If Geisinger Health Plan is already your health insurance carrier, download this form to report your business size for this year. After completion, return to GHP per the instructions.

Some definitions

• Small employer: A business who employed an average of at least 1 but not more than 50 employees on business days during the preceding calendar year.
• Employee: Any individual employed by a business (based on the common-law employee definition), including individuals who receive a W-2 form. This includes full-time, part-time and seasonal employees who may or may not have been eligible for or covered by your medical plan in the previous calendar year.
• Not employees: Independent contractors receiving a Form 1099 are not to be included in the employee count. Similarly, sole proprietors and their spouses should not be included in the employee count.

 

How to calculate average number of employees

To calculate the average number of employees:

1. Determine the total number of employees for each month (remember, don’t count independent contractors or sole proprietors and their spouses)
2. Add each month’s number to get an annual total
3. Divide by 12

Example
In the example below, 252 / 12 = 21.