This is an example of a Tax Year 2023 Form 8941, Credit for Small Employer Health Insurance Premiums with field descriptors.A. Did you pay premiums during your tax year for employee health insurance coverage you provided through a Small Business Health Options Program (SHOP) Marketplace (or do you quality for an exception to this requirement (see instructions) followed by two check boxes with 0.1.C.B.X to the left. The first box Yes Enter Marketplace Identifier (if any) and the second No Stop. Do not file Form 8941 (see instructions for an exception that may apply to a partnership, S corporation, estate, trust, or tax-exempt entity)B Enter the employer identification number (EIN) used to report employment taxes for individuals included on line 1 below, if different from the identifying number listed above. followed by 2.1.L.N.B.C. Does tax return you (or any predecessor) filed for a tax year beginning after 2013 and before 2021 include a Form 8941 with Line A checked Yes and line 12 showing a positive amount? The first check box says Yes. Stop. Do not file Form 8941 (see instructions for an exception that may apply to a partnership, S corporation, cooperative, estate, trust, or tax-exempt entity) (also see instructions for information about the credit period limitation)The second check box reads No.1 Enter the number of individuals you employed during the tax year who are considered employees for purposes of this credit (see instructions) field contains 2.1.L.N.1.2. Enter the number of full-time employees you had for the tax year (see instructions). If you entered 25 or more, skip lines 3 through 11 and enter -0- on line 12 field contains 2.1.0.2.3. Average annual wages you paid for the tax year (see instructions). If you entered $62,000 or more, skip lines 4 through 11 and enter -0- on line 12 field contains 2.1.0.3.4. Premiums you paid during the tax year for employees included on line 1a for health insurance coverage under a qualifying arrangement (see instructions) field contains 2.1.0.4.5. Premiums you would have entered on line 4 if the total premium for each employee equaled the average premium for the small group market in which you offered health insurance coverage (see instructions) field contains 2.1.0.5.10. Enter the total amount of any state premium subsidies paid and any state tax credits available to you for premiums included on line 4 (see instructions) field contains 2.1.1.0.13. If line 12 is zero, skip lines 13 and 14 and go to line 15. Otherwise, enter the number of employees included on line 1a for whom you paid premiums during the tax year for health insurance coverage under a qualifying arrangement (see instructions) field contains 2.1.1.3.14 Enter the number of full-time equivalent employees you would have entered on line 2 if you only included employees included on line 13. field contains 2.1.1.4.15 Credit for small employer health insurance premiums from partnerships, S corporations, cooperatives, estates, and trusts (see instructions) field contains 2.1.1.5.16 Add lines 12 through 15. Cooperatives, estates, and trusts, go to lines 17. Tax-exempt small employers, skip lines 17 and 18 and go to line 19. Partnerships and S corporations, and report this amount on Schedule K. All other, stop here and report this amount on Form 3800, line 4h. field contains 2.1.1.6.17 Amount allocated to patrons of the cooperative or beneficiaries of the estate or trust (see instructions) field contains 2.1.1.7.18 Cooperatives, estates, and trusts, subtract line 17 from line 16. Stop here and report this amount on Form 3800, line 4h field contains 2.1.1.8.