Instructions for Form 8941 (2017)

Credit for Small Employer Health Insurance Premiums

Section references are to the Internal Revenue Code unless otherwise noted.

2017


Instructions for Form 8941 - Introductory Material

Future Developments

For the latest information about developments related to Form 8941 and its instructions, such as legislation enacted after they were published, go to IRS.gov/Form8941.

What’s New

Employers in Hawaii cannot claim this credit for insurance premiums paid for health plan years beginning after 2016. For more information, see Waiver for Hawaii in the Line A instructions.

General Instructions

Purpose of Form

Eligible small employers (defined below) use Form 8941 to figure the credit for small employer health insurance premiums for tax years beginning after 2009. For tax years beginning after 2013, the credit is only available for a 2-consecutive-tax-year credit period. The maximum credit is generally a percentage of premiums the employer paid during the tax year for certain health insurance coverage the employer provided to certain employees enrolled in a qualified health plan offered through a Small Business Health Options Program (SHOP) Marketplace. But the credit may be reduced by limitations based on the employer's full-time equivalent employees, average annual wages, adjusted average premiums, and state premium subsidies and tax credits.

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For information about insurance plans offered through a SHOP Marketplace, visit Healthcare.gov.

For tax-exempt eligible small employers, the maximum credit is 35% of premiums paid, is limited to the amount of certain payroll taxes paid, and is claimed as a refundable credit on Form 990-T, Exempt Organization Business Income Tax Return. A tax-exempt eligible small employer is an eligible small employer described in section 501(c) that is exempt from taxation under section 501(a). A tax-exempt employer not described in section 501(c) is generally not eligible to claim this credit. However, a tax-exempt farmers' cooperative subject to tax under section 1381 may be able to claim the credit as a general business credit as discussed next.

For all other eligible small employers, the maximum credit is 50% of premiums paid, can be taken against both regular and alternative minimum tax, and is claimed as part of the general business credit on Form 3800.

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Partnerships, S corporations, cooperatives, estates, trusts, and tax-exempt eligible small employers must file this form to claim the credit. All other taxpayers must not complete or file this form if their only source for this credit is a partnership, S corporation, cooperative, estate, or trust. Instead, they must report this credit directly on line 4h in Part III of Form 3800, General Business Credit.

Eligible Small Employers

You are an eligible small employer for the tax year if you meet the following three requirements.

1. You paid premiums for employee health insurance coverage under a qualifying arrangement.

A qualifying arrangement is generally an arrangement that requires you to pay a uniform percentage (not less than 50%) of the premium cost for each enrolled employee's health insurance coverage (defined later). However, an arrangement that requires you to pay a uniform premium for each enrolled employee (composite billing) and offers different tiers of coverage (for example, employee-only, dependent, and family coverage) can be a qualifying arrangement even if it requires you to pay a uniform percentage that is less than 50% of the premium cost for employees not enrolled in employee-only coverage.

In addition, an arrangement that requires you to pay a separate premium for each employee based on age or other factors (list billing) can be a qualifying arrangement even if it requires you to pay a uniform percentage that is less than 50% of the premium cost for some employees.

For details, see Employer Premiums Paid, Health Insurance Coverage, and Qualifying Arrangement, later.

2. You had fewer than 25 full-time equivalent employees (FTEs) for the tax year.

You may be able to meet this requirement even if you had 25 or more employees. For details, see Worksheets 1 and 2.

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Although the term "eligible small employer" is defined in the Internal Revenue Code to include employers with "no more than" 25 FTEs, the phase out of the credit amount operates in such a way that an employer with exactly 25 FTEs is not in fact eligible for the credit.

3. You paid average annual wages for the tax year of less than $53,000 per FTE.

For details, see Worksheets 1 and 3.

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If you had more than 10 FTEs and average annual wages of more than $26,000, the FTE and average annual wage limitations (discussed later) will separately reduce your credit. This may reduce your credit to zero even if you had fewer than 25 FTEs and average annual wages of less than $53,000.

Employers treated as a single employer.

Treat the following employers as a single employer to figure the credit.

  • Employers who are corporations in a controlled group of corporations.

  • Employers who are members of an affiliated service group.

  • Employers who are partnerships, proprietorships, etc., under common control. See Regulations sections 1.414(c)-2, 1.414(c)-3, and 1.414(c)-4.

  • Tax-exempt employers under common control. See Regulations section 1.414(c)-5.

 

For details, see section 45R(e)(5)(A) and Regulations section 1.45R-2(b).

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No more than one Form 8941 can be filed with a tax return, unless the exception described in Example 2 below applies.

 

Example 1.

You are a sole proprietor with two separate businesses and you file a separate Schedule C (Form 1040) for each business. You must treat both businesses as a single employer to figure the credit. You will file one Form 8941 for both businesses.

 

Example 2.

You and your spouse are both sole proprietors and file a separate Schedule C (Form 1040) for each of your separate businesses. Neither spouse was an employee of the other spouse or participated in the management of the other spouse's business at any time during the tax year. No more than 50% of the gross income of either business was derived from royalties, rents, dividends, interest, and annuities and you otherwise meet the requirements listed in Regulations section 1.414(c)-4(b)(5)(ii). Don’t treat both businesses as a single employer to figure the credit. If you and your spouse are both eligible small employers, you can file two Forms 8941 with a jointly filed Form 1040.

 

Credit Period

For tax years beginning after 2013, the credit period during which the credit can be claimed is a 2-consecutive-tax-year period beginning with the first tax year in which:

  • An eligible small employer (or any predecessor) files an income tax return with an attached Form 8941 with line A checked "Yes" and a positive amount on line 12, or

  • A tax-exempt eligible small employer (or any predecessor) files Form 990-T with an attached Form 8941 with line A checked "Yes" and a positive amount on line 12.

 

Employer Premiums Paid

Only premiums you paid for health insurance coverage under a qualifying arrangement (discussed later) for individuals considered employees are counted when figuring your credit.

State premium subsidy or tax credit.

If you are entitled to a state tax credit or a state premium subsidy paid directly to you for premiums you paid, don’t reduce the amount you paid by the credit or subsidy amount. Also, if a state pays a premium subsidy directly to your insurance provider, treat the subsidy amount as an amount you paid for employee health insurance coverage.

Wellness programs.

A wellness program is generally an insurance program of health promotion or disease prevention. If you pay part or all of the cost of an employee's participation in a wellness program, use the amount you paid to figure your employer premiums paid.

Tobacco surcharges.

A tobacco surcharge is generally an additional amount charged for insurance for a tobacco user. If you pay part or all of an employee's tobacco surcharge, you can’t use the amount you paid to figure your employer premiums paid.

Dependent coverage.

Dependent coverage is generally coverage offered separately to an individual who is or may become eligible for coverage under the terms of a group health plan because of a relationship to a participant-employee, whether or not a dependent of the participant-employee. Dependent coverage doesn’t include coverage, such as family coverage, which includes coverage of the participant-employee. If you pay part or all of the cost of an employee's dependent coverage, use the amount you paid to figure your employer premiums paid.

Portion of premiums paid.

If you pay only a portion of the premiums and your employees pay the rest, only the portion you pay is taken into account. For this purpose, any premium paid through a salary reduction arrangement under a section 125 cafeteria plan isn’t treated as an employer paid premium. For more information on cafeteria plans, see section 1 of Pub. 15-B, Employer's Tax Guide to Fringe Benefits.

Example 3.

You offer health insurance coverage to employees under a qualifying arrangement that requires you to pay 60% of the premium cost for employee-only coverage for each employee enrolled in any health insurance coverage you provide to employees. The total premium for each employee enrolled in employee-only coverage is $5,200 per year or $100 ($5,200 ÷ 52) for each weekly payday. The total premium for each employee enrolled in family coverage is $13,000 per year or $250 ($13,000 ÷ 52) for each weekly payday.

Each payday you contribute $60 (60% of $100) toward the premium cost of each employee enrolled in employee-only coverage and withhold the remaining $40 from the employee's paycheck to obtain the $100 total weekly premium. Each payday you contribute $60 (the same amount you pay toward the premiums of employees enrolled in employee-only coverage) toward the premium cost of each employee enrolled in family coverage and withhold the remaining $190 from the employee's paycheck to obtain the $250 total weekly premium.

To determine the premiums you paid during the tax year, multiply the number of pay periods during which the employee was enrolled in the health insurance coverage by $60. For example, you would have paid $3,120 ($60 × 52) for an employee who was enrolled for the entire tax year. You would have paid $600 ($60 × 10) for an employee who was only enrolled for 10 pay periods. You will need an additional set of calculations if the premium amounts changed during the tax year.

Health Insurance Coverage

For tax years beginning after 2013, health insurance coverage generally means coverage provided to employees enrolled in a qualified health plan offered through a Small Business Health Options Program (SHOP) Marketplace. For an exception that applies to certain employers in Wisconsin, see the Line A instructions, later. If this exception applies, health insurance coverage means coverage as defined under Health Insurance Coverage in the 2013 Instructions for Form 8941.

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A stand-alone dental plan offered through a SHOP exchange will be considered a qualified health plan for purposes of the credit.

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Employer premiums paid for health insurance coverage can be counted in figuring the credit only if the premiums are paid under a qualifying arrangement.

Qualifying Arrangement

A qualifying arrangement is generally an arrangement that requires you to pay a uniform percentage (not less than 50%) of the premium cost for each enrolled employee's health insurance coverage (defined earlier). An arrangement that offers different tiers of coverage (for example, employee-only and family coverage) is generally a qualifying arrangement if it requires you to pay a uniform percentage (not less than 50%) separately for each tier of coverage you offer. However, an arrangement can be a qualifying arrangement even if it requires you to pay a uniform percentage that is less than 50% of the premium cost for some employees.

For more information about the following exceptions, see Regulations section 1.45R-4.

State or local law.

You will be treated as satisfying the uniform percentage requirement if your failure to otherwise satisfy the requirement was solely attributable to additional contributions you made to certain employees to comply with state or local law.

Wellness program.

If a plan of an employer provides a wellness program, for purposes of meeting the uniform percentage requirement any additional amount of the employer contribution attributable to an employee's participation in the wellness program over the employer contribution with respect to an employee that doesn’t participate in the wellness program is not taken into account in calculating the uniform percentage requirement, whether the difference is due to a discount for participation or a surcharge for nonparticipation. The employer contribution for employees who don’t participate in the wellness program must be at least 50% of the premium (including any premium surcharge for nonparticipation). However, for purposes of figuring the credit, the employer contributions are taken into account, including those contributions attributable to an employee's participation in a wellness program.

Tobacco surcharge.

Any additional amount you or your employee pay to cover a tobacco surcharge isn’t taken into account in figuring the uniform percentage requirement. Amounts you or your employee pay to cover a tobacco surcharge aren’t considered premiums paid for health insurance coverage when figuring this credit.

Dependent coverage.

Premiums you pay for dependent coverage aren’t subject to the uniform percentage requirement. You aren’t required to pay a uniform percentage (not less than 50%) for dependent coverage.

Arrangements with composite billing.

An arrangement that requires you to pay a uniform premium for each enrolled employee (composite billing) and offers different tiers of coverage can be a qualifying arrangement even if it requires you to pay a uniform percentage that is less than 50% of the premium cost for employees not enrolled in employee-only coverage. It is a qualifying arrangement (assuming employee-only coverage is the least expensive tier of coverage) if it requires you to pay the following amounts.

  • A uniform percentage (not less than 50%) of the premium cost for each employee (if any) enrolled in employee-only coverage.

  • A uniform amount that is no less than the amount you would have paid toward employee-only coverage for each employee (if any) enrolled in family coverage.

  • A uniform amount that is no less than the amount you would have paid toward employee-only coverage for each employee (if any) enrolled in any other tier of coverage (figured separately for each tier).

 

Arrangements with list billing and only employee-only coverage.

An arrangement that requires you to pay a separate premium for each employee based on age or other factors (list billing) that only provides employee-only coverage can be a qualifying arrangement even if it requires you to pay a uniform percentage that is less than 50% of the premium cost for some employees. It is a qualifying arrangement if it requires you to pay either of the following amounts.

  • A uniform percentage (not less than 50%) of the premium charged for each employee enrolled in the employee-only coverage.

  • A uniform percentage (not less than 50%) of your employer-computed composite rate (defined later) for your employee-only coverage for each employee enrolled in the employee-only coverage.

 

Arrangements with list billing and other tiers of coverage.

An arrangement that requires you to pay a separate premium for each employee based on age or other factors (list billing) that provides other tiers of coverage can be a qualifying arrangement even if it requires you to pay a uniform percentage that is less than 50% of the premium cost for some employees. It is a qualifying arrangement (assuming employee-only coverage is the least expensive tier of coverage) if it requires you to pay the following amounts.

  • A uniform percentage (not less than 50%) for each employee enrolled in employee-only coverage as discussed under Arrangements with list billing and only employee-only coverage above.

  • A uniform amount that is either equal to the amount you would have paid toward employee-only coverage (as discussed above), a uniform percentage (not less than 50%) of the premium charged, or a uniform percentage (not less than 50%) of your employer-computed composite rate (defined below) for your family coverage, for each employee (if any) enrolled in family coverage.

  • A uniform amount that is either equal to the amount you would have paid toward employee-only coverage (as discussed above), a uniform percentage (not less than 50%) of the premium charged, or a uniform percentage (not less than 50%) of your employer-computed composite rate (defined below) for any other tier of coverage, for each employee (if any) enrolled in any other tier of coverage (figured separately for each tier).

 

Employer-computed composite rate.

The employer-computed composite rate for a tier of coverage is the average rate determined by adding the premiums for that tier of coverage for all employees eligible to participate in the health insurance plan (whether or not they actually receive coverage under the plan or under that tier of coverage) and dividing by the total number of such eligible employees.

More than one plan.

Different types of health insurance plans are generally not aggregated for purposes of meeting the qualifying arrangement requirement. For example, if you offer a major medical insurance plan and a stand-alone vision plan, you generally must separately satisfy the requirements for a qualifying arrangement with respect to each type of coverage. For exceptions, see Regulations section 1.45R-4(c).

State subsidies and credits.

For this purpose, if you are entitled to a state tax credit or a state premium subsidy paid directly to you for premiums you paid, don’t reduce the amount you paid by the credit or subsidy amount. Also, if a state pays a premium subsidy directly to your insurance provider, treat the subsidy amount as an amount you paid for employee health insurance coverage.

State Premium Subsidy and Tax Credit Limitation

Your credit may be reduced if you are entitled to a state tax credit or a state premium subsidy for the cost of health insurance coverage you provide under a qualifying arrangement to individuals considered employees. The state tax credit may be refundable or nonrefundable and the state premium subsidy may be paid to you or directly to your insurance provider.

Although a state tax credit or premium subsidy paid directly to you doesn’t reduce the amount of your employer premiums paid, and although a state premium subsidy paid directly to an insurance provider is treated as an employer premium you paid, the amount of your credit can’t be more than your net premium payments.

Net premium payments are employer premiums paid (discussed earlier) minus the amount of any state tax credits you received or will receive and any state premium subsidies paid either to you or directly to your insurance provider for premiums for health insurance coverage you provide under a qualifying arrangement to individuals considered employees.

Payroll Tax Limitation for Tax-Exempt Eligible Small Employers

The credit for tax-exempt eligible small employers can’t exceed the amount of certain payroll taxes. For tax years beginning in 2017, payroll taxes, for this purpose, mean only the following taxes.

  • Federal income taxes the tax-exempt employer was required to withhold from employees' wages in calendar year 2017.

  • Medicare taxes the tax-exempt employer was required to withhold from employees' wages in calendar year 2017.

  • Medicare taxes the tax-exempt employer was required to pay for calendar year 2017.

 

Premium Deduction Reduced

You must reduce your deduction for the cost of providing health insurance coverage to your employees by the amount of any credit for small employer health insurance premiums allowed with respect to the coverage.

More Information

For more information about this credit, see the following.

 

Specific Instructions

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Partnerships, S corporations, cooperatives, estates, trusts, and tax-exempt eligible small employers must file this form to claim the credit. All other taxpayers must not complete or file this form if their only source for this credit is a partnership, S corporation, cooperative, estate, or trust. Instead, they must report this credit directly on line 4h in Part III of Form 3800.

Use Worksheets 1 through 7 to figure the amounts to report on various lines of Form 8941.

  • Use Worksheets 1, 2, and 3 to figure the amounts to report on lines 1, 2, and 3 of Form 8941.

  • Use Worksheet 4 to figure the amounts to report on lines 4, 5, and 13 of Form 8941.

  • Use Worksheets 5, 6, and 7 to figure the amounts to report on lines 8, 9, and 14 of Form 8941.

 

Line A

Answer "Yes" if one of the following applies.

  • You paid premiums for employee health insurance coverage you provided through a SHOP Marketplace or through a direct enrollment process, if available in your state.

  • You qualify for an exception to this requirement as discussed below.

 

If you answer "Yes" because you paid premiums for employee health insurance coverage you provided through a SHOP Marketplace, enter the Marketplace identifier, if any.

If you answer "No," don’t file Form 8941 unless you are filing it for a partnership, S corporation, cooperative, estate, trust, or tax-exempt eligible small employer that received from another entity a credit that must be reported on line 15. For more information, see the instructions for line 15.

Waiver for Hawaii.

Hawaii has received a 5-year State Innovation Waiver under section 1332 of the Affordable Care Act. Employers in Hawaii cannot participate in the SHOP Marketplace or claim the credit for insurance premiums paid for health plan years beginning after 2016. However, certain employers with a 2016 health plan year that continues into 2017 can claim the credit for part of their tax year beginning in 2017. For more information on the waiver, visit CMS.gov.

Exception for certain employers in Wisconsin.

For calendar year 2016, SHOP Marketplaces in certain counties of Wisconsin did not have qualified health plans available for employers to offer to employees. Transition relief allows employers with a principal business address in the counties listed below to claim the credit for their tax year beginning in 2016. Certain employers with a 2016 health plan year that continues into 2017 can claim the credit for part of their tax year beginning in 2017. For details, see Notice 2016-75, 2016-51 I.R.B. 832, available at IRS.gov/IRB/2016-51_IRB#NOT-2016-75.

Wisconsin:

Pierce, Polk, and St. Croix counties.

Line C

Answer "Yes" if a tax return you (or any predecessor) filed for a tax year beginning in 2014 or 2015 included a Form 8941 with line A checked "Yes" and line 12 showing a positive amount. For more information, see Credit Period, earlier.

If you answer "Yes," do not file Form 8941 unless you are filing it for a partnership, S corporation, cooperative, estate, trust, or tax-exempt eligible small employer that received from another entity a credit that must be reported on line 15. An entity that qualifies for this exception should not report any amount on line 12 . For more information, see the instructions for line 15.

 

Worksheet 1. Information Needed To Complete Line 1 and Worksheets 2 and 3

 

If you need more rows, use a separate sheet and include the additional amounts in the totals below.

 

(a)
Individuals
Considered
Employees
(b)
Employee
Hours of
Service
(c)
Employee
Wages
Paid
1.    
2.    
3.    
4.    
5.    
6.    
7.    
8.    
9.    
10.    
11.    
12.    
13.    
14.    
15.    
16.    
17.    
18.    
19.    
20.    
21.    
22.    
23.    
24.    
25.    


Totals:
   

 

Column (a), Individuals Considered Employees

Enter the name or other identifying information for all individuals considered employees for purposes of this credit.

In general, all employees who perform services for you during the tax year are taken into account in determining your FTEs, average annual wages, and premiums paid. Rules that apply to certain types of employees are discussed below.

Excluded employees.

The following individuals aren’t considered employees when you figure this credit. Hours and wages of these employees and premiums paid for them aren’t counted when you figure your credit.

  • The owner of a sole proprietorship.

  • A partner in a partnership.

  • A shareholder who owns (after applying the section 318 constructive ownership rules) more than 2% of an S corporation.

  • A shareholder who owns (after applying the section 318 constructive ownership rules) more than 5% of the outstanding stock or stock possessing more than 5% of the total combined voting power of all stock of a corporation that is not an S corporation.

  • A person who owns more than 5% of the capital or profits interest in any other business that isn’t a corporation.

  • Family members or a member of the household who is not a family member but qualifies as a dependent on the individual income tax return of a person listed above. Family members include a child (or descendant of a child), a sibling or step-sibling, a parent (or ancestor of a parent), a step-parent, a niece or nephew, an aunt or uncle, or a son-in-law, daughter-in-law, father-in-law, mother-in-law, brother-in-law, or sister-in-law. A spouse of any owner or family member listed above is also considered a family member for this purpose.

 

Former employees.

Premiums paid on behalf of a former employee with no hours of service may be treated as paid on behalf of an employee for purposes of figuring the credit provided that, if so treated, the former employee is also treated as an employee for purposes of the uniform percentage requirement.

Leased employees.

Don’t use premiums paid by the leasing organization to figure your credit. Also, a leased employee who isn’t a common law employee is considered an employee for credit purposes if he or she does all the following.

  • Provides services to you under an agreement between you and a leasing organization.

  • Has performed services for you (or for you and a related person) substantially full time for at least 1 year.

  • Performs services under your primary direction or control.

 

But don’t use hours, wages, or premiums paid with respect to the initial year of service on which leased employee status is based.

Seasonal employees.

Employees who perform labor or services on a seasonal basis and perform labor or services for you 120 or fewer days during the tax year aren’t considered employees in determining FTEs and average annual wages. But premiums paid on their behalf are counted in determining the amount of the credit. Seasonal workers include retail workers employed exclusively during holiday seasons. Seasonal workers also include workers employed exclusively during the summer.

Household and other nonbusiness employees.

Household employees and other employees who aren’t performing services in your trade or business are considered employees if they otherwise qualify as discussed above. A sole proprietor must include both business and nonbusiness employees to determine FTEs, average annual wages, and premiums paid.

Ministers.

A minister performing services in the exercise of his or her ministry is treated as self-employed for social security and Medicare purposes. However, for credit purposes, whether a minister is an employee or self-employed is determined under the common law test for determining worker status. Self-employed ministers aren’t considered employees.

Column (b), Employee Hours of Service

Enter the total hours of service for the tax year for each employee listed in column (a). Don’t enter more than 2,080 hours for any employee. But enter -0- for seasonal employees who worked 120 or fewer days during the tax year.

Employee hours of service.

An employee’s hours of service for a year include the following.

  • Each hour for which the employee is paid, or entitled to payment, for the performance of duties for the employer during the employer’s tax year.

  • Each hour for which an employee is paid, or entitled to payment, by the employer on account of a period of time during the employer's tax year during which no duties are performed due to vacation, holiday, illness, incapacity (including disability), layoff, jury duty, military duty, or leave of absence (except that no more than 160 hours of service are required to be counted for an employee on account of any single continuous period during which the employee performs no duties).

 

To figure the total number of hours of service you must take into account for an employee for the year, you can use any of the following methods.

Actual hours worked method.

Determine actual hours of service from records of hours worked and hours for which payment is made or due (payment is made or due for vacation, holiday, illness, incapacity, etc., as described above).

Days-worked equivalency method.

Use a days-worked equivalency whereby the employee is credited with 8 hours of service for each day for which the employee would be required to be credited with at least one hour of service under the rules described above.

Weeks-worked equivalency method.

Use a weeks-worked equivalency whereby the employee is credited with 40 hours of service for each week for which the employee would be required to be credited with at least one hour of service under the rules described above.

Column (c), Employee Wages Paid

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Complete Worksheet 2 before you complete column (c) of Worksheet 1. Do not complete column (c) if Worksheet 2, line 3, is 25 or more.

Enter the total wages paid for the tax year for each employee listed in column (a). But enter -0- for seasonal employees who worked 120 or fewer days during the tax year.

Wages, for this purpose, mean wages subject to social security and Medicare tax withholding determined without considering any wage base limit.

 

Worksheet 2. Information Needed To Complete Line 2 (FTEs)

 

Your credit is reduced if you had more than 10 full-time equivalent employees (FTEs) for the tax year. If you had 25 or more FTEs for the tax year, your credit is reduced to zero.

 

1. Enter the total employee hours of service from Worksheet 1, column (b) 1.  
2. Hours of service per FTE 2. 2,080
3. Full-time equivalent employees. Divide line 1 by line 2. If the result is not a whole number (0, 1, 2, etc.), generally round the result down to the next lowest whole number. For example, round 2.99 down to 2. However, if the result is less than one, enter 1. Report this number on Form 8941, line 2 3.  

 

 

Worksheet 3. Information Needed To Complete Line 3 (Average Annual Wages)

 

Your credit is reduced if you paid average annual wages of more than $26,000 for the tax year. If you paid average annual wages of $53,000 or more for the tax year, your credit is reduced to zero.

 

1. Enter the total employee wages paid from Worksheet 1, column (c) 1.  
2. Enter FTEs from Worksheet 2, line 3 2.  
3. Average annual wages. Divide line 1 by line 2. If the result is not a multiple of $1,000 ($1,000, $2,000, $3,000, etc.), round the result down to the next lowest multiple of $1,000. For example, round $2,999 down to $2,000. Report this amount on Form 8941, line 3 3.  

 

 

Worksheet 4. Information Needed To Complete Lines 4, 5, and 13 and Worksheet 7

 

If you need more rows, use a separate sheet and include the additional amounts in the totals below.

 

(a)
Enrolled
Individuals
Considered
Employees
(b)
Employer
Premiums
Paid
(c)
Adjusted
Average
Premiums
(d)
Enrolled
Employee
Hours of
Service
1.      
2.      
3.      
4.      
5.      
6.      
7.      
8.      
9.      
10.      
11.      
12.      
13.      
14.      
15.      
16.      
17.      
18.      
19.      
20.      
21.      
22.      
23.      
24.      
25.      


Totals:
     

 

Column (a), Enrolled Individuals Considered Employees

Enter the name or other identifying information for each individual listed in column (a) of Worksheet 1 who was enrolled in health insurance coverage you provided to employees during the tax year under a qualifying arrangement. For details, see Health Insurance Coverage and Qualifying Arrangement, earlier.

Column (b), Employer Premiums Paid

Enter the total employer premiums paid for the tax year for each employee listed in column (a). For details, see Employer Premiums Paid, earlier.

Column (c), Adjusted Average Premiums

Your credit is reduced if the employer premiums paid are more than the employer premiums that would have been paid if individuals considered employees were enrolled in a plan with a premium equal to the average premium for the small group market in the rating area in which the employee enrolls for coverage.

The rating area in which an employee enrolls for coverage is generally the rating area where your business is located (based on your primary business address). You will generally have selected a plan in your rating area that covers all employees located within or outside your rating area. However, if you have multiple businesses or operations in multiple states, and have set up plans in more than one SHOP Marketplace, the average premiums may be different for employees enrolled in each SHOP Marketplace.

Enter, for each employee listed in column (a), the premiums you would have paid if the employee had enrolled in a plan or plans with a total premium equal to the average premium for the small group market in the rating area in which the employee enrolls for coverage.

To find the average premium for the small group market in a rating area for tax years beginning in 2017, see the average premium tables at the end of these instructions. Family coverage includes any coverage other than employee-only coverage.

Example 4.

Assume the same facts that were used in Example 3. The $60 you contribute each payday toward employee health insurance coverage is 60% ($60 ÷ $100) of the weekly premium for each employee enrolled in employee-only coverage and 24% ($60 ÷ $250) of the weekly premium for each employee enrolled in family coverage.

In this situation, the total average premium limitation amounts that apply are 60% of the applicable average premium amounts for each employee enrolled in employee-only coverage and 24% of the applicable average premium amounts for each employee enrolled in family coverage.

You have an employee enrolled in employee-only coverage who enrolled for coverage in your local rating area. The applicable employee-only average premium amount for the rating area is $4,940 or $95 ($4,940 ÷ 52) for each weekly payday. The amount you would have paid toward this employee's health insurance coverage based on the average premiums is $57 (60% of $95) each payday.

To determine the premiums you would have paid for this employee during the tax year if the employee had enrolled in an average premium plan, multiply the number of pay periods during which your employee was enrolled in the health insurance coverage by $57. For example, you would have paid $2,964 ($57 × 52) if the employee was enrolled for the entire tax year. You would have paid $570 ($57 × 10) if the employee was only enrolled for 10 pay periods. You will need an additional set of calculations if the premium amounts changed during the tax year.

Column (d), Enrolled Employee Hours of Service

This is an Image: caution.gif

 

Don’t complete column (d) of Worksheet 4 if Form 8941, line 12, is zero.

Enter the amount from column (b) of Worksheet 1 for each employee listed in column (a) of Worksheet 4.

 

Worksheet 5. Information Needed To Complete Line 8 (If Line 2 is More Than 10)

1. Enter the amount from Form 8941, line 7 1.  
2. Enter the number from Form 8941, line 2 2.      
3. Subtract 10 from line 2 3.      
4. Divide line 3 by 15. Enter the result as a decimal (rounded to at least 3 places) 4.      
5. Multiply line 1 by line 4 5.  
6. Subtract line 5 from line 1. Report this amount on Form 8941, line 8 6.  

 

 

Worksheet 6. Information Needed To Complete Line 9 (If Line 3 is More Than $26,000)

1. Enter the amount from Form 8941, line 8 1.  
2. Enter the amount from Form 8941, line 7 2.      
3. Enter the amount from Form 8941, line 3 3.      
4. Subtract $26,200 from line 3 4.      
5. Divide line 4 by $26,200. Enter the result as a decimal (rounded to at least 3 places) 5.      
6. Multiply line 2 by line 5 6.  
7. Subtract line 6 from line 1. Report this amount on Form 8941, line 9 7.  

 

Line 10

Enter the total amount of any state premium subsidies paid and any state tax credits available to you for premiums included on line 4. For details, see State Premium Subsidy and Tax Credit Limitation, earlier.

 

Worksheet 7. Information Needed To Complete Line 14 (If Line 12 is More Than Zero)

1. Enter the total enrolled employee hours of service from Worksheet 4, column (d) 1.  
2. Hours of service per FTE 2. 2,080
3. Divide line 1 by line 2. If the result is not a whole number (0, 1, 2, etc.), generally round the result down to the next lowest whole number. For example, round 2.99 down to 2. However, if the result is less than one, enter 1. Report this number on Form 8941, line 14 3.  

 

Line 15

Enter any credit for small employer health insurance premiums from:

  • Schedule K-1 (Form 1065), box 15 (code P);

  • Schedule K-1 (Form 1120S), box 13 (code P);

  • Schedule K-1 (Form 1041), box 13 (code G); and

  • Form 1099-PATR, Taxable Distributions Received From Cooperatives, box 10, or other notice of credit allocation.

 

This is an Image: taxtip.gif

 

Partnerships, S corporations, cooperatives, estates, trusts, and tax-exempt eligible small employers always must report the above credits on line 15. All other filers figuring a separate credit on earlier lines also must report the above credits on line 15. All others not using earlier lines to figure a separate credit must report the above credits directly on Form 3800, Part lll, line 4h.

Line 17

Cooperatives.

A cooperative described in section 1381(a) must allocate to its patrons the credit in excess of its tax liability. Therefore, to figure the unused amount of the credit allocated to patrons, the cooperative must first figure its tax liability. While any excess is allocated to patrons, any credit recapture applies as if the cooperative had claimed the entire credit.

If the cooperative is subject to the passive activity rules, include on line 15 any credit for small employer health insurance premiums from passive activities disallowed for prior years and carried forward to this year. Complete Form 8810, Corporate Passive Activity Loss and Credit Limitations, to determine the allowed credit that must be allocated to patrons. For details, see the Instructions for Form 8810.

Estates and trusts.

Allocate the credit on line 16 between the estate or trust and the beneficiaries in the same proportion as income was allocated and enter the beneficiaries' share on line 17.

If the estate or trust is subject to the passive activity rules, include on line 15 any credit for small employer health insurance premiums from passive activities disallowed for prior years and carried forward to this year. Complete Form 8582-CR, Passive Activity Credit Limitations, to determine the allowed credit that must be allocated between the estate or trust and the beneficiaries. For details, see the Instructions for Form 8582-CR.

Line 19

Enter the total amount of certain payroll taxes. Payroll taxes, for this purpose, mean only the following taxes.

  • Federal income taxes the tax-exempt employer was required to withhold from employees' wages in calendar year 2017.

  • Medicare taxes the tax-exempt employer was required to withhold from employees' wages in calendar year 2017.

  • Medicare taxes the tax-exempt employer was required to pay for calendar year 2017.

 

Instructions for Form 8941 - Notices

Paperwork Reduction Act Notice.

We ask for the information on this form to carry out the Internal Revenue laws of the United States. You are required to give us the information. We need it to ensure that you are complying with these laws and to allow us to figure and collect the right amount of tax.

You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number. Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law. Generally, tax returns and return information are confidential, as required by section 6103.

The time needed to complete and file this form will vary depending on individual circumstances. The estimated burden for individual and business taxpayers filing this form is approved under OMB control number 1545-0074 and 1545-0123 and is included in the estimates shown in the instructions for their individual and business income tax return. The estimated burden for all other taxpayers who file this form is shown below.

Recordkeeping 10 hr., 51 min.
Learning about the law or the form 1 hr., 23 min.
Preparing and sending the form to the IRS 2 hr., 46 min.

 

If you have comments concerning the accuracy of these time estimates or suggestions for making this form simpler, we would be happy to hear from you. See the instructions for the tax return with which this form is filed.

Instructions for Form 8941 - Additional Material

Average Premiums Needed To Figure Adjusted Amounts on Worksheet 4

The following tables list the average premiums for the small group market in each rating area generally listed by county for each state for tax years beginning in 2017.

Alabama

County Employee-
Only
Dependent,
Family, etc.
Autauga 6,604 16,608
Baldwin 6,149 15,693
Barbour 6,149 15,693
Bibb 6,351 17,224
Blount 6,351 17,224
Bullock 6,149 15,693
Butler 6,149 15,693
Calhoun 6,031 16,936
Chambers 6,149 15,693
Cherokee 6,149 15,693
Chilton 6,351 17,224
Choctaw 6,149 15,693
Clarke 6,149 15,693
Clay 6,149 15,693
Cleburne 6,149 15,693
Coffee 6,149 15,693
Colbert 7,072 16,976
Conecuh 6,149 15,693
Coosa 6,149 15,693
Covington 6,149 15,693
Crenshaw 6,149 15,693
Cullman 6,149 15,693
Dale 6,149 15,693
Dallas 6,149 15,693
DeKalb 6,149 15,693
Elmore 6,604 16,608
Escambia 6,149 15,693
Etowah 5,448 16,355
Fayette 6,149 15,693
Franklin 6,149 15,693
Geneva 6,054 13,847
Greene 6,530 16,043
Hale 6,530 16,043
Henry 6,054 13,847
Houston 6,054 13,847
Jackson 6,149 15,693
Jefferson 6,351 17,224
Lamar 6,149 15,693
Lauderdale 7,072 16,976
Lawrence 7,490 17,986
Lee 5,727 13,471
Limestone 6,238 15,623
Lowndes 6,604 16,608
Macon 6,149 15,693
Madison 6,238 15,623
Marengo 6,149 15,693
Marion 6,149 15,693
Marshall 6,149 15,693
Mobile 5,864 16,050
Monroe 6,149 15,693
Montgomery 6,604 16,608
Morgan 7,490 17,986
Perry 6,149 15,693
Pickens 6,149 15,693
Pike 6,149 15,693
Randolph 6,149 15,693
Russell 7,030 16,447
Shelby 6,351 17,224
St. Clair 6,351 17,224
Sumter 6,149 15,693
Talladega 6,149 15,693
Tallapoosa 6,149 15,693
Tuscaloosa 6,530 16,043
Walker 6,351 17,224
Washington 6,149 15,693
Wilcox 6,149 15,693
Winston 6,149 15,693

 

Alaska

County Employee-
Only
Dependent,
Family, etc.
Aleutians East 10,434 26,154
Aleutians West 10,434 26,154
Anchorage 9,537 26,194
Bethel 9,537 26,194
Bristol Bay 10,434 26,154
Denali 10,434 26,154
Dillingham 9,537 26,194
Fairbanks North Star 10,434 26,154
Haines 10,239 24,784
Hoonah-Angoon 10,239 24,784
Juneau 10,239 24,784
Kenai Peninsula 10,434 26,154
Ketchikan Gateway 10,239 24,784
Kodiak Island 10,434 26,154
Lake and Peninsula 10,434 26,154
Matanuska Susitna 10,434 26,154
Nome 10,434 26,154
North Slope 10,434 26,154
Northwest Arctic 10,434 26,154
Petersburg 10,239 24,784
Prince of Wales-Hyder 10,239 24,784
Sitka 10,239 24,784
Skagway 10,239 24,784
Southeast Fairbanks 10,434 26,154
Valdez Cordova 9,537 26,194
Wade Hampton 10,434 26,154
Wrangell City and Borough 10,239 24,784
Yakutat 10,434 26,154
Yukon Koyukuk 10,434 26,154

 

Arizona

County Employee-
Only
Dependent,
Family, etc.
Apache 6,048 14,412
Cochise 6,445 16,932
Coconino 6,048 14,412
Gila 6,572 16,544
Graham 6,445 16,932
Greenlee 6,445 16,932
La Paz 7,132 19,568
Maricopa 5,993 16,312
Mohave 6,048 14,412
Navajo 6,048 14,412
Pima 5,732 17,349
Pinal 6,572 16,544
Santa Cruz 5,732 17,349
Yavapai 5,438 16,701
Yuma 7,132 19,568

 

Arkansas

County Employee-
Only
Dependent,
Family, etc.
Arkansas 5,710 14,595
Ashley 5,710 14,595
Baxter 4,573 13,288
Benton 4,573 13,288
Boone 4,573 13,288
Bradley 5,710 14,595
Calhoun 5,816 15,416
Carroll 4,573 13,288
Chicot 5,710 14,595
Clark 5,127 13,995
Clay 5,683 15,011
Cleburne 5,525 14,527
Cleveland 5,710 14,595
Columbia 5,816 15,416
Conway 5,525 14,527
Craighead 5,683 15,011
Crawford 5,152 15,139
Crittenden 5,683 15,011
Cross 5,683 15,011
Dallas 5,710 14,595
Desha 5,710 14,595
Drew 5,710 14,595
Faulkner 5,525 14,527
Franklin 5,152 15,139
Fulton 5,683 15,011
Garland 5,127 13,995
Grant 5,525 14,527
Greene 5,683 15,011
Hempstead 5,816 15,416
Hot Spring 5,127 13,995
Howard 5,816 15,416
Independence 5,683 15,011
Izard 5,683 15,011
Jackson 5,683 15,011
Jefferson 5,710 14,595
Johnson 5,152 15,139
Lafayette 5,816 15,416
Lawrence 5,683 15,011
Lee 5,710 14,595
Lincoln 5,710 14,595
Little River 5,816 15,416
Logan 5,152 15,139
Lonoke 5,525 14,527
Madison 4,573 13,288
Marion 4,573 13,288
Miller 5,816 15,416
Mississippi 5,683 15,011
Monroe 5,710 14,595
Montgomery 5,127 13,995
Nevada 5,816 15,416
Newton 4,573 13,288
Ouachita 5,816 15,416
Perry 5,525 14,527
Phillips 5,710 14,595
Pike 5,127 13,995
Poinsett 5,683 15,011
Polk 5,152 15,139
Pope 5,525 14,527
Prairie 5,525 14,527
Pulaski 5,525 14,527
Randolph 5,683 15,011
Saline 5,525 14,527
Scott 5,152 15,139
Searcy 4,573 13,288
Sebastian 5,152 15,139
Sevier 5,816 15,416
Sharp 5,683 15,011
St. Francis 5,683 15,011
Stone 5,683 15,011
Union 5,816 15,416
Van Buren 5,525 14,527
Washington 4,573 13,288
White 5,525 14,527
Woodruff 5,683 15,011
Yell 5,525 14,527

 

California

County Employee-
Only
Dependent,
Family, etc.
Alameda 6,810 17,385
Alpine 6,161 15,330
Amador 6,161 15,330
Butte 6,161 15,330
Calaveras 6,161 15,330
Colusa 6,161 15,330
Contra Costa 7,046 17,619
Del Norte 6,161 15,330
El Dorado 5,930 15,943
Fresno 6,269 17,056
Glenn 6,161 15,330
Humboldt 6,161 15,330
Imperial 5,644 14,675
Inyo 5,644 14,675
Kern 6,568 15,775
Kings 6,269 17,056
Lake 6,161 15,330
Lassen 6,161 15,330
Los Angeles 6,233 16,516
Madera 6,269 17,056
Marin 6,899 15,884
Mariposa 6,977 14,929
Mendocino 6,161 15,330
Merced 6,977 14,929
Modoc 6,161 15,330
Mono 5,644 14,675
Monterey 6,260 14,770
Napa 6,899 15,884
Nevada 6,161 15,330
Orange 6,346 17,261
Placer 5,930 15,943
Plumas 6,161 15,330
Riverside 5,704 14,548
Sacramento 5,930 15,943
San Benito 6,260 14,770
San Bernardino 5,704 14,548
San Diego 6,045 15,354
San Francisco 6,636 20,243
San Joaquin 6,977 14,929
San Luis Obispo 5,970 15,430
San Mateo 8,031 20,736
Santa Barbara 5,970 15,430
Santa Clara 7,125 18,858
Santa Cruz 6,260 14,770
Shasta 6,161 15,330
Sierra 6,161 15,330
Siskiyou 6,161 15,330
Solano 6,899 15,884
Sonoma 6,899 15,884
Stanislaus 6,977 14,929
Sutter 6,161 15,330
Tehama 6,161 15,330
Trinity 6,161 15,330
Tulare 6,977 14,929
Tuolumne 6,161 15,330
Ventura 5,970 15,430
Yolo 5,930 15,943
Yuba 6,161 15,330

 

Colorado

County Employee-
Only
Dependent,
Family, etc.
Adams 6,416 18,805
Alamosa 7,088 14,801
Arapahoe 6,416 18,805
Archuleta 7,176 15,918
Baca 7,088 14,801
Bent 7,088 14,801
Boulder 5,578 17,092
Broomfield 6,416 18,805
Chaffee 7,088 14,801
Cheyenne 7,088 14,801
Clear Creek 6,416 18,805
Conejos 7,088 14,801
Costilla 7,088 14,801
Crowley 7,088 14,801
Custer 7,088 14,801
Delta 7,176 15,918
Denver 6,416 18,805
Dolores 7,176 15,918
Douglas 6,416 18,805
Eagle 7,378 18,967
El Paso 6,109 16,336
Elbert 6,416 18,805
Fremont 7,088 14,801
Garfield 7,378 18,967
Gilpin 6,416 18,805
Grand 7,176 15,918
Gunnison 7,176 15,918
Hinsdale 7,176 15,918
Huerfano 7,088 14,801
Jackson 7,176 15,918
Jefferson 6,416 18,805
Kiowa 7,088 14,801
Kit Carson 7,088 14,801
La Plata 7,176 15,918
Lake 7,176 15,918
Larimer 6,924 15,012
Las Animas 7,088 14,801
Lincoln 7,088 14,801
Logan 6,204 16,834
Mesa 6,200 17,485
Mineral 7,088 14,801
Moffat 7,176 15,918
Montezuma 7,176 15,918
Montrose 7,176 15,918
Morgan 6,204 16,834
Otero 7,088 14,801
Ouray 7,176 15,918
Park 6,416 18,805
Phillips 6,204 16,834
Pitkin 7,378 18,967
Prowers 7,088 14,801
Pueblo 6,909 18,542
Rio Blanco 7,176 15,918
Rio Grande 7,088 14,801
Routt 7,176 15,918
Saguache 7,088 14,801
San Juan 7,176 15,918
San Miguel 7,176 15,918
Sedgwick 6,204 16,834
Summit 7,378 18,967
Teller 6,109 16,336
Washington 6,204 16,834
Weld 5,465 14,791
Yuma 6,204 16,834

 

Connecticut

County Employee-
Only
Dependent,
Family, etc.
Fairfield 7,969 20,972
Hartford 7,443 19,986
Litchfield 6,860 18,726
Middlesex 8,289 20,591
New Haven 7,661 19,642
New London 6,262 16,977
Tolland 7,109 15,267
Windham 7,050 24,756

 

Delaware

County Employee-
Only
Dependent,
Family, etc.
All 7,492 18,236

 

District of Columbia

County Employee-
Only
Dependent,
Family, etc.
All 6,547 19,479

 

Florida

County Employee-
Only
Dependent,
Family, etc.
Alachua 6,914 18,526
Baker 6,819 18,340
Bay 6,087 16,518
Bradford 6,228 18,668
Brevard 6,562 19,268
Broward 6,412 19,677
Calhoun 6,436 18,498
Charlotte 7,602 21,853
Citrus 6,175 16,645
Clay 5,248 18,079
Collier 5,724 18,249
Columbia 7,619 20,834
DeSoto 6,377 19,377
Dixie 5,675 15,282
Duval 6,680 17,101
Escambia 7,011 16,171
Flagler 7,325 17,746
Franklin 6,390 19,561
Gadsden 5,640 18,111
Gilchrist 6,191 18,470
Glades 6,694 21,069
Gulf 7,505 19,997
Hamilton 6,289 18,448
Hardee 6,611 15,476
Hendry 7,605 21,272
Hernando 6,794 19,628
Highlands 7,233 22,204
Hillsborough 6,063 18,134
Holmes 6,336 18,530
Indian River 5,680 15,775
Jackson 5,706 15,332
Jefferson 7,343 17,863
Lafayette 6,707 17,176
Lake 7,418 20,508
Lee 6,462 18,664
Leon 7,004 20,060
Levy 6,257 19,545
Liberty 6,502 18,954
Madison 7,585 19,890
Manatee 6,495 20,547
Marion 5,381 15,531
Martin 6,350 20,401
Miami-Dade 6,882 20,551
Monroe 7,638 21,499
Nassau 7,343 15,187
Okaloosa 6,647 25,545
Okeechobee 7,498 20,433
Orange 6,644 17,145
Osceola 6,558 21,366
Palm Beach 6,502 19,808
Pasco 7,222 17,303
Pinellas 6,793 17,736
Polk 6,725 18,523
Putnam 6,547 19,304
Santa Rosa 6,248 15,409
Sarasota 6,187 17,419
Seminole 6,403 16,459
St. Johns 6,230 20,276
St. Lucie 5,720 15,781
Sumter 6,343 20,097
Suwannee 5,794 18,191
Taylor 7,698 20,766
Union 6,404 18,849
Volusia 6,502 18,059
Wakulla 6,279 18,762
Walton 5,595 15,589
Washington 6,572 19,403

 

Georgia

County Employee-
Only
Dependent,
Family, etc.
Appling 5,981 17,458
Atkinson 7,013 19,033
Bacon 5,114 14,189
Baker 7,132 18,814
Baldwin 7,411 19,119
Banks 6,786 14,149
Barrow 5,344 17,934
Bartow 6,329 16,664
Ben Hill 7,286 20,529
Berrien 7,286 20,529
Bibb 6,078 17,514
Bleckley 6,078 17,514
Brantley 5,114 14,189
Brooks 7,286 20,529
Bryan 5,981 17,458
Bulloch 5,981 17,458
Burke 6,275 18,063
Butts 6,329 16,664
Calhoun 7,132 18,814
Camden 5,114 14,189
Candler 5,981 17,458
Carroll 6,471 19,520
Catoosa 6,368 17,701
Charlton 5,114 14,189
Chatham 5,981 17,458
Chattahoochee 5,440 18,095
Chattooga 7,357 18,355
Cherokee 6,329 16,664
Clarke 5,344 17,934
Clay 7,132 18,814
Clayton 6,329 16,664
Clinch 7,286 20,529
Cobb 6,329 16,664
Coffee 7,013 19,033
Colquitt 7,286 20,529
Columbia 6,275 18,063
Cook 7,286 20,529
Coweta 6,329 16,664
Crawford 6,078 17,514
Crisp 7,132 18,814
Dade 6,368 17,701
Dawson 6,786 14,149
Decatur 7,286 20,529
DeKalb 6,329 16,664
Dodge 6,078 17,514
Dooly 6,078 17,514
Dougherty 7,132 18,814
Douglas 6,329 16,664
Early 7,286 20,529
Echols 7,286 20,529
Effingham 5,981 17,458
Elbert 5,344 17,934
Emanuel 6,275 18,063
Evans 5,981 17,458
Fannin 5,986 15,344
Fayette 6,329 16,664
Floyd 7,357 18,355
Forsyth 6,329 16,664
Franklin 6,786 14,149
Fulton 6,329 16,664
Gilmer 7,357 18,355
Glascock 6,275 18,063
Glynn 5,114 14,189
Gordon 7,357 18,355
Grady 7,286 20,529
Greene 5,344 17,934
Gwinnett 6,329 16,664
Habersham 6,786 14,149
Hall 6,786 14,149
Hancock 7,411 19,119
Haralson 6,471 19,520
Harris 5,440 18,095
Hart 6,786 14,149
Heard 6,471 19,520
Henry 6,329 16,664
Houston 6,078 17,514
Irwin 7,286 20,529
Jackson 5,344 17,934
Jasper 6,329 16,664
Jeff Davis 7,013 19,033
Jefferson 6,275 18,063
Jenkins 6,275 18,063
Johnson 7,013 19,033
Jones 6,078 17,514
Lamar 6,329 16,664
Lanier 7,286 20,529
Laurens 7,013 19,033
Lee 7,132 18,814
Liberty 5,981 17,458
Lincoln 6,275 18,063
Long 5,981 17,458
Lowndes 7,286 20,529
Lumpkin 6,786 14,149
Macon 5,440 18,095
Madison 5,344 17,934
Marion 5,440 18,095
McDuffie 6,275 18,063
McIntosh 5,114 14,189
Meriwether 5,440 18,095
Miller 7,286 20,529
Mitchell 7,132 18,814
Monroe 6,078 17,514
Montgomery 7,013 19,033
Morgan 5,344 17,934
Murray 5,986 15,344
Muscogee 5,440 18,095
Newton 6,329 16,664
Oconee 5,344 17,934
Oglethorpe 5,344 17,934
Paulding 6,329 16,664
Peach 6,078 17,514
Pickens 7,357 18,355
Pierce 5,114 14,189
Pike 6,329 16,664
Polk 7,357 18,355
Pulaski 6,078 17,514
Putnam 6,078 17,514
Quitman 5,440 18,095
Rabun 6,786 14,149
Randolph 7,132 18,814
Richmond 6,275 18,063
Rockdale 6,329 16,664
Schley 7,132 18,814
Screven 5,981 17,458
Seminole 7,286 20,529
Spalding 6,329 16,664
Stephens 6,786 14,149
Stewart 5,440 18,095
Sumter 7,132 18,814
Talbot 5,440 18,095
Taliaferro 6,275 18,063
Tattnall 5,981 17,458
Taylor 5,440 18,095
Telfair 7,013 19,033
Terrell 7,132 18,814
Thomas 7,286 20,529
Tift 7,286 20,529
Toombs 7,013 19,033
Towns 6,786 14,149
Treutlen 7,013 19,033
Troup 5,440 18,095
Turner 7,286 20,529
Twiggs 6,078 17,514
Union 6,786 14,149
Upson 5,440 18,095
Walker 6,368 17,701
Walton 6,329 16,664
Ware 5,114 14,189
Warren 6,275 18,063
Washington 7,411 19,119
Wayne 5,114 14,189
Webster 5,440 18,095
Wheeler 7,013 19,033
White 6,786 14,149
Whitfield 5,986 15,344
Wilcox 6,078 17,514
Wilkes 6,275 18,063
Wilkinson 7,411 19,119
Worth 7,132 18,814

 

Hawaii

County Employee-
Only
Dependent,
Family, etc.
All 6,207 16,824

 

Idaho

County Employee-
Only
Dependent,
Family, etc.
Ada 5,018 14,199
Adams 4,899 13,438
Bannock 4,943 13,479
Bear Lake 4,943 13,479
Benewah 5,467 13,147
Bingham 4,943 13,479
Blaine 5,001 13,335
Boise 4,899 13,438
Bonner 5,467 13,147
Bonneville 5,631 13,163
Boundary 5,467 13,147
Butte 4,943 13,479
Camas 5,001 13,335
Canyon 4,899 13,438
Caribou 4,943 13,479
Cassia 5,001 13,335
Clark 5,631 13,163
Clearwater 5,251 15,940
Custer 4,943 13,479
Elmore 4,899 13,438
Franklin 4,943 13,479
Fremont 5,631 13,163
Gem 4,899 13,438
Gooding 5,001 13,335
Idaho 5,251 15,940
Jefferson 5,631 13,163
Jerome 5,001 13,335
Kootenai 5,467 13,147
Latah 5,467 13,147
Lemhi 5,631 13,163
Lewis 5,251 15,940
Lincoln 5,001 13,335
Madison 5,631 13,163
Minidoka 5,001 13,335
Nez Perce 5,251 15,940
Oneida 4,943 13,479
Owyhee 4,899 13,438
Payette 4,899 13,438
Power 4,943 13,479
Shoshone 5,467 13,147
Teton 5,631 13,163
Twin Falls 5,001 13,335
Valley 4,899 13,438
Washington 4,899 13,438

 

Illinois

County Employee-
Only
Dependent,
Family, etc.
Adams 6,399 15,963
Alexander 6,335 17,757
Bond 6,204 16,724
Boone 6,523 16,617
Brown 6,399 15,963
Bureau 5,251 17,388
Calhoun 6,204 16,724
Carroll 6,523 16,617
Cass 6,399 15,963
Champaign 6,755 16,857
Christian 6,399 15,963
Clark 6,755 16,857
Clay 6,335 17,757
Clinton 6,204 16,724
Coles 6,755 16,857
Cook 6,786 18,697
Crawford 6,335 17,757
Cumberland 6,755 16,857
DeKalb 6,523 16,617
DeWitt 7,095 22,039
Douglas 6,755 16,857
DuPage 7,109 19,152
Edgar 6,755 16,857
Edwards 6,335 17,757
Effingham 6,335 17,757
Fayette 6,335 17,757
Ford 6,755 16,857
Franklin 6,335 17,757
Fulton 7,117 17,009
Gallatin 6,335 17,757
Greene 6,204 16,724
Grundy 7,928 20,078
Hamilton 6,335 17,757
Hancock 5,251 17,388
Hardin 6,335 17,757
Henderson 5,251 17,388
Henry 5,251 17,388
Iroquois 6,755 16,857
Jackson 6,335 17,757
Jasper 6,335 17,757
Jefferson 6,335 17,757
Jersey 6,204 16,724
Jo Daviess 6,523 16,617
Johnson 6,335 17,757
Kane 7,109 19,152
Kankakee 7,928 20,078
Kendall 7,928 20,078
Knox 7,117 17,009
Lake 6,435 21,690
LaSalle 7,117 17,009
Lawrence 6,335 17,757
Lee 6,523 16,617
Livingston 7,095 22,039
Logan 6,399 15,963
Macon 6,399 15,963
Macoupin 6,204 16,724
Madison 6,989 17,646
Marion 6,335 17,757
Marshall 7,117 17,009
Mason 6,399 15,963
Massac 6,335 17,757
McDonough 7,117 17,009
McHenry 6,435 21,690
McLean 7,095 22,039
Menard 6,399 15,963
Mercer 5,251 17,388
Monroe 6,989 17,646
Montgomery 6,204 16,724
Morgan 6,399 15,963
Moultrie 6,399 15,963
Ogle 6,523 16,617
Peoria 7,117 17,009
Perry 6,335 17,757
Piatt 6,755 16,857
Pike 6,399 15,963
Pope 6,335 17,757
Pulaski 6,335 17,757
Putnam 7,117 17,009
Randolph 6,204 16,724
Richland 6,335 17,757
Rock Island 5,251 17,388
Saline 6,335 17,757
Sangamon 6,399 15,963
Schuyler 6,399 15,963
Scott 6,399 15,963
Shelby 6,399 15,963
St. Clair 6,989 17,646
Stark 7,117 17,009
Stephenson 6,523 16,617
Tazewell 7,117 17,009
Union 6,335 17,757
Vermilion 6,755 16,857
Wabash 6,335 17,757
Warren 5,251 17,388
Washington 6,204 16,724
Wayne 6,335 17,757
White 6,335 17,757
Whiteside 5,251 17,388
Will 7,928 20,078
Williamson 6,335 17,757
Winnebago 6,523 16,617
Woodford 7,117 17,009

 

Indiana

County Employee-
Only
Dependent,
Family, etc.
Adams 7,447 18,455
Allen 6,518 16,243
Bartholomew 6,875 16,452
Benton 6,839 19,061
Blackford 7,432 15,566
Boone 6,974 19,527
Brown 6,293 17,071
Carroll 6,908 21,010
Cass 6,893 16,758
Clark 6,454 15,683
Clay 7,068 19,132
Clinton 6,908 21,010
Crawford 6,454 15,683
Daviess 7,393 17,078
Dearborn 5,685 18,500
Decatur 6,875 16,452
DeKalb 7,447 18,455
Delaware 7,432 15,566
Dubois 7,393 17,078
Elkhart 7,205 15,931
Fayette 5,783 18,932
Floyd 6,454 15,683
Fountain 6,908 21,010
Franklin 5,685 18,500
Fulton 6,893 16,758
Gibson 8,317 19,043
Grant 7,432 15,566
Greene 7,393 17,078
Hamilton 6,974 19,527
Hancock 5,783 18,932
Harrison 6,454 15,683
Hendricks 6,974 19,527
Henry 5,783 18,932
Howard 6,893 16,758
Huntington 7,447 18,455
Jackson 6,875 16,452
Jasper 6,839 19,061
Jay 7,432 15,566
Jefferson 6,454 15,683
Jennings 6,875 16,452
Johnson 6,293 17,071
Knox 7,393 17,078
Kosciusko 7,205 15,931
LaGrange 7,447 18,455
Lake 7,139 17,521
LaPorte 7,139 17,521
Lawrence 6,293 17,071
Madison 5,783 18,932
Marion 6,974 19,527
Marshall 7,205 15,931
Martin 7,393 17,078
Miami 6,893 16,758
Monroe 6,293 17,071
Montgomery 6,908 21,010
Morgan 6,974 19,527
Newton 6,839 19,061
Noble 7,447 18,455
Ohio 5,685 18,500
Orange 7,393 17,078
Owen 6,293 17,071
Parke 7,068 19,132
Perry 7,393 17,078
Pike 7,393 17,078
Porter 7,139 17,521
Posey 8,317 19,043
Pulaski 6,893 16,758
Putnam 6,908 21,010
Randolph 7,432 15,566
Ripley 5,685 18,500
Rush 6,875 16,452
Scott 6,454 15,683
Shelby 6,974 19,527
Spencer 7,393 17,078
St. Joseph 7,205 15,931
Starke 7,205 15,931
Steuben 7,447 18,455
Sullivan 7,068 19,132
Switzerland 5,685 18,500
Tippecanoe 6,908 21,010
Tipton 6,908 21,010
Union 5,783 18,932
Vanderburgh 8,317 19,043
Vermillion 7,068 19,132
Vigo 7,068 19,132
Wabash 7,447 18,455
Warren 6,839 19,061
Warrick 8,317 19,043
Washington 6,454 15,683
Wayne 5,783 18,932
Wells 7,447 18,455
White 6,839 19,061
Whitley 7,447 18,455

 

Iowa

County Employee-
Only
Dependent,
Family, etc.
Adair 6,834 16,767
Adams 6,834 16,767
Allamakee 6,302 17,532
Appanoose 6,020 15,484
Audubon 6,834 16,767
Benton 6,045 16,431
Black Hawk 6,045 16,431
Boone 6,380 15,256
Bremer 6,302 17,532
Buchanan 6,045 16,431
Buena Vista 6,043 16,540
Butler 6,302 17,532
Calhoun 6,380 15,256
Carroll 6,380 15,256
Cass 6,834 16,767
Cedar 6,045 16,431
Cerro Gordo 6,302 17,532
Cherokee 6,043 16,540
Chickasaw 6,302 17,532
Clarke 6,834 16,767
Clay 6,043 16,540
Clayton 6,045 16,431
Clinton 6,045 16,431
Crawford 6,043 16,540
Dallas 6,305 15,095
Davis 6,020 15,484
Decatur 6,834 16,767
Delaware 6,045 16,431
Des Moines 6,020 15,484
Dickinson 6,043 16,540
Dubuque 6,045 16,431
Emmet 6,302 17,532
Fayette 6,302 17,532
Floyd 6,302 17,532
Franklin 6,302 17,532
Fremont 6,834 16,767
Greene 6,380 15,256
Grundy 6,380 15,256
Guthrie 6,834 16,767
Hamilton 6,380 15,256
Hancock 6,302 17,532
Hardin 6,380 15,256
Harrison 6,834 16,767
Henry 6,020 15,484
Howard 6,302 17,532
Humboldt 6,302 17,532
Ida 6,043 16,540
Iowa 6,045 16,431
Jackson 6,045 16,431
Jasper 6,305 15,095
Jefferson 6,020 15,484
Johnson 6,045 16,431
Jones 6,045 16,431
Keokuk 6,020 15,484
Kossuth 6,302 17,532
Lee 6,020 15,484
Linn 6,045 16,431
Louisa 6,020 15,484
Lucas 6,020 15,484
Lyon 6,043 16,540
Madison 6,305 15,095
Mahaska 6,020 15,484
Marion 6,305 15,095
Marshall 6,380 15,256
Mills 6,834 16,767
Mitchell 6,302 17,532
Monona 6,043 16,540
Monroe 6,020 15,484
Montgomery 6,834 16,767
Muscatine 6,020 15,484
O'Brien 6,043 16,540
Osceola 6,043 16,540
Page 6,834 16,767
Palo Alto 6,043 16,540
Plymouth 6,043 16,540
Pocahontas 6,043 16,540
Polk 6,305 15,095
Pottawattamie 6,834 16,767
Poweshiek 6,380 15,256
Ringgold 6,834 16,767
Sac 6,043 16,540
Scott 6,045 16,431
Shelby 6,834 16,767
Sioux 6,043 16,540
Story 6,380 15,256
Tama 6,380 15,256
Taylor 6,834 16,767
Union 6,834 16,767
Van Buren 6,020 15,484
Wapello 6,020 15,484
Warren 6,305 15,095
Washington 6,020 15,484
Wayne 6,020 15,484
Webster 6,380 15,256
Winnebago 6,302 17,532
Winneshiek 6,302 17,532
Woodbury 6,043 16,540
Worth 6,302 17,532
Wright 6,302 17,532

 

Kansas

County Employee-
Only
Dependent,
Family, etc.
Allen 5,786 18,209
Anderson 5,741 14,107
Atchison 5,741 14,107
Barber 6,516 15,988
Barton 5,999 18,229
Bourbon 5,786 18,209
Brown 5,741 14,107
Butler 5,446 14,674
Chase 5,446 14,674
Chautauqua 5,446 14,674
Cherokee 5,786 18,209
Cheyenne 5,999 18,229
Clark 6,516 15,988
Clay 5,210 14,578
Cloud 5,210 14,578
Coffey 5,741 14,107
Comanche 6,516 15,988
Cowley 5,446 14,674
Crawford 5,786 18,209
Decatur 5,999 18,229
Dickinson 5,210 14,578
Doniphan 5,741 14,107
Douglas 5,741 14,107
Edwards 6,516 15,988
Elk 5,446 14,674
Ellis 5,999 18,229
Ellsworth 5,210 14,578
Finney 6,516 15,988
Ford 6,516 15,988
Franklin 5,741 14,107
Geary 5,210 14,578
Gove 5,999 18,229
Graham 5,999 18,229
Grant 6,516 15,988
Gray 6,516 15,988
Greeley 5,999 18,229
Greenwood 5,446 14,674
Hamilton 6,516 15,988
Harper 5,446 14,674
Harvey 5,446 14,674
Haskell 6,516 15,988
Hodgeman 6,516 15,988
Jackson 5,741 14,107
Jefferson 5,741 14,107
Jewell 5,210 14,578
Johnson 6,519 16,493
Kearny 6,516 15,988
Kingman 5,446 14,674
Kiowa 6,516 15,988
Labette 5,786 18,209
Lane 5,999 18,229
Leavenworth 6,519 16,493
Lincoln 5,210 14,578
Linn 5,741 14,107
Logan 5,999 18,229
Lyon 5,741 14,107
Marion 5,446 14,674
Marshall 5,741 14,107
McPherson 5,446 14,674
Meade 6,516 15,988
Miami 6,519 16,493
Mitchell 5,210 14,578
Montgomery 5,446 14,674
Morris 5,210 14,578
Morton 6,516 15,988
Nemaha 5,741 14,107
Neosho 5,786 18,209
Ness 5,999 18,229
Norton 5,999 18,229
Osage 5,741 14,107
Osborne 5,999 18,229
Ottawa 5,210 14,578
Pawnee 6,516 15,988
Phillips 5,999 18,229
Pottawatomie 5,741 14,107
Pratt 6,516 15,988
Rawlins 5,999 18,229
Reno 5,446 14,674
Republic 5,210 14,578
Rice 5,446 14,674
Riley 5,210 14,578
Rooks 5,999 18,229
Rush 5,999 18,229
Russell 5,999 18,229
Saline 5,210 14,578
Scott 5,999 18,229
Sedgwick 5,446 14,674
Seward 6,516 15,988
Shawnee 5,741 14,107
Sheridan 5,999 18,229
Sherman 5,999 18,229
Smith 5,999 18,229
Stafford 6,516 15,988
Stanton 6,516 15,988
Stevens 6,516 15,988
Sumner 5,446 14,674
Thomas 5,999 18,229
Trego 5,999 18,229
Wabaunsee 5,741 14,107
Wallace 5,999 18,229
Washington 5,210 14,578
Wichita 5,999 18,229
Wilson 5,446 14,674
Woodson 5,786 18,209
Wyandotte 6,519 16,493

 

Kentucky

County Employee-
Only
Dependent,
Family, etc.
Adair 5,488 14,571
Allen 5,488 14,571
Anderson 5,857 15,664
Ballard 6,016 18,305
Barren 5,488 14,571
Bath 6,144 20,621
Bell 6,054 17,534
Boone 6,339 14,396
Bourbon 5,857 15,664
Boyd 6,144 20,621
Boyle 5,857 15,664
Bracken 6,144 20,621
Breathitt 6,054 17,534
Breckinridge 5,511 14,664
Bullitt 5,511 14,664
Butler 5,488 14,571
Caldwell 6,016 18,305
Calloway 6,016 18,305
Campbell 6,339 14,396
Carlisle 6,016 18,305
Carroll 5,511 14,664
Carter 6,144 20,621
Casey 5,488 14,571
Christian 6,622 16,252
Clark 5,857 15,664
Clay 6,054 17,534
Clinton 5,488 14,571
Crittenden 6,016 18,305
Cumberland 5,488 14,571
Daviess 6,622 16,252
Edmonson 5,488 14,571
Elliott 6,144 20,621
Estill 5,857 15,664
Fayette 5,857 15,664
Fleming 6,144 20,621
Floyd 6,054 17,534
Franklin 5,857 15,664
Fulton 6,016 18,305
Gallatin 6,339 14,396
Garrard 5,857 15,664
Grant 6,339 14,396
Graves 6,016 18,305
Grayson 5,511 14,664
Green 5,488 14,571
Greenup 6,144 20,621
Hancock 6,622 16,252
Hardin 5,511 14,664
Harlan 6,054 17,534
Harrison 5,857 15,664
Hart 5,488 14,571
Henderson 6,622 16,252
Henry 5,511 14,664
Hickman 6,016 18,305
Hopkins 6,622 16,252
Jackson 5,857 15,664
Jefferson 5,511 14,664
Jessamine 5,857 15,664
Johnson 6,054 17,534
Kenton 6,339 14,396
Knott 6,054 17,534
Knox 6,054 17,534
LaRue 5,511 14,664
Laurel 6,054 17,534
Lawrence 6,144 20,621
Lee 6,054 17,534
Leslie 6,054 17,534
Letcher 6,054 17,534
Lewis 6,144 20,621
Lincoln 5,857 15,664
Livingston 6,016 18,305
Logan 5,488 14,571
Lyon 6,016 18,305
Madison 5,857 15,664
Magoffin 6,054 17,534
Marion 5,511 14,664
Marshall 6,016 18,305
Martin 6,054 17,534
Mason 6,144 20,621
McCracken 6,016 18,305
McCreary 5,488 14,571
McLean 6,622 16,252
Meade 5,511 14,664
Menifee 6,144 20,621
Mercer 5,857 15,664
Metcalfe 5,488 14,571
Monroe 5,488 14,571
Montgomery 5,857 15,664
Morgan 6,144 20,621
Muhlenberg 6,622 16,252
Nelson 5,511 14,664
Nicholas 5,857 15,664
Ohio 6,622 16,252
Oldham 5,511 14,664
Owen 5,857 15,664
Owsley 6,054 17,534
Pendleton 6,339 14,396
Perry 6,054 17,534
Pike 6,054 17,534
Powell 5,857 15,664
Pulaski 5,488 14,571
Robertson 6,144 20,621
Rockcastle 5,857 15,664
Rowan 6,144 20,621
Russell 5,488 14,571
Scott 5,857 15,664
Shelby 5,511 14,664
Simpson 5,488 14,571
Spencer 5,511 14,664
Taylor 5,488 14,571
Todd 6,622 16,252
Trigg 6,622 16,252
Trimble 5,511 14,664
Union 6,622 16,252
Warren 5,488 14,571
Washington 5,511 14,664
Wayne 5,488 14,571
Webster 6,622 16,252
Whitley 6,054 17,534
Wolfe 6,054 17,534
Woodford 5,857 15,664

 

Louisiana

Parish Employee-
Only
Dependent,
Family, etc.
Acadia 6,157 16,311
Allen 6,575 18,510
Ascension 5,753 16,071
Assumption 6,653 16,751
Avoyelles 5,804 13,965
Beauregard 6,575 18,510
Bienville 6,916 17,311
Bossier 6,916 17,311
Caddo 6,916 17,311
Calcasieu 6,575 18,510
Caldwell 7,386 16,842
Cameron 6,575 18,510
Catahoula 5,804 13,965
Claiborne 6,916 17,311
Concordia 5,804 13,965
DeSoto 6,916 17,311
East Baton Rouge 5,753 16,071
East Carroll 7,386 16,842
East Feliciana 5,753 16,071
Evangeline 6,157 16,311
Franklin 7,386 16,842
Grant 5,804 13,965
Iberia 6,157 16,311
Iberville 5,753 16,071
Jackson 7,386 16,842
Jefferson 6,221 16,491
Jefferson Davis 6,575 18,510
Lafayette 6,157 16,311
Lafourche 6,653 16,751
LaSalle 5,804 13,965
Lincoln 7,386 16,842
Livingston 5,753 16,071
Madison 7,386 16,842
Morehouse 7,386 16,842
Natchitoches 6,916 17,311
Orleans 6,221 16,491
Ouachita 7,386 16,842
Plaquemines 6,221 16,491
Pointe Coupee 5,753 16,071
Rapides 5,804 13,965
Red River 6,916 17,311
Richland 7,386 16,842
Sabine 6,916 17,311
St. Bernard 6,221 16,491
St. Charles 6,221 16,491
St. Helena 5,753 16,071
St. James 6,221 16,491
St. John Baptist 6,221 16,491
St. Landry 6,157 16,311
St. Martin 6,157 16,311
St. Mary 6,157 16,311
St. Tammany 6,221 16,491
Tangipahoa 5,753 16,071
Tensas 7,386 16,842
Terrebonne 6,653 16,751
Union 7,386 16,842
Vermilion 6,157 16,311
Vernon 5,804 13,965
Washington 5,753 16,071
Webster 6,916 17,311
West Baton Rouge 5,753 16,071
West Carroll 7,386 16,842
West Feliciana 5,753 16,071
Winn 5,804 13,965

 

Maine

County Employee-
Only
Dependent,
Family, etc.
Androscoggin 6,005 15,419
Aroostook 6,566 18,274
Cumberland 5,748 15,578
Franklin 6,005 15,419
Hancock 6,566 18,274
Kennebec 5,989 16,112
Knox 5,989 16,112
Lincoln 5,989 16,112
Oxford 5,989 16,112
Penobscot 6,005 15,419
Piscataquis 6,005 15,419
Sagadahoc 5,748 15,578
Somerset 6,005 15,419
Waldo 6,005 15,419
Washington 6,566 18,274
York 5,748 15,578

 

Maryland

County Employee-
Only
Dependent,
Family, etc.
Allegany 5,979 15,272
Anne Arundel 6,283 17,167
Baltimore 6,283 17,167
Baltimore City 6,283 17,167
Calvert 6,172 15,613
Caroline 6,172 15,613
Carroll 5,979 15,272
Cecil 6,172 15,613
Charles 6,172 15,613
Dorchester 6,172 15,613
Frederick 5,979 15,272
Garrett 5,979 15,272
Harford 6,283 17,167
Howard 6,283 17,167
Kent 6,172 15,613
Montgomery 6,615 18,377
Prince George's 6,615 18,377
Queen Annes 6,172 15,613
Somerset 6,172 15,613
St. Marys 6,172 15,613
Talbot 6,172 15,613
Washington 5,979 15,272
Wicomico 6,172 15,613
Worcester 6,172 15,613

 

Massachusetts

County Employee-
Only
Dependent,
Family, etc.
Barnstable 8,746 22,384
Berkshire 6,608 17,893
Bristol 6,963 19,874
Dukes 8,746