Form 207 Hcc Instructions
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1FORM 207 HCC INSTRUCTIONS
Line 1: Enter total net direct subscriber charges received on any
Historic Homes Credit:
Enter the allowable Historic Homes
new or renewal contract during the calendar year.
Credit allowed by the Connecticut Historical Commission.
Neighborhood Assistance Act Credit: Attach to this return a
Line 2: Enter net direct subscriber charges received on any
copy of documentation from the Department of Revenue Services
contract or policy entered into with the State of Connecticut to
approving the proposal and stating the maximum credit allowable.
provide health care coverage to state employees, retirees or their
dependents.
Employer-Assisted Housing Credit: Attach to this return a copy
of documentation from the Connecticut Housing Finance Authority
Line 3:
Enter net direct subscriber charges received on any
(CHFA) approving said credit.
contract or policy entered into with the State of Connecticut on or
after February 1, 2000, to provide health care coverage to retired
Housing Program Contribution Credit: Attach to this return a
teachers, their spouses or their surviving spouses covered by
copy of the tax credit voucher issued by CHFA.
plans offered by the State Teachers’ Retirement System.
Child Day Care Credit Carryforward: Attach to this return a
Line 4: Enter net direct subscriber charges received from the
copy of the credit approval letter issued by the Commissioner of
federal government to provide coverage for Medicare patients.
Social Services.
Line 5: Enter net direct subscriber charges received under a
Electronic Data Processing Equipment Property Tax Credit:
contract or policy entered into with the State of Connecticut to
Attach to this return a copy of Form CT-1120 EDPC and the
provide health care coverage to Medicaid recipients under the
applicable property tax bill.
Medicaid managed care program established under Conn. Gen.
Connecticut Insurance Reinvestment Fund Credit: Attach to
Stat. §17b-28.
this return a copy of the documentation from the Department of
Line 6: Enter net direct subscriber charges received under any
Economic and Community Development, a copy of CT-1120K, and
contract or policy entered into with the State of Connecticut on or
Form CT-IRF.
after April 1, 1998, to provide health care coverage to eligible
Line 15: Subtract Line 14 from Line 11. If the result is negative,
beneficiaries under the Husky Medicaid Plan, Part A; Husky Part B;
enter zero.
or the Husky Plus Programs.
Line 16: Enter prior year overpayments.
Line 7: Enter net direct subscriber charges received under any
contract or policy entered into with the State of Connecticut to
Line 17: Enter estimated payments made with Forms 207 HCC
provide health care coverage to recipients of state administered
ESA, ESB, ESC, and ESD.
general assistance.
Line 18: Enter payment made with Form 207 HCC EXT. To
Line 8: Enter net direct subscriber charges received from the
request an extension of time to file Form 207 HCC, a company
federal Employees Health Benefits Fund to provide coverage for:
must file Form 207 HCC EXT, Application for Extension of Time to
United States Government employees, retired United States
File Health Care Center Tax Return, and pay all the tax it expects
Government employees, certain former United States Government
to owe on or before March 1, 2001.
employees and eligible members of their families.
Line 19: Add Lines 16, 17, and 18.
Line 10: Subtract Line 9 from Line 1.
Line 20: If Line 19 is greater than Line 15, subtract Line 15 from
Line 11: Multiply Line 10 by 1.75% (.0175).
Line 19.
Line 12: Enter the credit for providing health care coverage under
Line 21: Complete Line 21a and Line 21b if tax was not paid on
the HUSKY Medicaid Plan, Part A; HUSKY Part B; or HUSKY Plus
or before the due date.
programs. The credit is computed by:
Line 21a: Late Payment Penalty: Multiply Line 20 by 10% (.10).
1.
Adding the number of creditable persons as of the first day
Enter the result or $50, whichever is greater.
of each month for each month in the calendar year
Line 21b: Multiply Line 20 by 1% (.01) per month or fraction of a
2.
Multiplying the number of creditable persons by $55.
month from the original due date of the return to the date of
3.
Dividing the total by 12.
payment.
The credit may not exceed the health care center tax.
Line 22: If estimated tax was underpaid, complete and attach
Form 207 I, and enter the total interest due.
Line 13: Connecticut Business Tax Credits
Line 23a: Enter the amount of overpayment you want credited
For information about Connecticut business tax credits, see
to your 2001 Health Care Center Tax.
Informational Publication 95 (2.1), Guide to Connecticut
Corporation Business Tax Credits, and Special Notice 2000(15),
Line 23b:
Enter the amount of overpayment you want
Connecticut Corporation Business Tax Credits, 1999 - 2000
refunded to you.
Update.
Line 24:
Add the tax due amount from Line 20 and the
Available Credits
amounts from Line 22 and Line 23. Enter the sum on Line 24.
The following credits may be applied against the Connecticut
Health Care Center Tax. File attachments with this return.
Make check payable to:
Commissioner of Revenue Services
Computer Donation Credit: Enter the amount approved by the
Mail to:
Department of Revenue Services
Commissioner of Revenue Services.
PO Box 2990
Hartford CT 06104-2990
Form 207 HCC Back (Rev. 12/00)
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