Instructions for Form 8941 (2021)

Credit for Small Employer Health Insurance Premiums

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

2021


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.

.This is an Image: taxtip.gifFor 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 and can be taken against both regular and alternative minimum tax. The credit is claimed as part of the general business credit on Form 3800.

.This is an Image: taxtip.gifPartnerships, 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 example, an employer with 48 employees that are each half-time employees has 24 FTEs and can claim the credit. For details, see Worksheets 1 and 2.

.This is an Image: caution.gifAlthough 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 $56,000 per FTE.

For details, see Worksheets 1 and 3.

.This is an Image: caution.gifIf 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 $56,000..

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).

.This is an Image: taxtip.gifNo 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) 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 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, treat the amount you paid toward the employee’s participation as an amount you paid for employee health insurance coverage.

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.

.This is an Image: taxtip.gifA stand-alone dental plan offered through a SHOP exchange will be considered a qualified health plan for purposes of the credit..

.This is an Image: caution.gifEmployer 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, the following applies. 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 considered in calculating the uniform percentage requirement. This is true 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 each of the following amounts if you make the relevant tier of coverage available.

  • 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 each of the following amounts if you make the relevant tier of coverage available.

  • 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 2021, 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 2021.

  • Medicare taxes the tax-exempt employer was required to withhold from employees’ wages in calendar year 2021.

  • Medicare taxes the tax-exempt employer was required to pay for calendar year 2021.

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

.This is an Image: taxtip.gifPartnerships, 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 2021, 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 2021 if they properly claimed the credit under section 45R for all or part of 2020. For details, see Notice 2018-27, 2018-20, I.R.B. 580, available at IRS.gov/irb/2018-20_IRB#NOT-2018-27.

.This is an Image: taxtip.gifTo see whether a particular county has coverage available through a SHOP Exchange for 2021 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 after 2013 and before 2020 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

.This is an Image: caution.gifComplete 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 $56,000 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 2021, 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 $27,800 from line 3 4. _____    
5. Divide line 4 by $27,800. 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 12, or other notice of credit allocation.

.This is an Image: taxtip.gifPartnerships, 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 2021.

  • Medicare taxes the tax-exempt employer was required to withhold from employees’ wages in calendar year 2021.

  • Medicare taxes the tax-exempt employer was required to pay for calendar year 2021.

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 2021.

Alabama

County Employee-
Only
Dependent,
Family, etc.
Autauga 7,526 19,230
Baldwin 6,565 17,489
Barbour 6,565 17,489
Bibb 6,653 18,914
Blount 6,653 18,914
Bullock 6,565 17,489
Butler 6,565 17,489
Calhoun 6,836 18,615
Chambers 6,565 17,489
Cherokee 6,565 17,489
Chilton 6,653 18,914
Choctaw 6,565 17,489
Clarke 6,565 17,489
Clay 6,565 17,489
Cleburne 6,565 17,489
Coffee 6,565 17,489
Colbert 8,654 19,748
Conecuh 6,565 17,489
Coosa 6,565 17,489
Covington 6,565 17,489
Crenshaw 6,565 17,489
Cullman 6,565 17,489
Dale 6,565 17,489
Dallas 6,565 17,489
DeKalb 6,565 17,489
Elmore 7,526 19,230
Escambia 6,565 17,489
Etowah 6,447 18,794
Fayette 6,565 17,489
Franklin 6,565 17,489
Geneva 7,388 18,433
Greene 7,603 18,629
Hale 7,603 18,629
Henry 7,388 18,433
Houston 7,388 18,433
Jackson 6,565 17,489
Jefferson 6,653 18,914
Lamar 6,565 17,489
Lauderdale 8,654 19,748
Lawrence 7,893 19,596
Lee 6,298 15,915
Limestone 6,480 19,585
Lowndes 7,526 19,230
Macon 6,565 17,489
Madison 6,480 19,585
Marengo 6,565 17,489
Marion 6,565 17,489
Marshall 6,565 17,489
Mobile 7,468 18,918
Monroe 6,565 17,489
Montgomery 7,526 19,230
Morgan 7,893 19,596
Perry 6,565 17,489
Pickens 6,565 17,489
Pike 6,565 17,489
Randolph 6,565 17,489
Russell 7,136 18,051
Shelby 6,653 18,914
St. Clair 6,653 18,914
Sumter 6,565 17,489
Talladega 6,565 17,489
Tallapoosa 6,565 17,489
Tuscaloosa 7,603 18,629
Walker 6,653 18,914
Washington 6,565 17,489
Wilcox 6,565 17,489
Winston 6,565 17,489
 

Alaska

County Employee-
Only
Dependent,
Family, etc.
Aleutians East 12,011 27,855
Aleutians West 12,011 27,855
Anchorage 11,303 28,132
Bethel 11,303 28,132
Bristol Bay 12,011 27,855
Denali 12,011 27,855
Dillingham 11,303 28,132
Fairbanks North Star 12,011 27,855
Haines 11,771 28,003
Hoonah-Angoon 11,771 28,003
Juneau 11,771 28,003
Kenai Peninsula 12,011 27,855
Ketchikan Gateway 11,771 28,003
Kodiak Island 12,011 27,855
Lake and Peninsula 12,011 27,855
Matanuska Susitna 12,011 27,855
Nome 12,011 27,855
North Slope 12,011 27,855
Northwest Arctic 12,011 27,855
Petersburg 11,771 28,003
Prince of Wales-Hyder 11,771 28,003
Sitka 11,771 28,003
Skagway 11,771 28,003
Southeast Fairbanks 12,011 27,855
Valdez Cordova 11,303 28,132
Wade Hampton 12,011 27,855
Wrangell City and Borough 11,771 28,003
Yakutat 12,011 27,855
Yukon Koyukuk 12,011 27,855
 

Arizona

County Employee-
Only
Dependent,
Family, etc.
Apache 6,840 20,297
Cochise 6,558 17,906
Coconino 6,840 20,297
Gila 6,671 17,498
Graham 6,558 17,906
Greenlee 6,558 17,906
La Paz 7,826 19,901
Maricopa 6,811 18,849
Mohave 6,840 20,297
Navajo 6,840 20,297
Pima 6,452 17,791
Pinal 6,671 17,498
Santa Cruz 6,452 17,791
Yavapai 6,286 18,780
Yuma 7,826 19,901
 

Arkansas

County Employee-
Only
Dependent,
Family, etc.
Arkansas 6,501 16,114
Ashley 6,501 16,114
Baxter 6,230 18,525
Benton 6,230 18,525
Boone 6,230 18,525
Bradley 6,501 16,114
Calhoun 6,566 22,348
Carroll 6,230 18,525
Chicot 6,501 16,114
Clark 5,127 17,075
Clay 6,267 19,137
Cleburne 6,051 16,588
Cleveland 6,501 16,114
Columbia 6,566 22,348
Conway 6,051 16,588
Craighead 6,267 19,137
Crawford 6,078 18,584
Crittenden 6,267 19,137
Cross 6,267 19,137
Dallas 6,501 16,114
Desha 6,501 16,114
Drew 6,501 16,114
Faulkner 6,051 16,588
Franklin 6,078 18,584
Fulton 6,267 19,137
Garland 5,127 17,075
Grant 6,051 16,588
Greene 6,267 19,137
Hempstead 6,566 22,348
Hot Spring 5,127 17,075
Howard 6,566 22,348
Independence 6,267 19,137
Izard 6,267 19,137
Jackson 6,267 19,137
Jefferson 6,501 16,114
Johnson 6,078 18,584
Lafayette 6,566 22,348
Lawrence 6,267 19,137
Lee 6,501 16,114
Lincoln 6,501 16,114
Little River 6,566 22,348
Logan 6,078 18,584
Lonoke 6,051 16,588
Madison 6,230 18,525
Marion 6,230 18,525
Miller 6,566 22,348
Mississippi 6,267 19,137
Monroe 6,501 16,114
Montgomery 5,127 17,075
Nevada 6,566 22,348
Newton 6,230 18,525
Ouachita 6,566 22,348
Perry 6,051 16,588
Phillips 6,501 16,114
Pike 5,127 17,075
Poinsett 6,267 19,137
Polk 6,078 18,584
Pope 6,051 16,588
Prairie 6,051 16,588
Pulaski 6,051 16,588
Randolph 6,267 19,137
Saline 6,051 16,588
Scott 6,078 18,584
Searcy 6,230 18,525
Sebastian 6,078 18,584
Sevier 6,566 22,348
Sharp 6,267 19,137
St. Francis 6,267 19,137
Stone 6,267 19,137
Union 6,566 22,348
Van Buren 6,051 16,588
Washington 6,230 18,525
White 6,051 16,588
Woodruff 6,267 19,137
Yell 6,051 16,588
 

California

County Employee-
Only
Dependent,
Family, etc.
Alameda 8,242 22,491
Alpine 8,171 19,175
Amador 8,171 19,175
Butte 8,171 19,175
Calaveras 8,171 19,175
Colusa 8,171 19,175
Contra Costa 8,093 22,307
Del Norte 8,171 19,175
El Dorado 6,881 20,484
Fresno 6,633 22,121
Glenn 8,171 19,175
Humboldt 8,171 19,175
Imperial 6,764 19,134
Inyo 6,764 19,134
Kern 7,202 18,566
Kings 6,633 22,121
Lake 8,171 19,175
Lassen 8,171 19,175
Los Angeles 7,135 21,647
Madera 6,633 22,121
Marin 7,057 19,416
Mariposa 7,778 20,227
Mendocino 8,171 19,175
Merced 7,778 20,227
Modoc 8,171 19,175
Mono 6,764 19,134
Monterey 8,014 21,969
Napa 7,057 19,416
Nevada 8,171 19,175
Orange 7,573 23,118
Placer 6,881 20,484
Plumas 8,171 19,175
Riverside 7,561 19,737
Sacramento 6,881 20,484
San Benito 8,014 21,969
San Bernardino 7,561 19,737
San Diego 6,433 18,778
San Francisco 7,867 26,196
San Joaquin 7,778 20,227
San Luis Obispo 7,235 20,308
San Mateo 9,354 25,434
Santa Barbara 7,235 20,308
Santa Clara 8,304 24,507
Santa Cruz 8,014 21,969
Shasta 8,171 19,175
Sierra 8,171 19,175
Siskiyou 8,171 19,175
Solano 7,057 19,416
Sonoma 7,057 19,416
Stanislaus 7,778 20,227
Sutter 8,171 19,175
Tehama 8,171 19,175
Trinity 8,171 19,175
Tulare 7,778 20,227
Tuolumne 8,171 19,175
Ventura 7,235 20,308
Yolo 6,881 20,484
Yuba 8,171 19,175
 

Colorado

County Employee-
Only
Dependent,
Family, etc.
Adams 7,344 21,656
Alamosa 8,633 23,653
Arapahoe 7,344 21,656
Archuleta 8,143 24,827
Baca 8,633 23,653
Bent 8,633 23,653
Boulder 6,913 22,089
Broomfield 7,344 21,656
Chaffee 8,633 23,653
Cheyenne 8,633 23,653
Clear Creek 7,344 21,656
Conejos 8,633 23,653
Costilla 8,633 23,653
Crowley 8,633 23,653
Custer 8,633 23,653
Delta 8,143 24,827
Denver 7,344 21,656
Dolores 8,143 24,827
Douglas 7,344 21,656
Eagle 7,847 24,678
El Paso 6,539 22,503
Elbert 7,344 21,656
Fremont 8,633 23,653
Garfield 7,847 24,678
Gilpin 7,344 21,656
Grand 8,143 24,827
Gunnison 8,143 24,827
Hinsdale 8,143 24,827
Huerfano 8,633 23,653
Jackson 8,143 24,827
Jefferson 7,344 21,656
Kiowa 8,633 23,653
Kit Carson 8,633 23,653
La Plata 8,143 24,827
Lake 8,143 24,827
Larimer 8,694 19,692
Las Animas 8,633 23,653
Lincoln 8,633 23,653
Logan 6,930 21,955
Mesa 7,498 20,992
Mineral 8,633 23,653
Moffat 8,143 24,827
Montezuma 8,143 24,827
Montrose 8,143 24,827
Morgan 6,930 21,955
Otero 8,633 23,653
Ouray 8,143 24,827
Park 7,344 21,656
Phillips 6,930 21,955
Pitkin 7,847 24,678
Prowers 8,633 23,653
Pueblo 6,909 18,542
Rio Blanco 8,143 24,827
Rio Grande 8,633 23,653
Routt 8,143 24,827
Saguache 8,633 23,653
San Juan 8,143 24,827
San Miguel 8,143 24,827
Sedgwick 6,930 21,955
Summit 7,847 24,678
Teller 6,539 22,503
Washington 6,930 21,955
Weld 7,424 26,016
Yuma 6,930 21,955
 

Connecticut

County Employee-
Only
Dependent,
Family, etc.
Fairfield 8,215 23,998
Hartford 7,723 21,840
Litchfield 7,478 23,655
Middlesex 8,289 21,936
New Haven 8,748 24,357
New London 7,390 19,471
Tolland 7,379 17,769
Windham 8,445 31,308
 

Delaware

County Employee-
Only
Dependent,
Family, etc.
All 8,444 23,587
 

District of Columbia

County Employee-
Only
Dependent,
Family, etc.
All 8,036 23,874
 

Florida

County Employee-
Only
Dependent,
Family, etc.
Alachua 8,141 20,991
Baker 7,456 20,822
Bay 7,014 19,289
Bradford 7,019 20,950
Brevard 7,746 21,890
Broward 7,307 20,593
Calhoun 7,197 20,787
Charlotte 8,184 23,859
Citrus 7,199 19,641
Clay 6,623 20,828
Collier 6,835 24,981
Columbia 7,858 22,655
DeSoto 7,292 21,687
Dixie 7,073 19,151
Duval 7,059 20,947
Escambia 7,575 19,604
Flagler 7,911 21,062
Franklin 7,209 22,002
Gadsden 6,968 20,814
Gilchrist 6,775 20,814
Glades 7,542 23,373
Gulf 8,044 22,150
Hamilton 7,132 20,720
Hardee 7,067 18,671
Hendry 8,068 23,309
Hernando 7,636 21,653
Highlands 7,693 23,786
Hillsborough 6,699 20,708
Holmes 7,262 20,832
Indian River 6,943 19,405
Jackson 6,718 18,756
Jefferson 7,826 20,388
Lafayette 7,206 19,409
Lake 8,231 22,177
Lee 7,413 22,034
Leon 8,389 24,467
Levy 7,075 21,653
Liberty 7,211 21,544
Madison 7,995 21,842
Manatee 7,583 20,547
Marion 6,342 19,289
Martin 7,619 22,929
Miami-Dade 7,671 23,473
Monroe 8,165 23,652
Nassau 7,901 18,835
Okaloosa 7,623 27,260
Okeechobee 8,056 22,815
Orange 6,830 19,653
Osceola 8,112 22,721
Palm Beach 8,207 24,447
Pasco 7,366 20,034
Pinellas 7,005 22,139
Polk 6,725 20,680
Putnam 7,340 21,416
Santa Rosa 6,952 18,942
Sarasota 6,807 18,517
Seminole 7,594 18,876
St. Johns 9,412 24,636
St. Lucie 7,232 19,964
Sumter 7,459 22,769
Suwannee 6,687 20,690
Taylor 8,290 22,921
Union 7,237 21,396
Volusia 7,443 20,111
Wakulla 6,944 21,188
Walton 7,307 19,391
Washington 7,346 21,567
 

Georgia

County Employee-
Only
Dependent,
Family, etc.
Appling 8,993 24,273
Atkinson 7,013 20,446
Bacon 6,388 19,799
Baker 7,846 23,360
Baldwin 7,700 21,179
Banks 8,299 21,521
Barrow 7,964 19,863
Bartow 7,366 20,580
Ben Hill 7,286 20,627
Berrien 7,286 20,627
Bibb 6,954 18,181
Bleckley 6,954 18,181
Brantley 6,388 19,799
Brooks 7,286 20,627
Bryan 8,993 24,273
Bulloch 8,993 24,273
Burke 6,959 18,720
Butts 7,366 20,580
Calhoun 7,846 23,360
Camden 6,388 19,799
Candler 8,993 24,273
Carroll 7,089 21,387
Catoosa 7,029 20,867
Charlton 6,388 19,799
Chatham 8,993 24,273
Chattahoochee 6,546 18,862
Chattooga 7,794 21,273
Cherokee 7,366 20,580
Clarke 7,964 19,863
Clay 7,846 23,360
Clayton 7,366 20,580
Clinch 7,286 20,627
Cobb 7,366 20,580
Coffee 7,013 20,446
Colquitt 7,286 20,627
Columbia 6,959 18,720
Cook 7,286 20,627
Coweta 7,366 20,580
Crawford 6,954 18,181
Crisp 7,846 23,360
Dade 7,029 20,867
Dawson 8,299 21,521
Decatur 7,286 20,627
DeKalb 7,366 20,580
Dodge 6,954 18,181
Dooly 6,954 18,181
Dougherty 7,846 23,360
Douglas 7,366 20,580
Early 7,286 20,627
Echols 7,286 20,627
Effingham 8,993 24,273
Elbert 7,964 19,863
Emanuel 6,959 18,720
Evans 8,993 24,273
Fannin 7,329 20,158
Fayette 7,366 20,580
Floyd 7,794 21,273
Forsyth 7,366 20,580
Franklin 8,299 21,521
Fulton 7,366 20,580
Gilmer 7,794 21,273
Glascock 6,959 18,720
Glynn 6,388 19,799
Gordon 7,794 21,273
Grady 7,286 20,627
Greene 7,964 19,863
Gwinnett 7,366 20,580
Habersham 8,299 21,521
Hall 8,299 21,521
Hancock 7,700 21,179
Haralson 7,089 21,387
Harris 6,546 18,862
Hart 8,299 21,521
Heard 7,089 21,387
Henry 7,366 20,580
Houston 6,954 18,181
Irwin 7,286 20,627
Jackson 7,964 19,863
Jasper 7,366 20,580
Jeff Davis 7,013 20,446
Jefferson 6,959 18,720
Jenkins 6,959 18,720
Johnson 7,013 20,446
Jones 6,954 18,181
Lamar 7,366 20,580
Lanier 7,286 20,627
Laurens 7,013 20,446
Lee 7,846 23,360
Liberty 8,993 24,273
Lincoln 6,959 18,720
Long 8,993 24,273
Lowndes 7,286 20,627
Lumpkin 8,299 21,521
Macon 6,546 18,862
Madison 7,964 19,863
Marion 6,546 18,862
McDuffie 6,959 18,720
McIntosh 6,388 19,799
Meriwether 6,546 18,862
Miller 7,286 20,627
Mitchell 7,846 23,360
Monroe 6,954 18,181
Montgomery 7,013 20,446
Morgan 7,964 19,863
Murray 7,329 20,158
Muscogee 6,546 18,862
Newton 7,366 20,580
Oconee 7,964 19,863
Oglethorpe 7,964 19,863
Paulding 7,366 20,580
Peach 6,954 18,181
Pickens 7,794 21,273
Pierce 6,388 19,799
Pike 7,366 20,580
Polk 7,794 21,273
Pulaski 6,954 18,181
Putnam 6,954 18,181
Quitman 6,546 18,862
Rabun 8,299 21,521
Randolph 7,846 23,360
Richmond 6,959 18,720
Rockdale 7,366 20,580
Schley 7,846 23,360
Screven 8,993 24,273
Seminole 7,286 20,627
Spalding 7,366 20,580
Stephens 8,299 21,521
Stewart 6,546 18,862
Sumter 7,846 23,360
Talbot 6,546 18,862
Taliaferro 6,959 18,720
Tattnall 8,993 24,273
Taylor 6,546 18,862
Telfair 7,013 20,446
Terrell 7,846 23,360
Thomas 7,286 20,627
Tift 7,286 20,627
Toombs 7,013 20,446
Towns 8,299 21,521
Treutlen 7,013 20,446
Troup 6,546 18,862
Turner 7,286 20,627
Twiggs 6,954 18,181
Union 8,299 21,521
Upson 6,546 18,862
Walker 7,029 20,867
Walton 7,366 20,580
Ware 6,388 19,799
Warren 6,959 18,720
Washington 7,700 21,179
Wayne 6,388 19,799
Webster 6,546 18,862
Wheeler 7,013 20,446
White 8,299 21,521
Whitfield 7,329 20,158
Wilcox 6,954 18,181
Wilkes 6,959 18,720
Wilkinson 7,700 21,179
Worth 7,846 23,360
 

Hawaii

County Employee-
Only
Dependent,
Family, etc.
All 7,628 21,523
 

Idaho

County Employee-
Only
Dependent,
Family, etc.
Ada 6,050 16,519
Adams 5,587 15,087
Bannock 6,987 17,973
Bear Lake 6,987 17,973
Benewah 6,197 16,093
Bingham 6,987 17,973
Blaine 6,095 18,948
Boise 5,587 15,087
Bonner 6,197 16,093
Bonneville 6,574 18,278
Boundary 6,197 16,093
Butte 6,987 17,973
Camas 6,095 18,948
Canyon 5,587 15,087
Caribou 6,987 17,973
Cassia 6,095 18,948
Clark 6,574 18,278
Clearwater 6,778 16,818
Custer 6,987 17,973
Elmore 5,587 15,087
Franklin 6,987 17,973
Fremont 6,574 18,278
Gem 5,587 15,087
Gooding 6,095 18,948
Idaho 6,778 16,818
Jefferson 6,574 18,278
Jerome 6,095 18,948
Kootenai 6,197 16,093
Latah 6,197 16,093
Lemhi 6,574 18,278
Lewis 6,778 16,818
Lincoln 6,095 18,948
Madison 6,574 18,278
Minidoka 6,095 18,948
Nez Perce 6,778 16,818
Oneida 6,987 17,973
Owyhee 5,587 15,087
Payette 5,587 15,087
Power 6,987 17,973
Shoshone 6,197 16,093
Teton 6,574 18,278
Twin Falls 6,095 18,948
Valley 5,587 15,087
Washington 5,587 15,087
 

Illinois

County Employee-
Only
Dependent,
Family, etc.
Adams 7,685 19,139
Alexander 8,097 25,949
Bond 7,369 22,013
Boone 7,981 22,362
Brown 7,685 19,139
Bureau 6,673 20,301
Calhoun 7,369 22,013
Carroll 7,981 22,362
Cass 7,685 19,139
Champaign 8,290 21,185
Christian 7,685 19,139
Clark 8,290 21,185
Clay 8,097 25,949
Clinton 7,369 22,013
Coles 8,290 21,185
Cook 7,630 23,937
Crawford 8,097 25,949
Cumberland 8,290 21,185
DeKalb 7,981 22,362
DeWitt 8,401 24,851
Douglas 8,290 21,185
DuPage 7,901 23,738
Edgar 8,290 21,185
Edwards 8,097 25,949
Effingham 8,097 25,949
Fayette 8,097 25,949
Ford 8,290 21,185
Franklin 8,097 25,949
Fulton 7,908 21,322
Gallatin 8,097 25,949
Greene 7,369 22,013
Grundy 8,001 20,461
Hamilton 8,097 25,949
Hancock 6,673 20,301
Hardin 8,097 25,949
Henderson 6,673 20,301
Henry 6,673 20,301
Iroquois 8,290 21,185
Jackson 8,097 25,949
Jasper 8,097 25,949
Jefferson 8,097 25,949
Jersey 7,369 22,013
Jo Daviess 7,981 22,362
Johnson 8,097 25,949
Kane 7,901 23,738
Kankakee 8,001 20,461
Kendall 8,001 20,461
Knox 7,908 21,322
Lake 6,757 24,199
LaSalle 7,908 21,322
Lawrence 8,097 25,949
Lee 7,981 22,362
Livingston 8,401 24,851
Logan 7,685 19,139
Macon 7,685 19,139
Macoupin 7,369 22,013
Madison 7,872 20,961
Marion 8,097 25,949
Marshall 7,908 21,322
Mason 7,685 19,139
Massac 8,097 25,949
McDonough 7,908 21,322
McHenry 6,757 24,199
McLean 8,401 24,851
Menard 7,685 19,139
Mercer 6,673 20,301
Monroe 7,872 20,961
Montgomery 7,369 22,013
Morgan 7,685 19,139
Moultrie 7,685 19,139
Ogle 7,981 22,362
Peoria 7,908 21,322
Perry 8,097 25,949
Piatt 8,290 21,185
Pike 7,685 19,139
Pope 8,097 25,949
Pulaski 8,097 25,949
Putnam 7,908 21,322
Randolph 7,369 22,013
Richland 8,097 25,949
Rock Island 6,673 20,301
Saline 8,097 25,949
Sangamon 7,685 19,139
Schuyler 7,685 19,139
Scott 7,685 19,139
Shelby 7,685 19,139
St. Clair 7,872 20,961
Stark 7,908 21,322
Stephenson 7,981 22,362
Tazewell 7,908 21,322
Union 8,097 25,949
Vermilion 8,290 21,185
Wabash 8,097 25,949
Warren 6,673 20,301
Washington 7,369 22,013
Wayne 8,097 25,949
White 8,097 25,949
Whiteside 6,673 20,301
Will 8,001 20,461
Williamson 8,097 25,949
Winnebago 7,981 22,362
Woodford 7,908 21,322
 

Indiana

County Employee-
Only
Dependent,
Family, etc.
Adams 7,478 23,214
Allen 7,885 24,189
Bartholomew 7,972 22,560
Benton 8,165 25,391
Blackford 8,053 21,898
Boone 7,971 25,255
Brown 8,081 23,034
Carroll 7,797 26,016
Cass 7,663 21,199
Clark 6,966 21,081
Clay 7,068 22,156
Clinton 7,797 26,016
Crawford 6,966 21,081
Daviess 7,669 22,769
Dearborn 8,289 24,245
Decatur 7,972 22,560
DeKalb 7,478 23,214
Delaware 8,053 21,898
Dubois 7,669 22,769
Elkhart 8,340 22,494
Fayette 7,510 22,139
Floyd 6,966 21,081
Fountain 7,797 26,016
Franklin 8,289 24,245
Fulton 7,663 21,199
Gibson 9,570 24,463
Grant 8,053 21,898
Greene 7,669 22,769
Hamilton 7,971 25,255
Hancock 7,510 22,139
Harrison 6,966 21,081
Hendricks 7,971 25,255
Henry 7,510 22,139
Howard 7,663 21,199
Huntington 7,478 23,214
Jackson 7,972 22,560
Jasper 8,165 25,391
Jay 8,053 21,898
Jefferson 6,966 21,081
Jennings 7,972 22,560
Johnson 8,081 23,034
Knox 7,669 22,769
Kosciusko 8,340 22,494
LaGrange 7,478 23,214
Lake 8,474 22,352
LaPorte 8,474 22,352
Lawrence 8,081 23,034
Madison 7,510 22,139
Marion 7,971 25,255
Marshall 8,340 22,494
Martin 7,669 22,769
Miami 7,663 21,199
Monroe 8,081 23,034
Montgomery 7,797 26,016
Morgan 7,971 25,255
Newton 8,165 25,391
Noble 7,478 23,214
Ohio 8,289 24,245
Orange 7,669 22,769
Owen 8,081 23,034
Parke 7,068 22,156
Perry 7,669 22,769
Pike 7,669 22,769
Porter 8,474 22,352
Posey 9,570 24,463
Pulaski 7,663 21,199
Putnam 7,797 26,016
Randolph 8,053 21,898
Ripley 8,289 24,245
Rush 7,972 22,560
Scott 6,966 21,081
Shelby 7,971 25,255
Spencer 7,669 22,769
St. Joseph 8,340 22,494
Starke 8,340 22,494
Steuben 7,478 23,214
Sullivan 7,068 22,156
Switzerland 8,289 24,245
Tippecanoe 7,797 26,016
Tipton 7,797 26,016
Union 7,510 22,139
Vanderburgh 9,570 24,463
Vermillion 7,068 22,156
Vigo 7,068 22,156
Wabash 7,478 23,214
Warren 8,165 25,391
Warrick 9,570 24,463
Washington 6,966 21,081
Wayne 7,510 22,139
Wells 7,478 23,214
White 8,165 25,391
Whitley 7,478 23,214
 

Iowa

County Employee-
Only
Dependent,
Family, etc.
Adair 8,299 18,911
Adams 8,299 18,911
Allamakee 7,379 21,093
Appanoose 7,262 18,678
Audubon 8,299 18,911
Benton 6,970 19,956
Black Hawk 6,970 19,956
Boone 6,380 19,492
Bremer 7,379 21,093
Buchanan 6,970 19,956
Buena Vista 7,388 19,924
Butler 7,379 21,093
Calhoun 6,380 19,492
Carroll 6,380 19,492
Cass 8,299 18,911
Cedar 6,970 19,956
Cerro Gordo 7,379 21,093
Cherokee 7,388 19,924
Chickasaw 7,379 21,093
Clarke 8,299 18,911
Clay 7,388 19,924
Clayton 6,970 19,956
Clinton 6,970 19,956
Crawford 7,388 19,924
Dallas 6,825 20,228
Davis 7,262 18,678
Decatur 8,299 18,911
Delaware 6,970 19,956
Des Moines 7,262 18,678
Dickinson 7,388 19,924
Dubuque 6,970 19,956
Emmet 7,379 21,093
Fayette 7,379 21,093
Floyd 7,379 21,093
Franklin 7,379 21,093
Fremont 8,299 18,911
Greene 6,380 19,492
Grundy 6,380 19,492
Guthrie 8,299 18,911
Hamilton 6,380 19,492
Hancock 7,379 21,093
Hardin 6,380 19,492
Harrison 8,299 18,911
Henry 7,262 18,678
Howard 7,379 21,093
Humboldt 7,379 21,093
Ida 7,388 19,924
Iowa 6,970 19,956
Jackson 6,970 19,956
Jasper 6,825 20,228
Jefferson 7,262 18,678
Johnson 6,970 19,956
Jones 6,970 19,956
Keokuk 7,262 18,678
Kossuth 7,379 21,093
Lee 7,262 18,678
Linn 6,970 19,956
Louisa 7,262 18,678
Lucas 7,262 18,678
Lyon 7,388 19,924
Madison 6,825 20,228
Mahaska 7,262 18,678
Marion 6,825 20,228
Marshall 6,380 19,492
Mills 8,299 18,911
Mitchell 7,379 21,093
Monona 7,388 19,924
Monroe 7,262 18,678
Montgomery 8,299 18,911
Muscatine 7,262 18,678
O'Brien 7,388 19,924
Osceola 7,388 19,924
Page 8,299 18,911
Palo Alto 7,388 19,924
Plymouth 7,388 19,924
Pocahontas 7,388 19,924
Polk 6,825 20,228
Pottawattamie 8,299 18,911
Poweshiek 6,380 19,492
Ringgold 8,299 18,911
Sac 7,388 19,924
Scott 6,970 19,956
Shelby 8,299 18,911
Sioux 7,388 19,924
Story 6,380 19,492
Tama 6,380 19,492
Taylor 8,299 18,911
Union 8,299 18,911
Van Buren 7,262 18,678
Wapello 7,262 18,678
Warren 6,825 20,228
Washington 7,262 18,678
Wayne 7,262 18,678
Webster 6,380 19,492
Winnebago 7,379 21,093
Winneshiek 7,379 21,093
Woodbury 7,388 19,924
Worth 7,379 21,093
Wright 7,379 21,093
 

Kansas

County Employee-
Only
Dependent,
Family, etc.
Allen 7,460 19,378
Anderson 6,137 19,264
Atchison 6,137 19,264
Barber 6,516 20,210
Barton 6,919 21,412
Bourbon 7,460 19,378
Brown 6,137 19,264
Butler 6,295 18,161
Chase 6,295 18,161
Chautauqua 6,295 18,161
Cherokee 7,460 19,378
Cheyenne 6,919 21,412
Clark 6,516 20,210
Clay 6,086 17,604
Cloud 6,086 17,604
Coffey 6,137 19,264
Comanche 6,516 20,210
Cowley 6,295 18,161
Crawford 7,460 19,378
Decatur 6,919 21,412
Dickinson 6,086 17,604
Doniphan 6,137 19,264
Douglas 6,137 19,264
Edwards 6,516 20,210
Elk 6,295 18,161
Ellis 6,919 21,412
Ellsworth 6,086 17,604
Finney 6,516 20,210
Ford 6,516 20,210
Franklin 6,137 19,264
Geary 6,086 17,604
Gove 6,919 21,412
Graham 6,919 21,412
Grant 6,516 20,210
Gray 6,516 20,210
Greeley 6,919 21,412
Greenwood 6,295 18,161
Hamilton 6,516 20,210
Harper 6,295 18,161
Harvey 6,295 18,161
Haskell 6,516 20,210
Hodgeman 6,516 20,210
Jackson 6,137 19,264
Jefferson 6,137 19,264
Jewell 6,086 17,604
Johnson 7,265 20,490
Kearny 6,516 20,210
Kingman 6,295 18,161
Kiowa 6,516 20,210
Labette 7,460 19,378
Lane 6,919 21,412
Leavenworth 7,265 20,490
Lincoln 6,086 17,604
Linn 6,137 19,264
Logan 6,919 21,412
Lyon 6,137 19,264
Marion 6,295 18,161
Marshall 6,137 19,264
McPherson 6,295 18,161
Meade 6,516 20,210
Miami 7,265 20,490
Mitchell 6,086 17,604
Montgomery 6,295 18,161
Morris 6,086 17,604
Morton 6,516 20,210
Nemaha 6,137 19,264
Neosho 7,460 19,378
Ness 6,919 21,412
Norton 6,919 21,412
Osage 6,137 19,264
Osborne 6,919 21,412
Ottawa 6,086 17,604
Pawnee 6,516 20,210
Phillips 6,919 21,412
Pottawatomie 6,137 19,264
Pratt 6,516 20,210
Rawlins 6,919 21,412
Reno 6,295 18,161
Republic 6,086 17,604
Rice 6,295 18,161
Riley 6,086 17,604
Rooks 6,919 21,412
Rush 6,919 21,412
Russell 6,919 21,412
Saline 6,086 17,604
Scott 6,919 21,412
Sedgwick 6,295 18,161
Seward 6,516 20,210
Shawnee 6,137 19,264
Sheridan 6,919 21,412
Sherman 6,919 21,412
Smith 6,919 21,412
Stafford 6,516 20,210
Stanton 6,516 20,210
Stevens 6,516 20,210
Sumner 6,295 18,161
Thomas 6,919 21,412
Trego 6,919 21,412
Wabaunsee 6,137 19,264
Wallace 6,919 21,412
Washington 6,086 17,604
Wichita 6,919 21,412
Wilson 6,295 18,161
Woodson 7,460 19,378
Wyandotte 7,265 20,490
 

Kentucky

County Employee-
Only
Dependent,
Family, etc.
Adair 6,633 19,790
Allen 6,633 19,790
Anderson 6,360 19,187
Ballard 8,670 19,250
Barren 6,633 19,790
Bath 7,159 20,621
Bell 7,208 21,247
Boone 6,339 17,457
Bourbon 6,360 19,187
Boyd 7,159 20,621
Boyle 6,360 19,187
Bracken 7,159 20,621
Breathitt 7,208 21,247
Breckinridge 6,863 18,840
Bullitt 6,863 18,840
Butler 6,633 19,790
Caldwell 8,670 19,250
Calloway 8,670 19,250
Campbell 6,339 17,457
Carlisle 8,670 19,250
Carroll 6,863 18,840
Carter 7,159 20,621
Casey 6,633 19,790
Christian 8,314 20,031
Clark 6,360 19,187
Clay 7,208 21,247
Clinton 6,633 19,790
Crittenden 8,670 19,250
Cumberland 6,633 19,790
Daviess 8,314 20,031
Edmonson 6,633 19,790
Elliott 7,159 20,621
Estill 6,360 19,187
Fayette 6,360 19,187
Fleming 7,159 20,621
Floyd 7,208 21,247
Franklin 6,360 19,187
Fulton 8,670 19,250
Gallatin 6,339 17,457
Garrard 6,360 19,187
Grant 6,339 17,457
Graves 8,670 19,250
Grayson 6,863 18,840
Green 6,633 19,790
Greenup 7,159 20,621
Hancock 8,314 20,031
Hardin 6,863 18,840
Harlan 7,208 21,247
Harrison 6,360 19,187
Hart 6,633 19,790
Henderson 8,314 20,031
Henry 6,863 18,840
Hickman 8,670 19,250
Hopkins 8,314 20,031
Jackson 6,360 19,187
Jefferson 6,863 18,840
Jessamine 6,360 19,187
Johnson 7,208 21,247
Kenton 6,339 17,457
Knott 7,208 21,247
Knox 7,208 21,247
LaRue 6,863 18,840
Laurel 7,208 21,247
Lawrence 7,159 20,621
Lee 7,208 21,247
Leslie 7,208 21,247
Letcher 7,208 21,247
Lewis 7,159 20,621
Lincoln 6,360 19,187
Livingston 8,670 19,250
Logan 6,633 19,790
Lyon 8,670 19,250
Madison 6,360 19,187
Magoffin 7,208 21,247
Marion 6,863 18,840
Marshall 8,670 19,250
Martin 7,208 21,247
Mason 7,159 20,621
McCracken 8,670 19,250
McCreary 6,633 19,790
McLean 8,314 20,031
Meade 6,863 18,840
Menifee 7,159 20,621
Mercer 6,360 19,187
Metcalfe 6,633 19,790
Monroe 6,633 19,790
Montgomery 6,360 19,187
Morgan 7,159 20,621
Muhlenberg 8,314 20,031
Nelson 6,863 18,840
Nicholas 6,360 19,187
Ohio 8,314 20,031
Oldham 6,863 18,840
Owen 6,360 19,187
Owsley 7,208 21,247
Pendleton 6,339 17,457
Perry 7,208 21,247
Pike 7,208 21,247
Powell 6,360 19,187
Pulaski 6,633 19,790
Robertson 7,159 20,621
Rockcastle 6,360 19,187
Rowan 7,159 20,621
Russell 6,633 19,790
Scott 6,360 19,187
Shelby 6,863 18,840
Simpson 6,633 19,790
Spencer 6,863 18,840
Taylor 6,633 19,790
Todd 8,314 20,031
Trigg 8,314 20,031
Trimble 6,863 18,840
Union 8,314 20,031
Warren 6,633 19,790
Washington 6,863 18,840
Wayne 6,633 19,790
Webster 8,314 20,031
Whitley 7,208 21,247
Wolfe 7,208 21,247
Woodford 6,360 19,187
 

Louisiana

Parish Employee-
Only
Dependent,
Family, etc.
Acadia 7,541 18,078
Allen 7,717 20,137
Ascension 7,533 19,568
Assumption 7,514 17,764
Avoyelles 8,112 17,923
Beauregard 7,717 20,137
Bienville 7,794 19,283
Bossier 7,794 19,283
Caddo 7,794 19,283
Calcasieu 7,717 20,137
Caldwell 7,876 17,471
Cameron 7,717 20,137
Catahoula 8,112 17,923
Claiborne 7,794 19,283
Concordia 8,112 17,923
DeSoto 7,794 19,283
East Baton Rouge 7,533 19,568
East Carroll 7,876 17,471
East Feliciana 7,533 19,568
Evangeline 7,541 18,078
Franklin 7,876 17,471
Grant 8,112 17,923
Iberia 7,541 18,078
Iberville 7,533 19,568
Jackson 7,876 17,471
Jefferson 7,139 18,432
Jefferson Davis 7,717 20,137
Lafayette 7,541 18,078
Lafourche 7,514 17,764
LaSalle 8,112 17,923
Lincoln 7,876 17,471
Livingston 7,533 19,568
Madison 7,876 17,471
Morehouse