Employer'S Quarterly Wage And Contribution C-101 Report Item-By-Item Instructions - Vermont Department Of Labor Page 2
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5ITEM 12: Subtract Item 11 from Item 10 and enter the results. (This is the taxable wages for the quarter).
ITEM 13: Multiply Item 12 by your tax rate indicated on the form and enter the results. (The tax must not be deducted from
workers’ wages.)
ITEM 14: Any prior credit on your account will be indicated here. (This figure is subject to change as there may be charges or
credits to your account subsequent to the printing of original form, in such case, you will receive a bill.)
ITEM 15: Enter the amount due (Item 13 minus Item 14). If Item 14 is greater than Item 13, ENTER 0.
ITEM 16: Enter total number of uncovered FTE in this quarter. “FTE” or Full-time Equivalent means the number of employees
expressed as the number of employee hours worked during calendar quarter, divided by 520. (Enter from line C of Health Care
Assessment Worksheet (Form HC-1.) Examples below utilize the HC-1 Worksheet.
EXAMPLE 2
EXAMPLE 1
Shaded area denote “uncovered hours”
Shaded area denote “uncovered hours”
Hours
Hours
Hours
Hours
worked
Offered
Took
Declaration
worked
Offered
worked
Offered
worked
Offered
Took
Declaration
Emp
in Qtr.
Insurance
Emp
in Qtr.
Ins.
Ins.
on File
Emp
in Qtr.
Ins.
Ins.
on File
Emp
in Qtr.
Insurance
1
520
N
7
520
N
1
520
Y
Y
N/A
7
400
N
N/A
8
520
N
2
520
N
8
400
N
N/A
2
520
Y
Y
N/A
3
520
N
9
520
N
3
520
Y
Y
N/A
9
350
N
N/A
10
520
N
4
520
N
10
350
N
N/A
4
520
Y
Y
N/A
5
520
N
11
260
N
5
520
Y
N
Y -
11
260
N
N/A
no cov
6
520
N
12
260
N
6
520
Y
N
Y -
12
260
N
N/A
has cov
Line A = 5720 (Grand total of hours worked by all uncovered employees)
Line A = 2540 (Grand total of hours worked by all uncovered employees)
Line B = 11 (Grand total of hours worked divided by 520)
Line B = 4 (4.88 rounded down - Grand total of hours worked divided by 520)
Line C = 3 (FTEs minus exemption)
Line C = 0 (FTEs minus exemption)
Line D = $273.75 (Uncovered FTE for HC reporting times by $91.25)
Line D = 0
Example 1 Notes: Inasmuch as the employer did not offer to pay some
Example 2 Notes: The total uncovered FTEs was 4, but because of the exempt FTEs of 8, no HC contribution is due.
Employees 1 through 4 and 6 are considered covered. Employee 5 is considered uncovered as they have no insurance,
portion of a health care plan, all employees are considered “uncovered”.
HC contributions is only due on 3 FTEs due to the 8 FTEs exempted
even though they were offered and refused the employer’s coverage. Employees 7 through 12 are uncovered because
by law.
the employer did not offer to pay some portion of a health care plan.
ITEM 17: Multiply line 16 by $91.25 and enter the results. This is your quarterly Health Care Contribution. (Line D from Form
HC-1).
ITEM 18: Add lines 15 and 17 and enter total. Make check or money order payable to Vermont Department of Labor. (NOTE:
All delinquent payments will first be applied to any prior amounts due the department.)
CERTIFICATION: Please read and then provide telephone number and signature/title. (Must be owner, principle officer or
authorized representative.)
GENERAL INFORMATION
•
A penalty of $35.00 will be assessed if report is not: 1) legible, complete, or submitted in acceptable format; or 2) received
postmarked on or before the due date. Due dates that fall on a weekend or legal holiday will be accepted as timely if
postmarked on or before the next business day.
•
Interest accrues at 18% annually on any unpaid tax from the quarterly due date to the date payment is received.
•
Individuals exempt from coverage and not reportable include: Sole proprietor or members of partnerships or limited
liability companies; parents, spouses, civil union partners, and children under 18 years of age, of the sole proprietor;
individuals who are enrolled in a full-time accredited educational program which combines academic instruction with work
experience; elected officials of a government entity; and volunteer fire and emergency personnel.
•
Gross wages paid are defined as: Wages before deductions are made for such items as withholding and Social
Security/FICA taxes.
•
Wages include all remuneration for services such as: Salaries, draws, commissions, profit sharing draws, employees’
shares of Social Security, or any other term, paid in money or something other than money, on the basis of piece rates,
hour rates, day rates or fixed weekly, monthly or annual stipends; payments into pension funds, union dues, insurance,
etc.; meals and lodging provided by an employer to an employee even when used to meet minimum wage requirement;
severance pay, wages in lieu of notice, vacation, advances to employees for expenses (including travel) for which no
accounting or reporting to the employer by the employee is required; tips which are reported pursuant to Section 6053 of
the Internal Revenue Code; sick pay payments made under an employer’s plan through the first six months; sick payments
provided from a third-party insurer financed by employee-paid premiums are taxable to the employer if the employer is
notified by the insurer of said payment. Otherwise the insurer is responsible for reporting the taxable wage; employee
contributions to a 401K deferred-compensation plan; cash value of benefits provided under a Cafeteria Plan as described
in Section 125 of the Internal Revenue Service Code.
•
Wages do not include: Facilities or other privileges (entertainment, restaurant meals, medical services, “courtesy
discounts” on purchases) furnished or offered by an employer merely as a convenience to the work or as a means of
promoting the value or efficiency of work; director’s fees; payments paid by the employer to or on behalf of an employee for
sickness or accidental disability after six months; contributions paid by the employer to an employee pension plan;
payments made by Workers’ Compensation.
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