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.

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

Column (a): Enter number of eligible employees covered

between 2 and 50 employees may establish a health benefit

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

plan for the purpose of providing a plan as described under

Column (b): If you established or made contributions

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

during this tax year which constitutes the FIRST 12

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, credits

MONTHS of participation, multiply the number of eligible

shall be available to only corporations subject to the Kansas

employees for each month of participation by the lesser

corporate income tax (i.e., C corporations). Credits are not

of $50 or the actual amount paid per employee.

available to individuals, partnerships, S corporations, limited

Column (d): If you established or made contributions

liability companies, and other pass-through entities.

during this tax year which constitutes the NEXT 12

An eligible employee is one who is employed for an

MONTHS of participation, multiply number of eligible

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

employees for each month of participation by the lesser

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

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

includes individuals who are sole proprietors, business

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

partners, and limited partners who own the business. Eligible

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

employee does not include individuals: 1) engaged as

Column (e): Enter number of eligible employees covered

independent contractors; 2) whose periods of employment

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

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

Column (f): Multiply number of eligible employees for

employed by the employer for fewer than 90 days.

each month by $35.

A health savings account means a trust created or

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

organized in the United States as a health savings account

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

exclusively for the purpose of paying the qualified medical

complete, proceed to line 18. If established prior to

expenses of the account beneficiary, but only if the written

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

governing instrument creating the trust meets the

LINE 14 – Enter your total health insurance premium or health

requirements specified by the medicare, prescription drug,

savings account contributions for covered employees

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

during the tax period. Review your health insurance billings

108-173, 117 Stat. 2067.

for this particular tax year to obtain your cost.

As a condition to participate as a member of any small

LINE 15 – To figure the maximum credit allowed multiply

employer health benefit plan, an employer shall have not

line 14 by 50%.

contributed within the preceding two years to any health

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

insurance premium or health savings account on behalf of

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

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

years you have participated in this credit.

contribution other than a contribution by an employer to a

health insurance premium or health savings account within

PART B – COMPUTATION OF CREDIT

the preceding two years solely for the benefit of the employer

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

or the employer’s dependents.

you completed Schedule I, enter the amount from line 13,

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

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

unused portion shall be refunded to the taxpayer.

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

Addition Modification. The employer is required to

line 16 by the appropriate percentage from line 17. Enter

reduce any expense deduction that is included in federal

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

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

TAXPAYER ASSISTANCE

credit.

Documentation. Retain your monthly insurance billings

For assistance and information on establishing a Small

with your records as KDOR (Kansas Department of

Employer Health Benefit Plan, call the Insurance

Revenue) reserves the right to request additional information

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

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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