Small Business Verification Document List

You will need to submit proof of your eligibility as a Massachusetts small business to the Health Connector before you or your employees can shop for coverage. You can upload your documents through your account or fax to 1-617-722-4033.

If you are a… Submit ONE of these documents before you shop:
Group with only 1 employee
  • Most recent valid Massachusetts Quarterly Employment and Wage Detail Report from QUEST* form (preferred)
  • Most recent 1040 Schedule K1 (for partnerships) form
  • Most recent 1040 Schedule C/Schedule C-EZ (Profit or Loss from Business) form
  • Most recent Schedule SE form (1-ES)
Group with only 1 employee
AND
your business was formed within the last 6 months
  • Declaration pages of commercial insurance products (property, casualty, or worker’s compensation)
  • A bank reference (i.e., verification of small business line of credit)
  • A report from a credit rating agency
  • A business license for a sub-contractor (installer, plumbing, etc.) accompanied by a letter from a contracting agency verifying it is in a working relationship with the sub-contractor
Group with 2–50 employees
  • The most recent electronically filed version of Massachusetts Quarterly Employment and Wage Detail Report detailing Department of Revenue (DOR) wages from QUEST* (preferred)
  • Most recent third party payroll records with Federal Insurance Contributions Act (FICA) withholdings
Group with 2–50 employees
AND
your business was formed within the last 6 months
  • Declaration pages of commercial insurance products (property/casualty or worker’s compensation)
  • A bank reference (i.e., verification of small business line of credit)
  • A report from a credit rating agency
  • A business license for a sub-contractor (installer, plumbing, etc.) accompanied by a letter from a contracting agency verifying it is in a working relationship with the sub-contractor
  • Verification from the applicable city or town clerk’s office that the small business exists
  • Articles of incorporation filed with the Commonwealth of Massachusetts
  • A Temporary Registration Certificate issued by the Massachusetts Department of Revenue

*What is a QUEST form?

The QUEST form is a quarterly wage report that employers file through the Division of Unemployment Assistance QUEST system.  Visit www.mass.gov/uima for more information, user guides and access to QUEST.

We may contact you if we need additional information

The Health Connector will contact you or your broker if your chosen health insurer needs additional information. Coverage can be denied or canceled if the proper documentation is not received.

The Health Connector reserves the right to determine whether the documentation provided is acceptable.

If you have questions

  • Phone: 1-888-813-9220 or TTY: 711, Monday–Friday, 8:00 a.m.–6:00 p.m.
  • Fax: 1-617-722-4033
  • Email: SmallBusiness@state.ma.us

Last Updated: January 9, 2018