you on that. I tried but it’s an out of state employer that had no idea what any of this was about. Apparently they are NOT obliged to have health plan offerings adhere to MCC requirements. So I’m hoping I can find a reasonable ear at the state revenue service level. (Naive I know. LOL)

I’m guessing there more people than just me getting blindsided by this right now. Because I think 2022 was the first tax year where this could happen.

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freedraw t1_j9zl450 wrote

Are you the employer's only MA employee or are there a bunch of you? I would definitely contact any coworkers in MA you know to push for them to at least get on a compliant plan for 2023.

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SoPoOneO OP t1_j9zp6ef wrote

There are two or three of us in Mass. I def pinged them immediately with a heads up. My guess is they haven’t started their taxes yet and wouldn’t know.

But it’s also possible they picked another plan option that did slide in under the wire for MCC.

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freedraw t1_j9zszft wrote

If you had a choice of plans, at least one of which was MA compliant, you’re probably out of luck. Definitely switch during open enrollment.

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SoPoOneO OP t1_j9zu4y4 wrote

I’m sadly guessing you’re right. If I’d known AMA and MCC had diverged I definitely would have looked closer before choosing.

And it’s a legit Blue Cross Blue Shield provider, not some fly-by-night. It’s just not BCBS of Mass.

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BostonFoliage t1_j9z06su wrote

Government knows better what's best for you.

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GreatAndPowerfulNixy t1_j9z0rfw wrote

In this case, the government protects us from the disgusting exploitative practices of private health insurance.

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thefenceguy t1_j9zgakm wrote

While I would usually agree with a statement like this, unfortunately it has not been my experience. Our micro business is currently paying around $30k year to cover five people (four adults, one child) with a plan that only uses doctors in the BID network. This doesn’t sound too bad, until you realize that there is no way to know that this plan is so restrictive until you are enrolled in the plan. The carrier could not even be bothered to send out a welcome package or proof of insurance cards. The whole thing is a disaster.

We are changing plans to another carrier and to a plan that is more widely excepted, though the new plan is going to cost us another $538/month! It’s awful. It makes me feel like I’m Larry David living in some bizarro world. This new plan still has a $2k/$5k deductable too! Is g odamn crazy. The out of pocket max is like $20k.

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GreatAndPowerfulNixy t1_j9zjztb wrote

That's a failing of the regulations to prevent it. If your business only has 5 people, you can choose to not offer coverage so they can get significantly better Connector coverage.

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thefenceguy t1_ja07w4l wrote

For sure. But I like to try and do right by my staff. We only have two employees opting in, the other three people are me and my family. The whole thing is out of wack. It’s even worse when you’re in the lower end of the middle class. The hill becomes very steep, very quickly.

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