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QUICK REFERENCE GUIDE FOR PUBLIC EMPLOYERS <br />MEDICARE COVERAGE <br />This chart is meant as a guide only and is not a substitute for discussing difficult Section 218 coverage situations <br />with your State Social Security Administrator or taxation issues with your IRS FSLG agent. <br />Are services mandatory <br />exclusions' from social <br />security and Medicare <br />coverage? <br />No <br />Are the services covered for <br />social security and Medicare <br />under a Section 218 <br />Agreement? <br />Yes <br />Yes <br />No <br />Withhold <br />social security <br />AND <br />Medicare taxes. <br />Is employee a student2 <br />OR <br />an election worker3? <br />Do not withhold <br />Medicare tax <br />(or social security). <br />JIs employee a member <br />of a qualifying public <br />retirement system? 4 <br />No <br />Yes <br />Yes <br />Has the employee been in <br />continuous employment <br />with the same State or local <br />government since before <br />April 1, 1986? <br />Withhold <br />Medicare tax only <br />No <br />Do not withhold <br />Medicare tax <br />(or social security) <br />Yes <br />Yes <br />1 <br />Is the employee covered for <br />Medicare -only under a <br />Section 218 Agreement? <br />No <br />1 Mandatory Exclusions from Social Security and Medicare (FICA) coverage includes services performed: <br />• by individuals hired solely to be relieved from unemployment <br />• in a hospital, home or other institution by a patient or inmate <br />• by workers hired on a temporary basis in case of fire, storm, snow, earthquake, flood, or other similar emergency <br />• by non-resident aliens with F-1, J-1, M-1 & Q-1 visas <br />• in positions compensated solely by fees that are subject to self-employment tax (SECA) <br />2 Student enrolled and regularly attending classes at the school where services are performed <br />3 Election worker paid less than the mandatory coverage threshold ($1,600 in 2013) <br />4 Qualifies as a social security replacement plan. See section 4, Retirement Plans. <br />23 <br />