United healthcare federal identification number 1099 hc

Your Massachusetts Department of Revenue income tax filing will ask for data that is included on the MA 1099-HC form. If you were insured through Blue Cross for all 12 months of the tax year, the "Full Year Coverage" box will be checked off. If you were insured through Blue Cross for less than 12 months, only the months that you had at least 15 days of health insurance will be checked off.

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Members

If you have not received a form by the first week of February , please:

• Login to your MyBlue account and click on "Contact Us". From there you can request a PDF of your MA 1099-HC form to be sent via secure email
• Call Member Service at the number on the front of your ID card

Please note that any of your dependents who will be filing a separate state tax return will need this information to complete their filing. The MA 1099-HC may be photocopied. You do not need to contact us to request additional forms. If you had health insurance through another carrier during the year, you should receive a separate MA 1099-HC form from them.

The following members will not receive a MA 1099-HC form:

• Members younger than 18 years old
• Members with a dental-and/or vision-only plan through Blue Cross Blue Shield of Massachusetts
• Members enrolled in Medex®' or one of our Medicare Advantage plans

For More Information:

• Please direct all tax-related questions (including preparation of tax filings and financial penalties for not having insurance) to the Massachusetts Department of Revenue by visiting www.mass.gov/dor or calling 1-800-392-6089.
• If you have additional questions, please call Member Service at the number on the front of your ID card, or visit our Frequently Asked Questions page.
• You can also visit the Commonwealth Health Insurance Connector online at www.mahealthconnector.org or call 1-877-MA-ENROLL (1-877-623-6765).

1095-B Form

Qualifying Subscribers to Receive 1095-B Forms

We will issue 1095-B forms by January 31, , to qualifying members who were enrolled in a Blue Cross Blue Shield of Massachusetts plan at any time during the calendar year. This form states which months in you had health care coverage that meets the minimum essential coverage standards set by the federal government under the Affordable Care Act.

The Internal Revenue Service income tax filing will ask for information that is included on the 1095-B form. If you were insured through Blue Cross for all 12 months of the tax year, the "Covered all 12 months" box will be checked off. If you were insured through Blue Cross for less than 12 months, only the months that you had at least 1 day of health insurance will be checked off. If you switched plans with us within the year then you may receive more than one 1095-B from us.

Members

If you have not received a form by the first week of February , please:

• Call Member Service at 1-888-407-5719

Please note that any of your dependents who will be filing a separate federal tax return will need this information to complete their filing. The 1095-B form may be photocopied. You do not need to contact us to request additional forms. If you had health insurance through another carrier during the year, you should receive a separate 1095-B form from them.

The following members will not receive a 1095-B form:

• Members of self-funded plans
• Members with a dental—and/or vision—only plan through Blue Cross Blue Shield of Massachusetts
• Members enrolled in Medicare Part B or one of our Medicare Advantage plans
• Members enrolled in Health Savings Account plans
• Members enrolled in wellness programs that are part of minimum essential coverage

For more information:

• Please direct all tax-related questions (including preparation of tax filings and financial penalties for not having insurance) to the Internal Revenue Service by visiting www.irs.gov/ACA.
• If you have additional questions, please call Member Service at 1-888-407-5719, or visit our Frequently Asked Questions page.

As a result of Massachusetts health care law, most Massachusetts residents age 18 and older are required to have health insurance. The questions below will help you understand the 1099-HC form, which indicates the months you had health insurance coverage that meets the minimum creditable coverage (MCC) standards set by the Commonwealth Health Insurance Connector during the previous year.

If you have any questions, please call Member Service using the number on your medical ID card.

This information is provided for educational purposes. Please consult your tax advisor if you have questions.

The Massachusetts Department of Revenue (DOR) requires health insurance companies and/or employers to provide subscribers with the 1099-HC form to help Massachusetts residents complete their state tax filings.

1099-HC forms will be issued to subscribers of Blue Cross Blue Shield of Massachusetts and will list spouse and dependent information. Students who are dependents on a parent's insurance plan will need information contained on the 1099-HC form to complete their income tax returns.

Your 1099-HC form indicates whether you had minimum creditable coverage (MCC) for each month in the preceding year. A month with coverage is defined as a month in which the individual was covered for 15 days. If the individual had coverage for 14 days or less in a month, it is considered a month without coverage.

If you had health insurance with multiple insurance carriers, you may receive multiple 1099-HC forms. The 1099-HC form you receive from Blue Cross Blue Shield of Massachusetts will indicate which months in you had a Blue Cross Blue Shield of Massachusetts health insurance policy. If you had health insurance through another carrier, you may receive separate 1099-HC forms from them. If you were insured through Blue Cross Blue Shield of Massachusetts for all 12 months of the tax year, the "Full Year Coverage" box is checked off. If you were insured through Blue Cross Blue Shield of Massachusetts for less than 12 months, only those months that you or a dependent on your policy had 15 or more days of health insurance in a given month have a check in the appropriate month's box.

Please visit www.mass.gov/dor for more information regarding penalties. Blue Cross Blue Shield of Massachusetts is not involved in this process.

We use our enrollment records to determine the months in which you had Blue Cross Blue Shield of Massachusetts coverage for 15 days or more. This is consistent with Massachusetts Department of Revenue Schedule HC instructions.

1099-HC forms were mailed to Blue Cross Blue Shield of Massachusetts subscribers who live in Massachusetts and were enrolled in a health plan at some point in . Please refer to your tax filing information, your tax preparation advisor, or visit the Massachusetts Department of Revenue website at www.mass.gov/dor for information on how to use the information contained in the 1099-HC form to complete your state tax filing.

All 1099-HC forms to eligible subscribers will be post-marked by January 31, . If you have not received a form by the first week of February , please call Member Service using the number on the front of your medical ID card.

Please note that not all members will receive a 1099-HC form from Blue Cross Blue Shield of Massachusetts. You will not receive a form if you:

• You are a subscriber younger than 18-years-old
• You only have a dental and/or vision plan through Blue Cross Blue Shield of Massachusetts
• You are a member of one of our Medex®' or Medicare Advantage plans

If you still have questions about whether you are eligible or excluded, please refer to your tax advisor or the Massachusetts Department of Revenue at www.mass.gov/dor or call 1-800-392-6089.

No. Individuals with Medicare supplemental insurance or replacement plans will not receive a 1099-HC form.

If you turned 18 during , the health care mandate applies to you beginning on the first day of the first full month following your birthday. For example, if your birthday is June 15th, the mandate applies on July 1st.

At this time, we only provide the 1099-HC form by mail or through "Contact Us".

To request a PDF of your 1099-HC form via secure email, login to your Member Central account and click on "Contact Us". From there you can use our secure inquiry form to request your 1099-HC form in an email reply.

All forms will be mailed by January 31, . If there is an alternate address on the policy, the 1099-HC form will be mailed to the alternate address. If you still have not received a form by the first week of February , please call Member Service using the number on the front of your member ID card to request one.

You must first request an alternate address through our System Security process before we can send a 1099-HC form to that address. For assistance, please call Member Service at the number on the front of your ID card.

1099-HC form mailings are staggered throughout the month of January based on ZIP codes, and all forms to eligible subscribers will be post-marked by January 31, . If you do not receive your form by the first week of February, please call Member Service using the number on your ID card.

Not necessarily. Due to the set up for the 1099-HC form, member numbers may appear differently than on your member ID card. Member numbers on the 1099-HC form do not include the member suffix, and will contain additional zeros at the end of your member number. The 1099-HC form will list the subscriber's member number first followed by the subscriber's dependents, which will be listed by date of birth (oldest to youngest).

No. Subscribers can photocopy the form for the dependents.