Health Coverage Tax Credit Program

Health Coverage Tax Credit Program

HCTC is a tax credit that helps a specific population of eligible individuals. The program can pay for 65% of health insurance premiums for you and your family.

  • Eligibility
  • Enrollment
  • Premiums
  • Benefits

 

Eligibility

Who is Eligible?

The subscriber must participate in one of the following programs:

  • Trade Readjustment Allowance
  • Trade Adjustment Assistance
  • Alternative Trade Adjustment Assistance
  • Receive a pension benefit from the Pension Benefit Guarantee Corporation and be at least 55 years old

The subscriber must have three months of prior continuous coverage without a significant break in coverage as defined by the Health Insurance Portability & Accountability Act “HIPAA” (Creditable coverage certificates will be used to verify prior creditable coverage). Qualified Health Plans Include:

  • 1. COBRA continuation coverage where the employer/former employer pays less than 50% of the cost of coverage (This includes your or your spouse’s COBRA coverage.)
  • 2. HCTC state-qualified health plan
  • 3. Individual coverage in which you were enrolled for at least 30 days prior to separation from the job that made you TRA eligible, ATAA eligible, and/or PBGC eligible.

The subscriber must be a resident of the State of Utah.

 

Spouse & Dependents

  • Dependents are not required to meet the three months of prior continuous coverage or any previous coverage requirement.
  • Dependents must be residents of the State of Utah.

 

Who is Not Eligible?

Subscribers, Spouse, &/or Dependents that meet any of the following are not eligible for the HCTC:

  • Enrolled in a health plan maintained by an employer or former employer (including COBRA) that pays at least 50% of the cost of coverage
  • Entitled to Medicare Part A, or Medicare Part B
  • Enrolled in Medicaid
  • Enrolled in the State Children’s Health Insurance Program (SCHIP)
  • Enrolled in the Federal Employees Health Benefits Program (FEHBP)
  • Entitled to health coverage through the U.S. military health system (TRICARE/CHAMPUS)
  • Enrolled in a health plan maintained by your spouse’s employer. (This does not include COBRA plans. See “Qualified Health Plans” later in this document.) If the employer pays for less than 50% of the cost of coverage, you may be able to claim the credit when you file your federal tax return.
  • The subscriber can be claimed as a dependent on someone else’s federal tax return this year.
  • The subscriber is imprisoned under federal, state or local authority.
  • Not covered by a qualified health plan.
  • Individual, Group Conversion, Mini-COBRA

Spouses & Dependents

Spouses and dependents of prior qualified HCTC subscribers where the subscriber has moved to other coverage (i.e. Medicare, Medicaid, etc.) and the spouse will never be eligible for HCTC are not eligible to enroll in this program.

Enrollment

Enrollment Opportunities (HCTC Application)

Subscriber Spouse & Dependents

  • Effective the 1st of the month after receipt of completed application with SelectHealth. Exception: If the subscriber was previously terminated for non-payment, the subscriber may only enroll at the anniversary of the group.
  • Effective dates will be given according to the Federal Health Insurance Portability & Accountability Act (HIPAA) guidelines following a special enrollment event.
  • Effective date will be the anniversary of the group if submitted within the 30-day period following the group’s anniversary date if previously terminated for non-payment.

 

Premiums

Premium (Rate Table)

  • SelectHealth or DWS notifies the Federal government of enrollment and plan rates.
  • SelectHealth bills the subscriber 100% of premium
  • Federal government will bill subscriber 35% of premium
  • Subscriber pays Federal government 35% of premium
  • Federal government pays SelectHealth 100% of premium

 

Benefits

Coverage & Benefits (Member Payment Summary)

  • Coverage will be issued on a guaranteed basis if these eligibility provisions are met.
  • There is no Pre-Existing Conditions (PEC) waiting period for any member enrolled on this program. Federal law prohibits a PEC waiting period on spouses and dependents.
  • Subscribers are allowed to switch to any benefits offered only at the anniversary of the group which is January.