Employer and Insurance Company Mandated Reporting

Employer and Insurance Company Mandated Reporting - Data Gathering

Insurance companies are required to submit monthly reports on the first day of each month, of the previous month’s membership, identifying those individuals for whom they provided "creditable coverage". The Bureau will maintain a database of all health plan membership to confirm who in the Commonwealth has health insurance coverage and during what time frames.

Employers must provide a written coverage statement to each individual who resides in the Commonwealth to whom it provided health insurance in the previous calendar year. The coverage statement must be provided annually, on or before January 31 of each year. The statement must include:

-the name of the carrier or the employer
-the name of the covered individual and any covered dependents
-the insurance policy or similar number
-the dates of coverage during the year
-other information as required by the Commissioner of Revenue

Employees will use the information in the coverage statement to complete the section of their state income tax form that establishes their compliance with the individual mandate.

Employers may contract with service providers (contracted outside companies) or insurance carriers to meet this obligation. In addition, all employers must provide the state with a separate report verifying the statements given to employees (tax form HC).