Responsibilities

How do I make a payment and what resources are available? As a Health Connector member, you must pay your bill, in full, each month to stay enrolled in coverage. For members with a monthly premium You will get your monthly bill in the mail by the 10th of every month. If you are enrolled in both, health and dental coverage, you will receive a separate bill for each and must make two separate payments. Health Connector must receive your payment by the 23rd of the month. The payment is for the next month of coverage. There are 4 ways to make payments: Online through the new member portal By mail through a check or money order By phone by calling Health Connector customer service In-person at a walk-in center Log into your account to access the Payment Center from the "My Enrollments" page of your account. You can make a one-time payment, or set up AutoPay (automatic recurring payments). Or, you can make a Guest Payment. Find out more on the How to Pay page → Only payments by checking or saving account are accepted at this time. You can pay by mail using a check or money order (do not mail cash). Fill out a check or a money order making it payable to: Health Connector Include the detachable payment coupon (bottom part of your bill) with the payment. Important: Clearly write your 9-digit billing account number beginning with 7 in the memo field of [...]

Introduction When your income or household information change, you should update your application as soon as possible. Learn how to update your application --> There are three key things to keep in mind when reporting a change.  Depending on the change, you may be eligible to shop for a new plan, you may experience a premium increase or decrease, and the change may take effect either at the time the change is reported or at the start of the next month. Section 1: Overview of changes you can make and how they may impact you Type of Change Can you shop? Will your premium change? Change Takes Effect Changing Incorrect Information or Adding SSN No, unless it is Open Enrollment No Immediately after you report the change (although it may take up to 5 business days for your insurance carrier to receive the information) Adding Applicants (in case of birth, adoption, family change, loss of coverage) It depends on the life event that leads to adding an applicant, if you can shop you will be prompted to shop Yes Immediately after you report the change (although it may take up to 5 business days for your insurance carrier to receive the information) Premium change will depend on time of month Adding Applicants (in case of family changes (marriage), loss of coverage) It depends on the life event that leads to adding an applicant, if you can shop you will be prompted to shop Yes [...]

Introduction Each year, we will send you a packet of information about renewing your coverage for the upcoming year. This happens right before the Open Enrollment period. In general, if you keep paying your monthly premiums, you can renew for your upcoming year of coverage into: Your current plan, if it is available for the next year, or A similar plan from the same insurance company, if your current plan won’t be available for the next year. If you want to enroll in a different plan, you can shop and change plans during Open Enrollment. Section 1: When will my coverage be renewed?Health plans renew on January 1st of each year. Dental plans renew every 12 months in relation to your plan’s effective (start) date.While all health and dental plans’ coverage year ends on December 31. See the example below:Coverage start dateCoverage year end dateRenewal dateMay 1, 2024December 31, 2024January 1, 2025 Section 2: What mail will I receive as it related to my yearly renewal? The Health Connector will send a few important mailings leading up to the yearly Open Enrollment that includes your eligibility and renewal information for the next plan year. Eligibility notifications You will start getting eligibility notifications in the late-summer/early-fall. In these notifications, you will learn what you may be eligible for the next plan year based on the information in your application as well as state and federal data services. When you get [...]

Section Overview As a member of the Health Connector, there are important things you must do to maintain your coverage and continue to get help paying for your coverage if you are receiving a tax credit or enrolled in a ConnectorCare plan. These responsibilities include: Responding to requests for information or proof from the Health Connector Making premium payments to the Health Connector each month on time Updating information if you have any changes (such as a new address or a change in income or family size) If you are receiving a tax credit to help pay for your coverage, or if you are enrolled in a ConnectorCare plan, you also need to: File a federal income tax return each year Give the IRS information about the amount of tax credit you received during the year to help pay for coverage. You can learn more about each of these responsibilities in this section.

What happens if I do not make a payment on time? This depends on your enrollment status: If you’ve enrolled for the first time or changing plans, if you miss the payment deadline, your enrollment cannot be completed and you may experience a gap in coverage. If you are already enrolled and miss the payment deadline, then your account will go into a delinquent status, which can impact your ability to use your coverage, or even termination for non-payment. What can this mean for my coverage? A late payment may result in: The suspension or denial of claims by your health or dental insurer for healthcare services you receive while your account is delinquent. You may be responsible for paying the full costs for your health care. Your pharmacy benefits may be denied and you may have to pay full price for any prescription medication you need while your account is delinquent. Again, if you are newly enrolling in a plan and don’t make the first payment by the deadline, you may miss the coverage start date and will experience a gap in coverage. If you are having trouble making payments because you experienced a decrease in income, make sure you update your income information on your application. You may become eligible for more help paying for costs. If you are enrolled in a ConnectorCare plan, find out about requesting a waiver or reduction of premium → What should I do if I receive a delinquency [...]

You were able to enroll in a Health Connector Plan, but proof may be required when we need to know more about you The Health Connector uses federal and state electronic data sources to validate (confirm) information you enter in your application. These data sources include agencies like the IRS, Social Security Administration, Massachusetts Department of Revenue, Department of Homeland Security, and others. It’s important that the information in your application is as accurate as possible so that your household gets the correct eligibility determination as well as help paying for costs, if you are eligible. Why do we request information? When you first apply for coverage or make changes to your application during the year, there may be times when the state and federal electronic data sources we use could not validate (confirm) the information you provided. If this happens, you will need to send information to us so we can confirm information that could not be validated electronically. Where can I find what documents I need to send and how do I know I need to send documents? We will send you a letter telling you what proof we needed to confirm and examples of the documents you can send. This information is also available in your online account. A generic list of acceptable documentation for all kinds of verifications is on our website at MAhealthconnector.org/proof. When should I send the documents? You should send in the documents as soon as [...]

Am I responsible for canceling my own coverage? YES. If you no longer need health or dental coverage through the Health Connector, you must cancel your own coverage in most circumstances. There are 2 exceptions: If you update your account and are determined eligible for MassHealth coverage, your coverage may be automatically canceled at the end of the current coverage month. If you update your account and are determined not eligible for coverage through the Health Connector, your coverage will be automatically canceled at the end of the current coverage month. When should I cancel my coverage? As a Health Connector member, you have a right to cancel your health or dental plan at any time. But the day of the month when you cancel your plan is very important. If you need to cancel a health or dental plan for next month, then you must cancel the plan by the 23rd of the current month. Your coverage end date is the last day of the month that you request your plan cancellation even if you cancel before the 23rd of the month. Otherwise, your coverage will end the last day of the following month. So, if you cancel your plan on or before the 23rd of the month, you will still be covered through the last day of that same month. If you cancel your coverage the 24th of the month or later, you will be covered for the entire following month if you paid your monthly premium. [...]

If you are getting a tax credit to help you pay for your health insurance premiums throughout the year, there are two important things you’ll need to remember to do: 1: Let us know if anything changes throughout the year This includes changes to your home address, family size, income, or access to health insurance (such as through a job, Medicare, and other sources). If you have changes but don’t update your information, you could end up owing the IRS money at tax time.  You can update your information online through your account at MAhealthconnector.org. Make sure to submit any changes you make on the Rights & Responsibilities page. 2: File your taxes You must file federal income taxes for every year that you get tax credits. You will need to file even if you haven’t had to file in the past, or wouldn’t normally need to file because of your income. We’ll send you a 1095-A form at the end of January. This form shows how much was paid to your insurance company to help with the cost of your health coverage. You will use the information on your 1095-A to fill out IRS Form 8962 when you file your taxes. Why is this important? You’ll need to file taxes at the end of the year so that the IRS can be sure that you got the right amount of tax credit based on what your income was that year. This process is called [...]

Why does filing my taxes matter? As shared in the previous section, if you receive an Advance Premium Tax Credit to help lower your premium costs, you must file your taxes each you receive this tax credit to be eligible for this saving the next year, or any future year. This is true even if you receive the tax credit only part of the year. This is true even if your income is low enough that you haven’t needed to file taxes in the past. What information will the Connector give me? To file your taxes, we’ll send you a 1095-A form at the end of January. This form shows how much was paid to your insurance company to help with the cost of your health coverage. You will use the information on your 1095-A to fill out IRS Form 8962 when you file your taxes. What resources are available? If you need help filing your taxes, many people can get free tax help from programs such as Volunteer Income Tax Assistance (VITA) and Tax Counseling for the Elderly (TCE). Call the IRS hotline at 800-906-9887 to find a location near you. You can also visit MAhealthconnector.org/taxes for more information on how to get free help with your taxes. When is the best time to file? The best time to file is after you have received all of your tax filing documents, including those related to your health insurance. If you were covered by different types of insurance during [...]