Form 207 Hcc - Health Care Center Tax Return

Form 207 HCC Instructions

General Instructions

Line 11: Enter net direct subscriber charges received during calendar year

Complete the return in blue or black ink only.

2007 on any contract or policy entered into: (A) On or after July 1, 2003, to

Due Date: Form 207HCC, Health Care Center Tax Return, is due on or before

provide health care coverage for individuals eligible for a health coverage

March 1, 2008, for health care center tax liability for calendar year 2007.

tax credit and their dependents under a plan procured under Conn. Gen. Stat.

Attachments: Attach the following to this return:

§5-259(i); and (B) On or after July 1, 2005, to provide health care coverage for

•

The Statement of Revenue and Expenses from the Annual Statement filed

individuals eligible for a retirement benefit from the Connecticut municipal

with the Connecticut Insurance Department;

employees’ retirement system and their dependents under a plan procured under

•

Conn. Gen. Stat. §5-259(i).

A copy of Schedule T;

•

2007 Form 207I, if applicable; and

Line 15a: Your company may be eligible to claim certain Connecticut business

•

2007 Form CT-1120K, if applicable.

tax credits. For more information on Connecticut business tax credits that

your company may be eligible to claim, see Informational Publication

Rounding Off to Whole Dollars: You must round off cents to the nearest

2006(15), Guide to Connecticut Business Tax Credits. If your company

whole dollar on your return and schedules.

claims Connecticut business tax credits, Form CT-1120K, Business Tax

Filing an Amended Return: If an error(s) is made on your return, correct the

Credit Summary, must be completed and attached to this return.

error(s) by filing an amended return using a new Form 207 HCC. Complete

Lines 15b and 15c: The amount of tax credit(s) allowable against the health

Form 207 HCC using the correct figures and information for the reporting

care center tax may not exceed 70% of the amount of health care center tax

period. If filing an amended return, include the amount paid with the original

due prior to the application of the credit(s). See Special Notice 2003(16),

return on Line 19.

2003 Legislation Affecting the Health Care Center Tax, for more information.

Parties to a Civil Union: For subscriber charges received on or after

October 1, 2005, the references in the instructions for Lines 2, 4, 5, and 11 to

Line 18: Enter estimated payments made with Forms 207 HCC ESA, ESB,

the spouse or dependent of an employee or individual include, where the

ESC, and ESD.

employee or individual is a party to a civil union recognized under Connecticut

Line 19: Enter payment made with Form 207/207 HCC EXT, Application for

law, the other party to the civil union, and the references in the instructions for

Extension of Time to File Domestic Insurance Premiums Tax Return or Health

Line 3 to the spouse of a retired teacher include, where the retired teacher is a

Care Center Tax Return. To request an extension of time to file Form 207 HCC,

party to a civil union recognized under Connecticut law, the other party to the

you must file Form 207/207 HCC EXT, and pay all the tax it expects to owe on

civil union.

or before March 1, 2008.

Line Instructions

Line 20: If Line 13 is greater than Line 17, subtract Line 17 from

Line 13. This is the amount of tax you owe.

Line 1: Enter total net direct subscriber charges received during calendar

year 2007 on any new or renewal contract.

Line 22: Your election to credit your overpayment to your 2008 estimated health

care center tax, or to have your overpayment refunded to you, is irrevocable.

Line 2: Enter net direct subscriber charges received during calendar year

2007 on any contract or policy entered into with the State of Connecticut to

Line 22a: Enter the amount of overpayment you want credited to your 2008

provide health care coverage to state employees, retirees, or their dependents.

estimated health care center tax. Your overpayment will be credited to your

2008 estimated health care center tax as of March 1, 2008, or the date that this

Line 3: Enter net direct subscriber charges received during calendar year

return is filed, whichever is later. Therefore, if this return is filed after March 15,

2007 on any contract or policy entered into with the State of Connecticut on or

2008, your estimated health care center tax payment for March 15, 2008 will not

after February 1, 2000, to provide health care coverage to retired teachers,

be timely made.

their spouses, or their surviving spouses covered by plans offered by the

State Teachers’ Retirement System.

Line 22b: Enter the amount of overpayment you want refunded to you.

Line 4: Enter net direct subscriber charges received during calendar year

Line 24a: Late Payment Penalty: Multiply Line 23 by 10%. Enter the result

2007 on any contract or policy entered into on or after July 1, 2001, to provide

or $50, whichever is greater.

health care coverage for employees of a Connecticut municipality and their

Line 24b: Multiply Line 23 by 1% per month or fraction of a month from the

dependents under a plan procured under Conn. Gen. Stat. §5-259(i).

original due date of the return to the date of payment.

Line 5: Enter net direct subscriber charges received during calendar year

Line 25: If estimated tax was underpaid, complete and attach Form 207I,

2007 on any contract or policy entered into: (A) On or after July 1, 2001, to

Underpayment of Estimated Insurance Premiums Tax or Health Care Center

provide health care coverage for employees of a Connecticut nonprofit

Tax, and enter the amount from Line 22 of Form 207I.

organization and their dependents under a plan procured under Conn. Gen.

Stat. §5-259(i); and (B) On or after July 1, 2005, to provide health care coverage

Line 26: Add the amounts from Lines 23, 24, and 25.

for employees of a community action agency and their dependents under a

Make check payable to: Commissioner of Revenue Services. To ensure

plan procured under Conn. Gen. Stat. §5-259(i).

payment is applied to your account, write “2007 Form 207 HCC” and your

Line 6: Enter net direct subscriber charges received during calendar year

Connecticut Tax Registration Number on the front of your check. DRS may

2007 from the federal government to provide health care coverage for Medicare

submit your check to your bank electronically.

patients.

Mail to:

Department of Revenue Services

Line 7: Enter net direct subscriber charges received during calendar year

State of Connecticut

2007 from a contract or policy entered into with the State of Connecticut to

PO Box 2990

Hartford CT 06104-2990Signature: The treasurer of the company,

provide health care coverage to Medicaid recipients under the Medicaid Managed

Care program established under Conn. Gen. Stat. §17b-28.

or an authorized agent or officer of the company, must sign Form 207 HCC.

Line 8: Enter net direct subscriber charges received during calendar year

Paid Preparer Signature: A paid preparer must sign and date Form 207 HCC.

2007 from any contract or policy entered into with the State of Connecticut on

Paid preparers must also enter their Social Security Number (SSN) or Preparer

or after April 1, 1998, to provide health care coverage to eligible beneficiaries

Tax Identification Number (PTIN), and their firm’s Federal Employer ID Number

under the HUSKY Plan, Part A; HUSKY Plan, Part B; or the HUSKY Plus programs.

(FEIN) in the spaces provided.

Line 9: Enter net direct subscriber charges received during calendar year 2007

For More Information: If you have any questions, call the Taxpayer Services

from any contract or policy entered into with the State of Connecticut to provide

Division at 1-800-382-9463 (Connecticut calls outside the greater Hartford

health care coverage to recipients of state administered general assistance.

calling area only) or 860-297-5962 (from anywhere), or go to

Line 10: Enter net direct subscriber charges received during calendar year

to visit the DRS website.

2007 from the federal Employees Health Benefits Fund to provide health care

TTY, TDD, and Text Telephone users only may transmit inquiries anytime

coverage for United States government employees, retired United States

by calling 860-297-4911.

government employees, certain former United States government employees

and eligible members of their families.

Form 207 HCC Back (Rev. 12/07)

Form 207 Hcc - Health Care Center Tax Return - 2007 Page 2

Related Articles

Related forms

Related Categories