Instructions for Form 8941 (2020)

Credit for Small Employer Health Insurance Premiums

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

2020


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 2020, 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 2020.

  • Medicare taxes the tax-exempt employer was required to withhold from employees’ wages in calendar year 2020.

  • Medicare taxes the tax-exempt employer was required to pay for calendar year 2020.

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 2020, 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 2020 if they properly claimed the credit under section 45R for all or part of 2019. 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 2020 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, 2017, or 2018 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 2020, 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 $27,600 from line 3 4. _____    
5. Divide line 4 by $27,600. 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 2020.

  • Medicare taxes the tax-exempt employer was required to withhold from employees’ wages in calendar year 2020.

  • Medicare taxes the tax-exempt employer was required to pay for calendar year 2020.

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 2020.

Alabama

County Employee-
Only
Dependent,
Family, etc.
Autauga 7,502 19,230
Baldwin 6,364 17,134
Barbour 6,364 17,134
Bibb 6,653 18,914
Blount 6,653 18,914
Bullock 6,364 17,134
Butler 6,364 17,134
Calhoun 6,836 18,615
Chambers 6,364 17,134
Cherokee 6,364 17,134
Chilton 6,653 18,914
Choctaw 6,364 17,134
Clarke 6,364 17,134
Clay 6,364 17,134
Cleburne 6,364 17,134
Coffee 6,364 17,134
Colbert 8,654 19,748
Conecuh 6,364 17,134
Coosa 6,364 17,134
Covington 6,364 17,134
Crenshaw 6,364 17,134
Cullman 6,364 17,134
Dale 6,364 17,134
Dallas 6,364 17,134
DeKalb 6,364 17,134
Elmore 7,502 19,230
Escambia 6,364 17,134
Etowah 6,447 18,794
Fayette 6,364 17,134
Franklin 6,364 17,134
Geneva 6,455 17,196
Greene 7,603 18,629
Hale 7,603 18,629
Henry 6,455 17,196
Houston 6,455 17,196
Jackson 6,364 17,134
Jefferson 6,653 18,914
Lamar 6,364 17,134
Lauderdale 8,654 19,748
Lawrence 7,893 19,596
Lee 6,298 15,915
Limestone 6,480 19,585
Lowndes 7,502 19,230
Macon 6,364 17,134
Madison 6,480 19,585
Marengo 6,364 17,134
Marion 6,364 17,134
Marshall 6,364 17,134
Mobile 7,238 18,375
Monroe 6,364 17,134
Montgomery 7,502 19,230
Morgan 7,893 19,596
Perry 6,364 17,134
Pickens 6,364 17,134
Pike 6,364 17,134
Randolph 6,364 17,134
Russell 7,136 18,051
Shelby 6,653 18,914
St. Clair 6,653 18,914
Sumter 6,364 17,134
Talladega 6,364 17,134
Tallapoosa 6,364 17,134
Tuscaloosa 7,603 18,629
Walker 6,653 18,914
Washington 6,364 17,134
Wilcox 6,364 17,134
Winston 6,364 17,134
 

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 6,048 17,726
Cochise 6,445 17,906
Coconino 6,048 17,726
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 17,726
Navajo 6,048 17,726
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 6,450 16,114
Ashley 6,450 16,114
Baxter 6,120 17,714
Benton 6,120 17,714
Boone 6,120 17,714
Bradley 6,450 16,114
Calhoun 6,538 22,348
Carroll 6,120 17,714
Chicot 6,450 16,114
Clark 5,127 17,075
Clay 6,209 19,137
Cleburne 5,886 16,588
Cleveland 6,450 16,114
Columbia 6,538 22,348
Conway 5,886 16,588
Craighead 6,209 19,137
Crawford 6,021 18,584
Crittenden 6,209 19,137
Cross 6,209 19,137
Dallas 6,450 16,114
Desha 6,450 16,114
Drew 6,450 16,114
Faulkner 5,886 16,588
Franklin 6,021 18,584
Fulton 6,209 19,137
Garland 5,127 17,075
Grant 5,886 16,588
Greene 6,209 19,137
Hempstead 6,538 22,348
Hot Spring 5,127 17,075
Howard 6,538 22,348
Independence 6,209 19,137
Izard 6,209 19,137
Jackson 6,209 19,137
Jefferson 6,450 16,114
Johnson 6,021 18,584
Lafayette 6,538 22,348
Lawrence 6,209 19,137
Lee 6,450 16,114
Lincoln 6,450 16,114
Little River 6,538 22,348
Logan 6,021 18,584
Lonoke 5,886 16,588
Madison 6,120 17,714
Marion 6,120 17,714
Miller 6,538 22,348
Mississippi 6,209 19,137
Monroe 6,450 16,114
Montgomery 5,127 17,075
Nevada 6,538 22,348
Newton 6,120 17,714
Ouachita 6,538 22,348
Perry 5,886 16,588
Phillips 6,450 16,114
Pike 5,127 17,075
Poinsett 6,209 19,137
Polk 6,021 18,584
Pope 5,886 16,588
Prairie 5,886 16,588
Pulaski 5,886 16,588
Randolph 6,209 19,137
Saline 5,886 16,588
Scott 6,021 18,584
Searcy 6,120 17,714
Sebastian 6,021 18,584
Sevier 6,538 22,348
Sharp 6,209 19,137
St. Francis 6,209 19,137
Stone 6,209 19,137
Union 6,538 22,348
Van Buren 5,886 16,588
Washington 6,120 17,714
White 5,886 16,588
Woodruff 6,209 19,137
Yell 5,886 16,588
 

California

County Employee-
Only
Dependent,
Family, etc.
Alameda 7,649 22,491
Alpine 7,436 18,868
Amador 7,436 18,868
Butte 7,436 18,868
Calaveras 7,436 18,868
Colusa 7,436 18,868
Contra Costa 8,093 22,307
Del Norte 7,436 18,868
El Dorado 6,881 20,484
Fresno 6,633 22,121
Glenn 7,436 18,868
Humboldt 7,436 18,868
Imperial 6,376 18,072
Inyo 6,376 18,072
Kern 7,202 18,566
Kings 6,633 22,121
Lake 7,436 18,868
Lassen 7,436 18,868
Los Angeles 7,135 21,647
Madera 6,633 22,121
Marin 7,057 19,020
Mariposa 7,778 20,227
Mendocino 7,436 18,868
Merced 7,778 20,227
Modoc 7,436 18,868
Mono 6,376 18,072
Monterey 7,301 19,546
Napa 7,057 19,020
Nevada 7,436 18,868
Orange 7,256 23,118
Placer 6,881 20,484
Plumas 7,436 18,868
Riverside 7,232 19,737
Sacramento 6,881 20,484
San Benito 7,301 19,546
San Bernardino 7,232 19,737
San Diego 6,411 18,778
San Francisco 7,867 25,686
San Joaquin 7,778 20,227
San Luis Obispo 7,193 20,308
San Mateo 9,354 25,434
Santa Barbara 7,193 20,308
Santa Clara 8,304 24,507
Santa Cruz 7,301 19,546
Shasta 7,436 18,868
Sierra 7,436 18,868
Siskiyou 7,436 18,868
Solano 7,057 19,020
Sonoma 7,057 19,020
Stanislaus 7,778 20,227
Sutter 7,436 18,868
Tehama 7,436 18,868
Trinity 7,436 18,868
Tulare 7,778 20,227
Tuolumne 7,436 18,868
Ventura 7,193 20,308
Yolo 6,881 20,484
Yuba 7,436 18,868
 

Colorado

County Employee-
Only
Dependent,
Family, etc.
Adams 6,490 19,791
Alamosa 8,108 20,892
Arapahoe 6,490 19,791
Archuleta 7,782 22,728
Baca 8,108 20,892
Bent 8,108 20,892
Boulder 5,932 20,656
Broomfield 6,490 19,791
Chaffee 8,108 20,892
Cheyenne 8,108 20,892
Clear Creek 6,490 19,791
Conejos 8,108 20,892
Costilla 8,108 20,892
Crowley 8,108 20,892
Custer 8,108 20,892
Delta 7,782 22,728
Denver 6,490 19,791
Dolores 7,782 22,728
Douglas 6,490 19,791
Eagle 7,401 22,402
El Paso 6,109 19,408
Elbert 6,490 19,791
Fremont 8,108 20,892
Garfield 7,401 22,402
Gilpin 6,490 19,791
Grand 7,782 22,728
Gunnison 7,782 22,728
Hinsdale 7,782 22,728
Huerfano 8,108 20,892
Jackson 7,782 22,728
Jefferson 6,490 19,791
Kiowa 8,108 20,892
Kit Carson 8,108 20,892
La Plata 7,782 22,728
Lake 7,782 22,728
Larimer 7,842 17,707
Las Animas 8,108 20,892
Lincoln 8,108 20,892
Logan 6,452 19,153
Mesa 6,247 18,275
Mineral 8,108 20,892
Moffat 7,782 22,728
Montezuma 7,782 22,728
Montrose 7,782 22,728
Morgan 6,452 19,153
Otero 8,108 20,892
Ouray 7,782 22,728
Park 6,490 19,791
Phillips 6,452 19,153
Pitkin 7,401 22,402
Prowers 8,108 20,892
Pueblo 6,909 18,542
Rio Blanco 7,782 22,728
Rio Grande 8,108 20,892
Routt 7,782 22,728
Saguache 8,108 20,892
San Juan 7,782 22,728
San Miguel 7,782 22,728
Sedgwick 6,452 19,153
Summit 7,401 22,402
Teller 6,109 19,408
Washington 6,452 19,153
Weld 6,519 20,915
Yuma 6,452 19,153
 

Connecticut

County Employee-
Only
Dependent,
Family, etc.
Fairfield 8,215 22,318
Hartford 7,690 20,581
Litchfield 7,478 22,054
Middlesex 8,289 21,538
New Haven 8,748 21,530
New London 6,262 16,977
Tolland 7,379 15,494
Windham 8,445 27,550
 

Delaware

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

District of Columbia

County Employee-
Only
Dependent,
Family, etc.
All 7,071 22,894
 

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 7,291 20,593
Calhoun 7,197 20,787
Charlotte 8,184 23,859
Citrus 7,199 19,641
Clay 6,623 20,828
Collier 6,543 20,510
Columbia 7,858 22,655
DeSoto 7,292 21,687
Dixie 7,073 19,151
Duval 7,059 20,947
Escambia 7,575 19,577
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 20,406
Holmes 7,262 20,832
Indian River 6,943 19,312
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 8,289 23,046
Levy 7,075 21,653
Liberty 7,211 21,544
Madison 7,995 21,842
Manatee 7,419 20,547
Marion 6,342 18,693
Martin 7,619 22,929
Miami-Dade 7,671 23,473
Monroe 8,165 23,652
Nassau 7,901 18,734
Okaloosa 7,623 27,260
Okeechobee 8,056 22,815
Orange 6,830 19,653
Osceola 8,112 22,721
Palm Beach 8,029 23,416
Pasco 7,366 19,962
Pinellas 7,005 22,139
Polk 6,725 20,680
Putnam 7,340 21,416
Santa Rosa 6,952 18,849
Sarasota 6,807 18,517
Seminole 7,594 18,876
St. Johns 8,328 24,303
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 7,427 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 8,036 19,774
Atkinson 7,013 19,504
Bacon 5,784 17,208
Baker 7,132 20,481
Baldwin 7,411 19,588
Banks 7,658 19,049
Barrow 7,359 18,509
Bartow 6,646 19,111
Ben Hill 7,286 20,627
Berrien 7,286 20,627
Bibb 6,078 17,514
Bleckley 6,078 17,514
Brantley 5,784 17,208
Brooks 7,286 20,627
Bryan 8,036 19,774
Bulloch 8,036 19,774
Burke 6,803 18,522
Butts 6,646 19,111
Calhoun 7,132 20,481
Camden 5,784 17,208
Candler 8,036 19,774
Carroll 6,646 19,857
Catoosa 6,536 18,934
Charlton 5,784 17,208
Chatham 8,036 19,774
Chattahoochee 5,900 18,654
Chattooga 7,357 18,983
Cherokee 6,646 19,111
Clarke 7,359 18,509
Clay 7,132 20,481
Clayton 6,646 19,111
Clinch 7,286 20,627
Cobb 6,646 19,111
Coffee 7,013 19,504
Colquitt 7,286 20,627
Columbia 6,803 18,522
Cook 7,286 20,627
Coweta 6,646 19,111
Crawford 6,078 17,514
Crisp 7,132 20,481
Dade 6,536 18,934
Dawson 7,658 19,049
Decatur 7,286 20,627
DeKalb 6,646 19,111
Dodge 6,078 17,514
Dooly 6,078 17,514
Dougherty 7,132 20,481
Douglas 6,646 19,111
Early 7,286 20,627
Echols 7,286 20,627
Effingham 8,036 19,774
Elbert 7,359 18,509
Emanuel 6,803 18,522
Evans 8,036 19,774
Fannin 6,991 18,208
Fayette 6,646 19,111
Floyd 7,357 18,983
Forsyth 6,646 19,111
Franklin 7,658 19,049
Fulton 6,646 19,111
Gilmer 7,357 18,983
Glascock 6,803 18,522
Glynn 5,784 17,208
Gordon 7,357 18,983
Grady 7,286 20,627
Greene 7,359 18,509
Gwinnett 6,646 19,111
Habersham 7,658 19,049
Hall 7,658 19,049
Hancock 7,411 19,588
Haralson 6,646 19,857
Harris 5,900 18,654
Hart 7,658 19,049
Heard 6,646 19,857
Henry 6,646 19,111
Houston 6,078 17,514
Irwin 7,286 20,627
Jackson 7,359 18,509
Jasper 6,646 19,111
Jeff Davis 7,013 19,504
Jefferson 6,803 18,522
Jenkins 6,803 18,522
Johnson 7,013 19,504
Jones 6,078 17,514
Lamar 6,646 19,111
Lanier 7,286 20,627
Laurens 7,013 19,504
Lee 7,132 20,481
Liberty 8,036 19,774
Lincoln 6,803 18,522
Long 8,036 19,774
Lowndes 7,286 20,627
Lumpkin 7,658 19,049
Macon 5,900 18,654
Madison 7,359 18,509
Marion 5,900 18,654
McDuffie 6,803 18,522
McIntosh 5,784 17,208
Meriwether 5,900 18,654
Miller 7,286 20,627
Mitchell 7,132 20,481
Monroe 6,078 17,514
Montgomery 7,013 19,504
Morgan 7,359 18,509
Murray 6,991 18,208
Muscogee 5,900 18,654
Newton 6,646 19,111
Oconee 7,359 18,509
Oglethorpe 7,359 18,509
Paulding 6,646 19,111
Peach 6,078 17,514
Pickens 7,357 18,983
Pierce 5,784 17,208
Pike 6,646 19,111
Polk 7,357 18,983
Pulaski 6,078 17,514
Putnam 6,078 17,514
Quitman 5,900 18,654
Rabun 7,658 19,049
Randolph 7,132 20,481
Richmond 6,803 18,522
Rockdale 6,646 19,111
Schley 7,132 20,481
Screven 8,036 19,774
Seminole 7,286 20,627
Spalding 6,646 19,111
Stephens 7,658 19,049
Stewart 5,900 18,654
Sumter 7,132 20,481
Talbot 5,900 18,654
Taliaferro 6,803 18,522
Tattnall 8,036 19,774
Taylor 5,900 18,654
Telfair 7,013 19,504
Terrell 7,132 20,481
Thomas 7,286 20,627
Tift 7,286 20,627
Toombs 7,013 19,504
Towns 7,658 19,049
Treutlen 7,013 19,504
Troup 5,900 18,654
Turner 7,286 20,627
Twiggs 6,078 17,514
Union 7,658 19,049
Upson 5,900 18,654
Walker 6,536 18,934
Walton 6,646 19,111
Ware 5,784 17,208
Warren 6,803 18,522
Washington 7,411 19,588
Wayne 5,784 17,208
Webster 5,900 18,654
Wheeler 7,013 19,504
White 7,658 19,049
Whitfield 6,991 18,208
Wilcox 6,078 17,514
Wilkes 6,803 18,522
Wilkinson 7,411 19,588
Worth 7,132 20,481
 

Hawaii

County Employee-
Only
Dependent,
Family, etc.
All 6,993 20,813
 

Idaho

County Employee-
Only
Dependent,
Family, etc.
Ada 6,050 15,291
Adams 5,587 14,317
Bannock 6,358 16,504
Bear Lake 6,358 16,504
Benewah 6,197 14,300
Bingham 6,358 16,504
Blaine 6,095 16,987
Boise 5,587 14,317
Bonner 6,197 14,300
Bonneville 6,574 16,177
Boundary 6,197 14,300
Butte 6,358 16,504
Camas 6,095 16,987
Canyon 5,587 14,317
Caribou 6,358 16,504
Cassia 6,095 16,987
Clark 6,574 16,177
Clearwater 6,698 16,479
Custer 6,358 16,504
Elmore 5,587 14,317
Franklin 6,358 16,504
Fremont 6,574 16,177
Gem 5,587 14,317
Gooding 6,095 16,987
Idaho 6,698 16,479
Jefferson 6,574 16,177
Jerome 6,095 16,987
Kootenai 6,197 14,300
Latah 6,197 14,300
Lemhi 6,574 16,177
Lewis 6,698 16,479
Lincoln 6,095 16,987
Madison 6,574 16,177
Minidoka 6,095 16,987
Nez Perce 6,698 16,479
Oneida 6,358 16,504
Owyhee 5,587 14,317
Payette 5,587 14,317
Power 6,358 16,504
Shoshone 6,197 14,300
Teton 6,574 16,177
Twin Falls 6,095 16,987
Valley 5,587 14,317
Washington 5,587 14,317
 

Illinois

County Employee-
Only
Dependent,
Family, etc.
Adams 7,294 17,919
Alexander 7,805 23,378
Bond 6,987 19,098
Boone 7,565 19,271
Brown 7,294 17,919
Bureau 6,317 18,874
Calhoun 6,987 19,098
Carroll 7,565 19,271
Cass 7,294 17,919
Champaign 7,518 19,061
Christian 7,294 17,919
Clark 7,518 19,061
Clay 7,805 23,378
Clinton 6,987 19,098
Coles 7,518 19,061
Cook 7,432 21,993
Crawford 7,805 23,378
Cumberland 7,518 19,061
DeKalb 7,565 19,271
DeWitt 8,401 24,851
Douglas 7,518 19,061
DuPage 7,901 21,382
Edgar 7,518 19,061
Edwards 7,805 23,378
Effingham 7,805 23,378
Fayette 7,805 23,378
Ford 7,518 19,061
Franklin 7,805 23,378
Fulton 7,800 19,904
Gallatin 7,805 23,378
Greene 6,987 19,098
Grundy 8,001 20,461
Hamilton 7,805 23,378
Hancock 6,317 18,874
Hardin 7,805 23,378
Henderson 6,317 18,874
Henry 6,317 18,874
Iroquois 7,518 19,061
Jackson 7,805 23,378
Jasper 7,805 23,378
Jefferson 7,805 23,378
Jersey 6,987 19,098
Jo Daviess 7,565 19,271
Johnson 7,805 23,378
Kane 7,901 21,382
Kankakee 8,001 20,461
Kendall 8,001 20,461
Knox 7,800 19,904
Lake 6,690 23,338
LaSalle 7,800 19,904
Lawrence 7,805 23,378
Lee 7,565 19,271
Livingston 8,401 24,851
Logan 7,294 17,919
Macon 7,294 17,919
Macoupin 6,987 19,098
Madison 7,726 19,935
Marion 7,805 23,378
Marshall 7,800 19,904
Mason 7,294 17,919
Massac 7,805 23,378
McDonough 7,800 19,904
McHenry 6,690 23,338
McLean 8,401 24,851
Menard 7,294 17,919
Mercer 6,317 18,874
Monroe 7,726 19,935
Montgomery 6,987 19,098
Morgan 7,294 17,919
Moultrie 7,294 17,919
Ogle 7,565 19,271
Peoria 7,800 19,904
Perry 7,805 23,378
Piatt 7,518 19,061
Pike 7,294 17,919
Pope 7,805 23,378
Pulaski 7,805 23,378
Putnam 7,800 19,904
Randolph 6,987 19,098
Richland 7,805 23,378
Rock Island 6,317 18,874
Saline 7,805 23,378
Sangamon 7,294 17,919
Schuyler 7,294 17,919
Scott 7,294 17,919
Shelby 7,294 17,919
St. Clair 7,726 19,935
Stark 7,800 19,904
Stephenson 7,565 19,271
Tazewell 7,800 19,904
Union 7,805 23,378
Vermilion 7,518 19,061
Wabash 7,805 23,378
Warren 6,317 18,874
Washington 6,987 19,098
Wayne 7,805 23,378
White 7,805 23,378
Whiteside 6,317 18,874
Will 8,001 20,461
Williamson 7,805 23,378
Winnebago 7,565 19,271
Woodford 7,800 19,904
 

Indiana

County Employee-
Only
Dependent,
Family, etc.
Adams 7,447 23,214
Allen 7,176 23,045
Bartholomew 7,632 22,560
Benton 7,559 25,391
Blackford 7,432 21,898
Boone 7,104 25,255
Brown 7,225 22,415
Carroll 6,908 25,729
Cass 6,893 21,199
Clark 6,454 21,081
Clay 7,068 22,156
Clinton 6,908 25,729
Crawford 6,454 21,081
Daviess 7,396 22,769
Dearborn 7,583 24,245
Decatur 7,632 22,560
DeKalb 7,447 23,214
Delaware 7,432 21,898
Dubois 7,396 22,769
Elkhart 7,585 22,494
Fayette 7,173 22,139
Floyd 6,454 21,081
Fountain 6,908 25,729
Franklin 7,583 24,245
Fulton 6,893 21,199
Gibson 8,317 24,463
Grant 7,432 21,898
Greene 7,396 22,769
Hamilton 7,104 25,255
Hancock 7,173 22,139
Harrison 6,454 21,081
Hendricks 7,104 25,255
Henry 7,173 22,139
Howard 6,893 21,199
Huntington 7,447 23,214
Jackson 7,632 22,560
Jasper 7,559 25,391
Jay 7,432 21,898
Jefferson 6,454 21,081
Jennings 7,632 22,560
Johnson 7,225 22,415
Knox 7,396 22,769
Kosciusko 7,585 22,494
LaGrange 7,447 23,214
Lake 7,666 22,333
LaPorte 7,666 22,333
Lawrence 7,225 22,415
Madison 7,173 22,139
Marion 7,104 25,255
Marshall 7,585 22,494
Martin 7,396 22,769
Miami 6,893 21,199
Monroe 7,225 22,415
Montgomery 6,908 25,729
Morgan 7,104 25,255
Newton 7,559 25,391
Noble 7,447 23,214
Ohio 7,583 24,245
Orange 7,396 22,769
Owen 7,225 22,415
Parke 7,068 22,156
Perry 7,396 22,769
Pike 7,396 22,769
Porter 7,666 22,333
Posey 8,317 24,463
Pulaski 6,893 21,199
Putnam 6,908 25,729
Randolph 7,432 21,898
Ripley 7,583 24,245
Rush 7,632 22,560
Scott 6,454 21,081
Shelby 7,104 25,255
Spencer 7,396 22,769
St. Joseph 7,585 22,494
Starke 7,585 22,494
Steuben 7,447 23,214
Sullivan 7,068 22,156
Switzerland 7,583 24,245
Tippecanoe 6,908 25,729
Tipton 6,908 25,729
Union 7,173 22,139
Vanderburgh 8,317 24,463
Vermillion 7,068 22,156
Vigo 7,068 22,156
Wabash 7,447 23,214
Warren 7,559 25,391
Warrick 8,317 24,463
Washington 6,454 21,081
Wayne 7,173 22,139
Wells 7,447 23,214
White 7,559 25,391
Whitley 7,447 23,214
 

Iowa

County Employee-
Only
Dependent,
Family, etc.
Adair 7,284 16,767
Adams 7,284 16,767
Allamakee 6,731 19,889
Appanoose 6,650 17,923
Audubon 7,284 16,767
Benton 6,647 18,721
Black Hawk 6,647 18,721
Boone 6,380 19,023
Bremer 6,731 19,889
Buchanan 6,647 18,721
Buena Vista 6,589 18,908
Butler 6,731 19,889
Calhoun 6,380 19,023
Carroll 6,380 19,023
Cass 7,284 16,767
Cedar 6,647 18,721
Cerro Gordo 6,731 19,889
Cherokee 6,589 18,908
Chickasaw 6,731 19,889
Clarke 7,284 16,767
Clay 6,589 18,908
Clayton 6,647 18,721
Clinton 6,647 18,721
Crawford 6,589 18,908
Dallas 6,458 18,089
Davis 6,650 17,923
Decatur 7,284 16,767
Delaware 6,647 18,721
Des Moines 6,650 17,923
Dickinson 6,589 18,908
Dubuque 6,647 18,721
Emmet 6,731 19,889
Fayette 6,731 19,889
Floyd 6,731 19,889
Franklin 6,731 19,889
Fremont 7,284 16,767
Greene 6,380 19,023
Grundy 6,380 19,023
Guthrie 7,284 16,767
Hamilton 6,380 19,023
Hancock 6,731 19,889
Hardin 6,380 19,023
Harrison 7,284 16,767
Henry 6,650 17,923
Howard 6,731 19,889
Humboldt 6,731 19,889
Ida 6,589 18,908
Iowa 6,647 18,721
Jackson 6,647 18,721
Jasper 6,458 18,089
Jefferson 6,650 17,923
Johnson 6,647 18,721
Jones 6,647 18,721
Keokuk 6,650 17,923
Kossuth 6,731 19,889
Lee 6,650 17,923
Linn 6,647 18,721
Louisa 6,650 17,923
Lucas 6,650 17,923
Lyon 6,589 18,908
Madison 6,458 18,089
Mahaska 6,650 17,923
Marion 6,458 18,089
Marshall 6,380 19,023
Mills 7,284 16,767
Mitchell 6,731 19,889
Monona 6,589 18,908
Monroe 6,650 17,923
Montgomery 7,284 16,767
Muscatine 6,650 17,923
O'Brien 6,589 18,908
Osceola 6,589 18,908
Page 7,284 16,767
Palo Alto 6,589 18,908
Plymouth 6,589 18,908
Pocahontas 6,589 18,908
Polk 6,458 18,089
Pottawattamie 7,284 16,767
Poweshiek 6,380 19,023
Ringgold 7,284 16,767
Sac 6,589 18,908
Scott 6,647 18,721
Shelby 7,284 16,767
Sioux 6,589 18,908
Story 6,380 19,023
Tama 6,380 19,023
Taylor 7,284 16,767
Union 7,284 16,767
Van Buren 6,650 17,923
Wapello 6,650 17,923
Warren 6,458 18,089
Washington 6,650 17,923
Wayne 6,650 17,923
Webster 6,380 19,023
Winnebago 6,731 19,889
Winneshiek 6,731 19,889
Woodbury 6,589 18,908
Worth 6,731 19,889
Wright 6,731 19,889
 

Kansas

County Employee-
Only
Dependent,
Family, etc.
Allen 6,886 19,378
Anderson 5,741 16,956
Atchison 5,741 16,956
Barber 6,516 19,415
Barton 6,172 20,132
Bourbon 6,886 19,378
Brown 5,741 16,956
Butler 5,511 16,298
Chase 5,511 16,298
Chautauqua 5,511 16,298
Cherokee 6,886 19,378
Cheyenne 6,172 20,132
Clark 6,516 19,415
Clay 5,509 15,803
Cloud 5,509 15,803
Coffey 5,741 16,956
Comanche 6,516 19,415
Cowley 5,511 16,298
Crawford 6,886 19,378
Decatur 6,172 20,132
Dickinson 5,509 15,803
Doniphan 5,741 16,956
Douglas 5,741 16,956
Edwards 6,516 19,415
Elk 5,511 16,298
Ellis 6,172 20,132
Ellsworth 5,509 15,803
Finney 6,516 19,415
Ford 6,516 19,415
Franklin 5,741 16,956
Geary 5,509 15,803
Gove 6,172 20,132
Graham 6,172 20,132
Grant 6,516 19,415
Gray 6,516 19,415
Greeley 6,172 20,132
Greenwood 5,511 16,298
Hamilton 6,516 19,415
Harper 5,511 16,298
Harvey 5,511 16,298
Haskell 6,516 19,415
Hodgeman 6,516 19,415
Jackson 5,741 16,956
Jefferson 5,741 16,956
Jewell 5,509 15,803
Johnson 6,630 18,536
Kearny 6,516 19,415
Kingman 5,511 16,298
Kiowa 6,516 19,415
Labette 6,886 19,378
Lane 6,172 20,132
Leavenworth 6,630 18,536
Lincoln 5,509 15,803
Linn 5,741 16,956
Logan 6,172 20,132
Lyon 5,741 16,956
Marion 5,511 16,298
Marshall 5,741 16,956
McPherson 5,511 16,298
Meade 6,516 19,415
Miami 6,630 18,536
Mitchell 5,509 15,803
Montgomery 5,511 16,298
Morris 5,509 15,803
Morton 6,516 19,415
Nemaha 5,741 16,956
Neosho 6,886 19,378
Ness 6,172 20,132
Norton 6,172 20,132
Osage 5,741 16,956
Osborne 6,172 20,132
Ottawa 5,509 15,803
Pawnee 6,516 19,415
Phillips 6,172 20,132
Pottawatomie 5,741 16,956
Pratt 6,516 19,415
Rawlins 6,172 20,132
Reno 5,511 16,298
Republic 5,509 15,803
Rice 5,511 16,298
Riley 5,509 15,803
Rooks 6,172 20,132
Rush 6,172 20,132
Russell 6,172 20,132
Saline 5,509 15,803
Scott 6,172 20,132
Sedgwick 5,511 16,298
Seward 6,516 19,415
Shawnee 5,741 16,956
Sheridan 6,172 20,132
Sherman 6,172 20,132
Smith 6,172 20,132
Stafford 6,516 19,415
Stanton 6,516 19,415
Stevens 6,516 19,415
Sumner 5,511 16,298
Thomas 6,172 20,132
Trego 6,172 20,132
Wabaunsee 5,741 16,956
Wallace 6,172 20,132
Washington 5,509 15,803
Wichita 6,172 20,132
Wilson 5,511 16,298
Woodson 6,886 19,378
Wyandotte 6,630 18,536
 

Kentucky

County Employee-
Only
Dependent,
Family, etc.
Adair 6,272 19,247
Allen 6,272 19,247
Anderson 6,226 19,187
Ballard 8,670 19,250
Barren 6,272 19,247
Bath 7,159 20,621
Bell 6,994 21,247
Boone 6,339 16,734
Bourbon 6,226 19,187
Boyd 7,159 20,621
Boyle 6,226 19,187
Bracken 7,159 20,621
Breathitt 6,994 21,247
Breckinridge 6,775 18,840
Bullitt 6,775 18,840
Butler 6,272 19,247
Caldwell 8,670 19,250
Calloway 8,670 19,250
Campbell 6,339 16,734
Carlisle 8,670 19,250
Carroll 6,775 18,840
Carter 7,159 20,621
Casey 6,272 19,247
Christian 8,172 20,031
Clark 6,226 19,187
Clay 6,994 21,247
Clinton 6,272 19,247
Crittenden 8,670 19,250
Cumberland 6,272 19,247
Daviess 8,172 20,031
Edmonson 6,272 19,247
Elliott 7,159 20,621
Estill 6,226 19,187
Fayette 6,226 19,187
Fleming 7,159 20,621
Floyd 6,994 21,247
Franklin 6,226 19,187
Fulton 8,670 19,250
Gallatin 6,339 16,734
Garrard 6,226 19,187
Grant 6,339 16,734
Graves 8,670 19,250
Grayson 6,775 18,840
Green 6,272 19,247
Greenup 7,159 20,621
Hancock 8,172 20,031
Hardin 6,775 18,840
Harlan 6,994 21,247
Harrison 6,226 19,187
Hart 6,272 19,247
Henderson 8,172 20,031
Henry 6,775 18,840
Hickman 8,670 19,250
Hopkins 8,172 20,031
Jackson 6,226 19,187
Jefferson 6,775 18,840
Jessamine 6,226 19,187
Johnson 6,994 21,247
Kenton 6,339 16,734
Knott 6,994 21,247
Knox 6,994 21,247
LaRue 6,775 18,840
Laurel 6,994 21,247
Lawrence 7,159 20,621
Lee 6,994 21,247
Leslie 6,994 21,247
Letcher 6,994 21,247
Lewis 7,159 20,621
Lincoln 6,226 19,187
Livingston 8,670 19,250
Logan 6,272 19,247
Lyon 8,670 19,250
Madison 6,226 19,187
Magoffin 6,994 21,247
Marion 6,775 18,840
Marshall 8,670 19,250
Martin 6,994 21,247
Mason 7,159 20,621
McCracken 8,670 19,250
McCreary 6,272 19,247
McLean 8,172 20,031
Meade 6,775 18,840
Menifee 7,159 20,621
Mercer 6,226 19,187
Metcalfe 6,272 19,247
Monroe 6,272 19,247
Montgomery 6,226 19,187
Morgan 7,159 20,621
Muhlenberg 8,172 20,031
Nelson 6,775 18,840
Nicholas 6,226 19,187
Ohio 8,172 20,031
Oldham 6,775 18,840
Owen 6,226 19,187
Owsley 6,994 21,247
Pendleton 6,339 16,734
Perry 6,994 21,247
Pike 6,994 21,247
Powell 6,226 19,187
Pulaski 6,272 19,247
Robertson 7,159 20,621
Rockcastle 6,226 19,187
Rowan 7,159 20,621
Russell 6,272 19,247
Scott 6,226 19,187
Shelby 6,775 18,840
Simpson 6,272 19,247
Spencer 6,775 18,840
Taylor 6,272 19,247
Todd 8,172 20,031
Trigg 8,172 20,031
Trimble 6,775 18,840
Union 8,172 20,031
Warren 6,272 19,247
Washington 6,775 18,840
Wayne 6,272 19,247
Webster 8,172 20,031
Whitley 6,994 21,247
Wolfe 6,994 21,247
Woodford 6,226 19,187
 

Louisiana

Parish Employee-
Only
Dependent,
Family, etc.
Acadia 7,541 17,671
Allen 7,717 20,137
Ascension 7,533 18,621
Assumption 7,514 16,842
Avoyelles 7,930 16,248
Beauregard 7,717 20,137
Bienville 7,794 18,227
Bossier 7,794 18,227
Caddo 7,794 18,227
Calcasieu 7,717 20,137
Caldwell 7,876 17,471
Cameron 7,717 20,137
Catahoula 7,930 16,248
Claiborne 7,794 18,227
Concordia 7,930 16,248
DeSoto 7,794 18,227
East Baton Rouge 7,533 18,621
East Carroll 7,876 17,471
East Feliciana 7,533 18,621
Evangeline 7,541 17,671
Franklin 7,876 17,471
Grant 7,930 16,248
Iberia 7,541 17,671
Iberville 7,533 18,621
Jackson 7,876 17,471
Jefferson 7,139 16,795
Jefferson Davis 7,717 20,137
Lafayette 7,541 17,671
Lafourche 7,514 16,842
LaSalle 7,930 16,248
Lincoln 7,876 17,471
Livingston 7,533 18,621
Madison 7,876 17,471
Morehouse 7,876 17,471
Natchitoches 7,794 18,227
Orleans 7,139 16,795
Ouachita 7,876 17,471
Plaquemines 7,139 16,795
Pointe Coupee 7,533 18,621
Rapides 7,930 16,248
Red River 7,794 18,227
Richland 7,876 17,471
Sabine 7,794 18,227
St. Bernard 7,139 16,795
St. Charles 7,139 16,795
St. Helena 7,533 18,621
St. James 7,139 16,795
St. John Baptist 7,139 16,795
St. Landry 7,541 17,671
St. Martin 7,541 17,671
St. Mary 7,541 17,671
St. Tammany 7,139 16,795
Tangipahoa 7,533 18,621
Tensas 7,876 17,471
Terrebonne 7,514 16,842
Union 7,876 17,471
Vermilion 7,541 17,671
Vernon 7,930 16,248
Washington 7,533 18,621
Webster 7,794 18,227
West Baton Rouge 7,533 18,621
West Carroll 7,876 17,471
West Feliciana 7,533 18,621
Winn 7,930 16,248
 

Maine

County Employee-
Only
Dependent,
Family, etc.
Androscoggin 7,192 18,426
Aroostook 8,765 22,414
Cumberland 6,617 20,113
Franklin 7,192 18,426
Hancock 8,765 22,414
Kennebec 6,448 17,487
Knox 6,448 17,487
Lincoln