Form 1099-H - Health Coverage Tax Credit (Hctc) Advance Payments

Form 1099-H - Health Coverage Tax Credit (Hctc) Advance Payments - 2016 Page 4

Instructions for Recipient

This statement is provided to you because you received

Box 2. Shows the total number of months you received

Health Coverage Tax Credit (HCTC) advance payments

HCTC payments.

of your health coverage insurance premiums. These

Boxes 3 through 14. Shows the amount of HCTC

advance payments were forwarded directly to your

advance payments paid for you for each month. The

health insurance provider. You are qualified to receive

total of the amounts shown in these boxes equals the

advance payments if you were an eligible trade

amount shown in box 1.

adjustment assistance (TAA), Alternative TAA,

Future Developments

Reemployment TAA recipient, or a Pension Benefit

For the latest information about developments related to

Guaranty Corporation (PBGC) pension payee. See Form

Form 1099-H and its instructions, such as legislation

8885, Health Coverage Tax Credit, and its instructions

enacted after they were published, go to

for more details on qualified recipients and how to figure

any credit that you may be able to take on your Form

1040, 1040NR, 1040-SS, or 1040-PR.

Box 1. Shows the total amount of HCTC advance

payments of qualified health insurance costs that were

made on your behalf.

Form 1099-H - Health Coverage Tax Credit (Hctc) Advance Payments - 2016 Page 4