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IRS Employers Obligations on ACA
Mandated Medicare Surtax
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What exactly are high earners? The monetary thresholds are defined in the
IRS table below. Wages and self-employment earnings on which Medicare tax
is charged, and which exceed the thresholds listed, are subject to the
"additional Medicare tax," as the IRS calls it. The classes of employment and
types of payments which are subject to Medicare, as well as Social Security
and FUTA, are spelled out in IRS Publication 15.
Here are a few examples from the IRS.

Disabled workers' wages: Exempt if worker did not perform any service
for the employer during period for which payment is made.
Resident aliens: Taxable same as for U.S. citizens for services performed
in the U.S.
Spouse employed by a spouse: Taxable in the course of a spouse's
business.
Fringe benefits: Taxable on the excess of fair market value of the benefit
over the sum of an amount paid for it by the employee and any amount
excludable by law. "However," the IRS warns, "special valuation rules may
apply" (including those for cafeteria plans).
Employer contributions to a qualified retirement plan: Exempt.
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As the table indicates, the threshold for those filing married jointly, at
$250,000, is only slightly ($50,000) higher than the $200,000 threshold for
single taxpayers. However, you must withhold the additional 0.9 percent on
earnings over $200,000 for any employee, regardless of filing status. For
example: let's say an employee is earning, say, $210,000, and her spouse is
only earning $30,000.
Their combined income falls below the $250,000 threshold and thus is not
subject to the additional Medicare tax. Even so, you need to withhold the
extra $90 on the $10,000 which exceeds the $200,000 threshold.
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If it is clear that an insufficient amount will be withheld to cover the extra tax,
you (or employees, if applicable) can simply make estimated quarterly tax
payments. While they cannot be specifically designated to cover the extra
Medicare liability, it will all shake out when the taxpayers file their 1040 tax
forms.
Curiously, if employees expect to exceed the threshold and request a higher
withholding amount in anticipation of the excise tax, they cannot require you
to do so. Rather, they can request that you withhold "an additional amount of
tax withholding on Form W-4... the additional income tax withholding will be
applied against your tax shown on [the employee's] individual income tax
return," according to the IRS.
When Are Individuals Subject to Additional Medicare Tax?
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Filing Status
Threshold
Amount
Married filing jointly $250,000
Married filing separate $125,000
Single $200,000
Head of household (with
qualifying person)
$200,000
Qualifying widow(er) with
dependent child
$200,000
Mixing Earnings, Self-Employment Income
Things get a little more complicated when one earner in a family is paid a
salary, and the other is self-employed. Here's how it works: Suppose Jack and
Jill are married, filing jointly. Jack earns $150,000 from his employer, and Jill
has $175,000 in self-employment income.
Since Jack's $150,000 is below the $250,000 threshold for married couples
filing jointly, he is not directly subject to the extra withholding. But to
determine Jill's additional Medicare tax status, Jack's $150,000 in earnings is
subtracted from the $250,000 threshold, reducing it to $100,000. Jill's
$175,000 in self-employment income exceeds the adjusted $100,000 joint
return threshold by $75,000, and that amount is subject to the additional
Medicare tax.
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