Table of Contents
- Future Developments
- What's New
- Electronic Filing and Payment
- Forms in Spanish
- Hiring New Employees
- Paying Wages, Pensions, or Annuities
- Information Returns
- Nonpayroll Income Tax Withholding
- Change of Business Name
- Change of Business Address or Responsible Party
- Private Delivery Services
- Telephone Help
- Ordering Employer Tax Forms and Publications
- Filing Addresses
- Dishonored Payments
- Photographs of Missing Children
For the latest information about developments related to Publication 15 (Circular E), such as legislation enacted after it was published, go to www.irs.gov/pub15.
COBRA premium assistance credit. Effective for tax periods beginning after December 31, 2013, the credit for COBRA premium assistance payments cannot be claimed on Form 941, Employer's QUARTERLY Federal Tax Return (or Form 944, Employer's ANNUAL Federal Tax Return). Instead, after filing your Form 941 (or Form 944), file Form 941-X, Adjusted Employer's QUARTERLY Federal Tax Return or Claim for Refund (or Form 944-X, Adjusted Employer's ANNUAL Federal Tax Return or Claim for Refund), respectively, to claim the COBRA premium assistance credit. Filing a Form 941-X (or Form 944-X) before filing a Form 941 (or Form 944) for the return period may result in errors or delays in processing your Form 941-X (or Form 944-X). For more information, see the Instructions for Form 941 (or the Instructions for Form 944), or visit IRS.gov and enter “COBRA” in the search box.
Social security and Medicare tax for 2015. The social security tax rate is 6.2% each for the employee and employer, unchanged from 2014. The social security wage base limit is $118,500.The Medicare tax rate is 1.45% each for the employee and employer, unchanged from 2014. There is no wage base limit for Medicare tax.Social security and Medicare taxes apply to the wages of household workers you pay $1,900 or more in cash or an equivalent form of compensation. Social security and Medicare taxes apply to election workers who are paid $1,600 or more in cash or an equivalent form of compensation.
Medicaid waiver payments. Notice 2014-7 provides that certain Medicaid waiver payments are excludable from income for federal income tax purposes. See Notice 2014-7, 2014-4 I.R.B. 445, available at www.irs.gov/irb/2014-4_IRB/ar06.html. For more information, including questions and answers related to Notice 2014-7, visit IRS.gov and enter “Medicaid waiver payments” in the search box.
Leave-based donation programs to aid victims of the Ebola Virus Disease (EVD) outbreak in Guinea, Liberia, and Sierra Leone. Under these programs, employees may donate their vacation, sick, or personal leave in exchange for employer cash payments made before January 1, 2016, to qualified tax-exempt organizations providing relief for the victims of the EVD outbreak in Guinea, Liberia, and Sierra Leone. The donated leave will not be included in the income or wages of the employee. The employer may deduct the cash payments as business expenses or charitable contributions. For more information, see Notice 2014-68, 2014-47 I.R.B. 842, available at www.irs.gov/irb/2014-47_IRB/ar11.html.
Online payment agreement. You may be eligible to apply for an installment agreement online if you have a balance due when you file your employment tax return. For more information, see the instructions for your employment tax return or visit the IRS website at www.irs.gov/payments.
Work opportunity tax credit for qualified tax-exempt organizations hiring qualified veterans extended. The work opportunity tax credit is now available for eligible unemployed veterans who began work after December 31, 2013, and before January 1, 2015. Qualified tax-exempt organizations that hire eligible unemployed veterans can claim the work opportunity tax credit against their payroll tax liability using Form 5884-C, Work Opportunity Credit for Qualified Tax-Exempt Organizations Hiring Qualified Veterans. For more information, visit IRS.gov and enter “work opportunity tax credit” in the search box.
No federal income tax withholding on disability payments for injuries incurred as a direct result of a terrorist attack directed against the United States. Disability payments for injuries incurred as a direct result of a terrorist attack directed against the United States (or its allies) are not included in income. Because federal income tax withholding is only required when a payment is includable in income, no federal income tax should be withheld from these payments.
Voluntary withholding on dividends and other distributions by an Alaska Native Corporation (ANC). A shareholder of an ANC may now request voluntary income tax withholding on dividends and other distributions paid by an ANC. A shareholder may request voluntary withholding by giving the ANC a completed Form W-4V, Voluntary Withholding Request. For more information see Notice 2013-77, 2013-50 I.R.B. 632, available at www.irs.gov/irb/2013-50_IRB/ar10.html.
Change of responsible party. Beginning January 1, 2014, any entity with an employer identification number (EIN) must file Form 8822-B, Change of Address or Responsible Party — Business, to report the latest change to its responsible party. Form 8822-B must be filed within 60 days of the change. For a definition of “responsible party,” see the Form 8822-B instructions.
Same-sex marriage. For federal tax purposes, individuals of the same sex are considered married if they were lawfully married in a state (or foreign country) whose laws authorize the marriage of two individuals of the same sex, even if the state (or foreign country) in which they now live does not recognize same-sex marriage. For more information, see Revenue Ruling 2013-17, 2013-38 I.R.B. 201, available at www.irs.gov/irb/2013-38_IRB/ar07.html. Notice 2013-61 provides special administrative procedures for employers to make claims for refunds or adjustments of overpayments of social security and Medicare taxes with respect to certain same-sex spouse benefits before expiration of the period of limitations. Notice 2013-61, 2013-44 I.R.B. 432, is available at www.irs.gov/irb/2013-44_IRB/ar10.html.
Additional Medicare Tax withholding. In addition to withholding Medicare tax at 1.45%, you must withhold a 0.9% Additional Medicare Tax from wages you pay to an employee in excess of $200,000 in a calendar year. You are required to begin withholding Additional Medicare Tax in the pay period in which you pay wages in excess of $200,000 to an employee and continue to withhold it each pay period until the end of the calendar year. Additional Medicare Tax is only imposed on the employee. There is no employer share of Additional Medicare Tax. All wages that are subject to Medicare tax are subject to Additional Medicare Tax withholding if paid in excess of the $200,000 withholding threshold.For more information on what wages are subject to Medicare tax, see the chart, Special Rules for Various Types of Services and Payments , in section 15. For more information on Additional Medicare Tax, visit IRS.gov and enter “Additional Medicare Tax” in the search box.
Outsourcing payroll duties. Employers are responsible to ensure that tax returns are filed and deposits and payments are made, even if the employer contracts with a third party to perform these acts. The employer remains responsible if the third party fails to perform any required action. If you choose to outsource any of your payroll and related tax duties (that is, withholding, reporting, and paying over social security, Medicare, FUTA, and income taxes) to a third-party payer, such as a payroll service provider (PSP) or reporting agent, visit IRS.gov and enter “outsourcing payroll duties” in the search box for helpful information on this topic. For more information on the different types of third party payer arrangements, see section 16.
Severance payments are subject to social security and Medicare taxes, income tax withholding, and FUTA tax. . Severance payments are wages subject to social security and Medicare taxes. As noted in section 15, Special Rules for Various Types of Services and Payments , severance payments are also subject to income tax withholding and FUTA tax.
You must receive written notice from the IRS to file Form 944. If you have been filing Forms 941 (or Forms 941-SS, Employer's QUARTERLY Federal Tax Return—American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, and the U.S. Virgin Islands, or Formularios 941-PR, Planilla para la Declaración Federal TRIMESTRAL del Patrono), and believe your employment taxes for the calendar year will be $1,000 or less, and you would like to file Form 944 instead of Forms 941, you must contact the IRS to request to file Form 944. You must receive written notice from the IRS to file Form 944 instead of Forms 941 before you may file this form. For more information on requesting to file Form 944, see the Instructions for Form 944.
Employers can request to file Forms 941 instead of Form 944. If you received notice from the IRS to file Form 944 but would like to file Forms 941 instead, you must contact the IRS to request to file Forms 941. You must receive written notice from the IRS to file Forms 941 instead of Form 944 before you may file these forms. For more information on requesting to file Form 941, see the Instructions for Form 944.
Federal tax deposits must be made by electronic funds transfer (EFT). You must use EFT to make all federal tax deposits. Generally, an EFT is made using the Electronic Federal Tax Payment System (EFTPS). If you do not want to use EFTPS, you can arrange for your tax professional, financial institution, payroll service, or other trusted third party to make electronic deposits on your behalf. Also, you may arrange for your financial institution to initiate a same-day wire payment on your behalf. EFTPS is a free service provided by the Department of Treasury. Services provided by your tax professional, financial institution, payroll service, or other third party may have a fee.For more information on making federal tax deposits, see How To Deposit in section 11. To get more information about EFTPS or to enroll in EFTPS, visit www.eftps.gov, or call 1-800-555-4477 or 1-800-733-4829 (TDD). Additional information about EFTPS is also available in Publication 966, Electronic Federal Tax Payment System: A Guide To Getting Started.
Aggregate Form 941 filers. Agents must complete Schedule R (Form 941), Allocation Schedule for Aggregate Form 941 Filers, when filing an aggregate Form 941. Aggregate Forms 941 may only be filed by agents approved by the IRS under section 3504 of the Internal Revenue Code. To request approval to act as an agent for an employer, the agent files Form 2678, Employer/Payer Appointment of Agent, with the IRS.
Aggregate Form 940 filers. Agents must complete Schedule R (Form 940), Allocation Schedule for Aggregate Form 940 Filers, when filing an aggregate Form 940, Employer's Annual Federal Unemployment (FUTA) Tax Return. Aggregate Forms 940 can be filed by agents acting on behalf of home care service recipients who receive home care services through a program administered by a federal, state, or local government. To request approval to act as an agent on behalf of home care service recipients, the agent files Form 2678 with the IRS.
Now, more than ever before, businesses can enjoy the benefits of filing and paying their federal taxes electronically. Whether you rely on a tax professional or handle your own taxes, the IRS offers you convenient programs to make filing and payment easier.Spend less time and worry about taxes and more time running your business. Use e-file and the Electronic Federal Tax Payment System (EFTPS) to your benefit.
Electronic funds withdrawal (EFW). If you file Form 940, Form 941, Form 944, or Form 945 electronically, you can e-file and e-pay (electronic funds withdrawal) the balance due in a single step using tax preparation software or through a tax professional. However, do not use EFW to make federal tax deposits. For more information on paying your taxes using EFW, visit the IRS website at www.irs.gov/e-pay. A fee may be charged to file electronically.
Credit or debit card payments. For information on paying your taxes with a credit or debit card, visit the IRS website at www.irs.gov/e-pay. However, do not use credit or debit cards to make federal tax deposits.
You can provide Formulario W-4(SP), Certificado de Exención de Retenciones del Empleado, in place of Form W-4, Employee's Withholding Allowance Certificate, to your Spanish-speaking employees. For more information, see Publicación 17(SP), El Impuesto Federal sobre los Ingresos (Para Personas Físicas). For nonemployees, Formulario W-9(SP), Solicitud y Certificación del Número de Identificación del Contribuyente, may be used in place of Form W-9, Request for Taxpayer Identification Number and Certification.
Eligibility for employment. You must verify that each new employee is legally eligible to work in the United States. This includes completing the U.S. Citizenship and Immigration Services (USCIS) Form I-9, Employment Eligibility Verification. You can get the form from USCIS offices or by calling 1-800-870-3676. For more information, visit the USCIS website at www.uscis.gov, or call 1-800-375-5283 or 1-800-767-1833 (TDD).
New hire reporting. You are required to report any new employee to a designated state new hire registry. A new employee is an employee who has not previously been employed by you or was previously employed by you but has been separated from such prior employment for at least 60 consecutive days.Many states accept a copy of Form W-4 with employer information added. Visit the Office of Child Support Enforcement website at www.acf.hhs.gov/programs/cse/newhire for more information.
W-4 request. Ask each new employee to complete the 2015 Form W-4. See section 9.
Name and social security number. Record each new employee's name and number from his or her social security card. Any employee without a social security card should apply for one. See section 4.
Correcting Form 941 or Form 944. If you discover an error on a previously filed Form 941 or Form 944, make the correction using Form 941-X or Form 944-X. Forms 941-X and 944-X are stand-alone forms, meaning taxpayers can file them when an error is discovered. Forms 941-X and 944-X are used by employers to claim refunds or abatements of employment taxes, rather than Form 843, Claim for Refund and Request for Abatement. See section 13 for more information.
Income tax withholding. Withhold federal income tax from each wage payment or supplemental unemployment compensation plan benefit payment according to the employee's Form W-4 and the correct withholding table. If you have nonresident alien employees, see Withholding income taxes on the wages of nonresident alien employees in section 9.Withhold from periodic pension and annuity payments as if the recipient is married claiming three withholding allowances, unless he or she has provided Form W-4P, Withholding Certificate for Pension or Annuity Payments, either electing no withholding or giving a different number of allowances, marital status, or an additional amount to be withheld. Do not withhold on direct rollovers from qualified plans or governmental section 457(b) plans. See section 9 and Publication 15-A, Employer's Supplemental Tax Guide. Publication 15-A includes information about withholding on pensions and annuities.
Zero wage return. If you have not filed a “final” Form 941 or Form 944, or are not a “seasonal” employer, you must continue to file a Form 941 or Form 944, even for periods during which you paid no wages. The IRS encourages you to file your “Zero Wage” Forms 941 or 944 electronically using IRS e-file at www.irs.gov/efile.
|Employer Responsibilities: The following list provides a brief summary of your basic responsibilities. Because the individual circumstances for each employer can vary greatly, responsibilities for withholding, depositing, and reporting employment taxes can differ. Each item in this list has a page reference to a more detailed discussion in this publication.|
|New Employees:||Page||Annually (By January 31 of the current year,||Page|
|□||Verify work eligibility of new employees||4||for the prior year):|
|□||Record employees' names and SSNs from||□||File Form 944 if required (pay tax with return if|
|social security cards||4||not required to deposit)||30|
|□||Ask employees for Form W-4||4||Annually (see Calendar for due dates):|
|Each Payday:||□||Remind employees to submit a new Form W-4|
|□||Withhold federal income tax based on each||if they need to change their withholding||20|
|employee's Form W-4||20||□||Ask for a new Form W-4 from employees|
|□||Withhold employee's share of social security||claiming exemption from income tax|
|and Medicare taxes||23||withholding||21|
|□||Deposit:||□||Reconcile Forms 941 (or Form 944) with Forms|
|• Withheld income tax||W-2 and W-3||31|
|• Withheld and employer social security taxes||□||Furnish each employee a Form W-2||8|
|• Withheld and employer Medicare taxes||25||□||File Copy A of Forms W-2 and the transmittal|
|Note:Due date of deposit generally depends||Form W-3 with the SSA||8|
|on your deposit schedule (monthly or semiweekly)||□||Furnish each other payee a Form 1099 (for example, Form 1099-MISC, Miscellaneous Income)||8|
|Quarterly (By April 30, July 31, October 31, and January 31):||□||File Forms 1099 and the transmittal Form|
|□||Deposit FUTA tax if undeposited amount||1096||8|
|is over $500||35||□||File Form 940||8|
|□||File Form 941 (pay tax with return if not||□||File Form 945 for any nonpayroll income tax|
|required to deposit)||30||withholding||8|
You may be required to file information returns to report certain types of payments made during the year. For example, you must file Form 1099-MISC, Miscellaneous Income, to report payments of $600 or more to persons not treated as employees (for example, independent contractors) for services performed for your trade or business. For details about filing Forms 1099 and for information about required electronic filing, see the General Instructions for Certain Information Returns for general information and the separate, specific instructions for each information return you file (for example, Instructions for Form 1099-MISC). Generally, do not use Forms 1099 to report wages and other compensation you paid to employees; report these on Form W-2. See the General Instructions for Forms W-2 and W-3 for details about filing Form W-2 and for information about required electronic filing. If you file 250 or more Forms 1099, you must file them electronically. If you file 250 or more Forms W-2, you must file them electronically. IRS and SSA will not accept information returns filed on magnetic media.
Information reporting customer service site. The IRS operates an information return customer service site to answer questions about reporting on Forms W-2, W-3, 1099, and other information returns. If you have questions related to reporting on information returns, call 1-866-455-7438 (toll free), 304-263-8700 (toll call), or 304-579-4827 (TDD/TTY for persons who are deaf, hard of hearing, or have a speech disability). The center can also be reached by email at firstname.lastname@example.org. Do not include tax identification numbers (TINs) or attachments in email correspondence because electronic mail is not secure.
Nonpayroll federal income tax withholding (reported on Forms 1099 and Form W-2G, Certain Gambling Winnings) must be reported on Form 945, Annual Return of Withheld Federal Income Tax. Separate deposits are required for payroll (Form 941 or Form 944) and nonpayroll (Form 945) withholding. Nonpayroll items include:
Pensions (including distributions from tax-favored retirement plans, for example, section 401(k), section 403(b), and governmental section 457(b) plans) and annuities.
Indian gaming profits.
Certain other payments, such as unemployment compensation, social security, and Tier 1 railroad retirement benefits, subject to voluntary withholding.
Payments subject to backup withholding.
For details on depositing and reporting nonpayroll income tax withholding, see the Instructions for Form 945.
All income tax withholding reported on Form W-2 must be reported on Form 941, Form 943, Employer's Annual Federal Tax Return for Agricultural Employees, Form 944, or Schedule H (Form 1040), Household Employment Taxes.
Distributions from nonqualified pension plans and deferred compensation plans. Because distributions to participants from some nonqualified pension plans and deferred compensation plans (including section 457(b) plans of tax-exempt organizations) are treated as wages and are reported on Form W-2, income tax withheld must be reported on Form 941 or Form 944, not on Form 945. However, distributions from such plans to a beneficiary or estate of a deceased employee are not wages and are reported on Forms 1099-R, Distributions From Pensions, Annuities, Retirement or Profit-Sharing Plans, IRAs, Insurance Contracts, etc.; income tax withheld must be reported on Form 945.
Backup withholding. You generally must withhold 28% of certain taxable payments if the payee fails to furnish you with his or her correct taxpayer
identification number (TIN). This withholding is referred to as “backup withholding.”
Payments subject to backup withholding include interest, dividends, patronage dividends, rents, royalties, commissions,
nonemployee compensation, payments made in settlement of payment card or third-party network transactions, and certain other
payments you make in the course of your trade or business. In addition, transactions by brokers and barter exchanges and certain
payments made by fishing boat operators are subject to backup withholding.
Keep all records of employment taxes for at least 4 years. These should be available for IRS review. Your records should include the following information.
Amounts and dates of all wage, annuity, and pension payments.
Amounts of tips reported to you by your employees.
Records of allocated tips.
The fair market value of in-kind wages paid.
Names, addresses, social security numbers, and occupations of employees and recipients.
Any employee copies of Forms W-2 and W-2c returned to you as undeliverable.
Dates of employment for each employee.
Periods for which employees and recipients were paid while absent due to sickness or injury and the amount and weekly rate of payments you or third party payors made to them.
Copies of employees' and recipients' income tax withholding allowance certificates (Forms W-4, W-4P, W-4(SP), W-4S, and W-4V).
Dates and amounts of tax deposits you made and acknowledgment numbers for deposits made by EFTPS.
Copies of returns filed and confirmation numbers.
Records of fringe benefits and expense reimbursements provided to your employees, including substantiation.
Notify the IRS immediately if you change your business name. Write to the IRS office where you file your returns, using the Without a payment address provided in the instructions for your employment tax return, to notify the IRS of any business name change. See Pub. 1635, Employer Identification Number: Understanding Your EIN, to see if you need to apply for a new EIN.
Notify the IRS immediately if you change your business address or responsible party. Complete and mail Form 8822-B to notify the IRS of a business address or responsible party change. For a definition of “responsible party,” see the Form 8822-B instructions.
You can use certain private delivery services designated by the IRS to mail tax returns and payments. The list includes only the following:
Federal Express (FedEx): FedEx Priority Overnight, FedEx Standard Overnight, FedEx 2Day, FedEx International Priority, and FedEx International First.
United Parcel Service (UPS): UPS Next Day Air, UPS Next Day Air Saver, UPS 2nd Day Air, UPS 2nd Day Air A.M., UPS Worldwide Express Plus, and UPS Worldwide Express.
For the IRS mailing address to use if you are using a private delivery service, go to IRS.gov and enter “private delivery service” in the search box.
Your private delivery service can tell you how to get written proof of the mailing date.
Help for people with disabilities. You may call 1-800-829-4059 (TDD/TTY for persons who are deaf, hard of hearing, or have a speech disability) with any tax question or to order forms and publications. You may also use this number for assistance with unresolved tax problems.
Recorded tax information (TeleTax). The IRS TeleTax service provides recorded tax information on topics that answer many individual and business federal tax questions. You can listen to up to three topics on each call you make. Touch-Tone service is available 24 hours a day, 7 days a week. TeleTax topics are also available on the IRS website at www.irs.gov/taxtopics. Most tax topics listed next are also available in Spanish. For a complete list of Teletax Topics in Spanish, visit the IRS website at www.irs.gov/Spanish/Temas-Tributarios.A list of employment tax topics is provided next. Select, by number, the topic you want to hear and call 1-800-829-4477. For the directory of all topics, select Topic 123.
|560||Additional Medicare Tax|
|751||Social Security and Medicare Withholding Rates|
|752||Form W-2—Where, When, and How to File|
|753||Form W-4—Employee's Withholding Allowance Certificate|
|755||Employer Identification Number (EIN)—How to Apply|
|756||Employment Taxes for Household Employees|
|757||Forms 941 and 944—Deposit Requirements|
|758||Form 941—Employer's QUARTERLY Federal Tax Return and Form 944—Employer's ANNUAL Federal Tax Return|
|759||Form 940—Employer's Annual Federal Unemployment (FUTA) Tax Return—Filing and Deposit Requirements|
|760||Reporting and Deposit Requirements for Agricultural Employers|
|761||Tips—Withholding and Reporting|
|762||Independent Contractor vs. Employee|
|763||The Affordable Care Act|
You can order employer tax forms and publications and information returns online at www.irs.gov/businesses. To order 2014 and 2015 forms, click on the Online Ordering for Information Returns and Employer Returns link. You may also order employer tax forms and publications and information returns by calling 1-800-TAX-FORM (1-800-829-3676).
Instead of ordering paper Forms W-2 and W-3, consider filing them electronically using the Social Security Administration's (SSA) free e-file service. Visit the SSA's Employer W-2 Filing Instructions & Information website at www.socialsecurity.gov/employer to register for Business Services Online. You will be able to create Forms W-2 online and submit them to the SSA by typing your wage information into easy-to-use fill-in fields. In addition, you can print out completed copies of Forms W-2 to file with state or local governments, distribute to your employees, and keep for your records. Form W-3 will be created for you based on your Forms W-2.
Generally, your filing address for Forms 940, 941, 943, 944, 945, and CT-1 depends on the location of your residence or principal place of business and whether or not you are including a payment with your return. There are separate filing addresses for these returns if you are a tax-exempt organization or government entity. See the separate instructions for Forms 940, 941, 943, 944, 945, or CT-1 for the filing addresses.
Any form of payment that is dishonored and returned from a financial institution is subject to a penalty. The penalty is $25 or 2% of the payment, whichever is more. However, the penalty on dishonored payments of $24.99 or less is an amount equal to the payment. For example, a dishonored payment of $18 is charged a penalty of $18.
The IRS is a proud partner with the National Center for Missing and Exploited Children. Photographs of missing children selected by the Center may appear in this publication on pages that would otherwise be blank. You can help bring these children home by looking at the photographs and calling 1-800-THE-LOST (1-800-843-5678) if you recognize a child.
The following is a list of important dates. Also see Publication 509, Tax Calendars.
This publication explains your tax responsibilities as an employer. It explains the requirements for withholding, depositing, reporting, paying, and correcting employment taxes. It explains the forms you must give to your employees, those your employees must give to you, and those you must send to the IRS and SSA. This guide also has tax tables you need to figure the taxes to withhold from each employee for 2015. References to “income tax” in this guide apply only to “federal” income tax. Contact your state or local tax department to determine if their rules are different.
Additional employment tax information is available in Publication 15-A. Publication 15-A includes specialized information supplementing the basic employment tax information provided in this publication. Publication 15-B, Employer's Tax Guide to Fringe Benefits, contains information about the employment tax treatment and valuation of various types of noncash compensation.
Most employers must withhold (except FUTA), deposit, report, and pay the following employment taxes.
Social security tax.
There are exceptions to these requirements. See section 15 for guidance. Railroad retirement taxes are explained in the Instructions for Form CT-1.
Internal Revenue Service
Tax Forms and Publications
1111 Constitution Ave. NW, IR-6526
Washington, DC 20224
Information on the receipt of the assistance eligible individuals' 35% share of the premium, including dates and amounts.
In the case of an insurance plan, a copy of invoice or other supporting statement from the insurance carrier and proof of timely payment of the full premium to the insurance carrier required under COBRA.
In the case of a self-insured plan, proof of the premium amount and proof of the coverage provided to the assistance eligible individuals.
Attestation of involuntary termination, including the date of the involuntary termination for each covered employee whose involuntary termination is the basis for eligibility for the subsidy.
Proof of each assistance eligible individual's eligibility for COBRA coverage and the election of COBRA coverage.
A record of the SSNs of all covered employees, the amount of the subsidy reimbursed with respect to each covered employee, and whether the subsidy was for one individual or two or more individuals.
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