Minimum Creditable Coverage

As of January 1, 2009, the Massachusetts Health Care Reform Law requires each Massachusetts resident, eighteen (18) years of age and older, to have health coverage that meets the Minimum Creditable Coverage (“MCC”) standards set by the Commonwealth Health Insurance Connector (“Connector”), unless those plans meeting these standards are deemed to not be affordable by the person.

Your Qualified Student Health Insurance Plan (“QSHIP”) coverage underwritten by Monumental Life Insurance Company is group health plan coverage that satisfies the individual coverage mandate standard.

The attached forms, form MA 1099-HC and Schedule HC, must be filed with your state income tax return.

These forms have been pre-populated with required information about the insurance company and your coverage for your use in filing your tax return. These forms may be printed form the site.

If you have questions about this notice, you may contact the Division of Insurance by calling (617) 521-7794 or visiting its website at www.mass.gov/doi.