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BOISE, ID 83720-0041. Self Insured Employer Semi Annual Premium Tax Computation Form.This is a Idaho form and can be use in Surety Workers Compensation. Semi Annual Premium Tax Computation Form For Idaho Self Insured Employer {IC-4010A}. Idaho Forms ; IC-211, SELF- INSURED EMPLOYER REPORT OF TOTAL UNPAID LIABILITY. See the forms, schedules, instructions, and publications for the year of the tax return you are amending for guidance on specific topics. IdahoInformation Statement for SelfFunded Employee Health Care Plan . Follow the instructions, complete your NJ tax return, and file it online. Use the income and other information on the tax return in conjunction with Attachment 4-C to calculate the self-employment income. 32 and accounted for 69.