Instructions for IRS Form 8885 "Health Coverage Tax Credit"

This document contains official instructions for IRS Form 8885, Health Coverage Tax Credit - a tax form released and collected by the Internal Revenue Service (IRS), a subdivision of the U.S. Department of the Treasury. An up-to-date fillable IRS Form 8885 is available for download through this link.

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Download Instructions for IRS Form 8885 "Health Coverage Tax Credit"

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2018
Department of the Treasury
Internal Revenue Service
Instructions for Form 8885
Health Coverage Tax Credit
Definitions and Special
Section references are to the Internal Revenue
Health Coverage Tax Credit (HCTC)
Code unless otherwise noted.
Advance Payments.
Rules
What’s New
Who Can Take This Credit
TAA Recipient
You can elect to take the HCTC only if (a)
2018 Form 1040 redesigned. The 2018
You were an eligible TAA recipient as of
you were an eligible TAA, ATAA, or RTAA
Form 1040 has been redesigned and is
the first day of the month if, for any day in
recipient or PBGC payee in 2018; or you
supplemented with new Schedules 1
that month or the prior month, you:
were the qualifying family member of an
through 6. These additional schedules will
Received a trade readjustment
eligible TAA, ATAA, or RTAA recipient or
be used as needed to complete more
allowance, or
PBGC payee who passed away or
complex tax returns. References to Form
Would have been entitled to receive
finalized a divorce with you (see
1040 and its related schedules have been
such an allowance except that you hadn’t
Continued Qualification for Family
revised accordingly in these instructions.
exhausted all rights to any unemployment
Members After Certain Life
Events, later);
insurance (except additional
Future Developments
(b) you can’t be claimed as a dependent
compensation that is funded by a state
on someone else’s 2018 tax return; and
and isn’t reimbursed from any federal
For the latest information about
(c) you met all of the other conditions
funds) to which you were entitled (or
developments related to Form 8885 and
listed on line 1. If you can’t be claimed as
would be entitled if you applied).
its instructions, such as legislation
a dependent on someone else’s 2018 tax
enacted after they were published, go to
Example. You received a trade
return, review Form 8885, Part I, to see if
IRS.gov/Form8885.
readjustment allowance for January 2018.
you are eligible to take this credit.
You were an eligible TAA recipient as of
Relatively few people are eligible
Election to take the HCTC. You must
the first day of January and February.
for the Health Coverage Tax
!
elect the HCTC to receive the benefit of
Credit (HCTC). See
Who Can
ATAA Recipient
the HCTC. Make your election by
CAUTION
Take This
Credit, later, to determine
checking the box on line 1 for the first
You were an eligible ATAA recipient as of
whether you can claim the credit.
eligible coverage month you are electing
the first day of the month if, for that month
to take the HCTC and all boxes on line 1
or the prior month, you received benefits
General Instructions
for each eligible coverage month after the
under an alternative trade adjustment
election month. Once you elect to take the
assistance program for older workers
HCTC for a month in 2018, the election to
established by the Department of Labor.
Purpose of Form
take the HCTC applies to all subsequent
Example. You received benefits under
Use Form 8885 to elect and figure the
eligible coverage months in 2018. The
an alternative trade adjustment assistance
amount, if any, of your HCTC.
election doesn’t apply to any month for
program for older workers for October
which you aren’t eligible to take the HCTC.
Self-Employed Health Insurance De-
2018. The program was established by
For 2018, the election must be made
duction Worksheet. If you are
the Department of Labor. You were an
not later than the due date (including
completing the Self-Employed Health
eligible ATAA recipient as of the first day
extensions) of your tax return.
Insurance Deduction Worksheet in your
of October and November.
tax return instructions and you were an
Example. You were an eligible RTAA
RTAA Recipient
eligible trade adjustment assistance (TAA)
recipient between February 2018 and
recipient, alternative TAA (ATAA)
You were an eligible RTAA recipient as of
October 2018 and you otherwise met the
recipient, reemployment TAA (RTAA)
the first day of the month if, for that month
HCTC requirements during that period.
recipient, or Pension Benefit Guaranty
or the prior month, you received benefits
You wish to take the HCTC starting in April
Corporation (PBGC) payee, you must
under a reemployment trade adjustment
2018. You would check the box on line 1
complete Form 8885 before completing
assistance program for older workers
for April to elect the HCTC for your April
that worksheet. When figuring the amount
established by the Department of Labor.
coverage. You must then check every box
to enter on line 1 of the worksheet, do not
on line 1 through and including October
Example. You received benefits under
include:
because you’re eligible to take the HCTC
a reemployment trade adjustment
Any amounts you included on Form
for those coverage months. Your election
assistance program for older workers for
8885, line 4, or on Form 14095, The
applies to your April through October
January 2018. The program was
Health Coverage Tax Credit (HCTC)
coverage months.
established by the Department of Labor.
Reimbursement Request Form;
You were an eligible RTAA recipient as of
Even if you can’t claim the HCTC
Any qualified health insurance
the first day of January and February.
on your income tax return, you
!
coverage premiums you paid to “US
must still file Form 8885 to elect
PBGC Payee
Treasury-HCTC” for eligible coverage
CAUTION
the HCTC for any months you participated
months for which you received the benefit
You were an eligible PBGC payee as of
in the advance monthly payment program.
of the advance monthly payment program;
the first day of the month if both of the
Failing to make a timely election will
or
following apply.
require you to report advance monthly
Any advance monthly payments your
1. You were age 55 to 65 and not
HCTC payment amounts as an additional
health plan administrator received from
enrolled in Medicare as of the first day of
tax owed on your tax return.
the IRS, as shown on Form 1099-H,
the month.
Nov 07, 2018
Cat. No. 68158V
2018
Department of the Treasury
Internal Revenue Service
Instructions for Form 8885
Health Coverage Tax Credit
Definitions and Special
Section references are to the Internal Revenue
Health Coverage Tax Credit (HCTC)
Code unless otherwise noted.
Advance Payments.
Rules
What’s New
Who Can Take This Credit
TAA Recipient
You can elect to take the HCTC only if (a)
2018 Form 1040 redesigned. The 2018
You were an eligible TAA recipient as of
you were an eligible TAA, ATAA, or RTAA
Form 1040 has been redesigned and is
the first day of the month if, for any day in
recipient or PBGC payee in 2018; or you
supplemented with new Schedules 1
that month or the prior month, you:
were the qualifying family member of an
through 6. These additional schedules will
Received a trade readjustment
eligible TAA, ATAA, or RTAA recipient or
be used as needed to complete more
allowance, or
PBGC payee who passed away or
complex tax returns. References to Form
Would have been entitled to receive
finalized a divorce with you (see
1040 and its related schedules have been
such an allowance except that you hadn’t
Continued Qualification for Family
revised accordingly in these instructions.
exhausted all rights to any unemployment
Members After Certain Life
Events, later);
insurance (except additional
Future Developments
(b) you can’t be claimed as a dependent
compensation that is funded by a state
on someone else’s 2018 tax return; and
and isn’t reimbursed from any federal
For the latest information about
(c) you met all of the other conditions
funds) to which you were entitled (or
developments related to Form 8885 and
listed on line 1. If you can’t be claimed as
would be entitled if you applied).
its instructions, such as legislation
a dependent on someone else’s 2018 tax
enacted after they were published, go to
Example. You received a trade
return, review Form 8885, Part I, to see if
IRS.gov/Form8885.
readjustment allowance for January 2018.
you are eligible to take this credit.
You were an eligible TAA recipient as of
Relatively few people are eligible
Election to take the HCTC. You must
the first day of January and February.
for the Health Coverage Tax
!
elect the HCTC to receive the benefit of
Credit (HCTC). See
Who Can
ATAA Recipient
the HCTC. Make your election by
CAUTION
Take This
Credit, later, to determine
checking the box on line 1 for the first
You were an eligible ATAA recipient as of
whether you can claim the credit.
eligible coverage month you are electing
the first day of the month if, for that month
to take the HCTC and all boxes on line 1
or the prior month, you received benefits
General Instructions
for each eligible coverage month after the
under an alternative trade adjustment
election month. Once you elect to take the
assistance program for older workers
HCTC for a month in 2018, the election to
established by the Department of Labor.
Purpose of Form
take the HCTC applies to all subsequent
Example. You received benefits under
Use Form 8885 to elect and figure the
eligible coverage months in 2018. The
an alternative trade adjustment assistance
amount, if any, of your HCTC.
election doesn’t apply to any month for
program for older workers for October
which you aren’t eligible to take the HCTC.
Self-Employed Health Insurance De-
2018. The program was established by
For 2018, the election must be made
duction Worksheet. If you are
the Department of Labor. You were an
not later than the due date (including
completing the Self-Employed Health
eligible ATAA recipient as of the first day
extensions) of your tax return.
Insurance Deduction Worksheet in your
of October and November.
tax return instructions and you were an
Example. You were an eligible RTAA
RTAA Recipient
eligible trade adjustment assistance (TAA)
recipient between February 2018 and
recipient, alternative TAA (ATAA)
You were an eligible RTAA recipient as of
October 2018 and you otherwise met the
recipient, reemployment TAA (RTAA)
the first day of the month if, for that month
HCTC requirements during that period.
recipient, or Pension Benefit Guaranty
or the prior month, you received benefits
You wish to take the HCTC starting in April
Corporation (PBGC) payee, you must
under a reemployment trade adjustment
2018. You would check the box on line 1
complete Form 8885 before completing
assistance program for older workers
for April to elect the HCTC for your April
that worksheet. When figuring the amount
established by the Department of Labor.
coverage. You must then check every box
to enter on line 1 of the worksheet, do not
on line 1 through and including October
Example. You received benefits under
include:
because you’re eligible to take the HCTC
a reemployment trade adjustment
Any amounts you included on Form
for those coverage months. Your election
assistance program for older workers for
8885, line 4, or on Form 14095, The
applies to your April through October
January 2018. The program was
Health Coverage Tax Credit (HCTC)
coverage months.
established by the Department of Labor.
Reimbursement Request Form;
You were an eligible RTAA recipient as of
Even if you can’t claim the HCTC
Any qualified health insurance
the first day of January and February.
on your income tax return, you
!
coverage premiums you paid to “US
must still file Form 8885 to elect
PBGC Payee
Treasury-HCTC” for eligible coverage
CAUTION
the HCTC for any months you participated
months for which you received the benefit
You were an eligible PBGC payee as of
in the advance monthly payment program.
of the advance monthly payment program;
the first day of the month if both of the
Failing to make a timely election will
or
following apply.
require you to report advance monthly
Any advance monthly payments your
1. You were age 55 to 65 and not
HCTC payment amounts as an additional
health plan administrator received from
enrolled in Medicare as of the first day of
tax owed on your tax return.
the IRS, as shown on Form 1099-H,
the month.
Nov 07, 2018
Cat. No. 68158V
Qualifying Family Member
2. You received a benefit for that
connected with a group health plan or
month that was paid by the PBGC under
federal- or state-based health insurance
A qualifying family member is:
title IV of the Employee Retirement
coverage.
Your spouse (a spouse doesn’t include
Income Security Act of 1974 (ERISA).
3. Coverage under a Consolidated
someone who is legally separated from his
Omnibus Budget Reconciliation Act
or her spouse under a decree of divorce or
If you received a lump-sum payment
(COBRA) continuation provision (as
of separate maintenance (but see
Married
from the PBGC after August 5, 2002, you
defined in section 9832(d)(1)).
Persons Filing Separate
Returns, later)),
meet item (2) above for any month that
or
you would have received a PBGC benefit
4. State-based coverage. State-based
Anyone whom you can claim as a
if you hadn’t received the lump-sum
coverage includes the following.
dependent (but see the exception for
payment.
a. Continuation coverage provided by
Children of Divorced or Separated
the state under a state law that requires
Continued Qualification for
Parents, later).
such coverage.
Family Members After Certain
For any month that you are eligible to
b. A qualified state high risk pool (as
Life Events
take the HCTC, you can include premiums
defined in section 2744(c)(2) of the Public
paid for a qualifying family member for that
Qualifying family members (spouses and
Health Service Act).
eligible coverage month if all of the
dependents) (see
Qualifying Family
c. A health insurance program offered
following statements were true as of the
Member, later) can be considered
for state employees.
first day of that eligible coverage month.
recipients and file Form 8885 under their
d. A state-based health insurance
The qualifying family member was
name and social security number after
program that is comparable to the health
covered by qualified health insurance
certain life events. You are considered a
insurance program offered for state
coverage for which you paid some or all of
recipient and are eligible to newly receive
employees.
the premiums. You and your qualifying
or continue to receive the HCTC in the
family member don’t have to be covered
event that a related TAA, ATAA, or RTAA
e. An arrangement entered into by a
by the same coverage.
recipient or PBGC payee dies or finalizes
state and (i) a group health plan (including
The qualifying family member wasn’t
a divorce with you and you were a
such a plan which is a multiemployer plan
enrolled in Medicare Part A, B, or C.
qualifying family member immediately
as defined in section 3(37) of ERISA), (ii)
The qualifying family member wasn’t
before such event. The TAA, ATAA, or
an issuer of health insurance coverage,
enrolled in Medicaid or the Children’s
RTAA recipient or PBGC payee didn’t
(iii) an administrator, or (iv) an employer.
Health Insurance Program (CHIP).
need to elect the HCTC prior to the event.
f.
A state arrangement with a private
The qualifying family member wasn’t
People who were qualifying family
sector health care coverage purchasing
enrolled in the Federal Employees Health
members can receive the tax credit for
pool.
Benefits Program (FEHBP) or eligible to
eligible coverage months up to 24 months
g. A state-operated health plan that
receive benefits under the U.S. military
from the death or divorce, or until the first
doesn’t receive any federal financial
health system (TRICARE).
coverage month that begins on or after
participation.
The qualifying family member wasn’t
January 1, 2020, whichever comes first.
covered by, or eligible for coverage under,
5. Coverage under a health plan
Eligibility to receive the HCTC may begin
any employer-sponsored health insurance
funded by a voluntary employees’
in either the month of the death or divorce
coverage as described in the instructions
beneficiary association (VEBA) that was
or the month following the death or
for
line
1, later.
established through a bankruptcy court.
divorce.
Example. Your spouse was a PBGC
Note. If you are an eligible TAA, ATAA, or
Exception. Qualified health insurance
payee and died on August 20, 2017. You
RTAA recipient or PBGC payee who
coverage doesn’t include any of the
are eligible to receive the HCTC as a
enrolled in Medicare, you may be able to
following.
recipient for coverage for August 2017
take the HCTC for coverage of qualifying
Any state-based coverage listed in
through July 2019, subject to the other
family members. You can receive the
items 4a through 4g above unless it also
general HCTC requirements. If you didn’t
HCTC for the health plan premiums of
meets the requirements of section 35(e)
have separate coverage for August, you
your qualifying family member(s) for
(2).
are eligible to receive the HCTC as a
eligible coverage months up to 24 months
A flexible spending or similar
recipient for coverage for September 2017
from the month you enrolled in Medicare,
arrangement.
through August 2019, subject to the other
or until the first coverage month that
Any insurance if substantially all of its
general HCTC requirements.
begins on or after January 1, 2020,
coverage is of excepted benefits
whichever comes first. In order to receive
Qualified Health Insurance
described in section 9832(c). For
the HCTC, your qualifying family members
example, if you purchase dental or vision
Coverage
must meet all of the requirements
benefits separately, these benefits aren’t
Qualified health insurance coverage for
described earlier.
qualified health insurance coverage. But, if
the HCTC is any of the following.
you purchase dental or vision benefits as
Married Persons Filing
part of a comprehensive package and
1. Coverage under a group health
Separate Returns
these benefits don’t represent
plan available through the employment of
substantially all of its coverage, the
Your spouse isn’t treated as a qualifying
your spouse, but see the instructions for
comprehensive package of benefits,
family member if you and your spouse file
line
1, later, for information on when
including the dental and vision benefits,
separate returns and either (1) or (2)
enrollment in or an offer of
may be qualified health insurance
below applies.
employer-sponsored coverage makes you
coverage and the premiums paid may be
an individual ineligible for the HCTC.
1. Your spouse also was an eligible
eligible for the HCTC.
TAA, ATAA, or RTAA recipient or PBGC
2. Coverage under a non-group
payee in 2018.
(individual) health insurance plan other
For more information about
than a qualified health plan offered
whether your coverage is qualified
2. All of the following apply.
TIP
through a Marketplace. Individual health
health insurance coverage, go to
a. You lived apart from your spouse
insurance doesn’t include any insurance
IRS.gov/HCTC.
during the last 6 months of 2018.
Instructions for Form 8885 (2018)
-2-
b. A qualifying family member (other
a child of divorced or separated parents
and they are otherwise eligible to take the
than your spouse) lived in your home for
but you aren’t the child’s custodial parent,
PTC and the HCTC, as applicable.
more than half of 2018.
the child isn’t your qualifying family
You also may be able to claim the
member for purposes of the HCTC.
c. You provided over half of the cost
HCTC and the PTC for different coverage
of keeping up your home.
The child also must meet all the
of the same individuals in different months
other conditions of a qualifying
!
Children of Divorced or
of the year but need to apply the following
family member defined earlier in
special instructions for completing Form
Separated Parents
CAUTION
order for you to claim the HCTC for the
8962. If you elected to take the HCTC or
qualified health insurance coverage of the
Even if you can’t claim your child as a
received the benefit of advance payments
child.
dependent, he or she is treated as your
of the HCTC for at least 1 month of the
qualifying family member for the HCTC if
year and the individual(s) covered under
Participants in a Health
both of the following apply.
the qualified health insurance coverage for
You were the child’s custodial parent.
Insurance Marketplace
the HCTC also were enrolled in a qualified
Generally, the custodial parent is the
health plan offered through a Marketplace
A qualified health plan offered through a
parent with whom the child resided for the
for at least 1 other month of the year,
Marketplace isn’t qualified health
greater number of nights in 2018. If the
complete Form 8962 as provided in the
insurance coverage for the HCTC in 2018.
counting nights rule applies, and the child
Form 8962 instructions, but:
And you can’t take the premium tax credit
resided with each parent for an equal
Figure your PTC for only those months
(PTC) for any months checked on line 1.
number of nights in 2018, the custodial
not checked on Form 8885, line 1;
However, subject to the general eligibility
parent is the parent with the higher
Complete Form 8962, column (f) of
and election rules for the HCTC and the
adjusted gross income for 2018.
lines 12 through 23, for all months for
PTC, you may be able to claim the PTC
The child’s other parent can claim the
which advance payments of the premium
and the HCTC in the same month for
child as a dependent under the rules for
tax credit (APTC) were made, even those
different coverage. For example, if you
children of divorced or separated parents.
months checked on Form 8885, line 1;
elect the HCTC for self-only COBRA
See the Instructions for Form 1040 or Pub.
and
coverage in a month, you can take the
501, Dependents, Standard Deduction,
If you complete Form 8962, line 27
PTC for the Marketplace coverage of your
and Filing Information, for details.
(Excess advance payment of PTC),
family members for that same month if you
Conversely, if you can claim your child
determine Form 8962, line 28 (Repayment
limitation), as follows.
as a dependent under the special rule for
IF . . .
THEN . . .
the amount on Form 8962, line 5, is 400 or 401
leave Form 8962, line 28, blank and enter the amount from line 27 on line 29.
the amount on Form 8962, line 24, is zero or blank
leave Form 8962, line 28, blank and enter the amount from line 27 on line 29.
you didn’t receive the benefit of advance monthly payments of the HCTC
leave Form 8962, line 28, blank and enter the amount from line 27 on line 29.
the amount on Form 8962, line 24, is greater than zero
after you complete Form 8962, line 27, complete Form 8885.
and
If you aren’t instructed to complete the
Excess Advance HCTC Repayment Worksheet
for Form 8885, line 5, add the amount from Form 8885, line 5, if any, to the applicable
you received the benefit of advance monthly payments of the HCTC for
repayment limitation provided in the instructions for Form 8962, line 28. Enter the result
at least 1 month of the year for individual(s) who were enrolled in a
on Form 8962, line 28, and complete Form 8962, line 29.
qualified health plan offered through a Marketplace for at least 1 other
month of the year
If you are instructed to complete the
Excess Advance HCTC Repayment Worksheet
for
Form 8885, line 5, complete only lines 1 and 2 of the worksheet and do one of the
following.
(1) If line 1 of the worksheet is greater than or equal to line 2 of the worksheet:
(a)
Complete line 3 of the worksheet and enter the amount on Form 8885, line 5,
and Form 1040, Form 1040NR, Form 1040-SS, or Form 1040-PR, as
instructed;
(b)
On Form 8962, line 28, enter the sum of the amount on Form 8885, line 5,
and the applicable repayment limitation provided in the instructions for Form
8962, line 28; and
(c)
Complete Form 8962, line 29.
(2) If line 1 of the worksheet is less than line 2 of the worksheet:
(a)
Complete Form 8962, lines 28 and 29, using the applicable repayment
limitation provided in the Instructions for Form 8962 without any
adjustments; and
(b)
Using this information, complete lines 4 through 7 of the worksheet as
instructed.
See the
Excess Advance HCTC Repayment Worksheet
for details.
Instructions for Form 8885 (2018)
-3-
the coverage listed under item 3, 4a, or 4e
Example 1. You checked January on
Specific Instructions
in the definition of
Qualified Health
line 1. You paid $225 ($200 for basic
Insurance
Coverage, earlier) and the
coverage and $25 for dental benefits
Line 1
employer paid any part of the cost of the
which are purchased separately) directly
coverage.
to your health plan for your January
You must elect the HCTC to receive the
coverage. The $25 you paid for dental
benefit of the HCTC. Check the box for the
Any amounts contributed to the
benefits is ineligible for the HCTC. You
first eligible coverage month you are
cost of coverage by you or your
!
would include the $200 you paid for your
electing to take the HCTC. All of the
spouse on a pre-tax basis are
basic insurance on line 2.
CAUTION
statements listed on the form, and as
considered to have been paid by the
further explained in these instructions,
Example 2. You checked December
employer.
must be true as of the first day of that
on line 1. You participated in the advance
month. You also must check the box for
Example. You had health insurance
monthly payment program and paid only
$88 (27.5%) of your $320 December
each month after the election month for
coverage under an employer-sponsored
premium to “US Treasury-HCTC.” You
which all of the statements listed on the
health insurance plan as of October 1. The
form are true as of the first day of that
employer paid 40% of the cost of the
received a Form 1099-H showing an
month, even if you aren’t claiming the
coverage. You paid 60% of the cost of the
advance payment of $232 (72.5% of the
HCTC for those months.
$320 premium) for your December
coverage through pre-tax contributions.
coverage. You wouldn’t include any part of
You can’t take the HCTC for the month of
Employer-sponsored health insurance
the December coverage premium on line 2
October because the employer is
coverage. Don’t check the box for any
considered to have paid 100% of the cost
because you already received the benefit
month that, as of the first day of the month,
of the coverage.
of the advance monthly payment program
either (1) or (2) applies.
for December. You must still file Form
Line 2
1. You were covered under any
8885 to elect the HCTC for December.
employer-sponsored health insurance
Line 5
plan (including any employer-sponsored
If your qualified health insurance
coverage covers anyone other
health insurance plan of your spouse)
!
If the resulting amount from line 5 is
than you and your qualifying
(except insurance substantially all of the
negative, zero, or blank, you can’t claim
CAUTION
family members, see Pub. 502, Medical
coverage of which is of excepted benefits
the HCTC on your income tax return.
described in section 9832(c)) and the
and Dental Expenses, before completing
However, you must still file Form 8885 to
employer paid 50% or more of the cost of
line 2, to determine which amounts are
elect the HCTC for any months you
considered to be paid for coverage for you
the coverage.
participated in the advance monthly
and your qualifying family members.
2. You were an eligible ATAA or
payment program.
RTAA recipient and either of the following
Enter the total amount of insurance
You received an excess advance
applies.
premiums paid by you for coverage for
monthly payment of the HCTC if you
you and all qualifying family members
a. You were eligible for qualified
received the benefit of an advance
under
Qualified Health Insurance
health insurance coverage (including any
monthly payment for any month not
Coverage, earlier, for all eligible coverage
employer-sponsored health insurance
checked on line 1 (see Form 1099-H) or
months checked on line 1. But don’t
plan of your spouse) (other than the
received a reimbursement of the HCTC
include any insurance premiums paid by
coverage listed under item 3, 4a, or 4e in
during the year by filing Form 14095 for
you to “US Treasury-HCTC.” Also, don’t
the definition of
Qualified Health Insurance
any month not checked on line 1. You
include any advance monthly payments
Coverage, earlier) where the employer
must reduce the amount on line 5 by the
your health plan administrator received
would have paid 50% or more of the cost
total of these payments. Use the
Excess
from the IRS, as shown on Form 1099-H,
of the coverage.
Advance HCTC Repayment Worksheet
to
box 1, or any insurance premiums you
b. You were covered under any
figure the amount of the excess advance
paid for which you received a
qualified health insurance coverage
monthly payment that you must repay.
reimbursement of the HCTC during the
(including any employer-sponsored health
year by filing Form 14095.
insurance plan of your spouse) (other than
Instructions for Form 8885 (2018)
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Excess Advance HCTC Repayment Worksheet—Line 5
1. Multiply the amount from Form 8885, line 4, by 72.5% (0.725)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.
2. Enter the total advance monthly payments of the HCTC made on your behalf for coverage for any month not checked on Form 8885, line 1 (see
Form 1099-H) and reimbursements of the HCTC you received by filing Form 14095 for any month not checked on Form 8885, line 1. If line 2 is
greater than line 1, skip line 3 and go to line 4
2.
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3. Subtract line 2 from line 1. Enter the result here and on:
Form 8885, line 5; and
Schedule 5 (Form 1040), line 74 (check box c); Form 1040NR, line 69 (check box c); Form 1040-SS, line 10; or Form 1040-PR, line 10.
Don’t complete the rest of this worksheet
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3.
4. Subtract line 1 from line 2. Enter the result here
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4.
5. Consider all the individual(s) covered under the health insurance coverage for which you received the benefit of the advance monthly payments
of the HCTC during the year. Were any of those individual(s) also enrolled in a qualified health plan offered through a Marketplace for at least 1
other month of the year?
Yes. Complete Form 8962 using the special instructions under
Participants in a Health Insurance
Marketplace, earlier. Go to line 6.
No. Skip line 6. Enter the amount from line 4 on line 7.
6. Is the amount on Form 8962, line 5, less than 400 AND the amount on Form 8962, line 24, greater than zero?
Yes.
IF . . .
THEN enter on line 6 . . .
Form 8962, line 28, is blank
the sum of Form 8962, line 26, and the
applicable repayment limitation provided in the
instructions for Form 8962, line 28.
Form 8962, line 28, isn’t blank
Form 8962, line 28, reduced by Form 8962,
line 29.
Note. If you are married filing jointly and both you and your spouse must file Forms 8885, one spouse should
figure their repayment limitation on line 6 of this worksheet. If line 6 is greater than line 7, enter the difference
on line 6 of the second spouse’s worksheet. Otherwise, enter zero on lines 6 and 7 of the second spouse’s
worksheet.
No. Leave line 6 blank. Enter the amount from line 4 on line 7.
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6.
7. If you entered an amount on line 6, enter the smaller of line 4 or line 6 here. Also enter the items below where indicated.
IF you’re filing . . .
THEN include the amount on
AND enter “HCTC” and the amount on line 7 . . .
line 7 in the total entered on . . .
Form 1040
line 11
in the space next to box 3 on line 11; then check box 3.
Form 1040NR
line 42
in the space next to box c on line 42; then check box c.
Form 1040-SS or 1040-PR
line 6
on the dotted line next to line 6.
Then, on Form 8885, line 5, enter the line 7 amount as a negative number by enclosing it in parentheses
. . . . . . . . . . . . . . .
7.
Required Documents
For PBGC eligibility—A copy of the
premium includes amounts that don’t
official letter or a copy of your 2018 Form
count towards the HCTC, such as dental
If you claim any HCTC on line 5, you must
1099-R, Distributions From Pensions,
or vision coverage or coverage for family
provide verifiable proof for each month
Annuities, Retirement or Profit-Sharing
members who aren’t eligible for the HCTC,
you are claiming the credit on line 2 that
Plans, IRAs, Insurance Contracts, etc.,
your documentation also must specify
your health insurance coverage is
from the PBGC showing you received a
those ineligible amounts.
qualified health insurance coverage for the
benefit paid by the PBGC.
3. Proof of payment for each month
HCTC and that you paid premiums for the
2. A copy of your health insurance
you are claiming the credit on line 2 such
qualified health insurance coverage by
bills or COBRA payment coupons for each
as:**
attaching the documents listed below to
month you are claiming the credit on
your Form 8885. No documents are
a. Canceled checks (copy of front and
line 2.* The bills must have:
required if you file Form 8885 only to elect
back),
the HCTC for months you participated in
a. Your name (or name of the policy
b. Bank statements,
the advance monthly payment program.
holder),
c. Credit card statements, or
b. The name of your health plan,
All health plans. For all health plans,
d. Money orders.
you must include all of the following
c. Your monthly premium amount,
documents.
**Your proof of payment must indicate
d. Dates of coverage, and
the amount paid and to whom it was paid.
1. An official letter reflecting that you
e. Your health plan identification
If you don’t have one of these types of
were an eligible individual for the months
number(s).
proof of payment, contact your health plan
claimed on line 2 in 2018.
for a record of your payment(s).
For trade certified individuals
*If your health plan doesn’t provide
demonstrating TAA, ATAA, or RTAA
members with an insurance bill or COBRA
COBRA coverage. You must include
eligibility—A copy of the official letter from
payment coupon, you must provide health
the information under
All health
plans,
the Department of Labor, your state
plan enrollment documents or an official
earlier, and one of the following
workforce agency, or employment office
letter from your health plan that has the
documents.
stating you are eligible for trade
required information listed under items 2a
adjustment benefits.
through 2e above. If your monthly
Instructions for Form 8885 (2018)
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