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Formulár 8941 Inštrukcie

Pokyny pre formulár 8941, úver pre malé Zamestnávatelia zdravotné poistné

Rev. 2023

Súvisiace formuláre

  • Formulár 8941 - Kredit pre malé Zamestnávatelia zdravotné poistenie Premiums
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Department of the Treasury  
Internal Revenue Service  
2023  
Instructions for Form 8941  
Credit for Small Employer Health Insurance Premiums  
Section references are to the Internal Revenue Code  
unless otherwise noted.  
Partnerships, S corporations, cooperatives,  
estates, trusts, and tax-exempt eligible small  
employers must file this form to claim the credit.  
TIP  
Future Developments  
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.  
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/  
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.  
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.  
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  
2. You had fewer than 25 full-time equivalent employ-  
ees (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.  
through a SHOP Marketplace, go to  
TIP  
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.  
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 $62,000 per FTE. For details, see Worksheets  
1 and 3.  
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, General Business Credit.  
Nov 8, 2023  
Cat. No. 55222U  
If you had more than 10 FTEs and average annual  
wages of more than $30,000, the FTE and  
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.  
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  
!
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 $62,000.  
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).  
No more than one Form 8941 can be filed with a  
tax return, unless the exception described in  
TIP  
Example 2 below applies.  
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.  
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 1. You’re a sole proprietor with two separate  
businesses and you file a separate Schedule C (Form  
1040), Profit or Loss From Business, 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.  
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  
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:  
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  
An eligible small employer (or any predecessor) files an  
the premium cost of each employee enrolled in  
income tax return with an attached Form 8941 with line A  
checked “Yes” and a positive amount on line 12, or  
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.  
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.  
To determine the premiums you paid during the tax  
year, multiply the number of pay periods during which the  
-2-  
Instructions for Form 8941 (2023)  
     
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.  
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.  
Tobacco surcharge. Any additional amount you or your  
employee pays to cover a tobacco surcharge isn’t taken  
into account in figuring the uniform percentage  
requirement. Amounts you or your employee pays to cover  
a tobacco surcharge aren’t considered premiums paid for  
health insurance coverage when figuring this credit.  
Health Insurance Coverage  
For tax years beginning after 2013, health insurance  
coverage generally means coverage provided to  
employees enrolled in a qualified health plan offered  
through a Small Business Health Options Program  
(SHOP) Marketplace. For an exception that applies to  
certain employers in certain counties, see the instructions  
for line A, later. If this exception applies, health insurance  
coverage means coverage, as defined under Health  
Insurance Coverage in the 2013 Instructions for Form  
8941.  
Dependent coverage. Premiums you pay for dependent  
coverage aren’t subject to the uniform percentage  
requirement. You aren’t required to pay a uniform  
percentage (not less than 50%) for dependent coverage.  
Arrangements with composite billing. An arrangement  
that requires you to pay a uniform premium for each  
enrolled employee (composite billing) and offers different  
tiers of coverage can be a qualifying arrangement even if it  
requires you to pay a uniform percentage that is less than  
50% of the premium cost for employees not enrolled in  
employee-only coverage. It is a qualifying arrangement  
(assuming employee-only coverage is the least expensive  
tier of coverage) if it requires you to pay each of the  
following amounts if you make the relevant tier of coverage  
available.  
A stand-alone dental plan offered through a SHOP  
exchange will be considered a qualified health  
plan for purposes of the credit.  
TIP  
Employer premiums paid for health insurance  
coverage can be counted in figuring the credit only  
if the premiums are paid under a qualifying  
!
CAUTION  
arrangement.  
A uniform percentage (not less than 50%) of the  
premium cost for each employee (if any) enrolled in  
employee-only coverage.  
Qualifying Arrangement  
A uniform amount that is no less than the amount you  
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  
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).  
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-on-  
ly 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.  
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.  
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.  
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  
Arrangements with list billing and other tiers of cov-  
erage. 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  
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 premium  
Instructions for Form 8941 (2023)  
-3-  
     
requires you to pay each of the following amounts if you  
make the relevant tier of coverage available.  
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.  
A uniform percentage (not less than 50%) for each  
employee enrolled in employee-only coverage, as  
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  
Payroll Tax Limitation for Tax-Exempt  
Eligible Small Employers  
The credit for tax-exempt eligible small employers can’t  
exceed the amount of certain payroll taxes. For tax years  
beginning in 2023, payroll taxes, for this purpose, mean  
only the following taxes.  
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).  
Federal income taxes the tax-exempt employer was  
required to withhold from employees’ wages in calendar  
year 2023.  
Medicare taxes the tax-exempt employer was required  
to withhold from employees’ wages in calendar year 2023.  
Medicare taxes the tax-exempt employer was required  
to pay for calendar year 2023.  
Employer-computed composite rate. The  
Premium Deduction Reduced  
employer-computed composite rate for a tier of coverage  
is the average rate determined by adding the premiums for  
that tier of coverage for all employees eligible to  
participate in the health insurance plan (whether or not  
they actually receive coverage under the plan or under  
that tier of coverage) and dividing by the total number of  
such eligible employees.  
You must reduce your deduction for the cost of providing  
health insurance coverage to your employees by the  
amount of any credit for small employer health insurance  
premiums allowed with respect to the coverage.  
More Information  
For more information about this credit, see the following.  
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).  
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.  
Section 45R.  
Regulations sections 1.45R-0 through 1.45R-5.  
Specific Instructions  
Partnerships, S corporations, cooperatives,  
estates, trusts, and tax-exempt eligible small  
employers must file this form to claim the credit.  
TIP  
All other taxpayers must not complete or file this form if  
their only source for this credit is a partnership, S  
corporation, cooperative, estate, or trust. Instead, they  
must report this credit directly on line 4h in Part III of Form  
3800.  
State Premium Subsidy and Tax  
Credit Limitation  
Use Worksheets 1 through 7 to figure the amounts to  
report on various lines of Form 8941.  
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, 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.  
Line A  
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.  
-4-  
Instructions for Form 8941 (2023)  
   
You qualify for an exception to this requirement, as  
Worksheet 1. Information Needed To  
Complete Line 1 and Worksheets 2  
and 3  
discussed below.  
If you answer “Yes” because you paid premiums for  
employee health insurance coverage you provided  
through a SHOP Marketplace, enter the Marketplace  
identifier, if any.  
If you 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.  
(a)  
(b)  
(c)  
Employee  
Wages  
Paid  
Individuals  
Considered  
Employees  
Employee  
Hours of  
Service  
ꢀ1.  
ꢀ2.  
ꢀ3.  
ꢀ4.  
ꢀ5.  
ꢀ6.  
ꢀ7.  
ꢀ8.  
ꢀ9.  
10.  
11.  
12.  
13.  
14.  
15.  
16.  
17.  
18.  
19.  
20.  
21.  
22.  
23.  
24.  
25.  
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, go to CMS.gov.  
Exception for eligible small employers in certain  
counties. For calendar year 2023, 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 2023 if they  
properly claimed the credit under section 45R for all or  
part of 2022. For details, see Notice 2018-27, 2018-20,  
I.R.B. 580, available at IRS.gov/irb/  
To see whether a particular county has coverage  
available through a SHOP Exchange for 2023 and  
beyond, go to Healthcare.gov/small-business and  
TIP  
enter “plans and prices” in the search box.  
Line C  
Answer “Yes” if a tax return you (or any predecessor) filed  
for a tax year beginning after 2013 and before 2022  
included a Form 8941 with line A checked “Yes” and  
line 12 showing a positive amount. For more information,  
see Credit Period, earlier.  
If you answer “Yes,don’t file Form 8941 unless you’re  
filing it for a partnership, S corporation, cooperative,  
estate, trust, or tax-exempt eligible small employer that  
received from another entity a credit that must be reported  
on line 15. An entity that qualifies for this exception  
shouldn’t report any amount on line 12. For more  
information, see the instructions for line 15.  
Totals:  
Column (a), Individuals Considered  
Employees  
Enter the name or other identifying information for all  
individuals considered employees for purposes of this  
credit.  
In general, all employees who perform services for you  
during the tax year are taken into account in determining  
your FTEs, average annual wages, and premiums paid.  
Rules that apply to certain types of employees are  
discussed below.  
Instructions for Form 8941 (2023)  
-5-  
 
discussed above. A sole proprietor must include both  
business and nonbusiness employees to determine FTEs,  
average annual wages, and premiums paid.  
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.  
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.  
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.  
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.  
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).  
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.  
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).  
Provides services to you under an agreement between  
you and a leasing organization.  
Has performed services for you (or for you and a related  
Days-worked equivalency method. Use a  
person) substantially full time for at least 1 year.  
Performs services under your primary direction or  
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.  
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.  
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  
Column (c), Employee Wages Paid  
Complete Worksheet 2 before you complete  
column (c) of Worksheet 1. Do not complete  
!
CAUTION  
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.  
-6-  
Instructions for Form 8941 (2023)  
Wages, for this purpose, mean wages subject to social  
security and Medicare tax withholding determined without  
considering any wage base limit.  
Worksheet 4. Information Needed To  
Complete Lines 4, 5, and 13 and  
Worksheet 7  
Worksheet 2. Information Needed To  
Complete Line 2 (FTEs)  
If you need more rows, use a separate sheet and include  
the additional amounts in the totals below.  
Your credit is reduced if you had more than 10 FTEs for  
the tax year. If you had 25 or more FTEs for the tax year,  
your credit is reduced to zero.  
(a)  
(d)  
Enrolled  
(b)  
(c)  
Enrolled  
Employee  
Hours of  
Service  
Individuals  
Considered  
Employees  
Employer  
Premiums  
Paid  
Adjusted  
Average  
Premiums  
1. Enter the total employee hours of  
service from Worksheet 1, column  
(b) . . . . . . . . . . . . . . . . . . . . . . . . .  
Hours of service per FTE . . . . . . . . .  
1.  
2.  
ꢀ1.  
2,080  
2.  
ꢀ2.  
ꢀ3.  
ꢀ4.  
ꢀ5.  
ꢀ6.  
ꢀ7.  
ꢀ8.  
ꢀ9.  
10.  
11.  
12.  
13.  
14.  
15.  
16.  
17.  
18.  
19.  
20.  
21.  
22.  
23.  
24.  
25.  
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.  
Worksheet 3. Information Needed To  
Complete Line 3 (Average Annual  
Wages)  
Your credit is reduced if you paid average annual wages of  
more than $30,000 for the tax year. If you paid average  
annual wages of $62,000 or more for the tax year, your  
credit is reduced to zero.  
1. Enter the total employee wages paid  
from Worksheet 1, column (c) . . . . . .  
1.  
2.  
2. Enter FTEs from Worksheet 2,  
line 3 . . . . . . . . . . . . . . . . . . . . . . .  
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 . . .  
3.  
Totals:  
Column (a), Enrolled Individuals  
Considered Employees  
Enter the name or other identifying information for each  
individual listed in column (a) of Worksheet 1 who was  
enrolled in health insurance coverage you provided to  
employees during the tax year under a qualifying  
arrangement. For details, see Health Insurance Coverage  
and Qualifying Arrangement, earlier.  
Instructions for Form 8941 (2023)  
-7-  
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.  
Column (b), Employer Premiums Paid  
Enter the total employer premiums paid for the tax year for  
each employee listed in column (a). For details, see  
Column (d), Enrolled Employee Hours  
of Service  
Column (c), Adjusted Average  
Premiums  
Don’t complete column (d) of Worksheet 4 if Form  
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.  
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 . . . . . . . . . . . . . . . . . . . . . . . . . .  
1.  
2. Enter the number from Form  
8941, line 2 . . . . . . . . . . . .  
2.  
3.  
3. Subtract 10 from line 2 . . . . .  
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.  
4. Divide line 3 by 15. Enter the  
result as a decimal (rounded to  
at least 3 places) . . . . . . . .  
4.  
5. Multiply line 1 by line 4 . . . . . . . . . . . . . .  
5.  
6.  
6. Subtract line 5 from line 1. Report this  
amount on Form 8941, line 8 . . . . . . . . .  
To find the average premium for the small group market  
in a rating area for tax years beginning in 2023, see the  
average premium tables at the end of these instructions.  
Family coverage includes any coverage other than  
employee-only coverage.  
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.  
Worksheet 6. Information Needed To  
Complete Line 9 (If Line 3 Is More  
Than $30,000)  
1. Enter the amount from Form 8941,  
line 8 . . . . . . . . . . . . . . . . . . . . . . . . . .  
1.  
2. Enter the amount from Form  
8941, line 7 . . . . . . . . . . . . .  
2.  
3. Enter the amount from Form  
8941, line 3 . . . . . . . . . . . . .  
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  
3.  
4.  
4. Subtract $30,700 from line 3  
.
5. Divide line 4 by $30,700. Enter  
the result as a decimal (rounded  
to at least 3 places) . . . . . . . .  
5.  
6. Multiply line 2 by line 5 . . . . . . . . . . . . . .  
6.  
7.  
7. Subtract line 6 from line 1. Report this  
amount on Form 8941, line 9 . . . . . . . . .  
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  
-8-  
Instructions for Form 8941 (2023)  
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.  
Worksheet 7. Information Needed To  
Complete Line 14 (If Line 12 Is More  
Than Zero)  
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.  
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.  
1. Enter the total enrolled employee hours of  
service from Worksheet 4, column  
(d) . . . . . . . . . . . . . . . . . . . . . . . . . .  
2. Hours of service per FTE . . . . . . . . . .  
1.  
2.  
2,080  
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 . . . . . .  
3.  
If the estate or trust is subject to the passive activity  
rules, include on line 15 any credit for small employer  
health insurance premiums from passive activities  
disallowed for prior years and carried forward to this year.  
Complete Form 8582-CR, Passive Activity Credit  
Limitations, to determine the allowed credit that must be  
allocated between the estate or trust and the  
beneficiaries. For details, see the Instructions for Form  
8582-CR.  
Line 15  
Enter any credit for small employer health insurance  
premiums from:  
Schedule K-1 (Form 1065), Partner's Share of Income,  
Deductions, Credits, etc., box 15 (code BA);  
Schedule K-1 (Form 1120-S), Shareholder's Share of  
Income, Deductions, Credits, etc., box 13 (code BA);  
Schedule K-1 (Form 1041), Beneficiary’s Share of  
Income, Deductions, Credits, etc., box 13 (code G); and  
Form 1099-PATR, Taxable Distributions Received From  
Line 19  
Cooperatives, box 12, or other notice of credit allocation.  
Enter the total amount of certain payroll taxes. Payroll  
taxes, for this purpose, mean only the following taxes.  
Partnerships, S corporations, cooperatives,  
estates, trusts, and tax-exempt eligible small  
Federal income taxes the tax-exempt employer was  
TIP  
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.  
required to withhold from employees’ wages in calendar  
year 2023.  
Medicare taxes the tax-exempt employer was required  
to withhold from employees’ wages in calendar year 2023.  
Medicare taxes the tax-exempt employer was required  
to pay for calendar year 2023.  
Line 17  
Cooperatives. A cooperative described in section  
1381(a) must allocate to its patrons the credit in excess of  
Instructions for Form 8941 (2023)  
-9-  
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.  
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  
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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.  
-10-  
Instructions for Form 8941 (2023)  
Average Premiums Needed To Figure Adjusted Amounts on Worksheet 4  
The following tables list the average  
Limestone  
Lowndes  
Macon  
7,262  
8,391  
7,241  
7,262  
7,241  
7,241  
7,241  
7,468  
7,241  
8,391  
7,893  
7,241  
7,241  
7,241  
7,241  
7,210  
7,061  
7,061  
7,241  
7,241  
7,241  
7,665  
7,061  
7,241  
7,241  
7,241  
23,301  
23,453  
20,533  
23,301  
20,533  
20,533  
20,533  
22,163  
20,533  
23,453  
19,596  
20,533  
20,533  
20,533  
20,533  
21,092  
22,250  
22,250  
20,533  
20,533  
20,533  
21,879  
22,250  
20,533  
20,533  
20,533  
Petersburg  
11,771  
31,062  
31,062  
31,062  
31,062  
30,930  
29,868  
30,930  
31,062  
premiums for the small group market  
in each rating area generally listed by  
county for each state for tax years  
beginning in 2023.  
Prince of Wales-Hyder 11,771  
Sitka  
11,771  
11,771  
12,011  
11,303  
12,011  
11,771  
Madison  
Marengo  
Marion  
Skagway  
Southeast Fairbanks  
Valdez Cordova  
Wade Hampton  
Alabama  
Marshall  
Mobile  
Employee- Dependent,  
County  
Autauga  
Baldwin  
Barbour  
Bibb  
Only  
Family, etc.  
23,453  
20,533  
20,533  
22,250  
22,250  
20,533  
20,533  
20,924  
20,533  
20,533  
22,250  
20,533  
20,533  
20,533  
20,533  
20,533  
22,810  
20,533  
20,533  
20,533  
20,533  
20,533  
20,533  
20,533  
20,533  
23,453  
20,533  
22,226  
20,533  
20,533  
22,014  
21,879  
21,879  
22,014  
22,014  
20,533  
22,250  
20,533  
22,810  
19,596  
19,185  
Wrangell City and  
Borough  
8,391  
7,241  
7,241  
7,061  
7,061  
7,241  
7,241  
6,836  
7,241  
7,241  
7,061  
7,241  
7,241  
7,241  
7,241  
7,241  
8,701  
7,241  
7,241  
7,241  
7,241  
7,241  
7,241  
7,241  
7,241  
8,391  
7,241  
6,539  
7,241  
7,241  
7,505  
7,665  
7,665  
7,505  
7,505  
7,241  
7,061  
7,241  
8,701  
7,893  
6,462  
Monroe  
Montgomery  
Morgan  
Perry  
Yakutat  
12,011  
12,011  
30,930  
30,930  
Yukon Koyukuk  
Arizona  
Blount  
Pickens  
Pike  
Bullock  
Butler  
Employee- Dependent,  
Only  
County  
Apache  
Cochise  
Coconino  
Gila  
Family, etc.  
23,802  
21,771  
23,802  
20,592  
21,771  
21,771  
24,548  
22,558  
23,802  
23,802  
21,227  
20,592  
21,227  
21,670  
24,548  
Randolph  
Russell  
8,205  
7,758  
8,205  
7,732  
7,758  
7,758  
8,893  
7,176  
8,205  
8,205  
7,513  
7,732  
7,513  
7,412  
8,893  
Calhoun  
Chambers  
Cherokee  
Chilton  
Choctaw  
Clarke  
Shelby  
St. Clair  
Sumter  
Graham  
Greenlee  
La Paz  
Talladega  
Tallapoosa  
Tuscaloosa  
Walker  
Clay  
Maricopa  
Mohave  
Navajo  
Pima  
Cleburne  
Coffee  
Washington  
Wilcox  
Colbert  
Conecuh  
Coosa  
Winston  
Pinal  
Santa Cruz  
Yavapai  
Yuma  
Alaska  
Covington  
Crenshaw  
Cullman  
Dale  
Employee- Dependent,  
Only  
County  
Family, etc.  
30,930  
30,930  
29,868  
29,868  
30,930  
30,930  
29,868  
30,930  
31,062  
31,062  
31,062  
30,930  
31,062  
30,930  
30,930  
30,930  
30,930  
30,930  
30,930  
Aleutians East  
Aleutians West  
Anchorage  
12,011  
12,011  
11,303  
11,303  
12,011  
12,011  
11,303  
12,011  
11,771  
11,771  
11,771  
12,011  
11,771  
12,011  
12,011  
12,011  
12,011  
12,011  
12,011  
Arkansas  
Dallas  
Employee- Dependent,  
Only  
DeKalb  
Elmore  
Escambia  
Etowah  
Fayette  
Franklin  
Geneva  
Greene  
Hale  
County  
Arkansas  
Ashley  
Family, etc.  
17,389  
17,389  
21,429  
21,429  
21,429  
17,389  
23,029  
21,429  
17,389  
18,872  
21,560  
19,164  
17,389  
23,029  
19,164  
Bethel  
7,140  
7,140  
7,244  
7,244  
7,244  
7,140  
7,695  
7,244  
7,140  
6,191  
7,751  
7,028  
7,140  
7,695  
7,028  
Bristol Bay  
Denali  
Baxter  
Dillingham  
Benton  
Boone  
Fairbanks North Star  
Haines  
Bradley  
Calhoun  
Carroll  
Hoonah-Angoon  
Juneau  
Henry  
Kenai Peninsula  
Ketchikan Gateway  
Kodiak Island  
Lake and Peninsula  
Matanuska Susitna  
Nome  
Chicot  
Houston  
Jackson  
Jefferson  
Lamar  
Clark  
Clay  
Cleburne  
Cleveland  
Columbia  
Conway  
Lauderdale  
Lawrence  
Lee  
North Slope  
Northwest Arctic  
2023 Average Premium Tables  
-11-  
Craighead  
Crawford  
Crittenden  
Cross  
7,751  
6,714  
7,751  
7,751  
7,140  
7,140  
7,140  
7,028  
6,714  
7,751  
6,191  
7,028  
7,751  
7,695  
6,191  
7,695  
7,751  
7,751  
7,751  
7,140  
6,714  
7,695  
7,751  
7,140  
7,140  
7,695  
6,714  
7,028  
7,244  
7,244  
7,695  
7,751  
7,140  
6,191  
7,695  
7,244  
7,695  
7,028  
7,140  
6,191  
7,751  
6,714  
7,028  
7,028  
7,028  
7,751  
7,028  
6,714  
7,244  
6,714  
7,695  
7,751  
7,751  
21,560  
21,788  
21,560  
21,560  
17,389  
17,389  
17,389  
19,164  
21,788  
21,560  
18,872  
19,164  
21,560  
23,029  
18,872  
23,029  
21,560  
21,560  
21,560  
17,389  
21,788  
23,029  
21,560  
17,389  
17,389  
23,029  
21,788  
19,164  
21,429  
21,429  
23,029  
21,560  
17,389  
18,872  
23,029  
21,429  
23,029  
19,164  
17,389  
18,872  
21,560  
21,788  
19,164  
19,164  
19,164  
21,560  
19,164  
21,788  
21,429  
21,788  
23,029  
21,560  
21,560  
Stone  
7,751  
7,695  
7,028  
7,244  
7,028  
7,751  
7,028  
21,560  
23,029  
19,164  
21,429  
19,164  
21,560  
19,164  
Santa Clara  
Santa Cruz  
Shasta  
Sierra  
9,709  
9,395  
9,825  
9,825  
9,825  
8,407  
8,407  
9,008  
9,825  
9,825  
9,825  
9,008  
9,825  
8,551  
8,099  
9,825  
28,911  
26,386  
23,668  
23,668  
23,668  
22,859  
22,859  
24,693  
23,668  
23,668  
23,668  
24,693  
23,668  
25,169  
24,093  
23,668  
Union  
Van Buren  
Washington  
White  
Dallas  
Siskiyou  
Solano  
Sonoma  
Stanislaus  
Sutter  
Desha  
Woodruff  
Yell  
Drew  
Faulkner  
Franklin  
Fulton  
California  
Tehama  
Trinity  
Employee- Dependent,  
Only  
County  
Family, etc.  
26,876  
23,668  
23,668  
23,668  
23,668  
23,668  
26,914  
23,668  
24,093  
25,788  
23,668  
23,668  
22,422  
22,422  
20,242  
25,788  
23,668  
23,668  
24,150  
25,788  
22,859  
24,693  
23,668  
24,693  
23,668  
22,422  
26,386  
22,859  
23,668  
26,021  
24,093  
23,668  
24,188  
24,093  
26,386  
24,188  
19,698  
32,092  
24,693  
25,169  
30,804  
25,169  
Garland  
Grant  
Alameda  
Alpine  
9,991  
9,825  
9,825  
9,825  
9,825  
9,825  
9,461  
9,825  
8,099  
8,250  
9,825  
9,825  
8,038  
8,038  
8,576  
8,250  
9,825  
9,825  
8,516  
8,250  
8,407  
9,008  
9,825  
9,008  
9,825  
8,038  
9,395  
8,407  
9,825  
9,098  
8,099  
9,825  
8,823  
8,099  
9,395  
8,823  
7,936  
9,194  
9,008  
8,551  
10,893  
8,551  
Tulare  
Greene  
Hempstead  
Hot Spring  
Howard  
Independence  
Izard  
Tuolumne  
Ventura  
Yolo  
Amador  
Butte  
Calaveras  
Colusa  
Yuba  
Colorado  
Contra Costa  
Del Norte  
El Dorado  
Fresno  
Jackson  
Jefferson  
Johnson  
Lafayette  
Lawrence  
Lee  
Employee- Dependent,  
Only  
County  
Adams  
Family, etc.  
21,656  
23,653  
21,656  
24,827  
23,653  
23,653  
22,089  
21,656  
23,653  
23,653  
21,656  
23,653  
23,653  
23,653  
23,653  
24,827  
21,656  
24,827  
21,656  
24,678  
22,503  
21,656  
23,653  
24,678  
21,656  
24,827  
24,827  
24,827  
23,653  
24,827  
21,656  
23,653  
23,653  
7,411  
8,633  
7,411  
8,143  
8,633  
8,633  
7,775  
7,411  
8,633  
8,633  
7,411  
8,633  
8,633  
8,633  
8,633  
8,143  
7,411  
8,143  
7,411  
7,932  
6,583  
7,411  
8,633  
7,932  
7,411  
8,143  
8,143  
8,143  
8,633  
8,143  
7,411  
8,633  
8,633  
Glenn  
Alamosa  
Arapahoe  
Archuleta  
Baca  
Humboldt  
Imperial  
Inyo  
Lincoln  
Little River  
Logan  
Kern  
Bent  
Kings  
Boulder  
Broomfield  
Chaffee  
Cheyenne  
Clear Creek  
Conejos  
Costilla  
Crowley  
Custer  
Lake  
Lonoke  
Madison  
Marion  
Lassen  
Los Angeles  
Madera  
Miller  
Marin  
Mississippi  
Monroe  
Montgomery  
Nevada  
Newton  
Ouachita  
Perry  
Mariposa  
Mendocino  
Merced  
Modoc  
Delta  
Mono  
Denver  
Monterey  
Napa  
Dolores  
Douglas  
Eagle  
Phillips  
Pike  
Nevada  
Orange  
El Paso  
Elbert  
Poinsett  
Polk  
Placer  
Plumas  
Fremont  
Garfield  
Gilpin  
Pope  
Riverside  
Sacramento  
San Benito  
San Bernardino  
San Diego  
San Francisco  
San Joaquin  
San Luis Obispo  
San Mateo  
Santa Barbara  
Prairie  
Pulaski  
Randolph  
Saline  
Grand  
Gunnison  
Hinsdale  
Huerfano  
Jackson  
Jefferson  
Kiowa  
Scott  
Searcy  
Sebastian  
Sevier  
Sharp  
Kit Carson  
St. Francis  
-12-  
2023 Average Premium Tables  
Florida  
La Plata  
Lake  
8,143  
8,143  
8,694  
8,633  
8,633  
8,054  
8,998  
8,633  
8,143  
8,143  
8,143  
8,054  
8,633  
8,143  
7,411  
8,054  
7,932  
8,633  
7,319  
8,143  
8,633  
8,143  
8,633  
8,143  
8,143  
8,054  
7,932  
6,583  
8,054  
8,306  
8,054  
24,827  
24,827  
19,824  
23,653  
23,653  
23,081  
21,727  
23,653  
24,827  
24,827  
24,827  
23,081  
23,653  
24,827  
21,656  
23,081  
24,678  
23,653  
20,347  
24,827  
23,653  
24,827  
23,653  
24,827  
24,827  
23,081  
24,678  
22,503  
23,081  
26,016  
23,081  
Pasco  
7,525  
7,371  
8,801  
7,836  
7,489  
7,521  
7,715  
10,257  
7,591  
7,862  
7,668  
8,601  
7,932  
8,323  
7,548  
7,767  
7,947  
22,543  
22,139  
22,081  
23,177  
20,819  
21,644  
20,590  
27,879  
21,601  
24,206  
22,810  
24,552  
23,505  
20,111  
23,347  
21,234  
23,329  
Pinellas  
Polk  
Employee- Dependent,  
County  
Alachua  
Baker  
Only  
Family, etc.  
22,734  
22,501  
21,468  
23,023  
23,208  
23,328  
22,571  
25,787  
21,534  
22,922  
29,682  
24,544  
23,403  
21,209  
22,097  
21,756  
22,670  
23,949  
23,387  
22,553  
25,093  
23,946  
22,503  
20,987  
24,714  
23,493  
25,498  
25,008  
22,612  
21,289  
20,719  
22,557  
21,405  
24,889  
22,838  
28,653  
23,288  
22,899  
23,532  
21,046  
20,829  
24,627  
24,816  
25,476  
20,919  
28,477  
24,963  
20,908  
24,353  
28,912  
Larimer  
Las Animas  
Lincoln  
Logan  
8,574  
7,715  
7,461  
7,686  
8,879  
7,925  
7,789  
8,533  
7,757  
7,626  
7,988  
8,265  
7,735  
7,911  
7,679  
7,892  
8,808  
8,034  
7,735  
7,658  
8,083  
8,395  
7,602  
7,526  
8,388  
8,890  
8,138  
7,740  
7,742  
7,568  
7,381  
8,243  
7,903  
9,585  
7,667  
9,230  
7,541  
7,894  
8,248  
7,718  
6,342  
8,016  
8,031  
8,436  
8,332  
8,059  
8,465  
7,953  
8,438  
8,603  
Putnam  
Santa Rosa  
Sarasota  
Seminole  
St. Johns  
St. Lucie  
Sumter  
Bay  
Bradford  
Brevard  
Broward  
Calhoun  
Charlotte  
Citrus  
Mesa  
Mineral  
Moffat  
Montezuma  
Montrose  
Morgan  
Otero  
Suwannee  
Taylor  
Clay  
Union  
Collier  
Ouray  
Volusia  
Columbia  
DeSoto  
Dixie  
Park  
Wakulla  
Walton  
Phillips  
Pitkin  
Washington  
Duval  
Prowers  
Pueblo  
Georgia  
Escambia  
Flagler  
Rio Blanco  
Rio Grande  
Routt  
Employee- Dependent,  
Only  
County  
Appling  
Atkinson  
Bacon  
Family, etc.  
27,444  
22,962  
23,290  
25,176  
24,458  
22,594  
21,237  
22,689  
24,744  
24,744  
20,662  
20,662  
23,290  
24,744  
27,444  
27,444  
20,462  
22,689  
25,176  
23,290  
27,444  
24,070  
23,868  
23,290  
27,444  
20,658  
22,433  
22,689  
21,237  
25,176  
22,689  
24,744  
Franklin  
Gadsden  
Gilchrist  
Glades  
Gulf  
10,583  
7,649  
7,887  
8,463  
8,673  
8,299  
9,031  
7,850  
8,599  
8,599  
8,545  
8,545  
7,887  
8,599  
10,583  
10,583  
8,071  
7,850  
8,463  
7,887  
10,583  
8,130  
7,913  
7,887  
10,583  
7,316  
8,654  
7,850  
9,031  
8,463  
7,850  
8,599  
Saguache  
San Juan  
San Miguel  
Sedgwick  
Summit  
Teller  
Baker  
Baldwin  
Banks  
Hamilton  
Hardee  
Hendry  
Hernando  
Highlands  
Hillsborough  
Holmes  
Indian River  
Jackson  
Jefferson  
Lafayette  
Lake  
Barrow  
Bartow  
Ben Hill  
Berrien  
Bibb  
Washington  
Weld  
Yuma  
Connecticut  
Bleckley  
Brantley  
Brooks  
Bryan  
Employee- Dependent,  
Only  
County  
Family, etc.  
29,578  
26,680  
28,343  
27,077  
29,443  
25,787  
22,920  
31,760  
Fairfield  
9,528  
9,002  
8,527  
8,672  
9,794  
8,729  
8,001  
8,489  
Bulloch  
Burke  
Hartford  
Litchfield  
Middlesex  
New Haven  
New London  
Tolland  
Lee  
Butts  
Leon  
Calhoun  
Camden  
Candler  
Carroll  
Levy  
Liberty  
Madison  
Manatee  
Marion  
Windham  
Catoosa  
Charlton  
Chatham  
Chattahoochee  
Chattooga  
Cherokee  
Clarke  
Delaware  
Martin  
Miami-Dade  
Monroe  
Nassau  
Okaloosa  
Okeechobee  
Orange  
Osceola  
Palm Beach  
Employee- Dependent,  
Only  
County  
Family, etc.  
All  
8,846  
23,764  
District of Columbia  
Employee- Dependent,  
Only  
Clay  
County  
Family, etc.  
Clayton  
Clinch  
All  
9,368  
28,176  
2023 Average Premium Tables  
-13-  
Cobb  
7,850  
7,649  
8,599  
8,071  
8,599  
7,850  
8,545  
8,463  
7,913  
8,299  
8,599  
7,850  
8,545  
8,545  
8,463  
7,850  
8,599  
8,599  
10,583  
9,031  
8,071  
10,583  
8,050  
7,850  
8,654  
7,850  
8,299  
7,850  
8,654  
8,071  
7,887  
8,654  
8,599  
9,031  
7,850  
8,299  
8,299  
8,673  
8,130  
7,316  
8,299  
8,130  
7,850  
8,545  
8,599  
9,031  
7,850  
7,649  
8,071  
8,071  
7,649  
8,545  
7,850  
22,689  
22,962  
24,744  
20,462  
24,744  
22,689  
20,662  
25,176  
23,868  
22,594  
24,744  
22,689  
20,662  
20,662  
25,176  
22,689  
24,744  
24,744  
27,444  
21,237  
20,462  
27,444  
23,245  
22,689  
22,433  
22,689  
22,594  
22,689  
22,433  
20,462  
23,290  
22,433  
24,744  
21,237  
22,689  
22,594  
22,594  
24,458  
24,070  
20,658  
22,594  
24,070  
22,689  
20,662  
24,744  
21,237  
22,689  
22,962  
20,462  
20,462  
22,962  
20,662  
22,689  
Lanier  
8,599  
7,649  
8,463  
10,583  
8,071  
10,583  
8,599  
8,299  
7,316  
9,031  
7,316  
8,071  
7,887  
7,316  
8,599  
8,463  
8,545  
7,649  
9,031  
8,050  
7,316  
7,850  
9,031  
9,031  
7,850  
8,545  
8,654  
7,887  
7,850  
8,654  
8,545  
8,545  
7,316  
8,299  
8,463  
8,071  
7,850  
8,463  
10,583  
8,599  
7,850  
8,299  
7,316  
8,463  
7,316  
8,071  
10,583  
7,316  
7,649  
8,463  
8,599  
8,599  
7,649  
24,744  
22,962  
25,176  
27,444  
20,462  
27,444  
24,744  
22,594  
20,658  
21,237  
20,658  
20,462  
23,290  
20,658  
24,744  
25,176  
20,662  
22,962  
21,237  
23,245  
20,658  
22,689  
21,237  
21,237  
22,689  
20,662  
22,433  
23,290  
22,689  
22,433  
20,662  
20,662  
20,658  
22,594  
25,176  
20,462  
22,689  
25,176  
27,444  
24,744  
22,689  
22,594  
20,658  
25,176  
20,658  
20,462  
27,444  
20,658  
22,962  
25,176  
24,744  
24,744  
22,962  
Towns  
8,299  
7,649  
7,316  
8,599  
8,545  
8,299  
7,316  
7,913  
7,850  
7,887  
8,071  
8,673  
7,887  
7,316  
7,649  
8,299  
8,050  
8,545  
8,071  
8,673  
8,463  
22,594  
22,962  
20,658  
24,744  
20,662  
22,594  
20,658  
23,868  
22,689  
23,290  
20,462  
24,458  
23,290  
20,658  
22,962  
22,594  
23,245  
20,662  
20,462  
24,458  
25,176  
Coffee  
Colquitt  
Columbia  
Cook  
Laurens  
Lee  
Treutlen  
Troup  
Liberty  
Turner  
Lincoln  
Long  
Twiggs  
Union  
Coweta  
Crawford  
Crisp  
Lowndes  
Lumpkin  
Macon  
Upson  
Walker  
Walton  
Ware  
Dade  
Dawson  
Decatur  
DeKalb  
Dodge  
Dooly  
Madison  
Marion  
Warren  
Washington  
Wayne  
Webster  
Wheeler  
White  
McDuffie  
McIntosh  
Meriwether  
Miller  
Dougherty  
Douglas  
Early  
Mitchell  
Monroe  
Montgomery  
Morgan  
Murray  
Whitfield  
Wilcox  
Wilkes  
Wilkinson  
Worth  
Echols  
Effingham  
Elbert  
Emanuel  
Evans  
Muscogee  
Newton  
Oconee  
Oglethorpe  
Paulding  
Peach  
Hawaii  
Fannin  
Fayette  
Floyd  
Employee- Dependent,  
Only  
County  
Family, etc.  
All  
8,011  
21,523  
Forsyth  
Franklin  
Fulton  
Pickens  
Pierce  
Idaho  
Employee- Dependent,  
Only  
Gilmer  
Glascock  
Glynn  
Pike  
County  
Ada  
Family, etc.  
18,558  
18,579  
18,200  
18,200  
16,122  
18,200  
18,948  
18,579  
16,122  
20,506  
16,122  
18,200  
18,948  
18,579  
18,200  
18,948  
20,506  
19,086  
18,200  
18,579  
18,200  
20,506  
18,579  
Polk  
7,011  
6,888  
8,437  
8,437  
7,005  
8,437  
6,476  
6,888  
7,005  
7,918  
7,005  
8,437  
6,476  
6,888  
8,437  
6,476  
7,918  
8,172  
8,437  
6,888  
8,437  
7,918  
6,888  
Pulaski  
Putnam  
Quitman  
Rabun  
Adams  
Bannock  
Bear Lake  
Benewah  
Bingham  
Blaine  
Gordon  
Grady  
Greene  
Gwinnett  
Habersham  
Hall  
Randolph  
Richmond  
Rockdale  
Schley  
Boise  
Hancock  
Haralson  
Harris  
Bonner  
Bonneville  
Boundary  
Butte  
Screven  
Seminole  
Spalding  
Stephens  
Stewart  
Sumter  
Talbot  
Hart  
Heard  
Camas  
Canyon  
Caribou  
Cassia  
Clark  
Henry  
Houston  
Irwin  
Jackson  
Jasper  
Jeff Davis  
Jefferson  
Jenkins  
Johnson  
Jones  
Taliaferro  
Tattnall  
Taylor  
Clearwater  
Custer  
Telfair  
Elmore  
Franklin  
Fremont  
Gem  
Terrell  
Thomas  
Tift  
Lamar  
Toombs  
-14-  
2023 Average Premium Tables  
Gooding  
Idaho  
6,476  
8,172  
7,918  
6,476  
7,005  
7,005  
7,918  
8,172  
6,476  
7,918  
6,476  
8,172  
8,437  
6,888  
6,888  
8,437  
7,005  
7,918  
6,476  
6,888  
6,888  
18,948  
19,086  
20,506  
18,948  
16,122  
16,122  
20,506  
19,086  
18,948  
20,506  
18,948  
19,086  
18,200  
18,579  
18,579  
18,200  
16,122  
20,506  
18,948  
18,579  
18,579  
Fulton  
8,720  
9,777  
8,687  
9,101  
9,777  
8,243  
9,777  
8,243  
8,243  
9,646  
9,777  
9,777  
9,777  
8,687  
8,972  
9,777  
8,977  
9,101  
9,101  
8,720  
8,491  
8,720  
9,777  
8,972  
9,902  
8,465  
8,465  
8,687  
8,482  
9,777  
8,720  
8,465  
9,777  
8,720  
8,491  
9,902  
8,465  
8,243  
8,482  
8,687  
8,465  
8,465  
8,972  
8,720  
9,777  
9,646  
8,465  
9,777  
9,777  
8,720  
8,687  
9,777  
8,243  
23,057  
25,949  
25,047  
20,715  
25,949  
22,350  
25,949  
22,350  
22,350  
23,421  
25,949  
25,949  
25,949  
25,047  
22,362  
25,949  
24,388  
20,715  
20,715  
23,057  
24,199  
23,057  
25,949  
22,362  
24,851  
20,916  
20,916  
25,047  
22,961  
25,949  
23,057  
20,916  
25,949  
23,057  
24,199  
24,851  
20,916  
22,350  
22,961  
25,047  
20,916  
20,916  
22,362  
23,057  
25,949  
23,421  
20,916  
25,949  
25,949  
23,057  
25,047  
25,949  
22,350  
Saline  
9,777  
8,465  
8,465  
8,465  
8,465  
8,482  
8,720  
8,972  
8,720  
9,777  
9,646  
9,777  
8,243  
8,687  
9,777  
9,777  
8,243  
9,101  
9,777  
8,972  
8,720  
25,949  
20,916  
20,916  
20,916  
20,916  
22,961  
23,057  
22,362  
23,057  
25,949  
23,421  
25,949  
22,350  
25,047  
25,949  
25,949  
22,350  
20,715  
25,949  
22,362  
23,057  
Gallatin  
Greene  
Grundy  
Hamilton  
Hancock  
Hardin  
Sangamon  
Schuyler  
Scott  
Jefferson  
Jerome  
Kootenai  
Latah  
Shelby  
St. Clair  
Stark  
Lemhi  
Lewis  
Henderson  
Henry  
Stephenson  
Tazewell  
Union  
Lincoln  
Madison  
Minidoka  
Nez Perce  
Oneida  
Owyhee  
Payette  
Power  
Iroquois  
Jackson  
Jasper  
Vermilion  
Wabash  
Warren  
Jefferson  
Jersey  
Washington  
Wayne  
Jo Daviess  
Johnson  
Kane  
White  
Shoshone  
Teton  
Whiteside  
Will  
Kankakee  
Kendall  
Knox  
Twin Falls  
Valley  
Williamson  
Winnebago  
Woodford  
Washington  
Lake  
LaSalle  
Lawrence  
Lee  
Indiana  
Illinois  
Employee- Dependent,  
Only  
Employee- Dependent,  
Only  
County  
Adams  
Allen  
Family, etc.  
23,214  
24,189  
22,956  
25,391  
23,755  
25,255  
26,469  
26,016  
21,331  
21,619  
23,405  
26,016  
21,619  
25,780  
24,245  
22,956  
23,214  
23,755  
25,780  
22,494  
24,148  
21,619  
26,016  
24,245  
21,331  
24,463  
23,755  
25,780  
County  
Adams  
Alexander  
Bond  
Family, etc.  
20,916  
25,949  
25,047  
22,362  
20,916  
22,350  
25,047  
22,362  
20,916  
23,421  
20,916  
23,421  
25,949  
25,047  
23,421  
23,937  
25,949  
23,421  
22,362  
24,851  
23,421  
24,388  
23,421  
25,949  
25,949  
25,949  
23,421  
25,949  
Livingston  
Logan  
7,571  
8,107  
7,972  
8,516  
8,548  
8,202  
8,081  
8,352  
8,166  
7,522  
7,770  
8,352  
7,522  
8,249  
8,906  
7,972  
7,571  
8,548  
8,249  
8,340  
8,158  
7,522  
8,352  
8,906  
8,166  
9,588  
8,548  
8,249  
8,465  
9,777  
8,687  
8,972  
8,465  
8,243  
8,687  
8,972  
8,465  
9,646  
8,465  
9,646  
9,777  
8,687  
9,646  
8,729  
9,777  
9,646  
8,972  
9,902  
9,646  
8,977  
9,646  
9,777  
9,777  
9,777  
9,646  
9,777  
Macon  
Bartholomew  
Benton  
Blackford  
Boone  
Macoupin  
Madison  
Marion  
Boone  
Brown  
Bureau  
Calhoun  
Carroll  
Marshall  
Mason  
Brown  
Carroll  
Massac  
McDonough  
McHenry  
McLean  
Menard  
Mercer  
Monroe  
Montgomery  
Morgan  
Moultrie  
Ogle  
Cass  
Cass  
Clark  
Champaign  
Christian  
Clark  
Clay  
Clinton  
Crawford  
Daviess  
Dearborn  
Decatur  
DeKalb  
Delaware  
Dubois  
Elkhart  
Fayette  
Floyd  
Clay  
Clinton  
Coles  
Cook  
Crawford  
Cumberland  
DeKalb  
DeWitt  
Douglas  
DuPage  
Edgar  
Peoria  
Perry  
Piatt  
Pike  
Fountain  
Franklin  
Fulton  
Pope  
Edwards  
Effingham  
Fayette  
Ford  
Pulaski  
Putnam  
Randolph  
Richland  
Rock Island  
Gibson  
Grant  
Greene  
Franklin  
2023 Average Premium Tables  
-15-  
Hamilton  
Hancock  
Harrison  
Hendricks  
Henry  
8,202  
8,158  
7,522  
8,202  
8,158  
8,166  
7,571  
7,972  
8,516  
8,548  
7,522  
7,972  
8,081  
8,249  
8,340  
7,571  
8,474  
8,474  
8,081  
8,158  
8,202  
8,340  
8,249  
8,166  
8,081  
8,352  
8,202  
8,516  
7,571  
8,906  
8,249  
8,081  
7,770  
8,249  
8,249  
8,474  
9,588  
8,166  
8,352  
8,548  
8,906  
7,972  
7,522  
8,202  
8,249  
8,340  
8,340  
7,571  
7,770  
8,906  
8,352  
8,352  
8,158  
25,255  
24,148  
21,619  
25,255  
24,148  
21,331  
23,214  
22,956  
25,391  
23,755  
21,619  
22,956  
26,469  
25,780  
22,494  
23,214  
22,352  
22,352  
26,469  
24,148  
25,255  
22,494  
25,780  
21,331  
26,469  
26,016  
25,255  
25,391  
23,214  
24,245  
25,780  
26,469  
23,405  
25,780  
25,780  
22,352  
24,463  
21,331  
26,016  
23,755  
24,245  
22,956  
21,619  
25,255  
25,780  
22,494  
22,494  
23,214  
23,405  
24,245  
26,016  
26,016  
24,148  
Vanderburgh  
Vermillion  
Vigo  
9,588  
7,770  
7,770  
7,571  
8,516  
9,588  
7,522  
8,158  
7,571  
8,516  
7,571  
24,463  
23,405  
23,405  
23,214  
25,391  
24,463  
21,619  
24,148  
23,214  
25,391  
23,214  
Guthrie  
Hamilton  
Hancock  
Hardin  
8,697  
6,970  
7,445  
6,970  
8,697  
7,311  
7,445  
7,445  
8,032  
7,270  
7,270  
7,095  
7,311  
7,270  
7,270  
7,311  
7,445  
7,311  
7,270  
7,311  
7,311  
8,032  
7,095  
7,311  
7,095  
6,970  
8,697  
7,445  
8,032  
7,311  
8,697  
7,311  
8,032  
8,032  
8,697  
8,032  
8,032  
8,032  
7,095  
8,697  
6,970  
8,697  
8,032  
7,270  
8,697  
8,032  
6,970  
6,970  
8,697  
8,697  
7,311  
7,311  
7,095  
21,249  
20,188  
21,955  
20,188  
21,249  
19,465  
21,955  
21,955  
22,897  
21,569  
21,569  
22,233  
19,465  
21,569  
21,569  
19,465  
21,955  
19,465  
21,569  
19,465  
19,465  
22,897  
22,233  
19,465  
22,233  
20,188  
21,249  
21,955  
22,897  
19,465  
21,249  
19,465  
22,897  
22,897  
21,249  
22,897  
22,897  
22,897  
22,233  
21,249  
20,188  
21,249  
22,897  
21,569  
21,249  
22,897  
20,188  
20,188  
21,249  
21,249  
19,465  
19,465  
22,233  
Wabash  
Warren  
Warrick  
Washington  
Wayne  
Harrison  
Henry  
Howard  
Huntington  
Jackson  
Jasper  
Howard  
Humboldt  
Ida  
Wells  
Jay  
White  
Iowa  
Jefferson  
Jennings  
Johnson  
Knox  
Whitley  
Jackson  
Jasper  
Jefferson  
Johnson  
Jones  
Iowa  
Employee- Dependent,  
Only  
County  
Adair  
Family, etc.  
21,249  
21,249  
21,955  
19,465  
21,249  
21,569  
21,569  
20,188  
21,955  
21,569  
22,897  
21,955  
20,188  
20,188  
21,249  
21,569  
21,955  
22,897  
21,955  
21,249  
22,897  
21,569  
21,569  
22,897  
22,233  
19,465  
21,249  
21,569  
19,465  
22,897  
21,569  
21,955  
21,955  
21,955  
21,955  
21,249  
20,188  
20,188  
Kosciusko  
LaGrange  
Lake  
8,697  
8,697  
7,445  
7,311  
8,697  
7,270  
7,270  
6,970  
7,445  
7,270  
8,032  
7,445  
6,970  
6,970  
8,697  
7,270  
7,445  
8,032  
7,445  
8,697  
8,032  
7,270  
7,270  
8,032  
7,095  
7,311  
8,697  
7,270  
7,311  
8,032  
7,270  
7,445  
7,445  
7,445  
7,445  
8,697  
6,970  
6,970  
Keokuk  
Kossuth  
Lee  
Adams  
Allamakee  
Appanoose  
Audubon  
Benton  
LaPorte  
Lawrence  
Madison  
Marion  
Marshall  
Martin  
Linn  
Louisa  
Lucas  
Black Hawk  
Boone  
Lyon  
Madison  
Mahaska  
Marion  
Marshall  
Mills  
Bremer  
Miami  
Buchanan  
Buena Vista  
Butler  
Monroe  
Montgomery  
Morgan  
Newton  
Noble  
Calhoun  
Carroll  
Mitchell  
Monona  
Monroe  
Montgomery  
Muscatine  
O'Brien  
Osceola  
Page  
Cass  
Ohio  
Cedar  
Orange  
Owen  
Cerro Gordo  
Cherokee  
Chickasaw  
Clarke  
Parke  
Perry  
Pike  
Clay  
Porter  
Palo Alto  
Plymouth  
Pocahontas  
Polk  
Clayton  
Clinton  
Posey  
Pulaski  
Putnam  
Randolph  
Ripley  
Crawford  
Dallas  
Pottawattamie  
Poweshiek  
Ringgold  
Sac  
Davis  
Decatur  
Delaware  
Des Moines  
Dickinson  
Dubuque  
Emmet  
Rush  
Scott  
Shelby  
Scott  
Spencer  
St. Joseph  
Starke  
Shelby  
Sioux  
Story  
Fayette  
Steuben  
Sullivan  
Switzerland  
Tippecanoe  
Tipton  
Tama  
Floyd  
Taylor  
Franklin  
Fremont  
Greene  
Grundy  
Union  
Van Buren  
Wapello  
Warren  
Union  
-16-  
2023 Average Premium Tables  
Washington  
Wayne  
7,311  
7,311  
6,970  
7,445  
7,445  
8,032  
7,445  
7,445  
19,465  
19,465  
20,188  
21,955  
21,955  
22,897  
21,955  
21,955  
Hodgeman  
Jackson  
Jefferson  
Jewell  
6,640  
7,004  
7,004  
6,556  
7,490  
6,640  
6,660  
6,640  
7,646  
7,246  
7,490  
6,556  
7,004  
7,246  
7,004  
6,660  
7,004  
6,660  
6,640  
7,490  
6,556  
6,660  
6,556  
6,640  
7,004  
7,646  
7,246  
7,246  
7,004  
7,246  
6,556  
6,640  
7,246  
7,004  
6,640  
7,246  
6,660  
6,556  
6,660  
6,556  
7,246  
7,246  
7,246  
6,556  
7,246  
6,660  
6,640  
7,004  
7,246  
7,246  
7,246  
6,640  
6,640  
20,210  
19,947  
19,947  
17,604  
20,490  
20,210  
18,161  
20,210  
19,378  
21,412  
20,490  
17,604  
19,947  
21,412  
19,947  
18,161  
19,947  
18,161  
20,210  
20,490  
17,604  
18,161  
17,604  
20,210  
19,947  
19,378  
21,412  
21,412  
19,947  
21,412  
17,604  
20,210  
21,412  
19,947  
20,210  
21,412  
18,161  
17,604  
18,161  
17,604  
21,412  
21,412  
21,412  
17,604  
21,412  
18,161  
20,210  
19,947  
21,412  
21,412  
21,412  
20,210  
20,210  
Stevens  
Sumner  
6,640  
6,660  
7,246  
7,246  
7,004  
7,246  
6,556  
7,246  
6,660  
7,646  
7,490  
20,210  
18,161  
21,412  
21,412  
19,947  
21,412  
17,604  
21,412  
18,161  
19,378  
20,490  
Webster  
Winnebago  
Winneshiek  
Woodbury  
Worth  
Thomas  
Trego  
Johnson  
Kearny  
Kingman  
Kiowa  
Wabaunsee  
Wallace  
Washington  
Wichita  
Wright  
Labette  
Lane  
Wilson  
Kansas  
Woodson  
Wyandotte  
Leavenworth  
Lincoln  
Linn  
Employee- Dependent,  
Only  
County  
Allen  
Family, etc.  
19,378  
19,947  
19,947  
20,210  
21,412  
19,378  
19,947  
18,161  
18,161  
18,161  
19,378  
21,412  
20,210  
17,604  
17,604  
19,947  
20,210  
18,161  
19,378  
21,412  
17,604  
19,947  
19,947  
20,210  
18,161  
21,412  
17,604  
20,210  
20,210  
19,947  
17,604  
21,412  
21,412  
20,210  
20,210  
21,412  
18,161  
20,210  
18,161  
18,161  
20,210  
Kentucky  
7,646  
7,004  
7,004  
6,640  
7,246  
7,646  
7,004  
6,660  
6,660  
6,660  
7,646  
7,246  
6,640  
6,556  
6,556  
7,004  
6,640  
6,660  
7,646  
7,246  
6,556  
7,004  
7,004  
6,640  
6,660  
7,246  
6,556  
6,640  
6,640  
7,004  
6,556  
7,246  
7,246  
6,640  
6,640  
7,246  
6,660  
6,640  
6,660  
6,660  
6,640  
Anderson  
Atchison  
Barber  
Barton  
Logan  
Employee- Dependent,  
Only  
County  
Adair  
Family, etc.  
23,900  
23,900  
19,939  
20,839  
23,900  
22,247  
23,588  
20,870  
19,939  
22,247  
19,939  
22,247  
23,588  
20,556  
20,556  
23,900  
20,839  
20,839  
20,870  
20,839  
20,556  
22,247  
23,900  
23,593  
19,939  
23,588  
23,900  
20,839  
23,900  
23,593  
23,900  
22,247  
19,939  
19,939  
22,247  
23,588  
19,939  
20,839  
Lyon  
7,995  
7,995  
6,923  
9,237  
7,995  
7,608  
8,511  
6,901  
6,923  
7,608  
6,923  
7,608  
8,511  
7,219  
7,219  
7,995  
9,237  
9,237  
6,901  
9,237  
7,219  
7,608  
7,995  
8,681  
6,923  
8,511  
7,995  
9,237  
7,995  
8,681  
7,995  
7,608  
6,923  
6,923  
7,608  
8,511  
6,923  
9,237  
Marion  
Marshall  
McPherson  
Meade  
Miami  
Allen  
Anderson  
Ballard  
Barren  
Bath  
Bourbon  
Brown  
Butler  
Chase  
Mitchell  
Montgomery  
Morris  
Bell  
Chautauqua  
Cherokee  
Cheyenne  
Clark  
Boone  
Bourbon  
Boyd  
Morton  
Nemaha  
Neosho  
Ness  
Boyle  
Clay  
Bracken  
Breathitt  
Breckinridge  
Bullitt  
Cloud  
Coffey  
Norton  
Comanche  
Cowley  
Crawford  
Decatur  
Dickinson  
Doniphan  
Douglas  
Edwards  
Elk  
Osage  
Osborne  
Ottawa  
Pawnee  
Phillips  
Pottawatomie  
Pratt  
Butler  
Caldwell  
Calloway  
Campbell  
Carlisle  
Carroll  
Rawlins  
Reno  
Carter  
Casey  
Ellis  
Republic  
Rice  
Christian  
Clark  
Ellsworth  
Finney  
Riley  
Clay  
Ford  
Rooks  
Clinton  
Crittenden  
Cumberland  
Daviess  
Edmonson  
Elliott  
Franklin  
Geary  
Rush  
Russell  
Saline  
Gove  
Graham  
Grant  
Scott  
Sedgwick  
Seward  
Shawnee  
Sheridan  
Sherman  
Smith  
Gray  
Estill  
Greeley  
Greenwood  
Hamilton  
Harper  
Harvey  
Haskell  
Fayette  
Fleming  
Floyd  
Franklin  
Fulton  
Stafford  
Stanton  
2023 Average Premium Tables  
-17-  
Gallatin  
Garrard  
Grant  
6,901  
6,923  
6,901  
9,237  
7,219  
7,995  
7,608  
8,681  
7,219  
8,511  
6,923  
7,995  
8,681  
7,219  
9,237  
8,681  
6,923  
7,219  
6,923  
8,511  
6,901  
8,511  
8,511  
7,219  
8,511  
7,608  
8,511  
8,511  
8,511  
7,608  
6,923  
9,237  
7,995  
9,237  
6,923  
8,511  
7,219  
9,237  
8,511  
7,608  
9,237  
7,995  
8,681  
7,219  
7,608  
6,923  
7,995  
7,995  
6,923  
7,608  
8,681  
7,219  
6,923  
20,870  
19,939  
20,870  
20,839  
20,556  
23,900  
22,247  
23,593  
20,556  
23,588  
19,939  
23,900  
23,593  
20,556  
20,839  
23,593  
19,939  
20,556  
19,939  
23,588  
20,870  
23,588  
23,588  
20,556  
23,588  
22,247  
23,588  
23,588  
23,588  
22,247  
19,939  
20,839  
23,900  
20,839  
19,939  
23,588  
20,556  
20,839  
23,588  
22,247  
20,839  
23,900  
23,593  
20,556  
22,247  
19,939  
23,900  
23,900  
19,939  
22,247  
23,593  
20,556  
19,939  
Ohio  
8,681  
7,219  
6,923  
8,511  
6,901  
8,511  
8,511  
6,923  
7,995  
7,608  
6,923  
7,608  
7,995  
6,923  
7,219  
7,995  
7,219  
7,995  
8,681  
8,681  
7,219  
8,681  
7,995  
7,219  
7,995  
8,681  
8,511  
8,511  
6,923  
23,593  
20,556  
19,939  
23,588  
20,870  
23,588  
23,588  
19,939  
23,900  
22,247  
19,939  
22,247  
23,900  
19,939  
20,556  
23,900  
20,556  
23,900  
23,593  
23,593  
20,556  
23,593  
23,900  
20,556  
23,900  
23,593  
23,588  
23,588  
19,939  
Franklin  
8,275  
8,797  
7,541  
8,072  
8,275  
7,665  
8,459  
7,541  
7,692  
8,797  
8,275  
8,072  
8,275  
8,275  
7,834  
7,665  
8,275  
7,665  
8,072  
8,797  
7,834  
8,275  
7,834  
7,665  
7,665  
8,072  
7,665  
7,665  
7,541  
7,541  
7,541  
7,665  
8,072  
8,275  
7,692  
8,275  
7,541  
8,797  
8,072  
7,834  
8,072  
8,275  
8,072  
8,797  
20,521  
22,437  
20,453  
21,892  
20,521  
21,666  
21,861  
20,453  
20,542  
22,437  
20,521  
21,892  
20,521  
20,521  
21,179  
21,666  
20,521  
21,666  
21,892  
22,437  
21,179  
20,521  
21,179  
21,666  
21,666  
21,892  
21,666  
21,666  
20,453  
20,453  
20,453  
21,666  
21,892  
20,521  
20,542  
20,521  
20,453  
22,437  
21,892  
21,179  
21,892  
20,521  
21,892  
22,437  
Oldham  
Owen  
Grant  
Iberia  
Graves  
Grayson  
Green  
Owsley  
Pendleton  
Perry  
Iberville  
Jackson  
Jefferson  
Jefferson Davis  
Lafayette  
Lafourche  
LaSalle  
Greenup  
Hancock  
Hardin  
Pike  
Powell  
Pulaski  
Robertson  
Rockcastle  
Rowan  
Russell  
Scott  
Harlan  
Harrison  
Hart  
Lincoln  
Livingston  
Madison  
Henderson  
Henry  
Morehouse  
Natchitoches  
Orleans  
Hickman  
Hopkins  
Jackson  
Jefferson  
Jessamine  
Johnson  
Kenton  
Knott  
Shelby  
Simpson  
Spencer  
Taylor  
Ouachita  
Plaquemines  
Pointe Coupee  
Rapides  
Todd  
Trigg  
Trimble  
Union  
Red River  
Richland  
Knox  
Warren  
Washington  
Wayne  
Webster  
Whitley  
Wolfe  
Sabine  
LaRue  
St. Bernard  
St. Charles  
St. Helena  
St. James  
St. John Baptist  
St. Landry  
St. Martin  
St. Mary  
Laurel  
Lawrence  
Lee  
Leslie  
Letcher  
Lewis  
Woodford  
Louisiana  
Lincoln  
Livingston  
Logan  
St. Tammany  
Tangipahoa  
Tensas  
Employee- Dependent,  
Only  
Parish  
Family, etc.  
20,453  
21,861  
21,892  
20,542  
22,437  
21,861  
21,179  
21,179  
21,179  
21,861  
20,521  
21,861  
22,437  
21,179  
22,437  
21,179  
21,892  
20,521  
21,892  
20,453  
Acadia  
7,541  
8,459  
8,072  
7,692  
8,797  
8,459  
7,834  
7,834  
7,834  
8,459  
8,275  
8,459  
8,797  
7,834  
8,797  
7,834  
8,072  
8,275  
8,072  
7,541  
Lyon  
Allen  
Madison  
Magoffin  
Marion  
Terrebonne  
Union  
Ascension  
Assumption  
Avoyelles  
Beauregard  
Bienville  
Vermilion  
Vernon  
Marshall  
Martin  
Washington  
Webster  
Mason  
Bossier  
McCracken  
McCreary  
McLean  
Meade  
West Baton Rouge  
West Carroll  
West Feliciana  
Winn  
Caddo  
Calcasieu  
Caldwell  
Cameron  
Catahoula  
Claiborne  
Concordia  
DeSoto  
Menifee  
Mercer  
Metcalfe  
Monroe  
Montgomery  
Morgan  
Muhlenberg  
Nelson  
Nicholas  
Maine  
Employee- Dependent,  
Only  
County  
Family, etc.  
Androscoggin  
Aroostook  
Cumberland  
Franklin  
8,045  
9,703  
7,735  
8,045  
9,703  
22,601  
East Baton Rouge  
East Carroll  
East Feliciana  
Evangeline  
24,940  
22,574  
22,601  
Hancock  
24,940  
-18-  
2023 Average Premium Tables  
Kennebec  
Knox  
7,517  
7,517  
7,517  
7,517  
8,045  
8,045  
7,735  
8,045  
8,045  
9,703  
7,735  
20,158  
20,158  
20,158  
20,158  
22,601  
22,601  
22,574  
22,601  
22,601  
24,940  
22,574  
Norfolk  
9,358  
9,361  
9,358  
8,989  
26,811  
25,875  
26,811  
25,350  
Lenawee  
Livingston  
Luce  
7,587  
7,587  
9,363  
8,510  
7,838  
7,203  
9,363  
7,097  
7,097  
9,363  
7,425  
7,203  
8,584  
7,097  
8,510  
7,097  
7,097  
7,838  
7,097  
8,510  
9,363  
7,097  
8,510  
8,510  
7,097  
8,510  
8,510  
7,898  
8,709  
9,363  
8,060  
7,875  
8,527  
8,709  
8,527  
7,587  
8,584  
7,203  
22,510  
22,510  
22,114  
22,856  
22,752  
21,345  
22,114  
21,254  
21,254  
22,114  
21,232  
21,345  
24,261  
21,254  
22,856  
21,254  
21,254  
22,752  
21,254  
22,856  
22,114  
21,254  
22,856  
22,856  
21,254  
22,856  
22,856  
20,833  
21,559  
22,114  
19,416  
22,787  
24,805  
21,559  
24,805  
22,510  
24,261  
21,345  
Plymouth  
Suffolk  
Lincoln  
Oxford  
Worcester  
Mackinac  
Macomb  
Manistee  
Marquette  
Mason  
Penobscot  
Piscataquis  
Sagadahoc  
Somerset  
Waldo  
Michigan  
Employee- Dependent,  
Only  
County  
Alcona  
Alger  
Family, etc.  
22,856  
22,114  
21,587  
22,856  
21,345  
20,833  
22,114  
21,587  
20,833  
21,345  
24,805  
22,633  
22,633  
24,805  
21,345  
22,856  
22,856  
21,232  
21,466  
22,856  
22,114  
22,114  
21,466  
21,345  
19,416  
21,232  
22,114  
21,345  
20,833  
21,466  
22,114  
21,559  
21,466  
21,254  
22,856  
22,114  
21,232  
21,466  
22,633  
21,345  
21,254  
22,114  
21,254  
19,416  
21,345  
8,510  
9,363  
7,197  
8,510  
7,203  
7,898  
9,363  
7,197  
7,898  
7,203  
8,527  
8,488  
8,488  
8,527  
7,203  
8,510  
8,510  
7,425  
8,521  
8,510  
9,363  
9,363  
8,521  
7,203  
8,060  
7,425  
9,363  
7,203  
7,898  
8,521  
9,363  
8,709  
8,521  
7,097  
8,510  
9,363  
7,425  
8,521  
8,488  
7,203  
7,097  
9,363  
7,097  
8,060  
7,203  
Mecosta  
Menominee  
Midland  
Washington  
York  
Allegan  
Alpena  
Antrim  
Missaukee  
Monroe  
Maryland  
Arenac  
Baraga  
Barry  
Montcalm  
Montmorency  
Muskegon  
Newaygo  
Oakland  
Employee- Dependent,  
Only  
County  
Family, etc.  
24,040  
22,894  
22,894  
22,894  
21,174  
21,174  
24,040  
21,174  
21,174  
21,174  
24,040  
24,040  
22,894  
22,894  
21,174  
25,697  
25,697  
21,174  
21,174  
21,174  
21,174  
24,040  
21,174  
21,174  
Allegany  
Anne Arundel  
Baltimore  
Baltimore City  
Calvert  
8,282  
8,273  
8,273  
8,273  
8,337  
8,337  
8,282  
8,337  
8,337  
8,337  
8,282  
8,282  
8,273  
8,273  
8,337  
8,718  
8,718  
8,337  
8,337  
8,337  
8,337  
8,282  
8,337  
8,337  
Bay  
Benzie  
Berrien  
Branch  
Calhoun  
Cass  
Oceana  
Ogemaw  
Ontonagon  
Osceola  
Caroline  
Carroll  
Charlevoix  
Cheboygan  
Chippewa  
Clare  
Cecil  
Oscoda  
Charles  
Otsego  
Dorchester  
Frederick  
Garrett  
Ottawa  
Presque Isle  
Roscommon  
Saginaw  
Sanilac  
Clinton  
Crawford  
Delta  
Harford  
Howard  
Dickinson  
Eaton  
Kent  
Schoolcraft  
Shiawassee  
St. Clair  
Montgomery  
Prince George’s  
Queen Anne’s  
Somerset  
St. Mary’s  
Talbot  
Emmet  
Genesee  
Gladwin  
Gogebic  
Grand Traverse  
Gratiot  
St. Joseph  
Tuscola  
Van Buren  
Washtenaw  
Wayne  
Washington  
Wicomico  
Worcester  
Hillsdale  
Houghton  
Huron  
Wexford  
Minnesota  
Massachusetts  
Ingham  
Ionia  
Employee- Dependent,  
Only  
County  
Aitkin  
Family, etc.  
22,222  
23,928  
23,575  
22,222  
23,928  
21,521  
21,766  
22,580  
21,889  
23,928  
22,222  
Employee- Dependent,  
Only  
County  
Family, etc.  
27,157  
24,733  
25,875  
27,157  
25,727  
24,733  
24,733  
24,733  
26,811  
27,157  
Iosco  
8,499  
8,198  
8,286  
8,499  
8,198  
9,311  
10,352  
8,725  
8,693  
8,198  
8,499  
Barnstable  
Berkshire  
Bristol  
11,191  
8,363  
9,361  
11,191  
9,148  
8,363  
8,363  
8,363  
9,358  
11,191  
Iron  
Anoka  
Isabella  
Jackson  
Kalamazoo  
Kalkaska  
Kent  
Becker  
Beltrami  
Benton  
Big Stone  
Blue Earth  
Brown  
Dukes  
Essex  
Franklin  
Hampden  
Hampshire  
Middlesex  
Nantucket  
Keweenaw  
Lake  
Carlton  
Carver  
Cass  
Lapeer  
Leelanau  
2023 Average Premium Tables  
-19-  
Chippewa  
Chisago  
Clay  
9,311  
8,499  
8,286  
7,342  
8,693  
8,725  
8,499  
8,198  
8,999  
8,286  
10,352  
8,999  
8,999  
8,999  
8,286  
8,198  
8,999  
8,499  
8,499  
8,693  
8,725  
8,499  
9,311  
7,342  
8,693  
9,311  
8,693  
8,693  
10,352  
8,725  
9,311  
7,342  
7,342  
10,352  
9,311  
9,311  
8,499  
8,499  
8,999  
8,725  
10,352  
8,725  
7,342  
8,999  
8,286  
7,342  
8,499  
8,725  
7,342  
8,286  
8,198  
7,342  
8,725  
21,521  
22,222  
23,575  
23,307  
21,889  
22,580  
22,222  
23,928  
23,347  
23,575  
21,766  
23,347  
23,347  
23,347  
23,575  
23,928  
23,347  
22,222  
22,222  
21,889  
22,580  
22,222  
21,521  
23,307  
21,889  
21,521  
21,889  
21,889  
21,766  
22,580  
21,521  
23,307  
23,307  
21,766  
21,521  
21,521  
22,222  
22,222  
23,347  
22,580  
21,766  
22,580  
23,307  
23,347  
23,575  
23,307  
22,222  
22,580  
23,307  
23,575  
23,928  
23,307  
22,580  
Renville  
Rice  
9,311  
10,352  
8,725  
8,499  
8,198  
8,198  
9,311  
8,693  
8,198  
8,999  
8,286  
9,311  
8,499  
8,286  
8,999  
8,499  
10,352  
8,198  
10,352  
8,286  
8,999  
8,198  
9,311  
21,521  
21,766  
22,580  
22,222  
23,928  
23,928  
21,521  
21,889  
23,928  
23,347  
23,575  
21,521  
22,222  
23,575  
23,347  
22,222  
21,766  
23,928  
21,766  
23,575  
23,347  
23,928  
21,521  
Humphreys  
Issaquena  
Itawamba  
Jackson  
Jasper  
6,958  
6,958  
7,340  
7,844  
6,958  
6,958  
6,958  
7,522  
6,958  
6,958  
7,522  
6,958  
6,958  
6,958  
7,340  
6,958  
6,958  
6,958  
7,262  
6,958  
6,877  
6,958  
6,958  
6,958  
6,958  
6,958  
6,958  
6,958  
7,522  
7,522  
6,958  
7,340  
6,958  
6,958  
7,262  
6,958  
6,958  
7,262  
6,958  
7,844  
6,958  
6,958  
6,877  
7,340  
6,958  
6,877  
7,340  
6,958  
7,262  
6,958  
6,958  
6,958  
6,958  
18,688  
18,688  
18,912  
23,137  
18,688  
18,688  
18,688  
17,322  
18,688  
18,688  
17,322  
18,688  
18,688  
18,688  
18,912  
18,688  
18,688  
18,688  
17,857  
18,688  
23,091  
18,688  
18,688  
18,688  
18,688  
18,688  
18,688  
18,688  
17,322  
17,322  
18,688  
18,912  
18,688  
18,688  
17,857  
18,688  
18,688  
17,857  
18,688  
23,137  
18,688  
18,688  
23,091  
18,912  
18,688  
23,091  
18,912  
18,688  
17,857  
18,688  
18,688  
18,688  
18,688  
Rock  
Clearwater  
Cook  
Roseau  
Scott  
Cottonwood  
Crow Wing  
Dakota  
Sherburne  
Sibley  
Jefferson  
Jefferson Davis  
Jones  
St. Louis  
Stearns  
Steele  
Dodge  
Kemper  
Lafayette  
Lamar  
Douglas  
Faribault  
Fillmore  
Freeborn  
Goodhue  
Grant  
Stevens  
Swift  
Lauderdale  
Lawrence  
Leake  
Todd  
Traverse  
Wabasha  
Wadena  
Waseca  
Washington  
Watonwan  
Wilkin  
Lee  
Hennepin  
Houston  
Hubbard  
Isanti  
Leflore  
Lincoln  
Lowndes  
Madison  
Marion  
Itasca  
Jackson  
Kanabec  
Kandiyohi  
Kittson  
Winona  
Wright  
Marshall  
Monroe  
Montgomery  
Neshoba  
Newton  
Noxubee  
Oktibbeha  
Panola  
Yellow Medicine  
Mississippi  
Koochiching  
Lac qui Parle  
Lake  
Employee- Dependent,  
Only  
County  
Adams  
Alcorn  
Family, etc.  
18,688  
18,688  
18,688  
18,688  
18,912  
18,688  
18,688  
18,688  
18,688  
18,688  
18,688  
18,688  
18,688  
18,688  
17,857  
18,688  
23,091  
17,322  
18,688  
23,137  
17,322  
18,688  
23,137  
23,137  
17,857  
18,688  
6,958  
6,958  
6,958  
6,958  
7,340  
6,958  
6,958  
6,958  
6,958  
6,958  
6,958  
6,958  
6,958  
6,958  
7,262  
6,958  
6,877  
7,522  
6,958  
7,844  
7,522  
6,958  
7,844  
7,844  
7,262  
6,958  
Lake of the Woods  
Le Sueur  
Lincoln  
Pearl River  
Perry  
Amite  
Attala  
Lyon  
Pike  
Benton  
Bolivar  
Mahnomen  
Marshall  
Martin  
Pontotoc  
Prentiss  
Quitman  
Rankin  
Calhoun  
Carroll  
McLeod  
Meeker  
Chickasaw  
Choctaw  
Claiborne  
Clarke  
Scott  
Mille Lacs  
Morrison  
Mower  
Sharkey  
Simpson  
Smith  
Clay  
Murray  
Stone  
Coahoma  
Copiah  
Covington  
DeSoto  
Forrest  
Franklin  
George  
Greene  
Grenada  
Hancock  
Harrison  
Hinds  
Nicollet  
Sunflower  
Tallahatchie  
Tate  
Nobles  
Norman  
Olmsted  
Otter Tail  
Pennington  
Pine  
Tippah  
Tishomingo  
Tunica  
Union  
Pipestone  
Polk  
Walthall  
Warren  
Pope  
Washington  
Wayne  
Ramsey  
Red Lake  
Redwood  
Webster  
Wilkinson  
Holmes  
-20-  
2023 Average Premium Tables  
Winston  
Yalobusha  
Yazoo  
6,958  
6,958  
6,958  
18,688  
18,688  
18,688  
Iron  
7,282  
8,567  
7,152  
7,712  
7,494  
8,548  
7,843  
7,494  
7,843  
8,548  
7,712  
8,548  
10,197  
8,548  
8,348  
8,472  
8,548  
7,152  
10,197  
8,472  
8,348  
8,472  
8,472  
8,472  
8,472  
8,348  
7,152  
10,197  
7,282  
8,472  
7,843  
8,348  
8,348  
7,494  
7,282  
8,548  
8,567  
7,843  
7,282  
8,548  
8,548  
8,472  
10,197  
7,282  
7,282  
7,494  
8,548  
8,548  
8,348  
7,282  
8,548  
7,712  
7,494  
18,701  
22,493  
19,025  
20,240  
19,730  
20,952  
21,502  
19,730  
21,502  
20,952  
20,240  
20,952  
19,609  
20,952  
22,895  
21,174  
20,952  
19,025  
19,609  
21,174  
22,895  
21,174  
21,174  
21,174  
21,174  
22,895  
19,025  
19,609  
18,701  
21,174  
21,502  
22,895  
22,895  
19,730  
18,701  
20,952  
22,493  
21,502  
18,701  
20,952  
20,952  
21,174  
19,609  
18,701  
18,701  
19,730  
20,952  
20,952  
22,895  
18,701  
20,952  
20,240  
19,730  
St. Francois  
St. Louis  
St. Louis City  
Ste. Genevieve  
Stoddard  
Stone  
7,712  
7,712  
7,712  
7,712  
8,348  
7,843  
8,548  
7,843  
7,282  
7,494  
7,712  
7,712  
8,348  
7,843  
10,197  
7,843  
20,240  
20,240  
20,240  
20,240  
22,895  
21,502  
20,952  
21,502  
18,701  
19,730  
20,240  
20,240  
22,895  
21,502  
19,609  
21,502  
Jackson  
Jasper  
Jefferson  
Johnson  
Knox  
Missouri  
Employee- Dependent,  
Only  
County  
Adair  
Family, etc.  
20,952  
19,609  
19,609  
21,174  
21,502  
19,025  
19,730  
19,730  
22,895  
21,174  
19,609  
22,895  
19,609  
21,174  
21,174  
22,895  
19,609  
18,701  
22,493  
21,502  
21,174  
21,502  
20,952  
22,493  
19,609  
21,174  
21,174  
18,701  
21,502  
21,502  
19,609  
19,609  
18,701  
21,502  
22,895  
20,240  
21,174  
19,609  
21,502  
19,609  
19,609  
19,730  
21,502  
19,609  
21,174  
18,701  
Laclede  
Lafayette  
Lawrence  
Lewis  
Sullivan  
Taney  
8,548  
10,197  
10,197  
8,472  
7,843  
7,152  
7,494  
7,494  
8,348  
8,472  
10,197  
8,348  
10,197  
8,472  
8,472  
8,348  
10,197  
7,282  
8,567  
7,843  
8,472  
7,843  
8,548  
8,567  
10,197  
8,472  
8,472  
7,282  
7,843  
7,843  
10,197  
10,197  
7,282  
7,843  
8,348  
7,712  
8,472  
10,197  
7,843  
10,197  
10,197  
7,494  
7,843  
10,197  
8,472  
7,282  
Andrew  
Atchison  
Audrain  
Barry  
Texas  
Vernon  
Lincoln  
Linn  
Warren  
Washington  
Wayne  
Barton  
Bates  
Livingston  
Macon  
Webster  
Worth  
Benton  
Bollinger  
Boone  
Madison  
Maries  
Wright  
Marion  
McDonald  
Mercer  
Miller  
Montana  
Buchanan  
Butler  
Employee- Dependent,  
Only  
County  
Beaverhead  
Big Horn  
Blaine  
Family, etc.  
20,347  
20,347  
20,347  
22,167  
22,023  
20,347  
22,167  
22,167  
20,347  
20,347  
20,347  
22,167  
20,347  
20,347  
20,820  
22,167  
20,347  
20,347  
20,347  
20,347  
20,347  
22,167  
22,167  
20,820  
22,167  
20,347  
20,347  
20,347  
20,347  
20,347  
20,347  
20,820  
22,023  
Caldwell  
Callaway  
Camden  
Cape Girardeau  
Carroll  
8,693  
8,693  
8,693  
7,606  
8,123  
8,693  
7,606  
7,606  
8,693  
8,693  
8,693  
7,606  
8,693  
8,693  
7,863  
7,606  
8,693  
8,693  
8,693  
8,693  
8,693  
7,606  
7,606  
7,863  
7,606  
8,693  
8,693  
8,693  
8,693  
8,693  
8,693  
7,863  
8,123  
Mississippi  
Moniteau  
Monroe  
Montgomery  
Morgan  
New Madrid  
Newton  
Nodaway  
Oregon  
Osage  
Broadwater  
Carbon  
Carter  
Carter  
Cass  
Cascade  
Chouteau  
Custer  
Cedar  
Chariton  
Christian  
Clark  
Daniels  
Dawson  
Deer Lodge  
Fallon  
Clay  
Ozark  
Clinton  
Cole  
Pemiscot  
Perry  
Fergus  
Cooper  
Crawford  
Dade  
Pettis  
Flathead  
Gallatin  
Phelps  
Pike  
Garfield  
Glacier  
Dallas  
Platte  
Daviess  
DeKalb  
Dent  
Polk  
Golden Valley  
Granite  
Pulaski  
Putnam  
Ralls  
Hill  
Douglas  
Dunklin  
Franklin  
Gasconade  
Gentry  
Greene  
Grundy  
Harrison  
Henry  
Jefferson  
Judith Basin  
Lake  
Randolph  
Ray  
Reynolds  
Ripley  
Lewis and Clark  
Liberty  
Saline  
Lincoln  
Schuyler  
Scotland  
Scott  
Madison  
McCone  
Meagher  
Mineral  
Hickory  
Holt  
Shannon  
Shelby  
St. Charles  
St. Clair  
Missoula  
Musselshell  
Howard  
Howell  
2023 Average Premium Tables  
-21-  
Park  
8,693  
8,693  
8,693  
8,693  
8,693  
8,693  
8,693  
8,693  
8,693  
8,693  
8,693  
8,693  
8,693  
7,606  
8,123  
8,123  
7,606  
8,693  
8,693  
8,693  
8,693  
8,693  
8,123  
20,347  
20,347  
20,347  
20,347  
20,347  
20,347  
20,347  
20,347  
20,347  
20,347  
20,347  
20,347  
20,347  
22,167  
22,023  
22,023  
22,167  
20,347  
20,347  
20,347  
20,347  
20,347  
22,023  
Dodge  
7,859  
7,859  
9,129  
9,036  
8,981  
9,129  
8,981  
9,036  
9,129  
8,981  
8,981  
9,129  
8,981  
8,981  
8,981  
8,981  
9,129  
9,129  
8,981  
9,129  
8,981  
9,036  
9,036  
8,981  
9,129  
8,981  
9,129  
8,981  
9,036  
9,129  
9,129  
8,981  
8,981  
9,129  
8,981  
9,129  
8,981  
9,036  
8,981  
9,036  
9,036  
9,129  
8,981  
8,981  
8,981  
8,981  
9,129  
9,036  
8,981  
9,036  
7,859  
7,859  
9,129  
22,206  
22,206  
25,388  
24,033  
26,077  
25,388  
26,077  
24,033  
25,388  
26,077  
26,077  
25,388  
26,077  
26,077  
26,077  
26,077  
25,388  
25,388  
26,077  
25,388  
26,077  
24,033  
24,033  
26,077  
25,388  
26,077  
25,388  
26,077  
24,033  
25,388  
25,388  
26,077  
26,077  
25,388  
26,077  
25,388  
26,077  
24,033  
26,077  
24,033  
24,033  
25,388  
26,077  
26,077  
26,077  
26,077  
25,388  
24,033  
26,077  
24,033  
22,206  
22,206  
25,388  
Seward  
Sheridan  
Sherman  
Sioux  
9,036  
9,129  
8,981  
9,129  
8,981  
9,036  
9,129  
7,859  
8,981  
7,859  
8,981  
8,981  
8,981  
9,036  
24,033  
25,388  
26,077  
25,388  
26,077  
24,033  
25,388  
22,206  
26,077  
22,206  
26,077  
26,077  
26,077  
24,033  
Petroleum  
Phillips  
Douglas  
Dundy  
Pondera  
Powder River  
Powell  
Fillmore  
Franklin  
Frontier  
Furnas  
Gage  
Stanton  
Thayer  
Prairie  
Thomas  
Thurston  
Valley  
Ravalli  
Richland  
Roosevelt  
Rosebud  
Sanders  
Sheridan  
Silver Bow  
Stillwater  
Sweet Grass  
Teton  
Garden  
Garfield  
Gosper  
Grant  
Washington  
Wayne  
Webster  
Wheeler  
York  
Greeley  
Hall  
Hamilton  
Harlan  
Nevada  
Hayes  
Employee- Dependent,  
Only  
County  
Carson City  
Churchill  
Clark  
Family, etc.  
19,438  
23,111  
20,646  
19,438  
23,111  
23,111  
23,111  
23,111  
23,111  
23,111  
19,438  
23,111  
20,646  
23,111  
19,438  
21,180  
23,111  
Toole  
Hitchcock  
Holt  
7,344  
7,741  
7,204  
7,344  
7,741  
7,741  
7,741  
7,741  
7,741  
7,741  
7,344  
7,741  
7,204  
7,741  
7,344  
8,331  
7,741  
Treasure  
Valley  
Hooker  
Howard  
Jefferson  
Johnson  
Kearney  
Keith  
Wheatland  
Wibaux  
Douglas  
Elko  
Yellowstone  
Esmeralda  
Eureka  
Humboldt  
Lander  
Lincoln  
Lyon  
Nebraska  
Keya Paha  
Kimball  
Knox  
Employee- Dependent,  
Only  
County  
Adams  
Antelope  
Arthur  
Banner  
Blaine  
Boone  
Box Butte  
Boyd  
Family, etc.  
26,077  
26,077  
25,388  
25,388  
26,077  
26,077  
25,388  
26,077  
25,388  
26,077  
22,206  
26,077  
22,206  
26,077  
25,388  
25,388  
25,388  
26,077  
26,077  
26,077  
26,077  
26,077  
25,388  
26,077  
25,388  
26,077  
8,981  
8,981  
9,129  
9,129  
8,981  
8,981  
9,129  
8,981  
9,129  
8,981  
7,859  
8,981  
7,859  
8,981  
9,129  
9,129  
9,129  
8,981  
8,981  
8,981  
8,981  
8,981  
9,129  
8,981  
9,129  
8,981  
Lancaster  
Lincoln  
Logan  
Mineral  
Nye  
Pershing  
Storey  
Loup  
Madison  
McPherson  
Merrick  
Morrill  
Washoe  
White Pine  
Brown  
Buffalo  
Burt  
New Hampshire  
Nance  
Employee- Dependent,  
Only  
Nemaha  
Nuckolls  
Otoe  
County  
Family, etc.  
Butler  
All  
8,498  
26,225  
Cass  
Cedar  
Chase  
Cherry  
Cheyenne  
Clay  
Pawnee  
Perkins  
Phelps  
Pierce  
New Jersey  
Employee- Dependent,  
Only  
County  
Family, etc.  
All  
8,090  
24,143  
Platte  
Colfax  
Cuming  
Custer  
Dakota  
Dawes  
Dawson  
Deuel  
Polk  
New Mexico  
Red Willow  
Richardson  
Rock  
Employee- Dependent,  
Only  
County  
Bernalillo  
Catron  
Family, etc.  
7,758  
9,379  
9,379  
9,379  
21,368  
Saline  
29,015  
Sarpy  
Chaves  
Cibola  
29,015  
Saunders  
Scotts Bluff  
29,015  
Dixon  
-22-  
2023 Average Premium Tables  
Colfax  
9,379  
9,379  
9,379  
8,107  
9,379  
9,379  
9,379  
9,379  
9,379  
9,379  
9,379  
9,379  
9,379  
9,379  
9,379  
9,379  
9,379  
9,379  
9,379  
7,985  
9,379  
7,758  
8,139  
9,379  
9,379  
9,379  
7,758  
9,379  
7,758  
29,015  
29,015  
29,015  
20,387  
29,015  
29,015  
29,015  
29,015  
29,015  
29,015  
29,015  
29,015  
29,015  
29,015  
29,015  
29,015  
29,015  
29,015  
29,015  
21,236  
29,015  
21,368  
24,010  
29,015  
29,015  
29,015  
21,368  
29,015  
21,368  
Hamilton  
Herkimer  
Jefferson  
Kings  
9,203  
9,203  
9,203  
11,243  
9,203  
8,103  
9,203  
8,103  
8,439  
11,034  
11,243  
8,449  
9,203  
9,203  
8,103  
10,472  
8,449  
9,203  
9,203  
10,472  
11,243  
8,439  
11,243  
11,243  
8,439  
8,439  
8,439  
9,203  
8,103  
9,203  
9,203  
11,034  
10,472  
9,203  
9,203  
10,472  
8,439  
8,439  
8,103  
11,243  
8,449  
8,103  
25,195  
25,195  
25,195  
29,771  
25,195  
20,885  
25,195  
20,885  
21,463  
28,766  
29,771  
20,437  
25,195  
22,260  
20,885  
25,016  
20,437  
25,195  
25,195  
25,016  
29,771  
21,463  
29,771  
29,771  
21,463  
21,463  
21,463  
22,260  
20,885  
25,195  
22,260  
28,766  
25,016  
22,260  
22,260  
25,016  
21,463  
21,463  
20,885  
29,771  
20,437  
20,885  
Bertie  
7,967  
7,391  
7,906  
8,305  
7,960  
7,893  
7,960  
7,967  
9,047  
7,851  
7,960  
7,851  
8,305  
7,967  
8,305  
8,254  
7,906  
9,047  
7,391  
7,967  
9,047  
8,418  
8,418  
7,906  
7,851  
8,970  
8,418  
7,278  
8,254  
7,967  
8,305  
7,403  
8,970  
7,650  
7,967  
7,391  
8,305  
8,305  
7,967  
7,391  
9,047  
7,960  
8,305  
7,278  
9,047  
7,851  
9,047  
8,254  
8,305  
8,305  
7,967  
8,305  
7,893  
22,994  
23,420  
21,413  
21,752  
21,585  
22,733  
21,585  
22,994  
21,390  
25,284  
21,585  
25,284  
21,752  
22,994  
21,752  
22,198  
21,413  
21,390  
23,420  
22,994  
21,390  
23,593  
23,593  
21,413  
25,284  
27,984  
23,593  
22,091  
22,198  
22,994  
21,752  
20,823  
27,984  
21,582  
22,994  
23,420  
21,752  
21,752  
22,994  
23,420  
21,390  
21,585  
21,752  
22,091  
21,390  
25,284  
21,390  
22,198  
21,752  
21,752  
22,994  
21,752  
22,733  
Curry  
Bladen  
De Baca  
Doña Ana  
Eddy  
Brunswick  
Buncombe  
Burke  
Lewis  
Grant  
Livingston  
Madison  
Monroe  
Cabarrus  
Caldwell  
Camden  
Carteret  
Caswell  
Catawba  
Chatham  
Cherokee  
Chowan  
Clay  
Guadalupe  
Harding  
Hidalgo  
Lea  
Montgomery  
Nassau  
Lincoln  
Los Alamos  
Luna  
New York  
Niagara  
Oneida  
McKinley  
Mora  
Onondaga  
Ontario  
Otero  
Orange  
Cleveland  
Columbus  
Craven  
Quay  
Orleans  
Rio Arriba  
Roosevelt  
San Juan  
San Miguel  
Sandoval  
Santa Fe  
Sierra  
Oswego  
Otsego  
Cumberland  
Currituck  
Dare  
Putnam  
Queens  
Rensselaer  
Richmond  
Rockland  
Saratoga  
Schenectady  
Schoharie  
Schuyler  
Seneca  
Davidson  
Davie  
Duplin  
Socorro  
Taos  
Durham  
Edgecombe  
Forsyth  
Franklin  
Gaston  
Gates  
Torrance  
Union  
Valencia  
St. Lawrence  
Steuben  
Suffolk  
New York  
Graham  
Granville  
Greene  
Guilford  
Halifax  
Employee- Dependent,  
Only  
County  
Albany  
Family, etc.  
21,463  
20,437  
29,771  
22,260  
20,437  
22,260  
20,437  
22,260  
25,195  
25,195  
21,463  
22,260  
25,016  
25,016  
20,437  
25,195  
25,195  
21,463  
20,437  
21,463  
Sullivan  
8,439  
8,449  
11,243  
9,203  
8,449  
9,203  
8,449  
9,203  
9,203  
9,203  
8,439  
9,203  
10,472  
10,472  
8,449  
9,203  
9,203  
8,439  
8,449  
8,439  
Tioga  
Allegany  
Bronx  
Tompkins  
Ulster  
Harnett  
Haywood  
Henderson  
Hertford  
Hoke  
Broome  
Cattaraugus  
Cayuga  
Chautauqua  
Chemung  
Chenango  
Clinton  
Warren  
Washington  
Wayne  
Westchester  
Wyoming  
Yates  
Hyde  
Iredell  
Jackson  
Johnston  
Jones  
North Carolina  
Columbia  
Cortland  
Delaware  
Dutchess  
Erie  
Employee- Dependent,  
Only  
County  
Alamance  
Alexander  
Alleghany  
Anson  
Family, etc.  
25,284  
21,585  
23,965  
22,733  
23,965  
21,752  
21,390  
Lee  
7,851  
7,960  
8,494  
7,893  
8,494  
8,305  
9,047  
Lenoir  
Lincoln  
Essex  
Macon  
Franklin  
Fulton  
Madison  
Martin  
Ashe  
Avery  
Genesee  
Greene  
McDowell  
Mecklenburg  
Beaufort  
2023 Average Premium Tables  
-23-  
Mitchell  
Montgomery  
Moore  
8,305  
9,310  
9,310  
8,970  
7,906  
7,967  
7,906  
7,851  
9,047  
7,967  
7,906  
7,967  
7,851  
8,970  
8,305  
7,650  
7,391  
7,391  
7,650  
7,893  
8,305  
7,391  
7,391  
7,893  
8,418  
8,418  
8,305  
8,305  
9,047  
7,893  
7,403  
7,278  
7,403  
9,047  
8,494  
8,970  
8,494  
8,970  
8,418  
8,305  
21,752  
22,169  
22,169  
27,984  
21,413  
22,994  
21,413  
25,284  
21,390  
22,994  
21,413  
22,994  
25,284  
27,984  
21,752  
21,582  
23,420  
23,420  
21,582  
22,733  
21,752  
23,420  
23,420  
22,733  
23,593  
23,593  
21,752  
21,752  
21,390  
22,733  
20,823  
22,091  
20,823  
21,390  
23,965  
27,984  
23,965  
27,984  
23,593  
21,752  
Cavalier  
Dickey  
8,478  
8,478  
8,478  
8,478  
8,478  
8,478  
8,478  
8,478  
7,369  
8,478  
8,478  
8,478  
8,478  
8,478  
8,478  
8,478  
8,478  
8,478  
8,478  
8,478  
8,214  
8,478  
8,478  
8,478  
8,478  
8,478  
8,478  
8,478  
8,478  
8,478  
8,478  
8,478  
8,478  
8,478  
8,478  
8,478  
8,478  
8,478  
8,478  
8,478  
8,478  
8,478  
8,478  
8,478  
24,547  
24,547  
24,547  
24,547  
24,547  
24,547  
24,547  
24,547  
23,920  
24,547  
24,547  
24,547  
24,547  
24,547  
24,547  
24,547  
24,547  
24,547  
24,547  
24,547  
23,849  
24,547  
24,547  
24,547  
24,547  
24,547  
24,547  
24,547  
24,547  
24,547  
24,547  
24,547  
24,547  
24,547  
24,547  
24,547  
24,547  
24,547  
24,547  
24,547  
24,547  
24,547  
24,547  
24,547  
Auglaize  
Belmont  
Brown  
8,334  
7,905  
7,700  
7,872  
7,693  
7,552  
7,552  
7,700  
7,700  
7,575  
7,905  
7,799  
8,331  
7,552  
8,137  
7,351  
8,591  
7,351  
7,351  
7,351  
8,137  
9,816  
8,331  
7,552  
7,905  
7,872  
8,334  
8,334  
7,905  
8,137  
7,700  
8,183  
6,481  
8,591  
9,816  
7,905  
7,351  
8,331  
9,816  
7,351  
7,351  
8,331  
8,137  
7,351  
7,575  
7,861  
8,141  
8,183  
8,334  
7,552  
7,905  
7,552  
7,905  
21,287  
19,458  
19,544  
23,435  
22,733  
21,207  
21,207  
19,544  
19,544  
21,064  
19,458  
20,711  
23,234  
21,207  
21,370  
22,087  
22,268  
22,087  
22,087  
22,087  
21,370  
25,764  
23,234  
21,207  
19,458  
23,435  
21,287  
21,287  
19,458  
21,370  
19,544  
21,428  
20,621  
22,268  
25,764  
19,458  
22,087  
23,234  
25,764  
22,087  
22,087  
23,234  
21,370  
22,087  
21,064  
21,747  
22,928  
21,428  
21,287  
21,207  
19,458  
21,207  
19,458  
Divide  
Nash  
Dunn  
Butler  
New Hanover  
Northampton  
Onslow  
Orange  
Pamlico  
Pasquotank  
Pender  
Eddy  
Carroll  
Emmons  
Foster  
Champaign  
Clark  
Golden Valley  
Grand Forks  
Grant  
Clermont  
Clinton  
Columbiana  
Coshocton  
Crawford  
Cuyahoga  
Darke  
Griggs  
Perquimans  
Person  
Hettinger  
Kidder  
Pitt  
La Moure  
Logan  
Polk  
Defiance  
Delaware  
Erie  
Randolph  
Richmond  
Robeson  
Rockingham  
Rowan  
McHenry  
McIntosh  
McKenzie  
McLean  
Mercer  
Morton  
Mountrail  
Nelson  
Oliver  
Fairfield  
Fayette  
Franklin  
Fulton  
Rutherford  
Sampson  
Scotland  
Stanly  
Gallia