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Health Insurance Responsibility Disclosure Form Due 12/15

What is the Health Insurance Responsibility Disclosure (HIRD)?

Certain Massachusetts employers are required to file information to assist MassHealth in identifying individuals with access to qualifying employer-sponsored coverage who may be eligible for the Premium Assistance Program.

Which employers are required to complete the HIRD?

Any Massachusetts employer with six (6) or more employees in any month during the past twelve (12) months preceding the form’s due date must complete and submit annually the HIRD form. An individual is considered to be an employee if the employer included the individual in their quarterly wage report to the Department of Unemployment Assistance (DUA) during the past twelve (12) months.

Where does an employer submit the HIRD form?

An employer must submit the HIRD reporting through the MassTaxConnect (MTC) web portal. If the employer uses a payroll company, the payroll company may submit the form on the employer’s behalf. To file your HIRD form, login to your MTC withholding account and select the “File Health Insurance Responsibility Disclosure” hyperlink under the account alerts.

If you do not have an MTC account, or if you forgot your password or username, you may follow the instructions provided on the MTC web page: or contact the DOR at 617- 466-3940.

When is the HIRD Report filing due?

Employers must submit its employer HIRD form annually no later than December 15.

What are the penalties for noncompliance?

Employers will not be assessed any new fines or penalties based on information reported in the HIRD form.

However, per statute, employers that knowingly falsify or fail to file the form may be subject to a penalty of $1,000 to $5,000 per violation.

Do employers still need to complete similar reporting requirements under the Affordable Care Act (ACA)?

Yes, an employer that is subject to the Massachusetts HIRD form disclosure requirements must still comply with any applicable reporting and disclosure requirements under the ACA.

For more information, or to answer any outstanding questions on the HIRD Form, see the DOR’s “Health Insurance Responsibility Disclosure (HIRD) Frequently Asked Questions