FOREIGN INSURER: Exempt Insurer; Employee Benefit Trust/Association

NEW ADDRESS


Arizona Department of Insurance
100 North 15th Avenue, Suite 261

Phoenix, AZ  85007-2630


Starting July 1, 2020, we will be the
Department of Insurance and Financial Institutions (DIFI).

Taxes | Foreign Insurers | Exempt Insurer/Trust/Association


ARS § 20-401.05(A)(7) requires each insureremployee benefit trust or voluntary employees' beneficiary association holding a certificate of exemption to file on or before March 1 of each year a copy of its annual statement prepared pursuant to the laws of its state of domicile and the $300 annual statement filing fee prescribed on the Department's fee schedule pursuant to ARS § 20-167(A). 

Each insurer holding a certificate of exemption must also file a premium tax report (see Annual Tax and Fees Report Instructions).

ADOI Fee Schedule

Fees are nonrefundable upon payment.  ARS § 20-167(A)

Form E-TAX-I: Annual Tax and Fees Report Instructions

If the insurer's Data Sheet instructs the insurer to complete Form E-TAX, please READ THESE INSTRUCTIONS before proceeding.

Recent Document Updates
DATE DESCRIPTION
1/31/2020 Updated instructions uploaded
Form E-TAX: Annual Tax and Fees Report

You must use the NAIC OPTins (www.optins.org) system, or a system that is interfaced to provide reports and payments through the NAIC OPTins system, to file insurance premium tax reports and payments.  Reports and payments filed through the mail will be voided and returned, and will be considered not to have been filed.

Before proceeding with your OPTins tax/fee filing and payment:

  • Please read E-TAX-I instructions.
  • Resolve all errors in forms.  Do not submit a form if it contains cells highlighted with a yellow background or red error text.

Please only use the newest version of tax forms, which are continuously improved from tax preparer feedback and which are configured for use with OPTins.

DATE DESCRIPTION
Recent Document Updates
1/31/2020 New version

 

Form E-TC: Tax Credits

Use this form for an insurer that earned in the current year, carried forward from a prior year or carried forward to a future year a tax credit or offset.

Recent Document Updates
DATE DESCRIPTION
1/31/2020 Uploaded new version
Arizona Retaliation Guide

Use this guide when completing Form E-RT to help identify and calculate the taxes, fees, assessments and other obligations that the insurer's domicile imposes upon Arizona insurers. 

Date Description

Recent Document Updates

3/18/2019 Updated version posted.

 

Form E-RT: Retaliation Report

If the insurer is domiciled in Hawaii, Massachusetts, Minnesota, New York, or Rhode Island, do not complete or file Form E-RT.

For all other foreign/alien insurers, filing complete and correct retaliation reports will allow us serve you efficiently, and with minimal hassle.

Before proceeding with completing the Retaliation Report (Form E-RT):

  • Use the Arizona Retaliation Guide to assist you in identifying taxes, fees and assessments to which Arizona-domiciled insurers are subject in your domicile.
  • Resolve all errors in forms.  Do not submit a form if it contains cells highlighted with a yellow background or red error text.

NOTE:  The Arizona Department of Insurance no longer publishes an Annual Taxes and Fees Data Sheet.

Form Updates

Date Description
1/31/2020 Posted new version

 

Form E-TAX-AGENTS:

You must complete this form if the insurer's domicile requires Arizona insurers to pay appointment fees, appointment renewal fees, appointment termination fees, license fees or license renewal fees. Make sure to post the total from this form to Form E-RT.

Form E-AMEND: Summary to Changes to Taxes and Fees

Include this form with an amended Annual Tax and Fee Report.

Form E-INSTALL: Tax Installment Report

Each insurer that has a tax liability during the prior calendar year of $50,000 or more must file an installment payment by the 15th of each month, March through August, of the current year equal to 15% of the prior calendar year tax liability.  ARS § 20-224(E)

Completing Form E-INSTALL is optional.  It does not need to be included with your OPTins filing.

Insurers MUST use the NAIC OPTins system to pay Arizona tax installments.  ARS § 20-224(K).

HOW DID WE DO?

Please Provide Your Feedback

  • To report errors with forms or instructions, or to suggest ways to improve them, please send e-mail to our Tax Unit at [email protected].