Instructions For Form 8941 - Credit For Small Employer Health Insurance Premiums - 2016 Page 21

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Park
7,570
16,232
Dodge
5,944
15,607
Seward
6,164
17,146
Petroleum
7,570
16,232
Douglas
5,944
15,607
Sheridan
7,612
18,397
Phillips
7,570
16,232
Dundy
7,612
18,397
Sherman
6,371
16,268
Pondera
7,570
16,232
Fillmore
6,164
17,146
Sioux
7,612
18,397
Powder River
7,570
16,232
Franklin
6,371
16,268
Stanton
6,371
16,268
Powell
7,570
16,232
Frontier
7,612
18,397
Thayer
6,164
17,146
Prairie
7,570
16,232
Furnas
6,371
16,268
Thomas
7,612
18,397
Ravalli
7,570
16,232
Gage
6,164
17,146
Thurston
5,944
15,607
Richland
7,570
16,232
Garden
7,612
18,397
Valley
6,371
16,268
Roosevelt
7,570
16,232
Garfield
6,371
16,268
Washington
5,944
15,607
Rosebud
7,570
16,232
Gosper
6,371
16,268
Wayne
6,371
16,268
Sanders
7,570
16,232
Grant
7,612
18,397
Webster
6,371
16,268
Sheridan
7,570
16,232
Greeley
6,371
16,268
Wheeler
6,371
16,268
Silver Bow
6,661
15,663
Hall
6,371
16,268
York
6,164
17,146
Stillwater
6,619
15,530
Hamilton
6,371
16,268
Nevada
Sweet Grass
6,619
15,530
Harlan
6,371
16,268
Teton
6,661
15,663
Hayes
7,612
18,397
Employee-
Dependent,
County
Only
Family, etc.
Toole
7,570
16,232
Hitchcock
7,612
18,397
Carson City
6,236
14,551
Treasure
7,570
16,232
Holt
6,371
16,268
Churchill
7,586
17,920
Valley
7,570
16,232
Hooker
7,612
18,397
Clark
6,048
14,672
Wheatland
7,570
16,232
Howard
6,371
16,268
Douglas
6,236
14,551
Wibaux
7,570
16,232
Jefferson
6,164
17,146
Elko
7,586
17,920
Yellowstone
6,619
15,530
Johnson
6,164
17,146
Esmeralda
7,586
17,920
Kearney
6,371
16,268
Nebraska
Eureka
7,586
17,920
Keith
7,612
18,397
Humboldt
7,586
17,920
Keya Paha
6,371
16,268
Employee-
Dependent,
County
Only
Family, etc.
Lander
7,586
17,920
Kimball
7,612
18,397
Adams
6,371
16,268
Lincoln
7,586
17,920
Knox
6,371
16,268
Lyon
6,236
14,551
Antelope
6,371
16,268
Lancaster
6,164
17,146
Arthur
7,612
18,397
Mineral
7,586
17,920
Lincoln
7,612
18,397
Nye
6,048
14,672
Banner
7,612
18,397
Logan
7,612
18,397
Blaine
6,371
16,268
Pershing
7,586
17,920
Loup
6,371
16,268
Boone
6,371
16,268
Storey
6,236
14,551
Madison
6,371
16,268
Washoe
6,501
16,002
Box Butte
7,612
18,397
McPherson
7,612
18,397
Boyd
6,371
16,268
White Pine
7,586
17,920
Merrick
6,371
16,268
Brown
7,612
18,397
Morrill
7,612
18,397
New Hampshire
Buffalo
6,371
16,268
Nance
6,371
16,268
Burt
5,944
15,607
Employee-
Dependent,
Nemaha
6,164
17,146
County
Only
Family, etc.
Butler
6,371
16,268
Nuckolls
6,371
16,268
All
7,363
19,424
Cass
5,944
15,607
Otoe
6,164
17,146
Cedar
6,371
16,268
Pawnee
6,164
17,146
New Jersey
Chase
7,612
18,397
Perkins
7,612
18,397
Cherry
7,612
18,397
Employee-
Dependent,
Phelps
6,371
16,268
County
Only
Family, etc.
Cheyenne
7,612
18,397
Pierce
6,371
16,268
All
7,632
19,355
Clay
6,371
16,268
Platte
6,371
16,268
Colfax
6,371
16,268
New Mexico
Polk
6,371
16,268
Cuming
6,371
16,268
Red Willow
7,612
18,397
Employee-
Dependent,
Custer
6,371
16,268
Richardson
6,164
17,146
County
Only
Family, etc.
Dakota
6,371
16,268
Rock
6,371
16,268
Bernalillo
6,433
17,252
Dawes
7,612
18,397
Saline
6,164
17,146
Catron
6,834
19,377
Dawson
6,371
16,268
Sarpy
5,944
15,607
Chaves
6,834
19,377
Deuel
7,612
18,397
Saunders
5,944
15,607
Cibola
6,834
19,377
Dixon
6,371
16,268
Scotts Bluff
7,612
18,397
2017 Average Premium Tables
-21-

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