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The Monthly HCTC complete the registration form 3 3 6 To apply for the monthly HCTC, complete and mail the Registration Form that came with this Program Kit. The HCTC Program will review it and enroll you, if you are eligible. You receive an HCTC invoice, and send 20% of your health insurance premium to the HCTC Program by the due date each month. you pay 20% 6 HCTC The HCTC Program adds 80% to your payment. HCTC adds 80% 6 The HCTC Program sends a payment for 100% of your premium to your health plan. your health plan receives 100% 12

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