Health Coverage Tax Credit (HCTC) Advance Payments

2012

Instructions for Form 1099-H
Section references are to the Internal Revenue Code unless
otherwise noted.

What’s New
Truncating payee identifying number on paper payee
statement. Notice 2011-38 allows filers of this form to truncate
an individual payee’s identifying number (social security number
(SSN), individual taxpayer identification number (ITIN), or
adoption taxpayer identification number (ATIN)) on paper payee
statements for tax years 2011 and 2012. See part M in the 2012
General Instructions for Certain Information Returns.

Reminder
In addition to these specific instructions, you should also use
the 2012 General Instructions for Certain Information Returns.
Those general instructions include information about the
following topics.
• Backup withholding.
• Electronic reporting requirements.
• Penalties.
• Who must file (nominee/middleman).
• When and where to file.
• Taxpayer identification numbers.
• Statements to recipients.
• Corrected and void returns.
• Other general topics.
You can get the general instructions at IRS.gov, or by calling
1-800-TAX-FORM (1-800-829-3676).
Future developments. The IRS has created a page on
IRS.gov for information about Form 1099-H at www.irs.gov/
form1099h. Information about any recent developments
affecting Form 1099-H (such as legislation enacted after we
release it) will be posted on that page.
Copy 1. Form 1099-H includes Copy 1, which is provided to
recipients by the IRS Health Coverage Tax Credit (HCTC)
Transaction Center. Copy B must be provided to recipients by
all other filers.

Specific Instructions
File Form 1099-H, Health Coverage Tax Credit (HCTC)
Advance Payments, if you received in the course of your trade
or business any advance payments during the calendar year of
qualified health insurance payments for the benefit of eligible
trade adjustment assistance (TAA), Reemployment TAA, or
Pension Benefit Guaranty Corporation (PBGC) recipients and
their qualifying family members.

Who Must File
Section 6050T requires that if you are a provider of qualified
health insurance coverage (section 35(e)) you must file Forms
1099-H with the IRS reporting the advance payments that you
receive from the Department of the Treasury on behalf of

Nov 28, 2011

Department of the Treasury
Internal Revenue Service

eligible individuals. You must also furnish a statement to the
eligible recipient.
However, Notice 2004-47, 2004-29 I.R.B. 48, available at
www.irs.gov/irb/2004-29_IRB/ar11.html, provides that the
HCTC Transaction Center, as an administrator of the Health
Coverage Tax Credit (HCTC), will file the required returns and
furnish statements to the recipients unless you elect to file and
furnish information returns and statements on your own.
Contact the HCTC Transaction Center for this purpose by
calling 1-866-628-4282. Unless you notify the HCTC
Transaction Center of your intent to file information returns and
furnish statements, you will be considered to have elected to
have the Transaction Center file Form 1099-H and furnish
statements to recipients in satisfying section 6050T filing
requirements.

Statements to Recipients
If you are required to file Form 1099-H, a statement must be
furnished to the recipient. You or the Transaction Center, if
elected, must furnish a copy of Form 1099-H or an acceptable
substitute statement to each recipient. Also, see part M in the
2012 General Instructions for Certain Information Returns.

Penalties
Waiver of penalties. Section 6724(a) authorizes the IRS to
waive any penalties under sections 6721 and 6722 for failure to
comply with the reporting requirements of section 6050T if such
failures resulted from reasonable cause and not willful neglect.
If you elect to allow the HCTC Transaction Center to file and
furnish Forms 1099-H, the IRS will not assess the penalties
imposed by sections 6721 and 6722 regarding the reporting of
advance payments made to you. If you do not elect to allow the
HCTC Transaction Center to file and furnish Forms 1099-H, the
general rules for seeking a penalty waiver under section
6724(a) apply. See Regulations section 301.6724-1.
For more information on penalties, see part O in the 2012
General Instructions for Certain Information Returns.

Box 1—Amount of HCTC Advance Payments
Enter the total amount of advance payments of health
insurance premiums received on behalf of the recipient for the
period January 1, 2012, through December 31, 2012. The
amount received in 2012 cannot exceed 72.5% of the total
health insurance premium for the individual.

Box 2—No. of Months HCTC Payments
Received
Enter the number of months payments were received on behalf
of the recipient. This number cannot be more than 12.

Boxes 3 through 14—Amount of Advance
Payment(s) Included in Box 1
Enter the amount of the advance payment received for each
month in the applicable box. You may receive these payments
prior to the month for which they are paid. Be sure to enter the
amounts in the correct box.

Cat. No. 35080G