Health arrangements provided by an established religious organization seeking to meet the Minimum Creditable Coverage (MCC) reporting requirement for the MCC Reporting Year should complete this form to provide the Health Connector with certain information related to membership, operations, and finances.
A complete and timely response to this form satisfies one of the criteria for a health arrangement provided by an established religious organization to be deemed to provide minimum creditable coverage (“MCC”) (956 CMR 5.03(3)(d)6).
The Health Connector may, after review of this form and any attendant submissions, require additional information or clarifications regarding a health arrangement’s membership, operations, and finances. This completed form should be emailed to MCC.Certification@mass.gov by March 31, 2024.