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Quickly Pre-qualify
Download Documents
Quickly pre-qualify* by checking
each box that applies to your business. If you are able to check all boxes, your business should qualify.
A Business Must
Have 2 to 50 full-time employees, or be self-employed.
(Self-Employed please click here.)
Offer (or plan to offer) comprehensive health insurance to its employees.
Contribute (or be willing to contribute) at least 50% of the cost of the insurance purchased by the employee.
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
Be between the ages of 19 and 64 (inclusive).
Be a resident of Massachusetts and
meet citizenship requirements
.
Not have been offered health insurance by his current employer in the past six months, and not been eligible for health insurance through his spouses employer in the past six months.
Have a family income that does not exceed the
Employee Income Guidelines.
A Self-Employed Must
Be between the ages of 19 and 64 (inclusive).
Be a resident of Massachusetts and
meet citizenship requirements
.
Purchase or agree to purchase approved health insurance.
Have a family income that does not exceed the
Employee Income Guidelines.
* 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.
