DEPARTMENT OF INSURANCE FEE SCHEDULE

Non-refundable Fees

Description

FY 2016
Fee Amount*
FY 2017 FEE
AMOUNT*
Filing, original charter document $75.00 $75.00
Filing, amended charter document $30.00 $30.00
Filing, annual statement $300.00 $300.00
Filing, annual statement for exempt insurer transacting life/disability or annuity business per ARS § 20-401.05 $87.50 $87.50
Certificate of authority, issue, fraternal benefit society $30.00 $30.00
Certificate of authority, issue, medical or hospital service corporation, or domestic benefit insurer $75.00 $75.00
Certificate of authority, issue, mechanical reimbursement reinsurer $300.00 $300.00
Certificate of authority, issue, captive insurer $1,000.00 $1,000.00
Additional fee for each protected cell participant contract application for a protected cell captive insurer $1,000.00 $1,000.00
Certificate of authority, issue, all other insurers $195.00 $195.00
Certificate of authority amendment, captive insurer $200.00 $200.00
Certificate of authority, renewal, fraternal benefit society or domestic benefit insurer $30.00 $30.00
Certificate of authority, renewal, medical or hospital service corporation, HCSO or PDPO $75.00 $75.00
Certificate of authority, renewal, domestic stock life and/or disability insurer $1,500.00 $1,500.00
Certificate of authority, renewal, domestic life and/or disability reinsurer $4,500.00 $4,500.00
Certificate of authority, renewal, unaffiliated credit life and disability reinsurer $4,500.00 $4,500.00
Certificate of authority, renewal, mechanical reimbursement reinsurer $4,500.00 $4,500.00
Certificate of authority, renewal, captive insurer $5,500.00 $5,500.00
Additional renewal fee for each protected cell participant of a protected cell captive insurer $2,500.00 $2,500.00
Certificate of authority, renewal, all other insurers $135.00 $135.00
Certificate of registration as third party administrator $195.00 $195.00
Life settlement provider $1,000.00 $1,000.00
Life settlement broker, term of 2 years or more $500.00 $500.00
Life settlement broker, term of less than 2 years $250.00 $250.00
Authority to solicit applications for and issue policies by means of mechanical vending machines $60.00 $60.00
Permit, service company $300.00 $300.00
Application for motor vehicle service contract program approval $300.00 $300.00
Life care contract or annual report $450.00 $450.00
License, surplus lines broker, term of 2 years or more $1,000.00 $1,000.00
License, surplus lines broker, term of less than 2 years $500.00 $500.00
License, navigator or certified application counselor $0.00 $0.00
License, all other $120.00 $120.00
Late renewal fee - insurance producer or other insurance professional license holder $100.00 $100.00
Late renewal fee - life and health administrator, per day late $25.00 $25.00
Late renewal fee - service company, per day late $25.00 $25.00
Service of process upon director $15.00 $15.00
Certificate of director under seal $3.00 $3.00
Copy of document filed in director's office per page, non-commercial purpose $0.60 $0.60

*Per Laws 2015, Chapter 10 (SB 1471), Section 15, the Department of Insurance is not changing the fee schedule prescribed by ARS § 20-167(A) during Fiscal Year 2016 for fees to be charged in Fiscal Year 2017.