part25-69
- 25.19.4.1
Registration Overview - 25.19.4.2
Telephone Registration Overview - 25.19.4.3
Form/Paper Registration Overview - 25.19.4.4
Verifying Health Plan - 25.19.4.5
Outbound Re-Registration Request
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This section of the Internal Revenue Manual (IRM) provides information
on registering for the Health Coverage Tax Credit (HCTC). -
There are two methods of registration:
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Telephone
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Form/Paper
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Phone and Form Registration duties are handled by Customer Service Representatives
(CSRs). See IRM 25.19.1.3 (Customer Service Responsibilities).
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A candidate must register to receive the HCTC in advance on a monthly
basis. -
Registration questions and eligibility criteria differ among the potentially
eligible groups:-
Trade Adjustment Assistance (TAA)
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Alternative Trade Adjustment Assistance (ATAA),
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Pension Benefit Guaranty Corporation (PBGC).
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General guidelines must be followed.
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For specific registration guidelines, refer to: HCTC Siebel System User
Guide 302: Siebel Registration.
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Telephone registrations are handled by HCTC Customer Contact Centers
(CCC) CSRs in Waterloo, Iowa, and Peoria, Illinois. -
Several steps comprise a successful registration over the telephone:
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Identity Confirmation
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Eligibility Confirmation
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Eligibility Questions
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Quality Family and Eligibility Questions
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Policy Information Capture
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Registration Wrap-Up
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A candidates eligibility must be confirmed. See IRM 25.19.3 Eligibility.
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Use the Eligibility Tab on Siebel to determine if a candidate is potentially
eligible through the Pension Benefit Guaranty Corporation (PBGC), Trade Adjustment
Assistance (TAA), or Alternative Trade Adjustment Assistance (ATAA). See Siebel
System User Guide 302: Siebel Registration for details on the Eligibility
Tab. -
If a candidate has an Active eligibility status from PBGC, TAA, or ATAA,
proceed to the Eligibility Questions. See IRM
25.19.4.2.2. -
If a candidate does not have an Active eligibility from PBGC, TAA, or
ATAA, inform the individual and explain the next actions that must be taken. -
Refer the customer to his/her State Workforce Agency (SWA) or the PBGC
if he/she believes the information in the Siebel System record is incorrect.
If the SWA or PBGC indicated that the customer is eligible (but the person
is not in Active status), and the candidate has contacted his/her SWA or PBGC
more than once, create an Eligibility Issue Case for research. -
Proceed to Call Wrap-Up, See IRM 25.19.4.2.6.
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Once an individuals Active eligibility is located in the system, ask
the candidate to be sure that all necessary health plan documents are in his/her
possession, as the documents are required for registration. If the candidate
does have all documents available, open a New Registration in the Siebel System.
See HCTC Siebel User Guide 302: Siebel Registration for more details. -
Follow the Siebel Eligibility Questions for TAA/PBGC registration; see
HCTC Siebel User Guide 302: Siebel Registration. -
Ask all questions from the script, regardless
of whether a candidate is disqualified by earlier answers.Questions for TAA/PBGC Eligibility Yes No Candidate is at least 55 years of age (PBGC eligibility)? Move on to question 2. Candidate is ineligible. Candidate is enrolled in an employer-sponsored
health plan?Candidate is only eligible for End-of-Year credit
if employer pays less than 50 percent of premium (unless plan is COBRA).Move on to next question. Candidate is entitled to Medicare Part A? Candidate is ineligible. Move on to next question. Candidate is enrolled in Medicare Part B? Candidate is ineligible. Move on to next question. Candidate is enrolled in Medicaid? Candidate is ineligible. Move on to next question. Candidate is currently enrolled in the State
Childrens Health Insurance Program (SCHIP)?Candidate is ineligible. Move on to next question. Candidate is enrolled in the Federal Employees
Health Benefits Program (FEHBP)?Candidate is ineligible. Move on to next question. Candidate is entitled to health coverage through
the U.S. military health system (TRICARE/ CHAMPUS)?Candidate is ineligible. Move on to next question. Move on to next question. Candidate is enrolled in spouses employer-sponsored
health plan?Candidate is only eligible for End-of-Year credit
if employer pays less than 50 percent of premium (unless plan is COBRA).Move on to next question. Candidate can be claimed as a dependent on anyones
federal tax return?Candidate is ineligible. Move on to next question. Candidate is imprisoned under federal, state,
or local authority?Candidate is ineligible. Move on to next question. Candidate is enrolled in a health plan? Move on to next question. Candidate is ineligible. Health plan is COBRA continuation coverage? Candidate is eligible. Move on to Qualified Family
and Eligibility questions, See IRM 25.19.4.2.3.
Move on to next question. Health plan is a state qualified health plan? CSR must reference the State Qualified Health
Plan List to verify specific plans and group numbers. Candidate is eligible.
Move on to Qualified Family and Eligibility questions,
See IRM 25.19.4.2.3.Move on to next question. Health plan is non-group enrolled in at least
30 days prior to employment separation?CSR must ask when candidates non-group plan
became effective and date of last day of employment. Candidate is eligible.
Move on to Qualified Family and Eligibility questions,
See IRM 25.19.4.2.3.Candidate is ineligible if he/she was not enrolled
at least 30 days prior to separation from that job. -
Follow the Siebel Eligibility Questions for ATAA registration, see HCTC
Siebel System User Guide 302: Siebel Registration. -
Ask all of the questions on the script, regardless
of whether a candidate is disqualified by earlier answers.Note:
The ATAA
Eligibility Questions listed below do not appear sequentially on Siebel System.
Questions will appear on the script based on the candidates answers.Questions for ATAA Eligibility Yes No Candidate is enrolled in a current or former
employers health plan? (candidate with COBRAmust answer
yes)Move on to next question. Candidate is ineligible. Candidates employer pays 50 percent or more
of health plan premium? (this also includes pre-tax contributions from the
candidate)Candidate is ineligible. Move on to next question. Candidate is enrolled in a spouses current or
former employers health plan? (spouse with COBRAmust answer
yes)Move on to next question. Candidate is ineligible. Spouses current or former employer pays 50 percent
or more of health plan premium? (this includes pre-tax contributions made
by the spouse)Candidate is ineligible. Move on to next question. Spouses sponsored health plan is COBRA? Move on to next question. Candidate is ineligible. Candidate is enrolled in a qualified health plan
where his/her (or spouses) current or former employer pays any portion of
the health plan premium? (this includes pre-tax contributions)Candidate is ineligible. Move on to next question. Candidates employer-sponsored health plan any
of the following: COBRA, state-based continuation coverage, or a special insurance
program entered into by candidates state and an employer designed to qualify
for the HCTC?Inform candidate that if the premium is paid
directly from his/her pension check, this will have to be stopped. Move on
to next question.Candidate is ineligible. Candidate is eligible for qualified health plan
coverage where his/her or spouses current or former employer would pay at
least 50 percent of health plan premiums or where candidate or spouse can
pay on a pre-tax basis?Candidate is ineligible. Move on to next question. Candidates employer-sponsored health plan is
any of the following: COBRA, state-based continuation coverage, or a special
insurance program entered into by candidates state and an employer designed
to qualify for the HCTC?Candidate is ineligible. Move on to next question. Candidate is entitled to Medicare Part A? Candidate is ineligible. Move on to next question. Candidate is enrolled in Medicare Part B? Candidate is ineligible. Move on to next question. Candidate is enrolled in Medicaid? Candidate is ineligible. Move on to next question. Candidate is currently enrolled in the State
Childrens Health Insurance Program (SCHIP)?Candidate is ineligible. Move on to next question. Candidate is enrolled in the Federal Employees
Health Benefits Program (FEHBP)?Candidate is ineligible. Move on to next question. Candidate is entitled to health coverage through
the U.S. military health system (TRICARE/ CHAMPUS)?Candidate is ineligible. Move on to question
9.Move on to next question. Candidate is enrolled in spouses employer-sponsored
health plan?Candidate is only eligible for End-of-Year credit
if employer pays less than 50 percent of premium (unless plan is COBRA).Move on to next question. Candidate can be claimed as a dependent on anyones
federal tax return?Candidate is ineligible. Move on to next question. Candidate is imprisoned under federal, state,
or local authority?Candidate is ineligible. Move on to next question. Candidate is enrolled in a health plan? Move on to next question. Candidate is ineligible. Health plan is COBRA continuation coverage? Candidate is eligible. Move on to Qualified Family
and Eligibility questions, See IRM 25.19.4.2.3.
Move on to next question. Health plan is a state qualified health plan? CSR must reference the State Qualified Health
Plan List to verify specific plans and group numbers. Candidate is eligible.
Move on to Qualified Family and Eligibility questions,
See IRM 25.19.4.2.3.Move on to next question. Health plan is non-group enrolled in at least
30 days prior to employment separation?CSR will ask when candidates non-group plan
became effective and the last day of employment. If 30 days or more elapsed
between purchase of non-group plan and last day of employment, candidate is
eligible. Move on to Qualified Family and Eligibility question, See IRM 25.19.4.2.3.Candidate is ineligible if he/she was not enrolled
at least 30 days prior to separation from that job. -
Validate the candidates answers and identify any registration errors.
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If there are no errors, the Individual Eligibility View appears, and
Qualified Family Members may be added (if applicable). The primary individual
eligibility record is set to “Eligible.”
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The HCTC candidate must be eligible for the tax
credit in order for their Qualified Family Members (QFMs) to participate. -
Qualified Family Members are defined as: a spouse, and any dependents
that can be claimed on the candidates federal tax return. Children of divorced
or separated parents are treated as dependents of the custodial parent for
the purposes of HCTC. -
The non-custodial parent may not claim the credit, even if she or he
is entitled to claim the tax exemption for the child or carries the childs
health insurance. -
Qualified Family Members may be enrolled in a separate or different
health plan from the candidates, but the QFMs plan must be a qualified plan
to receive the HCTC. See HCTC Siebel User Guide 302: Siebel Registration for
more details. -
Additionally, the QFM will answer the following two (2) questions:
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Is your family member enrolled in the same health plan policy as you are?
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Is your family member enrolled in his or her own qualified health plan
policy separately from yours?
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Validate the candidates answers and identify any registration errors.
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Check the candidate and all QFMs eligibility statuses before adding
policy information. If the participant or a QFM changes health plan/product
information (product type, etc.), it is necessary that the participant re-register.
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To proceed, gather the policy information. For details of policy information
questions to ask the candidate, refer to HCTC Siebel User Guide 302: Siebel
Registration. -
The primary policyholder of the qualified plan must be added first.
See HCTC Siebel User Guide 302: Siebel Registration. -
If the candidate is ATAA-eligible, an additional policy-related
question must be asked:Are you receiving benefits under
the ATAA program?
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See HCTC Siebel System User Guide 302: Siebel Registration.
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Remind the HCTC participant to mail in the appropriate documentation.
Appropriate documentation is found on the last page of the registration form.Note:
Including the taxpayers signed consent to disclose information to
the state unemployment agency and the Department of Labor for purposes of
providing eligibility information regarding the NEG bridge fund program. This
procedures apply to when the client determines that he/she wants to include
information regarding consents to disclose information for NEG bridge fund
purposes. -
For more information on call (Wrap-Up), see IRM 25.19.2.1.1 Inbound
Calls.
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This section provides information on registering candidates for the
HCTC program by Form/Paper. Waterloo CCC handle these contacts. -
These steps must be followed to complete Form Registration:
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Eligibility Confirmation,
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Eligibility Questions,
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Qualified Family Members are entered,
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Policy Information Capture, and
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Form Registration Wrap-Up.
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A Form/Paper registration completed by an HCTC candidate is returned
to the CCC. Initiate enrollment. Candidate must have an eligibility record
provided by either the PBGC or a SWA in order to search Siebel on behalf of
the candidate.Note:
ATAA Form Registrations are not currently supported;
all ATAA candidates must register by telephone. Refer to IRM 25.19.3 Case
Escalations.Note:
If Individual Coverage is selected on the registration
form as the candidates health plan type, an Eligibility Issue Case is created
for an Outbound Call to confirm the Individual Coverage 30-day threshold.
See IRM 25.19.2.2 Outbound Call Process.
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Enter Qualified Family Members (QFMs) information exactly as it appears
on the registration form. -
There is no need to check QFM eligibility for Form Registrations.
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No detailed eligibility questions are asked for QFMs on the form. The
HCTC candidate is stating that he/she meets the requirements to be a Qualified
Family Member when they submit someones name on the registration form.
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Health Plan Administrator (HPAs) Invoices, COBRA Election Letters, QFM
Itemization Letters, and/or Excepted Benefits Itemization Letters are documents
needed to complete the registration process, and can be considered Proof of
Health Coverage. -
A recent HPA Invoice (less than 60 days old) is required for
all registrations. Not all of the documents above are required for
every registration. The required documents are dependent on the specifics
of the registration. For example, if the policy type on the registration is “COBRA”
, then a COBRA Election Letter is required, or if there
are Non-Qualified Family Members or Excepted Benefits on a policy, the appropriate
itemization letters are required. -
HPA CSRs receive these documents in multiple formats, either attached
to a Form/Paper registration that has been recently entered as a Correspondence
(Fax) Case or as loose documents mailed to complete a Telephone Registration. -
Participants who do not currently have an “Active”
Registration;
documents mentioned above are used to confirm policy information and premium
amounts in order to complete their registrations. -
Participants who do currently have an “Active”
in
HCTC with an “Active”
policy; the documents mentioned
above are typically used to process premium changes on the participants existing
policy. See HCTC Siebel System User Guide 302: Siebel Registration.Note:
A Premium Change Letter advising the participant that the HCTC program updated
his/her account to reflect a change to the health plan premium is sent to
the participant. This letter is created regardless of the timing of the premium
change. Refer to IRM 25.19.1.4 Outbound Mail Fulfillment.
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The HCTC CCC case may receive any incoming mail via FAX. FAX service
is used primarily to receive HPA Invoices and Letters from participants when
time is an issue. -
An incoming image to the HCTC FAX Server is manually migrated from the
FAX Server to a working directory. The image is then reviewed in an electronic
format to determine to whom the image should be associated. The Social Security
Number (SSN) on the electronic image is queried in the Siebel System for a
match. The Case is paired with the image and input in the customers record.
The Case then follows the steps in IRM 25.19.2.8 Case Management.
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For customers who currently have Inactive Registration, an Outbound
Call Case is created for outreach to the customer for further resolution.
See IRM 25.19.2.2 Outbound Calls.
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In some instances, an Outbound Call is necessary to clarify information
on the HPA documentation received. See IRM 25.19.2.2 Outbound Calls. -
The first time incorrect HPA documentation is received from an individual,
a letter is generated and mailed to the participant with an explanation of
Insufficient Documentation. -
The second time incorrect HPA documentation is received from the same
individual, an Outbound Call Case is created to clarify any misunderstandings
the individual may have. See IRM 25.19.2.2 Outbound Calls.
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CSRs place outbound calls to participants in order to complete Re-Registrations.
The causes for the Re-Registration may vary. Sometimes a system issue may
result in cancellation of the existing registration. In other scenarios, a
data discrepancy on the participants record or unknown HPA change may warrant
a Re-Registration. -
Regardless of the root cause, use the same five (5) Registration Processes
for Inbound Calls in order to complete the request. -
For all other Outbound Calls, refer to IRM 25.19.2.2 (Outbound Calls)
for more information.
