New for 2015
Forms have new lines in the Health Premiums– Additional Detail section for reporting both the Kids Only and Adult portions of Qualified Pediatric Dental with Family Coverage premiums.
Additionally, line labels in the Health Premiums – Additional Detail section have been changed to clarify premium reporting:
- Stand-Alone Adult Dental (Exchange) is now Adult Dental (Exchange)
- Qualified Pediatric Dental (Non-Exchange) is now Qualified Pediatric Dental Kids Only (Non-Exchange)
- Stand-Alone Qualified Pediatric Dental (Exchange) is now Qualified Pediatric Dental Kids Only (Exchange)
All health maintenance organizations, health care service contractors, and self-funded multiple employer welfare arrangements licensed in the State of Washington during the calendar year must file an electronic tax form, even if no business was actually transacted within Washington during that time. The filing of any form other than the online one provided by this office is not accepted.
The completed online form and payment must be received by the Office of Insurance Commissioner on or before March 1 following the end of the calendar year. When the due date falls on a Saturday or Sunday, the form and payment are considered timely if received on the next business day.
Caution: Do not mail a paper version of the form or any attachments to our office.
Completing your premium tax form
Tax is generally due on all premiums, unless specifically exempted on the tax form. If you have questions, please contact us.
Premiums reported must be on the same basis as required on the Annual Statement.
The tax rate is 2%. Calculations will be completed automatically.
Selecting "Print" will print your form exactly as it appears on the screen, even if you have not saved your work.
The "Save Progress" button does not check for errors.
Remember: Save your work before moving away from the form; your work is not automatically saved.
Premium Reporting section
Specify How Your Company Reports Premiums
Select whether you are reporting premiums on the tax form based on premiums written or premiums earned.
Health Premiums as Reported on the Annual Statement
All premiums and prepayments collected or received must be reported in this section.
Premiums reported in this section should, with few exceptions, match premiums reported for Washington on the Exhibit of Premiums, Enrollment and Utilization filed with the National Association of Insurance Commissioners (NAIC).
Medicaid pass-through payments received from Washington State Health Care Authority should also be reported in this section.
Health Premiums - Additional Detail
Premiums reported in this section are not in addition to premiums reported in the previous section; rather, they are a subset of those premiums.
Premiums reported in this section capture detail not available on the Exhibit of Premiums, Enrollment and Utilization. These premiums are carried through to the appropriate schedules as appropriate.
Adult Dental (Non-Exchange) premiums entered are used to reduce the taxable premiums on Schedule A.
Adult Dental (Exchange) premiums reflect plans offered through the WA Exchange and reduces the taxable premium on Schedule B. In 2015, no stand-alone adult dental plans were offered through the Exchange.
Qualified Pediatric Dental Kids Only (Non-Exchange) premiums are for informational purposes only. Because the tax revenue for Qualified Pediatric Dental Kids Only (Exchange) is required to be deposited into an account separate from other tax revenue at the state treasury, we need to capture the data for Qualified Pediatric Dental - Kids Only outside of the exchange as well.
Qualified Pediatric Dental with Family Coverage (Non-Exchange) premiums need reported in two parts:
- Kids Only Portion: These premiums are for informational purposes only.
- Adult Portion: These premiums reduce the taxable premiums on Schedule A.
Non-Qualified Pediatric Dental (Non-Exchange) premiums represent all other pediatric dental premiums that aren’t ‘Qualified’ and reduce the taxable premium on Schedule A. These premiums can include Pediatric Dental – Kids Only and Pediatric Dental with Family Coverage.
Qualified Pediatric Dental – Kids Only (Exchange) premiums reflect plans offered through the WA Exchange and are taxed on Schedule B. Tax revenue from all WA Exchange premiums is required to be deposited into an account separate from other tax revenue at the state treasury.
Schedule A - Non-Exchange Health Taxes
Most fields on this schedule are populated from the Premium Reporting section of the tax form.
If your company received Title XVIII Medicare premiums or stand-alone Medicare Part D payments, report the tax exempt portion on this schedule.
The health pool assessment available is displayed on this schedule. If the credit available would reduce taxable premiums below zero, the excess credit is carried to Schedule B. If there are no premiums reported on Schedule B, the excess credit is carried forward to the next tax year.
Schedule B - Exchange Health Taxes
All fields on this schedule are populated from the Premium Reporting section of the tax form.
The Health Pool Assessment Available, after being applied in Schedule A, is displayed on this schedule. If the credit available would reduce taxable premiums below zero, the excess credit is carried forward to the next tax year.
Most fields of this section are populated from other areas of the tax form.
If your company is no longer active in Washington and this is your final return, enter $0 as the Annual Statement Filing Fee.
2015 premium tax overpayments, if any, will be applied to prepayments due for 2016. Overpayments in excess of prepayments due will be processed as refunds and sent to the attention of the tax contact we have on file.
Declaration and final submission
Review the Declaration and, if necessary, update the contact information.
The contact information listed here is the insurance commissioner's only point of contact for premium taxes and regulatory surcharge purposes; please make sure the information is accurate.
Enter the name and title of the officer who has examined the form and declares that to the best of this officer’s knowledge and belief, the information is entirely true, accurate, and complete.
Submit your form to the insurance commissioner by clicking "Final Submission."