Massachusetts has issued the minimum creditable coverage (MCC) standards for the 2026 tax year. As a reminder, Massachusetts requires most state residents to maintain minimum creditable coverage, otherwise they are subject to a state tax. The law does not impose an obligation on employers to offer minimum creditable coverage, but it does require health plans to provide a 1099-HC that reflects whether the coverage offered meets minimum creditable coverage standards.
The 1099-HC must be provided no later than January 31 of the following year. The 1099-HC only needs to be provided to the primary subscriber and can be sent by mail or, if the subscriber consents, electronically.
Cost-of-Living Adjustments
An MCC-compliant health plan may impose varied levels of co-payments, deductibles, and coinsurance (see table below for limits), as long as the plan discloses to the insured the relevant deductible, co-pay, and co-insurance amounts applicable to both in and out-of-network services.
| In-network covered services | Individual | Family |
|---|---|---|
| Maximum deductible limit | $3,200
(indexed for 2026) $2,950 (indexed for 2025) |
$6,400
(indexed for 2026) $5,900 (indexed for 2025) |
| Maximum out-of-pocket* | $10,150
(indexed for 2026) $9,200 (indexed for 2025) |
$20,300
(indexed for 2026) $18,400 (indexed for 2025) |
| Separate prescription drug coverage | ||
|---|---|---|
| Maximum deductible | $400
(indexed for 2026) $360 (indexed for 2025) |
$800
(indexed for 2026) $720 (indexed for 2025) |
*Note: Calculation of out-of-pocket maximums must include deductibles, co-insurance, co-payments, or similar charges on behalf of an enrollee with respect to essential health benefits.
An HSA-compatible high deductible health plan can qualify as minimum creditable coverage if the plan covers core services and a broad range of medical benefits, as well as facilitates access to a health savings account (HSA). I.e., the plan sponsor and/or insurer must provide information to individuals explaining how to establish and fund an HSA.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.
