FOREIGN INSURER: HMDO Service Corporation


Beginning January 1, 2018, all insurers must use the NAIC OPTins system (or a system interfaced with NAIC OPTins) to report and pay insurance premium taxes and installment payments 

Annual Taxes and Fees Data Sheet for 2017

Use this document FIRST in order to determine your filing requirement.  Read the first page of the document, then find the one or two pages that contains information specific to the insurer.

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
1/13/2018 Included instructions relating to Arizona Life and Disability Insurance Guaranty Fund assessments; updated instructions relating to paying tax installments; eliminated duplication in instructions
Form E-TAX: Annual Tax and Fees Report

NEW FORM - READY FOR FILING!

Starting January 1, 2018, 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:

  • You should already have located and printed the insurer's page of the Annual Taxes and Fees Data Sheet as Step One.
  • Please read E-TAX-I instructions.
  • Complete PART A of Form E-TAX with information from the insurer's Annual Taxes and Fees Data Sheet.
  • 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
1/18/2018 New OPTins compliant version

 

Form E-SGHI: Accountable Health Plan Small-employer Group Health Insurance Plan Premium

An insurer may only report small-employer major medical premium as being tax exempt if

  • the insurer is an accountable health plan AND
  • the insurer issued (major medical) health benefit plans to small employers AND
  • the insurer notified the small employers of the reduction to the premium tax because of the tax exemption (ARS § 20-2304(J)) AND
  • the insurer complied with all other provisions of ARS §§ 20-2301 et seq.
DATE DESCRIPTION
Recent Document Updates
1/18/2018 Version containing corrections uploaded

 

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
2/1/2018 Corrected  calculation of credit for domestic stock life/disability insurers, which has been repealed
1/18/2018 Uploaded new version
11/28/2017 Corrected line numbering issue
10/26/2017 New OPTins-compatible form uploaded
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

1/22/2018 2017 version posted - some information for some states remains to be published.  Updates will be published as additional information becomes available.

 

Retaliation: Wisconsin-domiciled Insurers

A Wisconsin-domiciled insurer must, for Arizona retaliation purposes, complete the Wisconsin tax and retaliation report the same way that Wisconsin requires an Arizona-domiciled insurer to complete it. 

Form E-RT: Retaliation Report

If the insurer is domciled 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):

  • You should already have located and printed the insurer's page of the Annual Taxes and Fees Data Sheet as Step One.
  • Complete PART A of Form E-RT with information from the insurer's Annual Taxes and Fees Data Sheet.  The Data Sheet also shows the fees and assessments that you paid in Arizona during the previous year, which you will need to enter where requested on 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.

Form Updates

Date Description
1/17/2018 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.

2018 Additions to the Rates of Tax

Insurers domiciled in Alabama, Florida, Georgia, Kentucky, Louisiana, Mississippi, South Carolina and West Virginia must include the applicable addition to the rate of tax in the insurer's retaliation calculation. 

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).

Retaliatory Statement

The Retaliatory Statement is made available to enable other jurisdictions/domiciles to see a summary of the taxes, fees and assessment that Arizona imposes on insurers.

Historical Documents

Only use this document as needed to amend a 2012 retaliation report.

Only use this document as needed to amend a 2013 retaliation report.

Only use this document as needed to amend a 2014 retaliation report.

Only use this document as needed to amend a 2015 retaliation report.

Only use this document as needed to amend a 2016 retaliation report.

Insurers domiciled in Alabama, Florida, Georgia, Kentucky, Louisiana, Mississippi, South Carolina and West Virginia must include the applicable addition to the rate of tax in the insurer's retaliation calculation. 

Only use this document if needed to amend a 2013 tax report.

Only use this document if needed to amend a 2014 tax report.

Only use if needed to amend a 2015 tax report.

Only use this document if needed to amend a 2016 tax report.

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