Massachusetts Health Connector Appeals Unit - Final Appeal Decision - PA 23-723 - Appeal of the 2023 Tax Year Penalty

Sep 19, 2026

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Massachusetts Health Connector Appeals Unit issued a final decision on an allowed appeal for a 2023 individual mandate tax penalty. The penalty was waived after findings that the appellants lacked minimum creditable coverage while residing in Massachusetts as part-year residents from June 2023 through December 2023. The decision considered statutory authority, jurisdiction, and a 63-day gap rule, alongside evidence including a hearing notice, appeal case information sheet, and statement of grounds with attachments.

LanguageEnglish

CategoryLetters

FormatPDF

Pages110

Reading Time39 min

AccessFree to download

Authority

Jurisdiction

Hearing Record

Exhibits and Evidence

Findings of Fact

Coverage and Insurance History

Analysis and Conclusions of Law

Individual Mandate and Penalty

Massachusetts Health Connector Appeals Unit FINAL APPEAL DECISION: PA 23-723 Appeal Decision The appeal is allowed; the tax penalty is waived. Hearing Issue: Appeal of the 2023 Tax Year Penalty Hearing Date: February 19, 2025 Decision Date: February 24, 2025 AUTHORITY This hearing was conducted pursuant to the Massachusetts General Laws, Chapter 111M, Chapter 176Q, Chapter 30A and 801 CMR 1.02 and the rules and regulations promulgated thereunder. JURISDICTION Any person aggrieved by the assessment or potential assessment of the individual mandate penalty may file an appeal, pursuant to the provisions of Mass. General Laws Chapter 111M, Section 4 and 956 CMR 6.07. HEARING RECORD Appellants, who were a married couple, both appeared at the hearing, which was held by telephone, on February 19, 2024. They will be referred to as Husband and Wife in this decision. The hearing record consists of the testimony of Appellants, and the following documents, which were admitted into evidence: Exhibit 1: Health Connector Hearing Notice (2 pages) Exhibit 2: Appeal Case Information sheet1 (1 page) Exhibit 3: Statement of Grounds (with attachments) (10 pages) FINDINGS OF FACT The findings of fact are based on the testimony of Appellants and, if specifically noted, exhibits, and the reasonable inferences drawn therefrom. The record shows, and I so find: 1. Husband was 40 and Wife was 42 at the end of 2023. Exhibit 2. 2. Appellants lived in Barnstable County in 2023. Exhibit 2. 3. Appellants filed their taxes as married, filing jointly, with one dependent. Exhibit 2. The dependent was a minor child who lived with them. 1 Exhibit 2 is a computer printout containing information extracted from the Schedule HC that Appellant submitted as part of their 2023 Massachusetts tax return. The Schedule HC is the form on which Massachusetts taxpayers report information relevant to the individual mandate penalty, which is the subject of this appeal. 4. Appellant’s household income in 2023, as reported on their 2023 state income tax returns and confirmed at the hearing, equaled $142,269 . Exhibit 2. 5. Appellants filed their Massachusetts income taxes as part-year residents. Exhibit 2. They moved to Massachusetts in June 2023. 6. Appellants reported in the Schedule HC that they filed with their 2023 state income taxes, and confirmed at the hearing, that they did not have health insurance meeting minimum creditable coverage standards at any point in 2023. Exhibit 2. 7. At the start of 2023, Appellants lived in another state. Husband worked for an employer in that state. 8. The family obtained insurance through the husband’s employment. The insurance was offered by a national insurance company. See Exhibit 3 at page 6 (copy of insurance identification card) . 9. The insurance plan in which Appellants weres enrolled had an annual deductible of $8,000 for a family. Id. That means that the family would have to pay $8,000 out of pocket for health care costs before insurance would begin to cover their expenses. 10. In June 2023, the family relocated to Massachusetts. Husband continued to work at the same job. 11. While he was living in Massachusetts, Husband learned that the plan he and his family were enrolled in did not meet Massachusetts minimum creditable coverage standards. His employer did offer one plan that met these standards and Husband intended to switch to that plan as of the start of 2024, when it was possible to change insurance coverage. 12. However, in October 2023, Husband was laid off by his job. He chose to continue coverage in the same insurance plan through COBRA, which is a federal law requiring that individuals who leave or lose a job be given the opportunity to remain in their health insurance plans for a period of time at their own expense. Under COBRA, Husband’s only option was to remain in the same plan he had been in. 13. During 2023, Wife was self-employed working part-time. She d

FAQs

What was the outcome of the appeal?

The appeal was allowed and the tax penalty was waived.

Which tax year and penalty were under appeal?

The appeal concerned the 2023 tax year penalty related to the Massachusetts individual mandate.

Why were the appellants considered subject to the mandate during part of 2023?

They became subject when they moved to Massachusetts in June 2023 and the decision considered the period from June through December 2023.

Sep 19, 2026

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