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Printable Form Instructions 990-EZ Oxnard California: What You Should Know

See the section entitled “Complete This Filing” in the California Tax Guide for more information. FFSB-2018-Form-199-Full-Copy.pdf Exact Amount of State-Mandated Insurance (SL) or California Health Insurance Tax The amount of annual SL (Cal State Taxpayer Assistance, which may be described as “SL2” in some instances) or California Health Insurance Tax (CHIT) that an individual must pay. It does not include mandatory SL or CHIT payment made by a provider for coverage of any employee of such provider who: Is the spouse, parent, grandparent or child or parent or child of an employee. Must pay SL/CHIT to provide care and treatment to the employee's qualified family member(s). Must file Form 2113, Certificate of Disability, if applicable, and Form 2113-S as a dependent of a person described in paragraph (a) or (c) of this section. May not be paid directly by an employee or an agency that paid the amount toward the individual's health benefits if the amount is for care and treatment of a qualified family member, or to another health plan (for purposes of section 1026(c) of the Patient Protection and Affordable Care Act (PACA)), from funds designated for health care expenses directly and exclusively. The amount of SL/CHIT and the amount of the employee's monthly premium may be added to or deducted from other SL or CHIT payment(s) if the total SL or CHIT or the amount of the employee's monthly premium exceeds the federal poverty level. However, if such total SL or CHIT is more than 600 per month, then the employer must also provide information on a Form 990-EZ, “California Unemployment Insurance or Gasworks Certificate.” Check the box for the type of return being filed with Form 8859-SF and enter the applicable amount, if any, from the return. Enter the amount deducted from the employee's wages for the year that is required to be deducted for SL2 or CHIT, but do not check the box for tax-exempt organization deduction for annual SL2 or CH2 or if the total amount of SL or CHIT payment(s) is more than the amount specified in subsection (b). If no return has been filed that is required to be filed, enter the applicable amount, if any, from the return that you were required to file in 2017.

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