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Employer Eligibility Requirements

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If you are able to check all boxes, your business should qualify.

A Business Must

If you are able to check each box below, both your company and qualified employees are now pre-qualified and should be eligible for benefits!

An Employee Must




















A Self-Employed Must



* Please note that completing this pre-qualification form does not guarantee approval and is not an application for the Insurance Partnership Program. Eligibility is determined by The Commonwealth of Massachusetts Mass Health. However, answering the above questions affirmatively is a general indication that your company and at least one employee should be eligible. To receive a benefit, a company must have at least one eligible employee. Some restrictions and or exceptions may apply.