25.19.4  Registration

25.19.4.1  (09-01-2008)
Registration Overview

  1. This section of the Internal Revenue Manual (IRM) provides information on registering for the Health Coverage Tax Credit (HCTC).

  2. There are two methods of registration:

    • Telephone

    • Form/Paper

  3. Phone and Form Registration duties are handled by Customer Service Representatives (CSRs). See IRM 25.19.1.3 (Customer Service Responsibilities).

25.19.4.1.1  (09-01-2008)
Registration Guidelines

  1. A candidate must register to receive the HCTC in advance on a monthly basis.

  2. Registration questions and eligibility criteria differ among the potentially eligible groups:

    • Trade Adjustment Assistance (TAA)

    • Alternative Trade Adjustment Assistance (ATAA),

    • Pension Benefit Guaranty Corporation (PBGC).

  3. General guidelines must be followed.

  4. For specific registration guidelines, refer to: HCTC Siebel System User Guide 302: Siebel Registration.

25.19.4.2  (09-01-2008)
Telephone Registration Overview

  1. Telephone registrations are handled by HCTC Customer Contact Centers (CCC) CSRs in Waterloo, Iowa, and Peoria, Illinois.

  2. Several steps comprise a successful registration over the telephone:

    • Identity Confirmation

    • Eligibility Confirmation

    • Eligibility Questions

    • Quality Family and Eligibility Questions

    • Policy Information Capture

    • Registration Wrap-Up

25.19.4.2.1  (09-01-2008)
Eligibility Confirmation

  1. A candidate's eligibility must be confirmed. See IRM 25.19.3 Eligibility.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. Proceed to Call Wrap-Up, See IRM 25.19.4.2.6.

25.19.4.2.2  (09-01-2008)
Eligibility Questions

  1. Once an individual's 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.

  2. Follow the Siebel Eligibility Questions for TAA/PBGC registration; see HCTC Siebel User Guide 302: Siebel Registration.

  3. 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 Children's 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 spouse's 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 anyone's 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 candidate's 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.

  4. Follow the Siebel Eligibility Questions for ATAA registration, see HCTC Siebel System User Guide 302: Siebel Registration.

  5. 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 candidate's answers.

    Questions for ATAA Eligibility Yes No
    Candidate is enrolled in a current or former employer's health plan? (candidate with COBRAmust answer yes) Move on to next question. Candidate is ineligible.
    Candidate's 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 spouse's current or former employer's health plan? (spouse with COBRAmust answer yes) Move on to next question. Candidate is ineligible.
    Spouse's 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.
    Spouse's 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 spouse's) 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.
    Candidate's employer-sponsored health plan any of the following: COBRA, state-based continuation coverage, or a special insurance program entered into by candidate's 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 spouse's 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.
    Candidate's employer-sponsored health plan is any of the following: COBRA, state-based continuation coverage, or a special insurance program entered into by candidate's 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 Children's 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 spouse's 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 anyone's 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 candidate's 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.

  6. Validate the candidate's answers and identify any registration errors.

  7. 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."

25.19.4.2.2.1  (09-01-2008)
Ineligibility Letter

  1. When the candidate is ineligible, a systemic letter is issued the following business day. The letter provides an explanation of why the candidate is ineligible. See IRM 25.19.5, Invoice Fulfillment.

25.19.4.2.3  (09-01-2008)
Qualified Family Members and Eligibility Questions

  1. The HCTC candidate must be eligible for the tax credit in order for their Qualified Family Members (QFMs) to participate.

  2. Qualified Family Members are defined as: a spouse, and any dependents that can be claimed on the candidate's federal tax return. Children of divorced or separated parents are treated as dependents of the custodial parent for the purposes of HCTC.

  3. 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 child's health insurance.

  4. Qualified Family Members may be enrolled in a separate or different health plan from the candidate's, but the QFMs plan must be a qualified plan to receive the HCTC. See HCTC Siebel User Guide 302: Siebel Registration for more details.

  5. Additionally, the QFM will answer the following two (2) questions:

    • Is your family member enrolled in the same health plan policy as you are?

    • Is your family member enrolled in his or her own qualified health plan policy separately from yours?

  6. Validate the candidate's answers and identify any registration errors.

25.19.4.2.4  (09-01-2008)
Policy Information

  1. 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.

  2. 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.

  3. The primary policyholder of the qualified plan must be added first. See HCTC Siebel User Guide 302: Siebel Registration.

  4. If the candidate is ATAA-eligible, an additional policy-related question must be asked:

    Are you receiving benefits under the ATAA program?

25.19.4.2.5  (09-01-2008)
Complete Registration

  1. See HCTC Siebel System User Guide 302: Siebel Registration.

25.19.4.2.6  (09-01-2008)
Call Wrap-Up

  1. 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 taxpayer's 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.

  2. For more information on call (Wrap-Up), see IRM 25.19.2.1.1 Inbound Calls.

25.19.4.3  (09-01-2008)
Form/Paper Registration Overview

  1. This section provides information on registering candidates for the HCTC program by Form/Paper. Waterloo CCC handle these contacts.

  2. These steps must be followed to complete Form Registration:

    • Eligibility Confirmation,

    • Eligibility Questions,

    • Qualified Family Members are entered,

    • Policy Information Capture, and

    • Form Registration Wrap-Up.

25.19.4.3.1  (09-01-2008)
Form/Paper Registration

  1. 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 candidate's 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.

25.19.4.3.2  (09-01-2008)
Eligibility Confirmation

  1. See IRM 25.19.4.2.1.Eligibility Confirmation.

25.19.4.3.3  (09-01-2008)
Eligibility Questions

  1. See IRM 25.19.4.2.2.Eligibility Questions.

25.19.4.3.4  (09-01-2008)
Qualified Family Members

  1. Enter Qualified Family Members (QFMs) information exactly as it appears on the registration form.

  2. There is no need to check QFM eligibility for Form Registrations.

  3. 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 someone's name on the registration form.

25.19.4.3.5  (09-01-2008)
Policy Information

  1. See IRM 25.19.4.2.4. Policy Information.

25.19.4.3.6  (09-01-2008)
Log Documentation

  1. See HCTC Siebel User Guide 302: Siebel Registration.

25.19.4.3.7  (09-01-2008)
Complete Registration

  1. See HCTC Siebel User Guide 302: Siebel Registration.

25.19.4.4  (09-01-2008)
Verifying Health Plan

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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 participant's 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.

25.19.4.4.1  (09-01-2008)
Fax Operations

  1. 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.

  2. 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 customer's record. The Case then follows the steps in IRM 25.19.2.8 Case Management.

25.19.4.4.2  (09-01-2008)
Inactive Registration

  1. 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.

25.19.4.4.3  (09-01-2008)
Invoice Verification Questions

  1. In some instances, an Outbound Call is necessary to clarify information on the HPA documentation received. See IRM 25.19.2.2 Outbound Calls.

  2. 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.

  3. 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.

25.19.4.5  (09-01-2008)
Outbound Re-Registration Request

  1. 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 participant's record or unknown HPA change may warrant a Re-Registration.

  2. Regardless of the root cause, use the same five (5) Registration Processes for Inbound Calls in order to complete the request.

  3. For all other Outbound Calls, refer to IRM 25.19.2.2 (Outbound Calls) for more information.


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