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

What is Form 1099-H?

IRS Form 1099-H, Health Coverage Tax Credit (HCTC) Advance Payments, is a document released for those individuals who got payments during the calendar year of qualified health insurance payments for the benefit of eligible trade adjustment assistance. This form also covers alternative trade adjustment assistance, reemployment trade adjustment assistance, and Pension Benefit Guaranty Corporation payees.

The document is issued by the Internal Revenue Service (IRS) and was last revised in 2019 and is revised annually. A fillable 1099-H Form is available for download below. To see related 1099 forms follow the link here.

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IRS Form 1099-H Instructions

If an applicant has any difficulties while filling in the form, they should use the Official instructions for the 1099-H form developed by the IRS. It contains necessary explanations and examples, as well as provide information on penalties, corrected or void returns, statements to the recipients, etc.

The application is supposed to be filled in by issuers/providers of qualified health insurance coverage that obtained advance payments from the Department of the Treasury on behalf of eligible recipients. They must report those payments and provide information about payments to the recipient. For that purpose the application was developed in three copies:

  • Copy A - For the Internal Revenue Service Center;
  • Copy B - For the Recipient;
  • Copy C - For the Provides (Issuer).

Copy A of the form is supposed to be filed by the provider with the IRS electronically Before March 31, 2020.

All copies contain the same amount of information and are presented on one page each. The document is divided into several sections, which include:

  1. Information about the issuer/provider. This section includes certain data, such as issuer's / provider's name, full address (street address, town or city, state or province, country, zip code, and telephone number), their taxpayer identification number (TIN), which can be presented by a social security number, adoption taxpayer identification number, or individual taxpayer identification number.
  2. Information about the recipient. Here an applicant must enter the recipient's name, their full address (which by the analogy with the previous section must include street address, city or town, state or province, country, zip code, and telephone number), and their TIN as well.
  3. Information about payments. In the last part of the application, a filer must state the amount of HCTC advance payments of qualified health insurance costs that were made and designate the payments per month.
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VOID
CORRECTED
ISSUER'S/PROVIDER'S name, street address, city or town, state or
1 Amount of HCTC advance
OMB No. 1545-1813
payments
Health Coverage
province, country, ZIP or foreign postal code, and telephone no.
1099-H
$
Form
Tax Credit (HCTC)
2 No. of mos. HCTC
(Rev. December 2020)
payments received
Advance Payments
For calendar year
20
Copy A
3 Jan.
9 July
ISSUER'S/PROVIDER'S TIN
RECIPIENT'S TIN
For
$
$
Internal Revenue
RECIPIENT'S name
4 Feb.
10 Aug.
Service Center
$
$
5 Mar.
11 Sept.
$
$
For Privacy Act
and Paperwork
Street address (including apt. no.)
6 Apr.
12 Oct.
Reduction Act
$
$
Notice, see the
7 May
13 Nov.
City or town, state or province, country, and ZIP or foreign postal code
current General
$
$
Instructions for
Certain Information
8 June
14 Dec.
Returns.
$
$
1099-H
Form
(Rev. 12-2020)
Cat. No. 34912D
www.irs.gov/Form1099H
Department of the Treasury - Internal Revenue Service
Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page
VOID
CORRECTED
ISSUER'S/PROVIDER'S name, street address, city or town, state or
1 Amount of HCTC advance
OMB No. 1545-1813
payments
Health Coverage
province, country, ZIP or foreign postal code, and telephone no.
1099-H
$
Form
Tax Credit (HCTC)
2 No. of mos. HCTC
(Rev. December 2020)
payments received
Advance Payments
For calendar year
20
Copy A
3 Jan.
9 July
ISSUER'S/PROVIDER'S TIN
RECIPIENT'S TIN
For
$
$
Internal Revenue
RECIPIENT'S name
4 Feb.
10 Aug.
Service Center
$
$
5 Mar.
11 Sept.
$
$
For Privacy Act
and Paperwork
Street address (including apt. no.)
6 Apr.
12 Oct.
Reduction Act
$
$
Notice, see the
7 May
13 Nov.
City or town, state or province, country, and ZIP or foreign postal code
current General
$
$
Instructions for
Certain Information
8 June
14 Dec.
Returns.
$
$
1099-H
Form
(Rev. 12-2020)
Cat. No. 34912D
www.irs.gov/Form1099H
Department of the Treasury - Internal Revenue Service
Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page
CORRECTED (if checked)
ISSUER'S/PROVIDER'S name, street address, city or town, state or
1 Amount of HCTC advance
OMB No. 1545-1813
payments
Health Coverage
province, country, ZIP or foreign postal code, and telephone no.
1099-H
$
Form
Tax Credit (HCTC)
2 No. of mos. of HCTC advance
(Rev. December 2020)
payments and reimbursement
Advance Payments
For calendar year
credits paid to you
20
3 Jan.
9 July
ISSUER'S/PROVIDER'S TIN
RECIPIENT'S TIN
$
$
Copy B
RECIPIENT'S name
4 Feb.
10 Aug.
$
$
For Recipient
5 Mar.
11 Sept.
This is important
$
$
tax information
Street address (including apt. no.)
6 Apr.
12 Oct.
and is being
$
$
furnished to the
IRS.
7 May
13 Nov.
City or town, state or province, country, and ZIP or foreign postal code
$
$
8 June
14 Dec.
$
$
1099-H
(keep for your records)
Form
(Rev. 12-2020)
www.irs.gov/Form1099H
Department of the Treasury - Internal Revenue Service
Instructions for Recipient
However, the issuer has reported your complete TIN to
This statement is provided to you because you received
the IRS.
Health Coverage Tax Credit (HCTC) advance payments
of your health coverage insurance premiums. These
Box 1. Shows the total amount of HCTC advance
advance payments were forwarded directly to your
payments of qualified health insurance costs that were
health insurance provider. You are qualified to receive
made on your behalf.
advance payments if you were an eligible trade
Box 2. Shows the total number of months you received
adjustment assistance (TAA) recipient, an Alternative
HCTC payments.
TAA (ATAA) recipient, a Reemployment TAA (RTAA)
Boxes 3 through 14. Shows the amount of HCTC
recipient, or a Pension Benefit Guaranty Corporation
advance payments paid for you for each month. The
(PBGC) pension payee. See Form 8885, Health
total of the amounts shown in these boxes equals the
Coverage Tax Credit, and its instructions for more
amount shown in box 1.
details on qualified recipients and how to figure any
Future developments. For the latest information about
credit that you may be able to take on your Form 1040,
developments related to Form 1099-H and its
1040-SR, 1040-NR, 1040-SS, or 1040-PR.
instructions, such as legislation enacted after they were
Recipient’s taxpayer identification number (TIN). For
published, go to www.irs.gov/Form1099H.
your protection, this form may show only the last four
Free File. Go to www.irs.gov/FreeFile to see if you
digits of your TIN (social security number (SSN),
qualify for no-cost online federal tax preparation,
individual taxpayer identification number (ITIN), or
e-filing, and direct deposit or payment options.
adoption taxpayer identification number (ATIN)).
VOID
CORRECTED
ISSUER'S/PROVIDER'S name, street address, city or town, state or
1 Amount of HCTC advance
OMB No. 1545-1813
payments
Health Coverage
province, country, ZIP or foreign postal code, and telephone no.
1099-H
$
Form
Tax Credit (HCTC)
2 No. of mos. HCTC
(Rev. December 2020)
payments received
Advance Payments
For calendar year
20
3 Jan.
9 July
ISSUER'S/PROVIDER'S TIN
RECIPIENT'S TIN
$
$
Copy C
RECIPIENT'S name
4 Feb.
10 Aug.
For
$
$
Issuer/Provider
5 Mar.
11 Sept.
$
$
For Privacy Act
and Paperwork
Street address (including apt. no.)
6 Apr.
12 Oct.
Reduction Act
$
$
Notice, see the
7 May
13 Nov.
City or town, state or province, country, and ZIP or foreign postal code
current General
$
$
Instructions for
Certain Information
8 June
14 Dec.
Returns.
$
$
1099-H
Form
(Rev. 12-2020)
www.irs.gov/Form1099H
Department of the Treasury - Internal Revenue Service
Instructions for Issuer/Provider
Need help? If you have questions about reporting on
Form 1099-H, call the information reporting customer
To complete Form 1099-H, use:
service site toll free at 866-455-7438 or 304-263-8700
• The current General Instructions for Certain
(not toll free). Persons with a hearing or speech
Information Returns, and
disability with access to TTY/TDD equipment can call
• The current Instructions for Form 1099-H.
304-579-4827 (not toll free).
To order these instructions and additional forms, go to
www.irs.gov/Form1099H.
Filing and furnishing. For filing and furnishing
instructions, and to request filing or furnishing
extensions, see the current General Instructions for
Certain Information Returns. To file electronically, you
must have software that generates a file according to the
specifications in Pub. 1220.
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