Instructions for Form 8941 (2019)

Credit for Small Employer Health Insurance Premiums

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

2019


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.

Reminders

Exception for eligible small employers in certain counties.

Certain small employers whose principal business address is in a county with no qualified health plan through a Small Business Health Options Program (SHOP) Marketplace may be able to claim the credit for small employer health insurance premiums. For more information, see Exception for eligible small employers in certain counties in the instructions for line A.

Waiver for Hawaii.

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

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’re 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 phaseout 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 $55,000 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 $27,000, 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 $55,000.

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’re a sole proprietor with two separate businesses and you file a separate Schedule C (Form 1040 or 1040-SR) 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 or 1040-SR) 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 or 1040-SR.

 

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’re 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’ve paid $3,120 ($60 × 52) for an employee who was enrolled for the entire tax year. You would’ve 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 certain counties, see the instructions for line A, 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 isn’t 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’ve 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’ve 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’ve 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’ve 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’re 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’re 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 2019, 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 2019.

  • Medicare taxes the tax-exempt employer was required to withhold from employees’ wages in calendar year 2019.

  • Medicare taxes the tax-exempt employer was required to pay for calendar year 2019.

 

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’re 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 can’t participate in the SHOP Marketplace or claim the credit for insurance premiums paid for health plan years beginning after 2016. For more information on the waiver, visit CMS.gov.

Exception for eligible small employers in certain counties.

For calendar year 2019, SHOP Marketplaces in certain counties across the United States didn’t have qualified health plans available for employers to offer to employees. However, relief is available which allows eligible small employers with a principal business address in those counties to claim the credit for 2019 if they properly claimed the credit under section 45R for all or part of 2018. For details, see Notice 2018-27, 2018-20, I.R.B. 580, available at IRS.gov/irb/2018-20_IRB#NOT-2018-27.

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To see whether a particular county has coverage available through a SHOP Exchange for 2019 and beyond, go to Healthcare.gov/small-business and enter "plans and prices" in the search box.

Line C

Answer "Yes" if a tax return you (or any predecessor) filed for a tax year beginning in 2014, 2015, 2016, or 2017 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," don’t file Form 8941 unless you’re 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 shouldn’t 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 isn’t 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 isn’t 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 1 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 1 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 isn’t 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 $27,000 for the tax year. If you paid average annual wages of $55,000 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 isn’t 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’ve 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’ve 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 2019, 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’ve 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’ve 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’ve paid $2,964 ($57 × 52) if the employee was enrolled for the entire tax year. You would’ve paid $570 ($57 × 10) if the employee was only enrolled for 10 pay periods. You’ll 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 $27,000)

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 $27,100 from line 3 4.      
5. Divide line 4 by $27,100. 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 isn’t 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 1120-S), box 13 (code P);

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

  • Form 1099-PATR, Taxable Distributions Received From Cooperatives, box 11, or other notice of credit allocation.

 

This is an Image: taxtip.gif

 

Partnerships, S corporations, cooperatives, estates, trusts, and tax-exempt eligible small employers report the above credits on line 15. All other filers figuring a separate credit on earlier lines also 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 2019.

  • Medicare taxes the tax-exempt employer was required to withhold from employees’ wages in calendar year 2019.

  • Medicare taxes the tax-exempt employer was required to pay for calendar year 2019.

 

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 8 hr., 8 min.
Learning about the law or the form 1 hr., 2 min.
Preparing and sending the form to the IRS 2 hr., 5 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 2019.

Alabama

County Employee-
Only
Dependent,
Family, etc.
Autauga 7,496 19,230
Baldwin 6,299 17,134
Barbour 6,299 17,134
Bibb 6,653 18,549
Blount 6,653 18,549
Bullock 6,299 17,134
Butler 6,299 17,134
Calhoun 6,642 18,615
Chambers 6,299 17,134
Cherokee 6,299 17,134
Chilton 6,653 18,549
Choctaw 6,299 17,134
Clarke 6,299 17,134
Clay 6,299 17,134
Cleburne 6,299 17,134
Coffee 6,299 17,134
Colbert 8,558 19,748
Conecuh 6,299 17,134
Coosa 6,299 17,134
Covington 6,299 17,134
Crenshaw 6,299 17,134
Cullman 6,299 17,134
Dale 6,299 17,134
Dallas 6,299 17,134
DeKalb 6,299 17,134
Elmore 7,496 19,230
Escambia 6,299 17,134
Etowah 5,846 18,202
Fayette 6,299 17,134
Franklin 6,299 17,134
Geneva 6,414 16,386
Greene 7,603 16,924
Hale 7,603 16,924
Henry 6,414 16,386
Houston 6,414 16,386
Jackson 6,299 17,134
Jefferson 6,653 18,549
Lamar 6,299 17,134
Lauderdale 8,558 19,748
Lawrence 7,893 19,596
Lee 6,298 15,915
Limestone 6,480 18,506
Lowndes 7,496 19,230
Macon 6,299 17,134
Madison 6,480 18,506
Marengo 6,299 17,134
Marion 6,299 17,134
Marshall 6,299 17,134
Mobile 7,203 17,779
Monroe 6,299 17,134
Montgomery 7,496 19,230
Morgan 7,893 19,596
Perry 6,299 17,134
Pickens 6,299 17,134
Pike 6,299 17,134
Randolph 6,299 17,134
Russell 7,136 18,051
Shelby 6,653 18,549
St. Clair 6,653 18,549
Sumter 6,299 17,134
Talladega 6,299 17,134
Tallapoosa 6,299 17,134
Tuscaloosa 7,603 16,924
Walker 6,653 18,549
Washington 6,299 17,134
Wilcox 6,299 17,134
Winston 6,299 17,134

 

Alaska

County Employee-
Only
Dependent,
Family, etc.
Aleutians East 10,434 27,855
Aleutians West 10,434 27,855
Anchorage 9,537 28,132
Bethel 9,537 28,132
Bristol Bay 10,434 27,855
Denali 10,434 27,855
Dillingham 9,537 28,132
Fairbanks North Star 10,434 27,855
Haines 10,239 26,762
Hoonah-Angoon 10,239 26,762
Juneau 10,239 26,762
Kenai Peninsula 10,434 27,855
Ketchikan Gateway 10,239 26,762
Kodiak Island 10,434 27,855
Lake and Peninsula 10,434 27,855
Matanuska Susitna 10,434 27,855
Nome 10,434 27,855
North Slope 10,434 27,855
Northwest Arctic 10,434 27,855
Petersburg 10,239 26,762
Prince of Wales-Hyder 10,239 26,762
Sitka 10,239 26,762
Skagway 10,239 26,762
Southeast Fairbanks 10,434 27,855
Valdez Cordova 9,537 28,132
Wade Hampton 10,434 27,855
Wrangell City and Borough 10,239 26,762
Yakutat 10,434 27,855
Yukon Koyukuk 10,434 27,855

 

Arizona

County Employee-
Only
Dependent,
Family, etc.
Apache 6,048 16,062
Cochise 6,445 17,906
Coconino 6,048 16,062
Gila 6,572 17,498
Graham 6,445 17,906
Greenlee 6,445 17,906
La Paz 7,570 19,901
Maricopa 5,993 17,317
Mohave 6,048 16,062
Navajo 6,048 16,062
Pima 5,732 17,791
Pinal 6,572 17,498
Santa Cruz 5,732 17,791
Yavapai 5,662 18,780
Yuma 7,570 19,901

 

Arkansas

County Employee-
Only
Dependent,
Family, etc.
Arkansas 5,941 14,734
Ashley 5,941 14,734
Baxter 5,349 14,692
Benton 5,349 14,692
Boone 5,349 14,692
Bradley 5,941 14,734
Calhoun 6,135 18,778
Carroll 5,349 14,692
Chicot 5,941 14,734
Clark 5,127 15,166
Clay 6,168 17,023
Cleburne 5,748 14,866
Cleveland 5,941 14,734
Columbia 6,135 18,778
Conway 5,748 14,866
Craighead 6,168 17,023
Crawford 5,610 15,821
Crittenden 6,168 17,023
Cross 6,168 17,023
Dallas 5,941 14,734
Desha 5,941 14,734
Drew 5,941 14,734
Faulkner 5,748 14,866
Franklin 5,610 15,821
Fulton 6,168 17,023
Garland 5,127 15,166
Grant 5,748 14,866
Greene 6,168 17,023
Hempstead 6,135 18,778
Hot Spring 5,127 15,166
Howard 6,135 18,778
Independence 6,168 17,023
Izard 6,168 17,023
Jackson 6,168 17,023
Jefferson 5,941 14,734
Johnson 5,610 15,821
Lafayette 6,135 18,778
Lawrence 6,168 17,023
Lee 5,941 14,734
Lincoln 5,941 14,734
Little River 6,135 18,778
Logan 5,610 15,821
Lonoke 5,748 14,866
Madison 5,349 14,692
Marion 5,349 14,692
Miller 6,135 18,778
Mississippi 6,168 17,023
Monroe 5,941 14,734
Montgomery 5,127 15,166
Nevada 6,135 18,778
Newton 5,349 14,692
Ouachita 6,135 18,778
Perry 5,748 14,866
Phillips 5,941 14,734
Pike 5,127 15,166
Poinsett 6,168 17,023
Polk 5,610 15,821
Pope 5,748 14,866
Prairie 5,748 14,866
Pulaski 5,748 14,866
Randolph 6,168 17,023
Saline 5,748 14,866
Scott 5,610 15,821
Searcy 5,349 14,692
Sebastian 5,610 15,821
Sevier 6,135 18,778
Sharp 6,168 17,023
St. Francis 6,168 17,023
Stone 6,168 17,023
Union 6,135 18,778
Van Buren 5,748 14,866
Washington 5,349 14,692
White 5,748 14,866
Woodruff 6,168 17,023
Yell 5,748 14,866

 

California

County Employee-
Only
Dependent,
Family, etc.
Alameda 7,400 19,186
Alpine 6,686 17,135
Amador 6,686 17,135
Butte 6,686 17,135
Calaveras 6,686 17,135
Colusa 6,686 17,135
Contra Costa 7,587 19,440
Del Norte 6,686 17,135
El Dorado 6,442 16,884
Fresno 6,269 18,185
Glenn 6,686 17,135
Humboldt 6,686 17,135
Imperial 6,023 15,609
Inyo 6,023 15,609
Kern 7,202 17,484
Kings 6,269 18,185
Lake 6,686 17,135
Lassen 6,686 17,135
Los Angeles 6,446 17,582
Madera 6,269 18,185
Marin 6,899 17,066
Mariposa 7,223 16,485
Mendocino 6,686 17,135
Merced 7,223 16,485
Modoc 6,686 17,135
Mono 6,023 15,609
Monterey 6,851 16,720
Napa 6,899 17,066
Nevada 6,686 17,135
Orange 6,923 19,303
Placer 6,442 16,884
Plumas 6,686 17,135
Riverside 6,189 16,406
Sacramento 6,442 16,884
San Benito 6,851 16,720
San Bernardino 6,189 16,406
San Diego 6,254 16,251
San Francisco 6,928 22,099
San Joaquin 7,223 16,485
San Luis Obispo 6,565 17,216
San Mateo 8,446 21,619
Santa Barbara 6,565 17,216
Santa Clara 7,816 20,093
Santa Cruz 6,851 16,720
Shasta 6,686 17,135
Sierra 6,686 17,135
Siskiyou 6,686 17,135
Solano 6,899 17,066
Sonoma 6,899 17,066
Stanislaus 7,223 16,485
Sutter 6,686 17,135
Tehama 6,686 17,135
Trinity 6,686 17,135
Tulare 7,223 16,485
Tuolumne 6,686 17,135
Ventura 6,565 17,216
Yolo 6,442 16,884
Yuba 6,686 17,135

 

Colorado

County Employee-
Only
Dependent,
Family, etc.
Adams 6,473 18,805
Alamosa 8,108 18,152
Arapahoe 6,473 18,805
Archuleta 7,782 19,899
Baca 8,108 18,152
Bent 8,108 18,152
Boulder 5,932 18,751
Broomfield 6,473 18,805
Chaffee 8,108 18,152
Cheyenne 8,108 18,152
Clear Creek 6,473 18,805
Conejos 8,108 18,152
Costilla 8,108 18,152
Crowley 8,108 18,152
Custer 8,108 18,152
Delta 7,782 19,899
Denver 6,473 18,805
Dolores 7,782 19,899
Douglas 6,473 18,805
Eagle 7,401 19,560
El Paso 6,109 17,296
Elbert 6,473 18,805
Fremont 8,108 18,152
Garfield 7,401 19,560
Gilpin 6,473 18,805
Grand 7,782 19,899
Gunnison 7,782 19,899
Hinsdale 7,782 19,899
Huerfano 8,108 18,152
Jackson 7,782 19,899
Jefferson 6,473 18,805
Kiowa 8,108 18,152
Kit Carson 8,108 18,152
La Plata 7,782 19,899
Lake 7,782 19,899
Larimer 7,842 15,661
Las Animas 8,108 18,152
Lincoln 8,108 18,152
Logan 6,452 17,979
Mesa 6,247 17,485
Mineral 8,108 18,152
Moffat 7,782 19,899
Montezuma 7,782 19,899
Montrose 7,782 19,899
Morgan 6,452 17,979
Otero 8,108 18,152
Ouray 7,782 19,899
Park 6,473 18,805
Phillips 6,452 17,979
Pitkin 7,401 19,560
Prowers 8,108 18,152
Pueblo 6,909 18,542
Rio Blanco 7,782 19,899
Rio Grande 8,108 18,152
Routt 7,782 19,899
Saguache 8,108 18,152
San Juan 7,782 19,899
San Miguel 7,782 19,899
Sedgwick 6,452 17,979
Summit 7,401 19,560
Teller 6,109 17,296
Washington 6,452 17,979
Weld 6,266 18,203
Yuma 6,452 17,979

 

Connecticut

County Employee-
Only
Dependent,
Family, etc.
Fairfield 7,969 22,318
Hartford 7,443 20,581
Litchfield 7,107 21,335
Middlesex 8,289 21,538
New Haven 8,154 21,310
New London 6,262 16,977
Tolland 7,371 15,494
Windham 7,732 27,150

 

Delaware

County Employee-
Only
Dependent,
Family, etc.
All 7,718 21,577

 

District of Columbia

County Employee-
Only
Dependent,
Family, etc.
All 6,547 21,926

 

Florida

County Employee-
Only
Dependent,
Family, etc.
Alachua 7,824 18,767
Baker 6,819 18,340
Bay 6,104 16,525
Bradford 6,285 18,668
Brevard 7,268 19,268
Broward 6,504 19,677
Calhoun 6,436 18,498
Charlotte 7,602 21,853
Citrus 6,538 16,760
Clay 5,653 18,079
Collier 5,724 18,249
Columbia 7,619 20,834
DeSoto 6,496 19,377
Dixie 6,175 15,955
Duval 6,785 17,101
Escambia 7,011 16,923
Flagler 7,325 18,012
Franklin 6,390 19,561
Gadsden 6,099 18,111
Gilchrist 6,191 18,470
Glades 6,694 21,069
Gulf 7,505 19,997
Hamilton 6,404 18,448
Hardee 6,611 16,125
Hendry 7,605 21,272
Hernando 6,880 19,628
Highlands 7,233 22,204
Hillsborough 6,063 18,134
Holmes 6,664 18,530
Indian River 6,122 16,323
Jackson 5,893 15,950
Jefferson 7,343 17,863
Lafayette 6,707 17,496
Lake 7,765 20,508
Lee 6,462 18,925
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 5,798 16,598
Martin 6,960 20,401
Miami-Dade 6,882 20,551
Monroe 7,638 21,499
Nassau 7,343 16,112
Okaloosa 6,829 25,545
Okeechobee 7,498 20,433
Orange 6,644 17,215
Osceola 7,510 21,366
Palm Beach 7,054 19,831
Pasco 7,222 17,632
Pinellas 6,793 21,198
Polk 6,725 18,800
Putnam 6,547 19,304
Santa Rosa 6,248 15,808
Sarasota 6,314 17,419
Seminole 6,403 16,459
St. Johns 6,230 20,276
St. Lucie 6,195 16,453
Sumter 6,574 20,097
Suwannee 5,954 18,191
Taylor 7,698 20,766
Union 6,404 18,849
Volusia 6,515 18,059
Wakulla 6,279 18,762
Walton 6,203 15,878
Washington 6,572 19,403

 

Georgia

County Employee-
Only
Dependent,
Family, etc.
Appling 7,234 17,746
Atkinson 7,013 19,504
Bacon 5,509 15,512
Baker 7,132 18,814
Baldwin 7,411 19,119
Banks 7,372 17,098
Barrow 6,145 17,934
Bartow 6,329 17,391
Ben Hill 7,286 20,529
Berrien 7,286 20,529
Bibb 6,078 17,514
Bleckley 6,078 17,514
Brantley 5,509 15,512
Brooks 7,286 20,529
Bryan 7,234 17,746
Bulloch 7,234 17,746
Burke 6,568 18,206
Butts 6,329 17,391
Calhoun 7,132 18,814
Camden 5,509 15,512
Candler 7,234 17,746
Carroll 6,588 19,520
Catoosa 6,368 17,840
Charlton 5,509 15,512
Chatham 7,234 17,746
Chattahoochee 5,758 18,095
Chattooga 7,357 18,355
Cherokee 6,329 17,391
Clarke 6,145 17,934
Clay 7,132 18,814
Clayton 6,329 17,391
Clinch 7,286 20,529
Cobb 6,329 17,391
Coffee 7,013 19,504
Colquitt 7,286 20,529
Columbia 6,568 18,206
Cook 7,286 20,529
Coweta 6,329 17,391
Crawford 6,078 17,514
Crisp 7,132 18,814
Dade 6,368 17,840
Dawson 7,372 17,098
Decatur 7,286 20,529
DeKalb 6,329 17,391
Dodge 6,078 17,514
Dooly 6,078 17,514
Dougherty 7,132 18,814
Douglas 6,329 17,391
Early 7,286 20,529
Echols 7,286 20,529
Effingham 7,234 17,746
Elbert 6,145 17,934
Emanuel 6,568 18,206
Evans 7,234 17,746
Fannin 6,022 16,060
Fayette 6,329 17,391
Floyd 7,357 18,355
Forsyth 6,329 17,391
Franklin 7,372 17,098
Fulton 6,329 17,391
Gilmer 7,357 18,355
Glascock 6,568 18,206
Glynn 5,509 15,512
Gordon 7,357 18,355
Grady 7,286 20,529
Greene 6,145 17,934
Gwinnett 6,329 17,391
Habersham 7,372 17,098
Hall 7,372 17,098
Hancock 7,411 19,119
Haralson 6,588 19,520
Harris 5,758 18,095
Hart 7,372 17,098
Heard 6,588 19,520
Henry 6,329 17,391
Houston 6,078 17,514
Irwin 7,286 20,529
Jackson 6,145 17,934
Jasper 6,329 17,391
Jeff Davis 7,013 19,504
Jefferson 6,568 18,206
Jenkins 6,568 18,206
Johnson 7,013 19,504
Jones 6,078 17,514
Lamar 6,329 17,391
Lanier 7,286 20,529
Laurens 7,013 19,504
Lee 7,132 18,814
Liberty 7,234 17,746
Lincoln 6,568 18,206
Long 7,234 17,746
Lowndes 7,286 20,529
Lumpkin 7,372 17,098
Macon 5,758 18,095
Madison 6,145 17,934
Marion 5,758 18,095
McDuffie 6,568 18,206
McIntosh 5,509 15,512
Meriwether 5,758 18,095
Miller 7,286 20,529
Mitchell 7,132 18,814
Monroe 6,078 17,514
Montgomery 7,013 19,504
Morgan 6,145 17,934
Murray 6,022 16,060
Muscogee 5,758 18,095
Newton 6,329 17,391
Oconee 6,145 17,934
Oglethorpe 6,145 17,934
Paulding 6,329 17,391
Peach 6,078 17,514
Pickens 7,357 18,355
Pierce 5,509 15,512
Pike 6,329 17,391
Polk 7,357 18,355
Pulaski 6,078 17,514
Putnam 6,078 17,514
Quitman 5,758 18,095
Rabun 7,372 17,098
Randolph 7,132 18,814
Richmond 6,568 18,206
Rockdale 6,329 17,391
Schley 7,132 18,814
Screven 7,234 17,746
Seminole 7,286 20,529
Spalding 6,329 17,391
Stephens 7,372 17,098
Stewart 5,758 18,095
Sumter 7,132 18,814
Talbot 5,758 18,095
Taliaferro 6,568 18,206
Tattnall 7,234 17,746
Taylor 5,758 18,095
Telfair 7,013 19,504
Terrell 7,132 18,814
Thomas 7,286 20,529
Tift 7,286 20,529
Toombs 7,013 19,504
Towns 7,372 17,098
Treutlen 7,013 19,504
Troup 5,758 18,095
Turner 7,286 20,529
Twiggs 6,078 17,514
Union 7,372 17,098
Upson 5,758 18,095
Walker 6,368 17,840
Walton 6,329 17,391
Ware 5,509 15,512
Warren 6,568 18,206
Washington 7,411 19,119
Wayne 5,509 15,512
Webster 5,758 18,095
Wheeler 7,013 19,504
White 7,372 17,098
Whitfield 6,022 16,060
Wilcox 6,078 17,514
Wilkes 6,568 18,206
Wilkinson 7,411 19,119
Worth 7,132 18,814

 

Hawaii

County Employee-
Only
Dependent,
Family, etc.
All 6,207 18,141

 

Idaho

County Employee-
Only
Dependent,
Family, etc.
Ada 5,405 15,191
Adams 5,053 14,317
Bannock 5,745 16,504
Bear Lake 5,745 16,504
Benewah 5,467 13,471
Bingham 5,745 16,504
Blaine 5,246 16,271
Boise 5,053 14,317
Bonner 5,467 13,471
Bonneville 6,016 15,461
Boundary 5,467 13,471
Butte 5,745 16,504
Camas 5,246 16,271
Canyon 5,053 14,317
Caribou 5,745 16,504
Cassia 5,246 16,271
Clark 6,016 15,461
Clearwater 5,780 16,479
Custer 5,745 16,504
Elmore 5,053 14,317
Franklin 5,745 16,504
Fremont 6,016 15,461
Gem 5,053 14,317
Gooding 5,246 16,271
Idaho 5,780 16,479
Jefferson 6,016 15,461
Jerome 5,246 16,271
Kootenai 5,467 13,471
Latah 5,467 13,471
Lemhi 6,016 15,461
Lewis 5,780 16,479
Lincoln 5,246 16,271
Madison 6,016 15,461
Minidoka 5,246 16,271
Nez Perce 5,780 16,479
Oneida 5,745 16,504
Owyhee 5,053 14,317
Payette 5,053 14,317
Power 5,745 16,504
Shoshone 5,467 13,471
Teton 6,016 15,461
Twin Falls 5,246 16,271
Valley 5,053 14,317
Washington 5,053 14,317

 

Illinois

County Employee-
Only
Dependent,
Family, etc.
Adams 6,399 17,438
Alexander 6,467 21,320
Bond 6,204 17,569
Boone 6,523 19,271
Brown 6,399 17,438
Bureau 5,393 18,874
Calhoun 6,204 17,569
Carroll 6,523 19,271
Cass 6,399 17,438
Champaign 6,755 18,247
Christian 6,399 17,438
Clark 6,755 18,247
Clay 6,467 21,320
Clinton 6,204 17,569
Coles 6,755 18,247
Cook 6,786 20,268
Crawford 6,467 21,320
Cumberland 6,755 18,247
DeKalb 6,523 19,271
DeWitt 7,269 24,851
Douglas 6,755 18,247
DuPage 7,109 20,308
Edgar 6,755 18,247
Edwards 6,467 21,320
Effingham 6,467 21,320
Fayette 6,467 21,320
Ford 6,755 18,247
Franklin 6,467 21,320
Fulton 7,117 18,449
Gallatin 6,467 21,320
Greene 6,204 17,569
Grundy 7,928 20,461
Hamilton 6,467 21,320
Hancock 5,393 18,874
Hardin 6,467 21,320
Henderson 5,393 18,874
Henry 5,393 18,874
Iroquois 6,755 18,247
Jackson 6,467 21,320
Jasper 6,467 21,320
Jefferson 6,467 21,320
Jersey 6,204 17,569
Jo Daviess 6,523 19,271
Johnson 6,467 21,320
Kane 7,109 20,308
Kankakee 7,928 20,461
Kendall 7,928 20,461
Knox 7,117 18,449
Lake 6,435 23,338
LaSalle 7,117 18,449
Lawrence 6,467 21,320
Lee 6,523 19,271
Livingston 7,269 24,851
Logan 6,399 17,438
Macon 6,399 17,438
Macoupin 6,204 17,569
Madison 6,989 18,661
Marion 6,467 21,320
Marshall 7,117 18,449
Mason 6,399 17,438
Massac 6,467 21,320
McDonough 7,117 18,449
McHenry 6,435 23,338
McLean 7,269 24,851
Menard 6,399 17,438
Mercer 5,393 18,874
Monroe 6,989 18,661
Montgomery 6,204 17,569
Morgan 6,399 17,438
Moultrie 6,399 17,438
Ogle 6,523 19,271
Peoria 7,117 18,449
Perry 6,467 21,320
Piatt 6,755 18,247
Pike 6,399 17,438
Pope 6,467 21,320
Pulaski 6,467 21,320
Putnam 7,117 18,449
Randolph 6,204 17,569
Richland 6,467 21,320
Rock Island 5,393 18,874
Saline 6,467 21,320
Sangamon 6,399 17,438
Schuyler 6,399 17,438
Scott 6,399 17,438
Shelby 6,399 17,438
St. Clair 6,989 18,661
Stark 7,117 18,449
Stephenson 6,523 19,271
Tazewell 7,117 18,449
Union 6,467 21,320
Vermilion 6,755 18,247
Wabash 6,467 21,320
Warren 5,393 18,874
Washington 6,204 17,569
Wayne 6,467 21,320
White 6,467 21,320
Whiteside 5,393 18,874
Will 7,928 20,461
Williamson 6,467 21,320
Winnebago 6,523 19,271
Woodford 7,117 18,449

 

Indiana

County Employee-
Only
Dependent,
Family, etc.
Adams 7,447 20,133
Allen 6,518 18,284
Bartholomew 7,220 18,807
Benton 6,934 20,683
Blackford 7,432 17,837
Boone 6,974 20,636
Brown 6,293 19,033
Carroll 6,908 21,591
Cass 6,893 18,619
Clark 6,454 17,410
Clay 7,068 19,132
Clinton 6,908 21,591
Crawford 6,454 17,410
Daviess 7,396 19,890
Dearborn 6,523 20,034
Decatur 7,220 18,807
DeKalb 7,447 20,133
Delaware 7,432 17,837
Dubois 7,396 19,890
Elkhart 7,205 19,301
Fayette 6,074 20,055
Floyd 6,454 17,410
Fountain 6,908 21,591
Franklin 6,523 20,034
Fulton 6,893 18,619
Gibson 8,317 20,280
Grant 7,432 17,837
Greene 7,396 19,890
Hamilton 6,974 20,636
Hancock 6,074 20,055
Harrison 6,454 17,410
Hendricks 6,974 20,636
Henry 6,074 20,055
Howard 6,893 18,619
Huntington 7,447 20,133
Jackson 7,220 18,807
Jasper 6,934 20,683
Jay 7,432 17,837
Jefferson 6,454 17,410
Jennings 7,220 18,807
Johnson 6,293 19,033
Knox 7,396 19,890
Kosciusko 7,205 19,301
LaGrange 7,447 20,133
Lake 7,139 19,655
LaPorte 7,139 19,655
Lawrence 6,293 19,033
Madison 6,074 20,055
Marion 6,974 20,636
Marshall 7,205 19,301
Martin 7,396 19,890
Miami 6,893 18,619
Monroe 6,293 19,033
Montgomery 6,908 21,591
Morgan 6,974 20,636
Newton 6,934 20,683
Noble 7,447 20,133
Ohio 6,523 20,034
Orange 7,396 19,890
Owen 6,293 19,033
Parke 7,068 19,132
Perry 7,396 19,890
Pike 7,396 19,890
Porter 7,139 19,655
Posey 8,317 20,280
Pulaski 6,893 18,619
Putnam 6,908 21,591
Randolph 7,432 17,837
Ripley 6,523 20,034
Rush 7,220 18,807
Scott 6,454 17,410
Shelby 6,974 20,636
Spencer 7,396 19,890
St. Joseph 7,205 19,301
Starke 7,205 19,301
Steuben 7,447 20,133
Sullivan 7,068 19,132
Switzerland 6,523 20,034
Tippecanoe 6,908 21,591
Tipton 6,908 21,591
Union 6,074 20,055
Vanderburgh 8,317 20,280
Vermillion 7,068 19,132
Vigo 7,068 19,132
Wabash 7,447 20,133
Warren 6,934 20,683
Warrick 8,317 20,280
Washington 6,454 17,410
Wayne 6,074 20,055
Wells 7,447 20,133
White 6,934 20,683
Whitley 7,447 20,133

 

Iowa

County Employee-
Only
Dependent,
Family, etc.
Adair 7,241 16,767
Adams 7,241 16,767
Allamakee 6,731 18,689
Appanoose 6,650 16,174
Audubon 7,241 16,767
Benton 6,647 18,063
Black Hawk 6,647 18,063
Boone 6,380 16,316
Bremer 6,731 18,689
Buchanan 6,647 18,063
Buena Vista 6,589 16,992
Butler 6,731 18,689
Calhoun 6,380 16,316
Carroll 6,380 16,316
Cass 7,241 16,767
Cedar 6,647 18,063
Cerro Gordo 6,731 18,689
Cherokee 6,589 16,992
Chickasaw 6,731 18,689
Clarke 7,241 16,767
Clay 6,589 16,992
Clayton 6,647 18,063
Clinton 6,647 18,063
Crawford 6,589 16,992
Dallas 6,458 16,580
Davis 6,650 16,174
Decatur 7,241 16,767
Delaware 6,647 18,063
Des Moines 6,650 16,174
Dickinson 6,589 16,992
Dubuque 6,647 18,063
Emmet 6,731 18,689
Fayette 6,731 18,689
Floyd 6,731 18,689
Franklin 6,731 18,689
Fremont 7,241 16,767
Greene 6,380 16,316
Grundy 6,380 16,316
Guthrie 7,241 16,767
Hamilton 6,380 16,316
Hancock 6,731 18,689
Hardin 6,380 16,316
Harrison 7,241 16,767
Henry 6,650 16,174
Howard 6,731 18,689
Humboldt 6,731 18,689
Ida 6,589 16,992
Iowa 6,647 18,063
Jackson 6,647 18,063
Jasper 6,458 16,580
Jefferson 6,650 16,174
Johnson 6,647 18,063
Jones 6,647 18,063
Keokuk 6,650 16,174
Kossuth 6,731 18,689
Lee 6,650 16,174
Linn 6,647 18,063
Louisa 6,650 16,174
Lucas 6,650 16,174
Lyon 6,589 16,992
Madison 6,458 16,580
Mahaska 6,650 16,174
Marion 6,458 16,580
Marshall 6,380 16,316
Mills 7,241 16,767
Mitchell 6,731 18,689
Monona 6,589 16,992
Monroe 6,650 16,174
Montgomery 7,241 16,767
Muscatine 6,650 16,174
O'Brien 6,589 16,992
Osceola 6,589 16,992
Page 7,241 16,767
Palo Alto 6,589 16,992
Plymouth 6,589 16,992
Pocahontas 6,589 16,992
Polk 6,458 16,580
Pottawattamie 7,241 16,767
Poweshiek 6,380 16,316
Ringgold 7,241 16,767
Sac 6,589 16,992
Scott 6,647 18,063
Shelby 7,241 16,767
Sioux 6,589 16,992
Story 6,380 16,316
Tama 6,380 16,316
Taylor 7,241 16,767
Union 7,241 16,767
Van Buren 6,650 16,174
Wapello 6,650 16,174
Warren 6,458 16,580
Washington 6,650 16,174
Wayne 6,650 16,174
Webster 6,380 16,316
Winnebago 6,731 18,689
Winneshiek 6,731 18,689
Woodbury 6,589 16,992
Worth 6,731 18,689
Wright 6,731 18,689

 

Kansas

County Employee-
Only
Dependent,
Family, etc.
Allen 6,232 19,378
Anderson 5,741 16,956
Atchison 5,741 16,956
Barber 6,516 19,415
Barton 6,167 20,132
Bourbon 6,232 19,378
Brown 5,741 16,956
Butler 5,446 16,175
Chase 5,446 16,175
Chautauqua 5,446 16,175
Cherokee 6,232 19,378
Cheyenne 6,167 20,132
Clark 6,516 19,415
Clay 5,210 15,803
Cloud 5,210 15,803
Coffey 5,741 16,956
Comanche 6,516 19,415
Cowley 5,446 16,175
Crawford 6,232 19,378
Decatur 6,167 20,132
Dickinson 5,210 15,803
Doniphan 5,741 16,956
Douglas 5,741 16,956
Edwards 6,516 19,415
Elk 5,446 16,175
Ellis 6,167 20,132
Ellsworth 5,210 15,803
Finney 6,516 19,415
Ford 6,516 19,415
Franklin 5,741 16,956
Geary 5,210 15,803
Gove 6,167 20,132
Graham 6,167 20,132
Grant 6,516 19,415
Gray 6,516 19,415
Greeley 6,167 20,132
Greenwood 5,446 16,175
Hamilton 6,516 19,415
Harper 5,446 16,175
Harvey 5,446 16,175
Haskell 6,516 19,415
Hodgeman 6,516 19,415
Jackson 5,741 16,956
Jefferson 5,741 16,956
Jewell 5,210 15,803
Johnson 6,519 18,536
Kearny 6,516 19,415
Kingman 5,446 16,175
Kiowa 6,516 19,415
Labette 6,232 19,378
Lane 6,167 20,132
Leavenworth 6,519 18,536
Lincoln 5,210 15,803
Linn 5,741 16,956
Logan 6,167 20,132
Lyon 5,741 16,956
Marion 5,446 16,175
Marshall 5,741 16,956
McPherson 5,446 16,175
Meade 6,516 19,415
Miami 6,519 18,536
Mitchell 5,210 15,803
Montgomery 5,446 16,175
Morris 5,210 15,803
Morton 6,516 19,415
Nemaha 5,741 16,956
Neosho 6,232 19,378
Ness 6,167 20,132
Norton 6,167 20,132
Osage 5,741 16,956
Osborne 6,167 20,132
Ottawa 5,210 15,803
Pawnee 6,516 19,415
Phillips 6,167 20,132
Pottawatomie 5,741 16,956
Pratt 6,516 19,415
Rawlins 6,167 20,132
Reno 5,446 16,175
Republic 5,210 15,803
Rice 5,446 16,175
Riley 5,210 15,803
Rooks 6,167 20,132
Rush 6,167 20,132
Russell 6,167 20,132
Saline 5,210 15,803
Scott 6,167 20,132
Sedgwick 5,446 16,175
Seward 6,516 19,415
Shawnee 5,741 16,956
Sheridan 6,167 20,132
Sherman 6,167 20,132
Smith 6,167 20,132
Stafford 6,516 19,415
Stanton 6,516 19,415
Stevens 6,516 19,415
Sumner 5,446 16,175
Thomas 6,167 20,132
Trego 6,167 20,132
Wabaunsee 5,741 16,956
Wallace 6,167 20,132
Washington 5,210 15,803
Wichita 6,167 20,132
Wilson 5,446 16,175
Woodson 6,232 19,378
Wyandotte 6,519 18,536

 

Kentucky

County Employee-
Only
Dependent,
Family, etc.
Adair 5,792 16,225
Allen 5,792 16,225
Anderson 5,857 16,336
Ballard 7,830 18,655
Barren 5,792 16,225
Bath 6,144 20,621
Bell 6,491 18,733
Boone 6,339 15,093
Bourbon 5,857 16,336
Boyd 6,144 20,621
Boyle 5,857 16,336
Bracken 6,144 20,621
Breathitt 6,491 18,733
Breckinridge 5,975 16,269
Bullitt 5,975 16,269
Butler 5,792 16,225
Caldwell 7,830 18,655
Calloway 7,830 18,655
Campbell 6,339 15,093
Carlisle 7,830 18,655
Carroll 5,975 16,269
Carter 6,144 20,621
Casey 5,792 16,225
Christian 7,439 17,897
Clark 5,857 16,336
Clay 6,491 18,733
Clinton 5,792 16,225
Crittenden 7,830 18,655
Cumberland 5,792 16,225
Daviess 7,439 17,897
Edmonson 5,792 16,225
Elliott 6,144 20,621
Estill 5,857 16,336
Fayette 5,857 16,336
Fleming 6,144 20,621
Floyd 6,491 18,733
Franklin 5,857 16,336
Fulton 7,830 18,655
Gallatin 6,339 15,093
Garrard 5,857 16,336
Grant 6,339 15,093
Graves 7,830 18,655
Grayson 5,975 16,269
Green 5,792 16,225
Greenup 6,144 20,621
Hancock 7,439 17,897
Hardin 5,975 16,269
Harlan 6,491 18,733
Harrison 5,857 16,336
Hart 5,792 16,225
Henderson 7,439 17,897
Henry 5,975 16,269
Hickman 7,830 18,655
Hopkins 7,439 17,897
Jackson 5,857 16,336
Jefferson 5,975 16,269
Jessamine 5,857 16,336
Johnson 6,491 18,733
Kenton 6,339 15,093
Knott 6,491 18,733
Knox 6,491 18,733
LaRue 5,975 16,269
Laurel 6,491 18,733
Lawrence 6,144 20,621
Lee 6,491 18,733
Leslie 6,491 18,733
Letcher 6,491 18,733
Lewis 6,144 20,621
Lincoln 5,857 16,336
Livingston 7,830 18,655
Logan 5,792 16,225
Lyon 7,830 18,655
Madison 5,857 16,336
Magoffin 6,491 18,733
Marion 5,975 16,269
Marshall 7,830 18,655
Martin 6,491 18,733
Mason 6,144 20,621
McCracken 7,830 18,655
McCreary 5,792 16,225
McLean 7,439 17,897
Meade 5,975 16,269
Menifee 6,144 20,621
Mercer 5,857 16,336
Metcalfe 5,792 16,225
Monroe 5,792 16,225
Montgomery 5,857 16,336
Morgan 6,144 20,621
Muhlenberg 7,439 17,897
Nelson 5,975 16,269
Nicholas 5,857 16,336
Ohio 7,439 17,897
Oldham 5,975 16,269
Owen 5,857 16,336
Owsley 6,491 18,733
Pendleton 6,339 15,093
Perry 6,491 18,733
Pike 6,491 18,733
Powell 5,857 16,336
Pulaski 5,792 16,225
Robertson 6,144 20,621
Rockcastle 5,857 16,336
Rowan 6,144 20,621
Russell 5,792 16,225
Scott 5,857 16,336
Shelby 5,975 16,269
Simpson 5,792 16,225
Spencer 5,975 16,269
Taylor 5,792 16,225
Todd 7,439 17,897
Trigg 7,439 17,897
Trimble 5,975 16,269
Union 7,439 17,897
Warren 5,792 16,225
Washington 5,975 16,269
Wayne 5,792 16,225
Webster 7,439 17,897
Whitley 6,491 18,733
Wolfe 6,491 18,733
Woodford 5,857 16,336

 

Louisiana

Parish Employee-
Only
Dependent,
Family, etc.
Acadia 6,678 17,671
Allen 6,833 20,137
Ascension 6,303 18,182
Assumption 6,672 16,751
Avoyelles 6,784 15,197
Beauregard 6,833 20,137
Bienville 7,150 18,227
Bossier 7,150 18,227
Caddo 7,150 18,227
Calcasieu 6,833 20,137
Caldwell 7,386 17,471
Cameron 6,833 20,137
Catahoula 6,784 15,197
Claiborne 7,150 18,227
Concordia 6,784 15,197
DeSoto 7,150 18,227
East Baton Rouge 6,303 18,182
East Carroll 7,386 17,471
East Feliciana 6,303 18,182
Evangeline 6,678 17,671
Franklin 7,386 17,471
Grant 6,784 15,197
Iberia 6,678 17,671
Iberville 6,303 18,182
Jackson 7,386 17,471
Jefferson 6,367 16,795
Jefferson Davis 6,833 20,137
Lafayette 6,678 17,671
Lafourche 6,672 16,751
LaSalle 6,784