Form 14581-F - Social Security Coverage Compliance Self-Assessment For State And Local Government Entities Page 3

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Page 3
3.
If the entity has a Section 218 Agreement and/or Modification, are services
Yes
No
Follow Up
performed by any employees excluded from Social Security and/or Medicare
coverage
Note: Federal law requires the exclusion of the following services from voluntary (Section 218) coverage under the Social Security Act
(Section 218(c)(6)):
• Services performed by individuals hired to be relieved from unemployment.
• Services performed in a hospital, home or other institution by a patient or inmate thereof as an employee of a state or local
government.
• Services performed by an employee hired on a temporary basis in case of fire, storm, snow, earthquake, flood or similar
emergency.
• Services performed by a nonresident alien temporarily residing in the U.S., holding an F-1, J-1, M-1 or Q-1 visa, when the services
are performed to carry out the purpose for which the alien was admitted to the U.S.
• Covered transportation service as defined in SSA 210(k).
Note: Federal law allows for the optional exclusion of the following services from voluntary (Section 218) coverage under the Social
Security Act:
• Services in positions compensated solely by fees received directly from the public are subject to SECA (Self-Employment
Contributions Act) taxes.
• Services performed by a student enrolled and regularly attending classes at the school, college or university for which they are
working.
• Services performed by election officials or election workers paid less than the calendar year threshold amount mandated by law.
• Services that would be excluded if performed for a private employer because they are not work defined as employment under
Section 210(a) of the Social Security Act.
Note: The categories of employees excluded from a Section 218 Agreement may still be subject to Social Security and Medicare
withholding under the mandatory Social Security provisions if they do not participate in a retirement plan that replaces Social Security.
List the categories of workers excluded from coverage under the Section 218 Agreement or Modification
See IRS Publication 963, Federal-State Reference Guide, for information on exclusions from Section 218 coverage.
Comments
14581-F
Catalog Number 69849B
Form
(6-2017)

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