9/1 Shareholder Health & Supplemental Insurance

Shareholder Health & Supplemental Insurance

For your 2024 Payroll
READ THIS BEFORE COMPLETING: You will need information for premiums paid on Health Insurance, Dental Insurance, Vision Insurance, Medicare, and/or Long-Term Care. Include total amounts PAID or TO BE PAID by 12/31/2024.

Estimated Time to Complete: 5 - 15 minutes
Company Name*
Enter Legal Name of your S-Corporation
S-Corporation Primary Owner Name*

First NameLast Name
Email Address*
example@example.com
Are you eligible to receive insurance benefits through your spouse's employer?*

YesNoUnsure
No Deduction for Health Insurance! Other coverage: You are not eligible to take the Self-Employed Health Insurance Deduction if you are eligible to be covered through a spouse's employer plan. Note: This applies even if you decide to decline coverage and pay for your insurance through your S-Corporation. However, you can deduct the following: Medicare and Long-Term Care Premiums (if applicable). Click on Go to Next Page to provide this information.
Yes, you may be able to deduct your Health & Supplemental Insurance. You may be able to deduct your Vision and Dental Insurance as well. You may also be able to deduct your Medicare and Long-Term Care Premiums (if applicable). Click on Go to Next Page to provide this information.
Click on "Go to Next Page" to continue with your questionnaire. Need more Time? Click "Save for Later" only if you need to save your data and return later. If you do click Save for Later, you will receive an email with a link so you can return to it for completion.

Health Insurance Premiums
Do you have a Health Insurance Plan?*

YesNoUnsure
Is your Health Insurance covered through your spouse or through a Medi-Share program?*

YesNoUnsure
No deduction for Health Coverage. Non-deductible: Currently, contributions that members make to health sharing organizations for their membership fees are not deductibe for Federal Income Tax purposes. Not an insurance plan: Health sharing is a lower-cost alternative to medical insurance, they are not insurance plans themselves. Your contributions to a health sharing ministry or program do not qualify for the same tax treatment.

However, you may still be able to deduct: Dental Insurance, Vision Insurance, Medicare, and/or Long-Term Care. Click on Go to Next Page to determine eligibility.
Enter amount of Health Premiums paid or to be paid by 12/31/2024*
Enter EXACT amount paid or to be paid - No estimates or rounding
Your Health Insurance Premiums for 2024 have been paid:*

Directly by my CorporationPersonally, reimbursed by my Corporation before end of yearUnsure
Please note the following about your health premiums:

What to report? Only report amounts for you, your spouse, and your dependents. Do not include other employee premiums.

Paid directly by your Corporation: Premiums should be paid directly by your corporation to ensure 100% deductibility.

Reimburse yourself? If your Corporation has NOT directly paid your premiums, you should have the company reimburse you for premiums paid by end of year.

Dental Insurance
Do you have Dental Insurance*

YesNoUnsure
Is your Dental Insurance covered through your spouse or Medi-Share program?*

YesNoUnsure
No deduction for Dental Coverage. Non-deductible: Currently, contributions that members make to medical sharing organizations for their membership fees are not deductibe for Federal Income Tax purposes. Not an insurance plan: Medical sharing plan is a lower-cost alternative to medical insurance, they are not insurance plans themselves. Your contributions to a medical sharing ministry or program do not qualify for the same tax treatment.

However, you may still be able to deduct: Vision Insurance, Medicare, and/or Long-Term Care. Click on Go to Next Page to determine eligibility.
Enter amount of Dental Premiums paid or to be paid by 12/31/2024*
Enter EXACT amount paid or to be paid - No estimates or rounding
Your Dental Insurance Premiums for 2024 have been paid:*

Directly by my CorporationPersonally, reimbursed by my Corporation before end of yearUnsure
Please note the following about your dental premiums:

What to report? Only report amounts for you, your spouse, and your dependents. Do not include other employee premiums.

Paid directly by your Corporation: Premiums should be paid directly by your corporation to ensure 100% deductibility.

Reimburse yourself? If your Corporation has NOT directly paid your premiums, you should have the company reimburse you for premiums paid by end of year.

Vision Insurance
Do you have Vision Insurance*

YesNo
Is your Vision Insurance covered through your spouse or through a Medi-Share program?*

YesNoUnsure
No deduction for Vision Coverage. Non-deductible: Currently, contributions that members make to medical sharing organizations for their membership fees are not deductibe for Federal Income Tax purposes. Not an insurance plan: Medical sharing plan is a lower-cost alternative to medical insurance, they are not insurance plans themselves. Your contributions to a medical sharing ministry or program do not qualify for the same tax treatment.

However, you may still be able to deduct: Medicare, and/or Long-Term Care. Click on Go to Next Page to determine eligibility.
Enter amount of Vision Premiums paid or to be paid by 12/31/2024*
Enter EXACT amount paid or to be paid - No estimates or rounding
Your Vision Insurance Premiums for 2024 have been paid:*

Directly by my CorporationPersonally, reimbursed by my Corporation before end of yearUnsure
Please note the following about your vision premiums:

What to report? Only report amounts for you, your spouse, and your dependents. Do not include other employee premiums.

Paid directly by your Corporation: Premiums should be paid directly by your corporation to ensure 100% deductibility.

Reimburse yourself? If your Corporation has NOT directly paid your premiums, you should have the company reimburse you for premiums paid by end of year.

Medicare Coverage
Do you (and/or Spouse) have Medicare coverage?*

YesNoUnsure
Enter dollar amount of Medicare Coverage paid or to be paid by end of year*
Enter EXACT amount paid or to be paid - No estimates or rounding
Please note the following about your Medicare coverage:

What to report? Only report amounts for you and/or your spouse.

Paid directly by your Corporation: Medicare Premiums should be paid directly by your corporation to ensure 100% deductibility.

Reimbursement? If your corporation has NOT directly paid your premiums, you should have the company reimburse you for premiums paid by end of year.

Long-Term Care Insurance
Do you pay for Long-Term Care Insurance?*

YesNoUnsure
Your Long-Term Care paid or to be paid by year end:*
Enter EXACT amount paid or to be paid - No estimates or rounding
Do you pay for Long-Term Care Insurance for a Spouse?*

YesNoUnsure
Spouse Long-Term Care paid or to be paid by year end:*
Enter EXACT amount paid or to be paid - No estimates or rounding
Please note the following about your Long-Term Care premiums:

What to report? Only report amounts for you and/or your spouse.

Paid directly by your Corporation: Premiums should be paid directly by your corporation to ensure 100% deductibility.

Reimburse yourself? If your corporation has NOT directly paid your premiums, you should have the company reimburse you for premiums paid by end of year.

Questions, Comments, or Concerns - Please let us know
Enter any questions or comments about this form you would like us to be aware of.
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SUBMIT YOUR ANSWERS: Once complete, click "Submit Answers" to transmit your response to our office. Select "Save for Later" if you'd like to edit responses prior to submitting.

YOUR ANSWERS WILL BE REVIEWED: We will review your submission to determine next steps.

Thank you for your time in completing this form!
Should be Empty:

Shareholder Health & Supplemental Insurance

Health Insurance Premiums

Dental Insurance

Vision Insurance

Medicare Coverage

Long-Term Care Insurance

Questions, Comments, or Concerns - Please let us know

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