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2022
Instructions for Form 8941
Department of the Treasury
Internal Revenue Service
Credit for Small Employer Health Insurance Premiums
DRAFT AS OF
November 22, 2022
Partnerships, S corporations, cooperatives,
Section references are to the Internal Revenue Code
unless otherwise noted.
TIP estates, trusts, and tax-exempt eligible small
Future Developments
For the latest information about developments related to
Form 8941 and its instructions, such as legislation
enacted after they were published, go to IRS.gov/
Form8941.
Reminder
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 later) 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
tax under section 1381 may be able to claim the credit as
a general business credit, as discussed next.
For all other eligible small employers, the maximum
credit is 50% of premiums paid 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.
Nov 17, 2022
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 who 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.
!
3. You paid average annual wages for the tax year of
less than $58,000 per FTE. For details, see Worksheets
1 and 3.
Cat. No. 55222U
If you had more than 10 FTEs and average
annual wages of more than $28,000, 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 $58,000.
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).
DRAFT AS OF
November 22, 2022
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.
Dependent coverage. Dependent coverage is generally
coverage offered separately to an individual who is or may
become eligible for coverage under the terms of a group
health plan because of a relationship to a
participant-employee, whether or not a dependent of the
participant-employee. Dependent coverage doesn’t
include coverage, such as family coverage, which
includes coverage of the participant-employee. If you pay
part or all of the cost of an employee’s dependent
coverage, use the amount you paid to figure your
employer premiums paid.
No more than one Form 8941 can be filed with a
TIP tax return, unless the exception described in
Example 2 below applies.
Example 1. You’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
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
Credit Period
For tax years beginning after 2013, the credit period
during which the credit can be claimed is a
2-consecutive-tax-year period beginning with the first tax
year in which:
• An eligible small employer (or any predecessor) files an
income tax return with an attached Form 8941 with line A
checked “Yes” and a positive amount on line 12, or
• A tax-exempt eligible small employer (or any
predecessor) files Form 990-T with an attached Form
8941 with line A checked “Yes” and a positive amount on
line 12.
Employer Premiums Paid
Only premiums you paid for health insurance coverage
under a qualifying arrangement (discussed later) for
individuals considered employees are counted when
figuring your credit.
-2-
Instructions for Form 8941 (2022)
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.
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
DRAFT AS OF
November 22, 2022
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.
!
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
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
Instructions for Form 8941 (2022)
Arrangements with list billing and other tiers of coverage. An arrangement that requires you to pay a
separate premium for each employee based on age or
other factors (list billing) that provides other tiers of
coverage can be a qualifying arrangement even if it
requires you to pay a uniform percentage that is less than
50% of the premium cost for some employees. It is a
qualifying arrangement (assuming employee-only
coverage is the least expensive tier of coverage) if it
-3-
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.
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).
Payroll Tax Limitation for Tax-Exempt
Eligible Small Employers
DRAFT AS OF
November 22, 2022
The credit for tax-exempt eligible small employers can’t
exceed the amount of certain payroll taxes. For tax years
beginning in 2022, 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 2022.
• Medicare taxes the tax-exempt employer was required
to withhold from employees’ wages in calendar year 2022.
• Medicare taxes the tax-exempt employer was required
to pay for calendar year 2022.
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
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.
Answer “Yes” if one of the following applies.
• You paid premiums for employee health insurance
coverage you provided through a SHOP Marketplace or
through a direct enrollment process, if available in your
state.
Line A
-4-
Instructions for Form 8941 (2022)
• 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 answer “Yes” because you paid premiums for
employee health insurance coverage you provided
through a SHOP Marketplace, enter the Marketplace
identifier, if any.
If you need more rows, use a separate sheet and include
the additional amounts in the totals below.
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.
DRAFT AS OF
November 22, 2022
(a)
Individuals
Considered
Employees
(b)
Employee
Hours of
Service
(c)
Employee
Wages
Paid
1.
Waiver for Hawaii. Hawaii has received a 5-year State
Innovation Waiver under section 1332 of the Affordable
Care Act that has been extended for 5 more years.
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.
2.
3.
4.
5.
6.
Exception for eligible small employers in certain
counties. For calendar year 2022, 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 2022 if they
properly claimed the credit under section 45R for all or
part of 2021. For details, see Notice 2018-27, 2018-20,
I.R.B. 580, available at IRS.gov/irb/
2018-20_IRB#NOT-2018-27.
7.
8.
9.
10.
11.
12.
13.
14.
To see whether a particular county has coverage
15.
TIP available through a SHOP Exchange for 2022 and
16.
beyond, go to Healthcare.gov/small-business and
enter “plans and prices” in the search box.
17.
18.
Line C
19.
Answer “Yes” if a tax return you (or any predecessor) filed
for a tax year beginning after 2013 and before 2021
included a Form 8941 with line A checked “Yes” and
line 12 showing a positive amount. For more information,
see Credit Period, earlier.
20.
21.
22.
23.
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.
24.
25.
Totals:
Column (a), Individuals Considered
Employees
Enter the name or other identifying information for all
individuals considered employees for purposes of this
credit.
In general, all employees who perform services for you
during the tax year are taken into account in determining
your FTEs, average annual wages, and premiums paid.
Rules that apply to certain types of employees are
discussed below.
Instructions for Form 8941 (2022)
-5-
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 the minister’s 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.
DRAFT AS OF
November 22, 2022
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 the
employee does all the following.
• Provides services to you under an agreement between
you and a leasing organization.
• Has performed services for you (or for you and a
related person) substantially full time for at least 1 year.
• Performs services under your primary direction or
control.
But don’t use hours, wages, or premiums paid with
respect to the initial year of service on which leased
employee status is based.
Seasonal employees. Employees who perform labor or
services on a seasonal basis and perform labor or
services for you 120 or fewer days during the tax year
aren’t considered employees in determining FTEs and
average annual wages. But premiums paid on their behalf
are counted in determining the amount of the credit.
Seasonal workers include retail workers employed
exclusively during holiday seasons. Seasonal workers
also include workers employed exclusively during the
summer.
Column (c), Employee Wages Paid
!
CAUTION
Complete Worksheet 2 before you complete
column (c) of Worksheet 1. Do not complete
column (c) if Worksheet 2, line 3, is 25 or more.
Enter the total wages paid for the tax year for each
employee listed in column (a). But enter -0- for seasonal
employees who worked 120 or fewer days during the tax
year.
Household and other nonbusiness employees.
Household employees and other employees who aren’t
performing services in your trade or business are
considered employees if they otherwise qualify, as
-6-
Instructions for Form 8941 (2022)
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.
DRAFT AS OF
November 22, 2022
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 $28,000 for the tax year. If you paid average
annual wages of $58,000 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 (2022)
-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
DRAFT AS OF
November 22, 2022
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 2022, 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 $28,000)
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 $28,700 from
line 3 . . . . . . . . . . . . . . . . . .
4.
5. Divide line 4 by $28,700. 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 (2022)
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.
DRAFT AS OF
November 22, 2022
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 2022.
• Medicare taxes the tax-exempt employer was required
to withhold from employees’ wages in calendar year 2022.
• Medicare taxes the tax-exempt employer was required
to pay for calendar year 2022.
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 (2022)
-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 2022.
Limestone
7,165
23,301
Petersburg
11,771
28,522
Lowndes
8,391
23,453
Prince of Wales-Hyder 11,771
28,522
DRAFT AS OF
November 22, 2022
Alabama
Macon
7,241
20,533
Sitka
11,771
28,522
Madison
7,165
23,301
Skagway
11,771
28,522
Marengo
7,241
20,533
Southeast Fairbanks
12,011
27,855
Marion
7,241
20,533
Valdez Cordova
11,303
28,132
7,241
20,533
Wade Hampton
12,011
27,855
Wrangell City and
Borough
11,771
28,522
Yakutat
12,011
27,855
Yukon Koyukuk
12,011
27,855
County
Employee- Dependent,
Only
Family, etc.
Marshall
Mobile
7,468
22,163
Autauga
8,391
23,453
Monroe
7,241
20,533
Baldwin
7,241
20,533
Montgomery
8,391
23,453
Barbour
7,241
20,533
Morgan
7,893
19,596
Bibb
6,892
22,250
Perry
7,241
20,533
Blount
6,892
22,250
Pickens
7,241
20,533
Bullock
7,241
20,533
Pike
7,241
20,533
Butler
7,241
20,533
Randolph
7,241
20,533
Calhoun
6,836
20,924
Russell
7,210
21,092
Chambers
7,241
20,533
Shelby
6,892
22,250
Cherokee
7,241
20,533
St. Clair
6,892
22,250
Chilton
6,892
22,250
Sumter
7,241
20,533
Choctaw
7,241
20,533
Talladega
7,241
20,533
Clarke
7,241
20,533
Tallapoosa
7,241
20,533
Clay
7,241
20,533
Tuscaloosa
7,665
21,879
Cleburne
7,241
20,533
Walker
6,892
22,250
Coffee
7,241
20,533
Washington
7,241
20,533
Colbert
8,701
22,158
Wilcox
7,241
20,533
Conecuh
7,241
20,533
Winston
7,241
20,533
Coosa
7,241
20,533
Covington
7,241
20,533
Crenshaw
7,241
20,533
Cullman
7,241
20,533
County
Employee- Dependent,
Only
Family, etc.
Dale
7,241
20,533
Aleutians East
12,011
27,855
Dallas
7,241
20,533
Aleutians West
12,011
27,855
DeKalb
7,241
20,533
Anchorage
11,303
28,132
Elmore
8,391
23,453
Bethel
11,303
28,132
Escambia
7,241
20,533
Bristol Bay
12,011
27,855
Etowah
6,539
22,226
Denali
12,011
27,855
Fayette
7,241
20,533
Dillingham
11,303
28,132
Franklin
7,241
20,533
Fairbanks North Star
12,011
27,855
Geneva
7,505
22,014
Haines
11,771
28,522
Greene
7,665
21,879
Hoonah-Angoon
11,771
28,522
Hale
7,665
21,879
Juneau
11,771
28,522
Henry
7,505
22,014
Kenai Peninsula
12,011
27,855
Houston
7,505
22,014
Ketchikan Gateway
11,771
28,522
Jackson
7,241
20,533
Kodiak Island
12,011
27,855
Jefferson
6,892
22,250
Lake and Peninsula
12,011
27,855
Lamar
7,241
20,533
Matanuska Susitna
12,011
27,855
Lauderdale
8,701
22,158
Nome
12,011
27,855
Lawrence
7,893
19,596
North Slope
12,011
27,855
Lee
6,396
18,677
Northwest Arctic
12,011
27,855
Alaska
-10-
Arizona
County
Employee- Dependent,
Only
Family, etc.
Apache
8,205
23,802
Cochise
7,086
21,495
Coconino
8,205
23,802
Gila
7,189
20,592
Graham
7,086
21,495
Greenlee
7,086
21,495
La Paz
8,893
24,548
Maricopa
7,176
22,558
Mohave
8,205
23,802
Navajo
8,205
23,802
Pima
7,513
21,227
Pinal
7,189
20,592
Santa Cruz
7,513
21,227
Yavapai
7,321
21,670
Yuma
8,893
24,548
Arkansas
County
Employee- Dependent,
Only
Family, etc.
Arkansas
7,069
16,975
Ashley
7,069
16,975
Baxter
6,721
21,429
Benton
6,721
21,429
Boone
6,721
21,429
Bradley
7,069
16,975
Calhoun
7,009
23,029
Carroll
6,721
21,429
Chicot
7,069
16,975
Clark
5,177
18,872
Clay
6,792
21,560
Cleburne
6,353
17,802
Cleveland
7,069
16,975
Columbia
7,009
23,029
Conway
6,353
17,802
2022 Average Premium Tables
Craighead
6,792
21,560
Stone
6,792
21,560
Santa Clara
9,709
28,911
Crawford
6,120
21,788
Union
7,009
23,029
Santa Cruz
9,395
26,386
Crittenden
6,792
21,560
Van Buren
6,353
17,802
Shasta
9,825
23,668
Cross
6,792
21,560
Washington
6,721
21,429
Sierra
9,825
23,668
Dallas
7,069
16,975
White
6,353
17,802
Siskiyou
9,825
23,668
Desha
7,069
16,975
Woodruff
6,792
21,560
Solano
8,407
22,859
DRAFT AS OF
November 22, 2022
Drew
7,069
16,975
Faulkner
6,353
17,802
Franklin
6,120
21,788
Fulton
6,792
21,560
Garland
5,177
18,872
County
Grant
6,353
17,802
Yell
6,353
17,802
Sonoma
8,407
22,859
Stanislaus
9,008
24,693
Sutter
9,825
23,668
Employee- Dependent,
Only
Family, etc.
Tehama
9,825
23,668
Trinity
9,825
23,668
Alameda
9,991
26,876
Tulare
9,008
24,693
9,825
23,668
California
Greene
6,792
21,560
Alpine
Tuolumne
9,825
23,668
Hempstead
7,009
23,029
Amador
9,825
23,668
Ventura
8,551
25,169
Hot Spring
5,177
18,872
Butte
9,825
23,668
Yolo
8,099
24,093
9,825
23,668
Yuba
9,825
23,668
Howard
7,009
23,029
Calaveras
Independence
6,792
21,560
Colusa
9,825
23,668
Izard
6,792
21,560
Contra Costa
9,461
26,914
Jackson
6,792
21,560
Del Norte
9,825
23,668
Jefferson
7,069
16,975
El Dorado
8,099
24,093
County
Employee- Dependent,
Only
Family, etc.
Johnson
6,120
21,788
Fresno
8,250
25,788
Adams
7,411
21,656
9,825
23,668
Alamosa
8,633
23,653
Colorado
Lafayette
7,009
23,029
Glenn
Lawrence
6,792
21,560
Humboldt
9,825
23,668
Arapahoe
7,411
21,656
16,975
Imperial
7,920
22,422
Archuleta
8,143
24,827
7,920
22,422
Baca
8,633
23,653
Lee
7,069
Lincoln
7,069
16,975
Inyo
Little River
7,009
23,029
Kern
8,576
20,242
Bent
8,633
23,653
21,788
Kings
8,250
25,788
Boulder
7,775
22,089
9,825
23,668
Broomfield
7,411
21,656
Logan
6,120
Lonoke
6,353
17,802
Lake
Madison
6,721
21,429
Lassen
9,825
23,668
Chaffee
8,633
23,653
21,429
Los Angeles
8,516
24,150
Cheyenne
8,633
23,653
8,250
25,788
Clear Creek
7,411
21,656
Marion
6,721
Miller
7,009
23,029
Madera
Mississippi
6,792
21,560
Marin
8,407
22,859
Conejos
8,633
23,653
16,975
Mariposa
9,008
24,693
Costilla
8,633
23,653
9,825
23,668
Crowley
8,633
23,653
Monroe
7,069
Montgomery
5,177
18,872
Mendocino
Nevada
7,009
23,029
Merced
9,008
24,693
Custer
8,633
23,653
9,825
23,668
Delta
8,143
24,827
Newton
6,721
21,429
Modoc
Ouachita
7,009
23,029
Mono
7,920
22,422
Denver
7,411
21,656
Perry
6,353
17,802
Monterey
9,395
26,386
Dolores
8,143
24,827
8,407
22,859
Douglas
7,411
21,656
Phillips
7,069
16,975
Napa
Pike
5,177
18,872
Nevada
9,825
23,668
Eagle
7,932
24,678
Poinsett
6,792
21,560
Orange
9,098
26,021
El Paso
6,583
22,503
8,099
24,093
Elbert
7,411
21,656
Polk
6,120
21,788
Placer
Pope
6,353
17,802
Plumas
9,825
23,668
Fremont
8,633
23,653
17,802
Riverside
8,823
24,188
Garfield
7,932
24,678
8,099
24,093
Gilpin
7,411
21,656
Prairie
6,353
Pulaski
6,353
17,802
Sacramento
Randolph
6,792
21,560
San Benito
9,395
26,386
Grand
8,143
24,827
17,802
San Bernardino
8,823
24,188
Gunnison
8,143
24,827
7,595
19,698
Hinsdale
8,143
24,827
Saline
6,353
Scott
6,120
21,788
San Diego
Searcy
6,721
21,429
San Francisco
9,194
32,092
Huerfano
8,633
23,653
21,788
San Joaquin
9,008
24,693
Jackson
8,143
24,827
8,551
25,169
Jefferson
7,411
21,656
Sebastian
6,120
Sevier
7,009
23,029
San Luis Obispo
Sharp
6,792
21,560
San Mateo
10,893
30,804
Kiowa
8,633
23,653
21,560
Santa Barbara
8,551
25,169
Kit Carson
8,633
23,653
St. Francis
6,792
2022 Average Premium Tables
-11-
Florida
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
Pasco
7,525
22,543
Employee- Dependent,
Only
Family, etc.
Pinellas
7,005
22,139
Polk
7,777
22,081
Alachua
8,141
22,734
Putnam
7,723
23,177
23,653
Baker
7,672
22,501
Santa Rosa
7,366
20,819
21,955
Bay
7,455
21,468
Sarasota
6,965
21,644
DRAFT AS OF
November 22, 2022
Mesa
8,998
21,727
Bradford
7,492
23,023
Seminole
7,715
20,590
Mineral
8,633
23,653
Brevard
8,106
22,087
St. Johns
10,257
27,879
Moffat
8,143
24,827
Broward
7,922
23,328
St. Lucie
7,591
21,601
7,738
22,571
Montezuma
8,143
24,827
Calhoun
Sumter
7,862
24,206
Montrose
8,143
24,827
Charlotte
8,533
25,787
Suwannee
7,168
22,810
Morgan
6,930
21,955
Citrus
7,611
21,534
Taylor
8,601
24,552
7,120
22,922
Otero
8,633
23,653
Clay
Union
7,765
23,505
Ouray
8,143
24,827
Collier
7,988
29,682
Volusia
8,121
20,111
Park
7,411
21,656
Columbia
8,265
24,544
Wakulla
7,275
23,347
7,651
23,403
Walton
7,767
21,234
Washington
7,836
23,329
Phillips
6,930
21,955
DeSoto
Pitkin
7,932
24,678
Dixie
7,677
21,209
Prowers
8,633
23,653
Duval
7,299
22,097
Pueblo
6,993
18,542
Escambia
7,892
21,756
Rio Blanco
8,143
24,827
Flagler
8,191
22,670
Rio Grande
8,633
23,653
Franklin
7,622
23,949
County
Employee- Dependent,
Only
Family, etc.
Routt
8,143
24,827
Gadsden
7,421
23,387
Appling
10,583
27,444
Saguache
8,633
23,653
Gilchrist
7,198
22,553
Atkinson
7,649
20,446
24,827
Glades
8,083
25,093
Bacon
7,155
21,075
8,085
23,360
San Juan
8,143
Georgia
San Miguel
8,143
24,827
Gulf
8,395
23,946
Baker
Sedgwick
6,930
21,955
Hamilton
7,602
22,503
Baldwin
8,673
22,584
24,678
Hardee
7,526
20,987
Banks
8,299
22,594
9,031
21,237
Summit
7,932
Teller
6,583
22,503
Hendry
8,388
24,714
Barrow
Washington
6,930
21,955
Hernando
7,904
23,493
Bartow
7,850
20,580
26,016
Highlands
8,138
25,498
Ben Hill
8,599
24,744
8,599
24,744
Weld
Yuma
8,306
6,930
21,955
Connecticut
Hillsborough
7,740
25,008
Berrien
Holmes
7,599
22,612
Bibb
8,545
18,181
Indian River
7,343
21,289
Bleckley
8,545
18,181
7,155
21,075
Jackson
7,067
20,719
Brantley
Jefferson
8,243
22,557
Brooks
8,599
24,744
10,583
27,444
County
Employee- Dependent,
Only
Family, etc.
Fairfield
9,528
29,578
Lafayette
7,669
21,405
Bryan
Hartford
9,002
26,680
Lake
8,596
24,889
Bulloch
10,583
27,444
Litchfield
8,527
28,343
Lee
7,413
22,838
Burke
8,071
18,720
Middlesex
8,672
27,077
Leon
9,230
28,653
Butts
7,850
20,580
New Haven
9,794
29,443
Levy
7,368
23,288
Calhoun
8,085
23,360
New London
8,729
25,572
Liberty
7,425
22,899
Camden
7,155
21,075
Tolland
8,001
22,920
Madison
8,248
23,532
Candler
10,583
27,444
Windham
8,445
31,760
Manatee
7,718
21,046
Carroll
8,130
23,051
Marion
6,342
20,829
Catoosa
7,913
21,989
7,155
21,075
Delaware
County
Employee- Dependent,
Only
Family, etc.
All
8,846
23,764
District of Columbia
County
Employee- Dependent,
Only
Family, etc.
All
9,368
28,176
Martin
8,016
24,627
Charlton
Miami-Dade
8,031
24,816
Chatham
10,583
27,444
Monroe
8,436
25,476
Chattahoochee
7,316
18,862
8,654
22,271
Nassau
8,332
20,919
Chattooga
Okaloosa
8,059
28,477
Cherokee
7,850
20,580
Okeechobee
8,465
24,963
Clarke
9,031
21,237
8,085
23,360
Orange
7,953
20,908
Clay
Osceola
8,438
24,353
Clayton
7,850
20,580
Palm Beach
8,603
28,912
Clinch
8,599
24,744
-12-
2022 Average Premium Tables
Cobb
7,850
20,580
Lanier
8,599
24,744
Towns
8,299
22,594
Coffee
7,649
20,446
Laurens
7,649
20,446
Treutlen
7,649
20,446
Colquitt
8,599
24,744
Lee
8,085
23,360
Troup
7,316
18,862
Columbia
8,071
18,720
Liberty
10,583
27,444
Turner
8,599
24,744
Cook
8,599
24,744
Lincoln
8,071
18,720
Twiggs
8,545
18,181
Coweta
7,850
20,580
Long
10,583
27,444
Union
8,299
22,594
DRAFT AS OF
November 22, 2022
Crawford
8,545
18,181
Lowndes
8,599
24,744
Upson
7,316
18,862
Crisp
8,085
23,360
Lumpkin
8,299
22,594
Walker
7,913
21,989
Dade
7,913
21,989
Macon
7,316
18,862
Walton
7,850
20,580
Dawson
8,299
22,594
Madison
9,031
21,237
Ware
7,155
21,075
Decatur
8,599
24,744
Marion
7,316
18,862
Warren
8,071
18,720
DeKalb
7,850
20,580
McDuffie
8,071
18,720
Washington
8,673
22,584
Dodge
8,545
18,181
McIntosh
7,155
21,075
Wayne
7,155
21,075
Dooly
8,545
18,181
Meriwether
7,316
18,862
Webster
7,316
18,862
Dougherty
8,085
23,360
Miller
8,599
24,744
Wheeler
7,649
20,446
Douglas
7,850
20,580
Mitchell
8,085
23,360
White
8,299
22,594
Early
8,599
24,744
Monroe
8,545
18,181
Whitfield
7,946
21,682
Echols
8,599
24,744
Montgomery
7,649
20,446
Wilcox
8,545
18,181
Effingham
10,583
27,444
Morgan
9,031
21,237
Wilkes
8,071
18,720
Elbert
9,031
21,237
Murray
7,946
21,682
Wilkinson
8,673
22,584
Emanuel
8,071
18,720
Muscogee
7,316
18,862
Worth
8,085
23,360
Evans
10,583
27,444
Newton
7,850
20,580
Fannin
7,946
21,682
Oconee
9,031
21,237
Fayette
7,850
20,580
Oglethorpe
9,031
21,237
Floyd
8,654
22,271
Paulding
7,850
20,580
County
Employee- Dependent,
Only
Family, etc.
Forsyth
7,850
20,580
Peach
8,545
18,181
All
7,628
Franklin
8,299
22,594
Pickens
8,654
22,271
Fulton
7,850
20,580
Pierce
7,155
21,075
Gilmer
8,654
22,271
Pike
7,850
20,580
Glascock
8,071
18,720
Polk
8,654
22,271
Glynn
7,155
21,075
Pulaski
8,545
18,181
Gordon
8,654
22,271
Putnam
8,545
18,181
Grady
8,599
24,744
Quitman
7,316
18,862
Greene
9,031
21,237
Rabun
8,299
22,594
Gwinnett
7,850
20,580
Randolph
8,085
23,360
Habersham
8,299
22,594
Richmond
8,071
18,720
Hall
8,299
22,594
Rockdale
7,850
20,580
Hancock
8,673
22,584
Schley
8,085
23,360
Haralson
8,130
23,051
Screven
10,583
27,444
Harris
7,316
18,862
Seminole
8,599
24,744
Hart
8,299
22,594
Spalding
7,850
20,580
Heard
8,130
23,051
Stephens
8,299
22,594
Henry
7,850
20,580
Stewart
7,316
18,862
Houston
8,545
18,181
Sumter
8,085
23,360
Irwin
8,599
24,744
Talbot
7,316
18,862
Jackson
9,031
21,237
Taliaferro
8,071
18,720
Jasper
7,850
20,580
Tattnall
10,583
27,444
Jeff Davis
7,649
20,446
Taylor
7,316
18,862
Jefferson
8,071
18,720
Telfair
7,649
20,446
Jenkins
8,071
18,720
Terrell
8,085
23,360
Johnson
7,649
20,446
Thomas
8,599
24,744
Jones
8,545
18,181
Tift
8,599
24,744
Lamar
7,850
20,580
Toombs
7,649
20,446
2022 Average Premium Tables
-13-
Hawaii
21,523
Idaho
County
Employee- Dependent,
Only
Family, etc.
Ada
6,877
17,159
Adams
6,184
17,428
Bannock
8,437
18,200
Bear Lake
8,437
18,200
Benewah
7,005
16,093
Bingham
8,437
18,200
Blaine
6,228
18,948
Boise
6,184
17,428
Bonner
7,005
16,093
Bonneville
7,765
20,506
Boundary
7,005
16,093
Butte
8,437
18,200
Camas
6,228
18,948
Canyon
6,184
17,428
Caribou
8,437
18,200
Cassia
6,228
18,948
Clark
7,765
20,506
Clearwater
8,172
19,086
Custer
8,437
18,200
Elmore
6,184
17,428
Franklin
8,437
18,200
Fremont
7,765
20,506
Gem
6,184
17,428
Gooding
6,228
18,948
Fulton
8,720
21,322
Saline
9,777
25,949
Idaho
8,172
19,086
Gallatin
9,777
25,949
Sangamon
8,465
19,139
Jefferson
7,765
20,506
Greene
8,629
23,248
Schuyler
8,465
19,139
Jerome
6,228
18,948
Grundy
9,101
20,461
Scott
8,465
19,139
Kootenai
7,005
16,093
Hamilton
9,777
25,949
Shelby
8,465
19,139
Latah
7,005
16,093
Hancock
7,958
20,419
St. Clair
8,482
20,961
DRAFT AS OF
November 22, 2022
Lemhi
7,765
20,506
Hardin
9,777
25,949
Stark
8,720
21,322
Lewis
8,172
19,086
Henderson
7,958
20,419
Stephenson
8,972
22,362
Lincoln
6,228
18,948
Henry
7,958
20,419
Tazewell
8,720
21,322
Madison
7,765
20,506
Iroquois
9,646
23,421
Union
9,777
25,949
Minidoka
6,228
18,948
Jackson
9,777
25,949
Vermilion
9,646
23,421
Nez Perce
8,172
19,086
Jasper
9,777
25,949
Wabash
9,777
25,949
Oneida
8,437
18,200
Jefferson
9,777
25,949
Warren
7,958
20,419
Owyhee
6,184
17,428
Jersey
8,629
23,248
Washington
8,629
23,248
Payette
6,184
17,428
Jo Daviess
8,972
22,362
Wayne
9,777
25,949
Power
8,437
18,200
Johnson
9,777
25,949
White
9,777
25,949
Shoshone
7,005
16,093
Kane
8,977
24,388
Whiteside
7,958
20,419
Teton
7,765
20,506
Kankakee
9,101
20,461
Will
9,101
20,461
Twin Falls
6,228
18,948
Kendall
9,101
20,461
Williamson
9,777
25,949
Valley
6,184
17,428
Knox
8,720
21,322
Winnebago
8,972
22,362
Washington
6,184
17,428
Lake
8,029
24,199
Woodford
8,720
21,322
LaSalle
8,720
21,322
Lawrence
9,777
25,949
Illinois
Indiana
Employee- Dependent,
Only
Family, etc.
Lee
8,972
22,362
County
Livingston
9,902
24,851
County
Employee- Dependent,
Only
Family, etc.
Adams
8,465
19,139
Logan
8,465
19,139
Adams
7,478
23,214
Alexander
9,777
25,949
19,139
Allen
8,107
24,189
Bond
8,629
23,248
Macoupin
8,629
23,248
Bartholomew
7,972
22,560
Boone
8,972
22,362
Madison
8,482
20,961
Benton
8,516
25,391
Brown
8,465
19,139
25,949
Blackford
8,548
21,898
Bureau
7,958
20,419
Marshall
8,720
21,322
Boone
8,202
25,255
Calhoun
8,629
23,248
Mason
8,465
19,139
Brown
8,081
26,309
Carroll
8,972
22,362
25,949
Carroll
8,176
26,016
8,166
21,199
Macon
Marion
Massac
8,465
9,777
9,777
Cass
8,465
19,139
McDonough
8,720
21,322
Cass
Champaign
9,646
23,421
McHenry
8,029
24,199
Clark
7,522
21,081
Christian
8,465
19,139
McLean
9,902
24,851
Clay
7,068
22,156
Clark
9,646
23,421
Menard
8,465
19,139
Clinton
8,176
26,016
Clay
9,777
25,949
Mercer
7,958
20,419
Crawford
7,522
21,081
Clinton
8,629
23,248
Monroe
8,482
20,961
Daviess
8,249
25,780
Coles
9,646
23,421
Montgomery
8,629
23,248
Dearborn
8,906
24,245
Cook
8,729
23,937
Morgan
8,465
19,139
Decatur
7,972
22,560
Crawford
9,777
25,949
Moultrie
8,465
19,139
DeKalb
7,478
23,214
Cumberland
9,646
23,421
Ogle
8,972
22,362
Delaware
8,548
21,898
DeKalb
8,972
22,362
21,322
Dubois
8,249
25,780
DeWitt
9,902
24,851
Perry
9,777
25,949
Elkhart
8,340
22,494
Douglas
9,646
23,421
Piatt
9,646
23,421
Fayette
7,510
22,139
DuPage
8,977
24,388
19,139
Floyd
7,522
21,081
Edgar
9,646
23,421
Pope
9,777
25,949
Fountain
8,176
26,016
Edwards
9,777
25,949
Pulaski
9,777
25,949
Franklin
8,906
24,245
Effingham
9,777
25,949
21,322
Fulton
8,166
21,199
9,588
24,463
Peoria
Pike
Putnam
8,720
8,465
8,720
Fayette
9,777
25,949
Randolph
8,629
23,248
Gibson
Ford
9,646
23,421
Richland
9,777
25,949
Grant
8,548
21,898
Franklin
9,777
25,949
20,419
Greene
8,249
25,780
Rock Island
7,958
-14-
2022 Average Premium Tables
Hamilton
8,202
25,255
Vanderburgh
9,588
24,463
Guthrie
8,697
21,249
Hancock
7,510
22,139
Vermillion
7,068
22,156
Hamilton
6,451
20,188
Harrison
7,522
21,081
Vigo
7,068
22,156
Hancock
7,445
21,955
Hendricks
8,202
25,255
Wabash
7,478
23,214
Hardin
6,451
20,188
Henry
7,510
22,139
Warren
8,516
25,391
Harrison
8,697
21,249
Howard
8,166
21,199
Warrick
9,588
24,463
Henry
7,311
19,465
DRAFT AS OF
November 22, 2022
Huntington
7,478
23,214
Washington
7,522
21,081
Howard
7,445
21,955
Jackson
7,972
22,560
Wayne
7,510
22,139
Humboldt
7,445
21,955
Jasper
8,516
25,391
Wells
7,478
23,214
Ida
8,032
22,897
Jay
8,548
21,898
White
8,516
25,391
Iowa
7,127
21,569
Jefferson
7,522
21,081
Whitley
7,478
23,214
Jackson
7,127
21,569
Jennings
7,972
22,560
Jasper
7,095
22,233
Johnson
8,081
26,309
Jefferson
7,311
19,465
Knox
8,249
25,780
7,127
21,569
Kosciusko
8,340
22,494
County
Employee- Dependent,
Only
Family, etc.
Johnson
Jones
7,127
21,569
8,697
21,249
Iowa
LaGrange
7,478
23,214
Adair
Keokuk
7,311
19,465
Lake
8,474
22,352
Adams
8,697
21,249
Kossuth
7,445
21,955
LaPorte
8,474
22,352
Allamakee
7,445
21,955
Lee
7,311
19,465
7,311
19,465
Lawrence
8,081
26,309
Appanoose
Linn
7,127
21,569
Madison
7,510
22,139
Audubon
8,697
21,249
Louisa
7,311
19,465
Marion
8,202
25,255
Benton
7,127
21,569
Lucas
7,311
19,465
7,127
21,569
Marshall
8,340
22,494
Black Hawk
Lyon
8,032
22,897
Martin
8,249
25,780
Boone
6,451
20,188
Madison
7,095
22,233
7,445
21,955
Miami
8,166
21,199
Bremer
Mahaska
7,311
19,465
Monroe
8,081
26,309
Buchanan
7,127
21,569
Marion
7,095
22,233
Montgomery
8,176
26,016
Buena Vista
8,032
22,897
Marshall
6,451
20,188
7,445
21,955
Morgan
8,202
25,255
Butler
Mills
8,697
21,249
Newton
8,516
25,391
Calhoun
6,451
20,188
Mitchell
7,445
21,955
Noble
7,478
23,214
Carroll
6,451
20,188
Monona
8,032
22,897
8,697
21,249
Ohio
8,906
24,245
Cass
Monroe
7,311
19,465
Orange
8,249
25,780
Cedar
7,127
21,569
Montgomery
8,697
21,249
Owen
8,081
26,309
Cerro Gordo
7,445
21,955
Muscatine
7,311
19,465
8,032
22,897
Parke
7,068
22,156
Cherokee
O'Brien
8,032
22,897
Perry
8,249
25,780
Chickasaw
7,445
21,955
Osceola
8,032
22,897
Pike
8,249
25,780
Clarke
8,697
21,249
Page
8,697
21,249
8,032
22,897
Porter
8,474
22,352
Clay
Palo Alto
8,032
22,897
Posey
9,588
24,463
Clayton
7,127
21,569
Plymouth
8,032
22,897
Pulaski
8,166
21,199
Clinton
7,127
21,569
Pocahontas
8,032
22,897
8,032
22,897
Putnam
8,176
26,016
Crawford
Polk
7,095
22,233
Randolph
8,548
21,898
Dallas
7,095
22,233
Pottawattamie
8,697
21,249
Ripley
8,906
24,245
Davis
7,311
19,465
Poweshiek
6,451
20,188
8,697
21,249
Rush
7,972
22,560
Decatur
Ringgold
8,697
21,249
Scott
7,522
21,081
Delaware
7,127
21,569
Sac
8,032
22,897
7,311
19,465
Shelby
8,202
25,255
Des Moines
Scott
7,127
21,569
Spencer
8,249
25,780
Dickinson
8,032
22,897
Shelby
8,697
21,249
St. Joseph
8,340
22,494
Dubuque
7,127
21,569
Sioux
8,032
22,897
7,445
21,955
Starke
8,340
22,494
Emmet
Story
6,451
20,188
Steuben
7,478
23,214
Fayette
7,445
21,955
Tama
6,451
20,188
Sullivan
7,068
22,156
Floyd
7,445
21,955
Taylor
8,697
21,249
7,445
21,955
Switzerland
8,906
24,245
Franklin
Union
8,697
21,249
Tippecanoe
8,176
26,016
Fremont
8,697
21,249
Van Buren
7,311
19,465
Tipton
8,176
26,016
Greene
6,451
20,188
Wapello
7,311
19,465
22,139
Grundy
6,451
20,188
Warren
7,095
22,233
Union
7,510
2022 Average Premium Tables
-15-
Washington
7,311
19,465
Hodgeman
6,516
20,210
Stevens
6,516
20,210
Wayne
7,311
19,465
Jackson
7,004
19,947
Sumner
6,660
18,161
Webster
6,451
20,188
Jefferson
7,004
19,947
Thomas
7,246
21,412
Winnebago
7,445
21,955
Jewell
6,556
17,604
Trego
7,246
21,412
Winneshiek
7,445
21,955
Johnson
7,490
20,490
Wabaunsee
7,004
19,947
Woodbury
8,032
22,897
Kearny
6,516
20,210
Wallace
7,246
21,412
DRAFT AS OF
November 22, 2022
Worth
7,445
21,955
Kingman
6,660
18,161
Washington
6,556
17,604
Wright
7,445
21,955
Kiowa
6,516
20,210
Wichita
7,246
21,412
Labette
7,646
19,378
Wilson
6,660
18,161
Lane
7,246
21,412
Woodson
7,646
19,378
7,490
20,490
Wyandotte
7,490
20,490
Kansas
County
Employee- Dependent,
Only
Family, etc.
Leavenworth
Lincoln
6,556
17,604
Allen
7,646
19,378
Linn
7,004
19,947
Anderson
7,004
19,947
Logan
7,246
21,412
Atchison
7,004
19,947
Lyon
7,004
19,947
County
Employee- Dependent,
Only
Family, etc.
Barber
6,516
20,210
Marion
6,660
18,161
Adair
7,995
23,900
7,995
23,900
Kentucky
Barton
7,246
21,412
Marshall
7,004
19,947
Allen
Bourbon
7,646
19,378
McPherson
6,660
18,161
Anderson
6,923
19,939
Brown
7,004
19,947
Meade
6,516
20,210
Ballard
9,237
20,839
Butler
6,660
18,161
Miami
7,490
20,490
Barren
7,995
23,900
Chase
6,660
18,161
Mitchell
6,556
17,604
Bath
7,608
22,247
Chautauqua
6,660
18,161
Montgomery
6,660
18,161
Bell
8,511
22,079
Cherokee
7,646
19,378
Morris
6,556
17,604
Boone
6,646
20,870
Cheyenne
7,246
21,412
20,210
Bourbon
6,923
19,939
Clark
6,516
20,210
Nemaha
7,004
19,947
Boyd
7,608
22,247
Clay
6,556
17,604
Neosho
7,646
19,378
Boyle
6,923
19,939
Cloud
6,556
17,604
21,412
Bracken
7,608
22,247
Coffey
7,004
19,947
Norton
7,246
21,412
Breathitt
8,511
22,079
Comanche
6,516
20,210
Osage
7,004
19,947
Breckinridge
7,219
20,093
Cowley
6,660
18,161
21,412
Bullitt
7,219
20,093
Crawford
7,646
19,378
Ottawa
6,556
17,604
Butler
7,995
23,900
Decatur
7,246
21,412
Pawnee
6,516
20,210
Caldwell
9,237
20,839
Dickinson
6,556
17,604
21,412
Calloway
9,237
20,839
6,646
20,870
Morton
Ness
Osborne
Phillips
6,516
7,246
7,246
7,246
Doniphan
7,004
19,947
Pottawatomie
7,004
19,947
Campbell
Douglas
7,004
19,947
Pratt
6,516
20,210
Carlisle
9,237
20,839
Edwards
6,516
20,210
Rawlins
7,246
21,412
Carroll
7,219
20,093
Elk
6,660
18,161
Reno
6,660
18,161
Carter
7,608
22,247
Ellis
7,246
21,412
Republic
6,556
17,604
Casey
7,995
23,900
Ellsworth
6,556
17,604
Rice
6,660
18,161
Christian
8,681
22,562
Finney
6,516
20,210
Riley
6,556
17,604
Clark
6,923
19,939
Ford
6,516
20,210
Rooks
7,246
21,412
Clay
8,511
22,079
Franklin
7,004
19,947
Rush
7,246
21,412
Clinton
7,995
23,900
Geary
6,556
17,604
Russell
7,246
21,412
Crittenden
9,237
20,839
Gove
7,246
21,412
17,604
Cumberland
7,995
23,900
Graham
7,246
21,412
Scott
7,246
21,412
Daviess
8,681
22,562
Grant
6,516
20,210
Sedgwick
6,660
18,161
Edmonson
7,995
23,900
Gray
6,516
20,210
20,210
Elliott
7,608
22,247
Greeley
7,246
21,412
Shawnee
7,004
19,947
Estill
6,923
19,939
Greenwood
6,660
18,161
Sheridan
7,246
21,412
Fayette
6,923
19,939
Hamilton
6,516
20,210
21,412
Fleming
7,608
22,247
8,511
22,079
Saline
Seward
Sherman
6,556
6,516
7,246
Harper
6,660
18,161
Smith
7,246
21,412
Floyd
Harvey
6,660
18,161
Stafford
6,516
20,210
Franklin
6,923
19,939
Haskell
6,516
20,210
20,210
Fulton
9,237
20,839
Stanton
6,516
-16-
2022 Average Premium Tables
Gallatin
6,646
20,870
Ohio
8,681
22,562
Franklin
8,275
20,521
Garrard
6,923
19,939
Oldham
7,219
20,093
Grant
8,797
21,078
Grant
6,646
20,870
Owen
6,923
19,939
Iberia
7,541
20,453
Graves
9,237
20,839
Owsley
8,511
22,079
Iberville
8,072
21,892
Grayson
7,219
20,093
Pendleton
6,646
20,870
Jackson
8,275
20,521
Green
7,995
23,900
Perry
8,511
22,079
Jefferson
7,665
21,666
DRAFT AS OF
November 22, 2022
Greenup
7,608
22,247
Pike
8,511
22,079
Jefferson Davis
8,459
21,861
Hancock
8,681
22,562
Powell
6,923
19,939
Lafayette
7,541
20,453
Hardin
7,219
20,093
Pulaski
7,995
23,900
Lafourche
7,692
20,542
Harlan
8,511
22,079
Robertson
7,608
22,247
LaSalle
8,797
21,078
Harrison
6,923
19,939
Rockcastle
6,923
19,939
Lincoln
8,275
20,521
Hart
7,995
23,900
Rowan
7,608
22,247
Livingston
8,072
21,892
Henderson
8,681
22,562
Russell
7,995
23,900
Madison
8,275
20,521
Henry
7,219
20,093
Scott
6,923
19,939
Morehouse
8,275
20,521
Hickman
9,237
20,839
Shelby
7,219
20,093
Natchitoches
7,834
20,233
Hopkins
8,681
22,562
Simpson
7,995
23,900
Orleans
7,665
21,666
Jackson
6,923
19,939
Spencer
7,219
20,093
Ouachita
8,275
20,521
Jefferson
7,219
20,093
Taylor
7,995
23,900
Plaquemines
7,665
21,666
Jessamine
6,923
19,939
Todd
8,681
22,562
Pointe Coupee
8,072
21,892
Johnson
8,511
22,079
Trigg
8,681
22,562
Rapides
8,797
21,078
Kenton
6,646
20,870
Trimble
7,219
20,093
Red River
7,834
20,233
Knott
8,511
22,079
Union
8,681
22,562
Richland
8,275
20,521
Knox
8,511
22,079
Warren
7,995
23,900
Sabine
7,834
20,233
LaRue
7,219
20,093
Washington
7,219
20,093
St. Bernard
7,665
21,666
Laurel
8,511
22,079
Wayne
7,995
23,900
St. Charles
7,665
21,666
Lawrence
7,608
22,247
Webster
8,681
22,562
St. Helena
8,072
21,892
Lee
8,511
22,079
Whitley
8,511
22,079
St. James
7,665
21,666
Leslie
8,511
22,079
Wolfe
8,511
22,079
St. John Baptist
7,665
21,666
Letcher
8,511
22,079
Woodford
6,923
19,939
St. Landry
7,541
20,453
Lewis
7,608
22,247
St. Martin
7,541
20,453
Lincoln
6,923
19,939
St. Mary
7,541
20,453
Livingston
9,237
20,839
7,665
21,666
Louisiana
Employee- Dependent,
Only
Family, etc.
St. Tammany
Logan
7,995
23,900
Parish
Tangipahoa
8,072
21,892
Lyon
9,237
20,839
Acadia
7,541
20,453
Tensas
8,275
20,521
Madison
6,923
19,939
Allen
8,459
21,861
Terrebonne
7,692
20,542
8,072
21,892
Magoffin
8,511
22,079
Ascension
Union
8,275
20,521
Marion
7,219
20,093
Assumption
7,692
20,542
Vermilion
7,541
20,453
Marshall
9,237
20,839
Avoyelles
8,797
21,078
Vernon
8,797
21,078
8,459
21,861
Martin
8,511
22,079
Beauregard
Washington
8,072
21,892
Mason
7,608
22,247
Bienville
7,834
20,233
Webster
7,834
20,233
McCracken
9,237
20,839
Bossier
7,834
20,233
West Baton Rouge
8,072
21,892
7,834
20,233
McCreary
7,995
23,900
Caddo
West Carroll
8,275
20,521
McLean
8,681
22,562
Calcasieu
8,459
21,861
West Feliciana
8,072
21,892
8,275
20,521
Winn
8,797
21,078
Meade
7,219
20,093
Caldwell
Menifee
7,608
22,247
Cameron
8,459
21,861
Mercer
6,923
19,939
Catahoula
8,797
21,078
Metcalfe
7,995
23,900
Claiborne
7,834
20,233
8,797
21,078
County
Employee- Dependent,
Only
Family, etc.
Maine
Monroe
7,995
23,900
Concordia
Montgomery
6,923
19,939
DeSoto
7,834
20,233
Androscoggin
7,935
20,534
22,247
East Baton Rouge
8,072
21,892
Aroostook
9,703
24,940
8,275
20,521
Cumberland
7,655
22,574
Morgan
7,608
Muhlenberg
8,681
22,562
East Carroll
Nelson
7,219
20,093
East Feliciana
8,072
21,892
Franklin
7,935
20,534
19,939
Evangeline
7,541
20,453
Hancock
9,703
24,940
Nicholas
6,923
2022 Average Premium Tables
-17-
Kennebec
7,153
19,633
Norfolk
8,963
26,811
Lenawee
7,587
22,510
Knox
7,153
19,633
Plymouth
9,361
25,875
Livingston
7,587
22,510
Lincoln
7,153
19,633
Suffolk
8,963
26,811
Luce
9,363
22,114
Oxford
7,153
19,633
Worcester
8,989
24,581
Mackinac
8,510
22,856
Penobscot
7,935
20,534
Macomb
7,838
22,752
Piscataquis
7,935
20,534
Manistee
7,203
21,345
Michigan
DRAFT AS OF
November 22, 2022
Sagadahoc
7,655
22,574
9,363
22,114
7,935
20,534
County
Employee- Dependent,
Only
Family, etc.
Marquette
Somerset
Mason
7,097
21,254
Waldo
7,935
20,534
Alcona
8,510
22,856
Mecosta
7,097
21,254
9,363
22,114
Washington
9,703
24,940
Alger
Menominee
9,363
22,114
York
7,655
22,574
Allegan
7,197
21,587
Midland
7,425
21,232
Alpena
8,510
22,856
Missaukee
7,203
21,345
Antrim
7,203
21,345
Monroe
8,584
24,261
Arenac
7,898
20,833
Montcalm
7,097
21,254
Baraga
9,363
22,114
Montmorency
8,510
22,856
Maryland
County
Employee- Dependent,
Only
Family, etc.
Allegany
7,383
21,882
Barry
7,197
21,587
Muskegon
7,097
21,254
Anne Arundel
7,409
22,761
Bay
7,898
20,833
Newaygo
7,097
21,254
Baltimore
7,409
22,761
Benzie
7,203
21,345
Oakland
7,838
22,752
Baltimore City
7,409
22,761
Berrien
8,527
24,805
Oceana
7,097
21,254
Calvert
7,678
21,174
Branch
8,488
22,633
Ogemaw
8,510
22,856
Caroline
7,678
21,174
Calhoun
8,488
22,633
Ontonagon
9,363
22,114
Carroll
7,383
21,882
Cass
8,527
24,805
Osceola
7,097
21,254
Cecil
7,678
21,174
Charlevoix
7,203
21,345
Oscoda
8,510
22,856
Charles
7,678
21,174
Cheboygan
8,510
22,856
Otsego
8,510
22,856
Dorchester
7,678
21,174
Chippewa
8,510
22,856
Ottawa
7,097
21,254
Frederick
7,383
21,882
Clare
7,425
21,232
Presque Isle
8,510
22,856
Garrett
7,383
21,882
Clinton
8,521
21,466
Roscommon
8,510
22,856
Harford
7,409
22,761
Crawford
8,510
22,856
Saginaw
7,898
20,833
Howard
7,409
22,761
Delta
9,363
22,114
Sanilac
8,709
21,559
Kent
7,678
21,174
Dickinson
9,363
22,114
Schoolcraft
9,363
22,114
Montgomery
7,640
25,697
Eaton
8,521
21,466
Shiawassee
8,060
19,416
Prince George's
7,640
25,697
Emmet
7,203
21,345
St. Clair
7,875
22,787
Queen Anne’s
7,678
21,174
Genesee
8,060
19,416
St. Joseph
8,527
24,805
Somerset
7,678
21,174
Gladwin
7,425
21,232
Tuscola
8,709
21,559
St. Mary’s
7,678
21,174
Gogebic
9,363
22,114
Van Buren
8,527
24,805
Talbot
7,678
21,174
Grand Traverse
7,203
21,345
Washtenaw
7,587
22,510
Washington
7,383
21,882
Gratiot
7,898
20,833
Wayne
8,584
24,261
Wicomico
7,678
21,174
Hillsdale
8,521
21,466
Wexford
7,203
21,345
Worcester
7,678
21,174
Houghton
9,363
22,114
Huron
8,709
21,559
Ingham
8,521
21,466
7,097
21,254
County
Employee- Dependent,
Only
Family, etc.
County
Employee- Dependent,
Only
Family, etc.
Ionia
Iosco
8,510
22,856
Aitkin
8,499
19,704
Barnstable
10,057
27,157
Iron
9,363
22,114
Anoka
8,198
22,701
Berkshire
7,899
23,163
Isabella
7,425
21,232
Becker
8,286
23,575
Bristol
9,361
25,875
Jackson
8,521
21,466
Beltrami
8,499
19,704
Dukes
10,057
27,157
Kalamazoo
8,488
22,633
Benton
8,198
22,701
Essex
9,148
24,037
Kalkaska
7,203
21,345
Big Stone
9,311
21,521
Franklin
7,899
23,163
Kent
7,097
21,254
Blue Earth
10,352
21,578
Hampden
7,899
23,163
Keweenaw
9,363
22,114
Brown
8,725
22,000
Hampshire
7,899
23,163
Lake
7,097
21,254
Carlton
8,693
19,236
Middlesex
8,963
26,811
Lapeer
8,060
19,416
Carver
8,198
22,701
Nantucket
10,057
27,157
Leelanau
7,203
21,345
Cass
8,499
19,704
Massachusetts
-18-
Minnesota
2022 Average Premium Tables
Chippewa
9,311
21,521
Renville
9,311
21,521
Humphreys
6,958
18,688
Chisago
8,499
19,704
Rice
10,352
21,578
Issaquena
6,958
18,688
Clay
8,286
23,575
Rock
8,725
22,000
Itawamba
7,340
18,912
Clearwater
7,342
23,307
Roseau
8,499
19,704
Jackson
7,844
23,137
Cook
8,693
19,236
Scott
8,198
22,701
Jasper
6,958
18,688
Cottonwood
8,725
22,000
Sherburne
8,198
22,701
Jefferson
6,958
18,688
DRAFT AS OF
November 22, 2022
Crow Wing
8,499
19,704
Sibley
9,311
21,521
Jefferson Davis
6,958
18,688
Dakota
8,198
22,701
St. Louis
8,693
19,236
Jones
7,522
17,003
Dodge
8,999
21,065
Stearns
8,198
22,701
Kemper
6,958
18,688
Douglas
8,286
23,575
Steele
8,999
21,065
Lafayette
6,958
18,688
Faribault
10,352
21,578
Stevens
8,286
23,575
Lamar
7,522
17,003
Fillmore
8,999
21,065
Swift
9,311
21,521
Lauderdale
6,958
18,688
Freeborn
8,999
21,065
Todd
8,499
19,704
Lawrence
6,958
18,688
Goodhue
8,999
21,065
Traverse
8,286
23,575
Leake
6,958
18,688
Grant
8,286
23,575
Wabasha
8,999
21,065
Lee
7,340
18,912
Hennepin
8,198
22,701
Wadena
8,499
19,704
Leflore
6,958
18,688
Houston
8,999
21,065
Waseca
10,352
21,578
Lincoln
6,958
18,688
Hubbard
8,499
19,704
Washington
8,198
22,701
Lowndes
6,958
18,688
Isanti
8,499
19,704
Watonwan
10,352
21,578
Madison
7,262
17,274
Itasca
8,693
19,236
Wilkin
8,286
23,575
Marion
6,958
18,688
Jackson
8,725
22,000
Winona
8,999
21,065
Marshall
6,877
23,091
Kanabec
8,499
19,704
Wright
8,198
22,701
Monroe
6,958
18,688
Kandiyohi
9,311
21,521
Yellow Medicine
9,311
21,521
Montgomery
6,958
18,688
Kittson
7,342
23,307
Neshoba
6,958
18,688
Koochiching
8,693
19,236
Newton
6,958
18,688
Lac qui Parle
9,311
21,521
6,958
18,688
Mississippi
Employee- Dependent,
Only
Family, etc.
Noxubee
Lake
8,693
19,236
County
Oktibbeha
6,958
18,688
Lake of the Woods
8,693
19,236
Adams
6,958
18,688
Panola
6,958
18,688
Le Sueur
10,352
21,578
Alcorn
6,958
18,688
Pearl River
7,522
17,003
6,958
18,688
Lincoln
8,725
22,000
Amite
Perry
7,522
17,003
Lyon
9,311
21,521
Attala
6,958
18,688
Pike
6,958
18,688
Mahnomen
7,342
23,307
Benton
7,340
18,912
Pontotoc
7,340
18,912
6,958
18,688
Marshall
7,342
23,307
Bolivar
Prentiss
6,958
18,688
Martin
10,352
21,578
Calhoun
6,958
18,688
Quitman
6,958
18,688
McLeod
9,311
21,521
Carroll
6,958
18,688
Rankin
7,262
17,274
6,958
18,688
Meeker
9,311
21,521
Chickasaw
Scott
6,958
18,688
Mille Lacs
8,499
19,704
Choctaw
6,958
18,688
Sharkey
6,958
18,688
Morrison
8,499
19,704
Claiborne
6,958
18,688
Simpson
7,262
17,274
6,958
18,688
Mower
8,999
21,065
Clarke
Smith
6,958
18,688
Murray
8,725
22,000
Clay
6,958
18,688
Stone
7,844
23,137
Nicollet
10,352
21,578
Coahoma
6,958
18,688
Sunflower
6,958
18,688
7,262
17,274
Nobles
8,725
22,000
Copiah
Tallahatchie
6,958
18,688
Norman
7,342
23,307
Covington
6,958
18,688
Tate
6,877
23,091
6,877
23,091
Olmsted
8,999
21,065
DeSoto
Tippah
7,340
18,912
Otter Tail
8,286
23,575
Forrest
7,522
17,003
Tishomingo
6,958
18,688
Pennington
7,342
23,307
Franklin
6,958
18,688
Tunica
6,877
23,091
7,844
23,137
Pine
8,499
19,704
George
Union
7,340
18,912
Pipestone
8,725
22,000
Greene
7,522
17,003
Walthall
6,958
18,688
Polk
7,342
23,307
Grenada
6,958
18,688
Warren
7,262
17,274
7,844
23,137
Pope
8,286
23,575
Hancock
Washington
6,958
18,688
Ramsey
8,198
22,701
Harrison
7,844
23,137
Wayne
6,958
18,688
Red Lake
7,342
23,307
Hinds
7,262
17,274
Webster
6,958
18,688
22,000
Holmes
6,958
18,688
Wilkinson
6,958
18,688
Redwood
8,725
2022 Average Premium Tables
-19-
Winston
6,958
18,688
Iron
7,282
18,701
St. Francois
7,491
20,240
Yalobusha
6,958
18,688
Jackson
7,541
21,475
St. Louis
7,491
20,240
Yazoo
6,958
18,688
Jasper
6,032
17,957
St. Louis City
7,491
20,240
Jefferson
7,491
20,240
Ste. Genevieve
7,491
20,240
Johnson
7,494
19,730
Stoddard
8,348
21,959
8,548
20,952
Stone
7,786
21,502
Missouri
County
Employee- Dependent,
Only
Family, etc.
Knox
Laclede
7,786
21,502
Sullivan
8,548
20,952
Adair
8,548
20,952
Lafayette
7,494
19,730
Taney
7,786
21,502
Andrew
10,197
19,609
Lawrence
7,786
21,502
Texas
7,282
18,701
Atchison
10,197
19,609
Lewis
8,548
20,952
Vernon
7,494
19,730
Audrain
8,472
21,174
Lincoln
7,491
20,240
Warren
7,491
20,240
Barry
7,786
21,502
Linn
8,548
20,952
Washington
7,491
20,240
Barton
6,032
17,957
Livingston
10,197
19,609
Wayne
8,348
21,959
Bates
7,494
19,730
Macon
8,548
20,952
Webster
7,786
21,502
Benton
7,494
19,730
Madison
8,348
21,959
Worth
10,197
19,609
Bollinger
8,348
21,959
Maries
8,472
21,174
Wright
7,786
21,502
Boone
8,472
21,174
Marion
8,548
20,952
Buchanan
10,197
19,609
McDonald
6,032
17,957
Butler
8,348
21,959
Mercer
10,197
19,609
Caldwell
10,197
19,609
Miller
8,472
21,174
County
Employee- Dependent,
Only
Family, etc.
Callaway
8,472
21,174
Mississippi
8,348
21,959
Beaverhead
8,693
20,347
Camden
8,472
21,174
Moniteau
8,472
21,174
Big Horn
8,693
20,347
Cape Girardeau
8,348
21,959
Monroe
8,472
21,174
Blaine
8,693
20,347
Carroll
10,197
19,609
21,174
Broadwater
7,606
22,167
Carter
7,282
18,701
Morgan
8,472
21,174
Carbon
7,891
22,023
Cass
7,541
21,475
New Madrid
8,348
21,959
Carter
8,693
20,347
Cedar
7,786
21,502
17,957
Cascade
7,606
22,167
Chariton
8,472
21,174
Nodaway
10,197
19,609
Chouteau
7,606
22,167
Christian
7,786
21,502
Oregon
7,282
18,701
Custer
8,693
20,347
Clark
8,548
20,952
21,174
Daniels
8,693
20,347
Clay
7,541
21,475
Ozark
7,786
21,502
Dawson
8,693
20,347
Clinton
10,197
19,609
Pemiscot
8,348
21,959
Deer Lodge
7,606
22,167
Cole
8,472
21,174
21,959
Fallon
8,693
20,347
8,693
20,347
DRAFT AS OF
November 22, 2022
Montgomery
Newton
Osage
Perry
8,472
6,032
8,472
8,348
Montana
Cooper
8,472
21,174
Pettis
7,494
19,730
Fergus
Crawford
7,282
18,701
Phelps
7,282
18,701
Flathead
7,857
20,820
Dade
7,786
21,502
Pike
8,548
20,952
Gallatin
7,606
22,167
Dallas
7,786
21,502
Platte
7,541
21,475
Garfield
8,693
20,347
Daviess
10,197
19,609
Polk
7,786
21,502
Glacier
8,693
20,347
DeKalb
10,197
19,609
Pulaski
7,282
18,701
Golden Valley
8,693
20,347
Dent
7,282
18,701
Putnam
8,548
20,952
Granite
8,693
20,347
Douglas
7,786
21,502
Ralls
8,548
20,952
Hill
8,693
20,347
Dunklin
8,348
21,959
Randolph
8,472
21,174
Jefferson
7,606
22,167
Franklin
7,491
20,240
Ray
10,197
19,609
Judith Basin
7,606
22,167
Gasconade
8,472
21,174
18,701
Lake
7,857
20,820
Gentry
10,197
19,609
Ripley
7,282
18,701
Lewis and Clark
7,606
22,167
Greene
7,786
21,502
Saline
7,494
19,730
Liberty
8,693
20,347
Grundy
10,197
19,609
20,952
Lincoln
8,693
20,347
Harrison
10,197
19,609
Scotland
8,548
20,952
Madison
8,693
20,347
Henry
7,494
19,730
Scott
8,348
21,959
McCone
8,693
20,347
Hickory
7,786
21,502
18,701
Meagher
8,693
20,347
8,693
20,347
Reynolds
Schuyler
Shannon
7,282
8,548
7,282
Holt
10,197
19,609
Shelby
8,548
20,952
Mineral
Howard
8,472
21,174
St. Charles
7,491
20,240
Missoula
7,857
20,820
Howell
7,282
18,701
19,730
Musselshell
7,891
22,023
St. Clair
7,494
-20-
2022 Average Premium Tables
Park
8,693
20,347
Dodge
7,859
22,206
Seward
9,036
24,033
Petroleum
8,693
20,347
Douglas
7,859
22,206
Sheridan
9,129
25,388
Phillips
8,693
20,347
Dundy
9,129
25,388
Sherman
8,981
26,077
Pondera
8,693
20,347
Fillmore
9,036
24,033
Sioux
9,129
25,388
Powder River
8,693
20,347
Franklin
8,981
26,077
Stanton
8,981
26,077
Powell
8,693
20,347
Frontier
9,129
25,388
Thayer
9,036
24,033
DRAFT AS OF
November 22, 2022
Prairie
8,693
20,347
Furnas
8,981
26,077
Thomas
9,129
25,388
Ravalli
8,693
20,347
Gage
9,036
24,033
Thurston
7,859
22,206
Richland
8,693
20,347
Garden
9,129
25,388
Valley
8,981
26,077
Roosevelt
8,693
20,347
Garfield
8,981
26,077
Washington
7,859
22,206
Rosebud
8,693
20,347
Gosper
8,981
26,077
Wayne
8,981
26,077
Sanders
8,693
20,347
Grant
9,129
25,388
Webster
8,981
26,077
Sheridan
8,693
20,347
Greeley
8,981
26,077
Wheeler
8,981
26,077
Silver Bow
7,606
22,167
Hall
8,981
26,077
York
9,036
24,033
Stillwater
7,891
22,023
Hamilton
8,981
26,077
Sweet Grass
7,891
22,023
Harlan
8,981
26,077
Teton
7,606
22,167
Hayes
9,129
25,388
Toole
8,693
20,347
Hitchcock
9,129
25,388
County
Employee- Dependent,
Only
Family, etc.
Treasure
8,693
20,347
Holt
8,981
26,077
Carson City
7,344
19,438
Valley
8,693
20,347
Hooker
9,129
25,388
Churchill
7,741
23,111
Wheatland
8,693
20,347
Howard
8,981
26,077
Clark
7,204
20,646
7,344
19,438
Nevada
Wibaux
8,693
20,347
Jefferson
9,036
24,033
Douglas
Yellowstone
7,891
22,023
Johnson
9,036
24,033
Elko
7,741
23,111
26,077
Esmeralda
7,741
23,111
7,741
23,111
Kearney
Nebraska
8,981
Keith
9,129
25,388
Eureka
Keya Paha
8,981
26,077
Humboldt
7,741
23,111
25,388
Lander
7,741
23,111
7,741
23,111
County
Employee- Dependent,
Only
Family, etc.
Adams
8,981
26,077
Knox
8,981
26,077
Lincoln
Antelope
8,981
26,077
Lancaster
9,036
24,033
Lyon
7,344
19,438
Arthur
9,129
25,388
25,388
Mineral
7,741
23,111
Banner
9,129
25,388
Logan
9,129
25,388
Nye
7,204
20,646
Blaine
8,981
26,077
Loup
8,981
26,077
Pershing
7,741
23,111
Boone
8,981
26,077
26,077
Storey
7,344
19,438
8,331
21,180
7,741
23,111
Kimball
Lincoln
Madison
9,129
9,129
8,981
Box Butte
9,129
25,388
McPherson
9,129
25,388
Washoe
Boyd
8,981
26,077
Merrick
8,981
26,077
White Pine
Brown
9,129
25,388
Morrill
9,129
25,388
Buffalo
8,981
26,077
Nance
8,981
26,077
Burt
7,859
22,206
Nemaha
9,036
24,033
Butler
8,981
26,077
Nuckolls
8,981
26,077
Cass
7,859
22,206
Otoe
9,036
24,033
Cedar
8,981
26,077
Pawnee
9,036
24,033
Chase
9,129
25,388
Perkins
9,129
25,388
Cherry
9,129
25,388
Phelps
8,981
26,077
Cheyenne
9,129
25,388
Pierce
8,981
26,077
Clay
8,981
26,077
Platte
8,981
26,077
Colfax
8,981
26,077
Polk
8,981
26,077
Cuming
8,981
26,077
Red Willow
9,129
25,388
Custer
8,981
26,077
Richardson
9,036
24,033
Dakota
8,981
26,077
Rock
8,981
26,077
Dawes
9,129
25,388
Saline
9,036
24,033
Dawson
8,981
26,077
Sarpy
7,859
22,206
Deuel
9,129
25,388
Saunders
7,859
22,206
Dixon
8,981
26,077
Scotts Bluff
9,129
25,388
2022 Average Premium Tables
-21-
New Hampshire
County
Employee- Dependent,
Only
Family, etc.
All
7,964
26,225
New Jersey
County
Employee- Dependent,
Only
Family, etc.
All
8,090
22,786
New Mexico
County
Employee- Dependent,
Only
Family, etc.
Bernalillo
7,758
21,368
Catron
9,379
29,015
Chaves
9,379
29,015
Cibola
9,379
29,015
Colfax
9,379
29,015
Hamilton
9,118
23,428
Bertie
7,967
22,994
Curry
9,379
29,015
Herkimer
9,118
23,428
Bladen
7,233
23,420
De Baca
9,379
29,015
Jefferson
9,118
23,428
Brunswick
7,474
21,413
Doña Ana
8,107
20,387
Kings
11,243
29,771
Buncombe
7,301
21,752
Eddy
9,379
29,015
Lewis
9,118
23,428
Burke
7,023
20,967
Grant
9,379
29,015
Livingston
8,103
19,847
Cabarrus
7,131
22,733
DRAFT AS OF
November 22, 2022
Guadalupe
9,379
29,015
Madison
9,118
23,428
Caldwell
7,023
20,967
Harding
9,379
29,015
Monroe
8,103
19,847
Camden
7,967
22,994
Hidalgo
9,379
29,015
Montgomery
8,439
21,463
Carteret
9,047
21,390
Lea
9,379
29,015
Nassau
11,034
28,766
Caswell
7,438
25,284
Lincoln
9,379
29,015
New York
11,243
29,771
Catawba
7,023
20,967
Los Alamos
9,379
29,015
Niagara
7,921
19,730
Chatham
7,438
25,284
Luna
9,379
29,015
Oneida
9,118
23,428
Cherokee
7,301
21,752
McKinley
9,379
29,015
Onondaga
9,203
22,260
Chowan
7,967
22,994
Mora
9,379
29,015
Ontario
8,103
19,847
Clay
7,301
21,752
Otero
9,379
29,015
Orange
10,472
25,016
Cleveland
8,254
22,198
Quay
9,379
29,015
Orleans
7,921
19,730
Columbus
7,474
21,413
Rio Arriba
9,379
29,015
Oswego
9,118
23,428
Craven
9,047
21,390
Roosevelt
9,379
29,015
Otsego
9,118
23,428
Cumberland
7,233
23,420
San Juan
7,985
21,236
Putnam
10,472
25,016
Currituck
7,967
22,994
San Miguel
9,379
29,015
Queens
11,243
29,771
Dare
9,047
21,390
Sandoval
7,758
21,368
Rensselaer
8,439
21,463
Davidson
8,418
23,593
Santa Fe
8,139
24,010
Richmond
11,243
29,771
Davie
8,418
23,593
Sierra
9,379
29,015
Rockland
11,243
29,771
Duplin
7,474
21,413
Socorro
9,379
29,015
Saratoga
8,439
21,463
Durham
7,438
25,284
Taos
9,379
29,015
Schenectady
8,439
21,463
Edgecombe
8,970
27,984
Torrance
7,758
21,368
Schoharie
8,439
21,463
Forsyth
8,418
23,593
Union
9,379
29,015
Schuyler
9,203
22,260
Franklin
7,209
22,091
Valencia
7,758
21,368
Seneca
8,103
19,847
Gaston
8,254
22,198
St. Lawrence
9,118
23,428
Gates
7,967
22,994
Steuben
9,203
22,260
Graham
7,301
21,752
11,034
28,766
Granville
6,774
20,823
New York
County
Employee- Dependent,
Only
Family, etc.
Suffolk
Sullivan
10,472
25,016
Greene
8,970
27,984
Albany
8,439
21,463
Tioga
9,203
22,260
Guilford
7,341
21,582
Allegany
7,921
19,730
Tompkins
9,203
22,260
Halifax
7,967
22,994
Bronx
11,243
29,771
Ulster
10,472
25,016
Harnett
7,233
23,420
Broome
9,203
22,260
Warren
8,439
21,463
Haywood
7,301
21,752
Cattaraugus
7,921
19,730
Washington
8,439
21,463
Henderson
7,301
21,752
Cayuga
9,203
22,260
Wayne
8,103
19,847
Hertford
7,967
22,994
Chautauqua
7,921
19,730
Westchester
11,243
29,771
Hoke
7,233
23,420
Chemung
9,203
22,260
Wyoming
7,921
19,730
Hyde
9,047
21,390
Chenango
9,118
23,428
Yates
8,103
19,847
Iredell
7,023
20,967
Clinton
9,118
23,428
Jackson
7,301
21,752
Columbia
8,439
21,463
Cortland
9,203
22,260
Delaware
10,472
25,016
Dutchess
10,472
Erie
North Carolina
Johnston
7,209
22,091
Jones
9,047
21,390
County
Employee- Dependent,
Only
Family, etc.
Lee
7,438
25,284
25,016
Alamance
7,438
25,284
Lenoir
9,047
21,390
7,921
19,730
Alexander
7,023
20,967
Lincoln
8,254
22,198
Essex
9,118
23,428
Alleghany
7,736
23,965
Macon
7,301
21,752
Franklin
9,118
23,428
Anson
7,131
22,733
Madison
7,301
21,752
Fulton
8,439
21,463
Ashe
7,736
23,965
Martin
7,967
22,994
Genesee
7,921
19,730
Avery
7,301
21,752
McDowell
7,301
21,752
Greene
8,439
21,463
Beaufort
9,047
21,390
Mecklenburg
7,131
22,733
-22-
2022 Average Premium Tables
Mitchell
7,301
21,752
Cavalier
8,478
24,547
Auglaize
7,480
19,589
Montgomery
9,030
22,169
Dickey
8,478
24,547
Belmont
7,496
19,458
Moore
9,030
22,169
Divide
8,478
24,547
Brown
7,363
19,544
Nash
8,970
27,984
Dunn
8,478
24,547
Butler
7,124
22,838
New Hanover
7,474
21,413
Eddy
8,478
24,547
Carroll
7,521
21,311
Northampton
7,967
22,994
Emmons
8,478
24,547
Champaign
6,862
19,411
DRAFT AS OF
November 22, 2022
Onslow
7,474
21,413
Foster
8,478
24,547
Clark
6,862
19,411
Orange
7,438
25,284
Golden Valley
8,478
24,547
Clermont
7,363
19,544
Pamlico
9,047
21,390
Grand Forks
7,139
23,920
Clinton
7,363
19,544
Pasquotank
7,967
22,994
Grant
8,478
24,547
Columbiana
7,528
20,468
Pender
7,474
21,413
Griggs
8,478
24,547
Coshocton
7,496
19,458
Perquimans
7,967
22,994
Hettinger
8,478
24,547
Crawford
7,128
20,059
Person
7,438
25,284
Kidder
8,478
24,547
Cuyahoga
7,530
23,234
Pitt
8,970
27,984
La Moure
8,478
24,547
Darke
6,862
19,411
Polk
7,301
21,752
Logan
8,478
24,547
Defiance
8,137
21,370
Randolph
7,341
21,582
McHenry
8,478
24,547
Delaware
7,055
22,087
Richmond
7,233
23,420
McIntosh
8,478
24,547
Erie
8,591
20,639
Robeson
7,233
23,420
McKenzie
8,478
24,547
Fairfield
7,055
22,087
Rockingham
7,341
21,582
McLean
8,478
24,547
Fayette
7,055
22,087
Rowan
7,131
22,733
Mercer
8,478
24,547
Franklin
7,055
22,087
Rutherford
7,301
21,752
Morton
8,059
23,849
Fulton
8,137
21,370
Sampson
7,233
23,420
Mountrail
8,478
24,547
Gallia
8,906
23,548
Scotland
7,233
23,420
Nelson
8,478
24,547
Geauga
7,530
23,234
Stanly
7,131
22,733
Oliver
8,478
24,547
Greene
6,862
19,411
Stokes
8,418
23,593
Pembina
8,478
24,547
Guernsey
7,496
19,458
Surry
8,418
23,593
Pierce
8,478
24,547
Hamilton
7,124
22,838
Swain
7,301
21,752
Ramsey
8,478
24,547
Hancock
7,480
19,589
Transylvania
7,301
21,752
Ransom
8,478
24,547
Hardin
7,480
19,589
Tyrrell
9,047
21,390
Renville
8,478
24,547
Harrison
7,496
19,458
Union
7,131
22,733
Richland
8,478
24,547
Henry
8,137
21,370
Vance
6,774
20,823
Rolette
8,478
24,547
Highland
7,363
19,544
Wake
7,209
22,091
Sargent
8,478
24,547
Hocking
7,051
21,428
Warren
6,774
20,823
Sheridan
8,478
24,547
Holmes
5,810
18,897
Washington
9,047
21,390
Sioux
8,478
24,547
Huron
8,591
20,639
Watauga
7,736
23,965
Slope
8,478
24,547
Jackson
8,906
23,548
Wayne
8,970
27,984
Stark
8,478
24,547
Jefferson
7,496
19,458
Wilkes
7,736
23,965
Steele
8,478
24,547
Knox
7,055
22,087
Wilson
8,970
27,984
Stutsman
8,478
24,547
Lake
7,530
23,234
Yadkin
8,418
23,593
Towner
8,478
24,547
Lawrence
8,906
23,548
Yancey
7,301
21,752
Traill
8,478
24,547
Licking
7,055
22,087
Walsh
8,478
24,547
Logan
7,055
22,087
Ward
8,478
24,547
Lorain
7,530
23,234
Wells
8,478
24,547
Lucas
8,137
21,370
Williams
8,478
24,547
Madison
7,055
22,087
Mahoning
7,528
20,468
Marion
7,654
21,747
North Dakota
County
Employee- Dependent,
Only
Family, etc.
Adams
8,478
24,547
Barnes
8,478
24,547
Benson
8,478
24,547
7,297
22,928
8,478
24,547
County
Employee- Dependent,
Only
Family, etc.
Medina
Billings
Meigs
7,051
21,428
Bottineau
8,478
24,547
Adams
7,363
19,544
Mercer
7,480
19,589
Bowman
8,478
24,547
Allen
7,480
19,589
Miami
6,862
19,411
Burke
8,478
24,547
Ashland
7,297
22,928
Monroe
7,496
19,458
Burleigh
8,059
23,849
Ashtabula
7,530
23,234
Montgomery
6,862
19,411
Cass
7,707
24,039
Athens
7,051
21,428
Morgan
7,496
19,458
2022 Average Premium Tables
Ohio
-23-
Morrow
7,654
21,747
Custer
8,126
22,340
Wagoner
8,397
22,134
Muskingum
7,496
19,458
Delaware
8,126
22,340
Washington
8,126
22,340
Noble
7,496
19,458
Dewey
8,126
22,340
Washita
8,126
22,340
Ottawa
8,591
20,639
Ellis
8,126
22,340
Woods
8,126
22,340
Paulding
7,480
19,589
Garfield
8,126
22,340
Woodward
8,126
22,340
Perry
7,496
19,458
Garvin
8,126
22,340
Oregon
DRAFT AS OF
November 22, 2022
Pickaway
7,055
22,087
Grady
8,463
21,112
Pike
8,906
23,548
Grant
8,126
22,340
Portage
7,297
22,928
Greer
8,126
22,340
County
Employee- Dependent,
Only
Family, etc.
Preble
6,862
19,411
Harmon
8,126
22,340
Baker
9,689
22,450
7,925
19,683
Putnam
7,480
19,589
Harper
8,126
22,340
Benton
Richland
7,128
20,059
Haskell
8,126
22,340
Clackamas
7,421
20,588
22,340
Clatsop
9,288
23,313
9,288
23,313
Ross
8,906
23,548
Hughes
8,126
Sandusky
8,591
20,639
Jackson
8,126
22,340
Columbia
Scioto
8,906
23,548
Jefferson
8,126
22,340
Coos
9,288
23,313
22,340
Crook
9,689
22,450
9,288
23,313
Seneca
8,591
20,639
Johnston
8,126
Shelby
6,862
19,411
Kay
8,126
22,340
Curry
Stark
7,521
21,311
Kingfisher
8,126
22,340
Deschutes
7,854
23,403
7,446
20,341
Summit
7,297
22,928
Kiowa
8,126
22,340
Douglas
Trumbull
7,528
20,468
Latimer
8,126
22,340
Gilliam
9,689
22,450
Tuscarawas
7,496
19,458
Le Flore
7,472
19,440
Grant
9,689
22,450
9,689
22,450
Union
7,055
22,087
Lincoln
8,463
21,112
Harney
Van Wert
7,480
19,589
Logan
8,463
21,112
Hood River
9,689
22,450
22,340
Jackson
7,446
20,341
9,689
22,450
Vinton
8,906
23,548
Love
8,126
Warren
7,124
22,838
Major
8,126
22,340
Jefferson
Washington
7,051
21,428
Marshall
8,126
22,340
Josephine
7,446
20,341
22,340
Klamath
7,854
23,403
7,854
23,403
Wayne
5,810
18,897
Mayes
8,126
Williams
8,137
21,370
McClain
8,463
21,112
Lake
Wood
8,137
21,370
McCurtain
8,126
22,340
Lane
7,925
19,683
22,340
Lincoln
9,288
23,313
7,925
19,683
Wyandot
8,591
20,639
Oklahoma
McIntosh
8,126
Murray
8,126
22,340
Linn
Muskogee
8,126
22,340
Malheur
9,689
22,450
22,340
Marion
7,547
20,938
9,689
22,450
Noble
County
Employee- Dependent,
Only
Family, etc.
Nowata
8,126
22,340
Morrow
Adair
8,126
22,340
Okfuskee
8,126
22,340
Multnomah
7,421
20,588
Alfalfa
8,126
22,340
Oklahoma
8,463
21,112
Polk
7,547
20,938
Atoka
8,126
22,340
Okmulgee
8,397
22,134
Sherman
9,689
22,450
Beaver
8,126
22,340
Osage
8,397
22,134
Tillamook
9,288
23,313
Beckham
8,126
22,340
Ottawa
8,126
22,340
Umatilla
9,689
22,450
Blaine
8,126
22,340
Pawnee
8,397
22,134
Union
9,689
22,450
Bryan
8,126
22,340
Payne
8,126
22,340
Wallowa
9,689
22,450
Caddo
8,126
22,340
Pittsburg
8,126
22,340
Wasco
9,689
22,450
Canadian
8,463
21,112
Pontotoc
8,126
22,340
Washington
7,421
20,588
Carter
8,126
22,340
22,340
Wheeler
9,689
22,450
Cherokee
8,126
22,340
Pushmataha
8,126
22,340
Yamhill
7,421
20,588
Choctaw
8,126
22,340
Roger Mills
8,126
22,340
Cimarron
8,126
22,340
Rogers
8,397
22,134
Cleveland
8,463
21,112
Seminole
8,126
22,340
Coal
8,126
22,340
Sequoyah
7,472
19,440
Comanche
7,985
20,401
Stephens
8,126
22,340
Texas
8,126
22,340
Cotton
8,126
22,340
Pottawatomie
8,126
8,126
Craig
8,126
22,340
Tillman
8,126
22,340
Creek
8,397
22,134
Tulsa
8,397
22,134
-24-
Pennsylvania
County
Employee- Dependent,
Only
Family, etc.
Adams
8,517
24,095
Allegheny
7,505
20,973
Armstrong
7,505
20,973
Beaver
7,505
20,973
2022 Average Premium Tables
Bedford
8,469
18,764
Susquehanna
7,798
20,923
McCormick
8,590
22,487
Berks
8,517
24,095
Tioga
7,798
20,923
Newberry
8,550
21,978
Blair
8,469
18,764
Union
8,495
26,717
Oconee
9,341
25,843
Bradford
7,798
20,923
Venango
6,677
18,591
Orangeburg
8,291
23,112
Bucks
8,195
22,881
Warren
6,677
18,591
Pickens
7,983
21,437
Butler
7,505
20,973
Washington
7,505
20,973
Richland
8,074
22,898
DRAFT AS OF
November 22, 2022
Cambria
8,469
18,764
Wayne
7,798
20,923
Saluda
8,422
21,893
Cameron
7,314
22,737
Westmoreland
7,505
20,973
Spartanburg
7,709
22,370
Carbon
7,798
20,923
Wyoming
7,798
20,923
Sumter
7,679
18,991
Centre
8,495
26,717
York
8,517
24,095
Union
7,041
21,245
Chester
8,195
22,881
Williamsburg
7,261
21,058
Clarion
6,677
18,591
York
7,788
21,543
Clearfield
8,469
18,764
Clinton
7,798
20,923
County
Employee- Dependent,
Only
Family, etc.
Columbia
8,495
26,717
All
8,796
Crawford
6,677
18,591
Cumberland
7,824
22,892
Dauphin
7,824
22,892
Delaware
8,195
22,881
Elk
7,314
22,737
Erie
6,677
18,591
Fayette
7,505
20,973
Forest
6,677
18,591
Franklin
7,824
22,892
Fulton
7,824
22,892
Greene
7,505
20,973
Huntingdon
8,469
18,764
Indiana
7,505
20,973
Jefferson
8,469
18,764
Juniata
7,824
22,892
Lackawanna
7,798
20,923
Lancaster
8,517
24,095
Lawrence
7,505
20,973
Lebanon
7,824
22,892
Lehigh
8,495
26,717
Luzerne
7,798
20,923
Lycoming
7,798
20,923
McKean
6,677
18,591
Mercer
6,677
18,591
Mifflin
8,495
26,717
Monroe
7,798
20,923
Montgomery
8,195
22,881
Montour
8,495
26,717
Northampton
8,495
26,717
Northumberland
8,495
26,717
Perry
7,824
22,892
Philadelphia
8,195
22,881
Pike
7,798
20,923
Potter
7,314
22,737
Schuylkill
8,495
26,717
Snyder
8,495
26,717
Somerset
8,469
18,764
Sullivan
7,798
20,923
2022 Average Premium Tables
Rhode Island
South Dakota
22,443
South Carolina
County
Employee- Dependent,
Only
Family, etc.
Aurora
8,365
24,641
Employee- Dependent,
Only
Family, etc.
Beadle
7,825
23,411
County
Bennett
7,426
21,045
Abbeville
8,099
21,832
Bon Homme
8,365
24,641
Aiken
7,541
20,086
Brookings
7,825
23,411
Allendale
7,955
21,875
Brown
7,825
23,411
Anderson
7,847
21,384
Brule
8,365
24,641
Bamberg
7,113
21,596
Buffalo
8,365
24,641
Barnwell
6,912
20,869
Butte
7,426
21,045
Beaufort
8,126
20,827
Campbell
7,825
23,411
Berkeley
8,717
20,879
Charles Mix
8,365
24,641
Calhoun
7,482
21,376
Clark
7,825
23,411
Charleston
7,415
22,356
Clay
7,321
21,356
Cherokee
7,507
20,578
Codington
7,825
23,411
Chester
8,071
21,886
Corson
7,426
21,045
Chesterfield
7,763
21,539
Custer
7,426
21,045
Clarendon
6,892
21,517
Davison
8,365
24,641
Colleton
7,936
21,642
Day
7,825
23,411
Darlington
8,319
21,826
Deuel
7,825
23,411
Dillon
8,040
20,864
Dewey
7,426
21,045
Dorchester
9,023
21,735
Douglas
8,365
24,641
Edgefield
6,572
20,226
Edmunds
7,825
23,411
Fairfield
7,982
21,314
Fall River
7,426
21,045
Florence
8,165
21,727
Faulk
7,825
23,411
Georgetown
8,100
20,184
Grant
7,825
23,411
Greenville
8,011
21,912
Gregory
7,426
21,045
Greenwood
6,783
20,630
Haakon
7,426
21,045
Hampton
8,305
21,777
Hamlin
7,825
23,411
Horry
7,012
22,581
Hand
8,365
24,641
Jasper
7,799
21,474
Hanson
8,365
24,641
Kershaw
8,349
21,301
Harding
7,426
21,045
Lancaster
8,029
21,225
Hughes
8,365
24,641
Laurens
7,675
21,208
Hutchinson
8,365
24,641
Lee
7,814
21,118
Hyde
8,365
24,641
Lexington
8,215
21,027
Jackson
7,426
21,045
Marion
8,491
22,753
Jerauld
8,365
24,641
Marlboro
8,036
21,987
Jones
7,426
21,045
-25-
Kingsbury
7,825
23,411
DeKalb
6,672
16,567
Robertson
7,695
19,360
Lake
7,321
21,356
Dickson
6,733
18,618
Rutherford
7,695
19,360
Lawrence
7,426
21,045
Dyer
7,401
20,883
Scott
6,720
17,996
Lincoln
7,321
21,356
Fayette
7,200
18,799
Sequatchie
7,379
18,618
Lyman
7,426
21,045
Fentress
6,672
16,567
Sevier
6,720
17,996
Marshall
7,825
23,411
Franklin
7,379
18,618
Shelby
7,200
18,799
DRAFT AS OF
November 22, 2022
McCook
7,321
21,356
Gibson
7,401
20,883
Smith
6,672
16,567
McPherson
7,825
23,411
Giles
6,733
18,618
Stewart
6,733
18,618
Meade
7,426
21,045
Grainger
6,720
17,996
Sullivan
7,434
18,852
Mellette
7,426
21,045
Greene
7,434
18,852
Sumner
7,695
19,360
Miner
8,365
24,641
Grundy
7,379
18,618
Tipton
7,200
18,799
Minnehaha
7,321
21,356
Hamblen
6,720
17,996
Trousdale
7,695
19,360
Moody
7,321
21,356
Hamilton
7,379
18,618
Unicoi
7,434
18,852
Pennington
7,426
21,045
Hancock
7,434
18,852
Union
6,720
17,996
Perkins
7,426
21,045
Hardeman
7,401
20,883
Van Buren
6,672
16,567
Potter
7,825
23,411
Hardin
7,401
20,883
Warren
6,672
16,567
Roberts
7,825
23,411
Hawkins
7,434
18,852
Washington
7,434
18,852
Sanborn
8,365
24,641
Haywood
7,200
18,799
Wayne
6,733
18,618
Shannon
7,426
21,045
Henderson
7,401
20,883
Weakley
7,401
20,883
Spink
7,825
23,411
Henry
7,401
20,883
White
6,672
16,567
Stanley
7,426
21,045
Hickman
6,733
18,618
Williamson
7,695
19,360
Sully
8,365
24,641
Houston
6,733
18,618
Wilson
7,695
19,360
Todd
7,426
21,045
Humphreys
6,733
18,618
Tripp
7,426
21,045
Jackson
6,672
16,567
Turner
7,321
21,356
Jefferson
6,720
17,996
Union
7,321
21,356
Johnson
7,434
18,852
County
Employee- Dependent,
Only
Family, etc.
Walworth
7,825
23,411
Knox
6,720
17,996
Anderson
7,822
19,420
7,822
19,420
Texas
Yankton
8,365
24,641
Lake
7,401
20,883
Andrews
Ziebach
7,426
21,045
Lauderdale
7,200
18,799
Angelina
7,822
19,420
18,618
Aransas
8,102
26,628
8,440
20,716
Lawrence
Tennessee
County
Employee- Dependent,
Only
Family, etc.
6,733
Lewis
6,733
18,618
Archer
Lincoln
6,733
18,618
Armstrong
10,030
22,167
17,996
Atascosa
7,665
18,955
7,022
22,662
Loudon
6,720
Anderson
6,720
17,996
Macon
6,672
16,567
Austin
Bedford
6,733
18,618
Madison
7,401
20,883
Bailey
7,822
19,420
Benton
7,401
20,883
Marion
7,379
18,618
Bandera
7,665
18,955
Bledsoe
7,379
18,618
Marshall
6,733
18,618
Bastrop
7,061
20,191
Blount
6,720
17,996
Maury
6,733
18,618
Baylor
7,822
19,420
Bradley
7,379
18,618
McMinn
7,379
18,618
Bee
7,822
19,420
Campbell
6,720
17,996
McNairy
7,401
20,883
Bell
7,339
16,674
Cannon
6,672
16,567
Meigs
7,379
18,618
Bexar
7,665
18,955
Carroll
7,401
20,883
Monroe
6,720
17,996
Blanco
7,822
19,420
Carter
7,434
18,852
Montgomery
7,695
19,360
Borden
7,822
19,420
Cheatham
7,695
19,360
18,618
Bosque
7,822
19,420
Chester
7,401
20,883
Morgan
6,720
17,996
Bowie
6,585
18,517
Claiborne
6,720
17,996
Obion
7,401
20,883
Brazoria
7,022
22,662
Clay
6,672
16,567
16,567
Brazos
7,118
20,305
Cocke
6,720
17,996
Perry
6,733
18,618
Brewster
7,822
19,420
Coffee
6,733
18,618
Pickett
6,672
16,567
Briscoe
7,822
19,420
Crockett
7,401
20,883
18,618
Brooks
7,822
19,420
7,822
19,420
Moore
Overton
Polk
6,733
6,672
7,379
Cumberland
6,672
16,567
Putnam
6,672
16,567
Brown
Davidson
7,695
19,360
Rhea
7,379
18,618
Burleson
7,118
20,305
Decatur
7,401
20,883
17,996
Burnet
7,822
19,420
Roane
6,720
-26-
2022 Average Premium Tables
Caldwell
7,061
20,191
Freestone
7,822
19,420
Kimble
7,822
19,420
Calhoun
8,198
21,075
Frio
7,822
19,420
King
7,822
19,420
Callahan
7,456
20,335
Gaines
7,822
19,420
Kinney
7,822
19,420
Cameron
6,716
18,683
Galveston
7,022
22,662
Kleberg
7,822
19,420
Camp
7,822
19,420
Garza
7,822
19,420
Knox
7,822
19,420
Carson
10,030
22,167
Gillespie
7,822
19,420
Lamar
7,822
19,420
DRAFT AS OF
November 22, 2022
Cass
7,822
19,420
Glasscock
7,822
19,420
Lamb
7,822
19,420
Castro
7,822
19,420
Goliad
8,198
21,075
Lampasas
7,339
16,674
Chambers
7,022
22,662
Gonzales
7,822
19,420
LaSalle
7,822
19,420
Cherokee
7,822
19,420
Gray
7,822
19,420
Lavaca
7,822
19,420
Childress
7,822
19,420
Grayson
7,707
19,176
Lee
7,822
19,420
Clay
8,440
20,716
Gregg
6,126
22,987
Leon
7,822
19,420
Cochran
7,822
19,420
Grimes
7,822
19,420
Liberty
7,022
22,662
Coke
7,822
19,420
Guadalupe
7,665
18,955
Limestone
7,822
19,420
Coleman
7,822
19,420
Hale
7,822
19,420
Lipscomb
7,822
19,420
Collin
7,978
22,164
Hall
7,822
19,420
Live Oak
7,822
19,420
Collingsworth
7,822
19,420
Hamilton
7,822
19,420
Llano
7,822
19,420
Colorado
7,822
19,420
Hansford
7,822
19,420
Loving
7,822
19,420
Comal
7,665
18,955
Hardeman
7,822
19,420
Lubbock
6,457
21,917
Comanche
7,822
19,420
Hardin
9,052
22,480
Lynn
7,822
19,420
Concho
7,822
19,420
Harris
7,022
22,662
Madison
7,822
19,420
Cooke
7,822
19,420
Harrison
7,822
19,420
Marion
7,822
19,420
Coryell
7,339
16,674
Hartley
7,822
19,420
Martin
7,822
19,420
Cottle
7,822
19,420
Haskell
7,822
19,420
Mason
7,822
19,420
Crane
7,822
19,420
Hays
7,061
20,191
Matagorda
7,822
19,420
Crockett
7,822
19,420
Hemphill
7,822
19,420
Maverick
7,822
19,420
Crosby
6,457
21,917
Henderson
7,822
19,420
McCulloch
7,822
19,420
Culberson
7,822
19,420
Hidalgo
8,613
21,323
McLennan
5,696
16,196
Dallam
7,822
19,420
Hill
7,822
19,420
McMullen
7,822
19,420
Dallas
7,978
22,164
Hockley
7,822
19,420
Medina
7,665
18,955
Dawson
7,822
19,420
Hood
7,822
19,420
Menard
7,822
19,420
Deaf Smith
7,822
19,420
Hopkins
7,822
19,420
Midland
6,913
22,892
Delta
7,978
22,164
Houston
7,822
19,420
Milam
7,822
19,420
Denton
7,978
22,164
Howard
7,822
19,420
Mills
7,822
19,420
DeWitt
7,822
19,420
Hudspeth
7,822
19,420
Mitchell
7,822
19,420
Dickens
7,822
19,420
Hunt
7,978
22,164
Montague
7,822
19,420
Dimmit
7,822
19,420
Hutchinson
7,822
19,420
Montgomery
7,022
22,662
Donley
7,822
19,420
Irion
10,151
20,682
Moore
7,822
19,420
Duval
7,822
19,420
Jack
7,822
19,420
Morris
7,822
19,420
Eastland
7,822
19,420
Jackson
7,822
19,420
Motley
7,822
19,420
Ector
8,911
19,166
Jasper
7,822
19,420
Nacogdoches
7,822
19,420
Edwards
7,822
19,420
Jeff Davis
7,822
19,420
Navarro
7,822
19,420
El Paso
7,581
16,149
Jefferson
9,052
22,480
Newton
7,822
19,420
Ellis
7,978
22,164
Jim Hogg
7,822
19,420
Nolan
7,822
19,420
Erath
7,822
19,420
Jim Wells
7,822
19,420
Nueces
8,102
26,628
Falls
7,822
19,420
Johnson
7,978
22,164
Ochiltree
7,822
19,420
Fannin
7,822
19,420
Jones
7,456
20,335
Oldham
7,822
19,420
Fayette
7,822
19,420
Karnes
7,822
19,420
Orange
9,052
22,480
Fisher
7,822
19,420
Kaufman
7,978
22,164
Palo Pinto
7,822
19,420
Floyd
7,822
19,420
Kendall
7,665
18,955
Panola
7,822
19,420
Foard
7,822
19,420
Kenedy
7,822
19,420
Parker
7,978
22,164
Fort Bend
7,022
22,662
Kent
7,822
19,420
Parmer
7,822
19,420
Franklin
7,822
19,420
Kerr
7,822
19,420
Pecos
7,822
19,420
2022 Average Premium Tables
-27-
Virginia
Polk
7,822
19,420
Webb
7,455
20,524
Potter
10,030
22,167
Wharton
7,822
19,420
Presidio
7,822
19,420
Wheeler
7,822
19,420
County
Employee- Dependent,
Only
Family, etc.
Rains
7,822
19,420
Wichita
8,440
20,716
Accomack
7,346
19,191
Randall
10,030
22,167
Wilbarger
7,822
19,420
Albemarle
8,974
21,460
Reagan
7,822
19,420
Willacy
7,822
19,420
Alexandria City
7,542
23,327
DRAFT AS OF
November 22, 2022
Real
7,822
19,420
Williamson
7,061
20,191
Alleghany
7,346
19,191
Red River
7,822
19,420
Wilson
7,665
18,955
Amelia
7,131
22,408
Reeves
7,822
19,420
Winkler
7,822
19,420
Amherst
6,642
18,936
6,642
18,936
Refugio
7,822
19,420
Wise
7,978
22,164
Appomattox
Roberts
7,822
19,420
Wood
7,822
19,420
Arlington
7,542
23,327
Robertson
7,118
20,305
Yoakum
7,822
19,420
Augusta
7,346
19,191
7,346
19,191
Rockwall
7,978
22,164
Young
7,822
19,420
Bath
Runnels
7,822
19,420
Zapata
7,822
19,420
Bedford
6,642
18,936
Rusk
6,126
22,987
Zavala
7,822
19,420
Bedford City
6,642
18,936
Bland
7,346
19,191
Botetourt
7,631
22,437
7,629
18,863
Sabine
7,822
19,420
San Augustine
7,822
19,420
San Jacinto
7,022
22,662
Utah
Employee- Dependent,
Only
Family, etc.
Bristol City
San Patricio
8,102
26,628
County
Brunswick
7,346
19,191
San Saba
7,822
19,420
Beaver
7,720
21,979
Buchanan
7,346
19,191
Schleicher
7,822
19,420
Box Elder
7,158
20,264
Buckingham
7,346
19,191
8,509
23,989
Scurry
7,822
19,420
Cache
Buena Vista City
7,346
19,191
Shackelford
7,822
19,420
Carbon
7,720
21,979
Campbell
6,642
18,936
19,420
Daggett
7,720
21,979
Caroline
7,131
22,408
7,291
20,730
Shelby
7,822
Sherman
7,822
19,420
Davis
Carroll
7,346
19,191
Smith
7,669
22,893
Duchesne
7,720
21,979
Charles City
7,131
22,408
19,420
Emery
7,720
21,979
Charlotte
7,346
19,191
7,720
21,979
Somervell
7,822
Starr
7,822
19,420
Garfield
Charlottesville City
8,974
21,460
Stephens
7,822
19,420
Grand
7,720
21,979
Chesapeake City
7,659
21,119
19,420
Iron
9,091
20,622
Chesterfield
7,131
22,408
7,720
21,979
Sterling
7,822
Stonewall
7,822
19,420
Juab
Clarke
7,542
23,327
Sutton
7,822
19,420
Kane
7,720
21,979
Colonial Heights City
7,131
22,408
19,420
Millard
7,720
21,979
Covington City
7,346
19,191
7,158
20,264
Swisher
7,822
Tarrant
7,978
22,164
Morgan
Craig
7,631
22,437
Taylor
7,456
20,335
Piute
7,720
21,979
Culpeper
7,346
19,191
8,509
23,989
Terrell
7,822
19,420
Rich
Cumberland
7,131
22,408
Terry
7,822
19,420
Salt Lake
7,291
20,730
Danville City
8,956
21,176
Throckmorton
7,822
19,420
San Juan
7,720
21,979
Dickenson
7,346
19,191
7,720
21,979
Titus
7,822
19,420
Sanpete
Dinwiddie
7,131
22,408
Tom Green
10,151
20,682
Sevier
7,720
21,979
Emporia City
7,346
19,191
Travis
7,061
20,191
Summit
7,291
20,730
Essex
7,346
19,191
7,291
20,730
Trinity
7,822
19,420
Tooele
Fairfax
7,542
23,327
Tyler
7,822
19,420
Uintah
7,720
21,979
Fairfax City
7,542
23,327
22,987
Utah
6,255
21,210
Falls Church City
7,542
23,327
7,291
20,730
Upshur
6,126
Upton
7,822
19,420
Wasatch
Fauquier
7,542
23,327
Uvalde
7,822
19,420
Washington
9,091
20,622
Floyd
7,346
19,191
19,420
Wayne
7,720
21,979
Fluvanna
8,974
21,460
Weber
7,158
20,264
Franklin
7,631
22,437
Franklin City
7,346
19,191
Frederick
7,139
19,828
Fredericksburg City
7,542
23,327
Galax City
7,346
19,191
Giles
6,887
20,744
Val Verde
7,822
Van Zandt
7,822
19,420
Victoria
8,198
21,075
Walker
7,822
19,420
Waller
7,022
22,662
Ward
7,822
19,420
Washington
7,822
19,420
Vermont
County
Employee- Dependent,
Only
Family, etc.
All
8,460
-28-
23,240
2022 Average Premium Tables
Gloucester
7,659
21,119
Radford City
6,887
20,744
Kittitas
7,672
21,504
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
7,967
20,803
Greene
8,974
21,460
Richmond City
7,131
22,408
Lincoln
7,333
18,084
Greensville
7,346
19,191
Roanoke
7,631
22,437
Mason
7,967
20,803
Halifax
7,346
19,191
Roanoke City
7,631
22,437
Okanogan
7,672
21,504
DRAFT AS OF
November 22, 2022
Hampton City
7,659
21,119
Rockbridge
7,346
19,191
Pacific
7,967
20,803
Hanover
7,131
22,408
Rockingham
7,253
21,742
Pend Oreille
7,333
18,084
Harrisonburg City
7,253
21,742
Russell
7,346
19,191
Pierce
7,967
20,803
Henrico
7,131
22,408
Salem City
7,631
22,437
San Juan
7,967
20,803
Henry
7,346
19,191
Scott
7,629
18,863
Skagit
7,967
20,803
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
7,967
20,803
Isle of Wight
7,659
21,119
Southampton
7,346
19,191
Spokane
7,333
18,084
James City
7,659
21,119
Spotsylvania
7,542
23,327
Stevens
7,333
18,084
King and Queen
7,131
22,408
Stafford
7,542
23,327
Thurston
7,967
20,803
King George
7,346
19,191
Staunton City
7,346
19,191
Wahkiakum
7,967
20,803
King William
7,131
22,408
Suffolk City
7,659
21,119
Walla Walla
7,672
21,504
Lancaster
7,346
19,191
Surry
7,659
21,119
Whatcom
7,967
20,803
Lee
7,346
19,191
Sussex
7,131
22,408
Whitman
7,672
21,504
Lexington City
7,346
19,191
Tazewell
7,346
19,191
Yakima
7,672
21,504
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
18,863
Lynchburg City
6,642
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
8,482
24,657
21,119
Berkeley
7,970
24,049
7,875
26,140
Manassas City
7,542
23,327
Williamsburg City
7,659
West Virginia
Manassas Park City
7,542
23,327
Winchester City
7,139
19,828
Boone
Martinsville City
7,346
19,191
Wise
7,346
19,191
Braxton
9,567
25,392
19,191
Brooke
7,936
24,647
21,119
Cabell
7,745
24,334
Calhoun
9,567
25,392
Clay
9,567
25,392
Doddridge
7,968
22,054
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
8,974
21,460
New Kent
7,131
22,408
County
Employee- Dependent,
Only
Family, etc.
Fayette
9,567
25,392
7,672
21,504
Gilmer
7,968
22,054
Newport News City
7,659
21,119
Adams
Norfolk City
7,659
21,119
Asotin
7,672
21,504
Grant
6,607
22,895
Northampton
7,346
19,191
Benton
7,672
21,504
Greenbrier
9,567
25,392
7,672
21,504
Hampshire
6,607
22,895
Northumberland
7,346
19,191
Chelan
Norton City
7,346
19,191
Clallam
7,967
20,803
Hancock
7,936
24,647
Nottoway
7,346
19,191
Clark
7,145
18,452
Hardy
6,607
22,895
7,672
21,504
Harrison
8,482
24,657
Orange
7,346
19,191
Columbia
Page
7,346
19,191
Cowlitz
7,967
20,803
Jackson
9,390
28,051
19,191
Douglas
7,672
21,504
Jefferson
7,970
24,049
7,333
18,084
Kanawha
9,293
25,820
Patrick
7,346
Petersburg City
7,131
22,408
Ferry
Pittsylvania
8,956
21,176
Franklin
7,672
21,504
Lewis
7,968
22,054
21,119
Garfield
7,672
21,504
Lincoln
7,875
26,140
7,672
21,504
Logan
7,875
26,140
Poquoson
7,659
Portsmouth City
7,659
21,119
Grant
Powhatan
7,131
22,408
Grays Harbor
7,967
20,803
Marion
7,968
22,054
19,191
Island
7,967
20,803
Marshall
7,936
24,647
7,967
20,803
Mason
7,745
24,334
Prince Edward
7,346
Prince George
7,131
22,408
Jefferson
Prince William
7,542
23,327
King
7,851
21,289
McDowell
7,875
26,140
20,744
Kitsap
7,967
20,803
Mercer
7,754
20,390
Pulaski
6,887
2022 Average Premium Tables
-29-
Mineral
6,607
22,895
Dodge
6,944
21,470
Sawyer
7,985
25,622
Mingo
7,875
26,140
Door
7,305
22,221
Shawano
7,305
22,221
Monongalia
7,968
22,054
Douglas
7,985
25,622
Sheboygan
6,944
21,470
Monroe
7,754
20,390
Dunn
8,268
24,992
St. Croix
9,799
24,219
Morgan
6,607
22,895
Eau Claire
8,268
24,992
Taylor
7,671
22,602
Nicholas
9,567
25,392
Florence
6,647
21,458
Trempealeau
7,117
21,007
DRAFT AS OF
November 22, 2022
Ohio
7,936
24,647
Fond du Lac
6,944
21,470
Vernon
8,133
23,995
Pendleton
6,607
22,895
Forest
6,647
21,458
Vilas
6,647
21,458
Pleasants
9,390
28,051
Grant
8,133
23,995
Walworth
8,008
26,080
Pocahontas
8,482
24,657
Green
8,008
26,080
Washburn
7,985
25,622
Preston
8,482
24,657
Green Lake
7,489
29,125
Washington
7,826
24,696
Putnam
7,745
24,334
Iowa
8,133
23,995
Waukesha
7,826
24,696
Raleigh
7,754
20,390
Iron
6,647
21,458
Waupaca
6,944
21,470
Randolph
8,482
24,657
Jackson
7,117
21,007
Waushara
6,944
21,470
Ritchie
9,390
28,051
Jefferson
8,008
26,080
Winnebago
6,944
21,470
Roane
9,567
25,392
Juneau
7,489
29,125
Wood
8,141
24,385
Summers
7,754
20,390
Kenosha
8,772
26,795
Taylor
8,482
24,657
Kewaunee
7,305
22,221
Tucker
8,482
24,657
La Crosse
7,117
21,007
Tyler
9,390
28,051
Lafayette
8,133
23,995
County
Employee- Dependent,
Only
Family, etc.
Upshur
8,482
24,657
Langlade
6,647
21,458
Albany
8,544
24,339
8,544
24,339
Wyoming
Wayne
7,745
24,334
Lincoln
8,141
24,385
Big Horn
Webster
8,482
24,657
Manitowoc
7,305
22,221
Campbell
8,544
24,339
24,385
Carbon
8,544
24,339
8,544
24,339
Wetzel
7,968
22,054
Marathon
8,141
Wirt
9,390
28,051
Marinette
7,305
22,221
Converse
Wood
9,390
28,051
Marquette
7,489
29,125
Crook
8,544
24,339
22,221
Fremont
8,544
24,339
8,544
24,339
Wyoming
7,875
26,140
Wisconsin
Menomonee
7,305
Milwaukee
7,723
26,745
Goshen
Monroe
7,117
21,007
Hot Springs
8,544
24,339
22,221
Johnson
8,544
24,339
8,671
22,222
Employee- Dependent,
Only
Family, etc.
Oconto
County
Oneida
6,647
21,458
Laramie
Adams
7,489
29,125
Outagamie
6,944
21,470
Lincoln
8,544
24,339
Ashland
7,985
25,622
24,696
Natrona
8,899
22,349
8,544
24,339
Ozaukee
7,305
7,826
Barron
7,671
22,602
Pepin
8,268
24,992
Niobrara
Bayfield
7,985
25,622
Pierce
9,799
24,219
Park
8,544
24,339
Brown
7,305
22,221
Polk
9,799
24,219
Platte
8,544
24,339
Buffalo
7,117
21,007
Portage
8,141
24,385
Sheridan
8,544
24,339
Burnett
7,985
25,622
Price
7,671
22,602
Sublette
8,544
24,339
Calumet
6,944
21,470
Racine
8,772
26,795
Sweetwater
8,544
24,339
Chippewa
8,268
24,992
Richland
7,489
29,125
Teton
8,544
24,339
Clark
7,671
22,602
Rock
8,008
26,080
Uinta
8,544
24,339
Columbia
8,008
26,080
Rusk
7,671
22,602
Washakie
8,544
24,339
Crawford
8,133
23,995
Sauk
7,489
29,125
Weston
8,544
24,339
Dane
7,594
25,699
-30-
2022 Average Premium Tables
| File Type | application/pdf |
| File Title | 2022 Instructions for Form 8941 |
| Subject | Instructions for Form 8941, Credit for Small Employer Health Insurance Premiums |
| Author | W:CAR:MP:FP |
| File Modified | 2022-12-12 |
| File Created | 2022-11-17 |