Massachusetts Affidavit of No Coverage by Another Group Health Plan

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Multi-State
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US-321EM
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Description

The employee named in this affidavit attests to the fact that he or she is not covered by any other group health plan.

Massachusetts Affidavit of No Coverage by Another Group Health Plan is a legal document that serves as proof that an individual or group is not covered by any other group health plan. This affidavit is required when applying for health insurance in Massachusetts and plays a significant role in determining eligibility for various health programs. Keywords: Massachusetts, Affidavit of No Coverage, Group Health Plan, health insurance, eligibility, legal document, proof. There are several types of Massachusetts Affidavit of No Coverage by Another Group Health Plan, including: 1. Individual Affidavit of No Coverage: This affidavit is used when an individual is applying for health insurance coverage and does not have access to any other group health plan, such as through an employer or spouse's employer. 2. Spousal Affidavit of No Coverage: This type of affidavit is specifically for individuals who are married and do not have access to their spouse's group health plan. 3. Dependent Affidavit of No Coverage: When applying for health insurance coverage as a dependent, such as a child or a student, this affidavit is necessary to confirm that the dependent is not covered by any other group health plan. 4. Small Business Affidavit of No Coverage: Small business owners or employers who do not offer group health plans to their employees must provide this affidavit to verify that no coverage is available through the business. It is important to note that the Massachusetts Affidavit of No Coverage by Another Group Health Plan must be completed accurately and honestly. If it is found that false information has been provided, legal consequences may apply.

How to fill out Affidavit Of No Coverage By Another Group Health Plan?

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FAQ

If you have multiple health insurance policies, you'll have to pay any applicable premiums and deductibles for both plans. Your secondary insurance won't pay toward your primary's deductible. You may also owe other cost sharing or out-of-pocket costs, such as copayments or coinsurance.

@jamescanonge You can cancel by going to Plans tab> "Manage Plans" > "Make Changes to Plans" > "Cancel Enrollment" > "Checkout and Confirm".

Please Note: If you would like to disenroll or opt-out of your One Care Plan, please call the MassHealth Customer Service Center at 1-800-841-2900 or TTY:1-800-497-4648 for assistance.

If you are enrolled in a health plan through MassHealth or the HealthConnector and need to cancel it because you are now eligible for employer-sponsored coverage, you should contact MassHealth or the HealthConnector directly to disenroll.

EMPLOYER REQUIREMENTS UNDER MASSACHUSETTS LAWCurrent Massachusetts law requires employers with 11 or more full-time equivalent employees (FTE) to make a fair and reasonable contribution to their employees' health insurance or pay a Fair Share Contribution (FSC) of up to $295 per employee per year to the state.

MassHealth and the Massachusetts Health Connector use the same streamlined application to determine if you qualify for MassHealth, the Health Safety Net, Children's Medical Security Plan, ConnectorCare plans, or Advance Premium Tax Credits.

If you're a Massachusetts resident and go without insurance because you can't afford the plans available to you, you won't be penalized. You also won't be penalized if your income is at or below 150% of the federal poverty level. If you owe a tax penalty, the amount varies by income, age and family size.

Introduction. The Massachusetts Health Care Reform Law requires that most residents over 18 who can afford health insurance have coverage for the entire year, or pay a penalty through their tax returns.

If you enroll in a plan that does not meet MCC standards, you could be subject to a tax penalty under Massachusetts state law. In 2020, these penalties can be up to $135/month or $1,620/year for an individual.

MassHealthLog in to... Apply for MassHealth Coverage.MassHealth. Address. One Ashburton Place. Phone. MassHealth Customer Service Center (800) 841-2900.

More info

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Child support and support enforcement services vary among these programs. The state will often assist with the implementation of its program to help families of dependent children with the most common child support obligations: maintenance, support/reimbursement for children, and child care.

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Massachusetts Affidavit of No Coverage by Another Group Health Plan