The Health Coverage Tax
Credit
What is the
Health Coverage Tax
Credit (HCTC)?
The HCTC is a new
federal tax credit
program established to
help eligible
individuals pay for
health care coverage for
themselves and qualified
family members. Eligible
individuals primarily
consist of certain
groups of displaced
workers and pension
recipients. The HCTC is
expected to help an
increasing number of
eligible Texas
individuals and their
family members pay for
health coverage they
might otherwise not be
able to afford.
The U.S. Internal
Revenue Service
administers the program,
in partnership with
other federal agencies,
state governments, and
health plan
administrators. In
Texas, the partnership
involves the efforts of
two state agencies - the
Texas Workforce
Commission and the Texas
Department of Insurance.
The Texas Workforce
Commission helps
identify people who are
eligible and helps
promote the program. The
Texas Department of
Insurance works together
with health plan
administrators to make
qualified coverage plans
available for eligible
individuals.
What does HCTC
do?
HCTC provides a tax
credit that will pay 65%
of the qualified health
insurance premiums paid
by eligible individuals.
An eligible individual
may claim the tax credit
on the individual´s
federal tax return or
take the credit as a
monthly advance to be
paid to the health plan
administrator as
premiums become due.
Who is eligible
for the HCTC?
To be eligible for HCTC,
an individual must be
included in one of the
following groups:
-
The individual must
be unemployed or in
danger of becoming
unemployed as a
result of the
effects of
international trade
and:
-
receive a Trade
Readjustment
Allowance (TRA);
or
-
be eligible to
receive a TRA,
but is still
receiving
unemployment
Insurance (UI)
benefits.
-
The individual must
be unemployed or in
danger of becoming
unemployed as a
result of the
effects of
international trade
and receive
Alternative Trade
Adjustment
Assistance (ATAA)
benefits.
-
The individual must
be at least 55 years
old and receiving
pension benefits
from the Pension
Benefit Guaranty
Corporation (PBGC)
as:
-
a PBGC
participant;
-
a beneficiary or
survivor of a
PBGC
participant; or
-
an alternate
payee of an ex-spouse´s
benefit.
-
The individual must
be at least 65 years
old, receiving
pension benefits
from the PBGC, and
not be eligible to
receive Medicare
Part A.
What health
coverage qualifies for
the HCTC tax credit?
To be qualified health
coverage under the HCTC,
the health coverage may
be automatically
qualified or
state-qualified.
-
Plans that are
automatically
qualified include:
-
COBRA
continuation
coverage;
-
Coverage through
a spouse´s
health plan
provided the
spouse´s
employer pays
for less than
50% of the
premium (This
type of coverage
currently does
not qualify for
the monthly
advance tax
credit. It may
only be claimed
on your 2003
federal tax
return.); or
-
Coverage through
an individual
(non-group)
health plan that
began at least
30 days prior to
separation from
employment.
-
Plans that are
state-qualified in
Texas must:
-
Comply with
Texas laws and
regulations;
-
meet certain
conditions set
by federal law;
and
-
be qualified by
the Texas
Department of
Insurance.
You may obtain a listing
of qualified plans
organized by state by
contacting the HCTC
Customer Contact Center
at 1-866-628-4282 or via
their website at
www.irs.gov
(enter their keyword:
HCTC).
You may obtain a
listing of qualified
plans in Texas
by contacting the Texas
Department of Insurance
at 1-800-578-4677.
Who is not
eligible for the HCTC?
An individual is not
eligible for the HCTC,
if the individual is:
-
Entitled to Medicare
Part A or enrolled
in Medicare Part B;
-
Enrolled in a
state´s Medicaid
program or State
Children´s Health
Insurance Program (SCHIP);
-
Enrolled in any
health plan
maintained by an
employer, former
employer, or
spouse´s employer
that pays at least
50% of the cost of
coverage or the cost
of coverage is paid
with pre-taxed
dollars;
-
Enrolled in a plan
in the Federal
Employees´ Health
Benefit Program (FEHBP);
-
Entitled in a
Department of
Defense health plan
(Tricare/CHAMPUS);
or
-
Imprisoned - whether
in a local, state,
or federal facility.
Alternate
Resources:
The following is a list
of resources that you
may contact for
additional information:
For an overview of the
HCTC, or to obtain a pdf
version of the HCTC
program kit: Visit the
Internal Revenue Service
website --
www.irs.gov
(enter their Keyword:
HCTC)
For eligibility
questions or to register
for the HCTC program
call the HCTC Customer
Contact Center at:
-
1-866-628-4282 (toll
free)
1-866-626-4282 (TDD/TTY
callers)
Hours of operation:
7:00 AM to 7:00 PM
Central time, Monday
through Friday
For more information on
the Trade Act of 2002,
TAA, and ATAA:
Contact the Department
of Labor Employment and
Training Administration
(DOLETA) at:
-
1-877-872-5627,
Or visit their
website:
www.doleta.gov/eta_default.htm
For more information on
the Pension Benefit
Guaranty Corporation:
Contact the Pension
Benefit Guaranty
Corporation at:
-
1-800-400-7242
Or visit their
website:
www.pbgc.gov/
For information
regarding trade affected
worker eligibility,
application for TAA
benefits, or other
matters relating to
benefits for unemployed
or dislocated workers
contact the Texas
Workforce Commission at:
-
1-800-939-6631
(Unemployment
Insurance Claims) or
-
1-888-562-7489
(Dislocated Workers
Unit & TAA)
-
Or visit their
website:
www.texasworkforce.org
For more information on
Texas´ state-qualified
health plans:
Contact the Texas
Department of Insurance
Life / Health Division
at:
-
1-512-322-3409
-
Or via e-mail at
LifeHealth@tdi.state.tx.us
List of State-Qualified
Plans for the Health
Coverage Tax Credit
Texas has qualified the
following plans for the
HCTC:
-
Texas Health
Insurance Risk Pool
1-888-398-3927
(Customer Service
8AM - 5 PM)
1-800-735-2988 (TTD/TTY
Customer Service 8
AM - 5 PM)
Website:
www.txhealthpool.org/index.html
-
BlueCross
BlueShield of Texas
1-800-531-4456 (New
Customers)
1-800-521-2227
(Customer Service
for Current
Customers)
Website:
www.bcbstx.com
For written requests
for information:
Individual Products
PO Box 833922
Richardson, TX 75080
(Please visit the
BlueCross BlueShield
Web site -
www.bcbstx.com
- for more
information)
-
State-mandated right
to continuation of
coverage under
Texas Insurance Code
Article 3.51-6
This option consists
of a 6 month
state-mandated
continuation period,
analogous to COBRA,
which state law
requires carriers to
offer to persons
losing coverage
under certain group
health benefit
plans. For questions
about the
continuation
benefit, you may
contact either your
group health benefit
plan administrator,
or the Texas
Department of
Insurance Life /
Health Division at
1-512-322-3409, or
via e-mail at
LifeHealth@tdi.state.tx.us
These
state-qualified
plans are in
addition to any
plans automatically
qualified under the
HCTC.