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Some vendors and TPAs distribute the 1099-HC forms and report to the DOR; however, it is ultimately the employer's responsibility to fulfill these obligations. Employers should check in with their TPAs to determine what action (if any) must be taken.
Your Harvard Pilgrim ID card will reference the name of your plan in the upper right hand corner of the ID card. If you are enrolled in the HMO with $250 Deductible, the Harvard Pilgrim group number is 040949. If you are enrolled in the HMO with $1,000 Deductible, the Harvard Pilgrim group number is 040950.
With the Harvard Pilgrim Core Coverage HMO, emergency services are subject to a copayment. This copayment is waived if you are admitted di- rectly to the hospital from the emergency room.
If you can't find your 1099-HC, you can call us at (866) 682-6745; TDD/TTY: 711 for a replacement copy. You can also contact the MassHealth Customer Service Center at (866) 682-6745; TDD/TTY: 711. You will need your MassHealth member ID, last name, and date of birth to request your Form 1095-B.
The member ID number on a Harvard Pilgrim member's ID card will start with the prefix HP, with the following exceptions: \u2022 The member ID number for a Passport Connect member will not contain an alpha prefix. These cards include a nine-digit subscriber number, followed by a six-digit group number.

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This form is provided by your health insurance carrier and not the GIC. To download an electronic copy of your Form 1099-HC, you may sign into your medical insurance carrier's online account, or contact their member services at the number on your ID card for more information.
Harvard Pilgrim Harvard Pilgrim Health Care, Inc. Plan Markeling Insurance Agency, Inc. Care Management Services, Inc. (MA for-profit) FEIN# 04- 3438779 Trestle Tree LLC (MA Ilmited Liability Company) FEIN# 30- 0852110 .....
Important: If you do not receive a 1099-HC form, you do not need it to fill out your state income tax return. For more information about the Form 1099-HC, visit health care reform for individuals.
The 1099-HC form is a Massachusetts tax document which provides proof of health insurance coverage for Massachusetts residents. Every Commonwealth of Massachusetts resident who has health insurance will receive a 1099-HC form. This form is provided by your health insurance carrier and not the GIC.
If you haven't received your Form 1099-HC, contact your insurance carrier. You may also enter into your tax return: The name of your insurance carrier or administrator. The subscriber number for your plan (this number can be for either for individuals or groups).

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