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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.
tax under section 1381 may be able to claim the credit as
a general business credit, as discussed next.
Future Developments
For all other eligible small employers, the maximum
credit is 50% of premiums paid and can be taken against
both regular and alternative minimum tax. The credit is
claimed as part of the general business credit on Form
3800.
For the latest information about developments related to
Form 8941 and its instructions, such as legislation
enacted after they were published, go to IRS.gov/
Form8941.
Reminders
Exception for eligible small employers in certain
counties. Certain small employers whose principal
business address is in a county with no qualified health
plan through a Small Business Health Options Program
(SHOP) Marketplace may be able to claim the credit for
small employer health insurance premiums. For more
information, see Exception for eligible small employers in
certain counties in the instructions for line A.
Waiver for Hawaii. Employers in Hawaii can’t claim this
credit for insurance premiums paid for health plan years
beginning after 2016. For more information, see Waiver
for Hawaii in the instructions for line A.
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 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
Nov 17, 2021
Partnerships, S corporations, cooperatives,
TIP estates, trusts, and tax-exempt eligible small
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’re 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 example, an employer with 48 employees that are
each half-time employees has 24 FTEs and can claim the
credit. For details, see Worksheets 1 and 2.
Although the term “eligible small employer” is
defined in the Internal Revenue Code to include
CAUTION employers with “no more than” 25 FTEs, the
phaseout of the credit amount operates in such a way that
an employer with exactly 25 FTEs is not, in fact, eligible
for the credit.
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Cat. No. 55222U
Employer Premiums Paid
3. You paid average annual wages for the tax year of
less than $56,000 per FTE. For details, see Worksheets
1 and 3.
Only premiums you paid for health insurance coverage
under a qualifying arrangement (discussed later) for
individuals considered employees are counted when
figuring your credit.
If you had more than 10 FTEs and average
annual wages of more than $27,000, 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 $56,000.
!
State premium subsidy or tax credit. If you’re 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 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).
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, treat the
amount you paid toward the employee’s participation as
an amount you paid for employee health insurance
coverage.
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.
No more than one Form 8941 can be filed with a
TIP tax return, unless the exception described in
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.
Example 2 below applies.
Example 1. You’re 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.
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 or 1040-SR.
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 Pub. 15-B, Employer’s Tax Guide
to Fringe Benefits.
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
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.
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Instructions for Form 8941 (2021)
requirement. This is true 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.
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’ve paid $3,120 ($60 × 52)
for an employee who was enrolled for the entire tax year.
You would’ve 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.
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
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.
Health Insurance Coverage
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 certain counties, see the instructions
for line A, 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 aren’t 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
each of the following amounts if you make the relevant tier
of coverage available.
• 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’ve 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’ve 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.
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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, the following applies. 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
isn’t considered in calculating the uniform percentage
Instructions for Form 8941 (2021)
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
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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.
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 each of the following amounts if you
make the relevant tier of coverage available.
• 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’ve 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 your family coverage,
for each employee (if any) enrolled in family coverage.
• A uniform amount that is either equal to the amount you
would’ve 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).
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.
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
beginning in 2021, 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 2021.
• Medicare taxes the tax-exempt employer was required
to withhold from employees’ wages in calendar year 2021.
• Medicare taxes the tax-exempt employer was required
to pay for calendar year 2021.
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.
Premium Deduction Reduced
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.
• 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
State subsidies and credits. For this purpose, if you’re
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.
Partnerships, S corporations, cooperatives,
TIP estates, trusts, and tax-exempt eligible small
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
Your credit may be reduced if you’re 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.
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.
Although a state tax credit or premium subsidy paid
directly to you doesn’t reduce the amount of your
Answer “Yes” if one of the following applies.
Line A
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Instructions for Form 8941 (2021)
• 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.
Worksheet 1. Information Needed To
Complete Line 1 and Worksheets 2
and 3
If you need more rows, use a separate sheet and include
the additional amounts in the totals 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.
(a)
Individuals
Considered
Employees
If you answer “No,” don’t file Form 8941 unless you’re
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.
(b)
Employee
Hours of
Service
(c)
Employee
Wages
Paid
1.
2.
3.
4.
Waiver for Hawaii. Hawaii has received a 5-year State
Innovation Waiver under section 1332 of the Affordable
Care Act. Employers in Hawaii can’t participate in the
SHOP Marketplace or claim the credit for insurance
premiums paid for health plan years beginning after 2016.
For more information on the waiver, visit CMS.gov.
5.
6.
7.
8.
Exception for eligible small employers in certain
counties. For calendar year 2021, SHOP Marketplaces
in certain counties across the United States didn’t have
qualified health plans available for employers to offer to
employees. However, relief is available, which allows
eligible small employers with a principal business address
in those counties to claim the credit for 2021 if they
properly claimed the credit under section 45R for all or
part of 2020. For details, see Notice 2018-27, 2018-20,
I.R.B. 580, available at IRS.gov/irb/
2018-20_IRB#NOT-2018-27.
9.
To see whether a particular county has coverage
TIP available through a SHOP Exchange for 2021 and
beyond, go to Healthcare.gov/small-business and
enter “plans and prices” in the search box.
17.
10.
11.
12.
13.
14.
15.
16.
18.
19.
20.
Line C
21.
Answer “Yes” if a tax return you (or any predecessor) filed
for a tax year beginning after 2013 and before 2020
included a Form 8941 with line A checked “Yes” and
line 12 showing a positive amount. For more information,
see Credit Period, earlier.
22.
23.
24.
25.
If you answer “Yes,” don’t file Form 8941 unless you’re
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
shouldn’t report any amount on line 12. For more
information, see the instructions for line 15.
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 (2021)
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discussed above. A sole proprietor must include both
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 isn’t 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
isn’t 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 of
any owner or family member listed above 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 1
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 1 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
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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
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Instructions for Form 8941 (2021)
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.
(a)
Enrolled
Individuals
Considered
Employees
3.
4.
5.
6.
7.
8.
9.
10.
Your credit is reduced if you paid average annual wages
of more than $27,000 for the tax year. If you paid average
annual wages of $56,000 or more for the tax year, your
credit is reduced to zero.
14.
2. Enter FTEs from Worksheet 2,
line 3 . . . . . . . . . . . . . . . . . . . . . . .
2.
3. Average annual wages. Divide line 1
by line 2. If the result isn’t 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 . . .
(d)
Enrolled
Employee
Hours of
Service
2.
2,080
Worksheet 3. Information Needed To
Complete Line 3 (Average Annual
Wages)
1.
(c)
Adjusted
Average
Premiums
1.
3. Full-time equivalent employees.
Divide line 1 by line 2. If the result isn’t 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 . . .
3.
1. Enter the total employee wages paid
from Worksheet 1, column (c) . . . . . .
(b)
Employer
Premiums
Paid
11.
12.
13.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
3.
25.
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 (2021)
-7-
Column (b), Employer Premiums Paid
enrolled for the entire tax year. You would’ve paid $570
($57 × 10) if the employee was only enrolled for 10 pay
periods. You’ll 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 (d), Enrolled Employee Hours
of Service
Column (c), Adjusted Average
Premiums
Your credit is reduced if the employer premiums paid are
more than the employer premiums that would’ve 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.
Worksheet 5. Information Needed To
Complete Line 8 (If Line 2 Is More
Than 10)
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.
1. Enter the amount from Form 8941,
line 7 . . . . . . . . . . . . . . . . . . . . . . . . . .
Enter, for each employee listed in column (a), the
premiums you would’ve 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.
To find the average premium for the small group market
in a rating area for tax years beginning in 2021, see the
average premium tables at the end of these instructions.
Family coverage includes any coverage other than
employee-only coverage.
2. Enter the number from Form
8941, line 2 . . . . . . . . . . . .
2.
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.
1.
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 $27,000)
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’ve 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’ve 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’ve paid $2,964 ($57 × 52) if the employee was
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 $27,800 from
line 3 . . . . . . . . . . . . . . . . . .
4.
5. Divide line 4 by $27,800. 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 (2021)
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 . . . . . . . . . .
3. Divide line 1 by line 2. If the result isn’t 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 14 . . .
2.
2,080
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.
3.
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 1120-S), box 13 (code P);
• Schedule K-1 (Form 1041), box 13 (code G); and
• Form 1099-PATR, Taxable Distributions Received
From Cooperatives, box 12, or other notice of credit
allocation.
Line 19
Partnerships, S corporations, cooperatives,
TIP estates, trusts, and tax-exempt eligible small
employers report the above credits on line 15. All
other filers figuring a separate credit on earlier lines 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 2021.
• Medicare taxes the tax-exempt employer was required
to withhold from employees’ wages in calendar year 2021.
• Medicare taxes the tax-exempt employer was required
to pay for calendar year 2021.
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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8 hr., 8 min.
1 hr., 2 min.
2 hr., 5 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 (2021)
-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 2021.
Alabama
Limestone
6,480
19,585
Petersburg
11,771
28,003
Lowndes
7,526
19,230
Prince of Wales-Hyder 11,771
28,003
Macon
6,565
17,489
Sitka
11,771
28,003
Madison
6,480
19,585
Skagway
11,771
28,003
Marengo
6,565
17,489
Southeast Fairbanks
12,011
27,855
Marion
6,565
17,489
Valdez Cordova
11,303
28,132
Employee- Dependent,
Only
Family, etc.
Marshall
6,565
17,489
Wade Hampton
12,011
27,855
County
Mobile
7,468
18,918
11,771
28,003
Autauga
7,526
19,230
Monroe
6,565
17,489
Wrangell City and
Borough
Baldwin
6,565
17,489
Montgomery
7,526
19,230
Yakutat
12,011
27,855
Barbour
6,565
17,489
Morgan
7,893
19,596
Yukon Koyukuk
12,011
27,855
Bibb
6,653
18,914
Perry
6,565
17,489
Blount
6,653
18,914
Pickens
6,565
17,489
Bullock
6,565
17,489
Pike
6,565
17,489
Butler
6,565
17,489
Randolph
6,565
17,489
Calhoun
6,836
18,615
Russell
7,136
18,051
Chambers
6,565
17,489
Shelby
6,653
18,914
Cherokee
6,565
17,489
St. Clair
6,653
18,914
Chilton
6,653
18,914
Sumter
6,565
17,489
Choctaw
6,565
17,489
Talladega
6,565
17,489
Clarke
6,565
17,489
Tallapoosa
6,565
17,489
Clay
6,565
17,489
Tuscaloosa
7,603
18,629
Cleburne
6,565
17,489
Walker
6,653
18,914
Coffee
6,565
17,489
Washington
6,565
17,489
Colbert
8,654
19,748
Wilcox
6,565
17,489
Conecuh
6,565
17,489
Winston
6,565
17,489
Coosa
6,565
17,489
Covington
6,565
17,489
Crenshaw
6,565
17,489
Cullman
6,565
17,489
County
Employee- Dependent,
Only
Family, etc.
Dale
6,565
17,489
Aleutians East
12,011
27,855
Dallas
6,565
17,489
Aleutians West
12,011
27,855
DeKalb
6,565
17,489
Anchorage
11,303
28,132
Elmore
7,526
19,230
Bethel
11,303
28,132
Escambia
6,565
17,489
Bristol Bay
12,011
27,855
Etowah
6,447
18,794
Denali
12,011
27,855
Fayette
6,565
17,489
Dillingham
11,303
28,132
Franklin
6,565
17,489
Fairbanks North Star
12,011
27,855
Geneva
7,388
18,433
Haines
11,771
28,003
Greene
7,603
18,629
Hoonah-Angoon
11,771
28,003
Hale
7,603
18,629
Juneau
11,771
28,003
Henry
7,388
18,433
Kenai Peninsula
12,011
27,855
Houston
7,388
18,433
Ketchikan Gateway
11,771
28,003
Jackson
6,565
17,489
Kodiak Island
12,011
27,855
Jefferson
6,653
18,914
Lake and Peninsula
12,011
27,855
Lamar
6,565
17,489
Matanuska Susitna
12,011
27,855
Lauderdale
8,654
19,748
Nome
12,011
27,855
Lawrence
7,893
19,596
North Slope
12,011
27,855
Lee
6,298
15,915
Northwest Arctic
12,011
27,855
Alaska
-10-
Arizona
County
Employee- Dependent,
Only
Family, etc.
Apache
6,840
20,297
Cochise
6,558
17,906
Coconino
6,840
20,297
Gila
6,671
17,498
Graham
6,558
17,906
Greenlee
6,558
17,906
La Paz
7,826
19,901
Maricopa
6,811
18,849
Mohave
6,840
20,297
Navajo
6,840
20,297
Pima
6,452
17,791
Pinal
6,671
17,498
Santa Cruz
6,452
17,791
Yavapai
6,286
18,780
Yuma
7,826
19,901
Arkansas
County
Employee- Dependent,
Only
Family, etc.
Arkansas
6,501
16,114
Ashley
6,501
16,114
Baxter
6,230
18,525
Benton
6,230
18,525
Boone
6,230
18,525
Bradley
6,501
16,114
Calhoun
6,566
22,348
Carroll
6,230
18,525
Chicot
6,501
16,114
Clark
5,127
17,075
Clay
6,267
19,137
Cleburne
6,051
16,588
Cleveland
6,501
16,114
Columbia
6,566
22,348
Conway
6,051
16,588
2021 Average Premium Tables
Craighead
6,267
19,137
Stone
6,267
19,137
Santa Clara
8,304
24,507
Crawford
6,078
18,584
Union
6,566
22,348
Santa Cruz
8,014
21,969
Crittenden
6,267
19,137
Van Buren
6,051
16,588
Shasta
8,171
19,175
Cross
6,267
19,137
Washington
6,230
18,525
Sierra
8,171
19,175
Dallas
6,501
16,114
White
6,051
16,588
Siskiyou
8,171
19,175
Desha
6,501
16,114
Woodruff
6,267
19,137
Solano
7,057
19,416
Drew
6,501
16,114
Yell
6,051
16,588
Sonoma
7,057
19,416
Faulkner
6,051
16,588
Stanislaus
7,778
20,227
Franklin
6,078
18,584
Sutter
8,171
19,175
Fulton
6,267
19,137
8,171
19,175
5,127
17,075
County
Employee- Dependent,
Only
Family, etc.
Tehama
Garland
Trinity
8,171
19,175
Grant
6,051
16,588
Alameda
8,242
22,491
Tulare
7,778
20,227
8,171
19,175
California
Greene
6,267
19,137
Alpine
Tuolumne
8,171
19,175
Hempstead
6,566
22,348
Amador
8,171
19,175
Ventura
7,235
20,308
Hot Spring
5,127
17,075
Butte
8,171
19,175
Yolo
6,881
20,484
8,171
19,175
Yuba
8,171
19,175
Howard
6,566
22,348
Calaveras
Independence
6,267
19,137
Colusa
8,171
19,175
Izard
6,267
19,137
Contra Costa
8,093
22,307
Jackson
6,267
19,137
Del Norte
8,171
19,175
Jefferson
6,501
16,114
El Dorado
6,881
20,484
County
Employee- Dependent,
Only
Family, etc.
Johnson
6,078
18,584
Fresno
6,633
22,121
Adams
7,344
21,656
8,171
19,175
Alamosa
8,633
23,653
Colorado
Lafayette
6,566
22,348
Glenn
Lawrence
6,267
19,137
Humboldt
8,171
19,175
Arapahoe
7,344
21,656
16,114
Imperial
6,764
19,134
Archuleta
8,143
24,827
6,764
19,134
Baca
8,633
23,653
Lee
6,501
Lincoln
6,501
16,114
Inyo
Little River
6,566
22,348
Kern
7,202
18,566
Bent
8,633
23,653
18,584
Kings
6,633
22,121
Boulder
6,913
22,089
8,171
19,175
Broomfield
7,344
21,656
Logan
6,078
Lonoke
6,051
16,588
Lake
Madison
6,230
18,525
Lassen
8,171
19,175
Chaffee
8,633
23,653
18,525
Los Angeles
7,135
21,647
Cheyenne
8,633
23,653
6,633
22,121
Clear Creek
7,344
21,656
Marion
6,230
Miller
6,566
22,348
Madera
Mississippi
6,267
19,137
Marin
7,057
19,416
Conejos
8,633
23,653
16,114
Mariposa
7,778
20,227
Costilla
8,633
23,653
8,171
19,175
Crowley
8,633
23,653
Monroe
6,501
Montgomery
5,127
17,075
Mendocino
Nevada
6,566
22,348
Merced
7,778
20,227
Custer
8,633
23,653
8,171
19,175
Delta
8,143
24,827
Newton
6,230
18,525
Modoc
Ouachita
6,566
22,348
Mono
6,764
19,134
Denver
7,344
21,656
Perry
6,051
16,588
Monterey
8,014
21,969
Dolores
8,143
24,827
7,057
19,416
Douglas
7,344
21,656
Phillips
6,501
16,114
Napa
Pike
5,127
17,075
Nevada
8,171
19,175
Eagle
7,847
24,678
Poinsett
6,267
19,137
Orange
7,573
23,118
El Paso
6,539
22,503
6,881
20,484
Elbert
7,344
21,656
Polk
6,078
18,584
Placer
Pope
6,051
16,588
Plumas
8,171
19,175
Fremont
8,633
23,653
16,588
Riverside
7,561
19,737
Garfield
7,847
24,678
6,881
20,484
Gilpin
7,344
21,656
Prairie
6,051
Pulaski
6,051
16,588
Sacramento
Randolph
6,267
19,137
San Benito
8,014
21,969
Grand
8,143
24,827
16,588
San Bernardino
7,561
19,737
Gunnison
8,143
24,827
6,433
18,778
Hinsdale
8,143
24,827
Saline
6,051
Scott
6,078
18,584
San Diego
Searcy
6,230
18,525
San Francisco
7,867
26,196
Huerfano
8,633
23,653
18,584
San Joaquin
7,778
20,227
Jackson
8,143
24,827
7,235
20,308
Jefferson
7,344
21,656
Sebastian
6,078
Sevier
6,566
22,348
San Luis Obispo
Sharp
6,267
19,137
San Mateo
9,354
25,434
Kiowa
8,633
23,653
19,137
Santa Barbara
7,235
20,308
Kit Carson
8,633
23,653
St. Francis
6,267
2021 Average Premium Tables
-11-
Florida
Pasco
7,366
20,034
Employee- Dependent,
Only
Family, etc.
Pinellas
7,005
22,139
Polk
6,725
20,680
Alachua
8,141
20,991
Putnam
7,340
21,416
23,653
Baker
7,456
20,822
Santa Rosa
6,952
18,942
21,955
Bay
7,014
19,289
Sarasota
6,807
18,517
7,019
20,950
La Plata
8,143
24,827
Lake
8,143
24,827
Larimer
8,694
19,692
County
Las Animas
8,633
23,653
Lincoln
8,633
Logan
6,930
Mesa
7,498
20,992
Bradford
Seminole
7,594
18,876
Mineral
8,633
23,653
Brevard
7,746
21,890
St. Johns
9,412
24,636
Moffat
8,143
24,827
Broward
7,307
20,593
St. Lucie
7,232
19,964
7,197
20,787
Montezuma
8,143
24,827
Calhoun
Sumter
7,459
22,769
Montrose
8,143
24,827
Charlotte
8,184
23,859
Suwannee
6,687
20,690
Morgan
6,930
21,955
Citrus
7,199
19,641
Taylor
8,290
22,921
6,623
20,828
Otero
8,633
23,653
Clay
Union
7,237
21,396
Ouray
8,143
24,827
Collier
6,835
24,981
Volusia
7,443
20,111
Park
7,344
21,656
Columbia
7,858
22,655
Wakulla
6,944
21,188
7,292
21,687
Walton
7,307
19,391
Washington
7,346
21,567
Phillips
6,930
21,955
DeSoto
Pitkin
7,847
24,678
Dixie
7,073
19,151
Prowers
8,633
23,653
Duval
7,059
20,947
Pueblo
6,909
18,542
Escambia
7,575
19,604
Rio Blanco
8,143
24,827
Flagler
7,911
21,062
Rio Grande
8,633
23,653
Franklin
7,209
22,002
County
Employee- Dependent,
Only
Family, etc.
Routt
8,143
24,827
Gadsden
6,968
20,814
Appling
8,993
24,273
Saguache
8,633
23,653
Gilchrist
6,775
20,814
Atkinson
7,013
20,446
24,827
Glades
7,542
23,373
Bacon
6,388
19,799
7,846
23,360
San Juan
8,143
Georgia
San Miguel
8,143
24,827
Gulf
8,044
22,150
Baker
Sedgwick
6,930
21,955
Hamilton
7,132
20,720
Baldwin
7,700
21,179
24,678
Hardee
7,067
18,671
Banks
8,299
21,521
7,964
19,863
Summit
7,847
Teller
6,539
22,503
Hendry
8,068
23,309
Barrow
Washington
6,930
21,955
Hernando
7,636
21,653
Bartow
7,366
20,580
26,016
Highlands
7,693
23,786
Ben Hill
7,286
20,627
7,286
20,627
Weld
Yuma
7,424
6,930
21,955
Connecticut
Hillsborough
6,699
20,708
Berrien
Holmes
7,262
20,832
Bibb
6,954
18,181
Indian River
6,943
19,405
Bleckley
6,954
18,181
6,388
19,799
Jackson
6,718
18,756
Brantley
Jefferson
7,826
20,388
Brooks
7,286
20,627
8,993
24,273
County
Employee- Dependent,
Only
Family, etc.
Fairfield
8,215
23,998
Lafayette
7,206
19,409
Bryan
Hartford
7,723
21,840
Lake
8,231
22,177
Bulloch
8,993
24,273
Litchfield
7,478
23,655
Lee
7,413
22,034
Burke
6,959
18,720
Middlesex
8,289
21,936
Leon
8,389
24,467
Butts
7,366
20,580
New Haven
8,748
24,357
Levy
7,075
21,653
Calhoun
7,846
23,360
New London
7,390
19,471
Liberty
7,211
21,544
Camden
6,388
19,799
Tolland
7,379
17,769
Madison
7,995
21,842
Candler
8,993
24,273
Windham
8,445
31,308
Manatee
7,583
20,547
Carroll
7,089
21,387
Marion
6,342
19,289
Catoosa
7,029
20,867
6,388
19,799
Delaware
County
Employee- Dependent,
Only
Family, etc.
All
8,444
23,587
District of Columbia
County
Employee- Dependent,
Only
Family, etc.
All
8,036
23,874
Martin
7,619
22,929
Charlton
Miami-Dade
7,671
23,473
Chatham
8,993
24,273
Monroe
8,165
23,652
Chattahoochee
6,546
18,862
7,794
21,273
Nassau
7,901
18,835
Chattooga
Okaloosa
7,623
27,260
Cherokee
7,366
20,580
Okeechobee
8,056
22,815
Clarke
7,964
19,863
7,846
23,360
Orange
6,830
19,653
Clay
Osceola
8,112
22,721
Clayton
7,366
20,580
Palm Beach
8,207
24,447
Clinch
7,286
20,627
-12-
2021 Average Premium Tables
Cobb
7,366
20,580
Lanier
7,286
20,627
Towns
8,299
21,521
Coffee
7,013
20,446
Laurens
7,013
20,446
Treutlen
7,013
20,446
Colquitt
7,286
20,627
Lee
7,846
23,360
Troup
6,546
18,862
Columbia
6,959
18,720
Liberty
8,993
24,273
Turner
7,286
20,627
Cook
7,286
20,627
Lincoln
6,959
18,720
Twiggs
6,954
18,181
Coweta
7,366
20,580
Long
8,993
24,273
Union
8,299
21,521
Crawford
6,954
18,181
Lowndes
7,286
20,627
Upson
6,546
18,862
Crisp
7,846
23,360
Lumpkin
8,299
21,521
Walker
7,029
20,867
Dade
7,029
20,867
Macon
6,546
18,862
Walton
7,366
20,580
Dawson
8,299
21,521
Madison
7,964
19,863
Ware
6,388
19,799
Decatur
7,286
20,627
Marion
6,546
18,862
Warren
6,959
18,720
DeKalb
7,366
20,580
McDuffie
6,959
18,720
Washington
7,700
21,179
Dodge
6,954
18,181
McIntosh
6,388
19,799
Wayne
6,388
19,799
Dooly
6,954
18,181
Meriwether
6,546
18,862
Webster
6,546
18,862
Dougherty
7,846
23,360
Miller
7,286
20,627
Wheeler
7,013
20,446
Douglas
7,366
20,580
Mitchell
7,846
23,360
White
8,299
21,521
Early
7,286
20,627
Monroe
6,954
18,181
Whitfield
7,329
20,158
Echols
7,286
20,627
Montgomery
7,013
20,446
Wilcox
6,954
18,181
Effingham
8,993
24,273
Morgan
7,964
19,863
Wilkes
6,959
18,720
Elbert
7,964
19,863
Murray
7,329
20,158
Wilkinson
7,700
21,179
Emanuel
6,959
18,720
Muscogee
6,546
18,862
Worth
7,846
23,360
Evans
8,993
24,273
Newton
7,366
20,580
Fannin
7,329
20,158
Oconee
7,964
19,863
Fayette
7,366
20,580
Oglethorpe
7,964
19,863
Floyd
7,794
21,273
Paulding
7,366
20,580
County
Employee- Dependent,
Only
Family, etc.
Forsyth
7,366
20,580
Peach
6,954
18,181
All
7,628
Franklin
8,299
21,521
Pickens
7,794
21,273
Fulton
7,366
20,580
Pierce
6,388
19,799
Gilmer
7,794
21,273
Pike
7,366
20,580
Glascock
6,959
18,720
Polk
7,794
21,273
Glynn
6,388
19,799
Pulaski
6,954
18,181
Gordon
7,794
21,273
Putnam
6,954
18,181
Grady
7,286
20,627
Quitman
6,546
18,862
Greene
7,964
19,863
Rabun
8,299
21,521
Gwinnett
7,366
20,580
Randolph
7,846
23,360
Habersham
8,299
21,521
Richmond
6,959
18,720
Hall
8,299
21,521
Rockdale
7,366
20,580
Hancock
7,700
21,179
Schley
7,846
23,360
Haralson
7,089
21,387
Screven
8,993
24,273
Harris
6,546
18,862
Seminole
7,286
20,627
Hart
8,299
21,521
Spalding
7,366
20,580
Heard
7,089
21,387
Stephens
8,299
21,521
Henry
7,366
20,580
Stewart
6,546
18,862
Houston
6,954
18,181
Sumter
7,846
23,360
Irwin
7,286
20,627
Talbot
6,546
18,862
Jackson
7,964
19,863
Taliaferro
6,959
18,720
Jasper
7,366
20,580
Tattnall
8,993
24,273
Jeff Davis
7,013
20,446
Taylor
6,546
18,862
Jefferson
6,959
18,720
Telfair
7,013
20,446
Jenkins
6,959
18,720
Terrell
7,846
23,360
Johnson
7,013
20,446
Thomas
7,286
20,627
Jones
6,954
18,181
Tift
7,286
20,627
Lamar
7,366
20,580
Toombs
7,013
20,446
2021 Average Premium Tables
-13-
Hawaii
21,523
Idaho
County
Employee- Dependent,
Only
Family, etc.
Ada
6,050
16,519
Adams
5,587
15,087
Bannock
6,987
17,973
Bear Lake
6,987
17,973
Benewah
6,197
16,093
Bingham
6,987
17,973
Blaine
6,095
18,948
Boise
5,587
15,087
Bonner
6,197
16,093
Bonneville
6,574
18,278
Boundary
6,197
16,093
Butte
6,987
17,973
Camas
6,095
18,948
Canyon
5,587
15,087
Caribou
6,987
17,973
Cassia
6,095
18,948
Clark
6,574
18,278
Clearwater
6,778
16,818
Custer
6,987
17,973
Elmore
5,587
15,087
Franklin
6,987
17,973
Fremont
6,574
18,278
Gem
5,587
15,087
Gooding
6,095
18,948
Fulton
7,908
21,322
Saline
8,097
25,949
Idaho
6,778
16,818
Gallatin
8,097
25,949
Sangamon
7,685
19,139
Jefferson
6,574
18,278
Greene
7,369
22,013
Schuyler
7,685
19,139
Jerome
6,095
18,948
Grundy
8,001
20,461
Scott
7,685
19,139
Kootenai
6,197
16,093
Hamilton
8,097
25,949
Shelby
7,685
19,139
Latah
6,197
16,093
Hancock
6,673
20,301
St. Clair
7,872
20,961
Lemhi
6,574
18,278
Hardin
8,097
25,949
Stark
7,908
21,322
Lewis
6,778
16,818
Henderson
6,673
20,301
Stephenson
7,981
22,362
Lincoln
6,095
18,948
Henry
6,673
20,301
Tazewell
7,908
21,322
Madison
6,574
18,278
Iroquois
8,290
21,185
Union
8,097
25,949
Minidoka
6,095
18,948
Jackson
8,097
25,949
Vermilion
8,290
21,185
Nez Perce
6,778
16,818
Jasper
8,097
25,949
Wabash
8,097
25,949
Oneida
6,987
17,973
Jefferson
8,097
25,949
Warren
6,673
20,301
Owyhee
5,587
15,087
Jersey
7,369
22,013
Washington
7,369
22,013
Payette
5,587
15,087
Jo Daviess
7,981
22,362
Wayne
8,097
25,949
Power
6,987
17,973
Johnson
8,097
25,949
White
8,097
25,949
Shoshone
6,197
16,093
Kane
7,901
23,738
Whiteside
6,673
20,301
Teton
6,574
18,278
Kankakee
8,001
20,461
Will
8,001
20,461
Twin Falls
6,095
18,948
Kendall
8,001
20,461
Williamson
8,097
25,949
Valley
5,587
15,087
Knox
7,908
21,322
Winnebago
7,981
22,362
Washington
5,587
15,087
Lake
6,757
24,199
Woodford
7,908
21,322
LaSalle
7,908
21,322
Lawrence
8,097
25,949
Illinois
Indiana
Employee- Dependent,
Only
Family, etc.
Lee
7,981
22,362
County
Livingston
8,401
24,851
County
Employee- Dependent,
Only
Family, etc.
Adams
7,685
19,139
Logan
7,685
19,139
Adams
7,478
23,214
Alexander
8,097
25,949
19,139
Allen
7,885
24,189
Bond
7,369
22,013
Macoupin
7,369
22,013
Bartholomew
7,972
22,560
Boone
7,981
22,362
Madison
7,872
20,961
Benton
8,165
25,391
Brown
7,685
19,139
25,949
Blackford
8,053
21,898
Bureau
6,673
20,301
Marshall
7,908
21,322
Boone
7,971
25,255
Calhoun
7,369
22,013
Mason
7,685
19,139
Brown
8,081
23,034
Carroll
7,981
22,362
25,949
Carroll
7,797
26,016
7,663
21,199
Macon
Marion
Massac
7,685
8,097
8,097
Cass
7,685
19,139
McDonough
7,908
21,322
Cass
Champaign
8,290
21,185
McHenry
6,757
24,199
Clark
6,966
21,081
Christian
7,685
19,139
McLean
8,401
24,851
Clay
7,068
22,156
Clark
8,290
21,185
Menard
7,685
19,139
Clinton
7,797
26,016
Clay
8,097
25,949
Mercer
6,673
20,301
Crawford
6,966
21,081
Clinton
7,369
22,013
Monroe
7,872
20,961
Daviess
7,669
22,769
Coles
8,290
21,185
Montgomery
7,369
22,013
Dearborn
8,289
24,245
Cook
7,630
23,937
Morgan
7,685
19,139
Decatur
7,972
22,560
Crawford
8,097
25,949
Moultrie
7,685
19,139
DeKalb
7,478
23,214
Cumberland
8,290
21,185
Ogle
7,981
22,362
Delaware
8,053
21,898
DeKalb
7,981
22,362
21,322
Dubois
7,669
22,769
DeWitt
8,401
24,851
Perry
8,097
25,949
Elkhart
8,340
22,494
Douglas
8,290
21,185
Piatt
8,290
21,185
Fayette
7,510
22,139
DuPage
7,901
23,738
19,139
Floyd
6,966
21,081
Edgar
8,290
21,185
Pope
8,097
25,949
Fountain
7,797
26,016
Edwards
8,097
25,949
Pulaski
8,097
25,949
Franklin
8,289
24,245
Effingham
8,097
25,949
21,322
Fulton
7,663
21,199
9,570
24,463
Peoria
Pike
Putnam
7,908
7,685
7,908
Fayette
8,097
25,949
Randolph
7,369
22,013
Gibson
Ford
8,290
21,185
Richland
8,097
25,949
Grant
8,053
21,898
Franklin
8,097
25,949
20,301
Greene
7,669
22,769
Rock Island
6,673
-14-
2021 Average Premium Tables
Hamilton
7,971
25,255
Vanderburgh
9,570
24,463
Guthrie
8,299
18,911
Hancock
7,510
22,139
Vermillion
7,068
22,156
Hamilton
6,380
19,492
Harrison
6,966
21,081
Vigo
7,068
22,156
Hancock
7,379
21,093
Hendricks
7,971
25,255
Wabash
7,478
23,214
Hardin
6,380
19,492
Henry
7,510
22,139
Warren
8,165
25,391
Harrison
8,299
18,911
Howard
7,663
21,199
Warrick
9,570
24,463
Henry
7,262
18,678
Huntington
7,478
23,214
Washington
6,966
21,081
Howard
7,379
21,093
Jackson
7,972
22,560
Wayne
7,510
22,139
Humboldt
7,379
21,093
Jasper
8,165
25,391
Wells
7,478
23,214
Ida
7,388
19,924
Jay
8,053
21,898
White
8,165
25,391
Iowa
6,970
19,956
Jefferson
6,966
21,081
Whitley
7,478
23,214
Jackson
6,970
19,956
Jennings
7,972
22,560
Jasper
6,825
20,228
Johnson
8,081
23,034
Jefferson
7,262
18,678
Knox
7,669
22,769
6,970
19,956
Kosciusko
8,340
22,494
County
Employee- Dependent,
Only
Family, etc.
Johnson
Jones
6,970
19,956
8,299
18,911
Iowa
LaGrange
7,478
23,214
Adair
Keokuk
7,262
18,678
Lake
8,474
22,352
Adams
8,299
18,911
Kossuth
7,379
21,093
LaPorte
8,474
22,352
Allamakee
7,379
21,093
Lee
7,262
18,678
7,262
18,678
Lawrence
8,081
23,034
Appanoose
Linn
6,970
19,956
Madison
7,510
22,139
Audubon
8,299
18,911
Louisa
7,262
18,678
Marion
7,971
25,255
Benton
6,970
19,956
Lucas
7,262
18,678
6,970
19,956
Marshall
8,340
22,494
Black Hawk
Lyon
7,388
19,924
Martin
7,669
22,769
Boone
6,380
19,492
Madison
6,825
20,228
7,379
21,093
Miami
7,663
21,199
Bremer
Mahaska
7,262
18,678
Monroe
8,081
23,034
Buchanan
6,970
19,956
Marion
6,825
20,228
Montgomery
7,797
26,016
Buena Vista
7,388
19,924
Marshall
6,380
19,492
7,379
21,093
Morgan
7,971
25,255
Butler
Mills
8,299
18,911
Newton
8,165
25,391
Calhoun
6,380
19,492
Mitchell
7,379
21,093
Noble
7,478
23,214
Carroll
6,380
19,492
Monona
7,388
19,924
8,299
18,911
Ohio
8,289
24,245
Cass
Monroe
7,262
18,678
Orange
7,669
22,769
Cedar
6,970
19,956
Montgomery
8,299
18,911
Owen
8,081
23,034
Cerro Gordo
7,379
21,093
Muscatine
7,262
18,678
7,388
19,924
Parke
7,068
22,156
Cherokee
O'Brien
7,388
19,924
Perry
7,669
22,769
Chickasaw
7,379
21,093
Osceola
7,388
19,924
Pike
7,669
22,769
Clarke
8,299
18,911
Page
8,299
18,911
7,388
19,924
Porter
8,474
22,352
Clay
Palo Alto
7,388
19,924
Posey
9,570
24,463
Clayton
6,970
19,956
Plymouth
7,388
19,924
Pulaski
7,663
21,199
Clinton
6,970
19,956
Pocahontas
7,388
19,924
7,388
19,924
Putnam
7,797
26,016
Crawford
Polk
6,825
20,228
Randolph
8,053
21,898
Dallas
6,825
20,228
Pottawattamie
8,299
18,911
Ripley
8,289
24,245
Davis
7,262
18,678
Poweshiek
6,380
19,492
8,299
18,911
Rush
7,972
22,560
Decatur
Ringgold
8,299
18,911
Scott
6,966
21,081
Delaware
6,970
19,956
Sac
7,388
19,924
7,262
18,678
Shelby
7,971
25,255
Des Moines
Scott
6,970
19,956
Spencer
7,669
22,769
Dickinson
7,388
19,924
Shelby
8,299
18,911
St. Joseph
8,340
22,494
Dubuque
6,970
19,956
Sioux
7,388
19,924
7,379
21,093
Starke
8,340
22,494
Emmet
Story
6,380
19,492
Steuben
7,478
23,214
Fayette
7,379
21,093
Tama
6,380
19,492
Sullivan
7,068
22,156
Floyd
7,379
21,093
Taylor
8,299
18,911
7,379
21,093
Switzerland
8,289
24,245
Franklin
Union
8,299
18,911
Tippecanoe
7,797
26,016
Fremont
8,299
18,911
Van Buren
7,262
18,678
Tipton
7,797
26,016
Greene
6,380
19,492
Wapello
7,262
18,678
22,139
Grundy
6,380
19,492
Warren
6,825
20,228
Union
7,510
2021 Average Premium Tables
-15-
Washington
7,262
18,678
Hodgeman
6,516
20,210
Stevens
6,516
20,210
Wayne
7,262
18,678
Jackson
6,137
19,264
Sumner
6,295
18,161
Webster
6,380
19,492
Jefferson
6,137
19,264
Thomas
6,919
21,412
Winnebago
7,379
21,093
Jewell
6,086
17,604
Trego
6,919
21,412
Winneshiek
7,379
21,093
Johnson
7,265
20,490
Wabaunsee
6,137
19,264
Woodbury
7,388
19,924
Kearny
6,516
20,210
Wallace
6,919
21,412
Worth
7,379
21,093
Kingman
6,295
18,161
Washington
6,086
17,604
Wright
7,379
21,093
Kiowa
6,516
20,210
Wichita
6,919
21,412
Labette
7,460
19,378
Wilson
6,295
18,161
Lane
6,919
21,412
Woodson
7,460
19,378
7,265
20,490
Wyandotte
7,265
20,490
Kansas
County
Employee- Dependent,
Only
Family, etc.
Leavenworth
Lincoln
6,086
17,604
Allen
7,460
19,378
Linn
6,137
19,264
Anderson
6,137
19,264
Logan
6,919
21,412
Atchison
6,137
19,264
Lyon
6,137
19,264
County
Employee- Dependent,
Only
Family, etc.
Barber
6,516
20,210
Marion
6,295
18,161
Adair
6,633
19,790
6,633
19,790
Kentucky
Barton
6,919
21,412
Marshall
6,137
19,264
Allen
Bourbon
7,460
19,378
McPherson
6,295
18,161
Anderson
6,360
19,187
Brown
6,137
19,264
Meade
6,516
20,210
Ballard
8,670
19,250
Butler
6,295
18,161
Miami
7,265
20,490
Barren
6,633
19,790
Chase
6,295
18,161
Mitchell
6,086
17,604
Bath
7,159
20,621
Chautauqua
6,295
18,161
Montgomery
6,295
18,161
Bell
7,208
21,247
Cherokee
7,460
19,378
Morris
6,086
17,604
Boone
6,339
17,457
Cheyenne
6,919
21,412
20,210
Bourbon
6,360
19,187
Clark
6,516
20,210
Nemaha
6,137
19,264
Boyd
7,159
20,621
Clay
6,086
17,604
Neosho
7,460
19,378
Boyle
6,360
19,187
Cloud
6,086
17,604
21,412
Bracken
7,159
20,621
Coffey
6,137
19,264
Norton
6,919
21,412
Breathitt
7,208
21,247
Comanche
6,516
20,210
Osage
6,137
19,264
Breckinridge
6,863
18,840
Cowley
6,295
18,161
21,412
Bullitt
6,863
18,840
Crawford
7,460
19,378
Ottawa
6,086
17,604
Butler
6,633
19,790
Decatur
6,919
21,412
Pawnee
6,516
20,210
Caldwell
8,670
19,250
Dickinson
6,086
17,604
21,412
Calloway
8,670
19,250
6,339
17,457
Morton
Ness
Osborne
Phillips
6,516
6,919
6,919
6,919
Doniphan
6,137
19,264
Pottawatomie
6,137
19,264
Campbell
Douglas
6,137
19,264
Pratt
6,516
20,210
Carlisle
8,670
19,250
Edwards
6,516
20,210
Rawlins
6,919
21,412
Carroll
6,863
18,840
Elk
6,295
18,161
Reno
6,295
18,161
Carter
7,159
20,621
Ellis
6,919
21,412
Republic
6,086
17,604
Casey
6,633
19,790
Ellsworth
6,086
17,604
Rice
6,295
18,161
Christian
8,314
20,031
Finney
6,516
20,210
Riley
6,086
17,604
Clark
6,360
19,187
Ford
6,516
20,210
Rooks
6,919
21,412
Clay
7,208
21,247
Franklin
6,137
19,264
Rush
6,919
21,412
Clinton
6,633
19,790
Geary
6,086
17,604
Russell
6,919
21,412
Crittenden
8,670
19,250
Gove
6,919
21,412
17,604
Cumberland
6,633
19,790
Graham
6,919
21,412
Scott
6,919
21,412
Daviess
8,314
20,031
Grant
6,516
20,210
Sedgwick
6,295
18,161
Edmonson
6,633
19,790
Gray
6,516
20,210
20,210
Elliott
7,159
20,621
Greeley
6,919
21,412
Shawnee
6,137
19,264
Estill
6,360
19,187
Greenwood
6,295
18,161
Sheridan
6,919
21,412
Fayette
6,360
19,187
Hamilton
6,516
20,210
21,412
Fleming
7,159
20,621
7,208
21,247
Saline
Seward
Sherman
6,086
6,516
6,919
Harper
6,295
18,161
Smith
6,919
21,412
Floyd
Harvey
6,295
18,161
Stafford
6,516
20,210
Franklin
6,360
19,187
Haskell
6,516
20,210
20,210
Fulton
8,670
19,250
Stanton
6,516
-16-
2021 Average Premium Tables
Gallatin
6,339
17,457
Ohio
8,314
20,031
Franklin
7,876
17,471
Garrard
6,360
19,187
Oldham
6,863
18,840
Grant
8,112
17,923
Grant
6,339
17,457
Owen
6,360
19,187
Iberia
7,541
18,078
Graves
8,670
19,250
Owsley
7,208
21,247
Iberville
7,533
19,568
Grayson
6,863
18,840
Pendleton
6,339
17,457
Jackson
7,876
17,471
Green
6,633
19,790
Perry
7,208
21,247
Jefferson
7,139
18,432
Greenup
7,159
20,621
Pike
7,208
21,247
Jefferson Davis
7,717
20,137
Hancock
8,314
20,031
Powell
6,360
19,187
Lafayette
7,541
18,078
Hardin
6,863
18,840
Pulaski
6,633
19,790
Lafourche
7,514
17,764
Harlan
7,208
21,247
Robertson
7,159
20,621
LaSalle
8,112
17,923
Harrison
6,360
19,187
Rockcastle
6,360
19,187
Lincoln
7,876
17,471
Hart
6,633
19,790
Rowan
7,159
20,621
Livingston
7,533
19,568
Henderson
8,314
20,031
Russell
6,633
19,790
Madison
7,876
17,471
Henry
6,863
18,840
Scott
6,360
19,187
Morehouse
7,876
17,471
Hickman
8,670
19,250
Shelby
6,863
18,840
Natchitoches
7,794
19,283
Hopkins
8,314
20,031
Simpson
6,633
19,790
Orleans
7,139
18,432
Jackson
6,360
19,187
Spencer
6,863
18,840
Ouachita
7,876
17,471
Jefferson
6,863
18,840
Taylor
6,633
19,790
Plaquemines
7,139
18,432
Jessamine
6,360
19,187
Todd
8,314
20,031
Pointe Coupee
7,533
19,568
Johnson
7,208
21,247
Trigg
8,314
20,031
Rapides
8,112
17,923
Kenton
6,339
17,457
Trimble
6,863
18,840
Red River
7,794
19,283
Knott
7,208
21,247
Union
8,314
20,031
Richland
7,876
17,471
Knox
7,208
21,247
Warren
6,633
19,790
Sabine
7,794
19,283
LaRue
6,863
18,840
Washington
6,863
18,840
St. Bernard
7,139
18,432
Laurel
7,208
21,247
Wayne
6,633
19,790
St. Charles
7,139
18,432
Lawrence
7,159
20,621
Webster
8,314
20,031
St. Helena
7,533
19,568
Lee
7,208
21,247
Whitley
7,208
21,247
St. James
7,139
18,432
Leslie
7,208
21,247
Wolfe
7,208
21,247
St. John Baptist
7,139
18,432
Letcher
7,208
21,247
Woodford
6,360
19,187
St. Landry
7,541
18,078
Lewis
7,159
20,621
St. Martin
7,541
18,078
Lincoln
6,360
19,187
St. Mary
7,541
18,078
Livingston
8,670
19,250
7,139
18,432
Louisiana
Employee- Dependent,
Only
Family, etc.
St. Tammany
Logan
6,633
19,790
Parish
Tangipahoa
7,533
19,568
Lyon
8,670
19,250
Acadia
7,541
18,078
Tensas
7,876
17,471
Madison
6,360
19,187
Allen
7,717
20,137
Terrebonne
7,514
17,764
7,533
19,568
Magoffin
7,208
21,247
Ascension
Union
7,876
17,471
Marion
6,863
18,840
Assumption
7,514
17,764
Vermilion
7,541
18,078
Marshall
8,670
19,250
Avoyelles
8,112
17,923
Vernon
8,112
17,923
7,717
20,137
Martin
7,208
21,247
Beauregard
Washington
7,533
19,568
Mason
7,159
20,621
Bienville
7,794
19,283
Webster
7,794
19,283
McCracken
8,670
19,250
Bossier
7,794
19,283
West Baton Rouge
7,533
19,568
7,794
19,283
McCreary
6,633
19,790
Caddo
West Carroll
7,876
17,471
McLean
8,314
20,031
Calcasieu
7,717
20,137
West Feliciana
7,533
19,568
7,876
17,471
Winn
8,112
17,923
Meade
6,863
18,840
Caldwell
Menifee
7,159
20,621
Cameron
7,717
20,137
Mercer
6,360
19,187
Catahoula
8,112
17,923
Metcalfe
6,633
19,790
Claiborne
7,794
19,283
8,112
17,923
County
Employee- Dependent,
Only
Family, etc.
Maine
Monroe
6,633
19,790
Concordia
Montgomery
6,360
19,187
DeSoto
7,794
19,283
Androscoggin
7,935
20,534
20,621
East Baton Rouge
7,533
19,568
Aroostook
9,703
24,940
7,876
17,471
Cumberland
7,291
22,574
Morgan
7,159
Muhlenberg
8,314
20,031
East Carroll
Nelson
6,863
18,840
East Feliciana
7,533
19,568
Franklin
7,935
20,534
19,187
Evangeline
7,541
18,078
Hancock
9,703
24,940
Nicholas
6,360
2021 Average Premium Tables
-17-
Kennebec
7,153
19,633
Norfolk
8,383
26,811
Lenawee
6,203
20,058
Knox
7,153
19,633
Plymouth
8,922
25,875
Livingston
6,203
20,058
Lincoln
7,153
19,633
Suffolk
8,383
26,811
Luce
7,933
22,114
Oxford
7,153
19,633
Worcester
8,398
24,581
Mackinac
7,306
22,856
Penobscot
7,935
20,534
Macomb
6,883
21,112
Piscataquis
7,935
20,534
Manistee
5,945
19,853
Sagadahoc
7,291
22,574
7,933
22,114
7,935
20,534
County
Employee- Dependent,
Only
Family, etc.
Marquette
Somerset
Mason
5,904
18,777
Waldo
7,935
20,534
Alcona
7,306
22,856
Mecosta
5,904
18,777
7,933
22,114
Michigan
Washington
9,703
24,940
Alger
Menominee
7,933
22,114
York
7,291
22,574
Allegan
6,103
19,026
Midland
6,448
20,141
Alpena
7,306
22,856
Missaukee
5,945
19,853
Antrim
5,945
19,853
Monroe
7,321
21,933
Arenac
6,682
19,935
Montcalm
5,904
18,777
Baraga
7,933
22,114
Montmorency
7,306
22,856
Maryland
County
Employee- Dependent,
Only
Family, etc.
Allegany
7,269
18,458
Barry
6,103
19,026
Muskegon
5,904
18,777
Anne Arundel
7,090
19,649
Bay
6,682
19,935
Newaygo
5,904
18,777
Baltimore
7,090
19,649
Benzie
5,945
19,853
Oakland
6,883
21,112
Baltimore City
7,090
19,649
Berrien
7,151
23,984
Oceana
5,904
18,777
Calvert
7,678
17,961
Branch
7,590
22,120
Ogemaw
7,306
22,856
Caroline
7,678
17,961
Calhoun
7,590
22,120
Ontonagon
7,933
22,114
Carroll
7,269
18,458
Cass
7,151
23,984
Osceola
5,904
18,777
Cecil
7,678
17,961
Charlevoix
5,945
19,853
Oscoda
7,306
22,856
Charles
7,678
17,961
Cheboygan
7,306
22,856
Otsego
7,306
22,856
Dorchester
7,678
17,961
Chippewa
7,306
22,856
Ottawa
5,904
18,777
Frederick
7,269
18,458
Clare
6,448
20,141
Presque Isle
7,306
22,856
Garrett
7,269
18,458
Clinton
6,916
18,119
Roscommon
7,306
22,856
Harford
7,090
19,649
Crawford
7,306
22,856
Saginaw
6,682
19,935
Howard
7,090
19,649
Delta
7,933
22,114
Sanilac
7,278
20,214
Kent
7,678
17,961
Dickinson
7,933
22,114
Schoolcraft
7,933
22,114
Montgomery
7,640
21,099
Eaton
6,916
18,119
Shiawassee
6,652
18,730
Prince George's
7,640
21,099
Emmet
5,945
19,853
St. Clair
7,028
21,419
Queen Annes
7,678
17,961
Genesee
6,652
18,730
St. Joseph
7,151
23,984
Somerset
7,678
17,961
Gladwin
6,448
20,141
Tuscola
7,278
20,214
St. Marys
7,678
17,961
Gogebic
7,933
22,114
Van Buren
7,151
23,984
Talbot
7,678
17,961
Grand Traverse
5,945
19,853
Washtenaw
6,203
20,058
Washington
7,269
18,458
Gratiot
6,682
19,935
Wayne
7,321
21,933
Wicomico
7,678
17,961
Hillsdale
6,916
18,119
Wexford
5,945
19,853
Worcester
7,678
17,961
Houghton
7,933
22,114
Huron
7,278
20,214
Ingham
6,916
18,119
5,904
18,777
County
Employee- Dependent,
Only
Family, etc.
County
Employee- Dependent,
Only
Family, etc.
Ionia
Iosco
7,306
22,856
Aitkin
6,897
19,587
Barnstable
9,814
27,157
Iron
7,933
22,114
Anoka
7,502
22,701
Berkshire
7,317
23,163
Isabella
6,448
20,141
Becker
7,354
23,575
Bristol
8,922
25,875
Jackson
6,916
18,119
Beltrami
6,897
19,587
Dukes
9,814
27,157
Kalamazoo
7,590
22,120
Benton
7,502
22,701
Essex
7,958
24,037
Kalkaska
5,945
19,853
Big Stone
8,235
21,521
Franklin
7,317
23,163
Kent
5,904
18,777
Blue Earth
8,762
21,578
Hampden
7,317
23,163
Keweenaw
7,933
22,114
Brown
7,201
22,000
Hampshire
7,317
23,163
Lake
5,904
18,777
Carlton
7,111
19,236
Middlesex
8,383
26,811
Lapeer
6,652
18,730
Carver
7,502
22,701
Nantucket
9,814
27,157
Leelanau
5,945
19,853
Cass
6,897
19,587
Massachusetts
-18-
Minnesota
2021 Average Premium Tables
Chippewa
8,235
21,521
Renville
8,235
21,521
Humphreys
6,646
18,400
Chisago
6,897
19,587
Rice
8,762
21,578
Issaquena
6,646
18,400
Clay
7,354
23,575
Rock
7,201
22,000
Itawamba
7,057
18,763
Clearwater
6,603
23,307
Roseau
6,897
19,587
Jackson
7,057
20,432
Cook
7,111
19,236
Scott
7,502
22,701
Jasper
6,646
18,400
Cottonwood
7,201
22,000
Sherburne
7,502
22,701
Jefferson
6,646
18,400
Crow Wing
6,897
19,587
Sibley
8,235
21,521
Jefferson Davis
6,646
18,400
Dakota
7,502
22,701
St. Louis
7,111
19,236
Jones
7,319
16,028
Dodge
7,636
20,649
Stearns
7,502
22,701
Kemper
6,646
18,400
Douglas
7,354
23,575
Steele
7,636
20,649
Lafayette
6,646
18,400
Faribault
8,762
21,578
Stevens
7,354
23,575
Lamar
7,319
16,028
Fillmore
7,636
20,649
Swift
8,235
21,521
Lauderdale
6,646
18,400
Freeborn
7,636
20,649
Todd
6,897
19,587
Lawrence
6,646
18,400
Goodhue
7,636
20,649
Traverse
7,354
23,575
Leake
6,646
18,400
Grant
7,354
23,575
Wabasha
7,636
20,649
Lee
7,057
18,763
Hennepin
7,502
22,701
Wadena
6,897
19,587
Leflore
6,646
18,400
Houston
7,636
20,649
Waseca
8,762
21,578
Lincoln
6,646
18,400
Hubbard
6,897
19,587
Washington
7,502
22,701
Lowndes
6,646
18,400
Isanti
6,897
19,587
Watonwan
8,762
21,578
Madison
6,422
17,274
Itasca
7,111
19,236
Wilkin
7,354
23,575
Marion
6,646
18,400
Jackson
7,201
22,000
Winona
7,636
20,649
Marshall
6,271
22,451
Kanabec
6,897
19,587
Wright
7,502
22,701
Monroe
6,646
18,400
Kandiyohi
8,235
21,521
Yellow Medicine
8,235
21,521
Montgomery
6,646
18,400
Kittson
6,603
23,307
Neshoba
6,646
18,400
Koochiching
7,111
19,236
Newton
6,646
18,400
Lac qui Parle
8,235
21,521
6,646
18,400
Mississippi
Employee- Dependent,
Only
Family, etc.
Noxubee
Lake
7,111
19,236
County
Oktibbeha
6,646
18,400
Lake of the Woods
7,111
19,236
Adams
6,646
18,400
Panola
6,646
18,400
Le Sueur
8,762
21,578
Alcorn
6,646
18,400
Pearl River
7,319
16,028
6,646
18,400
Lincoln
7,201
22,000
Amite
Perry
7,319
16,028
Lyon
8,235
21,521
Attala
6,646
18,400
Pike
6,646
18,400
Mahnomen
6,603
23,307
Benton
7,057
18,763
Pontotoc
7,057
18,763
6,646
18,400
Marshall
6,603
23,307
Bolivar
Prentiss
6,646
18,400
Martin
8,762
21,578
Calhoun
6,646
18,400
Quitman
6,646
18,400
McLeod
8,235
21,521
Carroll
6,646
18,400
Rankin
6,422
17,274
6,646
18,400
Meeker
8,235
21,521
Chickasaw
Scott
6,646
18,400
Mille Lacs
6,897
19,587
Choctaw
6,646
18,400
Sharkey
6,646
18,400
Morrison
6,897
19,587
Claiborne
6,646
18,400
Simpson
6,422
17,274
6,646
18,400
Mower
7,636
20,649
Clarke
Smith
6,646
18,400
Murray
7,201
22,000
Clay
6,646
18,400
Stone
7,057
20,432
Nicollet
8,762
21,578
Coahoma
6,646
18,400
Sunflower
6,646
18,400
6,422
17,274
Nobles
7,201
22,000
Copiah
Tallahatchie
6,646
18,400
Norman
6,603
23,307
Covington
6,646
18,400
Tate
6,271
22,451
6,271
22,451
Olmsted
7,636
20,649
DeSoto
Tippah
7,057
18,763
Otter Tail
7,354
23,575
Forrest
7,319
16,028
Tishomingo
6,646
18,400
Pennington
6,603
23,307
Franklin
6,646
18,400
Tunica
6,271
22,451
7,057
20,432
Pine
6,897
19,587
George
Union
7,057
18,763
Pipestone
7,201
22,000
Greene
7,319
16,028
Walthall
6,646
18,400
Polk
6,603
23,307
Grenada
6,646
18,400
Warren
6,422
17,274
7,057
20,432
Pope
7,354
23,575
Hancock
Washington
6,646
18,400
Ramsey
7,502
22,701
Harrison
7,057
20,432
Wayne
6,646
18,400
Red Lake
6,603
23,307
Hinds
6,422
17,274
Webster
6,646
18,400
22,000
Holmes
6,646
18,400
Wilkinson
6,646
18,400
Redwood
7,201
2021 Average Premium Tables
-19-
Winston
6,646
18,400
Iron
6,860
17,500
St. Francois
6,704
18,420
Yalobusha
6,646
18,400
Jackson
6,642
19,711
St. Louis
6,704
18,420
Yazoo
6,646
18,400
Jasper
5,676
17,136
St. Louis City
6,704
18,420
Jefferson
6,704
18,420
Ste. Genevieve
6,704
18,420
Johnson
7,493
19,730
Stoddard
6,757
18,156
7,301
17,909
Stone
6,490
18,133
Missouri
County
Employee- Dependent,
Only
Family, etc.
Knox
Laclede
6,490
18,133
Sullivan
7,301
17,909
Adair
7,301
17,909
Lafayette
7,493
19,730
Taney
6,490
18,133
Andrew
8,473
16,325
Lawrence
6,490
18,133
Texas
6,860
17,500
Atchison
8,473
16,325
Lewis
7,301
17,909
Vernon
7,493
19,730
Audrain
7,641
20,273
Lincoln
6,704
18,420
Warren
6,704
18,420
Barry
6,490
18,133
Linn
7,301
17,909
Washington
6,704
18,420
Barton
5,676
17,136
Livingston
8,473
16,325
Wayne
6,757
18,156
Bates
7,493
19,730
Macon
7,301
17,909
Webster
6,490
18,133
Benton
7,493
19,730
Madison
6,757
18,156
Worth
8,473
16,325
Bollinger
6,757
18,156
Maries
7,641
20,273
Wright
6,490
18,133
Boone
7,641
20,273
Marion
7,301
17,909
Buchanan
8,473
16,325
McDonald
5,676
17,136
Butler
6,757
18,156
Mercer
8,473
16,325
Caldwell
8,473
16,325
Miller
7,641
20,273
County
Employee- Dependent,
Only
Family, etc.
Callaway
7,641
20,273
Mississippi
6,757
18,156
Beaverhead
7,671
17,348
Camden
7,641
20,273
Moniteau
7,641
20,273
Big Horn
7,671
17,348
Cape Girardeau
6,757
18,156
Monroe
7,641
20,273
Blaine
7,671
17,348
Carroll
8,473
16,325
20,273
Broadwater
6,661
18,324
Carter
6,860
17,500
Morgan
7,641
20,273
Carbon
6,774
18,736
Cass
6,642
19,711
New Madrid
6,757
18,156
Carter
7,671
17,348
Cedar
6,490
18,133
17,136
Cascade
6,661
18,324
Chariton
7,641
20,273
Nodaway
8,473
16,325
Chouteau
6,661
18,324
Christian
6,490
18,133
Oregon
6,860
17,500
Custer
7,671
17,348
Clark
7,301
17,909
20,273
Daniels
7,671
17,348
Clay
6,642
19,711
Ozark
6,490
18,133
Dawson
7,671
17,348
Clinton
8,473
16,325
Pemiscot
6,757
18,156
Deer Lodge
6,661
18,324
Cole
7,641
20,273
18,156
Fallon
7,671
17,348
7,671
17,348
Montgomery
Newton
Osage
Perry
7,641
5,676
7,641
6,757
Montana
Cooper
7,641
20,273
Pettis
7,493
19,730
Fergus
Crawford
6,860
17,500
Phelps
6,860
17,500
Flathead
6,607
17,742
Dade
6,490
18,133
Pike
7,301
17,909
Gallatin
6,661
18,324
Dallas
6,490
18,133
Platte
6,642
19,711
Garfield
7,671
17,348
Daviess
8,473
16,325
Polk
6,490
18,133
Glacier
7,671
17,348
DeKalb
8,473
16,325
Pulaski
6,860
17,500
Golden Valley
7,671
17,348
Dent
6,860
17,500
Putnam
7,301
17,909
Granite
7,671
17,348
Douglas
6,490
18,133
Ralls
7,301
17,909
Hill
7,671
17,348
Dunklin
6,757
18,156
Randolph
7,641
20,273
Jefferson
6,661
18,324
Franklin
6,704
18,420
Ray
8,473
16,325
Judith Basin
6,661
18,324
Gasconade
7,641
20,273
17,500
Lake
6,607
17,742
Gentry
8,473
16,325
Ripley
6,860
17,500
Lewis and Clark
6,661
18,324
Greene
6,490
18,133
Saline
7,493
19,730
Liberty
7,671
17,348
Grundy
8,473
16,325
17,909
Lincoln
7,671
17,348
Harrison
8,473
16,325
Scotland
7,301
17,909
Madison
7,671
17,348
Henry
7,493
19,730
Scott
6,757
18,156
McCone
7,671
17,348
Hickory
6,490
18,133
17,500
Meagher
7,671
17,348
7,671
17,348
Reynolds
Schuyler
Shannon
6,860
7,301
6,860
Holt
8,473
16,325
Shelby
7,301
17,909
Mineral
Howard
7,641
20,273
St. Charles
6,704
18,420
Missoula
6,607
17,742
Howell
6,860
17,500
19,730
Musselshell
6,774
18,736
St. Clair
7,493
-20-
2021 Average Premium Tables
Park
7,671
17,348
Dodge
7,620
21,151
Seward
7,849
23,014
Petroleum
7,671
17,348
Douglas
7,620
21,151
Sheridan
9,129
25,388
Phillips
7,671
17,348
Dundy
9,129
25,388
Sherman
8,126
23,525
Pondera
7,671
17,348
Fillmore
7,849
23,014
Sioux
9,129
25,388
Powder River
7,671
17,348
Franklin
8,126
23,525
Stanton
8,126
23,525
Powell
7,671
17,348
Frontier
9,129
25,388
Thayer
7,849
23,014
Prairie
7,671
17,348
Furnas
8,126
23,525
Thomas
9,129
25,388
Ravalli
7,671
17,348
Gage
7,849
23,014
Thurston
7,620
21,151
Richland
7,671
17,348
Garden
9,129
25,388
Valley
8,126
23,525
Roosevelt
7,671
17,348
Garfield
8,126
23,525
Washington
7,620
21,151
Rosebud
7,671
17,348
Gosper
8,126
23,525
Wayne
8,126
23,525
Sanders
7,671
17,348
Grant
9,129
25,388
Webster
8,126
23,525
Sheridan
7,671
17,348
Greeley
8,126
23,525
Wheeler
8,126
23,525
Silver Bow
6,661
18,324
Hall
8,126
23,525
York
7,849
23,014
Stillwater
6,774
18,736
Hamilton
8,126
23,525
Sweet Grass
6,774
18,736
Harlan
8,126
23,525
Teton
6,661
18,324
Hayes
9,129
25,388
Toole
7,671
17,348
Hitchcock
9,129
25,388
County
Employee- Dependent,
Only
Family, etc.
Treasure
7,671
17,348
Holt
8,126
23,525
Carson City
6,296
15,350
Valley
7,671
17,348
Hooker
9,129
25,388
Churchill
7,586
19,806
Wheatland
7,671
17,348
Howard
8,126
23,525
Clark
6,048
18,187
6,296
15,350
Nevada
Wibaux
7,671
17,348
Jefferson
7,849
23,014
Douglas
Yellowstone
6,774
18,736
Johnson
7,849
23,014
Elko
7,586
19,806
23,525
Esmeralda
7,586
19,806
7,586
19,806
Kearney
Nebraska
8,126
Keith
9,129
25,388
Eureka
Keya Paha
8,126
23,525
Humboldt
7,586
19,806
25,388
Lander
7,586
19,806
7,586
19,806
County
Employee- Dependent,
Only
Family, etc.
Adams
8,126
23,525
Knox
8,126
23,525
Lincoln
Antelope
8,126
23,525
Lancaster
7,849
23,014
Lyon
6,296
15,350
Arthur
9,129
25,388
25,388
Mineral
7,586
19,806
Banner
9,129
25,388
Logan
9,129
25,388
Nye
6,048
18,187
Blaine
8,126
23,525
Loup
8,126
23,525
Pershing
7,586
19,806
Boone
8,126
23,525
23,525
Storey
6,296
15,350
6,981
18,962
7,586
19,806
Kimball
Lincoln
Madison
9,129
9,129
8,126
Box Butte
9,129
25,388
McPherson
9,129
25,388
Washoe
Boyd
8,126
23,525
Merrick
8,126
23,525
White Pine
Brown
9,129
25,388
Morrill
9,129
25,388
Buffalo
8,126
23,525
Nance
8,126
23,525
Burt
7,620
21,151
Nemaha
7,849
23,014
Butler
8,126
23,525
Nuckolls
8,126
23,525
Cass
7,620
21,151
Otoe
7,849
23,014
Cedar
8,126
23,525
Pawnee
7,849
23,014
Chase
9,129
25,388
Perkins
9,129
25,388
Cherry
9,129
25,388
Phelps
8,126
23,525
Cheyenne
9,129
25,388
Pierce
8,126
23,525
Clay
8,126
23,525
Platte
8,126
23,525
Colfax
8,126
23,525
Polk
8,126
23,525
Cuming
8,126
23,525
Red Willow
9,129
25,388
Custer
8,126
23,525
Richardson
7,849
23,014
Dakota
8,126
23,525
Rock
8,126
23,525
Dawes
9,129
25,388
Saline
7,849
23,014
Dawson
8,126
23,525
Sarpy
7,620
21,151
Deuel
9,129
25,388
Saunders
7,620
21,151
Dixon
8,126
23,525
Scotts Bluff
9,129
25,388
2021 Average Premium Tables
-21-
New Hampshire
County
Employee- Dependent,
Only
Family, etc.
All
7,919
22,830
New Jersey
County
Employee- Dependent,
Only
Family, etc.
All
8,090
22,786
New Mexico
County
Employee- Dependent,
Only
Family, etc.
Bernalillo
7,140
19,041
Catron
8,553
23,423
Chaves
8,553
23,423
Cibola
8,553
23,423
Colfax
8,553
23,423
Hamilton
7,885
22,540
Bertie
7,967
20,483
Curry
8,553
23,423
Herkimer
7,885
22,540
Bladen
7,233
21,609
De Baca
8,553
23,423
Jefferson
7,885
22,540
Brunswick
7,474
19,121
Doña Ana
7,080
18,980
Kings
9,816
29,771
Buncombe
7,042
18,614
Eddy
8,553
23,423
Lewis
7,885
22,540
Burke
6,599
19,000
Grant
8,553
23,423
Livingston
6,959
19,847
Cabarrus
6,886
19,226
Guadalupe
8,553
23,423
Madison
7,885
22,540
Caldwell
6,599
19,000
Harding
8,553
23,423
Monroe
6,959
19,847
Camden
7,967
20,483
Hidalgo
8,553
23,423
Montgomery
7,383
21,433
Carteret
8,358
18,197
Lea
8,553
23,423
Nassau
9,466
28,140
Caswell
7,128
20,756
Lincoln
8,553
23,423
New York
9,816
29,771
Catawba
6,599
19,000
Los Alamos
8,553
23,423
Niagara
6,884
19,730
Chatham
7,128
20,756
Luna
8,553
23,423
Oneida
7,885
22,540
Cherokee
7,042
18,614
McKinley
8,553
23,423
Onondaga
8,067
22,260
Chowan
7,967
20,483
Mora
8,553
23,423
Ontario
6,959
19,847
Clay
7,042
18,614
Otero
8,553
23,423
Orange
8,882
21,506
Cleveland
7,897
20,082
Quay
8,553
23,423
Orleans
6,884
19,730
Columbus
7,474
19,121
Rio Arriba
8,553
23,423
Oswego
7,885
22,540
Craven
8,358
18,197
Roosevelt
8,553
23,423
Otsego
7,885
22,540
Cumberland
7,233
21,609
San Juan
7,088
18,909
Putnam
8,882
21,506
Currituck
7,967
20,483
San Miguel
8,553
23,423
Queens
9,816
29,771
Dare
8,358
18,197
Sandoval
7,140
19,041
Rensselaer
7,383
21,433
Davidson
7,499
20,349
Santa Fe
7,420
19,914
Richmond
9,816
29,771
Davie
7,499
20,349
Sierra
8,553
23,423
Rockland
9,816
29,771
Duplin
7,474
19,121
Socorro
8,553
23,423
Saratoga
7,383
21,433
Durham
7,128
20,756
Taos
8,553
23,423
Schenectady
7,383
21,433
Edgecombe
8,184
23,007
Torrance
7,140
19,041
Schoharie
7,383
21,433
Forsyth
7,499
20,349
Union
8,553
23,423
Schuyler
8,067
22,260
Franklin
7,209
19,540
Valencia
7,140
19,041
Seneca
6,959
19,847
Gaston
7,897
20,082
St. Lawrence
7,885
22,540
Gates
7,967
20,483
Steuben
8,067
22,260
Graham
7,042
18,614
9,466
28,140
Granville
6,736
18,464
New York
County
Employee- Dependent,
Only
Family, etc.
Suffolk
Sullivan
8,882
21,506
Greene
8,184
23,007
Albany
7,383
21,433
Tioga
8,067
22,260
Guilford
7,341
19,809
Allegany
6,884
19,730
Tompkins
8,067
22,260
Halifax
7,967
20,483
Bronx
9,816
29,771
Ulster
8,882
21,506
Harnett
7,233
21,609
Broome
8,067
22,260
Warren
7,383
21,433
Haywood
7,042
18,614
Cattaraugus
6,884
19,730
Washington
7,383
21,433
Henderson
7,042
18,614
Cayuga
8,067
22,260
Wayne
6,959
19,847
Hertford
7,967
20,483
Chautauqua
6,884
19,730
Westchester
9,816
29,771
Hoke
7,233
21,609
Chemung
8,067
22,260
Wyoming
6,884
19,730
Hyde
8,358
18,197
Chenango
7,885
22,540
Yates
6,959
19,847
Iredell
6,599
19,000
Clinton
7,885
22,540
Jackson
7,042
18,614
Columbia
7,383
21,433
Cortland
8,067
22,260
Delaware
8,882
21,506
Dutchess
8,882
Erie
North Carolina
Johnston
7,209
19,540
Jones
8,358
18,197
County
Employee- Dependent,
Only
Family, etc.
Lee
7,128
20,756
21,506
Alamance
7,128
20,756
Lenoir
8,358
18,197
6,884
19,730
Alexander
6,599
19,000
Lincoln
7,897
20,082
Essex
7,885
22,540
Alleghany
7,736
21,519
Macon
7,042
18,614
Franklin
7,885
22,540
Anson
6,886
19,226
Madison
7,042
18,614
Fulton
7,383
21,433
Ashe
7,736
21,519
Martin
7,967
20,483
Genesee
6,884
19,730
Avery
7,042
18,614
McDowell
7,042
18,614
Greene
7,383
21,433
Beaufort
8,358
18,197
Mecklenburg
6,886
19,226
-22-
2021 Average Premium Tables
Mitchell
7,042
18,614
Cavalier
7,694
21,610
Auglaize
7,480
19,589
Montgomery
9,030
19,601
Dickey
7,694
21,610
Belmont
7,496
19,458
Moore
9,030
19,601
Divide
7,694
21,610
Brown
7,363
19,533
Nash
8,184
23,007
Dunn
7,694
21,610
Butler
6,820
20,816
New Hanover
7,474
19,121
Eddy
7,694
21,610
Carroll
7,521
21,193
Northampton
7,967
20,483
Emmons
7,694
21,610
Champaign
6,862
19,411
Onslow
7,474
19,121
Foster
7,694
21,610
Clark
6,862
19,411
Orange
7,128
20,756
Golden Valley
7,694
21,610
Clermont
7,363
19,533
Pamlico
8,358
18,197
Grand Forks
7,097
19,584
Clinton
7,363
19,533
Pasquotank
7,967
20,483
Grant
7,694
21,610
Columbiana
7,489
20,468
Pender
7,474
19,121
Griggs
7,694
21,610
Coshocton
7,496
19,458
Perquimans
7,967
20,483
Hettinger
7,694
21,610
Crawford
7,128
19,831
Person
7,128
20,756
Kidder
7,694
21,610
Cuyahoga
7,530
21,580
Pitt
8,184
23,007
La Moure
7,694
21,610
Darke
6,862
19,411
Polk
7,042
18,614
Logan
7,694
21,610
Defiance
8,137
21,370
Randolph
7,341
19,809
McHenry
7,694
21,610
Delaware
6,996
22,087
Richmond
7,233
21,609
McIntosh
7,694
21,610
Erie
8,591
20,639
Robeson
7,233
21,609
McKenzie
7,694
21,610
Fairfield
6,996
22,087
Rockingham
7,341
19,809
McLean
7,694
21,610
Fayette
6,996
22,087
Rowan
6,886
19,226
Mercer
7,694
21,610
Franklin
6,996
22,087
Rutherford
7,042
18,614
Morton
7,235
20,866
Fulton
8,137
21,370
Sampson
7,233
21,609
Mountrail
7,694
21,610
Gallia
8,906
23,548
Scotland
7,233
21,609
Nelson
7,694
21,610
Geauga
7,530
21,580
Stanly
6,886
19,226
Oliver
7,694
21,610
Greene
6,862
19,411
Stokes
7,499
20,349
Pembina
7,694
21,610
Guernsey
7,496
19,458
Surry
7,499
20,349
Pierce
7,694
21,610
Hamilton
6,820
20,816
Swain
7,042
18,614
Ramsey
7,694
21,610
Hancock
7,480
19,589
Transylvania
7,042
18,614
Ransom
7,694
21,610
Hardin
7,480
19,589
Tyrrell
8,358
18,197
Renville
7,694
21,610
Harrison
7,496
19,458
Union
6,886
19,226
Richland
7,694
21,610
Henry
8,137
21,370
Vance
6,736
18,464
Rolette
7,694
21,610
Highland
7,363
19,533
Wake
7,209
19,540
Sargent
7,694
21,610
Hocking
7,051
21,428
Warren
6,736
18,464
Sheridan
7,694
21,610
Holmes
5,810
17,178
Washington
8,358
18,197
Sioux
7,694
21,610
Huron
8,591
20,639
Watauga
7,736
21,519
Slope
7,694
21,610
Jackson
8,906
23,548
Wayne
8,184
23,007
Stark
7,694
21,610
Jefferson
7,496
19,458
Wilkes
7,736
21,519
Steele
7,694
21,610
Knox
6,996
22,087
Wilson
8,184
23,007
Stutsman
7,694
21,610
Lake
7,530
21,580
Yadkin
7,499
20,349
Towner
7,694
21,610
Lawrence
8,906
23,548
Yancey
7,042
18,614
Traill
7,694
21,610
Licking
6,996
22,087
Walsh
7,694
21,610
Logan
6,996
22,087
Ward
7,694
21,610
Lorain
7,530
21,580
Wells
7,694
21,610
Lucas
8,137
21,370
Williams
7,694
21,610
Madison
6,996
22,087
Mahoning
7,489
20,468
Marion
7,654
21,747
North Dakota
County
Employee- Dependent,
Only
Family, etc.
Adams
7,694
21,610
Barnes
7,694
21,610
Benson
7,694
21,610
7,297
22,924
7,694
21,610
County
Employee- Dependent,
Only
Family, etc.
Medina
Billings
Meigs
7,051
21,428
Bottineau
7,694
21,610
Adams
7,363
19,533
Mercer
7,480
19,589
Bowman
7,694
21,610
Allen
7,480
19,589
Miami
6,862
19,411
Burke
7,694
21,610
Ashland
7,297
22,924
Monroe
7,496
19,458
Burleigh
7,235
20,866
Ashtabula
7,530
21,580
Montgomery
6,862
19,411
Cass
7,057
20,490
Athens
7,051
21,428
Morgan
7,496
19,458
2021 Average Premium Tables
Ohio
-23-
Morrow
7,654
21,747
Custer
6,935
18,162
Wagoner
7,193
18,948
Muskingum
7,496
19,458
Delaware
6,935
18,162
Washington
6,935
18,162
Noble
7,496
19,458
Dewey
6,935
18,162
Washita
6,935
18,162
Ottawa
8,591
20,639
Ellis
6,935
18,162
Woods
6,935
18,162
Paulding
7,480
19,589
Garfield
6,935
18,162
Woodward
6,935
18,162
Perry
7,496
19,458
Garvin
6,935
18,162
Pickaway
6,996
22,087
Grady
6,983
18,124
Pike
8,906
23,548
Grant
6,935
18,162
Portage
7,297
22,924
Greer
6,935
18,162
County
Employee- Dependent,
Only
Family, etc.
Preble
6,862
19,411
Harmon
6,935
18,162
Baker
8,587
20,259
6,908
19,683
Oregon
Putnam
7,480
19,589
Harper
6,935
18,162
Benton
Richland
7,128
19,831
Haskell
6,935
18,162
Clackamas
6,653
18,369
18,162
Clatsop
8,510
21,269
8,510
21,269
Ross
8,906
23,548
Hughes
6,935
Sandusky
8,591
20,639
Jackson
6,935
18,162
Columbia
Scioto
8,906
23,548
Jefferson
6,935
18,162
Coos
8,510
21,269
18,162
Crook
8,587
20,259
8,510
21,269
Seneca
8,591
20,639
Johnston
6,935
Shelby
6,862
19,411
Kay
6,935
18,162
Curry
Stark
7,521
21,193
Kingfisher
6,935
18,162
Deschutes
6,685
21,185
6,795
19,262
Summit
7,297
22,924
Kiowa
6,935
18,162
Douglas
Trumbull
7,489
20,468
Latimer
6,935
18,162
Gilliam
8,587
20,259
Tuscarawas
7,496
19,458
Le Flore
6,359
16,749
Grant
8,587
20,259
8,587
20,259
Union
6,996
22,087
Lincoln
6,983
18,124
Harney
Van Wert
7,480
19,589
Logan
6,983
18,124
Hood River
8,587
20,259
18,162
Jackson
6,795
19,262
8,587
20,259
Vinton
8,906
23,548
Love
6,935
Warren
6,820
20,816
Major
6,935
18,162
Jefferson
Washington
7,051
21,428
Marshall
6,935
18,162
Josephine
6,795
19,262
18,162
Klamath
6,685
21,185
6,685
21,185
Wayne
5,810
17,178
Mayes
6,935
Williams
8,137
21,370
McClain
6,983
18,124
Lake
Wood
8,137
21,370
McCurtain
6,935
18,162
Lane
6,908
19,683
18,162
Lincoln
8,510
21,269
6,908
19,683
Wyandot
8,591
20,639
Oklahoma
McIntosh
6,935
Murray
6,935
18,162
Linn
Muskogee
6,935
18,162
Malheur
8,587
20,259
18,162
Marion
6,503
17,428
8,587
20,259
Noble
County
Employee- Dependent,
Only
Family, etc.
Nowata
6,935
18,162
Morrow
Adair
6,935
18,162
Okfuskee
6,935
18,162
Multnomah
6,653
18,369
Alfalfa
6,935
18,162
Oklahoma
6,983
18,124
Polk
6,503
17,428
Atoka
6,935
18,162
Okmulgee
7,193
18,948
Sherman
8,587
20,259
Beaver
6,935
18,162
Osage
7,193
18,948
Tillamook
8,510
21,269
Beckham
6,935
18,162
Ottawa
6,935
18,162
Umatilla
8,587
20,259
Blaine
6,935
18,162
Pawnee
7,193
18,948
Union
8,587
20,259
Bryan
6,935
18,162
Payne
6,935
18,162
Wallowa
8,587
20,259
Caddo
6,935
18,162
Pittsburg
6,935
18,162
Wasco
8,587
20,259
Canadian
6,983
18,124
Pontotoc
6,935
18,162
Washington
6,653
18,369
Carter
6,935
18,162
18,162
Wheeler
8,587
20,259
Cherokee
6,935
18,162
Pushmataha
6,935
18,162
Yamhill
6,653
18,369
Choctaw
6,935
18,162
Roger Mills
6,935
18,162
Cimarron
6,935
18,162
Rogers
7,193
18,948
Cleveland
6,983
18,124
Seminole
6,935
18,162
Coal
6,935
18,162
Sequoyah
6,359
16,749
Comanche
6,813
16,976
Stephens
6,935
18,162
Texas
6,935
18,162
Cotton
6,935
18,162
Pottawatomie
6,935
6,935
Craig
6,935
18,162
Tillman
6,935
18,162
Creek
7,193
18,948
Tulsa
7,193
18,948
-24-
Pennsylvania
County
Employee- Dependent,
Only
Family, etc.
Adams
7,546
21,105
Allegheny
6,933
19,582
Armstrong
6,933
19,582
Beaver
6,933
19,582
2021 Average Premium Tables
Bedford
7,397
17,192
Susquehanna
7,282
19,690
McCormick
8,590
21,032
Berks
7,546
21,105
Tioga
7,282
19,690
Newberry
8,550
20,783
Blair
7,397
17,192
Union
7,272
23,760
Oconee
8,469
24,250
Bradford
7,282
19,690
Venango
6,088
17,396
Orangeburg
8,291
22,084
Bucks
7,839
22,060
Warren
6,088
17,396
Pickens
7,983
20,225
Butler
6,933
19,582
Washington
6,933
19,582
Richland
8,074
22,788
Cambria
7,397
17,192
Wayne
7,282
19,690
Saluda
8,422
20,345
Cameron
7,151
21,373
Westmoreland
6,933
19,582
Spartanburg
7,709
22,370
Carbon
7,282
19,690
Wyoming
7,282
19,690
Sumter
7,679
17,932
Centre
7,272
23,760
York
7,546
21,105
Union
6,837
19,565
Chester
7,839
22,060
Williamsburg
7,261
20,304
Clarion
6,088
17,396
York
7,788
21,526
Clearfield
7,397
17,192
Clinton
7,282
19,690
County
Employee- Dependent,
Only
Family, etc.
Columbia
7,272
23,760
All
7,859
Crawford
6,088
17,396
Cumberland
6,997
20,639
Dauphin
6,997
20,639
Delaware
7,839
22,060
Elk
7,151
21,373
Erie
6,088
17,396
Fayette
6,933
19,582
Forest
6,088
17,396
Franklin
6,997
20,639
Fulton
6,997
20,639
Greene
6,933
19,582
Huntingdon
7,397
17,192
Indiana
6,933
19,582
Jefferson
7,397
17,192
Juniata
6,997
20,639
Lackawanna
7,282
19,690
Lancaster
7,546
21,105
Lawrence
6,933
19,582
Lebanon
6,997
20,639
Lehigh
7,272
23,760
Luzerne
7,282
19,690
Lycoming
7,282
19,690
McKean
6,088
17,396
Mercer
6,088
17,396
Mifflin
7,272
23,760
Monroe
7,282
19,690
Montgomery
7,839
22,060
Montour
7,272
23,760
Northampton
7,272
23,760
Northumberland
7,272
23,760
Perry
6,997
20,639
Philadelphia
7,839
22,060
Pike
7,282
19,690
Potter
7,151
21,373
Schuylkill
7,272
23,760
Snyder
7,272
23,760
Somerset
7,397
17,192
Sullivan
7,282
19,690
2021 Average Premium Tables
Rhode Island
South Dakota
21,309
South Carolina
County
Employee- Dependent,
Only
Family, etc.
Aurora
8,300
23,257
Employee- Dependent,
Only
Family, etc.
Beadle
7,514
22,096
County
Bennett
7,426
20,355
Abbeville
8,099
20,919
Bon Homme
8,300
23,257
Aiken
7,541
20,086
Brookings
7,514
22,096
Allendale
7,842
20,831
Brown
7,514
22,096
Anderson
7,847
20,959
Brule
8,300
23,257
Bamberg
6,954
20,530
Buffalo
8,300
23,257
Barnwell
6,912
19,914
Butte
7,426
20,355
Beaufort
7,986
20,613
Campbell
7,514
22,096
Berkeley
7,424
19,824
Charles Mix
8,300
23,257
Calhoun
7,341
19,962
Clark
7,514
22,096
Charleston
7,415
21,744
Clay
7,262
20,479
Cherokee
7,379
19,592
Codington
7,514
22,096
Chester
8,071
21,109
Corson
7,426
20,355
Chesterfield
7,763
20,670
Custer
7,426
20,355
Clarendon
6,716
20,634
Davison
8,300
23,257
Colleton
7,919
20,163
Day
7,514
22,096
Darlington
8,319
20,569
Deuel
7,514
22,096
Dillon
8,040
19,816
Dewey
7,426
20,355
Dorchester
9,023
20,762
Douglas
8,300
23,257
Edgefield
6,523
19,546
Edmunds
7,514
22,096
Fairfield
7,982
20,184
Fall River
7,426
20,355
Florence
8,165
21,485
Faulk
7,514
22,096
Georgetown
8,100
19,278
Grant
7,514
22,096
Greenville
8,011
21,322
Gregory
7,426
20,355
Greenwood
6,760
19,800
Haakon
7,426
20,355
Hampton
8,281
20,203
Hamlin
7,514
22,096
Horry
7,012
21,673
Hand
8,300
23,257
Jasper
7,754
20,106
Hanson
8,300
23,257
Kershaw
8,349
21,301
Harding
7,426
20,355
Lancaster
8,029
20,176
Hughes
8,300
23,257
Laurens
7,618
20,138
Hutchinson
8,300
23,257
Lee
7,703
20,075
Hyde
8,300
23,257
Lexington
8,215
21,027
Jackson
7,426
20,355
Marion
8,491
21,351
Jerauld
8,300
23,257
Marlboro
7,995
20,375
Jones
7,426
20,355
-25-
Kingsbury
7,514
22,096
DeKalb
6,067
16,567
Robertson
6,583
18,999
Lake
7,262
20,479
Dickson
6,673
15,728
Rutherford
6,583
18,999
Lawrence
7,426
20,355
Dyer
6,825
20,883
Scott
6,173
17,996
Lincoln
7,262
20,479
Fayette
6,415
18,799
Sequatchie
6,780
18,618
Lyman
7,426
20,355
Fentress
6,067
16,567
Sevier
6,173
17,996
Marshall
7,514
22,096
Franklin
6,780
18,618
Shelby
6,415
18,799
McCook
7,262
20,479
Gibson
6,825
20,883
Smith
6,067
16,567
McPherson
7,514
22,096
Giles
6,673
15,728
Stewart
6,673
15,728
Meade
7,426
20,355
Grainger
6,173
17,996
Sullivan
6,052
18,355
Mellette
7,426
20,355
Greene
6,052
18,355
Sumner
6,583
18,999
Miner
8,300
23,257
Grundy
6,780
18,618
Tipton
6,415
18,799
Minnehaha
7,262
20,479
Hamblen
6,173
17,996
Trousdale
6,583
18,999
Moody
7,262
20,479
Hamilton
6,780
18,618
Unicoi
6,052
18,355
Pennington
7,426
20,355
Hancock
6,052
18,355
Union
6,173
17,996
Perkins
7,426
20,355
Hardeman
6,825
20,883
Van Buren
6,067
16,567
Potter
7,514
22,096
Hardin
6,825
20,883
Warren
6,067
16,567
Roberts
7,514
22,096
Hawkins
6,052
18,355
Washington
6,052
18,355
Sanborn
8,300
23,257
Haywood
6,415
18,799
Wayne
6,673
15,728
Shannon
7,426
20,355
Henderson
6,825
20,883
Weakley
6,825
20,883
Spink
7,514
22,096
Henry
6,825
20,883
White
6,067
16,567
Stanley
7,426
20,355
Hickman
6,673
15,728
Williamson
6,583
18,999
Sully
8,300
23,257
Houston
6,673
15,728
Wilson
6,583
18,999
Todd
7,426
20,355
Humphreys
6,673
15,728
Tripp
7,426
20,355
Jackson
6,067
16,567
Turner
7,262
20,479
Jefferson
6,173
17,996
Union
7,262
20,479
Johnson
6,052
18,355
County
Employee- Dependent,
Only
Family, etc.
Walworth
7,514
22,096
Knox
6,173
17,996
Anderson
7,549
18,696
7,549
18,696
Texas
Yankton
8,300
23,257
Lake
6,825
20,883
Andrews
Ziebach
7,426
20,355
Lauderdale
6,415
18,799
Angelina
7,549
18,696
15,728
Aransas
7,523
23,184
8,440
19,625
Lawrence
Tennessee
County
Employee- Dependent,
Only
Family, etc.
6,673
Lewis
6,673
15,728
Archer
Lincoln
6,673
15,728
Armstrong
9,936
22,167
17,996
Atascosa
6,869
17,544
6,858
22,358
Loudon
6,173
Anderson
6,173
17,996
Macon
6,067
16,567
Austin
Bedford
6,673
15,728
Madison
6,825
20,883
Bailey
7,549
18,696
Benton
6,825
20,883
Marion
6,780
18,618
Bandera
6,869
17,544
Bledsoe
6,780
18,618
Marshall
6,673
15,728
Bastrop
6,830
20,191
Blount
6,173
17,996
Maury
6,673
15,728
Baylor
7,549
18,696
Bradley
6,780
18,618
McMinn
6,780
18,618
Bee
7,549
18,696
Campbell
6,173
17,996
McNairy
6,825
20,883
Bell
7,339
16,416
Cannon
6,067
16,567
Meigs
6,780
18,618
Bexar
6,869
17,544
Carroll
6,825
20,883
Monroe
6,173
17,996
Blanco
7,549
18,696
Carter
6,052
18,355
Montgomery
6,583
18,999
Borden
7,549
18,696
Cheatham
6,583
18,999
15,728
Bosque
7,549
18,696
Chester
6,825
20,883
Morgan
6,173
17,996
Bowie
6,460
17,651
Claiborne
6,173
17,996
Obion
6,825
20,883
Brazoria
6,858
22,358
Clay
6,067
16,567
16,567
Brazos
6,856
19,688
Cocke
6,173
17,996
Perry
6,673
15,728
Brewster
7,549
18,696
Coffee
6,673
15,728
Pickett
6,067
16,567
Briscoe
7,549
18,696
Crockett
6,825
20,883
18,618
Brooks
7,549
18,696
7,549
18,696
Moore
Overton
Polk
6,673
6,067
6,780
Cumberland
6,067
16,567
Putnam
6,067
16,567
Brown
Davidson
6,583
18,999
Rhea
6,780
18,618
Burleson
6,856
19,688
Decatur
6,825
20,883
17,996
Burnet
7,549
18,696
Roane
6,173
-26-
2021 Average Premium Tables
Caldwell
6,830
20,191
Freestone
7,549
18,696
Kimble
7,549
18,696
Calhoun
7,778
19,083
Frio
7,549
18,696
King
7,549
18,696
Callahan
7,399
19,412
Gaines
7,549
18,696
Kinney
7,549
18,696
Cameron
6,716
16,903
Galveston
6,858
22,358
Kleberg
7,549
18,696
Camp
7,549
18,696
Garza
7,549
18,696
Knox
7,549
18,696
Carson
9,936
22,167
Gillespie
7,549
18,696
Lamar
7,549
18,696
Cass
7,549
18,696
Glasscock
7,549
18,696
Lamb
7,549
18,696
Castro
7,549
18,696
Goliad
7,778
19,083
Lampasas
7,339
16,416
Chambers
6,858
22,358
Gonzales
7,549
18,696
LaSalle
7,549
18,696
Cherokee
7,549
18,696
Gray
7,549
18,696
Lavaca
7,549
18,696
Childress
7,549
18,696
Grayson
7,707
18,670
Lee
7,549
18,696
Clay
8,440
19,625
Gregg
6,073
22,987
Leon
7,549
18,696
Cochran
7,549
18,696
Grimes
7,549
18,696
Liberty
6,858
22,358
Coke
7,549
18,696
Guadalupe
6,869
17,544
Limestone
7,549
18,696
Coleman
7,549
18,696
Hale
7,549
18,696
Lipscomb
7,549
18,696
Collin
7,839
22,047
Hall
7,549
18,696
Live Oak
7,549
18,696
Collingsworth
7,549
18,696
Hamilton
7,549
18,696
Llano
7,549
18,696
Colorado
7,549
18,696
Hansford
7,549
18,696
Loving
7,549
18,696
Comal
6,869
17,544
Hardeman
7,549
18,696
Lubbock
6,117
20,071
Comanche
7,549
18,696
Hardin
8,776
22,480
Lynn
7,549
18,696
Concho
7,549
18,696
Harris
6,858
22,358
Madison
7,549
18,696
Cooke
7,549
18,696
Harrison
7,549
18,696
Marion
7,549
18,696
Coryell
7,339
16,416
Hartley
7,549
18,696
Martin
7,549
18,696
Cottle
7,549
18,696
Haskell
7,549
18,696
Mason
7,549
18,696
Crane
7,549
18,696
Hays
6,830
20,191
Matagorda
7,549
18,696
Crockett
7,549
18,696
Hemphill
7,549
18,696
Maverick
7,549
18,696
Crosby
6,117
20,071
Henderson
7,549
18,696
McCulloch
7,549
18,696
Culberson
7,549
18,696
Hidalgo
7,941
19,219
McLennan
5,696
15,474
Dallam
7,549
18,696
Hill
7,549
18,696
McMullen
7,549
18,696
Dallas
7,839
22,047
Hockley
7,549
18,696
Medina
6,869
17,544
Dawson
7,549
18,696
Hood
7,549
18,696
Menard
7,549
18,696
Deaf Smith
7,549
18,696
Hopkins
7,549
18,696
Midland
6,720
18,951
Delta
7,839
22,047
Houston
7,549
18,696
Milam
7,549
18,696
Denton
7,839
22,047
Howard
7,549
18,696
Mills
7,549
18,696
DeWitt
7,549
18,696
Hudspeth
7,549
18,696
Mitchell
7,549
18,696
Dickens
7,549
18,696
Hunt
7,839
22,047
Montague
7,549
18,696
Dimmit
7,549
18,696
Hutchinson
7,549
18,696
Montgomery
6,858
22,358
Donley
7,549
18,696
Irion
9,685
18,365
Moore
7,549
18,696
Duval
7,549
18,696
Jack
7,549
18,696
Morris
7,549
18,696
Eastland
7,549
18,696
Jackson
7,549
18,696
Motley
7,549
18,696
Ector
8,911
19,166
Jasper
7,549
18,696
Nacogdoches
7,549
18,696
Edwards
7,549
18,696
Jeff Davis
7,549
18,696
Navarro
7,549
18,696
El Paso
7,581
16,149
Jefferson
8,776
22,480
Newton
7,549
18,696
Ellis
7,839
22,047
Jim Hogg
7,549
18,696
Nolan
7,549
18,696
Erath
7,549
18,696
Jim Wells
7,549
18,696
Nueces
7,523
23,184
Falls
7,549
18,696
Johnson
7,839
22,047
Ochiltree
7,549
18,696
Fannin
7,549
18,696
Jones
7,399
19,412
Oldham
7,549
18,696
Fayette
7,549
18,696
Karnes
7,549
18,696
Orange
8,776
22,480
Fisher
7,549
18,696
Kaufman
7,839
22,047
Palo Pinto
7,549
18,696
Floyd
7,549
18,696
Kendall
6,869
17,544
Panola
7,549
18,696
Foard
7,549
18,696
Kenedy
7,549
18,696
Parker
7,839
22,047
Fort Bend
6,858
22,358
Kent
7,549
18,696
Parmer
7,549
18,696
Franklin
7,549
18,696
Kerr
7,549
18,696
Pecos
7,549
18,696
2021 Average Premium Tables
-27-
Virginia
Polk
7,549
18,696
Webb
7,455
20,274
Potter
9,936
22,167
Wharton
7,549
18,696
Presidio
7,549
18,696
Wheeler
7,549
18,696
County
Employee- Dependent,
Only
Family, etc.
Rains
7,549
18,696
Wichita
8,440
19,625
Accomack
7,346
19,191
Randall
9,936
22,167
Wilbarger
7,549
18,696
Albemarle
8,418
21,460
Reagan
7,549
18,696
Willacy
7,549
18,696
Alexandria City
7,542
23,327
7,346
19,191
Real
7,549
18,696
Williamson
6,830
20,191
Alleghany
Red River
7,549
18,696
Wilson
6,869
17,544
Amelia
7,131
22,408
Reeves
7,549
18,696
Winkler
7,549
18,696
Amherst
6,596
18,936
6,596
18,936
Refugio
7,549
18,696
Wise
7,839
22,047
Appomattox
Roberts
7,549
18,696
Wood
7,549
18,696
Arlington
7,542
23,327
Robertson
6,856
19,688
Yoakum
7,549
18,696
Augusta
7,346
19,191
7,346
19,191
Rockwall
7,839
22,047
Young
7,549
18,696
Bath
Runnels
7,549
18,696
Zapata
7,549
18,696
Bedford
6,596
18,936
Rusk
6,073
22,987
Zavala
7,549
18,696
Bedford City
6,596
18,936
Bland
7,346
19,191
Botetourt
7,502
22,437
7,629
18,046
Sabine
7,549
18,696
San Augustine
7,549
18,696
San Jacinto
6,858
22,358
Utah
Employee- Dependent,
Only
Family, etc.
Bristol City
San Patricio
7,523
23,184
County
Brunswick
7,346
19,191
San Saba
7,549
18,696
Beaver
6,852
20,098
Buchanan
7,346
19,191
Schleicher
7,549
18,696
Box Elder
6,892
18,718
Buckingham
7,346
19,191
7,110
20,044
Scurry
7,549
18,696
Cache
Buena Vista City
7,346
19,191
Shackelford
7,549
18,696
Carbon
6,852
20,098
Campbell
6,596
18,936
18,696
Daggett
6,852
20,098
Caroline
7,131
22,408
6,373
19,108
Shelby
7,549
Sherman
7,549
18,696
Davis
Carroll
7,346
19,191
Smith
7,149
22,893
Duchesne
6,852
20,098
Charles City
7,131
22,408
18,696
Emery
6,852
20,098
Charlotte
7,346
19,191
6,852
20,098
Somervell
7,549
Starr
7,549
18,696
Garfield
Charlottesville City
8,418
21,460
Stephens
7,549
18,696
Grand
6,852
20,098
Chesapeake City
7,659
21,119
18,696
Iron
7,759
18,607
Chesterfield
7,131
22,408
6,852
20,098
Sterling
7,549
Stonewall
7,549
18,696
Juab
Clarke
7,542
23,327
Sutton
7,549
18,696
Kane
6,852
20,098
Colonial Heights City
7,131
22,408
18,696
Millard
6,852
20,098
Covington City
7,346
19,191
6,892
18,718
Swisher
7,549
Tarrant
7,839
22,047
Morgan
Craig
7,502
22,437
Taylor
7,399
19,412
Piute
6,852
20,098
Culpeper
7,346
19,191
7,110
20,044
Terrell
7,549
18,696
Rich
Cumberland
7,131
22,408
Terry
7,549
18,696
Salt Lake
6,373
19,108
Danville City
8,956
21,176
Throckmorton
7,549
18,696
San Juan
6,852
20,098
Dickenson
7,346
19,191
6,852
20,098
Titus
7,549
18,696
Sanpete
Dinwiddie
7,131
22,408
Tom Green
9,685
18,365
Sevier
6,852
20,098
Emporia City
7,346
19,191
Travis
6,830
20,191
Summit
6,373
19,108
Essex
7,346
19,191
6,373
19,108
Trinity
7,549
18,696
Tooele
Fairfax
7,542
23,327
Tyler
7,549
18,696
Uintah
6,852
20,098
Fairfax City
7,542
23,327
22,987
Utah
5,832
19,513
Falls Church City
7,542
23,327
6,373
19,108
Upshur
6,073
Upton
7,549
18,696
Wasatch
Fauquier
7,542
23,327
Uvalde
7,549
18,696
Washington
7,759
18,607
Floyd
7,346
19,191
18,696
Wayne
6,852
20,098
Fluvanna
8,418
21,460
Weber
6,892
18,718
Franklin
7,502
22,437
Franklin City
7,346
19,191
Frederick
7,139
19,737
Fredericksburg City
7,542
23,327
Galax City
7,346
19,191
Giles
6,887
20,744
Val Verde
7,549
Van Zandt
7,549
18,696
Victoria
7,778
19,083
Walker
7,549
18,696
Waller
6,858
22,358
Ward
7,549
18,696
Washington
7,549
18,696
Vermont
County
Employee- Dependent,
Only
Family, etc.
All
7,718
-28-
21,717
2021 Average Premium Tables
Gloucester
7,659
21,119
Radford City
6,887
20,744
Kittitas
7,178
18,564
Goochland
7,131
22,408
Rappahannock
7,346
19,191
Klickitat
7,145
18,452
Grayson
7,346
19,191
Richmond
7,346
19,191
Lewis
7,920
19,530
Greene
8,418
21,460
Richmond City
7,131
22,408
Lincoln
6,427
16,070
Greensville
7,346
19,191
Roanoke
7,502
22,437
Mason
7,920
19,530
Halifax
7,346
19,191
Roanoke City
7,502
22,437
Okanogan
7,178
18,564
Hampton City
7,659
21,119
Rockbridge
7,346
19,191
Pacific
7,920
19,530
Hanover
7,131
22,408
Rockingham
7,202
21,742
Pend Oreille
6,427
16,070
Harrisonburg City
7,202
21,742
Russell
7,346
19,191
Pierce
7,920
19,530
Henrico
7,131
22,408
Salem City
7,502
22,437
San Juan
7,920
19,530
Henry
7,346
19,191
Scott
7,629
18,046
Skagit
7,920
19,530
Highland
7,346
19,191
Shenandoah
7,346
19,191
Skamania
7,145
18,452
Hopewell City
7,131
22,408
Smyth
7,346
19,191
Snohomish
7,920
19,530
Isle of Wight
7,659
21,119
Southampton
7,346
19,191
Spokane
6,427
16,070
James City
7,659
21,119
Spotsylvania
7,542
23,327
Stevens
6,427
16,070
King and Queen
7,131
22,408
Stafford
7,542
23,327
Thurston
7,920
19,530
King George
7,346
19,191
Staunton City
7,346
19,191
Wahkiakum
7,920
19,530
King William
7,131
22,408
Suffolk City
7,659
21,119
Walla Walla
7,178
18,564
Lancaster
7,346
19,191
Surry
7,659
21,119
Whatcom
7,920
19,530
Lee
7,346
19,191
Sussex
7,131
22,408
Whitman
7,178
18,564
Lexington City
7,346
19,191
Tazewell
7,346
19,191
Yakima
7,178
18,564
Loudoun
7,542
23,327
Virginia Beach City
7,659
21,119
Louisa
7,131
22,408
Warren
7,542
23,327
Lunenburg
7,346
19,191
Washington
7,629
18,046
Lynchburg City
6,596
18,936
Waynesboro City
7,346
19,191
County
Employee- Dependent,
Only
Family, etc.
Madison
7,346
19,191
Westmoreland
7,346
19,191
Barbour
8,041
20,190
21,119
Berkeley
7,226
21,137
7,779
25,595
Manassas City
7,542
23,327
Williamsburg City
7,659
West Virginia
Manassas Park City
7,542
23,327
Winchester City
7,139
19,737
Boone
Martinsville City
7,346
19,191
Wise
7,346
19,191
Braxton
7,918
22,618
19,191
Brooke
7,541
22,840
21,119
Cabell
6,855
21,267
Calhoun
7,918
22,618
Clay
7,918
22,618
Doddridge
6,995
20,375
Mathews
7,659
21,119
Mecklenburg
7,346
19,191
Middlesex
7,346
19,191
Montgomery
6,887
20,744
Wythe
York
7,346
7,659
Washington
Nelson
8,418
21,460
New Kent
7,131
22,408
County
Employee- Dependent,
Only
Family, etc.
Fayette
7,918
22,618
7,178
18,564
Gilmer
6,995
20,375
Newport News City
7,659
21,119
Adams
Norfolk City
7,659
21,119
Asotin
7,178
18,564
Grant
6,607
18,713
Northampton
7,346
19,191
Benton
7,178
18,564
Greenbrier
7,918
22,618
7,178
18,564
Hampshire
6,607
18,713
Northumberland
7,346
19,191
Chelan
Norton City
7,346
19,191
Clallam
7,920
19,530
Hancock
7,541
22,840
Nottoway
7,346
19,191
Clark
7,145
18,452
Hardy
6,607
18,713
7,178
18,564
Harrison
8,041
20,190
Orange
7,346
19,191
Columbia
Page
7,346
19,191
Cowlitz
7,920
19,530
Jackson
8,689
22,655
19,191
Douglas
7,178
18,564
Jefferson
7,226
21,137
6,427
16,070
Kanawha
8,584
21,661
Patrick
7,346
Petersburg City
7,131
22,408
Ferry
Pittsylvania
8,956
21,176
Franklin
7,178
18,564
Lewis
6,995
20,375
21,119
Garfield
7,178
18,564
Lincoln
7,779
25,595
7,178
18,564
Logan
7,779
25,595
Poquoson
7,659
Portsmouth City
7,659
21,119
Grant
Powhatan
7,131
22,408
Grays Harbor
7,920
19,530
Marion
6,995
20,375
19,191
Island
7,920
19,530
Marshall
7,541
22,840
7,920
19,530
Mason
6,855
21,267
Prince Edward
7,346
Prince George
7,131
22,408
Jefferson
Prince William
7,542
23,327
King
7,650
20,561
McDowell
7,779
25,595
20,744
Kitsap
7,920
19,530
Mercer
7,406
20,390
Pulaski
6,887
2021 Average Premium Tables
-29-
Mineral
6,607
18,713
Dodge
6,535
18,262
Sawyer
7,985
22,651
Mingo
7,779
25,595
Door
6,654
19,193
Shawano
6,654
19,193
Monongalia
6,995
20,375
Douglas
7,985
22,651
Sheboygan
6,535
18,262
Monroe
7,406
20,390
Dunn
8,268
22,331
St. Croix
8,366
20,588
Morgan
6,607
18,713
Eau Claire
8,268
22,331
Taylor
7,523
19,467
Nicholas
7,918
22,618
Florence
6,621
18,403
Trempealeau
6,947
19,611
Ohio
7,541
22,840
Fond du Lac
6,535
18,262
Vernon
8,132
20,925
Pendleton
6,607
18,713
Forest
6,621
18,403
Vilas
6,621
18,403
Pleasants
8,689
22,655
Grant
8,132
20,925
Walworth
6,843
23,239
Pocahontas
8,041
20,190
Green
6,843
23,239
Washburn
7,985
22,651
Preston
8,041
20,190
Green Lake
6,268
23,908
Washington
7,117
20,253
Putnam
6,855
21,267
Iowa
8,132
20,925
Waukesha
7,117
20,253
Raleigh
7,406
20,390
Iron
6,621
18,403
Waupaca
6,535
18,262
Randolph
8,041
20,190
Jackson
6,947
19,611
Waushara
6,535
18,262
Ritchie
8,689
22,655
Jefferson
6,843
23,239
Winnebago
6,535
18,262
Roane
7,918
22,618
Juneau
6,268
23,908
Wood
7,721
21,981
Summers
7,406
20,390
Kenosha
7,404
22,066
Taylor
8,041
20,190
Kewaunee
6,654
19,193
Tucker
8,041
20,190
La Crosse
6,947
19,611
Tyler
8,689
22,655
Lafayette
8,132
20,925
County
Employee- Dependent,
Only
Family, etc.
Upshur
8,041
20,190
Langlade
6,621
18,403
Albany
8,544
22,712
8,544
22,712
Wyoming
Wayne
6,855
21,267
Lincoln
7,721
21,981
Big Horn
Webster
8,041
20,190
Manitowoc
6,654
19,193
Campbell
8,544
22,712
21,981
Carbon
8,544
22,712
8,544
22,712
Wetzel
6,995
20,375
Marathon
7,721
Wirt
8,689
22,655
Marinette
6,654
19,193
Converse
Wood
8,689
22,655
Marquette
6,268
23,908
Crook
8,544
22,712
19,193
Fremont
8,544
22,712
8,544
22,712
Wyoming
7,779
25,595
Wisconsin
Menomonee
6,654
Milwaukee
7,245
23,079
Goshen
Monroe
6,947
19,611
Hot Springs
8,544
22,712
19,193
Johnson
8,544
22,712
8,671
22,003
Employee- Dependent,
Only
Family, etc.
Oconto
County
Oneida
6,621
18,403
Laramie
Adams
6,268
23,908
Outagamie
6,535
18,262
Lincoln
8,544
22,712
Ashland
7,985
22,651
20,253
Natrona
8,389
21,674
8,544
22,712
Ozaukee
6,654
7,117
Barron
7,523
19,467
Pepin
8,268
22,331
Niobrara
Bayfield
7,985
22,651
Pierce
8,366
20,588
Park
8,544
22,712
Brown
6,654
19,193
Polk
8,366
20,588
Platte
8,544
22,712
Buffalo
6,947
19,611
Portage
7,721
21,981
Sheridan
8,544
22,712
Burnett
7,985
22,651
Price
7,523
19,467
Sublette
8,544
22,712
Calumet
6,535
18,262
Racine
7,404
22,066
Sweetwater
8,544
22,712
Chippewa
8,268
22,331
Richland
6,268
23,908
Teton
8,544
22,712
Clark
7,523
19,467
Rock
6,843
23,239
Uinta
8,544
22,712
Columbia
6,843
23,239
Rusk
7,523
19,467
Washakie
8,544
22,712
Crawford
8,132
20,925
Sauk
6,268
23,908
Weston
8,544
22,712
Dane
6,980
21,819
-30-
2021 Average Premium Tables
| File Type | application/pdf |
| File Title | 2021 Instructions for Form 8941 |
| Subject | Instructions for Form 8941, Credit for Small Employer Health Insurance Premiums |
| Author | W:CAR:MP:FP |
| File Modified | 2021-12-15 |
| File Created | 2021-12-13 |