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Form 8928: Return of Certain Excise Taxes Under Chapter 43 of the Internal Revenue Code
IRS Form 8928 is a return for reporting excise taxes related to failures by group health plans or employers, such as not meeting pediatric vaccine coverage requirements or continuation rules. The minimum penalty for late filing is the smaller of $525 or 100% of tax due.
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IRS Form 8928 - Return of Certain Excise Taxes Under Chapter 43 of the Internal Revenue Code
IRS Form 8928 is a return for reporting excise taxes related to failures by group health plans or employers, such as not meeting pediatric vaccine coverage requirements or continuation rules. The minimum penalty for late filing is the smaller of $525 or 100% of tax due.
Risk Radar
Scan points- 1Failing to file on time without showing reasonable cause can trigger the minimum $525 late filing penalty.
- 2Forgetting to complete Part I/II/III for each qualifying event
- 3Omitting a reasonable cause statement when filing late
- 4Incorrectly calculating the total excise tax on line 7 (or 24/33)
- 5Missing required information in summary form items A-G
Plain English
This form helps group health plans or employers report taxes when they fail to meet rules about covering pediatric vaccines, continuing employee health benefits after job loss, or making required MSA contributions. It ensures the IRS collects tax on these noncompliance issues.
Submission Date
- Filing date: 2025-12-30 16:11:26
- Preparation window: collect IDs, supporting records, and signatures in advance.
- Final review: verify names, dates, and required fields before submission.
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What this form is for
- Use this form when you need to report excise taxes due from failures by group health plans or employers (e.g., not meeting pediatric vaccine coverage requirements).
- Not stated
- Check Form 7004 instead when requesting an automatic extension of time to file this return.
Deadline or filing window
Not stated in the official source.
Checklist
What you need before filling it out
Line 40 — Tax Paid With Form 7004
Amount of tax paid when filing Form 7004 · Prior tax return or payment records
Line 41 — Tax Due
Total excise tax due (from calculations) · Calculations on the form
Failure type description (e.g., pediatric vaccine coverage failure)
Details of the specific failure from plan documentation · Plan records or policy documents
Signature block
Personal signature and date · Filers' personal records
Before you submit
- 1Verify the revision date is Rev. December 2025 (matches current edition).
- 2Complete all required fields for failure type and tax calculations.
- 3If there's an overpayment on line 42a, enter direct deposit info on lines 42b-d.
- 4Pay any tax due in full by filing; see IRS.gov/Payments for options.
- 5Attach a statement explaining reasonable cause if filing late (per penalty section).
- 6Send to Department of the Treasury Internal Revenue Service Center Kansas City, MO 64999 via designated PDS or mail.
- 7Keep a copy of the filed form.
How to file this form
- 1Gather plan documentation for failure details (e.g., pediatric vaccine coverage records).
- 2Calculate total excise tax due on Line 41.
- 3If there's an overpayment on Line 42a, enter direct deposit info on lines 42b-d.
- 4Pay any tax due electronically via EFTPS or same-day wire if available; otherwise use IRS.gov/Payments.
- 5File Form 8928 by the applicable deadline (on or before federal income tax return due date for employer failures).
- 6Send to Department of the Treasury Internal Revenue Service Center Kansas City, MO 64999 via designated PDS or mail.
Known limitations
- 1The form does not specify exact thresholds or percentages for pediatric vaccine coverage compliance requirements.
- 2When multiple qualifying events occur in a single period, instructions on how to aggregate or separate reporting are not provided here.
- 3While the minimum late filing penalty is stated as $525 (or 100% of tax due), additional penalties beyond this threshold after 60 days are not detailed—expect updates before filing if you anticipate delays.
- 4No guidance is included on required supporting documentation for each part, such as proof of continuation coverage or MSA contribution records.
Field map
Compact field-by-field guide
Entity Info
1 items
Name and taxpayer ID of the entity claiming the credit.
Credit Info
1 items
Type of credit or incentive being claimed.
Calculation
2 items
The base amount used to calculate the credit.
Calculated credit amount after applying formulas and limitations.
Certification
1 items
Detailed breakdown supporting the credit calculation.
Signatures
1 items
Sign and date the form.
Almost done reviewing the fields?
Fillable formOpen in Editor->The current edition is Rev. December 2025; for updates go to IRS.gov/Form8928.
What changed or needs a fresh check
- Edition date — confirm it reads Rev. December 2025.
- Mailing address — send to Department of the Treasury Internal Revenue Service Center Kansas City, MO 64999.
- Signature — sign before sending (general filing requirement).
- Direct deposit fields on lines 42b-d if there is an overpayment on line 42a.
Quick Facts
Downloads
After you file
- 1Keep a copy of Form 8928 for your records.
- 2If you filed late, attach a statement explaining reasonable cause (if applicable).
- 3Interest and penalties will be billed separately after the return is filed; pay them promptly if due.
- 4To correct errors or claim refunds/credits, file an amended Form 8928 by marking 'Amended Return' at the top.
Sources
- SRCInstructions p.1 — Purpose of Form 8928 is to report excise taxes on failures by group health plans or employers (pediatric vaccine coverage, continuation requirements).
- SRCInstructions p.2 — Minimum penalty for late filing is the smaller of $525 or 100% of tax due.
- SRCInstructions p.1 — Direct deposit fields added on lines 42b, 42c, and 42d.
- SRCInstructions p.1 — Send Form 8928 to Department of Treasury Internal Revenue Service Center Kansas City, MO 64999.
- SRCInstructions p.2 — Penalty for late payment is 1/2 of 1% per month or part, up to 25% of unpaid tax.
- SRCInstructions p.2 — File an amended Form 8928 by marking 'Amended Return' at the top.
Common confusion points
When do I need to file Form 8928?
Unclear if your group health plan or employer failed to meet pediatric vaccine coverage requirements or continuation rules under section 4980B.
→ Review your plan's coverage for pediatric vaccines (as of May 1, 1993) and continuation requirements; if there was a failure, file Form 8928.
How do I request an extension to file?
Might confuse Form 7004 with extending payment time (it does not).
→ File Form 7004 on or before the regular due date of Form 8928; note it only extends filing time, not payment.
What happens if I file late?
Not filing by the due date may result in a penalty.
→ If you miss the due date, attach a statement explaining reasonable cause and pay any balance due promptly.
How do I claim a refund or credit for overpaid taxes?
Might think they need a separate form; not aware of filing an amended Form 8928.
→ File an amended Form 8928 by marking 'Amended Return' at the top and completing appropriate parts.
How do I send payment if there's a balance due?
Might not know to use IRS.gov/Payments or direct deposit fields on line 42.
→ For overpayment, enter direct deposit info on lines 42b-42d; for balance due, go to IRS.gov/Payments.
Can I use a private delivery service (PDS)?
Might not know PDS restrictions (can't deliver to P.O. boxes).
→ Use designated PDSs; if using, go to IRS.gov/PDSStreetAddresses for mailing address.
Workflow map
Related forms and next steps
Before
Current
After
Often used with
⚠ If something goes wrong
- File an amended Form 8928 (by marking 'Amended Return' at the top) to correct errors or claim a refund/credit.
Questions about IRS Form 8928
What is IRS Form 8928 used for?
This form helps group health plans or employers report taxes when they fail to meet rules about covering pediatric vaccines, continuing employee health benefits after job loss, or making required MSA contributions. It ensures the IRS collects tax on these noncompliance issues.
Who must file IRS Form 8928?
Group health plans or employers that have failures in coverage requirements must file this form.
What information does IRS Form 8928 require?
Form 8928 collects information on excise tax amounts owed for failures by group health plans or employers to meet rules like providing pediatric vaccine coverage, continuing employee benefits after job loss, or making required MSA contributions.
How do I complete IRS Form 8928?
Complete Part I, II, or III separately for each qualifying event related to continuation coverage, portability/access rules, or MSA contributions. Then create a 'summary' Form 8928 with totals from lines 7/24/33 and attach all original parts.
What happens if IRS Form 8928 is filed incorrectly?
Failing to file Form 8928 properly can result in late filing penalties (up to 25% of unpaid tax or a minimum $525 for being more than 60 days late).
When do I need to file Form 8928?
Unclear if your group health plan or employer failed to meet pediatric vaccine coverage requirements or continuation rules under section 4980B. Review your plan's coverage for pediatric vaccines (as of May 1, 1993) and continuation requirements; if there was a failure, file Form 8928.
How do I request an extension to file?
Might confuse Form 7004 with extending payment time (it does not). File Form 7004 on or before the regular due date of Form 8928; note it only extends filing time, not payment.
What happens if I file late?
Not filing by the due date may result in a penalty. If you miss the due date, attach a statement explaining reasonable cause and pay any balance due promptly.
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