Montana Form Hi - Health Insurance For Uninsured Montanans Credit - 2014 Page 2
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Form HI Instructions
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Please Note: Although similar, the Health Insurance for
or S corporation’s name and Federal Employer Identification
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Uninsured Montanans credit is not the same as the tax credit
Number.
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available through the Insure Montana Small Business Health
If you are a partner or shareholder in more than one
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Insurance program. If you are using insurance premiums to
partnership or S corporation, you will need to complete a
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calculate the Insure Montana Small Business Health Insurance
separate Form HI for each entity you are receiving the credit
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credit, those premium payments cannot be used to calculate
from.
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this health insurance credit.
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Part II. Qualifications
I am an employer who paid traditional health insurance
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premiums for my employees but heard this referred to
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To qualify for this credit, you must answer yes to each of the
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as a credit for employers who paid disability insurance
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four statements in Part II.
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premiums. Is there a difference?
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Line 1 – You must have been in business in Montana for at
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Disability health insurance is insurance against the following:
least 12 months.
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●
bodily injury, bodily disablement or accidental death, or the
Line 2 – You must employ at least 2 but not more than 20
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medical expense or medical reimbursement involved; or
employees who work at least 20 hours a week during the year
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●
bodily disablement or the medical expense or
the credit is claimed.
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reimbursements resulting from sickness.
For the purpose of this credit, an employee can be the sole
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In essence, disability insurance is the same as “health
proprietor, a partner in a partnership, or an independent
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insurance” and includes any insurance plan offered by an
contractor as long as each one of these classes of employees
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insurance company that provides coverage for the following
are included as an employee under your employer health
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conditions:
benefit plan.
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personal health,
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If you had seasonal employees that increased your total
●
disablement,
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employee count to more than 20 employees in the year, you
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●
accidental death, or
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are not eligible to claim this credit. However, if your seasonal
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employees did not increase your employee count to more than
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●
medical expenses or the reimbursement of these expenses.
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However, disability insurance does not include workers’
requirements.
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compensation insurance or credit disability insurance. These
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If you had employee turnover throughout the year that
two types of insurance premiums cannot be used in calculating
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increased the total number of individuals who worked for you
this credit.
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to more than 20, you will still be eligible for the credit as long
What information do I have to include with my tax return
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as your total employee count did not exceed 20 employees at
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when I claim this credit?
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any one time.
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Individuals. If you are filing a paper return, include a copy of
Line 3 – At least 50% of each employee’s insurance premium
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Form HI with your individual income tax return.
must be paid by the employer. The insurance policy must
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meet the minimum requirements of the Small Employer Health
●
C corporations. If you are filing a paper return, include a
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Insurance Availability Act.
copy of Form HI with your corporate income tax return.
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●
S corporations and partnerships. If you are filing a paper
Line 4 – You cannot claim this credit for a period of more than
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return, include Form HI with your Montana information return
36 consecutive months which begins with the first month for
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Form CLT-4S or PR-1 and include a separate statement
which the credit is claimed. In addition, this tax credit cannot
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identifying each owner and their share.
be granted to an employer or the employer’s successor within
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10 years of the last consecutive credit claimed.
You will need to complete a separate Form HI for each source
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you are receiving the credit from. For example, if you are a
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Part III. Credit Computation
partner in one partnership that qualifies for this credit, and you,
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as an individual, also qualify for this credit, you would need to
Complete the table in Part III. Please note that there are only
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complete two forms.
10 lines on the chart because you are not entitled to a tax
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If you file electronically, you do not need to mail this form to us
credit for more than 10 employees.
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unless we contact you for a copy.
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Line 1 – Multiple the total of Column F by 50%. Your credit
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cannot exceed 50% of the premium cost for each employee.
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Part I. Partners in a Partnership or Shareholders of an
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Line 2 – Enter the total of Column G.
S Corporation
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Line 3 – Enter the smaller of line 1 or line 2. If the amount on
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If you complete Part I, do not complete Part II or III.
this line exceeds your tax liability, you cannot carry back or
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If you received this credit from a partnership or S corporation,
carry forward any of your unused credit.
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you will need to fill out Part I in its entirety. Your portion of
Administrative Rules of Montana: 42.4.2404 and 42.4.2801
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the credit can be obtained from the Montana Schedule K-1
through 42.4.2803
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that you received from the entity. In addition to reporting your
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Questions? Please call us toll free at (866) 859-2254
portion of the credit, you will need to provide the partnership’s
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(in Helena, 444-6900).
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