Instructions For Form 8941 - Credit For Small Employer Health Insurance Premiums - 2016 Page 7
ADVERTISEMENT
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
26
27
28
29
30Worksheet 4. Information Needed To
Wages, for this purpose, mean wages subject to social
security and Medicare tax withholding determined without
Complete Lines 4, 5, and 13 and
considering any wage base limit.
Worksheet 7
Worksheet 2. Information Needed To
Complete Line 2 (FTEs)
If you need more rows, use a separate sheet and include
the additional amounts in the totals below.
Your credit is reduced if you had more than 10 full-time
(a)
(d)
equivalent employees (FTEs) for the tax year. If you had
Enrolled
(b)
(c)
Enrolled
25 or more FTEs for the tax year, your credit is reduced to
Individuals
Employer
Adjusted
Employee
zero.
Considered
Premiums
Average
Hours of
Employees
Paid
Premiums
Service
1. Enter the total employee hours of
service from Worksheet 1, column
1.
(b)
1.
. . . . . . . . . . . . . . . . . . . . . . . . .
2.
2. Hours of service per FTE
2,080
2.
. . . . . . . . .
3.
3. Full-time equivalent employees.
4.
Divide line 1 by line 2. If the result is not
a whole number (0, 1, 2, etc.),
5.
generally round the result down to
6.
the next lowest whole number. For
example, round 2.99 down to 2.
7.
However, if the result is less than one,
8.
enter 1. Report this number on Form
9.
8941, line 2
3.
. . . . . . . . . . . . . . . . . .
10.
Worksheet 3. Information Needed To
11.
Complete Line 3 (Average Annual
12.
Wages)
13.
14.
Your credit is reduced if you paid average annual wages
15.
of more than $26,000 for the tax year. If you paid average
16.
annual wages of $53,000 or more for the tax year, your
credit is reduced to zero.
17.
1. Enter the total employee wages paid
18.
from Worksheet 1, column (c)
1.
. . . . . .
19.
2. Enter FTEs from Worksheet 2,
20.
line 3
2.
. . . . . . . . . . . . . . . . . . . . . . .
21.
3. Average annual wages. Divide line 1
by line 2. If the result is not a multiple of
22.
$1,000 ($1,000, $2,000, $3,000, etc.),
23.
round the result down to the next
lowest multiple of $1,000. For example,
24.
round $2,999 down to $2,000. Report
25.
this amount on Form 8941, line 3
3.
. . .
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.
-7-
Instructions for Form 8941 (2017)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial