Fillable Schedule K-57 - Kansas Small Employer Healthcare Credit (Page 2 of 2) in pdf

INSTRUCTIONS FOR SCHEDULE K-57

GENERAL INFORMATION

SPECIFIC LINE INSTRUCTIONS

Complete the information at the top of the schedule.

K.S.A. 40-2246 allows an income tax credit to those

employers that make contributions to a health savings

PART A – COMPUTATION OF ELIGIBLE EMPLOYEE AMOUNT

account of an eligible covered employee after 12/31/2004.

(C Corporations only)

The credit is $70 per month per eligible covered employee

Complete the appropriate schedule. If the employer

for the first 12 months of participation, $50 per month per

established this plan after 12/31/2004, complete Schedule I.

eligible covered employee for the next 12 months of

If it was established prior to 1/1/2005, complete Schedule II.

participation and $35 per month per eligible covered

LINES 1-12 – Schedule I (Plans after 12/31/2004)

employee for the next 12 months of participation.

Column (a): Enter number of eligible employees covered

Any small employer (defined by K.S.A. 40-2209d) having

by this plan for each month of the employer’s tax year.

between 2 and 50 employees may establish a health benefit

Column (b): If you established or made contributions

plan for the purpose of providing a plan as described under

during this tax year which constitutes the FIRST 12

K.S.A. 40-2240 covering such employer’s eligible employees

MONTHS of participation, multiply the number of eligible

and such employees’ family members. For plans established

employees for each month of participation by the lesser

prior to 1/1/2005, a certificate issued by the Commissioner

of $70 or the actual amount paid per employee.

of Insurance entitling a “small employer” to claim the tax credit

Column (c): If you established or made contributions

authorized by K.S.A. 40-2246 must have been obtained.

during this tax year which constitutes the NEXT 12

For tax year 2013, and all tax years thereafter,

MONTHS of participation, multiply the number of eligible

credits shall be available to only corporations

employees for each month of participation by the lesser

subject to the Kansas corporate income tax (i.e.,

of $50 or the actual amount paid per employee.

C corporations). Credits shall no longer be available to

Column (d): If you established or made contributions

individuals, partnerships, S corporations, limited liability

during this tax year which constitutes the NEXT 12

companies, and other pass-through entities.

MONTHS of participation, multiply number of eligible

employees for each month of participation by the lesser

An eligible employee is one who is employed for an

of $35 or the actual amount paid per employee. (The total

average of at least 30 hours per week and elects to participate

of columns b, c and d should be only 12 months.)

in one of the benefit plans provided under this act, and

includes individuals who are sole proprietors, business

LINES 1-12 – Schedule II (Plans prior to 1/1/2005)

partners, and limited partners who own the business. Eligible

Column (e): Enter number of eligible employees covered

employee does not include individuals: 1) engaged as

by this plan for each month of the employer’s tax year.

independent contractors; 2) whose periods of employment

Column (f): Multiply number of eligible employees for

are on an intermittent or irregular basis; or, 3) who have been

each month by $35.

employed by the employer for fewer than 90 days.

LINE 13 – Add lines 1 through 12 and enter result. If the plan

A health savings account means a trust created or

was established after 12/31/2004 and Schedule I is

organized in the United States as a health savings account

complete, proceed to line 18. If established prior to

exclusively for the purpose of paying the qualified medical

1/1/2005 and Schedule II is complete, proceed to line 14.

expenses of the account beneficiary, but only if the written

LINE 14 – Enter your total health insurance premium or health

governing instrument creating the trust meets the

savings account contributions for covered employees

requirements specified by the medicare, prescription drug,

during the tax period. Review your health insurance billings

improvement and modernization act of 2003, Pub. L. No.

for this particular tax year to obtain your cost.

108-173, 117 Stat. 2067.

LINE 15 – To figure the maximum credit allowed multiply

As a condition to participate as a member of any small

line 14 by 50%.

employer health benefit plan, an employer shall have not

LINE 16 – Enter the lesser of line 13, column (f) or line 15.

contributed within the preceding two years to any health

LINE 17 – Check the appropriate box for the number of tax

insurance premium or health savings account on behalf of

years you have participated in this credit.

an employee who is to be covered by the employer’s

contribution other than a contribution by an employer to a

PART B – COMPUTATION OF CREDIT

health insurance premium or health savings account within

LINE 18 – If the plan was established after 12/31/2004 and

the preceding two years solely for the benefit of the employer

you completed Schedule I, enter the amount from line

or the employer’s dependents.

13, columns (b), (c), and/or (d). If the plan was established

If the credit exceeds the current year’s tax liability, the

prior to 1/1/2005 and you completed Schedule II, multiply

unused portion shall be refunded to the taxpayer.

line 16 by the appropriate percentage from line 17. Enter

Addition Modification Required: The employer must

result here and on the appropriate line of Form K-120.

reduce any expense deduction that is included in federal

TAXPAYER ASSISTANCE

taxable income for the tax year by the dollar amount of the

credit.

For assistance and information on establishing a Small

Retain your monthly insurance billings with your records

Employer Health Benefit Plan, call the Insurance

as KDOR (Kansas Department of Revenue) reserves the

Commissioner’s office at (785) 296-7850. For assistance

right to request additional information as necessary.

with Schedule K-57, call KDOR at (785) 368-8222.

Schedule K-57 - Kansas Small Employer Healthcare Credit Page 2

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