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Health Insurance Responsibility Disclosure (HIRD) Form Distribution and Tracking


Massachusetts Healthcare legislation requires that employers collect an Employee HIRD (Health Insurance Responsibility Disclosure) Form from employees who decline employer-sponsored health insurance and from certain benefits ineligible employees. Crosby has developed a process to coordinate the necessary steps associated with HIRD Form distribution and collection, which is compliant with current regulations. We manage the communication loop between you and the employees so that you don't have to.

Some features of our HIRD Form service include:

  • Mailing a customized cover letter and customized employer pre-populated HIRD form with carbon copy to employee's home.
  • Mail Date Tracking.
  • Mailing of reminder letters if original HIRD form is not returned within 60 days.
  • Review of returned HIRD forms for completeness.
  • Storage of electronically imaged HIRD forms for three years.
  • Telephone and Email customer service for employees related to the HIRD form collection process.