C.  TRADE – HCTC

Q. C-1.  When a SWA (state workforce agency) representative calls the IRS HCTC (Health Coverage Tax Credit) Customer Contact Center, the CS Representative asks for the name, address, etc. of the SWA and Trade worker.  After gathering all of that information, the SWA is often told that they cannot answer the question because of IRS privacy restrictions.  Why do they ask for all of the SWA information in the first place?

A. C-1.  Answer:   In order to protect individual’s privacy, the IRS enforces strict security procedures.  Certain types of information can only be shared with the individual to which the information belongs or a third party designee.

            Explanation:   The Customer Service Representatives (CSRs) are trained to gather general information from each caller.  This is to assist the HCTC Customer Contact Center in tracking callers’ requests and questions and helps them create a case for escalation of the request to the HCTC State Liaison Team.  When calling the HCTC Customer Contact Center, a SWA representative should identify himself/herself as a “stakeholder from XXX agency.”  If the representative is calling for the first time as a “stakeholder from XXX agency,” the CSR will record all of his/her contact information.  Then the next time the representative calls and identifies himself/herself as a “stakeholder from XXX agency,” the CSR will be able to pull up the file and the information will be listed for the CSR to view.

Q. C-2.  Is the SWA responsible for notifying the IRS of an individual’s ineligibility in the following scenario?  An individual is determined TAA eligible and was certified for Unemployment Insurance (UI) /Trade Readjustment Allowance (TRA) weeks that create potential HCTC eligibility.  The individual then claims HCTC.  Subsequently, it is determined that the individual had earnings that were not considered in determining the UI/TRA payments, and the individual really was not eligible for UI or TRA.  Should the SWA notify the HCTC program when an individual’s TAA/ATAA eligibility has been reversed for previous months?

A. C-2.  Answer:  Yes. 

            Explanation:   The SWA is responsible for notifying the HCTC Program of any subsequently determined weeks of UI/TRA ineligibility--provided there are no other UI/TRA weeks that fall within the month in which the individual is otherwise eligible for UI/TRA.  If the individual's HCTC eligibility should be reversed, the SWA should create a record (as instructed in UIPL 24-03) and transmit it over the ICON.

Q. C-3.  Is the SWA or the IRS responsible for determining the eligibility of TAA individuals for HCTC?

A.  C-3.  Answer:   For HCTC, the IRS is responsible for making the determination.

            Explanation:    Such determination is based upon (1) the information it receives from the SWA vis-à-vis an individual’s eligibility for TRA (or would be eligible for TRA if UI had been exhausted), and (2) the determination that the health plans available in a state (and for which an individual applies) meet the requirements for qualified health plans pursuant to the Trade Act of 2002.  Therefore, the accuracy and timeliness of ICON transmissions on a daily basis by the SWAs to the IRS are critical.

Q.  C-4.  Is the SWA responsible for determining whether specific insurance plans meet the requirements for “eligible plans” for the purposes of HCTC under the Trade Reform Act of 2002?

A.  C-4.  Answer:  No. 

            Explanation:   The IRS and DOL are responsible for making that determination in concert with the state insurance agency and other entities.