This screen requests certain information about the insurance plans you offer. The Estimator does not determine what types of coverage are allowable for the credit. Refer to the instructions for Form 8941 for additional information on which ones you can include.

For each plan that you offer, complete the form and click the "Add" button each time to add the plan to the list. When you've added all your eligible plans, click the "Your Credit" link to continue.

Required Fields

Plan offered in (state) - Drop-down list

This is state where the plan is offered. If you offer plans in only one state, this will be preselected.

Name of Plan - Letters, Numbers, and Spaces

This is the name of the plan.

Annual costs per employee

For each plan, enter the total annual cost for each tier, how much you pay and whether you pay a dollar amount or percentage of the total. If you entered a percentage, enter as a number between 50 - 100 (minimum amount you can pay is 50%).

Self, Self Plus One, and Family Cost - Dollar amount

These fields are for the total annual cost of coverage for each tier, per employee. The Estimator assumes these are the only tiers of coverage offered by each plan. If a tier isn't offered, leave it blank.

Editing or Deleting a Plan

After you've entered the information for each plan, click the "Add" button. The Estimator will add the plan to the list and clear the input form. If you have additional plans to enter, complete the form for each one.

If you need to change or delete a plan, click the "Edit" and "Delete" buttons, respectively. Clicking Edit puts the plan information back in the form where you can change what you need.

Click the Update button to save your changes.