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Instructions for Form 8941
Department of the Treasury
Internal Revenue Service
Credit for Small Employer Health Insurance Premiums
Section references are to the Internal Revenue Code
unless otherwise noted.
Partnerships, S corporations, cooperatives,
TIP estates, trusts, and tax-exempt eligible small
Future Developments
For the latest information about developments related to
Form 8941 and its instructions, such as legislation
enacted after they were published, go to www.irs.gov/
form8941.
What’s New
Line C was added to reflect the 2 consecutive tax year
credit limitation for tax years beginning after 2013. For
more information, see Credit Period.
General Instructions
Purpose of Form
Eligible small employers (defined below) use Form 8941
to figure the credit for small employer health insurance
premiums for tax years beginning after 2009. For tax
years beginning after 2013, the credit is only available for
a 2 consecutive tax year credit period. The maximum
credit is generally a percentage of premiums the employer
paid during the tax year for certain health insurance
coverage the employer provided to certain employees
enrolled in a qualified health plan offered through a Small
Business Health Options Program (SHOP) Marketplace.
But the credit may be reduced by limitations based on the
employer's full-time equivalent employees, average
annual wages, adjusted average premiums, and state
premium subsidies and tax credits.
For information about insurance plans offered
TIP through a SHOP Marketplace, visit
healthcare.gov.
For tax-exempt eligible small employers, the
maximum credit is 35% of premiums paid, is also limited
to the amount of certain payroll taxes paid, and is claimed
as a refundable credit on Form 990-T, Exempt
Organization Business Income Tax Return. A tax-exempt
eligible small employer is an eligible small employer
described in section 501(c) that is exempt from taxation
under section 501(a). A tax-exempt employer not
described in section 501(c) is generally not eligible to
claim this credit. However, a tax-exempt farmers'
cooperative subject to tax under section 1381 may be
able to claim the credit as a general business credit as
discussed next.
For all other eligible small employers, the maximum
credit is 50% of premiums paid, can be taken against both
regular and alternative minimum tax, and is claimed as
part of the general business credit on Form 3800.
Dec 06, 2016
employers must file this form to claim the credit.
All other taxpayers must not complete or file this form if
their only source for this credit is a partnership, S
corporation, cooperative, estate, or trust. Instead, they
must report this credit directly on line 4h in Part III of Form
3800, General Business Credit.
Eligible Small Employers
You are an eligible small employer for the tax year if you
meet the following three requirements.
1. You paid premiums for employee health insurance
coverage under a qualifying arrangement. A
qualifying arrangement is generally an arrangement that
requires you to pay a uniform percentage (not less than
50%) of the premium cost for each enrolled employee's
health insurance coverage (defined later). However, an
arrangement that requires you to pay a uniform premium
for each enrolled employee (composite billing) and offers
different tiers of coverage (for example, employee-only,
dependent, and family coverage) can be a qualifying
arrangement even if it requires you to pay a uniform
percentage that is less than 50% of the premium cost for
employees not enrolled in employee-only coverage.
In addition, an arrangement that requires you to pay a
separate premium for each employee based on age or
other factors (list billing) can be a qualifying arrangement
even if it requires you to pay a uniform percentage that is
less than 50% of the premium cost for some employees.
For details, see Employer Premiums Paid, Health
Insurance Coverage, and Qualifying Arrangement, later.
2. You had fewer than 25 full-time equivalent employees (FTEs) for the tax year. You may be able to meet
this requirement even if you had 25 or more employees.
For details, see Worksheets 1 and 2.
Although the term "eligible small employer" is
TIP defined in the Internal Revenue Code to include
employers with "no more than" 25 FTEs, the
phase out of the credit amount operates in such a way
that an employer with exactly 25 FTEs is not in fact
eligible for the credit.
3. You paid average annual wages for the tax year of
less than $52,000 per FTE. For details, see Worksheets
1 and 3.
If you had more than 10 FTEs and average
annual wages of more than $25,000, the FTE and
CAUTION average annual wage limitations (discussed later)
will separately reduce your credit. This may reduce your
credit to zero even if you had fewer than 25 FTEs and
average annual wages of less than $52,000.
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Cat. No. 55222U
Wellness programs. A wellness program is generally an
insurance program of health promotion or disease
prevention. If you pay part or all of the cost of an
employee's participation in a wellness program, use the
amount you paid to figure your employer premiums paid.
Employers treated as a single employer. Treat the
following employers as a single employer to figure the
credit.
Employers who are corporations in a controlled group
of corporations.
Employers who are members of an affiliated service
group.
Employers who are partnerships, proprietorships, etc.,
under common control. See Regulations sections
1.414(c)-2, 1.414(c)-3, and 1.414(c)-4.
Tax-exempt employers under common control. See
Regulations section 1.414(c)-5.
For details, see section 45R(e)(5)(A) and Regulations
section 1.45R-2(b).
Tobacco surcharges. A tobacco surcharge is generally
an additional amount charged for insurance for a tobacco
user. If you pay part or all of an employee's tobacco
surcharge, you can’t use the amount you paid to figure
your employer premiums paid.
Dependent coverage. Dependent coverage is generally
coverage offered separately to an individual who is or may
become eligible for coverage under the terms of a group
health plan because of a relationship to a
participant-employee, whether or not a dependent of the
participant-employee. Dependent coverage doesn’t
include coverage, such as family coverage, which
includes coverage of the participant-employee. If you pay
part or all of the cost of an employee's dependent
coverage, use the amount you paid to figure your
employer premiums paid.
No more than one Form 8941 can be filed with a
TIP tax return, unless the exception described in
Example 2 below applies.
Example 1. You are a sole proprietor with two
separate businesses and you file a separate Schedule C
(Form 1040) for each business. You must treat both
businesses as a single employer to figure the credit. You
will file one Form 8941 for both businesses.
Portion of premiums paid. If you pay only a portion of
the premiums and your employees pay the rest, only the
portion you pay is taken into account. For this purpose,
any premium paid through a salary reduction arrangement
under a section 125 cafeteria plan isn’t treated as an
employer paid premium. For more information on cafeteria
plans, see section 1 of Publication 15-B, Employer's Tax
Guide to Fringe Benefits.
Example 2. You and your spouse are both sole
proprietors and file a separate Schedule C (Form 1040)
for each of your separate businesses. Neither spouse was
an employee of the other spouse or participated in the
management of the other spouse's business at any time
during the tax year. No more than 50% of the gross
income of either business was derived from royalties,
rents, dividends, interest, and annuities and you otherwise
meet the requirements listed in Regulations section
1.414(c)-4(b)(5)(ii). Don’t treat both businesses as a
single employer to figure the credit. If you and your
spouse are both eligible small employers, you can file two
Forms 8941 with a jointly filed Form 1040.
Example 3. You offer health insurance coverage to
employees under a qualifying arrangement that requires
you to pay 60% of the premium cost for employee-only
coverage for each employee enrolled in any health
insurance coverage you provide to employees. The total
premium for each employee enrolled in employee-only
coverage is $5,200 per year or $100 ($5,200 ÷ 52) for
each weekly payday. The total premium for each
employee enrolled in family coverage is $13,000 per year
or $250 ($13,000 ÷ 52) for each weekly payday.
Each payday you contribute $60 (60% of $100) toward
the premium cost of each employee enrolled in
employee-only coverage and withhold the remaining $40
from the employee's paycheck to obtain the $100 total
weekly premium. Each payday you contribute $60 (the
same amount you pay toward the premiums of employees
enrolled in employee-only coverage) toward the premium
cost of each employee enrolled in family coverage and
withhold the remaining $190 from the employee's
paycheck to obtain the $250 total weekly premium.
To determine the premiums you paid during the tax
year, multiply the number of pay periods during which the
employee was enrolled in the health insurance coverage
by $60. For example, you would have paid $3,120 ($60 ×
52) for an employee who was enrolled for the entire tax
year. You would have paid $600 ($60 × 10) for an
employee who was only enrolled for 10 pay periods. You
will need an additional set of calculations if the premium
amounts changed during the tax year.
Credit Period
For tax years beginning after 2013, the credit period
during which the credit can be claimed is a 2 consecutive
tax year period beginning with the first tax year in which:
An eligible small employer (or any predecessor) files an
income tax return with an attached Form 8941 with line A
checked “Yes” and a positive amount on line 12, or
A tax-exempt eligible small employer (or any
predecessor) files Form 990-T with an attached Form
8941 with line A checked “Yes” and a positive amount on
line 12.
Employer Premiums Paid
Only premiums you paid for health insurance coverage
under a qualifying arrangement (discussed later) for
individuals considered employees are counted when
figuring your credit.
State premium subsidy or tax credit. If you are entitled
to a state tax credit or a state premium subsidy paid
directly to you for premiums you paid, do not reduce the
amount you paid by the credit or subsidy amount. Also, if
a state pays a premium subsidy directly to your insurance
provider, treat the subsidy amount as an amount you paid
for employee health insurance coverage.
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Instructions for Form 8941 (2016)
Health Insurance Coverage
requirement. Amounts you or your employee pay to cover
a tobacco surcharge aren’t considered premiums paid for
health insurance coverage when figuring this credit.
For tax years beginning after 2013, health insurance
coverage generally means coverage provided to
employees enrolled in a qualified health plan offered
through a Small Business Health Options Program
(SHOP) Marketplace. For an exception that applies to
certain employers in Iowa and Wisconsin, see the Line A
instructions, later. If this exception applies, health
insurance coverage means coverage as defined under
Health Insurance Coverage in the 2013 Instructions for
Form 8941.
Dependent coverage. Premiums you pay for dependent
coverage aren’t subject to the uniform percentage
requirement. You are not required to pay a uniform
percentage (not less than 50%) for dependent coverage.
Arrangements with composite billing. An
arrangement that requires you to pay a uniform premium
for each enrolled employee (composite billing) and offers
different tiers of coverage can be a qualifying arrangement
even if it requires you to pay a uniform percentage that is
less than 50% of the premium cost for employees not
enrolled in employee-only coverage. It is a qualifying
arrangement (assuming employee-only coverage is the
least expensive tier of coverage) if it requires you to pay
the following amounts.
A uniform percentage (not less than 50%) of the
premium cost for each employee (if any) enrolled in
employee-only coverage.
A uniform amount that is no less than the amount you
would have paid toward employee-only coverage for each
employee (if any) enrolled in family coverage.
A uniform amount that is no less than the amount you
would have paid toward employee-only coverage for each
employee (if any) enrolled in any other tier of coverage
(figured separately for each tier).
A stand-alone dental plan offered through a
TIP SHOP exchange will be considered a qualified
health plan for purposes of the credit.
Employer premiums paid for health insurance
coverage can be counted in figuring the credit
CAUTION only if the premiums are paid under a qualifying
arrangement.
!
Qualifying Arrangement
A qualifying arrangement is generally an arrangement that
requires you to pay a uniform percentage (not less than
50%) of the premium cost for each enrolled employee's
health insurance coverage (defined earlier). An
arrangement that offers different tiers of coverage (for
example, employee-only and family coverage) is generally
a qualifying arrangement if it requires you to pay a uniform
percentage (not less than 50%) separately for each tier of
coverage you offer. However, an arrangement can be a
qualifying arrangement even if it requires you to pay a
uniform percentage that is less than 50% of the premium
cost for some employees.
Arrangements with list billing and only employee-only coverage. An arrangement that requires you to pay a
separate premium for each employee based on age or
other factors (list billing) that only provides employee-only
coverage can be a qualifying arrangement even if it
requires you to pay a uniform percentage that is less than
50% of the premium cost for some employees. It is a
qualifying arrangement if it requires you to pay either of
the following amounts.
A uniform percentage (not less than 50%) of the
premium charged for each employee enrolled in the
employee-only coverage.
A uniform percentage (not less than 50%) of your
employer-computed composite rate (defined later) for
your employee-only coverage for each employee enrolled
in the employee-only coverage.
For more information about the following exceptions,
see Regulations section 1.45R-4.
State or local law. You will be treated as satisfying the
uniform percentage requirement if your failure to
otherwise satisfy the requirement was solely attributable
to additional contributions you made to certain employees
to comply with state or local law.
Wellness program. If a plan of an employer provides a
wellness program, for purposes of meeting the uniform
percentage requirement any additional amount of the
employer contribution attributable to an employee's
participation in the wellness program over the employer
contribution with respect to an employee that doesn’t
participate in the wellness program is not taken into
account in calculating the uniform percentage
requirement, whether the difference is due to a discount
for participation or a surcharge for nonparticipation. The
employer contribution for employees who don’t participate
in the wellness program must be at least 50% of the
premium (including any premium surcharge for
nonparticipation). However, for purposes of figuring the
credit, the employer contributions are taken into account,
including those contributions attributable to an employee's
participation in a wellness program.
Arrangements with list billing and other tiers of coverage. An arrangement that requires you to pay a
separate premium for each employee based on age or
other factors (list billing) that provides other tiers of
coverage can be a qualifying arrangement even if it
requires you to pay a uniform percentage that is less than
50% of the premium cost for some employees. It is a
qualifying arrangement (assuming employee-only
coverage is the least expensive tier of coverage) if it
requires you to pay the following amounts.
A uniform percentage (not less than 50%) for each
employee enrolled in employee-only coverage as
discussed under Arrangements with list billing and only
employee-only coverage above.
A uniform amount that is either equal to the amount you
would have paid toward employee-only coverage (as
discussed above), a uniform percentage (not less than
50%) of the premium charged, or a uniform percentage
(not less than 50%) of your employer-computed
Tobacco surcharge. Any additional amount you or your
employee pay to cover a tobacco surcharge isn’t taken
into account in figuring the uniform percentage
Instructions for Form 8941 (2016)
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beginning in 2016, payroll taxes, for this purpose, mean
only the following taxes.
Federal income taxes the tax-exempt employer was
required to withhold from employees' wages in calendar
year 2016.
Medicare taxes the tax-exempt employer was required
to withhold from employees' wages in calendar year 2016.
Medicare taxes the tax-exempt employer was required
to pay for calendar year 2016.
composite rate (defined below) for your family coverage,
for each employee (if any) enrolled in family coverage.
A uniform amount that is either equal to the amount you
would have paid toward employee-only coverage (as
discussed above), a uniform percentage (not less than
50%) of the premium charged, or a uniform percentage
(not less than 50%) of your employer-computed
composite rate (defined below) for any other tier of
coverage, for each employee (if any) enrolled in any other
tier of coverage (figured separately for each tier).
Premium Deduction Reduced
Employer-computed composite rate. The
employer-computed composite rate for a tier of coverage
is the average rate determined by adding the premiums
for that tier of coverage for all employees eligible to
participate in the health insurance plan (whether or not
they actually receive coverage under the plan or under
that tier of coverage) and dividing by the total number of
such eligible employees.
You must reduce your deduction for the cost of providing
health insurance coverage to your employees by the
amount of any credit for small employer health insurance
premiums allowed with respect to the coverage.
More Information
For more information about this credit, see the following.
Section 45R.
Regulations sections 1.45R-0 through 1.45R-5.
www.irs.gov/Affordable-Care-Act/Employers/SmallBusiness-Health-Care-Tax-Credit-and-the-SHOPMarketplace.
More than one plan. Different types of health insurance
plans are generally not aggregated for purposes of
meeting the qualifying arrangement requirement. For
example, if you offer a major medical insurance plan and a
stand-alone vision plan, you generally must separately
satisfy the requirements for a qualifying arrangement with
respect to each type of coverage. For exceptions, see
Regulations section 1.45R-4(c).
Specific Instructions
Partnerships, S corporations, cooperatives,
TIP estates, trusts, and tax-exempt eligible small
State subsidies and credits. For this purpose, if you
are entitled to a state tax credit or a state premium
subsidy paid directly to you for premiums you paid, don’t
reduce the amount you paid by the credit or subsidy
amount. Also, if a state pays a premium subsidy directly to
your insurance provider, treat the subsidy amount as an
amount you paid for employee health insurance coverage.
employers must file this form to claim the credit.
All other taxpayers must not complete or file this form if
their only source for this credit is a partnership, S
corporation, cooperative, estate, or trust. Instead, they
must report this credit directly on line 4h in Part III of Form
3800.
State Premium Subsidy and Tax
Credit Limitation
Use Worksheets 1 through 7 to figure the amounts to
report on various lines of Form 8941.
Use Worksheets 1, 2, and 3 to figure the amounts to
report on lines 1, 2, and 3 of Form 8941.
Use Worksheet 4 to figure the amounts to report on
lines 4, 5, and 13 of Form 8941.
Use Worksheets 5, 6, and 7 to figure the amounts to
report on lines 8, 9, and 14 of Form 8941.
Your credit may be reduced if you are entitled to a state
tax credit or a state premium subsidy for the cost of health
insurance coverage you provide under a qualifying
arrangement to individuals considered employees. The
state tax credit may be refundable or nonrefundable and
the state premium subsidy may be paid to you or directly
to your insurance provider.
Although a state tax credit or premium subsidy paid
directly to you doesn’t reduce the amount of your
employer premiums paid, and although a state premium
subsidy paid directly to an insurance provider is treated as
an employer premium you paid, the amount of your credit
can’t be more than your net premium payments.
Net premium payments are employer premiums paid
(discussed earlier) minus the amount of any state tax
credits you received or will receive and any state premium
subsidies paid either to you or directly to your insurance
provider for premiums for health insurance coverage you
provide under a qualifying arrangement to individuals
considered employees.
Line A
Answer "Yes" if one of the following applies.
You paid premiums for employee health insurance
coverage you provided through a SHOP Marketplace or
through a direct enrollment process, if available in your
state.
You qualify for an exception to this requirement as
discussed below.
If you answer "Yes" because you paid premiums for
employee health insurance coverage you provided
through a SHOP Marketplace, enter the Marketplace
identifier, if any.
If you answer "No," don’t file Form 8941 unless you are
filing it for a partnership, S corporation, cooperative,
estate, trust, or tax-exempt eligible small employer that
received from another entity a credit that must be reported
on line 15. For more information, see the instructions for
line 15.
Payroll Tax Limitation for Tax-Exempt
Eligible Small Employers
The credit for tax-exempt eligible small employers can’t
exceed the amount of certain payroll taxes. For tax years
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Instructions for Form 8941 (2016)
Worksheet 1. Information Needed To
Complete Line 1 and Worksheets 2
and 3
Exception for certain employers in Iowa. For calendar
year 2015, SHOP Marketplaces in certain counties of
Iowa did not have qualified health plans available for
employers to offer to employees. Transition relief allows
employers with a principal business address in the
counties listed below to claim the credit for their tax year
beginning in 2015. Certain employers with a 2015 health
plan year that continues into 2016 can claim the credit for
part of their tax year beginning in 2016. For details, see
Notice 2015-08, 2015-6 I.R.B. 589, available at
www.irs.gov/irb/2015-6_IRB/ar11.
If you need more rows, use a separate sheet and include
the additional amounts in the totals below.
(a)
Individuals
Considered
Employees
Iowa: Adair, Adams, Appanoose, Audubon, Benton,
Black Hawk, Boone, Bremer, Buchanan, Buena Vista,
Butler, Calhoun, Carroll, Cass, Cedar, Cerro Gordo,
Cherokee, Chickasaw, Clarke, Clinton, Crawford, Dallas,
Davis, Decatur, Delaware, Des Moines, Dubuque, Floyd,
Franklin, Fremont, Greene, Grundy, Guthrie, Hamilton,
Hancock, Hardin, Harrison, Henry, Humboldt, Iowa,
Jackson, Jasper, Jefferson, Johnson, Jones, Keokuk,
Kossuth, Lee, Linn, Louisa, Lucas, Madison, Mahaska,
Marion, Marshall, Mills, Mitchell, Monona, Monroe,
Montgomery, Muscatine, Page, Palo Alto, Pocahontas,
Polk, Pottawattamie, Poweshiek, Ringgold, Sac, Scott,
Shelby, Story, Tama, Taylor, Union, Van Buren, Wapello,
Warren, Washington, Wayne, Webster, Winnebago,
Worth, and Wright counties.
(b)
Employee
Hours of
Service
(c)
Employee
Wages
Paid
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Exception for certain employers in Wisconsin. For
calendar year 2016, SHOP Marketplaces in certain
counties of Wisconsin will not have qualified health plans
available for employers to offer to employees. Transition
relief allows employers with a principal business address
in the counties listed below to claim the credit for their tax
year beginning in 2016. For details, see Notice 2016-75 in
Internal Revenue Bulletin 2016-51, available at
www.irs.gov/irb/2016-51_IRB/index.html.
11.
Wisconsin: Pierce, Polk, and St. Croix counties.
18.
Line C
19.
12.
13.
14.
15.
16.
17.
20.
Answer “Yes” if a tax return you (or any predecessor) filed
for a tax year beginning in 2014 included a Form 8941
with line A checked “Yes” and line 12 showing a positive
amount. For more information, see Credit Period, earlier.
21.
22.
23.
If you answer “Yes,” do not file Form 8941 unless you
are filing it for a partnership, S corporation, cooperative,
estate, trust, or tax-exempt eligible small employer that
received from another entity a credit that must be reported
on line 15. An entity that qualifies for this exception should
not report any amount on line 12 . For more information,
see the instructions for line 15.
24.
25.
Totals:
Column (a), Individuals Considered
Employees
Enter the name or other identifying information for all
individuals considered employees for purposes of this
credit.
In general, all employees who perform services for you
during the tax year are taken into account in determining
your FTEs, average annual wages, and premiums paid.
Rules that apply to certain types of employees are
discussed below.
Instructions for Form 8941 (2016)
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business and nonbusiness employees to determine FTEs,
average annual wages, and premiums paid.
Excluded employees. The following individuals aren’t
considered employees when you figure this credit. Hours
and wages of these employees and premiums paid for
them aren’t counted when you figure your credit.
The owner of a sole proprietorship.
A partner in a partnership.
A shareholder who owns (after applying the section 318
constructive ownership rules) more than 2% of an S
corporation.
A shareholder who owns (after applying the section 318
constructive ownership rules) more than 5% of the
outstanding stock or stock possessing more than 5% of
the total combined voting power of all stock of a
corporation that is not an S corporation.
A person who owns more than 5% of the capital or
profits interest in any other business that isn’t a
corporation.
Family members or a member of the household who is
not a family member but qualifies as a dependent on the
individual income tax return of a person listed above.
Family members include a child (or descendant of a
child), a sibling or step-sibling, a parent (or ancestor of a
parent), a step-parent, a niece or nephew, an aunt or
uncle, or a son-in-law, daughter-in-law, father-in-law,
mother-in-law, brother-in-law, or sister-in-law. A spouse is
also considered a family member for this purpose.
Ministers. A minister performing services in the exercise
of his or her ministry is treated as self-employed for social
security and Medicare purposes. However, for credit
purposes, whether a minister is an employee or
self-employed is determined under the common law test
for determining worker status. Self-employed ministers
aren’t considered employees.
Column (b), Employee Hours of
Service
Enter the total hours of service for the tax year for each
employee listed in column (a). Don’t enter more than
2,080 hours for any employee. But enter -0- for seasonal
employees who worked 120 or fewer days during the tax
year.
Employee hours of service. An employee’s hours of
service for a year include the following.
Each hour for which the employee is paid, or entitled to
payment, for the performance of duties for the employer
during the employer’s tax year.
Each hour for which an employee is paid, or entitled to
payment, by the employer on account of a period of time
during the employer's tax year during which no duties are
performed due to vacation, holiday, illness, incapacity
(including disability), layoff, jury duty, military duty, or
leave of absence (except that no more than 160 hours of
service are required to be counted for an employee on
account of any single continuous period during which the
employee performs no duties).
To figure the total number of hours of service you must
take into account for an employee for the year, you can
use any of the following methods.
Actual hours worked method. Determine actual
hours of service from records of hours worked and hours
for which payment is made or due (payment is made or
due for vacation, holiday, illness, incapacity, etc., as
described above).
Days-worked equivalency method. Use a
days-worked equivalency whereby the employee is
credited with 8 hours of service for each day for which the
employee would be required to be credited with at least
one hour of service under the rules described above.
Weeks-worked equivalency method. Use a
weeks-worked equivalency whereby the employee is
credited with 40 hours of service for each week for which
the employee would be required to be credited with at
least one hour of service under the rules described above.
Former employees. Premiums paid on behalf of a
former employee with no hours of service may be treated
as paid on behalf of an employee for purposes of figuring
the credit provided that, if so treated, the former employee
is also treated as an employee for purposes of the uniform
percentage requirement.
Leased employees. Don’t use premiums paid by the
leasing organization to figure your credit. Also, a leased
employee who isn’t a common law employee is
considered an employee for credit purposes if he or she
does all the following.
Provides services to you under an agreement between
you and a leasing organization.
Has performed services for you (or for you and a
related person) substantially full time for at least 1 year.
Performs services under your primary direction or
control.
But don’t use hours, wages, or premiums paid with
respect to the initial year of service on which leased
employee status is based.
Seasonal employees. Employees who perform labor or
services on a seasonal basis and perform labor or
services for you 120 or fewer days during the tax year
aren’t considered employees in determining FTEs and
average annual wages. But premiums paid on their behalf
are counted in determining the amount of the credit.
Seasonal workers include retail workers employed
exclusively during holiday seasons. Seasonal workers
also include workers employed exclusively during the
summer.
Column (c), Employee Wages Paid
!
CAUTION
Complete Worksheet 2 before you complete
column (c) of Worksheet 1. Do not complete
column (c) if Worksheet 2, line 3, is 25 or more.
Enter the total wages paid for the tax year for each
employee listed in column (a). But enter -0- for seasonal
employees who worked 120 or fewer days during the tax
year.
Household and other nonbusiness employees.
Household employees and other employees who aren’t
performing services in your trade or business are
considered employees if they otherwise qualify as
discussed above. A sole proprietor must include both
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Instructions for Form 8941 (2016)
Worksheet 4. Information Needed To
Complete Lines 4, 5, and 13 and
Worksheet 7
Wages, for this purpose, mean wages subject to social
security and Medicare tax withholding determined without
considering any wage base limit.
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
equivalent employees (FTEs) for the tax year. If you had
25 or more FTEs for the tax year, your credit is reduced to
zero.
1. Enter the total employee hours of
service from Worksheet 1, column
(b) . . . . . . . . . . . . . . . . . . . . . . . . .
1.
2. Hours of service per FTE . . . . . . . . .
2.
3. Full-time equivalent employees.
Divide line 1 by line 2. If the result is not
a whole number (0, 1, 2, etc.),
generally round the result down to
the next lowest whole number. For
example, round 2.99 down to 2.
However, if the result is less than one,
enter 1. Report this number on Form
8941, line 2 . . . . . . . . . . . . . . . . . .
(a)
Enrolled
Individuals
Considered
Employees
(c)
Adjusted
Average
Premiums
(d)
Enrolled
Employee
Hours of
Service
1.
2.
2,080
3.
4.
5.
6.
7.
8.
9.
3.
10.
Worksheet 3. Information Needed To
Complete Line 3 (Average Annual
Wages)
11.
12.
13.
14.
Your credit is reduced if you paid average annual wages
of more than $25,000 for the tax year. If you paid average
annual wages of $52,000 or more for the tax year, your
credit is reduced to zero.
1. Enter the total employee wages paid
from Worksheet 1, column (c) . . . . . .
1.
2. Enter FTEs from Worksheet 2,
line 3 . . . . . . . . . . . . . . . . . . . . . . .
2.
3. Average annual wages. Divide line 1
by line 2. If the result is not a multiple of
$1,000 ($1,000, $2,000, $3,000, etc.),
round the result down to the next
lowest multiple of $1,000. For example,
round $2,999 down to $2,000. Report
this amount on Form 8941, line 3 . . .
(b)
Employer
Premiums
Paid
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
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.
Instructions for Form 8941 (2016)
-7-
Column (b), Employer Premiums Paid
was enrolled for the entire tax year. You would have paid
$570 ($57 × 10) if the employee was only enrolled for 10
pay periods. You will need an additional set of
calculations if the premium amounts changed during the
tax year.
Enter the total employer premiums paid for the tax year for
each employee listed in column (a). For details, see
Employer Premiums Paid, earlier.
Column (c), Adjusted Average
Premiums
Column (d), Enrolled Employee Hours
of Service
Your credit is reduced if the employer premiums paid are
more than the employer premiums that would have been
paid if individuals considered employees were enrolled in
a plan with a premium equal to the average premium for
the small group market in the rating area in which the
employee enrolls for coverage.
!
Don’t complete column (d) of Worksheet 4 if
Form 8941, line 12, is zero.
CAUTION
Enter the amount from column (b) of Worksheet 1 for
each employee listed in column (a) of Worksheet 4.
The rating area in which an employee enrolls for
coverage is generally the rating area where your business
is located (based on your primary business address). You
will generally have selected a plan in your rating area that
covers all employees located within or outside your rating
area. However, if you have multiple businesses or
operations in multiple states, and have set up plans in
more than one SHOP Marketplace, the average premiums
may be different for employees enrolled in each SHOP
Marketplace.
Worksheet 5. Information Needed To
Complete Line 8 (If Line 2 is More
Than 10)
1. Enter the amount from Form 8941,
line 7 . . . . . . . . . . . . . . . . . . . . . . . . . .
1.
2. Enter the number from Form
8941, line 2 . . . . . . . . . . . .
2.
Enter, for each employee listed in column (a), the
premiums you would have paid if the employee had
enrolled in a plan or plans with a total premium equal to
the average premium for the small group market in the
rating area in which the employee enrolls for coverage.
3. Subtract 10 from line 2 . . . . .
3.
4. Divide line 3 by 15. Enter the
result as a decimal (rounded to
at least 3 places) . . . . . . . .
4.
To find the average premium for the small group market
in a rating area for tax years beginning in 2016, see the
average premium tables at the end of these instructions.
Family coverage includes any coverage other than
employee-only coverage.
5. Multiply line 1 by line 4 . . . . . . . . . . . . . .
5.
6. Subtract line 5 from line 1. Report this
amount on Form 8941, line 8 . . . . . . . . .
6.
Worksheet 6. Information Needed To
Complete Line 9 (If Line 3 is More
Than $25,000)
Example 4. Assume the same facts that were used in
Example 3. The $60 you contribute each payday toward
employee health insurance coverage is 60% ($60 ÷ $100)
of the weekly premium for each employee enrolled in
employee-only coverage and 24% ($60 ÷ $250) of the
weekly premium for each employee enrolled in family
coverage.
In this situation, the total average premium limitation
amounts that apply are 60% of the applicable average
premium amounts for each employee enrolled in
employee-only coverage and 24% of the applicable
average premium amounts for each employee enrolled in
family coverage.
You have an employee enrolled in employee-only
coverage who enrolled for coverage in your local rating
area. The applicable employee-only average premium
amount for the rating area is $4,940 or $95 ($4,940 ÷ 52)
for each weekly payday. The amount you would have paid
toward this employee's health insurance coverage based
on the average premiums is $57 (60% of $95) each
payday.
To determine the premiums you would have paid for
this employee during the tax year if the employee had
enrolled in an average premium plan, multiply the number
of pay periods during which your employee was enrolled
in the health insurance coverage by $57. For example,
you would have paid $2,964 ($57 × 52) if the employee
1. Enter the amount from Form 8941,
line 8 . . . . . . . . . . . . . . . . . . . . . . . . . .
2. Enter the amount from Form
8941, line 7 . . . . . . . . . . . . .
2.
3. Enter the amount from Form
8941, line 3 . . . . . . . . . . . . .
3.
4. Subtract $25,900 from
line 3 . . . . . . . . . . . . . . . . . .
4.
5. Divide line 4 by $25,900. Enter
the result as a decimal (rounded
to at least 3 places) . . . . . . . .
5.
1.
6. Multiply line 2 by line 5 . . . . . . . . . . . . . .
6.
7. Subtract line 6 from line 1. Report this
amount on Form 8941, line 9 . . . . . . . . .
7.
Line 10
Enter the total amount of any state premium subsidies
paid and any state tax credits available to you for
premiums included on line 4. For details, see State
Premium Subsidy and Tax Credit Limitation, earlier.
-8-
Instructions for Form 8941 (2016)
Worksheet 7. Information Needed To
Complete Line 14 (If Line 12 is More
Than Zero)
its tax liability. Therefore, to figure the unused amount of
the credit allocated to patrons, the cooperative must first
figure its tax liability. While any excess is allocated to
patrons, any credit recapture applies as if the cooperative
had claimed the entire credit.
If the cooperative is subject to the passive activity rules,
include on line 15 any credit for small employer health
insurance premiums from passive activities disallowed for
prior years and carried forward to this year. Complete
Form 8810, Corporate Passive Activity Loss and Credit
Limitations, to determine the allowed credit that must be
allocated to patrons. For details, see the Instructions for
Form 8810.
1. Enter the total enrolled employee hours of
service from Worksheet 4, column
(d) . . . . . . . . . . . . . . . . . . . . . . . . . .
1.
2. Hours of service per FTE . . . . . . . . . .
2.
2,080
3. Divide line 1 by line 2. If the result is not a
whole number (0, 1, 2, etc.), generally
round the result down to the next
lowest whole number. For example,
round 2.99 down to 2. However, if the
result is less than one, enter 1. Report
3.
this number on Form 8941, line 14 . . .
Estates and trusts. Allocate the credit on line 16
between the estate or trust and the beneficiaries in the
same proportion as income was allocated and enter the
beneficiaries' share on line 17.
If the estate or trust is subject to the passive activity
rules, include on line 15 any credit for small employer
health insurance premiums from passive activities
disallowed for prior years and carried forward to this year.
Complete Form 8582-CR, Passive Activity Credit
Limitations, to determine the allowed credit that must be
allocated between the estate or trust and the
beneficiaries. For details, see the Instructions for Form
8582-CR.
Line 15
Enter any credit for small employer health insurance
premiums from:
Schedule K-1 (Form 1065), box 15 (code P);
Schedule K-1 (Form 1120S), box 13 (code P);
Schedule K-1 (Form 1041), box 13 (code G); and
Form 1099-PATR, Taxable Distributions Received
From Cooperatives, box 10, or other notice of credit
allocation.
Line 19
Partnerships, S corporations, cooperatives,
TIP estates, trusts, and tax-exempt eligible small
employers must always report the above credits
on line 15. All other filers figuring a separate credit on
earlier lines must also report the above credits on line 15.
All others not using earlier lines to figure a separate credit
must report the above credits directly on Form 3800, Part
lll, line 4h.
Enter the total amount of certain payroll taxes. Payroll
taxes, for this purpose, mean only the following taxes.
Federal income taxes the tax-exempt employer was
required to withhold from employees' wages in calendar
year 2016.
Medicare taxes the tax-exempt employer was required
to withhold from employees' wages in calendar year 2016.
Medicare taxes the tax-exempt employer was required
to pay for calendar year 2016.
Line 17
Cooperatives. A cooperative described in section
1381(a) must allocate to its patrons the credit in excess of
Paperwork Reduction Act Notice. We ask for the information on this form to carry out the Internal Revenue laws of the
United States. You are required to give us the information. We need it to ensure that you are complying with these laws
and to allow us to figure and collect the right amount of tax.
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act
unless the form displays a valid OMB control number. Books or records relating to a form or its instructions must be
retained as long as their contents may become material in the administration of any Internal Revenue law. Generally, tax
returns and return information are confidential, as required by section 6103.
h
The time needed to complete and file this form will vary depending on individual circumstances. The estimated burden
for individual and business taxpayers filing this form is approved under OMB control number 1545-0074 and 1545-0123
and is included in the estimates shown in the instructions for their individual and business income tax return. The
estimated burden for all other taxpayers who file this form is shown below.
Recordkeeping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Learning about the law or the form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Preparing and sending the form to the IRS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10 hr., 51 min.
1 hr., 23 min.
2 hr., 46 min.
If you have comments concerning the accuracy of these time estimates or suggestions for making this form simpler,
we would be happy to hear from you. See the instructions for the tax return with which this form is filed.
Instructions for Form 8941 (2016)
-9-
Average Premiums Needed To Figure Adjusted Amounts on Worksheet 4
The following tables list the average
premiums for the small group market
in each rating area generally listed by
county for each state for tax years
beginning in 2016.
Alabama
Limestone
5,669
13,414
Petersburg
10,192
24,648
Lowndes
5,946
15,035
Prince of Wales-Hyder 10,192
24,648
Macon
5,705
14,192
Sitka
10,192
24,648
Madison
5,669
13,414
Skagway
10,192
24,648
Marengo
5,705
14,192
Southeast Fairbanks
10,042
24,324
Marion
5,705
14,192
Valdez Cordova
9,267
25,236
Employee- Dependent,
Only
Family, etc.
Marshall
5,705
14,192
Wade Hampton
10,042
24,324
County
Mobile
5,290
15,021
10,192
24,648
Autauga
5,946
15,035
Monroe
5,705
14,192
Wrangell City and
Borough
Baldwin
5,705
14,192
Montgomery
5,946
15,035
Yakutat
10,042
24,324
Barbour
5,705
14,192
Morgan
6,804
16,557
Yukon Koyukuk
10,042
24,324
Bibb
6,092
16,300
Perry
5,705
14,192
Blount
6,092
16,300
Pickens
5,705
14,192
Bullock
5,705
14,192
Pike
5,705
14,192
Butler
5,705
14,192
Randolph
5,705
14,192
Calhoun
5,708
16,163
Russell
7,030
16,447
Chambers
5,705
14,192
Shelby
6,092
16,300
Cherokee
5,705
14,192
St. Clair
6,092
16,300
Chilton
6,092
16,300
Sumter
5,705
14,192
Choctaw
5,705
14,192
Talladega
5,705
14,192
Clarke
5,705
14,192
Tallapoosa
5,705
14,192
Clay
5,705
14,192
Tuscaloosa
5,681
16,043
Cleburne
5,705
14,192
Walker
6,092
16,300
Coffee
5,705
14,192
Washington
5,705
14,192
Colbert
5,867
16,166
Wilcox
5,705
14,192
Conecuh
5,705
14,192
Winston
5,705
14,192
Coosa
5,705
14,192
Covington
5,705
14,192
Crenshaw
5,705
14,192
Cullman
5,705
14,192
County
Employee- Dependent,
Only
Family, etc.
Dale
5,705
14,192
Aleutians East
10,042
24,324
Dallas
5,705
14,192
Aleutians West
10,042
24,324
DeKalb
5,705
14,192
Anchorage
9,267
25,236
Elmore
5,946
15,035
Bethel
9,267
25,236
Escambia
5,705
14,192
Bristol Bay
10,042
24,324
Etowah
5,237
16,355
Denali
10,042
24,324
Fayette
5,705
14,192
Dillingham
9,267
25,236
Franklin
5,705
14,192
Fairbanks North Star
10,042
24,324
Geneva
5,945
12,597
Haines
10,192
24,648
Greene
5,681
16,043
Hoonah-Angoon
10,192
24,648
Hale
5,681
16,043
Juneau
10,192
24,648
Henry
5,945
12,597
Kenai Peninsula
10,042
24,324
Houston
5,945
12,597
Ketchikan Gateway
10,192
24,648
Jackson
5,705
14,192
Kodiak Island
10,042
24,324
Jefferson
6,092
16,300
Lake and Peninsula
10,042
24,324
Lamar
5,705
14,192
Matanuska Susitna
10,042
24,324
Lauderdale
5,867
16,166
Nome
10,042
24,324
Lawrence
6,804
16,557
North Slope
10,042
24,324
Lee
5,727
12,927
Northwest Arctic
10,042
24,324
Alaska
-10-
Arizona
County
Employee- Dependent,
Only
Family, etc.
Apache
6,048
14,412
Cochise
6,445
15,283
Coconino
6,048
14,412
Gila
6,572
16,264
Graham
6,445
15,283
Greenlee
6,445
15,283
La Paz
7,132
19,568
Maricopa
5,993
15,340
Mohave
6,048
14,412
Navajo
6,048
14,412
Pima
5,732
16,348
Pinal
6,572
16,264
Santa Cruz
5,732
16,348
Yavapai
5,438
16,656
Yuma
7,132
19,568
Arkansas
County
Employee- Dependent,
Only
Family, etc.
Arkansas
5,215
14,595
Ashley
5,215
14,595
Baxter
4,564
13,288
Benton
4,564
13,288
Boone
4,564
13,288
Bradley
5,215
14,595
Calhoun
5,272
15,416
Carroll
4,564
13,288
Chicot
5,215
14,595
Clark
5,127
13,995
Clay
5,181
15,011
Cleburne
5,192
14,527
Cleveland
5,215
14,595
Columbia
5,272
15,416
Conway
5,192
14,527
2016 Average Premium Tables
Craighead
5,181
15,011
Stone
5,181
15,011
Santa Clara
6,949
17,022
Crawford
5,029
15,139
Union
5,272
15,416
Santa Cruz
6,056
13,519
Crittenden
5,181
15,011
Van Buren
5,192
14,527
Shasta
6,161
13,993
Cross
5,181
15,011
Washington
4,564
13,288
Sierra
6,161
13,993
Dallas
5,215
14,595
White
5,192
14,527
Siskiyou
6,161
13,993
Desha
5,215
14,595
Woodruff
5,181
15,011
Solano
6,899
14,887
Drew
5,215
14,595
Yell
5,192
14,527
Sonoma
6,899
14,887
Faulkner
5,192
14,527
Stanislaus
6,834
13,815
Franklin
5,029
15,139
Sutter
6,161
13,993
Fulton
5,181
15,011
6,161
13,993
5,127
13,995
County
Employee- Dependent,
Only
Family, etc.
Tehama
Garland
Trinity
6,161
13,993
Grant
5,192
14,527
Alameda
6,715
15,793
Tulare
6,834
13,815
6,161
13,993
California
Greene
5,181
15,011
Alpine
Tuolumne
6,161
13,993
Hempstead
5,272
15,416
Amador
6,161
13,993
Ventura
5,970
13,955
Hot Spring
5,127
13,995
Butte
6,161
13,993
Yolo
5,930
14,907
6,161
13,993
Yuba
6,161
13,993
Howard
5,272
15,416
Calaveras
Independence
5,181
15,011
Colusa
6,161
13,993
Izard
5,181
15,011
Contra Costa
6,690
17,129
Jackson
5,181
15,011
Del Norte
6,161
13,993
Jefferson
5,215
14,595
El Dorado
5,930
14,907
County
Employee- Dependent,
Only
Family, etc.
Johnson
5,029
15,139
Fresno
6,269
17,056
Adams
6,416
18,805
6,161
13,993
Alamosa
6,714
14,801
Colorado
Lafayette
5,272
15,416
Glenn
Lawrence
5,181
15,011
Humboldt
6,161
13,993
Arapahoe
6,416
18,805
14,595
Imperial
5,644
14,662
Archuleta
7,176
14,051
5,644
14,662
Baca
6,714
14,801
Lee
5,215
Lincoln
5,215
14,595
Inyo
Little River
5,272
15,416
Kern
6,568
14,918
Bent
6,714
14,801
15,139
Kings
6,269
17,056
Boulder
5,415
17,092
6,161
13,993
Broomfield
6,416
18,805
Logan
5,029
Lonoke
5,192
14,527
Lake
Madison
4,564
13,288
Lassen
6,161
13,993
Chaffee
6,714
14,801
13,288
Los Angeles
6,233
15,277
Cheyenne
6,714
14,801
6,269
17,056
Clear Creek
6,416
18,805
Marion
4,564
Miller
5,272
15,416
Madera
Mississippi
5,181
15,011
Marin
6,899
14,887
Conejos
6,714
14,801
14,595
Mariposa
6,834
13,815
Costilla
6,714
14,801
6,161
13,993
Crowley
6,714
14,801
Monroe
5,215
Montgomery
5,127
13,995
Mendocino
Nevada
5,272
15,416
Merced
6,834
13,815
Custer
6,714
14,801
6,161
13,993
Delta
7,176
14,051
Newton
4,564
13,288
Modoc
Ouachita
5,272
15,416
Mono
5,644
14,662
Denver
6,416
18,805
Perry
5,192
14,527
Monterey
6,056
13,519
Dolores
7,176
14,051
6,899
14,887
Douglas
6,416
18,805
Phillips
5,215
14,595
Napa
Pike
5,127
13,995
Nevada
6,161
13,993
Eagle
7,378
18,967
Poinsett
5,181
15,011
Orange
6,303
16,378
El Paso
6,109
16,336
5,930
14,907
Elbert
6,416
18,805
Polk
5,029
15,139
Placer
Pope
5,192
14,527
Plumas
6,161
13,993
Fremont
6,714
14,801
14,527
Riverside
5,704
14,108
Garfield
7,378
18,967
5,930
14,907
Gilpin
6,416
18,805
Prairie
5,192
Pulaski
5,192
14,527
Sacramento
Randolph
5,181
15,011
San Benito
6,056
13,519
Grand
7,176
14,051
14,527
San Bernardino
5,704
14,108
Gunnison
7,176
14,051
6,045
13,847
Hinsdale
7,176
14,051
Saline
5,192
Scott
5,029
15,139
San Diego
Searcy
4,564
13,288
San Francisco
6,636
19,045
Huerfano
6,714
14,801
15,139
San Joaquin
6,834
13,815
Jackson
7,176
14,051
5,970
13,955
Jefferson
6,416
18,805
Sebastian
5,029
Sevier
5,272
15,416
San Luis Obispo
Sharp
5,181
15,011
San Mateo
8,031
19,551
Kiowa
6,714
14,801
15,011
Santa Barbara
5,970
13,955
Kit Carson
6,714
14,801
St. Francis
5,181
2016 Average Premium Tables
-11-
Florida
Pasco
7,222
17,241
Employee- Dependent,
Only
Family, etc.
Pinellas
6,793
17,284
Polk
6,725
18,523
Alachua
6,483
18,526
Putnam
6,547
19,304
14,801
Baker
6,819
18,340
Santa Rosa
6,248
15,409
16,834
Bay
6,087
16,518
Sarasota
6,187
17,419
6,228
18,668
La Plata
7,176
14,051
Lake
7,176
14,051
Larimer
6,924
15,012
County
Las Animas
6,714
14,801
Lincoln
6,714
Logan
6,143
Mesa
6,200
17,485
Bradford
Seminole
6,403
16,459
Mineral
6,714
14,801
Brevard
6,562
19,268
St. Johns
6,230
20,276
Moffat
7,176
14,051
Broward
6,412
19,677
St. Lucie
5,720
15,781
6,436
18,498
Montezuma
7,176
14,051
Calhoun
Sumter
6,343
20,097
Montrose
7,176
14,051
Charlotte
7,602
21,853
Suwannee
5,794
18,191
Morgan
6,143
16,834
Citrus
6,175
16,645
Taylor
7,698
20,766
5,248
18,079
Otero
6,714
14,801
Clay
Union
6,404
18,849
Ouray
7,176
14,051
Collier
5,724
18,249
Volusia
6,502
18,059
Park
6,416
18,805
Columbia
7,619
20,834
Wakulla
6,279
18,762
6,377
19,377
Walton
5,595
15,589
Washington
6,572
19,403
Phillips
6,143
16,834
DeSoto
Pitkin
7,378
18,967
Dixie
5,585
15,282
Prowers
6,714
14,801
Duval
6,680
17,101
Pueblo
6,909
18,542
Escambia
7,011
16,171
Rio Blanco
7,176
14,051
Flagler
7,325
17,746
Rio Grande
6,714
14,801
Franklin
6,390
19,561
County
Employee- Dependent,
Only
Family, etc.
Routt
7,176
14,051
Gadsden
5,640
18,111
Appling
5,981
17,458
Saguache
6,714
14,801
Gilchrist
6,191
18,470
Atkinson
7,013
19,033
14,051
Glades
6,694
21,069
Bacon
4,793
14,025
7,132
18,814
San Juan
7,176
Georgia
San Miguel
7,176
14,051
Gulf
7,505
19,997
Baker
Sedgwick
6,143
16,834
Hamilton
6,289
18,448
Baldwin
7,411
19,119
18,967
Hardee
6,611
15,476
Banks
6,244
14,149
5,149
17,934
Summit
7,378
Teller
6,109
16,336
Hendry
7,605
21,272
Barrow
Washington
6,143
16,834
Hernando
6,794
19,628
Bartow
6,329
16,664
14,791
Highlands
7,233
22,204
Ben Hill
7,286
20,529
7,286
20,529
Weld
Yuma
5,267
6,143
16,834
Connecticut
Hillsborough
6,063
18,134
Berrien
Holmes
6,336
18,530
Bibb
6,078
17,514
Indian River
5,576
15,775
Bleckley
6,078
17,514
4,793
14,025
Jackson
5,706
15,332
Brantley
Jefferson
7,343
17,863
Brooks
7,286
20,529
5,981
17,458
County
Employee- Dependent,
Only
Family, etc.
Fairfield
7,969
20,619
Lafayette
6,707
17,176
Bryan
Hartford
7,443
19,986
Lake
6,829
20,508
Bulloch
5,981
17,458
Litchfield
6,860
18,489
Lee
6,462
18,664
Burke
6,205
18,063
Middlesex
8,289
20,355
Leon
7,004
20,060
Butts
6,329
16,664
New Haven
7,661
19,642
Levy
6,257
19,545
Calhoun
7,132
18,814
New London
6,262
16,977
Liberty
6,502
18,954
Camden
4,793
14,025
Tolland
7,109
15,267
Madison
7,585
19,890
Candler
5,981
17,458
Windham
7,050
22,180
Manatee
6,495
20,547
Carroll
6,471
19,520
Marion
5,381
15,531
Catoosa
6,368
17,701
4,793
14,025
Delaware
County
Employee- Dependent,
Only
Family, etc.
All
7,035
17,582
District of Columbia
County
Employee- Dependent,
Only
Family, etc.
All
6,534
19,177
Martin
5,707
20,401
Charlton
Miami-Dade
6,882
20,551
Chatham
5,981
17,458
Monroe
7,638
21,499
Chattahoochee
5,440
18,095
7,357
18,355
Nassau
7,343
15,017
Chattooga
Okaloosa
6,647
25,545
Cherokee
6,329
16,664
Okeechobee
7,498
20,433
Clarke
5,149
17,934
7,132
18,814
Orange
6,644
17,145
Clay
Osceola
6,558
21,366
Clayton
6,329
16,664
Palm Beach
6,502
19,808
Clinch
7,286
20,529
-12-
2016 Average Premium Tables
Cobb
6,329
16,664
Lanier
7,286
20,529
Towns
6,244
14,149
Coffee
7,013
19,033
Laurens
7,013
19,033
Treutlen
7,013
19,033
Colquitt
7,286
20,529
Lee
7,132
18,814
Troup
5,440
18,095
Columbia
6,205
18,063
Liberty
5,981
17,458
Turner
7,286
20,529
Cook
7,286
20,529
Lincoln
6,205
18,063
Twiggs
6,078
17,514
Coweta
6,329
16,664
Long
5,981
17,458
Union
6,244
14,149
Crawford
6,078
17,514
Lowndes
7,286
20,529
Upson
5,440
18,095
Crisp
7,132
18,814
Lumpkin
6,244
14,149
Walker
6,368
17,701
Dade
6,368
17,701
Macon
5,440
18,095
Walton
6,329
16,664
Dawson
6,244
14,149
Madison
5,149
17,934
Ware
4,793
14,025
Decatur
7,286
20,529
Marion
5,440
18,095
Warren
6,205
18,063
DeKalb
6,329
16,664
McDuffie
6,205
18,063
Washington
7,411
19,119
Dodge
6,078
17,514
McIntosh
4,793
14,025
Wayne
4,793
14,025
Dooly
6,078
17,514
Meriwether
5,440
18,095
Webster
5,440
18,095
Dougherty
7,132
18,814
Miller
7,286
20,529
Wheeler
7,013
19,033
Douglas
6,329
16,664
Mitchell
7,132
18,814
White
6,244
14,149
Early
7,286
20,529
Monroe
6,078
17,514
Whitfield
5,986
15,155
Echols
7,286
20,529
Montgomery
7,013
19,033
Wilcox
6,078
17,514
Effingham
5,981
17,458
Morgan
5,149
17,934
Wilkes
6,205
18,063
Elbert
5,149
17,934
Murray
5,986
15,155
Wilkinson
7,411
19,119
Emanuel
6,205
18,063
Muscogee
5,440
18,095
Worth
7,132
18,814
Evans
5,981
17,458
Newton
6,329
16,664
Fannin
5,986
15,155
Oconee
5,149
17,934
Fayette
6,329
16,664
Oglethorpe
5,149
17,934
Floyd
7,357
18,355
Paulding
6,329
16,664
County
Employee- Dependent,
Only
Family, etc.
Forsyth
6,329
16,664
Peach
6,078
17,514
All
5,862
Franklin
6,244
14,149
Pickens
7,357
18,355
Fulton
6,329
16,664
Pierce
4,793
14,025
Gilmer
7,357
18,355
Pike
6,329
16,664
Glascock
6,205
18,063
Polk
7,357
18,355
Glynn
4,793
14,025
Pulaski
6,078
17,514
Gordon
7,357
18,355
Putnam
6,078
17,514
Grady
7,286
20,529
Quitman
5,440
18,095
Greene
5,149
17,934
Rabun
6,244
14,149
Gwinnett
6,329
16,664
Randolph
7,132
18,814
Habersham
6,244
14,149
Richmond
6,205
18,063
Hall
6,244
14,149
Rockdale
6,329
16,664
Hancock
7,411
19,119
Schley
7,132
18,814
Haralson
6,471
19,520
Screven
5,981
17,458
Harris
5,440
18,095
Seminole
7,286
20,529
Hart
6,244
14,149
Spalding
6,329
16,664
Heard
6,471
19,520
Stephens
6,244
14,149
Henry
6,329
16,664
Stewart
5,440
18,095
Houston
6,078
17,514
Sumter
7,132
18,814
Irwin
7,286
20,529
Talbot
5,440
18,095
Jackson
5,149
17,934
Taliaferro
6,205
18,063
Jasper
6,329
16,664
Tattnall
5,981
17,458
Jeff Davis
7,013
19,033
Taylor
5,440
18,095
Jefferson
6,205
18,063
Telfair
7,013
19,033
Jenkins
6,205
18,063
Terrell
7,132
18,814
Johnson
7,013
19,033
Thomas
7,286
20,529
Jones
6,078
17,514
Tift
7,286
20,529
Lamar
6,329
16,664
Toombs
7,013
19,033
2016 Average Premium Tables
-13-
Hawaii
16,824
Idaho
County
Employee- Dependent,
Only
Family, etc.
Ada
5,018
12,194
Adams
4,873
11,810
Bannock
4,785
11,613
Bear Lake
4,785
11,613
Benewah
5,467
12,479
Bingham
4,785
11,613
Blaine
5,001
11,586
Boise
4,873
11,810
Bonner
5,467
12,479
Bonneville
5,057
11,748
Boundary
5,467
12,479
Butte
4,785
11,613
Camas
5,001
11,586
Canyon
4,873
11,810
Caribou
4,785
11,613
Cassia
5,001
11,586
Clark
5,057
11,748
Clearwater
5,251
14,166
Custer
4,785
11,613
Elmore
4,873
11,810
Franklin
4,785
11,613
Fremont
5,057
11,748
Gem
4,873
11,810
Gooding
5,001
11,586
Fulton
7,117
16,869
Saline
6,335
16,564
Idaho
5,251
14,166
Gallatin
6,335
16,564
Sangamon
6,399
14,879
Jefferson
5,057
11,748
Greene
6,204
15,375
Schuyler
6,399
14,879
Jerome
5,001
11,586
Grundy
7,928
18,777
Scott
6,399
14,879
Kootenai
5,467
12,479
Hamilton
6,335
16,564
Shelby
6,399
14,879
Latah
5,467
12,479
Hancock
5,251
16,725
St. Clair
6,989
15,545
Lemhi
5,057
11,748
Hardin
6,335
16,564
Stark
7,117
16,869
Lewis
5,251
14,166
Henderson
5,251
16,725
Stephenson
6,523
16,519
Lincoln
5,001
11,586
Henry
5,251
16,725
Tazewell
7,117
16,869
Madison
5,057
11,748
Iroquois
6,755
15,702
Union
6,335
16,564
Minidoka
5,001
11,586
Jackson
6,335
16,564
Vermilion
6,755
15,702
Nez Perce
5,251
14,166
Jasper
6,335
16,564
Wabash
6,335
16,564
Oneida
4,785
11,613
Jefferson
6,335
16,564
Warren
5,251
16,725
Owyhee
4,873
11,810
Jersey
6,204
15,375
Washington
6,204
15,375
Payette
4,873
11,810
Jo Daviess
6,523
16,519
Wayne
6,335
16,564
Power
4,785
11,613
Johnson
6,335
16,564
White
6,335
16,564
Shoshone
5,467
12,479
Kane
7,109
18,214
Whiteside
5,251
16,725
Teton
5,057
11,748
Kankakee
7,928
18,777
Will
7,928
18,777
Twin Falls
5,001
11,586
Kendall
7,928
18,777
Williamson
6,335
16,564
Valley
4,873
11,810
Knox
7,117
16,869
Winnebago
6,523
16,519
Washington
4,873
11,810
Lake
6,435
17,934
Woodford
7,117
16,869
LaSalle
7,117
16,869
Lawrence
6,335
16,564
Illinois
Indiana
Employee- Dependent,
Only
Family, etc.
Lee
6,523
16,519
County
Livingston
6,991
19,010
County
Employee- Dependent,
Only
Family, etc.
Adams
6,399
14,879
Logan
6,399
14,879
Adams
7,447
15,954
Alexander
6,335
16,564
14,879
Allen
6,518
13,989
Bond
6,204
15,375
Macoupin
6,204
15,375
Bartholomew
6,875
14,505
Boone
6,523
16,519
Madison
6,989
15,545
Benton
6,839
17,073
Brown
6,399
14,879
16,564
Blackford
7,432
13,298
Bureau
5,251
16,725
Marshall
7,117
16,869
Boone
6,974
16,617
Calhoun
6,204
15,375
Mason
6,399
14,879
Brown
6,293
14,260
Carroll
6,523
16,519
16,564
Carroll
6,908
18,523
6,893
16,017
Macon
Marion
Massac
6,399
6,335
6,335
Cass
6,399
14,879
McDonough
7,117
16,869
Cass
Champaign
6,755
15,702
McHenry
6,435
17,934
Clark
6,454
13,690
Christian
6,399
14,879
McLean
6,991
19,010
Clay
7,068
16,165
Clark
6,755
15,702
Menard
6,399
14,879
Clinton
6,908
18,523
Clay
6,335
16,564
Mercer
5,251
16,725
Crawford
6,454
13,690
Clinton
6,204
15,375
Monroe
6,989
15,545
Daviess
7,393
15,630
Coles
6,755
15,702
Montgomery
6,204
15,375
Dearborn
5,685
17,814
Cook
6,786
17,592
Morgan
6,399
14,879
Decatur
6,875
14,505
Crawford
6,335
16,564
Moultrie
6,399
14,879
DeKalb
7,447
15,954
Cumberland
6,755
15,702
Ogle
6,523
16,519
Delaware
7,432
13,298
DeKalb
6,523
16,519
16,869
Dubois
7,393
15,630
DeWitt
6,991
19,010
Perry
6,335
16,564
Elkhart
7,205
13,812
Douglas
6,755
15,702
Piatt
6,755
15,702
Fayette
5,783
16,812
DuPage
7,109
18,214
14,879
Floyd
6,454
13,690
Edgar
6,755
15,702
Pope
6,335
16,564
Fountain
6,908
18,523
Edwards
6,335
16,564
Pulaski
6,335
16,564
Franklin
5,685
17,814
Effingham
6,335
16,564
16,869
Fulton
6,893
16,017
8,317
17,426
Peoria
Pike
Putnam
7,117
6,399
7,117
Fayette
6,335
16,564
Randolph
6,204
15,375
Gibson
Ford
6,755
15,702
Richland
6,335
16,564
Grant
7,432
13,298
Franklin
6,335
16,564
16,725
Greene
7,393
15,630
Rock Island
5,251
-14-
2016 Average Premium Tables
Hamilton
6,974
16,617
Vanderburgh
8,317
17,426
Guthrie
6,834
16,767
Hancock
5,783
16,812
Vermillion
7,068
16,165
Hamilton
6,380
14,549
Harrison
6,454
13,690
Vigo
7,068
16,165
Hancock
6,302
16,083
Hendricks
6,974
16,617
Wabash
7,447
15,954
Hardin
6,380
14,549
Henry
5,783
16,812
Warren
6,839
17,073
Harrison
6,834
16,767
Howard
6,893
16,017
Warrick
8,317
17,426
Henry
6,020
15,410
Huntington
7,447
15,954
Washington
6,454
13,690
Howard
6,302
16,083
Jackson
6,875
14,505
Wayne
5,783
16,812
Humboldt
6,302
16,083
Jasper
6,839
17,073
Wells
7,447
15,954
Ida
6,043
15,981
Jay
7,432
13,298
White
6,839
17,073
Iowa
6,045
15,576
Jefferson
6,454
13,690
Whitley
7,447
15,954
Jackson
6,045
15,576
Jennings
6,875
14,505
Jasper
6,305
14,438
Johnson
6,293
14,260
Jefferson
6,020
15,410
Knox
7,393
15,630
6,045
15,576
Kosciusko
7,205
13,812
County
Employee- Dependent,
Only
Family, etc.
Johnson
Jones
6,045
15,576
6,834
16,767
Iowa
LaGrange
7,447
15,954
Adair
Keokuk
6,020
15,410
Lake
7,139
15,459
Adams
6,834
16,767
Kossuth
6,302
16,083
LaPorte
7,139
15,459
Allamakee
6,302
16,083
Lee
6,020
15,410
6,020
15,410
Lawrence
6,293
14,260
Appanoose
Linn
6,045
15,576
Madison
5,783
16,812
Audubon
6,834
16,767
Louisa
6,020
15,410
Marion
6,974
16,617
Benton
6,045
15,576
Lucas
6,020
15,410
6,045
15,576
Marshall
7,205
13,812
Black Hawk
Lyon
6,043
15,981
Martin
7,393
15,630
Boone
6,380
14,549
Madison
6,305
14,438
6,302
16,083
Miami
6,893
16,017
Bremer
Mahaska
6,020
15,410
Monroe
6,293
14,260
Buchanan
6,045
15,576
Marion
6,305
14,438
Montgomery
6,908
18,523
Buena Vista
6,043
15,981
Marshall
6,380
14,549
6,302
16,083
Morgan
6,974
16,617
Butler
Mills
6,834
16,767
Newton
6,839
17,073
Calhoun
6,380
14,549
Mitchell
6,302
16,083
Noble
7,447
15,954
Carroll
6,380
14,549
Monona
6,043
15,981
6,834
16,767
Ohio
5,685
17,814
Cass
Monroe
6,020
15,410
Orange
7,393
15,630
Cedar
6,045
15,576
Montgomery
6,834
16,767
Owen
6,293
14,260
Cerro Gordo
6,302
16,083
Muscatine
6,020
15,410
6,043
15,981
Parke
7,068
16,165
Cherokee
O'Brien
6,043
15,981
Perry
7,393
15,630
Chickasaw
6,302
16,083
Osceola
6,043
15,981
Pike
7,393
15,630
Clarke
6,834
16,767
Page
6,834
16,767
6,043
15,981
Porter
7,139
15,459
Clay
Palo Alto
6,043
15,981
Posey
8,317
17,426
Clayton
6,045
15,576
Plymouth
6,043
15,981
Pulaski
6,893
16,017
Clinton
6,045
15,576
Pocahontas
6,043
15,981
6,043
15,981
Putnam
6,908
18,523
Crawford
Polk
6,305
14,438
Randolph
7,432
13,298
Dallas
6,305
14,438
Pottawattamie
6,834
16,767
Ripley
5,685
17,814
Davis
6,020
15,410
Poweshiek
6,380
14,549
6,834
16,767
Rush
6,875
14,505
Decatur
Ringgold
6,834
16,767
Scott
6,454
13,690
Delaware
6,045
15,576
Sac
6,043
15,981
6,020
15,410
Shelby
6,974
16,617
Des Moines
Scott
6,045
15,576
Spencer
7,393
15,630
Dickinson
6,043
15,981
Shelby
6,834
16,767
St. Joseph
7,205
13,812
Dubuque
6,045
15,576
Sioux
6,043
15,981
6,302
16,083
Starke
7,205
13,812
Emmet
Story
6,380
14,549
Steuben
7,447
15,954
Fayette
6,302
16,083
Tama
6,380
14,549
Sullivan
7,068
16,165
Floyd
6,302
16,083
Taylor
6,834
16,767
6,302
16,083
Switzerland
5,685
17,814
Franklin
Union
6,834
16,767
Tippecanoe
6,908
18,523
Fremont
6,834
16,767
Van Buren
6,020
15,410
Tipton
6,908
18,523
Greene
6,380
14,549
Wapello
6,020
15,410
16,812
Grundy
6,380
14,549
Warren
6,305
14,438
Union
5,783
2016 Average Premium Tables
-15-
Washington
6,020
15,410
Hodgeman
6,442
13,697
Stevens
6,442
13,697
Wayne
6,020
15,410
Jackson
5,719
14,038
Sumner
5,306
13,826
Webster
6,380
14,549
Jefferson
5,719
14,038
Thomas
5,426
16,873
Winnebago
6,302
16,083
Jewell
4,707
14,000
Trego
5,426
16,873
Winneshiek
6,302
16,083
Johnson
5,981
15,294
Wabaunsee
5,719
14,038
Woodbury
6,043
15,981
Kearny
6,442
13,697
Wallace
5,426
16,873
Worth
6,302
16,083
Kingman
5,306
13,826
Washington
4,707
14,000
Wright
6,302
16,083
Kiowa
6,442
13,697
Wichita
5,426
16,873
Labette
4,959
16,537
Wilson
5,306
13,826
Lane
5,426
16,873
Woodson
4,959
16,537
5,981
15,294
Wyandotte
5,981
15,294
Kansas
County
Employee- Dependent,
Only
Family, etc.
Leavenworth
Lincoln
4,707
14,000
Allen
4,959
16,537
Linn
5,719
14,038
Anderson
5,719
14,038
Logan
5,426
16,873
Atchison
5,719
14,038
Lyon
5,719
14,038
County
Employee- Dependent,
Only
Family, etc.
Barber
6,442
13,697
Marion
5,306
13,826
Adair
5,488
14,189
5,488
14,189
Kentucky
Barton
5,426
16,873
Marshall
5,719
14,038
Allen
Bourbon
4,959
16,537
McPherson
5,306
13,826
Anderson
5,857
15,664
Brown
5,719
14,038
Meade
6,442
13,697
Ballard
5,940
18,305
Butler
5,306
13,826
Miami
5,981
15,294
Barren
5,488
14,189
Chase
5,306
13,826
Mitchell
4,707
14,000
Bath
6,144
20,621
Chautauqua
5,306
13,826
Montgomery
5,306
13,826
Bell
6,054
17,534
Cherokee
4,959
16,537
Morris
4,707
14,000
Boone
6,339
14,396
Cheyenne
5,426
16,873
13,697
Bourbon
5,857
15,664
Clark
6,442
13,697
Nemaha
5,719
14,038
Boyd
6,144
20,621
Clay
4,707
14,000
Neosho
4,959
16,537
Boyle
5,857
15,664
Cloud
4,707
14,000
16,873
Bracken
6,144
20,621
Coffey
5,719
14,038
Norton
5,426
16,873
Breathitt
6,054
17,534
Comanche
6,442
13,697
Osage
5,719
14,038
Breckinridge
5,511
14,664
Cowley
5,306
13,826
16,873
Bullitt
5,511
14,664
Crawford
4,959
16,537
Ottawa
4,707
14,000
Butler
5,488
14,189
Decatur
5,426
16,873
Pawnee
6,442
13,697
Caldwell
5,940
18,305
Dickinson
4,707
14,000
16,873
Calloway
5,940
18,305
6,339
14,396
Morton
Ness
Osborne
Phillips
6,442
5,426
5,426
5,426
Doniphan
5,719
14,038
Pottawatomie
5,719
14,038
Campbell
Douglas
5,719
14,038
Pratt
6,442
13,697
Carlisle
5,940
18,305
Edwards
6,442
13,697
Rawlins
5,426
16,873
Carroll
5,511
14,664
Elk
5,306
13,826
Reno
5,306
13,826
Carter
6,144
20,621
Ellis
5,426
16,873
Republic
4,707
14,000
Casey
5,488
14,189
Ellsworth
4,707
14,000
Rice
5,306
13,826
Christian
6,622
16,252
Finney
6,442
13,697
Riley
4,707
14,000
Clark
5,857
15,664
Ford
6,442
13,697
Rooks
5,426
16,873
Clay
6,054
17,534
Franklin
5,719
14,038
Rush
5,426
16,873
Clinton
5,488
14,189
Geary
4,707
14,000
Russell
5,426
16,873
Crittenden
5,940
18,305
Gove
5,426
16,873
14,000
Cumberland
5,488
14,189
Graham
5,426
16,873
Scott
5,426
16,873
Daviess
6,622
16,252
Grant
6,442
13,697
Sedgwick
5,306
13,826
Edmonson
5,488
14,189
Gray
6,442
13,697
13,697
Elliott
6,144
20,621
Greeley
5,426
16,873
Shawnee
5,719
14,038
Estill
5,857
15,664
Greenwood
5,306
13,826
Sheridan
5,426
16,873
Fayette
5,857
15,664
Hamilton
6,442
13,697
16,873
Fleming
6,144
20,621
6,054
17,534
Saline
Seward
Sherman
4,707
6,442
5,426
Harper
5,306
13,826
Smith
5,426
16,873
Floyd
Harvey
5,306
13,826
Stafford
6,442
13,697
Franklin
5,857
15,664
Haskell
6,442
13,697
13,697
Fulton
5,940
18,305
Stanton
6,442
-16-
2016 Average Premium Tables
Gallatin
6,339
14,396
Ohio
6,622
16,252
Franklin
7,386
16,842
Garrard
5,857
15,664
Oldham
5,511
14,664
Grant
5,804
13,965
Grant
6,339
14,396
Owen
5,857
15,664
Iberia
6,008
16,284
Graves
5,940
18,305
Owsley
6,054
17,534
Iberville
5,695
15,919
Grayson
5,511
14,664
Pendleton
6,339
14,396
Jackson
7,386
16,842
Green
5,488
14,189
Perry
6,054
17,534
Jefferson
6,221
16,491
Greenup
6,144
20,621
Pike
6,054
17,534
Jefferson Davis
5,882
17,766
Hancock
6,622
16,252
Powell
5,857
15,664
Lafayette
6,008
16,284
Hardin
5,511
14,664
Pulaski
5,488
14,189
Lafourche
6,203
16,312
Harlan
6,054
17,534
Robertson
6,144
20,621
LaSalle
5,804
13,965
Harrison
5,857
15,664
Rockcastle
5,857
15,664
Lincoln
7,386
16,842
Hart
5,488
14,189
Rowan
6,144
20,621
Livingston
5,695
15,919
Henderson
6,622
16,252
Russell
5,488
14,189
Madison
7,386
16,842
Henry
5,511
14,664
Scott
5,857
15,664
Morehouse
7,386
16,842
Hickman
5,940
18,305
Shelby
5,511
14,664
Natchitoches
6,502
16,598
Hopkins
6,622
16,252
Simpson
5,488
14,189
Orleans
6,221
16,491
Jackson
5,857
15,664
Spencer
5,511
14,664
Ouachita
7,386
16,842
Jefferson
5,511
14,664
Taylor
5,488
14,189
Plaquemines
6,221
16,491
Jessamine
5,857
15,664
Todd
6,622
16,252
Pointe Coupee
5,695
15,919
Johnson
6,054
17,534
Trigg
6,622
16,252
Rapides
5,804
13,965
Kenton
6,339
14,396
Trimble
5,511
14,664
Red River
6,502
16,598
Knott
6,054
17,534
Union
6,622
16,252
Richland
7,386
16,842
Knox
6,054
17,534
Warren
5,488
14,189
Sabine
6,502
16,598
LaRue
5,511
14,664
Washington
5,511
14,664
St. Bernard
6,221
16,491
Laurel
6,054
17,534
Wayne
5,488
14,189
St. Charles
6,221
16,491
Lawrence
6,144
20,621
Webster
6,622
16,252
St. Helena
5,695
15,919
Lee
6,054
17,534
Whitley
6,054
17,534
St. James
6,221
16,491
Leslie
6,054
17,534
Wolfe
6,054
17,534
St. John Baptist
6,221
16,491
Letcher
6,054
17,534
Woodford
5,857
15,664
St. Landry
6,008
16,284
Lewis
6,144
20,621
St. Martin
6,008
16,284
Lincoln
5,857
15,664
St. Mary
6,008
16,284
Livingston
5,940
18,305
6,221
16,491
Louisiana
Employee- Dependent,
Only
Family, etc.
St. Tammany
Logan
5,488
14,189
Parish
Tangipahoa
5,695
15,919
Lyon
5,940
18,305
Acadia
6,008
16,284
Tensas
7,386
16,842
Madison
5,857
15,664
Allen
5,882
17,766
Terrebonne
6,203
16,312
5,695
15,919
Magoffin
6,054
17,534
Ascension
Union
7,386
16,842
Marion
5,511
14,664
Assumption
6,203
16,312
Vermilion
6,008
16,284
Marshall
5,940
18,305
Avoyelles
5,804
13,965
Vernon
5,804
13,965
5,882
17,766
Martin
6,054
17,534
Beauregard
Washington
5,695
15,919
Mason
6,144
20,621
Bienville
6,502
16,598
Webster
6,502
16,598
McCracken
5,940
18,305
Bossier
6,502
16,598
West Baton Rouge
5,695
15,919
6,502
16,598
McCreary
5,488
14,189
Caddo
West Carroll
7,386
16,842
McLean
6,622
16,252
Calcasieu
5,882
17,766
West Feliciana
5,695
15,919
7,386
16,842
Winn
5,804
13,965
Meade
5,511
14,664
Caldwell
Menifee
6,144
20,621
Cameron
5,882
17,766
Mercer
5,857
15,664
Catahoula
5,804
13,965
Metcalfe
5,488
14,189
Claiborne
6,502
16,598
5,804
13,965
County
Employee- Dependent,
Only
Family, etc.
Maine
Monroe
5,488
14,189
Concordia
Montgomery
5,857
15,664
DeSoto
6,502
16,598
Androscoggin
6,005
15,419
20,621
East Baton Rouge
5,695
15,919
Aroostook
6,566
18,274
7,386
16,842
Cumberland
5,748
15,578
Morgan
6,144
Muhlenberg
6,622
16,252
East Carroll
Nelson
5,511
14,664
East Feliciana
5,695
15,919
Franklin
6,005
15,419
15,664
Evangeline
6,008
16,284
Hancock
6,566
18,274
Nicholas
5,857
2016 Average Premium Tables
-17-
Kennebec
5,989
16,112
Norfolk
7,448
20,478
Lenawee
6,203
15,819
Knox
5,989
16,112
Plymouth
6,963
19,874
Livingston
6,203
15,819
Lincoln
5,989
16,112
Suffolk
7,448
20,478
Luce
6,447
14,394
Oxford
5,989
16,112
Worcester
6,682
19,812
Mackinac
5,742
15,789
Penobscot
6,005
15,419
Macomb
6,325
16,211
Piscataquis
6,005
15,419
Manistee
4,934
13,899
Sagadahoc
5,748
15,578
6,447
14,394
6,005
15,419
County
Employee- Dependent,
Only
Family, etc.
Marquette
Somerset
Mason
5,528
13,730
Waldo
6,005
15,419
Alcona
5,742
15,789
Mecosta
5,528
13,730
6,447
14,394
Michigan
Washington
6,566
18,274
Alger
Menominee
6,447
14,394
York
5,748
15,578
Allegan
5,731
11,828
Midland
5,117
14,911
Alpena
5,742
15,789
Missaukee
4,934
13,899
Antrim
4,934
13,899
Monroe
5,904
15,998
Arenac
5,756
14,905
Montcalm
5,528
13,730
Baraga
6,447
14,394
Montmorency
5,742
15,789
Maryland
County
Employee- Dependent,
Only
Family, etc.
Allegany
5,979
15,272
Barry
5,731
11,828
Muskegon
5,528
13,730
Anne Arundel
6,277
17,167
Bay
5,756
14,905
Newaygo
5,528
13,730
Baltimore
6,277
17,167
Benzie
4,934
13,899
Oakland
6,325
16,211
Baltimore City
6,277
17,167
Berrien
6,352
17,286
Oceana
5,528
13,730
Calvert
6,087
15,613
Branch
5,473
15,212
Ogemaw
5,742
15,789
Caroline
6,087
15,613
Calhoun
5,473
15,212
Ontonagon
6,447
14,394
Carroll
5,979
15,272
Cass
6,352
17,286
Osceola
5,528
13,730
Cecil
6,087
15,613
Charlevoix
4,934
13,899
Oscoda
5,742
15,789
Charles
6,087
15,613
Cheboygan
5,742
15,789
Otsego
5,742
15,789
Dorchester
6,087
15,613
Chippewa
5,742
15,789
Ottawa
5,528
13,730
Frederick
5,979
15,272
Clare
5,117
14,911
Presque Isle
5,742
15,789
Garrett
5,979
15,272
Clinton
5,456
14,332
Roscommon
5,742
15,789
Harford
6,277
17,167
Crawford
5,742
15,789
Saginaw
5,756
14,905
Howard
6,277
17,167
Delta
6,447
14,394
Sanilac
7,003
15,606
Kent
6,087
15,613
Dickinson
6,447
14,394
Schoolcraft
6,447
14,394
Montgomery
6,615
18,377
Eaton
5,456
14,332
Shiawassee
5,432
14,664
Prince George's
6,615
18,377
Emmet
4,934
13,899
St. Clair
6,605
14,819
Queen Annes
6,087
15,613
Genesee
5,432
14,664
St. Joseph
6,352
17,286
Somerset
6,087
15,613
Gladwin
5,117
14,911
Tuscola
7,003
15,606
St. Marys
6,087
15,613
Gogebic
6,447
14,394
Van Buren
6,352
17,286
Talbot
6,087
15,613
Grand Traverse
4,934
13,899
Washtenaw
6,203
15,819
Washington
5,979
15,272
Gratiot
5,756
14,905
Wayne
5,904
15,998
Wicomico
6,087
15,613
Hillsdale
5,456
14,332
Wexford
4,934
13,899
Worcester
6,087
15,613
Houghton
6,447
14,394
Huron
7,003
15,606
Ingham
5,456
14,332
5,528
13,730
County
Employee- Dependent,
Only
Family, etc.
County
Employee- Dependent,
Only
Family, etc.
Ionia
Iosco
5,742
15,789
Aitkin
5,924
15,215
Barnstable
8,746
22,384
Iron
6,447
14,394
Anoka
6,248
15,995
Berkshire
6,608
17,893
Isabella
5,117
14,911
Becker
6,694
16,078
Bristol
6,963
19,874
Jackson
5,456
14,332
Beltrami
5,924
15,215
Dukes
8,746
22,384
Kalamazoo
5,473
15,212
Benton
6,248
15,995
Essex
7,252
19,601
Kalkaska
4,934
13,899
Big Stone
5,758
15,728
Franklin
6,608
17,893
Kent
5,528
13,730
Blue Earth
5,826
14,341
Hampden
6,608
17,893
Keweenaw
6,447
14,394
Brown
5,519
15,519
Hampshire
6,608
17,893
Lake
5,528
13,730
Carlton
6,247
13,448
Middlesex
7,448
20,478
Lapeer
5,432
14,664
Carver
6,248
15,995
Nantucket
8,746
22,384
Leelanau
4,934
13,899
Cass
5,924
15,215
Massachusetts
-18-
Minnesota
2016 Average Premium Tables
Chippewa
5,758
15,728
Renville
5,758
15,728
Humphreys
5,923
12,589
Chisago
5,924
15,215
Rice
5,826
14,341
Issaquena
5,923
12,589
Clay
6,694
16,078
Rock
5,519
15,519
Itawamba
5,731
12,070
Clearwater
6,247
16,543
Roseau
5,924
15,215
Jackson
6,284
12,779
Cook
6,247
13,448
Scott
6,248
15,995
Jasper
5,923
12,589
Cottonwood
5,519
15,519
Sherburne
6,248
15,995
Jefferson
5,923
12,589
Crow Wing
5,924
15,215
Sibley
5,758
15,728
Jefferson Davis
5,923
12,589
Dakota
6,248
15,995
St. Louis
6,247
13,448
Jones
5,581
12,475
Dodge
6,499
16,021
Stearns
6,248
15,995
Kemper
5,923
12,589
Douglas
6,694
16,078
Steele
6,499
16,021
Lafayette
5,923
12,589
Faribault
5,826
14,341
Stevens
6,694
16,078
Lamar
5,581
12,475
Fillmore
6,499
16,021
Swift
5,758
15,728
Lauderdale
5,923
12,589
Freeborn
6,499
16,021
Todd
5,924
15,215
Lawrence
5,923
12,589
Goodhue
6,499
16,021
Traverse
6,694
16,078
Leake
5,923
12,589
Grant
6,694
16,078
Wabasha
6,499
16,021
Lee
5,731
12,070
Hennepin
6,248
15,995
Wadena
5,924
15,215
Leflore
5,923
12,589
Houston
6,499
16,021
Waseca
5,826
14,341
Lincoln
5,923
12,589
Hubbard
5,924
15,215
Washington
6,248
15,995
Lowndes
5,923
12,589
Isanti
5,924
15,215
Watonwan
5,826
14,341
Madison
5,694
13,432
Itasca
6,247
13,448
Wilkin
6,694
16,078
Marion
5,923
12,589
Jackson
5,519
15,519
Winona
6,499
16,021
Marshall
5,105
12,607
Kanabec
5,924
15,215
Wright
6,248
15,995
Monroe
5,923
12,589
Kandiyohi
5,758
15,728
Yellow Medicine
5,758
15,728
Montgomery
5,923
12,589
Kittson
6,247
16,543
Neshoba
5,923
12,589
Koochiching
6,247
13,448
Newton
5,923
12,589
Lac qui Parle
5,758
15,728
5,923
12,589
Mississippi
Employee- Dependent,
Only
Family, etc.
Noxubee
Lake
6,247
13,448
County
Oktibbeha
5,923
12,589
Lake of the Woods
6,247
13,448
Adams
5,923
12,589
Panola
5,923
12,589
Le Sueur
5,826
14,341
Alcorn
5,923
12,589
Pearl River
5,581
12,475
5,923
12,589
Lincoln
5,519
15,519
Amite
Perry
5,581
12,475
Lyon
5,758
15,728
Attala
5,923
12,589
Pike
5,923
12,589
Mahnomen
6,247
16,543
Benton
5,731
12,070
Pontotoc
5,731
12,070
5,923
12,589
Marshall
6,247
16,543
Bolivar
Prentiss
5,923
12,589
Martin
5,826
14,341
Calhoun
5,923
12,589
Quitman
5,923
12,589
McLeod
5,758
15,728
Carroll
5,923
12,589
Rankin
5,694
13,432
5,923
12,589
Meeker
5,758
15,728
Chickasaw
Scott
5,923
12,589
Mille Lacs
5,924
15,215
Choctaw
5,923
12,589
Sharkey
5,923
12,589
Morrison
5,924
15,215
Claiborne
5,923
12,589
Simpson
5,694
13,432
5,923
12,589
Mower
6,499
16,021
Clarke
Smith
5,923
12,589
Murray
5,519
15,519
Clay
5,923
12,589
Stone
6,284
12,779
Nicollet
5,826
14,341
Coahoma
5,923
12,589
Sunflower
5,923
12,589
5,694
13,432
Nobles
5,519
15,519
Copiah
Tallahatchie
5,923
12,589
Norman
6,247
16,543
Covington
5,923
12,589
Tate
5,105
12,607
5,105
12,607
Olmsted
6,499
16,021
DeSoto
Tippah
5,731
12,070
Otter Tail
6,694
16,078
Forrest
5,581
12,475
Tishomingo
5,923
12,589
Pennington
6,247
16,543
Franklin
5,923
12,589
Tunica
5,105
12,607
6,284
12,779
Pine
5,924
15,215
George
Union
5,731
12,070
Pipestone
5,519
15,519
Greene
5,581
12,475
Walthall
5,923
12,589
Polk
6,247
16,543
Grenada
5,923
12,589
Warren
5,694
13,432
6,284
12,779
Pope
6,694
16,078
Hancock
Washington
5,923
12,589
Ramsey
6,248
15,995
Harrison
6,284
12,779
Wayne
5,923
12,589
Red Lake
6,247
16,543
Hinds
5,694
13,432
Webster
5,923
12,589
15,519
Holmes
5,923
12,589
Wilkinson
5,923
12,589
Redwood
5,519
2016 Average Premium Tables
-19-
Winston
5,923
12,589
Iron
5,932
15,086
St. Francois
5,730
14,803
Yalobusha
5,923
12,589
Jackson
5,861
15,293
St. Louis
5,730
14,803
Yazoo
5,923
12,589
Jasper
5,676
13,318
St. Louis City
5,730
14,803
Jefferson
5,730
14,803
Ste. Genevieve
5,730
14,803
Johnson
6,391
17,594
Stoddard
6,757
14,363
6,905
14,468
Stone
5,334
13,518
Missouri
County
Employee- Dependent,
Only
Family, etc.
Knox
Laclede
5,334
13,518
Sullivan
6,905
14,468
Adair
6,905
14,468
Lafayette
6,391
17,594
Taney
5,334
13,518
Andrew
6,971
14,166
Lawrence
5,334
13,518
Texas
5,932
15,086
Atchison
6,971
14,166
Lewis
6,905
14,468
Vernon
6,391
17,594
Audrain
6,016
16,164
Lincoln
5,730
14,803
Warren
5,730
14,803
Barry
5,334
13,518
Linn
6,905
14,468
Washington
5,730
14,803
Barton
5,676
13,318
Livingston
6,971
14,166
Wayne
6,757
14,363
Bates
6,391
17,594
Macon
6,905
14,468
Webster
5,334
13,518
Benton
6,391
17,594
Madison
6,757
14,363
Worth
6,971
14,166
Bollinger
6,757
14,363
Maries
6,016
16,164
Wright
5,334
13,518
Boone
6,016
16,164
Marion
6,905
14,468
Buchanan
6,971
14,166
McDonald
5,676
13,318
Butler
6,757
14,363
Mercer
6,971
14,166
Caldwell
6,971
14,166
Miller
6,016
16,164
County
Employee- Dependent,
Only
Family, etc.
Callaway
6,016
16,164
Mississippi
6,757
14,363
Beaverhead
7,551
16,232
Camden
6,016
16,164
Moniteau
6,016
16,164
Big Horn
7,551
16,232
Cape Girardeau
6,757
14,363
Monroe
6,016
16,164
Blaine
7,551
16,232
Carroll
6,971
14,166
16,164
Broadwater
6,521
15,485
Carter
5,932
15,086
Morgan
6,016
16,164
Carbon
6,473
15,097
Cass
5,861
15,293
New Madrid
6,757
14,363
Carter
7,551
16,232
Cedar
5,334
13,518
13,318
Cascade
6,521
15,485
Chariton
6,016
16,164
Nodaway
6,971
14,166
Chouteau
6,521
15,485
Christian
5,334
13,518
Oregon
5,932
15,086
Custer
7,551
16,232
Clark
6,905
14,468
16,164
Daniels
7,551
16,232
Clay
5,861
15,293
Ozark
5,334
13,518
Dawson
7,551
16,232
Clinton
6,971
14,166
Pemiscot
6,757
14,363
Deer Lodge
6,521
15,485
Cole
6,016
16,164
14,363
Fallon
7,551
16,232
7,551
16,232
Montgomery
Newton
Osage
Perry
6,016
5,676
6,016
6,757
Montana
Cooper
6,016
16,164
Pettis
6,391
17,594
Fergus
Crawford
5,932
15,086
Phelps
5,932
15,086
Flathead
6,270
14,155
Dade
5,334
13,518
Pike
6,905
14,468
Gallatin
6,521
15,485
Dallas
5,334
13,518
Platte
5,861
15,293
Garfield
7,551
16,232
Daviess
6,971
14,166
Polk
5,334
13,518
Glacier
7,551
16,232
DeKalb
6,971
14,166
Pulaski
5,932
15,086
Golden Valley
7,551
16,232
Dent
5,932
15,086
Putnam
6,905
14,468
Granite
7,551
16,232
Douglas
5,334
13,518
Ralls
6,905
14,468
Hill
7,551
16,232
Dunklin
6,757
14,363
Randolph
6,016
16,164
Jefferson
6,521
15,485
Franklin
5,730
14,803
Ray
6,971
14,166
Judith Basin
6,521
15,485
Gasconade
6,016
16,164
15,086
Lake
6,270
14,155
Gentry
6,971
14,166
Ripley
5,932
15,086
Lewis and Clark
6,521
15,485
Greene
5,334
13,518
Saline
6,391
17,594
Liberty
7,551
16,232
Grundy
6,971
14,166
14,468
Lincoln
7,551
16,232
Harrison
6,971
14,166
Scotland
6,905
14,468
Madison
7,551
16,232
Henry
6,391
17,594
Scott
6,757
14,363
McCone
7,551
16,232
Hickory
5,334
13,518
15,086
Meagher
7,551
16,232
7,551
16,232
Reynolds
Schuyler
Shannon
5,932
6,905
5,932
Holt
6,971
14,166
Shelby
6,905
14,468
Mineral
Howard
6,016
16,164
St. Charles
5,730
14,803
Missoula
6,270
14,155
Howell
5,932
15,086
17,594
Musselshell
6,473
15,097
St. Clair
6,391
-20-
2016 Average Premium Tables
Park
7,551
16,232
Dodge
5,652
15,386
Seward
5,994
17,142
Petroleum
7,551
16,232
Douglas
5,652
15,386
Sheridan
6,941
16,552
Phillips
7,551
16,232
Dundy
6,941
16,552
Sherman
6,091
15,524
Pondera
7,551
16,232
Fillmore
5,994
17,142
Sioux
6,941
16,552
Powder River
7,551
16,232
Franklin
6,091
15,524
Stanton
6,091
15,524
Powell
7,551
16,232
Frontier
6,941
16,552
Thayer
5,994
17,142
Prairie
7,551
16,232
Furnas
6,091
15,524
Thomas
6,941
16,552
Ravalli
7,551
16,232
Gage
5,994
17,142
Thurston
5,652
15,386
Richland
7,551
16,232
Garden
6,941
16,552
Valley
6,091
15,524
Roosevelt
7,551
16,232
Garfield
6,091
15,524
Washington
5,652
15,386
Rosebud
7,551
16,232
Gosper
6,091
15,524
Wayne
6,091
15,524
Sanders
7,551
16,232
Grant
6,941
16,552
Webster
6,091
15,524
Sheridan
7,551
16,232
Greeley
6,091
15,524
Wheeler
6,091
15,524
Silver Bow
6,521
15,485
Hall
6,091
15,524
York
5,994
17,142
Stillwater
6,473
15,097
Hamilton
6,091
15,524
Sweet Grass
6,473
15,097
Harlan
6,091
15,524
Teton
6,521
15,485
Hayes
6,941
16,552
Toole
7,551
16,232
Hitchcock
6,941
16,552
County
Employee- Dependent,
Only
Family, etc.
Treasure
7,551
16,232
Holt
6,091
15,524
Carson City
5,674
14,551
Valley
7,551
16,232
Hooker
6,941
16,552
Churchill
6,885
17,134
Wheatland
7,551
16,232
Howard
6,091
15,524
Clark
5,410
14,672
5,674
14,551
Nevada
Wibaux
7,551
16,232
Jefferson
5,994
17,142
Douglas
Yellowstone
6,473
15,097
Johnson
5,994
17,142
Elko
6,885
17,134
15,524
Esmeralda
6,885
17,134
6,885
17,134
Kearney
Nebraska
6,091
Keith
6,941
16,552
Eureka
Keya Paha
6,091
15,524
Humboldt
6,885
17,134
16,552
Lander
6,885
17,134
6,885
17,134
County
Employee- Dependent,
Only
Family, etc.
Adams
6,091
15,524
Knox
6,091
15,524
Lincoln
Antelope
6,091
15,524
Lancaster
5,994
17,142
Lyon
5,674
14,551
Arthur
6,941
16,552
16,552
Mineral
6,885
17,134
Banner
6,941
16,552
Logan
6,941
16,552
Nye
5,410
14,672
Blaine
6,091
15,524
Loup
6,091
15,524
Pershing
6,885
17,134
Boone
6,091
15,524
15,524
Storey
5,674
14,551
6,052
16,002
6,885
17,134
Kimball
Lincoln
Madison
6,941
6,941
6,091
Box Butte
6,941
16,552
McPherson
6,941
16,552
Washoe
Boyd
6,091
15,524
Merrick
6,091
15,524
White Pine
Brown
6,941
16,552
Morrill
6,941
16,552
Buffalo
6,091
15,524
Nance
6,091
15,524
Burt
5,652
15,386
Nemaha
5,994
17,142
Butler
6,091
15,524
Nuckolls
6,091
15,524
Cass
5,652
15,386
Otoe
5,994
17,142
Cedar
6,091
15,524
Pawnee
5,994
17,142
Chase
6,941
16,552
Perkins
6,941
16,552
Cherry
6,941
16,552
Phelps
6,091
15,524
Cheyenne
6,941
16,552
Pierce
6,091
15,524
Clay
6,091
15,524
Platte
6,091
15,524
Colfax
6,091
15,524
Polk
6,091
15,524
Cuming
6,091
15,524
Red Willow
6,941
16,552
Custer
6,091
15,524
Richardson
5,994
17,142
Dakota
6,091
15,524
Rock
6,091
15,524
Dawes
6,941
16,552
Saline
5,994
17,142
Dawson
6,091
15,524
Sarpy
5,652
15,386
Deuel
6,941
16,552
Saunders
5,652
15,386
Dixon
6,091
15,524
Scotts Bluff
6,941
16,552
2016 Average Premium Tables
-21-
New Hampshire
County
Employee- Dependent,
Only
Family, etc.
All
7,363
19,424
New Jersey
County
Employee- Dependent,
Only
Family, etc.
All
7,632
19,355
New Mexico
County
Employee- Dependent,
Only
Family, etc.
Bernalillo
6,433
15,511
Catron
6,834
16,484
Chaves
6,834
16,484
Cibola
6,834
16,484
Colfax
6,834
16,484
Hamilton
6,450
17,120
Bertie
6,786
17,420
Curry
6,834
16,484
Herkimer
6,450
17,120
Bladen
5,940
14,124
De Baca
6,834
16,484
Jefferson
6,450
17,120
Brunswick
6,642
14,934
Dona Ana
6,860
15,381
Kings
7,839
23,291
Buncombe
5,713
13,618
Eddy
6,834
16,484
Lewis
6,450
17,120
Burke
5,769
16,132
Grant
6,834
16,484
Livingston
5,413
14,888
Cabarrus
5,762
15,915
Guadalupe
6,834
16,484
Madison
6,450
17,120
Caldwell
5,769
16,132
Harding
6,834
16,484
Monroe
5,413
14,888
Camden
6,786
17,420
Hidalgo
6,834
16,484
Montgomery
6,971
17,662
Carteret
5,755
12,777
Lea
6,834
16,484
Nassau
7,535
21,531
Caswell
6,291
13,056
Lincoln
6,834
16,484
New York
7,839
23,291
Catawba
5,769
16,132
Los Alamos
6,834
16,484
Niagara
5,704
16,154
Chatham
6,291
13,056
Luna
6,834
16,484
Oneida
6,450
17,120
Cherokee
5,713
13,618
McKinley
6,834
16,484
Onondaga
6,265
17,359
Chowan
6,786
17,420
Mora
6,834
16,484
Ontario
5,413
14,888
Clay
5,713
13,618
Otero
6,834
16,484
Orange
6,677
17,568
Cleveland
5,470
14,225
Quay
6,834
16,484
Orleans
5,704
16,154
Columbus
6,642
14,934
Rio Arriba
6,834
16,484
Oswego
6,450
17,120
Craven
5,755
12,777
Roosevelt
6,834
16,484
Otsego
6,450
17,120
Cumberland
5,940
14,124
San Juan
6,750
15,615
Putnam
6,677
17,568
Currituck
6,786
17,420
San Miguel
6,834
16,484
Queens
7,839
23,291
Dare
5,755
12,777
Sandoval
6,433
15,511
Rensselaer
6,971
17,662
Davidson
5,916
13,648
Santa Fe
6,155
15,206
Richmond
7,839
23,291
Davie
5,916
13,648
Sierra
6,834
16,484
Rockland
7,839
23,291
Duplin
6,642
14,934
Socorro
6,834
16,484
Saratoga
6,971
17,662
Durham
6,291
13,056
Taos
6,834
16,484
Schenectady
6,971
17,662
Edgecombe
5,883
17,577
Torrance
6,433
15,511
Schoharie
6,971
17,662
Forsyth
5,916
13,648
Union
6,834
16,484
Schuyler
6,265
17,359
Franklin
6,343
16,463
Valencia
6,433
15,511
Seneca
5,413
14,888
Gaston
5,470
14,225
St. Lawrence
6,450
17,120
Gates
6,786
17,420
Steuben
6,265
17,359
Graham
5,713
13,618
7,535
21,531
Granville
5,338
12,219
New York
County
Employee- Dependent,
Only
Family, etc.
Suffolk
Sullivan
6,677
17,568
Greene
5,883
17,577
Albany
6,971
17,662
Tioga
6,265
17,359
Guilford
6,265
14,505
Allegany
5,704
16,154
Tompkins
6,265
17,359
Halifax
6,786
17,420
Bronx
7,839
23,291
Ulster
6,677
17,568
Harnett
5,940
14,124
Broome
6,265
17,359
Warren
6,971
17,662
Haywood
5,713
13,618
Cattaraugus
5,704
16,154
Washington
6,971
17,662
Henderson
5,713
13,618
Cayuga
6,265
17,359
Wayne
5,413
14,888
Hertford
6,786
17,420
Chautauqua
5,704
16,154
Westchester
7,839
23,291
Hoke
5,940
14,124
Chemung
6,265
17,359
Wyoming
5,704
16,154
Hyde
5,755
12,777
Chenango
6,450
17,120
Yates
5,413
14,888
Iredell
5,769
16,132
Clinton
6,450
17,120
Jackson
5,713
13,618
Columbia
6,971
17,662
Cortland
6,265
17,359
Delaware
6,677
17,568
Dutchess
6,677
Erie
North Carolina
Johnston
6,343
16,463
Jones
5,755
12,777
County
Employee- Dependent,
Only
Family, etc.
Lee
6,291
13,056
17,568
Alamance
6,291
13,056
Lenoir
5,755
12,777
5,704
16,154
Alexander
5,769
16,132
Lincoln
5,470
14,225
Essex
6,450
17,120
Alleghany
7,573
17,074
Macon
5,713
13,618
Franklin
6,450
17,120
Anson
5,762
15,915
Madison
5,713
13,618
Fulton
6,971
17,662
Ashe
7,573
17,074
Martin
6,786
17,420
Genesee
5,704
16,154
Avery
5,713
13,618
McDowell
5,713
13,618
Greene
6,971
17,662
Beaufort
5,755
12,777
Mecklenburg
5,762
15,915
-22-
2016 Average Premium Tables
Mitchell
5,713
13,618
Cavalier
6,940
17,297
Auglaize
7,480
16,162
Montgomery
6,207
11,961
Dickey
6,940
17,297
Belmont
7,496
19,458
Moore
6,207
11,961
Divide
6,940
17,297
Brown
7,363
17,363
Nash
5,883
17,577
Dunn
6,940
17,297
Butler
6,812
16,297
New Hanover
6,642
14,934
Eddy
6,940
17,297
Carroll
7,521
18,214
Northampton
6,786
17,420
Emmons
6,940
17,297
Champaign
6,576
18,414
Onslow
6,642
14,934
Foster
6,940
17,297
Clark
6,576
18,414
Orange
6,291
13,056
Golden Valley
6,940
17,297
Clermont
7,363
17,363
Pamlico
5,755
12,777
Grand Forks
6,243
15,522
Clinton
7,363
17,363
Pasquotank
6,786
17,420
Grant
6,940
17,297
Columbiana
7,312
19,976
Pender
6,642
14,934
Griggs
6,940
17,297
Coshocton
7,496
19,458
Perquimans
6,786
17,420
Hettinger
6,940
17,297
Crawford
7,128
18,124
Person
6,291
13,056
Kidder
6,940
17,297
Cuyahoga
7,530
18,227
Pitt
5,883
17,577
La Moure
6,940
17,297
Darke
6,576
18,414
Polk
5,713
13,618
Logan
6,940
17,297
Defiance
7,221
17,269
Randolph
6,265
14,505
McHenry
6,940
17,297
Delaware
6,996
19,040
Richmond
5,940
14,124
McIntosh
6,940
17,297
Erie
7,709
18,253
Robeson
5,940
14,124
McKenzie
6,940
17,297
Fairfield
6,996
19,040
Rockingham
6,265
14,505
McLean
6,940
17,297
Fayette
6,996
19,040
Rowan
5,762
15,915
Mercer
6,940
17,297
Franklin
6,996
19,040
Rutherford
5,713
13,618
Morton
5,914
16,471
Fulton
7,221
17,269
Sampson
5,940
14,124
Mountrail
6,940
17,297
Gallia
8,906
20,656
Scotland
5,940
14,124
Nelson
6,940
17,297
Geauga
7,530
18,227
Stanly
5,762
15,915
Oliver
6,940
17,297
Greene
6,576
18,414
Stokes
5,916
13,648
Pembina
6,940
17,297
Guernsey
7,496
19,458
Surry
5,916
13,648
Pierce
6,940
17,297
Hamilton
6,812
16,297
Swain
5,713
13,618
Ramsey
6,940
17,297
Hancock
7,480
16,162
Transylvania
5,713
13,618
Ransom
6,940
17,297
Hardin
7,480
16,162
Tyrrell
5,755
12,777
Renville
6,940
17,297
Harrison
7,496
19,458
Union
5,762
15,915
Richland
6,940
17,297
Henry
7,221
17,269
Vance
5,338
12,219
Rolette
6,940
17,297
Highland
7,363
17,363
Wake
6,343
16,463
Sargent
6,940
17,297
Hocking
5,813
13,331
Warren
5,338
12,219
Sheridan
6,940
17,297
Holmes
5,810
15,434
Washington
5,755
12,777
Sioux
6,940
17,297
Huron
7,709
18,253
Watauga
7,573
17,074
Slope
6,940
17,297
Jackson
8,906
20,656
Wayne
5,883
17,577
Stark
6,940
17,297
Jefferson
7,496
19,458
Wilkes
7,573
17,074
Steele
6,940
17,297
Knox
6,996
19,040
Wilson
5,883
17,577
Stutsman
6,940
17,297
Lake
7,530
18,227
Yadkin
5,916
13,648
Towner
6,940
17,297
Lawrence
8,906
20,656
Yancey
5,713
13,618
Traill
6,940
17,297
Licking
6,996
19,040
Walsh
6,940
17,297
Logan
6,996
19,040
Ward
6,940
17,297
Lorain
7,530
18,227
Wells
6,940
17,297
Lucas
7,221
17,269
Williams
6,940
17,297
Madison
6,996
19,040
Mahoning
7,312
19,976
Marion
7,654
17,717
North Dakota
County
Employee- Dependent,
Only
Family, etc.
Adams
6,940
17,297
Barnes
6,940
17,297
Benson
6,940
17,297
6,887
16,038
6,940
17,297
County
Employee- Dependent,
Only
Family, etc.
Medina
Billings
Meigs
5,813
13,331
Bottineau
6,940
17,297
Adams
7,363
17,363
Mercer
7,480
16,162
Bowman
6,940
17,297
Allen
7,480
16,162
Miami
6,576
18,414
Burke
6,940
17,297
Ashland
6,887
16,038
Monroe
7,496
19,458
Burleigh
5,914
16,471
Ashtabula
7,530
18,227
Montgomery
6,576
18,414
Cass
6,347
16,007
Athens
5,813
13,331
Morgan
7,496
19,458
2016 Average Premium Tables
Ohio
-23-
Morrow
7,654
17,717
Custer
6,190
13,456
Wagoner
6,499
13,890
Muskingum
7,496
19,458
Delaware
6,190
13,456
Washington
6,190
13,456
Noble
7,496
19,458
Dewey
6,190
13,456
Washita
6,190
13,456
Ottawa
7,709
18,253
Ellis
6,190
13,456
Woods
6,190
13,456
Paulding
7,480
16,162
Garfield
6,190
13,456
Woodward
6,190
13,456
Perry
7,496
19,458
Garvin
6,190
13,456
Pickaway
6,996
19,040
Grady
6,540
14,352
Pike
8,906
20,656
Grant
6,190
13,456
Portage
6,887
16,038
Greer
6,190
13,456
County
Employee- Dependent,
Only
Family, etc.
Preble
6,576
18,414
Harmon
6,190
13,456
Baker
6,873
13,528
6,155
16,245
Oregon
Putnam
7,480
16,162
Harper
6,190
13,456
Benton
Richland
7,128
18,124
Haskell
6,190
13,456
Clackamas
6,401
15,581
13,456
Clatsop
7,226
16,161
7,226
16,161
Ross
8,906
20,656
Hughes
6,190
Sandusky
7,709
18,253
Jackson
6,190
13,456
Columbia
Scioto
8,906
20,656
Jefferson
6,190
13,456
Coos
7,226
16,161
13,456
Crook
6,873
13,528
7,226
16,161
Seneca
7,709
18,253
Johnston
6,190
Shelby
6,576
18,414
Kay
6,190
13,456
Curry
Stark
7,521
18,214
Kingfisher
6,190
13,456
Deschutes
5,745
12,564
6,534
14,279
Summit
6,887
16,038
Kiowa
6,190
13,456
Douglas
Trumbull
7,312
19,976
Latimer
6,190
13,456
Gilliam
6,873
13,528
Tuscarawas
7,496
19,458
Le Flore
5,655
11,909
Grant
6,873
13,528
6,873
13,528
Union
6,996
19,040
Lincoln
6,540
14,352
Harney
Van Wert
7,480
16,162
Logan
6,540
14,352
Hood River
6,873
13,528
13,456
Jackson
6,534
14,279
6,873
13,528
Vinton
8,906
20,656
Love
6,190
Warren
6,812
16,297
Major
6,190
13,456
Jefferson
Washington
5,813
13,331
Marshall
6,190
13,456
Josephine
6,534
14,279
13,456
Klamath
5,745
12,564
5,745
12,564
Wayne
5,810
15,434
Mayes
6,190
Williams
7,221
17,269
McClain
6,540
14,352
Lake
Wood
7,221
17,269
McCurtain
6,190
13,456
Lane
6,155
16,245
13,456
Lincoln
7,226
16,161
6,155
16,245
Wyandot
7,709
18,253
Oklahoma
McIntosh
6,190
Murray
6,190
13,456
Linn
Muskogee
6,190
13,456
Malheur
6,873
13,528
13,456
Marion
6,316
15,307
6,873
13,528
Noble
County
Employee- Dependent,
Only
Family, etc.
Nowata
6,190
13,456
Morrow
Adair
6,190
13,456
Okfuskee
6,190
13,456
Multnomah
6,401
15,581
Alfalfa
6,190
13,456
Oklahoma
6,540
14,352
Polk
6,316
15,307
Atoka
6,190
13,456
Okmulgee
6,499
13,890
Sherman
6,873
13,528
Beaver
6,190
13,456
Osage
6,499
13,890
Tillamook
7,226
16,161
Beckham
6,190
13,456
Ottawa
6,190
13,456
Umatilla
6,873
13,528
Blaine
6,190
13,456
Pawnee
6,499
13,890
Union
6,873
13,528
Bryan
6,190
13,456
Payne
6,190
13,456
Wallowa
6,873
13,528
Caddo
6,190
13,456
Pittsburg
6,190
13,456
Wasco
6,873
13,528
Canadian
6,540
14,352
Pontotoc
6,190
13,456
Washington
6,401
15,581
Carter
6,190
13,456
13,456
Wheeler
6,873
13,528
Cherokee
6,190
13,456
Pushmataha
6,190
13,456
Yamhill
6,401
15,581
Choctaw
6,190
13,456
Roger Mills
6,190
13,456
Cimarron
6,190
13,456
Rogers
6,499
13,890
Cleveland
6,540
14,352
Seminole
6,190
13,456
Coal
6,190
13,456
Sequoyah
5,655
11,909
Comanche
6,039
13,901
Stephens
6,190
13,456
Texas
6,190
13,456
Cotton
6,190
13,456
Pottawatomie
6,190
6,190
Craig
6,190
13,456
Tillman
6,190
13,456
Creek
6,499
13,890
Tulsa
6,499
13,890
-24-
Pennsylvania
County
Employee- Dependent,
Only
Family, etc.
Adams
6,697
17,746
Allegheny
6,766
17,502
Armstrong
6,766
17,502
Beaver
6,766
17,502
2016 Average Premium Tables
Bedford
6,932
16,622
Susquehanna
7,282
18,425
McCormick
7,551
17,439
Berks
6,697
17,746
Tioga
7,282
18,425
Newberry
7,334
16,581
Blair
6,932
16,622
Union
7,272
15,898
Oconee
7,338
16,567
Bradford
7,282
18,425
Venango
5,642
14,336
Orangeburg
6,893
18,268
Bucks
7,839
19,987
Warren
5,642
14,336
Pickens
5,856
14,211
Butler
6,766
17,502
Washington
6,766
17,502
Richland
6,053
16,561
Cambria
6,932
16,622
Wayne
7,282
18,425
Saluda
7,316
16,664
Cameron
6,566
17,121
Westmoreland
6,766
17,502
Spartanburg
5,425
13,602
Carbon
7,282
18,425
Wyoming
7,282
18,425
Sumter
6,464
17,081
Centre
7,272
15,898
York
6,697
17,746
Union
5,313
13,267
Chester
7,839
19,987
Williamsburg
6,083
15,186
Clarion
5,642
14,336
York
6,594
13,818
Clearfield
6,932
16,622
Clinton
7,282
18,425
County
Employee- Dependent,
Only
Family, etc.
Columbia
7,272
15,898
All
6,928
Crawford
5,642
14,336
Cumberland
6,997
17,883
Dauphin
6,997
17,883
Delaware
7,839
19,987
Elk
6,566
17,121
Erie
5,642
14,336
Fayette
6,766
17,502
Forest
5,642
14,336
Franklin
6,997
17,883
Fulton
6,997
17,883
Greene
6,766
17,502
Huntingdon
6,932
16,622
Indiana
6,766
17,502
Jefferson
6,932
16,622
Juniata
6,997
17,883
Lackawanna
7,282
18,425
Lancaster
6,697
17,746
Lawrence
6,766
17,502
Lebanon
6,997
17,883
Lehigh
7,272
15,898
Luzerne
7,282
18,425
Lycoming
7,282
18,425
McKean
5,642
14,336
Mercer
5,642
14,336
Mifflin
7,272
15,898
Monroe
7,282
18,425
Montgomery
7,839
19,987
Montour
7,272
15,898
Northampton
7,272
15,898
Northumberland
7,272
15,898
Perry
6,997
17,883
Philadelphia
7,839
19,987
Pike
7,282
18,425
Potter
6,566
17,121
Schuylkill
7,272
15,898
Snyder
7,272
15,898
Somerset
6,932
16,622
Sullivan
7,282
18,425
2016 Average Premium Tables
Rhode Island
South Dakota
18,786
South Carolina
County
Employee- Dependent,
Only
Family, etc.
Aurora
6,285
16,510
Employee- Dependent,
Only
Family, etc.
Beadle
6,163
16,963
County
Bennett
6,264
16,546
Abbeville
6,937
17,233
Bon Homme
6,285
16,510
Aiken
5,752
11,878
Brookings
6,163
16,963
Allendale
6,207
15,329
Brown
6,163
16,963
Anderson
6,424
14,930
Brule
6,285
16,510
Bamberg
5,262
13,687
Buffalo
6,285
16,510
Barnwell
5,387
13,043
Butte
6,264
16,546
Beaufort
6,876
13,989
Campbell
6,163
16,963
Berkeley
6,494
17,197
Charles Mix
6,285
16,510
Calhoun
5,472
12,916
Clark
6,163
16,963
Charleston
6,104
14,237
Clay
6,104
17,502
Cherokee
5,861
13,474
Codington
6,163
16,963
Chester
6,690
16,340
Corson
6,264
16,546
Chesterfield
6,121
15,091
Custer
6,264
16,546
Clarendon
5,176
16,923
Davison
6,285
16,510
Colleton
6,048
13,674
Day
6,163
16,963
Darlington
7,418
17,113
Deuel
6,163
16,963
Dillon
6,435
14,058
Dewey
6,264
16,546
Dorchester
6,430
12,948
Douglas
6,285
16,510
Edgefield
5,276
13,982
Edmunds
6,163
16,963
Fairfield
6,380
15,700
Fall River
6,264
16,546
Florence
6,169
17,021
Faulk
6,163
16,963
Georgetown
6,184
15,172
Grant
6,163
16,963
Greenville
6,183
14,671
Gregory
6,264
16,546
Greenwood
5,526
13,786
Haakon
6,264
16,546
Hampton
6,829
15,500
Hamlin
6,163
16,963
Horry
6,623
13,194
Hand
6,285
16,510
Jasper
6,165
13,460
Hanson
6,285
16,510
Kershaw
7,411
17,003
Harding
6,264
16,546
Lancaster
6,894
14,929
Hughes
6,285
16,510
Laurens
6,269
14,179
Hutchinson
6,285
16,510
Lee
6,062
14,934
Hyde
6,285
16,510
Lexington
6,284
17,459
Jackson
6,264
16,546
Marion
7,353
16,969
Jerauld
6,285
16,510
Marlboro
6,555
15,057
Jones
6,264
16,546
-25-
Kingsbury
6,163
16,963
DeKalb
5,032
13,049
Robertson
5,459
13,453
Lake
6,104
17,502
Dickson
5,529
12,700
Rutherford
5,459
13,453
Lawrence
6,264
16,546
Dyer
5,004
16,951
Scott
5,151
13,797
Lincoln
6,104
17,502
Fayette
5,491
12,481
Sequatchie
6,003
14,048
Lyman
6,264
16,546
Fentress
5,032
13,049
Sevier
5,151
13,797
Marshall
6,163
16,963
Franklin
6,003
14,048
Shelby
5,491
12,481
McCook
6,104
17,502
Gibson
5,004
16,951
Smith
5,032
13,049
McPherson
6,163
16,963
Giles
5,529
12,700
Stewart
5,529
12,700
Meade
6,264
16,546
Grainger
5,151
13,797
Sullivan
5,214
14,321
Mellette
6,264
16,546
Greene
5,214
14,321
Sumner
5,459
13,453
Miner
6,285
16,510
Grundy
6,003
14,048
Tipton
5,491
12,481
Minnehaha
6,104
17,502
Hamblen
5,151
13,797
Trousdale
5,459
13,453
Moody
6,104
17,502
Hamilton
6,003
14,048
Unicoi
5,214
14,321
Pennington
6,264
16,546
Hancock
5,214
14,321
Union
5,151
13,797
Perkins
6,264
16,546
Hardeman
5,004
16,951
Van Buren
5,032
13,049
Potter
6,163
16,963
Hardin
5,004
16,951
Warren
5,032
13,049
Roberts
6,163
16,963
Hawkins
5,214
14,321
Washington
5,214
14,321
Sanborn
6,285
16,510
Haywood
5,491
12,481
Wayne
5,529
12,700
Shannon
6,264
16,546
Henderson
5,004
16,951
Weakley
5,004
16,951
Spink
6,163
16,963
Henry
5,004
16,951
White
5,032
13,049
Stanley
6,264
16,546
Hickman
5,529
12,700
Williamson
5,459
13,453
Sully
6,285
16,510
Houston
5,529
12,700
Wilson
5,459
13,453
Todd
6,264
16,546
Humphreys
5,529
12,700
Tripp
6,264
16,546
Jackson
5,032
13,049
Turner
6,104
17,502
Jefferson
5,151
13,797
Union
6,104
17,502
Johnson
5,214
14,321
County
Employee- Dependent,
Only
Family, etc.
Walworth
6,163
16,963
Knox
5,151
13,797
Anderson
7,421
16,249
7,421
16,249
Texas
Yankton
6,285
16,510
Lake
5,004
16,951
Andrews
Ziebach
6,264
16,546
Lauderdale
5,491
12,481
Angelina
7,421
16,249
12,700
Aransas
5,649
16,677
8,349
16,667
Lawrence
Tennessee
County
Employee- Dependent,
Only
Family, etc.
5,529
Lewis
5,529
12,700
Archer
Lincoln
5,529
12,700
Armstrong
6,689
16,660
13,797
Atascosa
5,437
14,188
6,665
19,326
Loudon
5,151
Anderson
5,151
13,797
Macon
5,032
13,049
Austin
Bedford
5,529
12,700
Madison
5,004
16,951
Bailey
7,421
16,249
Benton
5,004
16,951
Marion
6,003
14,048
Bandera
5,437
14,188
Bledsoe
6,003
14,048
Marshall
5,529
12,700
Bastrop
5,781
16,200
Blount
5,151
13,797
Maury
5,529
12,700
Baylor
7,421
16,249
Bradley
6,003
14,048
McMinn
6,003
14,048
Bee
7,421
16,249
Campbell
5,151
13,797
McNairy
5,004
16,951
Bell
6,555
16,416
Cannon
5,032
13,049
Meigs
6,003
14,048
Bexar
5,437
14,188
Carroll
5,004
16,951
Monroe
5,151
13,797
Blanco
7,421
16,249
Carter
5,214
14,321
Montgomery
5,459
13,453
Borden
7,421
16,249
Cheatham
5,459
13,453
12,700
Bosque
7,421
16,249
Chester
5,004
16,951
Morgan
5,151
13,797
Bowie
5,450
13,732
Claiborne
5,151
13,797
Obion
5,004
16,951
Brazoria
6,665
19,326
Clay
5,032
13,049
13,049
Brazos
5,510
13,951
Cocke
5,151
13,797
Perry
5,529
12,700
Brewster
7,421
16,249
Coffee
5,529
12,700
Pickett
5,032
13,049
Briscoe
7,421
16,249
Crockett
5,004
16,951
14,048
Brooks
7,421
16,249
7,421
16,249
Moore
Overton
Polk
5,529
5,032
6,003
Cumberland
5,032
13,049
Putnam
5,032
13,049
Brown
Davidson
5,459
13,453
Rhea
6,003
14,048
Burleson
5,510
13,951
Decatur
5,004
16,951
13,797
Burnet
7,421
16,249
Roane
5,151
-26-
2016 Average Premium Tables
Caldwell
5,781
16,200
Freestone
7,421
16,249
Kimble
7,421
16,249
Calhoun
5,396
15,732
Frio
7,421
16,249
King
7,421
16,249
Callahan
7,106
16,443
Gaines
7,421
16,249
Kinney
7,421
16,249
Cameron
6,716
12,301
Galveston
6,665
19,326
Kleberg
7,421
16,249
Camp
7,421
16,249
Garza
7,421
16,249
Knox
7,421
16,249
Carson
6,689
16,660
Gillespie
7,421
16,249
Lamar
7,421
16,249
Cass
7,421
16,249
Glasscock
7,421
16,249
Lamb
7,421
16,249
Castro
7,421
16,249
Goliad
5,396
15,732
Lampasas
6,555
16,416
Chambers
6,665
19,326
Gonzales
7,421
16,249
LaSalle
7,421
16,249
Cherokee
7,421
16,249
Gray
7,421
16,249
Lavaca
7,421
16,249
Childress
7,421
16,249
Grayson
7,707
15,650
Lee
7,421
16,249
Clay
8,349
16,667
Gregg
6,073
16,852
Leon
7,421
16,249
Cochran
7,421
16,249
Grimes
7,421
16,249
Liberty
6,665
19,326
Coke
7,421
16,249
Guadalupe
5,437
14,188
Limestone
7,421
16,249
Coleman
7,421
16,249
Hale
7,421
16,249
Lipscomb
7,421
16,249
Collin
6,518
15,906
Hall
7,421
16,249
Live Oak
7,421
16,249
Collingsworth
7,421
16,249
Hamilton
7,421
16,249
Llano
7,421
16,249
Colorado
7,421
16,249
Hansford
7,421
16,249
Loving
7,421
16,249
Comal
5,437
14,188
Hardeman
7,421
16,249
Lubbock
5,170
14,760
Comanche
7,421
16,249
Hardin
7,483
17,058
Lynn
7,421
16,249
Concho
7,421
16,249
Harris
6,665
19,326
Madison
7,421
16,249
Cooke
7,421
16,249
Harrison
7,421
16,249
Marion
7,421
16,249
Coryell
6,555
16,416
Hartley
7,421
16,249
Martin
7,421
16,249
Cottle
7,421
16,249
Haskell
7,421
16,249
Mason
7,421
16,249
Crane
7,421
16,249
Hays
5,781
16,200
Matagorda
7,421
16,249
Crockett
7,421
16,249
Hemphill
7,421
16,249
Maverick
7,421
16,249
Crosby
5,170
14,760
Henderson
7,421
16,249
McCulloch
7,421
16,249
Culberson
7,421
16,249
Hidalgo
5,702
13,824
McLennan
5,096
12,301
Dallam
7,421
16,249
Hill
7,421
16,249
McMullen
7,421
16,249
Dallas
6,518
15,906
Hockley
7,421
16,249
Medina
5,437
14,188
Dawson
7,421
16,249
Hood
7,421
16,249
Menard
7,421
16,249
Deaf Smith
7,421
16,249
Hopkins
7,421
16,249
Midland
6,019
14,806
Delta
6,518
15,906
Houston
7,421
16,249
Milam
7,421
16,249
Denton
6,518
15,906
Howard
7,421
16,249
Mills
7,421
16,249
DeWitt
7,421
16,249
Hudspeth
7,421
16,249
Mitchell
7,421
16,249
Dickens
7,421
16,249
Hunt
6,518
15,906
Montague
7,421
16,249
Dimmit
7,421
16,249
Hutchinson
7,421
16,249
Montgomery
6,665
19,326
Donley
7,421
16,249
Irion
5,414
14,408
Moore
7,421
16,249
Duval
7,421
16,249
Jack
7,421
16,249
Morris
7,421
16,249
Eastland
7,421
16,249
Jackson
7,421
16,249
Motley
7,421
16,249
Ector
8,055
18,635
Jasper
7,421
16,249
Nacogdoches
7,421
16,249
Edwards
7,421
16,249
Jeff Davis
7,421
16,249
Navarro
7,421
16,249
El Paso
5,982
14,595
Jefferson
7,483
17,058
Newton
7,421
16,249
Ellis
6,518
15,906
Jim Hogg
7,421
16,249
Nolan
7,421
16,249
Erath
7,421
16,249
Jim Wells
7,421
16,249
Nueces
5,649
16,677
Falls
7,421
16,249
Johnson
6,518
15,906
Ochiltree
7,421
16,249
Fannin
7,421
16,249
Jones
7,106
16,443
Oldham
7,421
16,249
Fayette
7,421
16,249
Karnes
7,421
16,249
Orange
7,483
17,058
Fisher
7,421
16,249
Kaufman
6,518
15,906
Palo Pinto
7,421
16,249
Floyd
7,421
16,249
Kendall
5,437
14,188
Panola
7,421
16,249
Foard
7,421
16,249
Kenedy
7,421
16,249
Parker
6,518
15,906
Fort Bend
6,665
19,326
Kent
7,421
16,249
Parmer
7,421
16,249
Franklin
7,421
16,249
Kerr
7,421
16,249
Pecos
7,421
16,249
2016 Average Premium Tables
-27-
Virginia
Polk
7,421
16,249
Webb
6,623
18,329
Potter
6,689
16,660
Wharton
7,421
16,249
Presidio
7,421
16,249
Wheeler
7,421
16,249
County
Employee- Dependent,
Only
Family, etc.
Rains
7,421
16,249
Wichita
8,349
16,667
Accomack
5,352
15,557
Randall
6,689
16,660
Wilbarger
7,421
16,249
Albemarle
4,993
13,641
Reagan
7,421
16,249
Willacy
7,421
16,249
Alexandria City
6,186
18,884
5,352
15,557
Real
7,421
16,249
Williamson
5,781
16,200
Alleghany
Red River
7,421
16,249
Wilson
5,437
14,188
Amelia
5,738
16,253
Reeves
7,421
16,249
Winkler
7,421
16,249
Amherst
5,076
14,621
5,076
14,621
Refugio
7,421
16,249
Wise
6,518
15,906
Appomattox
Roberts
7,421
16,249
Wood
7,421
16,249
Arlington
6,186
18,884
Robertson
5,510
13,951
Yoakum
7,421
16,249
Augusta
5,352
15,557
5,352
15,557
Rockwall
6,518
15,906
Young
7,421
16,249
Bath
Runnels
7,421
16,249
Zapata
7,421
16,249
Bedford
5,076
14,621
Rusk
6,073
16,852
Zavala
7,421
16,249
Bedford City
5,076
14,621
Bland
5,352
15,557
Botetourt
5,453
17,326
6,072
14,350
Sabine
7,421
16,249
San Augustine
7,421
16,249
San Jacinto
6,665
19,326
Utah
Employee- Dependent,
Only
Family, etc.
Bristol City
San Patricio
5,649
16,677
County
Brunswick
5,352
15,557
San Saba
7,421
16,249
Beaver
6,852
18,976
Buchanan
5,352
15,557
Schleicher
7,421
16,249
Box Elder
6,057
15,454
Buckingham
5,352
15,557
6,493
15,134
Scurry
7,421
16,249
Cache
Buena Vista City
5,352
15,557
Shackelford
7,421
16,249
Carbon
6,852
18,976
Campbell
5,076
14,621
16,249
Daggett
6,852
18,976
Caroline
5,738
16,253
5,884
16,949
Shelby
7,421
Sherman
7,421
16,249
Davis
Carroll
5,352
15,557
Smith
6,387
16,454
Duchesne
6,852
18,976
Charles City
5,738
16,253
16,249
Emery
6,852
18,976
Charlotte
5,352
15,557
6,852
18,976
Somervell
7,421
Starr
7,421
16,249
Garfield
Charlottesville City
4,993
13,641
Stephens
7,421
16,249
Grand
6,852
18,976
Chesapeake City
6,079
16,597
16,249
Iron
7,759
15,641
Chesterfield
5,738
16,253
6,852
18,976
Sterling
7,421
Stonewall
7,421
16,249
Juab
Clarke
6,186
18,884
Sutton
7,421
16,249
Kane
6,852
18,976
Colonial Heights City
5,738
16,253
16,249
Millard
6,852
18,976
Covington City
5,352
15,557
6,057
15,454
Swisher
7,421
Tarrant
6,518
15,906
Morgan
Craig
5,453
17,326
Taylor
7,106
16,443
Piute
6,852
18,976
Culpeper
5,352
15,557
6,493
15,134
Terrell
7,421
16,249
Rich
Cumberland
5,738
16,253
Terry
7,421
16,249
Salt Lake
5,884
16,949
Danville City
6,612
14,908
Throckmorton
7,421
16,249
San Juan
6,852
18,976
Dickenson
5,352
15,557
6,852
18,976
Titus
7,421
16,249
Sanpete
Dinwiddie
5,738
16,253
Tom Green
5,414
14,408
Sevier
6,852
18,976
Emporia City
5,352
15,557
Travis
5,781
16,200
Summit
5,884
16,949
Essex
5,352
15,557
5,884
16,949
Trinity
7,421
16,249
Tooele
Fairfax
6,186
18,884
Tyler
7,421
16,249
Uintah
6,852
18,976
Fairfax City
6,186
18,884
16,852
Utah
5,501
14,403
Falls Church City
6,186
18,884
5,884
16,949
Upshur
6,073
Upton
7,421
16,249
Wasatch
Fauquier
6,186
18,884
Uvalde
7,421
16,249
Washington
7,759
15,641
Floyd
5,352
15,557
16,249
Wayne
6,852
18,976
Fluvanna
4,993
13,641
Weber
6,057
15,454
Franklin
5,453
17,326
Franklin City
5,352
15,557
Frederick
5,238
14,279
Fredericksburg City
6,186
18,884
Galax City
5,352
15,557
Giles
5,548
15,322
Val Verde
7,421
Van Zandt
7,421
16,249
Victoria
5,396
15,732
Walker
7,421
16,249
Waller
6,665
19,326
Ward
7,421
16,249
Washington
7,421
16,249
Vermont
County
Employee- Dependent,
Only
Family, etc.
All
6,273
-28-
17,080
2016 Average Premium Tables
Gloucester
6,079
16,597
Radford City
5,548
15,322
Kittitas
6,107
14,438
Goochland
5,738
16,253
Rappahannock
5,352
15,557
Klickitat
6,381
17,446
Grayson
5,352
15,557
Richmond
5,352
15,557
Lewis
6,005
13,946
Greene
4,993
13,641
Richmond City
5,738
16,253
Lincoln
5,353
12,931
Greensville
5,352
15,557
Roanoke
5,453
17,326
Mason
6,005
13,946
Halifax
5,352
15,557
Roanoke City
5,453
17,326
Okanogan
6,107
14,438
Hampton City
6,079
16,597
Rockbridge
5,352
15,557
Pacific
6,005
13,946
Hanover
5,738
16,253
Rockingham
4,560
14,559
Pend Oreille
5,353
12,931
Harrisonburg City
4,560
14,559
Russell
5,352
15,557
Pierce
6,005
13,946
Henrico
5,738
16,253
Salem City
5,453
17,326
San Juan
6,005
13,946
Henry
5,352
15,557
Scott
6,072
14,350
Skagit
6,005
13,946
Highland
5,352
15,557
Shenandoah
5,352
15,557
Skamania
6,381
17,446
Hopewell City
5,738
16,253
Smyth
5,352
15,557
Snohomish
6,005
13,946
Isle of Wight
6,079
16,597
Southampton
5,352
15,557
Spokane
5,353
12,931
James City
6,079
16,597
Spotsylvania
6,186
18,884
Stevens
5,353
12,931
King and Queen
5,738
16,253
Stafford
6,186
18,884
Thurston
6,005
13,946
King George
5,352
15,557
Staunton City
5,352
15,557
Wahkiakum
6,005
13,946
King William
5,738
16,253
Suffolk City
6,079
16,597
Walla Walla
6,107
14,438
Lancaster
5,352
15,557
Surry
6,079
16,597
Whatcom
6,005
13,946
Lee
5,352
15,557
Sussex
5,738
16,253
Whitman
6,107
14,438
Lexington City
5,352
15,557
Tazewell
5,352
15,557
Yakima
6,107
14,438
Loudoun
6,186
18,884
Virginia Beach City
6,079
16,597
Louisa
5,738
16,253
Warren
6,186
18,884
Lunenburg
5,352
15,557
Washington
6,072
14,350
Lynchburg City
5,076
14,621
Waynesboro City
5,352
15,557
County
Employee- Dependent,
Only
Family, etc.
Madison
5,352
15,557
Westmoreland
5,352
15,557
Barbour
7,045
16,359
16,597
Berkeley
5,736
15,883
6,549
18,623
Manassas City
6,186
18,884
Williamsburg City
6,079
West Virginia
Manassas Park City
6,186
18,884
Winchester City
5,238
14,279
Boone
Martinsville City
5,352
15,557
Wise
5,352
15,557
Braxton
7,267
20,572
15,557
Brooke
6,120
17,672
16,597
Cabell
6,661
18,411
Calhoun
7,267
20,572
Clay
7,267
20,572
Doddridge
6,706
17,518
Mathews
6,079
16,597
Mecklenburg
5,352
15,557
Middlesex
5,352
15,557
Montgomery
5,548
15,322
Wythe
York
5,352
6,079
Washington
Nelson
4,993
13,641
New Kent
5,738
16,253
County
Employee- Dependent,
Only
Family, etc.
Fayette
7,267
20,572
6,107
14,438
Gilmer
6,706
17,518
Newport News City
6,079
16,597
Adams
Norfolk City
6,079
16,597
Asotin
6,107
14,438
Grant
6,042
16,639
Northampton
5,352
15,557
Benton
6,107
14,438
Greenbrier
7,267
20,572
6,107
14,438
Hampshire
6,042
16,639
Northumberland
5,352
15,557
Chelan
Norton City
5,352
15,557
Clallam
6,005
13,946
Hancock
6,120
17,672
Nottoway
5,352
15,557
Clark
6,381
17,446
Hardy
6,042
16,639
6,107
14,438
Harrison
7,045
16,359
Orange
5,352
15,557
Columbia
Page
5,352
15,557
Cowlitz
6,005
13,946
Jackson
7,802
17,032
15,557
Douglas
6,107
14,438
Jefferson
5,736
15,883
5,353
12,931
Kanawha
7,063
17,554
Patrick
5,352
Petersburg City
5,738
16,253
Ferry
Pittsylvania
6,612
14,908
Franklin
6,107
14,438
Lewis
6,706
17,518
16,597
Garfield
6,107
14,438
Lincoln
6,549
18,623
6,107
14,438
Logan
6,549
18,623
Poquoson
6,079
Portsmouth City
6,079
16,597
Grant
Powhatan
5,738
16,253
Grays Harbor
6,005
13,946
Marion
6,706
17,518
15,557
Island
6,005
13,946
Marshall
6,120
17,672
6,005
13,946
Mason
6,661
18,411
Prince Edward
5,352
Prince George
5,738
16,253
Jefferson
Prince William
6,186
18,884
King
6,158
15,076
McDowell
6,549
18,623
15,322
Kitsap
6,005
13,946
Mercer
6,576
19,408
Pulaski
5,548
2016 Average Premium Tables
-29-
Mineral
6,042
16,639
Dodge
5,941
18,101
Sawyer
5,565
17,203
Mingo
6,549
18,623
Door
5,633
17,379
Shawano
5,633
17,379
Monongalia
6,706
17,518
Douglas
5,565
17,203
Sheboygan
5,941
18,101
Monroe
6,576
19,408
Dunn
7,551
19,809
St. Croix
5,901
16,564
Morgan
6,042
16,639
Eau Claire
7,551
19,809
Taylor
7,523
17,880
Nicholas
7,267
20,572
Florence
6,621
17,777
Trempealeau
6,593
19,611
Ohio
6,120
17,672
Fond du Lac
5,941
18,101
Vernon
6,339
18,766
Pendleton
6,042
16,639
Forest
6,621
17,777
Vilas
6,621
17,777
Pleasants
7,802
17,032
Grant
6,339
18,766
Walworth
6,379
20,614
Pocahontas
7,045
16,359
Green
6,379
20,614
Washburn
5,565
17,203
Preston
7,045
16,359
Green Lake
5,411
17,199
Washington
6,208
17,268
Putnam
6,661
18,411
Iowa
6,339
18,766
Waukesha
6,208
17,268
Raleigh
6,576
19,408
Iron
6,621
17,777
Waupaca
5,941
18,101
Randolph
7,045
16,359
Jackson
6,593
19,611
Waushara
5,941
18,101
Ritchie
7,802
17,032
Jefferson
6,379
20,614
Winnebago
5,941
18,101
Roane
7,267
20,572
Juneau
5,411
17,199
Wood
6,812
17,511
Summers
6,576
19,408
Kenosha
5,996
19,952
Taylor
7,045
16,359
Kewaunee
5,633
17,379
Tucker
7,045
16,359
La Crosse
6,593
19,611
Tyler
7,802
17,032
Lafayette
6,339
18,766
County
Employee- Dependent,
Only
Family, etc.
Upshur
7,045
16,359
Langlade
6,621
17,777
Albany
7,563
17,018
7,563
17,018
Wyoming
Wayne
6,661
18,411
Lincoln
6,812
17,511
Big Horn
Webster
7,045
16,359
Manitowoc
5,633
17,379
Campbell
7,563
17,018
17,511
Carbon
7,563
17,018
7,563
17,018
Wetzel
6,706
17,518
Marathon
6,812
Wirt
7,802
17,032
Marinette
5,633
17,379
Converse
Wood
7,802
17,032
Marquette
5,411
17,199
Crook
7,563
17,018
17,379
Fremont
7,563
17,018
7,563
17,018
Wyoming
6,549
18,623
Wisconsin
Menomonee
5,633
Milwaukee
6,233
19,579
Goshen
Monroe
6,593
19,611
Hot Springs
7,563
17,018
17,379
Johnson
7,563
17,018
7,419
16,680
Employee- Dependent,
Only
Family, etc.
Oconto
County
Oneida
6,621
17,777
Laramie
Adams
5,411
17,199
Outagamie
5,941
18,101
Lincoln
7,563
17,018
Ashland
5,565
17,203
17,268
Natrona
7,028
17,105
7,563
17,018
Ozaukee
5,633
6,208
Barron
7,523
17,880
Pepin
7,551
19,809
Niobrara
Bayfield
5,565
17,203
Pierce
5,901
16,564
Park
7,563
17,018
Brown
5,633
17,379
Polk
5,901
16,564
Platte
7,563
17,018
Buffalo
6,593
19,611
Portage
6,812
17,511
Sheridan
7,563
17,018
Burnett
5,565
17,203
Price
7,523
17,880
Sublette
7,563
17,018
Calumet
5,941
18,101
Racine
5,996
19,952
Sweetwater
7,563
17,018
Chippewa
7,551
19,809
Richland
5,411
17,199
Teton
7,563
17,018
Clark
7,523
17,880
Rock
6,379
20,614
Uinta
7,563
17,018
Columbia
6,379
20,614
Rusk
7,523
17,880
Washakie
7,563
17,018
Crawford
6,339
18,766
Sauk
5,411
17,199
Weston
7,563
17,018
Dane
5,538
17,578
-30-
2016 Average Premium Tables
| File Type | application/pdf |
| File Title | 2016 Instructions for Form 8941 |
| Subject | Instructions for Form 8941, Credit for Small Employer Health Insurance Premiums |
| Author | W:CAR:MP:FP |
| File Modified | 2016-12-07 |
| File Created | 2016-12-06 |