HEALTH COVERAGE TAX CREDIT - Attachment A.pdf

ETA Advisory File Text

HEALTH COVERAGE TAX CREDIT QUESTIONS AND ANSWERS Administration 1. Question program Answer HCTC office. www.irs.gov addresses questions related to the administration of the HCTC. While the IRS is responsible for the HCTC it is being implemented through the cooperative efforts of the Department of Health and Human Services HHS the Pension Benefit Guaranty Corporation PBGC the Department of the Treasury and the Department of Labor in conjunction with the State Workforce Agencies SWAs . 2. Question advance HCTC program Answer information to claimants concerning the HCTC program together with information on TAA services and 2 to identify eligible TAA recipients as defined in the Act i.e. individuals who are eligible to receive trade readjustment allowances TRA or who would be eligible for TRA except that they have not exhausted their unemployment compensation and report certain information about those individuals to the HCTC office. Unemployment Insurance Program Letter UIPL No. 24-03 provided instructions to the SWAs about their responsibilities related to the advance HCTC. that are operating a state bridge National Emergency Grant NEG are not addressed in this UIPL. Note Assistance ATAA recipients who may qualify for the credit when the ATAA program becomes operational in August 2003. list of potentially eligible PBGC recipients who may qualify for the credit to the HCTC office. 3. Question responsibility for the HCTC Answer Administration ETA share responsibility for the HCTC program coordination with the IRS HCTC office The ETA Office of National Response has responsibility for the TAA program and activity. 9 18 24 1 41 PM HEALTH COVERAGE TAX CREDIT https www.dol.gov sites dolgov files ETA advisories UIPL 2003 UIPL33-03 AttachA.html 1 10 The ETA Office of Workforce Security which has responsibility for the UI program is responsible for the UI TRA program activity related to the transmission of information the SWAs are required to provide to the IRS HCTC office. Administrative Costs 1. Question Answer administrative activities and SWAs should request funding through the established NEG process to cover all costs related to the HCTC program. Unemployment Insurance UI grant funds may not be used to cover non-UI activities and all states must request NEG funds to cover costs related to their responsibilities involving the HCTC. 2. Question Form 8887 or special letters advising UI claimants as appropriate to report to a UI office or One-Stop Center to enroll in training or request a waiver Answer states incorrectly that they could use penalty mail for the HCTC program. change to the TEGL will be issued. use of penalty mail for HCTC activities and pay for future postage costs from NEG funds. Advance Credit 1. Question Answer August 1 2003 . End-of-Year Credit 1. Question future Answer provide instructions for any future issuances of the IRS Form 8887 when final decisions are reached and information is provided to DOL by the IRS. Note information about eligible TAA recipients to the IRS during November 2002. SWAs also issued IRS Form 8887 in February 2003 to individuals who received TRA or would have been eligible to receive TRA had their UI been exhausted during December 2002. for this process furnished a reporting format for the IRS Form 8887 for 2002. Eligibility Certificates 1. Question 9 18 24 1 41 PM HEALTH COVERAGE TAX CREDIT https www.dol.gov sites dolgov files ETA advisories UIPL 2003 UIPL33-03 AttachA.html 2 10 Answer before the IRS can make advance payment of the credit on behalf of an eligible TAA or ATAA recipient the Secretary of Labor or any other person or entity designated by the Secretary must issue an eligibility certificate i.e. written verification that the individual is an eligible TAA recipient or an ATAA recipient. The SWAs transmittal of the appropriate information via the UI Interstate Connection ICON network will identify individuals as eligible TAA or ATAA recipients and provide the IRS contractor the needed information for this purpose. HCTC. 2. Question be kept confidential Answer returns and return information must be kept confidential. taxpayers and must be extended to eligible TAA and ATAA recipients who are potentially eligible for the HCTC. taxpayer name and insurance policy information to providers of health insurance to the extent necessary to remit payments on behalf of the eligible TAA and ATAA recipient to carry out the advance HCTC program. ATAA information obtained from SWAs shall be considered information that is for official use only and will be kept confidential. Listings of Eligible TAA and ATAA Recipients 1. Question eligible TAA and ATAA recipients to the HCTC office Answer recipients to the IRS HCTC office so that it can quickly enroll individuals in the HCTC program. only once a month unless there is a reversal of eligibility. 2. Question Answer listings that SWAs provide to the HCTC office. SWA provides will identify individuals eligible to receive TRA or ATAA including UI claimants eligible for TRA except for exhaustion of UI . IRS HCTC office creates a monthly file for its use to enroll individuals in the HCTC program. claimants recipients so that it can issue payments to health providers on their behalf. continue to be eligible to receive TRA including UI claimants that are eligible for TRA except for exhaustion of UI or ATAA. 3. Question Answer recipients no later than August 1 2003 . program by July 21 and must have submitted the required files to the HCTC office to meet the legal requirements. Start-up List from each state that contains data on all individuals who were 9 18 24 1 41 PM HEALTH COVERAGE TAX CREDIT https www.dol.gov sites dolgov files ETA advisories UIPL 2003 UIPL33-03 AttachA.html 3 10 determined TAA eligible between January 1 2003 and the start-up list run date to initialize the advance HCTC program. up list with data back to January 1 2003 they are asked to submit a list beginning July 1 2003 and to submit a January June list as soon as possible. Receipt of TRA and HCTC Eligibility Issues 1. Question Answer receive TRA but for the fact that he she has not exhausted UI entitlement is an eligible TAA recipient and is potentially eligible for the HCTC for that month. Individuals are also eligible for the HCTC for one additional month after they cease being an eligible TAA recipient. 2. Question IRS HCTC office by SWAs only considered potentially eligible for the HCTC rather than eligible for HCTC Answer recipient a claimant must meet other HCTC criteria. determine if those individuals who are included in the SWA transmission of eligible TAA and ATAA recipients also meet the other HCTC eligibility criteria. For example they must have qualified health insurance coverage as of the first day of the month and they must not be in prison. 3. Question mean receiving for the eligibility period for which an individual is determined eligible the date the check is issued or the date the check is received by the individual Answer for which the benefit is payable. met the TRA eligibility requirements for a given week it is determined payable and received. Saturday within a given week s . received or negotiated. Note Although some states issue biweekly payments UI or TRA eligibility is determined on a weekly basis. 4. Question Answer eligible TAA or ATAA recipient and is meeting the other HCTC eligibility criteria. Individuals are also eligible for the HCTC for one additional month after they cease being an eligible TAA recipient. SWAs are responsible for determining if the individual is an eligible TAA or ATAA recipient each month. office will determine if the individual is eligible for the HCTC. 5. Question potentially eligible for HCTC based on this waiting week 9 18 24 1 41 PM HEALTH COVERAGE TAX CREDIT https www.dol.gov sites dolgov files ETA advisories UIPL 2003 UIPL33-03 AttachA.html 4 10 Answer waiting week requirement. the other applicable TRA eligibility criteria to be potentially eligible. 6. Question meeting the able and available requirements provided in the state employment security law is he she potentially HCTC eligible for that month Answer disqualification issued under state UI law then he she is not an eligible TAA recipient for that week. he she is eligible for any other single day of that month meaning he she is eligible and is in payable status for a week within the same month. claimant is eligible for any week the SWA will report the claimant as an eligible TAA recipient and the IRS will then determine if the individual is eligible for the HCTC. month to not be potentially eligible for the HCTC for that month. 7. Question disqualifies the individual from receiving any UI TRA and or is working for wages that are determined as excessive earnings under the applicable state UI law is he she potentially eligible for the HCTC for the week Answer week if no UI TRA is payable and should not be reported by the SWA as an eligible TAA recipient for that week. earnings may vary on a weekly basis thus the claimant may be potentially eligible for the HCTC if during any other given week of the month the claimant receives a UI TRA payment due to lesser earnings. disqualifying conditions remain for the entire month the claimant would not be reported as an eligible TAA recipient for that month. 8. Question intercepted for tax liabilities child support payments overpayment offset or for the satisfaction of other indebtedness as provided under state law should the claimant be reported as an eligible TAA recipient and is the claimant potentially HCTC eligible Answer potentially eligible for the HCTC. disqualified from receiving a payment during a given week in this case the individual was eligible to receive a payment that is being diverted to satisfy other liabilities or indebtedness. 9. Question did not receive a UI or TRA payment. the claimant did receive a payment. the second week and is the claimant potentially eligible for the HCTC for the month Answer eligibility established and the fact that the claimant is in payable status during the second week establishes potential HCTC eligibility. an individual meets the definition of an eligible TAA recipient by receiving a 9 18 24 1 41 PM HEALTH COVERAGE TAX CREDIT https www.dol.gov sites dolgov files ETA advisories UIPL 2003 UIPL33-03 AttachA.html 5 10 payment for any day of the month. HCTC eligible. 10. Question entitlement thus the initial establishment of potential HCTC eligibility Answer entitlement is the first week of unemployment that begins more than 60 days after the filing date of a petition that is later certified. initial eligibility for the HCTC. Transmission of Data and Programming 1. Question transmission. included in one transmission or must we transmit separately Answer is for the PBGC s use only and will not be used by the SWAs. and ATAA recipients that are eligible on the same day for a particular month it will send the TAA and ATAA data in the same data transmission. for the TAA data must be coded as 01 and the detail data sent along with that header the header for the ATAA data must be coded as 02 and the detail data sent along with that header. 2. Question transmission 2003 and report them via the ICON Answer The HCTC advance option begins August 1 2003. office will begin paying health premiums for individuals that have met all of the HCTC eligibility requirements for the month of August for any eligible TAA recipient entitled to a TRA payment for any day of the month of August. will report individuals at the point in time that they determine the individual is an eligible TAA recipient. entitlement to receive a benefit for any day of a particular month not based on when the check is received. Note that contains data on all individuals who were determined TAA eligible between January 1 2003 and the start-up list run date in order to initialize the advance HCTC program. If states cannot submit a start-up list with data back to January 1 2003 they are asked to submit a list beginning July 1 2003 and to submit a January June list as soon as possible. 3. Question criteria of creating and maintaining an IB13 log and its process Answer The current system is capable of handling the HCTC data and related tasks as outlined in the Program Logic Document. IB13 are being developed by Lockheed Martin and the HCTC office. the issues have been addressed the SWAs will be notified of how the system will work. 9 18 24 1 41 PM HEALTH COVERAGE TAX CREDIT https www.dol.gov sites dolgov files ETA advisories UIPL 2003 UIPL33-03 AttachA.html 6 10 4. Question and the candidate data record Answer 5. Question member information 1 record for each member Answer claimant record it will send a Program Kit to the eligible individual explaining what the individual should do to determine if he she and his her family are eligible. can call the HCTC office for additional information. 6. Question all eligible participants in the TAA program Answer a prior transmission to the HCTC office. send their daily transmission for that day identifying those claimants eligible to receive a TRA UI TRA eligible payment that was processed for that day week the week which includes August 1 . See Answer to Question 2. 7. Question status changes on its files Answer submitted each new month on all eligible TAA or ATAA recipients when the SWA determines an individual first meets the criteria stated in Attachment C to UIPL No. 24-03 for any given month. determined to be eligible for benefits and a week determined payable for a particular month the individual s record will be sent to the HCTC office for that month. listed in Attachment B to UIPL No. 24-03 exists under the Eligible Adjustment Code. individual first becomes eligible within a given month code 20 - 24 is used to notify that an individual has lost the eligibility status as previously reported and is not eligible during that time as reported. eligible for one day of a particular month that individual is considered an eligible TAA recipient for the entire month. 8. Question master file August 1 or anytime thereafter Answer SWAs will begin sending their daily records and will not send any records until the individual claimants have met the criteria for an eligible TAA recipient. August 1 2003 is the start of the advance HCTC option. recipients must certify for a TRA applicable UI payable week thus becoming eligible for a TRA applicable UI benefit for the month of August before a record is transmitted to the HCTC office. that point forward. 9 18 24 1 41 PM HEALTH COVERAGE TAX CREDIT https www.dol.gov sites dolgov files ETA advisories UIPL 2003 UIPL33-03 AttachA.html 7 10 9. Question address Answer and name when they transmit any record in the routine daily transmission. 10. Question month s end for the entire month and empty daily files as required Answer daily records in a timely manner. supply the records to the HCTC office there may not be sufficient time to process the data and make the 65 percent payment to the insurance provider. 11. Question Answer Program Logic Document and UIPL No. 24-03. 12. Question determines the individual was not eligible because of an error appeal reversal etc. how does it rescind the prior month Answer not an eligible TAA or ATAA recipient the SWA will submit a record and provide a code if information is available to the SWA electronically on why the prior record was changed. Month Year that the SWA is amending and enter the correct Eligibility Adjustment Code e.g. 20 21 22 23 or 24 . Note Attachment B to UIPL No. 24-03 page 1 under Eligibility Adjustment Code list the codes as 00 10 20 21 22 23 25 and 99. there is no code 25. 13. Question should be provided in the two fields 6 and 7 in the Header record. Answer eligibility requirements of the TAA program e.g. TAA Coordinator rather than an information technology specialist but the SWA can best determine the appropriate contact point based on its circumstances. 14. Question first day of the month the file will include all TAA ATAA qualifying recipients who still qualify plus any new ones for that day large group from the previous month minus those that dropped off for the new month plus the new individuals for that day. Answer is determined to be an eligible TAA or ATAA recipient and a week is payable for the first time within the month. 9 18 24 1 41 PM HEALTH COVERAGE TAX CREDIT https www.dol.gov sites dolgov files ETA advisories UIPL 2003 UIPL33-03 AttachA.html 8 10 15. Question to UIPL No. 24-03 and the PLD Answer DD is for the Day of the month two digits CC is for the Century 20 -- do not put 21 for the century Note The HCTC office used this naming convention because of HIPAA standards. YY is for the Year 03 Example On August 6 2003 the SWA creates a record for the month of August because the individual met the requirements outlined in Attachment C to UIPL 24-03. the individual s record that will be submitted to the HCTC office. 16. Question Answer if your state uses an Interactive Voice Response IVR system and you determine the person is eligible on Sunday then the file date would be Sunday. If on Monday the SWA extracts the data and creates the file then Monday would be the file creation date. the same. 17. Question Answer the states will submit records of all individuals who are eligible TAA or ATAA recipients during the month regardless of that individual s eligibility status for any prior months. when it first recognizes in its system that a payable week has been processed. Note 10 per individual per month. eligibility requirements for a week in August that results in creation and submission of a code 00 record then the HCTC office recognizes that the individual is an eligible TAA recipient for the entire month of August. additional weeks of TRA that become payable in August the SWA is not required to create and submit additional code 00 records for the month of August. If this same individual meets the TAA eligibility criteria for September considered a new month for week ending September 6 2003 the SWA will submit a record for September on the TAA eligible individual i.e. a record with 092003 in the Eligibility Month Year field. 18. Question is indicated as 2 digits in length but a 3-digit position is indicated. Also the chart does not indicate it is required data. Answer is a required field. 19. Question is no longer a TAA eligible recipient reversing the claimant s eligibility entirely 9 18 24 1 41 PM HEALTH COVERAGE TAX CREDIT https www.dol.gov sites dolgov files ETA advisories UIPL 2003 UIPL33-03 AttachA.html 9 10 will code s 20 24 be used by the SWA to correct the record Answer reverse previously reported information. Example month of August because the individual met the eligibility criteria for the first week in August. week in December. not to be an eligible TAA recipient because of an appeal reversing the previous determination of eligibility. The state would submit a record with the Eligibility Adjustment Code shown as 24 for each of the months that the individual was determined not to be an eligible TAA recipient in this case the months of August September October November and December. records sent for these months. 20. Question is no longer a TAA eligible recipient subsequent to the initial period of eligibility will code s 20 24 be used by the SWA to report the claimant s ineligibility status Answer individual unless it is needed to correct or reverse prior eligibility information. Example month of August because the individual met the eligibility criteria for the first week in August. week in December. not to be an eligible TAA recipient effective December 14 due to a disqualification. The state would not submit a record to correct or reverse the eligibility status since the individual continues to remain eligible for August through the first two weeks of December. once the December ineligibility disqualification is imposed no further records would be sent to the HCTC office. Note first week of a month yet is determined not to be eligible for the remaining portion of the month due to adjudication of some issue a correction record would not be sent since it is not reversing the record of eligibility during the first week of that month and the individual is potentially eligible for the HCTC based on that first week. If an individual is determined to be an eligible TAA individual for just one day in a given month he she is an eligible TAA individual for the entire month for purposes of the HCTC. previously sent will a state submit a corrected record. 9 18 24 1 41 PM HEALTH COVERAGE TAX CREDIT https www.dol.gov sites dolgov files ETA advisories UIPL 2003 UIPL33-03 AttachA.html 10 10