MA HIRD Form Annual Filing due by 12/15/20

By The CIP Group

April 8, 2021

Attention Massachusetts Employers with Six or More Employees in Massachusetts. Filing can be done as early as November 15, 2020 on the MassTaxConnect (MTC) Web Portal. The Annual Health Insurance Responsibility Disclosure (HIRD) Form is due no later than December 15, 2020.

In 2018, the state of Massachusetts re-introduced the HIRD form. The HIRD form is a state reporting requirement which collects information about your employer-sponsored insurance (ESI). The HIRD reporting is administered by MassHealth and the Department of Revenue (DOR) through the MTC web portal. The HIRD form will assist MassHealth in identifying its members with access to qualifying ESI who may be eligible for the MassHealth Premium Assistance Program.

If you employ or employed six or more employees in Massachusetts in any month from December 15, 2019 through December 14, 2020 you will need to submit a HIRD form. Employees would be defined as full-time, part-time or any employee that is hired to perform work for a wage or salary in Massachusetts, regardless if you required to file a Department of Unemployment Assistance (DUA) report.

The HIRD form consists of questions related to each medical plan that you offer. Some information such as deductibles and out-of-pocket maximum levels may be found within your Summary of Benefits.

You may also be asked to provide:

  • Eligibility waiting periods

  • Minimum hours worked per week to qualify for health insurance

  • Any eligibility categories i.e. full-time, part-time, salary, hourly

  • Plan Year/Renewal Date

  • Monthly cost for each plan including employer and employee cost share

The state of Massachusetts provided the following instructions on filing through the MTC Web Portal: Login to your MTC withholding account here

To file your HIRD form, login to your MTC account and click onto the Withholding tax account then select the File health insurance responsibility disclosure hyperlink. This form is to be completed electronically and paper forms or any substitution of the form will not be accepted.

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.

While it is the responsibility of the employer to ensure that the HIRD form is timely filed, the HIRD form may be filed on MTC by either you or your payroll company. You may want to contact your payroll provider to determine if they will provide this service on your behalf. Generally, payroll providers do not have access to all of the pertinent information required to complete the on-line form. If you need assistance with information regarding your benefit plan(s), please reach out to your account manager at CIP.

Massachusetts released Frequently Asked Questions related to the HIRD form. These FAQ’s can be found here.

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