payroll item for an unconditional opt out as it applies to healthcare

I can share some information about setting up payroll items in QuickBooks Online Payroll, @arickelmann. 

At this time, you can only set up Medical Insurance, Vision Insurance, or Dental Insurance in QuickBooks Online (QBO). You may check with your insurance plan provider to learn more about your policy and then follow the steps provided in the following article on how to add to the account: Set up and manage payroll items for your insurance benefit plan. 

Refer to the following article for more information about setting up company-paid contributions to an employee’s retirement or health insurance plan: Set up and manage company contributions. 

From here, you can run a payroll summary report by employee to view the payroll wages, taxes, deductions, and contributions totaled by employees. 

Let me know if you need help setting up payroll items for your healthcare. I'm always here to assist you. Have a great rest of the day!