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Health Insurance Claims Assessment (HICA) Act

On September 20, 2011 Governor Snyder signed legislation creating the Health Insurance Claims Assessment (HICA) Act (P.A. 142 of 2011). Beginning January 1, 2012, certain third party administrators, carriers and self-insured entities are required to pay an assessment on certain paid health care claims.

PA 58 of 2013 has extended The Health Insurance Claims Assessment through 2017.
Registration and Payments
All payments under the HICA Act are required to be remitted to the Michigan Department of Treasury (Treasury) by Electronic Funds Transfer (EFT). EFT payment options include both EFT Credit and EFT Debit. In order to be registered to make payments by EFT, you must complete and submit Form 4926, Electronic Funds Transfer Application – Health Insurance Claims Assessment to Treasury. Please allow at least four weeks for processing your EFT application.
  • Quarterly payment due dates are April 30, July 30, October 30 and January 30.
    All EFT transmissions must be made at least one business day before the due date. If the due date falls on a weekend, state holiday, or banking holiday, the due date is the next business day. For a listing of specific state holidays, refer to Form 3149, Due Dates for Holidays and Weekends

  • EFT Credit: Filers must contact their financial institution to determine when the transaction needs to be initiated for it to be settled by our bank on or before the due date.

    Note: Improper formatting of your EFT Credit payment file may result in the payment being misapplied. You must follow the CCD+ format outlined in Form 4925, Instructions for Payment of Health Insurance Claims Assessment (HICA) Using Electronic Funds Transfer (EFT) Credit , when making an EFT Credit payment to Treasury.

  • EFT Debit: Filers must complete their transaction by 9:00 p.m. ET one business day prior to the due date for it to be settled by our bank on the due date.
The 2013 Annual Return is now available for filing.
Annual Return
An annual return is required to be e-filed online through an interface with Treasury. E-file your annual return using Treasury's secure Web site, .
  • Annual return and payment due date is February 28.

  • All registered HICA filers must file an annual return with Treasury.

  • Treasury will not issue refunds for $1.00 or less

Note: If you received a notification letter from Treasury, but do not believe you are subject to the HICA, you must submit to Treasury a written letter of explanation detailing why you believe you are not subject to the HICA. Treasury will acknowledge receipt of your letter. A self-determination that you are not subject to HICA is not binding on Treasury and is subject to potential review or audit at a later date. Mail the letter to:

Michigan Department of Treasury
Special Taxes Division/Misc. Taxes and Fees
PO Box 30781
Lansing, MI 48909
Helpful Information
Electronic Funds Transfer (EFT):
Form 5015, HICA Instruction Booklet , including: PDF
  • Form 4931, Annual Return for Health Insurance Claims Assessment (HICA) [must be e-filed]
Contact Information:
  • Substantive questions regarding the HICA Act
    Michigan Department of Treasury
    Technical Services Section
    Phone: 517-636-4357
    Note: Substantive questions will not be answered on an individual basis, but will be considered for inclusion in future FAQs.
  • Account Inquiries
    Michigan Department of Treasury
    Special Taxes Division/Misc. Taxes and Fees
    PO Box 30781
    Lansing, MI 48909
    Phone: 517-636-0515
    Fax: 517-636-4378
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