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Massachusetts HIV Drug Assistance Program (HEAP) & Comprehensive Health Insurance Initiative (CHIP): Adult & Pediatric Application Form Please read these instructions before you fill out the following
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HDAPCHII stands for High Deductible Health Plan Coverage Information. It is a form that provides information about an individual's high deductible health plan coverage.
Insurers and certain sponsors of self-insured coverage are required to file HDAPCHII.
HDAPCHII can be filled out electronically using the required format and codes provided by the IRS.
The purpose of HDAPCHII is to gather information about an individual's high deductible health plan coverage for tax reporting purposes.
HDAPCHII must include information about the individual's coverage period, type of coverage, and any applicable employer contributions.
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