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26 U.S.C. § 7527Advance payment of credit for health insurance costs of eligible individuals

submitted 24 years ago by Pub. L. 107-210 to r/title-26-INTERNAL-REVENUE-CODE · 640 words · no verdicts yet

in plain englishAI-generated · not legal advice

The Secretary must set up a program that pays part of some people's health insurance premiums. These "certified individuals" get up to 72.5 percent of their premium paid, month by month. The program can also pay some premiums retroactively, minus any amount a different grant already covered.

(a) Within one year after the Trade Adjustment Assistance Reauthorization Act of 2015 became law, the Secretary had to set up a program that pays "qualified health insurance" providers directly, on behalf of "certified individuals." (b) The program can pay no more than 72.5% of what the taxpayer paid for qualified health insurance covering themselves and their qualifying family members, for each "eligible coverage month" that falls in the tax year. (c) A "certified individual" is anyone who has a valid "qualified health insurance costs eligibility certificate" in effect. (d) (1) That certificate is a written statement saying someone is an "eligible individual" under section 35(c). It must include whatever information the Secretary needs, and it must be certified: by the Secretary of Labor (or someone the Secretary designates) for an "eligible TAA recipient" or "eligible alternative TAA recipient," or by the Pension Benefit Guaranty Corporation (or a designee) for an "eligible PBGC pension recipient." (2) The certificate isn't valid unless it also includes: the name, address, and phone number of the state office that helps the person enroll in qualified health insurance; a list of the coverage options the person's state treats as "qualified health insurance"; and, for a "TAA-eligible individual," a notice that the person has 63 days — starting 7 days after the certificate issues — to enroll without a gap in "creditable coverage." (e) (1) The program must also make one or more retroactive payments, again capped at 72.5% of the premium, for eligible coverage months that start after the 1-year deadline in (a) but before the person's first advance payment under (a). (2) That retroactive payment amount gets reduced by any amount the taxpayer already received for the same coverage months from a "national emergency grant" under the older version of the Workforce Investment Act.
the actual law source: uscode.house.gov ↗public domain
(a) General rule

Not later than the date that is 1 year after the date of the enactment of the Trade Adjustment Assistance Reauthorization Act of 2015, the Secretary shall establish a program for making payments on behalf of certified individuals to providers of qualified health insurance (as defined in section 35(e)) for such individuals.

(b) Limitation on advance payments during any taxable year

The Secretary may make payments under subsection (a) only to the extent that the total amount of such payments made on behalf of any individual during the taxable year does not exceed 72.5 percent of the amount paid by the taxpayer for coverage of the taxpayer and qualifying family members under qualified health insurance for eligible coverage months beginning in the taxable year.

(c) Certified individual

For purposes of this section, the term “certified individual” means any individual for whom a qualified health insurance costs credit eligibility certificate is in effect.

(d) Qualified health insurance costs eligibility certificate
(1) In general

For purposes of this section, the term “qualified health insurance costs eligibility certificate” means any written statement that an individual is an eligible individual (as defined in section 35(c)) if such statement provides such information as the Secretary may require for purposes of this section and—

(A)

in the case of an eligible TAA recipient (as defined in section 35(c)(2)) or an eligible alternative TAA recipient (as defined in section 35(c)(3)), is certified by the Secretary of Labor (or by any other person or entity designated by the Secretary), or

(B)

in the case of an eligible PBGC pension recipient (as defined in section 35(c)(4)), is certified by the Pension Benefit Guaranty Corporation (or by any other person or entity designated by the Secretary).

(2) Inclusion of certain information

In the case of any statement described in paragraph (1), such statement shall not be treated as a qualified health insurance costs credit eligibility certificate unless such statement includes—

(A)

the name, address, and telephone number of the State office or offices responsible for providing the individual with assistance with enrollment in qualified health insurance (as defined in section 35(e)),

(B)

a list of the coverage options that are treated as qualified health insurance (as so defined) by the State in which the individual resides, and

(C)

in the case of a TAA-eligible individual (as defined in section 4980B(f)(5)(C)(iv)(II)), a statement informing the individual that the individual has 63 days from the date that is 7 days after the date of the issuance of such certificate to enroll in such insurance without a lapse in creditable coverage (as defined in section 9801(c)).

(e) Payment for premiums due prior to commencement of advance payments
(1) In general

The program established under subsection (a) shall provide that the Secretary shall make 1 or more retroactive payments on behalf of a certified individual in an aggregate amount equal to 72.5 percent of the premiums for coverage of the taxpayer and qualifying family members under qualified health insurance for eligible coverage months (as defined in section 35(b)) occurring—

(A)

after the date that is 1 year after the date of the enactment of the Trade Adjustment Assistance Reauthorization Act of 2015; and

(B)

prior to the first month for which an advance payment is made on behalf of such individual under subsection (a).

(2) Reduction of payment for amounts received under national emergency grants

The amount of any payment determined under paragraph (1) shall be reduced by the amount of any payment made to the taxpayer for the purchase of qualified health insurance under a national emergency grant pursuant to section 173(f) of the Workforce Investment Act of 1998 (as in effect on the day before the date of enactment of the Workforce Innovation and Opportunity Act) for a taxable year including the eligible coverage months described in paragraph (1).

Source credit: (Added Pub. L. 107–210, div. A, title II, § 202(a), Aug. 6, 2002, 116 Stat. 960; amended Pub. L. 111–5, div. B, title I, §§ 1899A(a)(2), 1899B(a), 1899H(a), Feb. 17, 2009, 123 Stat. 424, 430; Pub. L. 111–344, title I, §§ 111(b), 112(a), 118(a), Dec. 29, 2010, 124 Stat. 3615, 3616; Pub. L. 112–40, title II, § 241(b)(2), Oct. 21, 2011, 125 Stat. 418; Pub. L. 113–128, title V, § 512(r), July 22, 2014, 128 Stat. 1712; Pub. L. 114–27, title IV, § 407(c), June 29, 2015, 129 Stat. 382.)

history & why it existsrecord from the source credit
  • 2002Enacted · Pub. L. 107-210 · 116 Stat. 960
  • 2009Amended · Pub. L. 111-5 · 123 Stat. 424, 430
  • 2010Amended · Pub. L. 111-344 · 124 Stat. 3615, 3616
  • 2011Amended · Pub. L. 112-40 · 125 Stat. 418
  • 2014Amended · Pub. L. 113-128 · 128 Stat. 1712
  • 2015Amended · Pub. L. 114-27 · 129 Stat. 382

A history note hasn’t been published yet. The record shows enactment by Pub. L. 107-210 on 2002-08-06.

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