Form 14581-C - Medicare Coverage Compliance Self-Assessment For State And Local Government Employers Page 3

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Page 3
a. If the employer has rehired annuitants, is Social Security tax withheld and paid on
Yes
No
Follow Up
those employees as applicable
Comments
b. If yes, is Medicare tax withheld and paid on those employees
Yes
No
Follow Up
Note: When an employee retires, the employee has terminated employment for purposes of the continuing employment exception.
Thus, if that former employee is rehired, the employee will be subject to Medicare tax, even if the employee was previously exempt
because of the continuing employment exception.
Comments
Notes/Follow-up
You have completed the Medicare Coverage Compliance Self-Assessment.
14581-C
Catalog Number 69846U
Form
(6-2017)

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