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Premium Tax Survey Because different agencies may be responsible for the areas this survey addresses, we request that the chief insurance financial regulator of each state be responsible for contacting the appropriate agencies so that accurate responses may be obtained. This survey is addressing premium tax calculation for those companies that pay premium tax in your state. The survey excludes surplus lines companies that may pay a tax in your state. The survey excludes unauthorized or direct placement business that may be required to pay tax in your state. The survey is to gain information on basic premium tax collection and calculation for your state. The Blanks Working Group has been charged with surveying the states to determine the requirements for reporting premium for taxation and assessment purposes. Please respond to this survey by November 20, 2008. If answer differs by type of premium, please indicate such in the column (s). All Premium Adm L P/C H Yes No X X X X X X X X X X X X X X X X X X X X X X X Life Premium P & C Premium Health Premium Yes No Yes No Yes No X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X Annuity Premium Yes No X X X X appropriate 1. In your state does the Department of Insurance collect premium tax filings? Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware DC Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska HMO Yes No X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 1 of 41 All Premium Adm L P/C H Nevada - General premium tax paid is collected by the Department of Taxation: DOI collects Surplus lines taxes and Captive premium taxes. (yes & no) New Hampshire New Jersey New Mexico New York North Carolina - Prem taxes for surplus lines companies and risk retention groups (RRGs) are collected by the Department of Insurance. All other collected by the NC Dept of Revenue North Dakota - annuities not taxed Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming 51 X X X X Life Premium P & C Premium Health Premium X X X X X X X X X Annuity Premium HMO X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X 33 45 Yes X X X X X X X X X X X X X X X X 33 45 Yes X X X X X X X X X X X X X X X X X X X X X X X X X X X 33 45 Yes X X X X X X X X X X X X X X X X X X 33 45 Yes X X X X X X X X X X X X X X X X X X X X X 12 12 12 12 4 14 9 9 2. Are audits performed on the premium tax filing? Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware DC Florida Georgia Hawaii ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 No No No No Yes No X X Yes X X No X X X X X X X 2 of 41 Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetss Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming 51 ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 All Premium Adm L P/C H X X X X X X X X X Life Premium P & C Premium Health Premium X X X X X X X X X X X X X X X X X X X X X X X X X X X Annuity Premium X X X HMO X X X X X X X X X X X X X X X X X X X X X X X X X 42 X X X X X X X X X X X X X X X X X X X X X X X 42 X X X X X X X X X X X X X X X X X X X X X X X 42 X X X X X X X X X X X X X X X X X X X X X X X 42 X X X X X X X X X X X X X X X X X X X X X 1 1 1 1 3 of 41 All Premium Adm L P/C H Life Premium P & C Premium Health Premium 43 43 43 43 (Respond "yes" if authority exists even if none have been conducted.) a. Desk Audit Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware DC Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada - by Taxation New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 Annuity Premium HMO Yes X X X X X X X X X X X X X X X X X X X X No X X Yes X X X X X X X X X X X X X X X X X X X X No Yes X X X X X X X X X X X X X X X X X X X X No Yes X X X X X X X X X X X X X X X X X X X X No Yes No X X Yes X X No X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X 4 of 41 Oklahoma Oregon - Only for retaliatory tax filings and Fire marshall tax filings Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming 51 All Premium Adm L P/C H X X X X X X X X X X X X X X X 43 44 Yes X X X X Life Premium P & C Premium Health Premium X X X X X X X X X X X X X X X X X X X X X X X X X X X X 44 44 Yes X X X X X X X X X X X X X 44 44 Yes X X X X X X X X X X X 43 44 Yes X X Annuity Premium X X X HMO X X X X X X X 1 0 0 1 b. On-site audit Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware DC Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 No X No X No X No X Yes No X X Yes X No X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X 5 of 41 All Premium Adm L P/C H Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada - by DOI Examiners New Hampshire New Jersey New Mexico New York North Carolina - Examiners review this during the fianncial examination but only once every five years. North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming - we would include premium tax testing during our regular domestic exams 51 X X X X X X X X X X X X X 23 37 X 14 Life Premium P & C Premium Health Premium Annuity Premium HMO X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X 24 37 X 13 X X X X 24 37 X X X X X X X X X X X X X X X X X X 13 23 37 X X X X X X X X X X X X X X X X X 14 3. Is the filing information matched with information from the annual statutory financial statement? Alabama Alaska Arkansas Arizona ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 Yes X X X X No Yes X X No Yes X X X X No Yes X X X X No Yes No Yes No (a) (a,b,c) (a,b,c,d) (c) X X X X X X X 6 of 41 All Premium Adm L P/C H California Colorado Connecticut Delaware DC Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kanas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Jersey New Mexico New York North Carolina (c) North Dakota (c) Ohio Oklahoma Oregon (a,b,c,d) (a,b,c) (b,c) X X X X X X X X X (a,b,c) X (c) (c) (a,b,c) (c) (c) X X X X X X X (c) (c) (c) X X X (a,b,c,d) (c) (c) (c) (c) (c) (c) (c) (a,b,c) (c) (c) (c) (a,b,c) X X X X X X X X X X X X X X Life Premium P & C Premium Health Premium X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X Annuity Premium X HMO X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X New Hampshire (c) Pennsylvania (c) Rhode Island (c) South Carolina (a,b,c) ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 7 of 41 All Premium Adm L P/C H South Dakota (b) Tennessee Texas Utah Vermont Virginia (a,b,c) (c) (a,b,c) X X X X X X X 44 45 If yes, by: a. Schedule T Alabama Alaska Arkansas California Idaho Kansas Montana New Mexico Ohio Oklahoma South Carolina Tennessee Utah Virginia Wyoming 15 1 (a,b,c,d) X X Life Premium P & C Premium Health Premium X X X X X X X X X 44 45 1 X X X X X X X X X 44 45 1 X X X X X X X X X 44 45 1 Annuity Premium HMO X X X X X X Washington (c) West Virginia (c) Wisconsin Wyoming 51 (c) (a,b,c) Yes X X X X X X X No X X Yes X X X X X No X Yes X X X X X No X Yes X X X X X No X Yes No X X Yes No X X X X X X X X X X X X 10 15 Yes X X X X X 5 X 10 15 Yes X X X X X X X X X X X X X X X 5 10 15 Yes X X X X X X X X X X X X X 5 10 15 Yes X X X X X X X X X X 5 X X X X b. State Page Alaska Arkansas California Idaho Kansas ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 No X X No X No X No X Yes No X X Yes X No X X X 8 of 41 Montana New Mexico Ohio Oklahoma Oregon South Carolina South Dakota Tennessee Utah Virginia Wyoming 16 All Premium Adm L P/C H X X X X X X X X X X X 14 2 16 Yes X X X X X X X X X X X X X X X X X X X X X X X X No X Life Premium P & C Premium Health Premium X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X 14 2 14 2 14 2 16 16 16 Yes X X X X X X X X X X X X X X X X X X X X X X X X No Yes X X X X X X X X X X X X X X X X X X X X X X X X No Yes X X X X X X X X X X X X X X X X X X X X X X X X No Annuity Premium HMO X X X X X X X X c. Both Schedule T and State Page Alaska Arkansas Arizona California Colorado Connecticut - also assets page & U&I Exhibits Delaware DC Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Louisiana Maine Maryland Missouri Mississippi Montana Nebraska Nevada New Hampshire ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 Yes No X X Yes X X No X X X X X X X X X X X X X X X X X 9 of 41 New Mexico North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina Tennessee Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming 42 All Premium Adm L P/C H X X X X X X X X X X X X X X X X X X 39 3 42 Life Premium P & C Premium Health Premium X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X 39 3 39 3 39 3 42 42 42 Annuity Premium HMO X X X X X X X X X d. Other page(s). Please specify:________________________________________ Arkansas - page 34 ARK HMO Page 8 Underwriting and Investment HMO California - Assets/Liability, Surplus & Other Funds/Statement of Income/ State page Ohio - Data fromother filings and other state agencies, particularly with regard to exemp premiums, tax credits, etc. Tennessee - Schedule D, F, and Y for P&C, Schedule Y for Life 4. Is the premium information reported on the premium tax filing for purposes of calculating premium tax defined? (Check all that apply) Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware DC Florida Georgia Hawaii ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 Yes X X X X X X X X X X X X No X Yes X X X X X X X X X X X X No Yes X X X X X X X X X X X X No Yes X X X X X X X X X X X X No Yes No X X Yes X X No X X X X 10 of 41 Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Missouri Mississippi Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon - for retaliatory tax filings Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming 51 ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 All Premium Adm L P/C H X X X X X X X X X Life Premium P & C Premium Health Premium X X X X X X X X X X X X X X X X X X X X X X X X X X X Annuity Premium HMO X X X X X X X X X X X X X X X X X X X X X X X X 44 X X X X X X X X X X X X X X X X X X X X X X X 43 X X X X X X X X X X X X X X X X X X X X X X X 43 X X X X X X X X X X X X X X X X X X X X X X X 43 X X X X X X X X X X X X X X X 1 1 1 1 11 of 41 All Premium Adm L P/C H 45 If yes, defined by: a. State statute Code cite: ____________________________ Alaska Cite: 21.09.210, 21.90.900(35) Alabama - Ala. Code Section 27-4A-2 and 27-4A-3 Arkansas - 26-57-601 premium tax (et. seq.) 23-61-703 cfrf 23-63-102 retaliatory tax 23-62-107 wet marine 23-63-1614 captive 23-73-105 fmaa 23-75-119 hms 23-76-131 hmo 23-91-226 legal insurance 23-100-104 fraud fee 26-57-614 fprf 11-9-303 State statutecomp Code cite: ARS 20-224 states " ......total direct premium income including workers Arizona policy membership and other fees and all other considerations for insurance from all classes of business whether designated as a premium or otherwise received by it during the preceding calendar year on account of policies and contracts covering property, subjects or risks located, resident or to be performed in this state, after deducting from such total direct premium income applicable cancellations, returned premiums, the amount of reduction in or refund of premiums allowed to industrial life policyholders for payment of premiums direct to an office of the insurer and all policy dividends, refunds, savings coupons and other similar returns paid or credited to policyholders within this state and not reapplied as premiums for new, additional or extended insurance. No deduction shall be made of the cash surrender values of policies or contracts. Considerations received on annuity contracts, as well as the unabsorbed portion of any premium deposit, shall not be included in total direct premium income, and neither shall be subject to tax California - California Revenue & Taxation Code 12221, CA Insurance Code Sections 995.5 and 1530 Colorado - CRS 10-3-209 Connecticut - Conn Gen. Stat. 12-201 Delaware - Cite: 18 Del. C 702 et al DC - DC Official Code 47-2608 Florida - code: Section 624 509 Florida Statutes Georgia - O.C.G.A. 33-8-4 Hawaii - Hawaii Revised Statutes ("HRS") 431:7-202 and 431:10-218 Idaho Cite - 41-402 Illinois - Cite 215 ILCS 5/409 Indiana - IC 27-1-18-2 & IC 27-13-29-1-HOM exclusion Iowa - Cite - 432 Kansas 0 KSA 40-252 Kentucky - KRS 136.320(4); 136.340; 136.350-370; 136.392(l) Louisiana - LRS 22:5(13), 22:1066 ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 Life Premium P & C Premium Health Premium 44 44 44 Annuity Premium HMO Yes X X No Yes X X No Yes X X No Yes X X No Yes No X Yes X No X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X 12 of 41 Maryland - Insurance Art. Annotated Code of MD - Title 6 Mississippi - code 27-25-103, 27-15-109 Missouri - 148.320-148.330-148.340.148.350-148.376-148.380 Montana - Section 33-2-705, MCA Nebraska - Cite: 77-908 & 44-150 Nevada - NRS 680B.025 to NRS 680 B.039 Inclusive New Hampshire - NH RSA 400-A:31 New Mexico North Carolina - Cite NCGS 58-6-25, NCGS 58-21-85 (Surplus Lines) NCGS 58-22-20(3)(a) RRGs North Dakota - ND Cent. Code Section 26.1-03-17 Ohio - Cite 5729.02, 5729.03 and 5825.18 Ohio Revised Code (ORC) Oklahoma - Title 36 Section 624 Oregon - Oregon Revised Statute 731.808 Pennsylvania - Article IX of Tax Reform Code of 1971 Rhode Island - Cite 44-17-2 South Carolina Section 38-7-20, SC Code of Laws South Dakota SDCL 10-44 Tennessee - Title 56, Chapter 4 and variuod other cites in Titles 56 and 50 of the TCA Utah - Utah Code Ann. 59-9-101 Vermont Title 32 8551,8554 Virginia - 58-1-25-- of the Code of Viriginia West Virginia - 33-3-14-14a-14b-14c-14d-15-17-33 Wisconsin - Code: 600.03(38) Wyoming - Wyo. Stat. 26-4-103 43 All Premium Adm L P/C H X X X X X X X X X X X X X X X X X X X X X X X X X 43 0 43 Yes X No X Life Premium P & C Premium Health Premium X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X 43 0 43 0 43 0 43 43 43 Yes X No X Yes X No X Yes X No X Annuity Premium HMO X X X X X X X X X X b. Regulation Regulation cite: ________________________ Alaska Arkansas - Rule 56 CFRF Arizona - Regulation cite: HMO's only : R20-6-405(E)(14) "Net charges" means the total of all sums prepaid by or for all enrollees, less approved refunds, adjustments and deductions, as consideration for Health Care Services of a Health Care Plan under an Evidence of Coverage. California Illinois Cite 50 ILL ADMIN Code 2500 Iowa Maryland - MD Regs. 31.06.01-31.06.06 Montana Nevada - NAC 680.B.095 New Hampshire New Mexico ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 Yes No X Yes No X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X 13 of 41 Ohio Oklahoma Rhode Island Tennessee Utah Washington Revised Code of WA: 48.14.020,48.14.201,48.14.30 Wyoming - Insurance Department Regulations, Chapter 38 18 All Premium Adm L P/C H X X X X X X X 8 10 18 Yes No X Life Premium P & C Premium Health Premium X X X X X X X X X X X X X X X X X X X X X 8 10 8 10 8 10 18 18 18 Yes No X Yes No X Yes No X Annuity Premium X HMO X X X X c. Agency practice/determination and or tax form instructions. Reference: ________________ Alaska Arkansas - 26-57-601 premium tax (et. seq.) 23-61-703 cfrf 23-63-102 retaliatory tax 23-62-107 wet marine 23-63-1614 captive 23-73-105 fmaa 23-75-119 hms 23-76-131 hmo 23-91-226 legal insurance 23-100-104 fraud fee 26-57-614 fprf 11-9-303 workers comp California - tax forms & instructions Colorado Delaware Illinois - As shown on the Annual Statement Indiana - reference www.in.gov/idoi/2369 Iowa Maryland Montana Nevada - http://tax.state.nv.us/forms.htm New Hampshire North Dakota - Reconciled Tax Statement at http://www.nd.gov/eforms/doc/sfn11050.pdf Ohio - General premium tax return instructions are located online at http://ohio insurance .gov/Company/statform.htm. More specific instructions are also on the actual online premium tax returns, which can be viewed through the same link by selecting company type and then the tax return to be filed. Oklahoma - reference:Tax forms Rhode Island South Carolina - Tax Return Instructions ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 Yes No X Yes No X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X 14 of 41 Tennessee Utah - Tax form instruction West Virginia Wyoming 21 All Premium Adm L P/C H X X X X 15 6 21 Life Premium P & C Premium Health Premium X X X X X X X X X X X X 15 6 15 6 15 6 21 21 21 Annuity Premium X X HMO d. Other. Please specify; _____________________________________________________ Ohio - Attorney General Opinion Nevada - Capitve tax and forms NRS 694C.450 to 694C.060 inclusive 2 X X 2 2 5 a. If the state defines taxable premium, what is the definition? i. Premium on contracts delivered in the state. Alaska Arkansas Arizona California Idaho Iowa Kentucky Montana Nevada New Hampshire North Dakota Ohio Oklahoma Rhode Island South Carolina Tennessee Utah 17 0 X X 2 2 0 X X 2 2 0 X X 2 2 0 Yes X 1 17 No X X X X X X X X X X X X X X X X X 16 Yes X No X X X X X X X X X X X Yes X No X X X X X X X X X X X X X X X X 16 Yes X No X X X X X X X X X X X X X X X X 16 Yes No X X X Yes X No X X X X X X X X X 15 X X 2 17 1 17 1 17 ii. Premium on contracts issued in the state. Alaska Arizona California ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 Yes No X X X Yes No X X X Yes No X X X Yes No X X X Yes No X X Yes No X X 15 of 41 Idaho Iowa Kentucky Montana Nevada New Hampshire New Mexico North Dakota Ohio Oklahoma Rhode Island South Carolina Tennessee Utah Vermont - Property & Casualty Virginia 19 All Premium Adm L P/C H X X X X X X X X X X X X X X X X 5 14 19 Yes No X X X X X X X X X X X X X X X X X X X Life Premium P & C Premium Health Premium X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X 6 13 5 14 5 14 19 19 19 Yes No X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X Yes No X X X X X X X Yes No X X X X X Annuity Premium HMO X X X X X X iii. Premium collected in the state. Alaska Arizona California Idaho Indiana Iowa Kansas Kentucky Missouri Montana Nevada New Hampshire North Carolina North Dakota Ohio Oklahoma Rhode Island South Carolina Tennessee Utah ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 Yes No X X Yes No X X X X X X X X X X X X 16 of 41 Vermont - Life and Accident & Health Washington 22 All Premium Adm L P/C H X X 7 15 22 Yes X X No Life Premium P & C Premium Health Premium X X X X X X 7 15 7 15 7 15 22 22 22 Yes X X No Yes X X No Yes X X No Annuity Premium X HMO iv. Premium paid on risk located in the state. Alabama Alaska Arizona California Colorado Delaware DC Florida Georgia Idaho Iowa Kentucky Montana Nebraska Nevada New Hampshire North Dakota Ohio Pennsylvania Rhode Island South Carolina Tennessee Utah Washington Wisconsin Wyoming 26 Yes No X Yes X No X X X X X X X X X X X X X X X X X X X X X X X 15 26 X X X 16 26 X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X 15 26 X X X X X X X X X X X X X X X X X X X 17 26 11 10 9 11 v. Other. Please specify:__________________________________________________ Alabama - 27-4A-3 … each year thereafter, every insurer shall pay to the commissioner a premium tax equal to the percentage, as set out in this subsection (a), of the premiums received by the insurer for business done in this state, whether the same was actually received by the insurer in this state or elsewhere: Arkansas - direct written premium in state ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 17 of 41 Arizona - See response to 4c. And reference to "premium income… received by it … on account of policies and contracts covering property, subjects or risks located, resident or to be performed I this state… after deducting…" and fro HMO's only " … all sums prepaid by or for all enrollees, less approved refnds, adjustments and deductions, as consideration for Health Care Service of a Health Care Plan under an Evidence of Coverage". California - Gross premiums, less return premiums , received in such year…upon business done in the state. Connecticut - The tax is payable on the total net direct premiums received by the insurance company from policies written on property or risks located or resident in Connecticut. Florida Hawaii - see #4 above Idaho - Premium on policies covering subjects of insurance resident located or performed in this state. Illinois - 50 ILL ADMIN Code 2510 .20 Kentucky - Generally, on premium receipts for business done in state Louisiana - N/A Maryland - Premims allocable to the State Mississippi - Premium receipts received from and on insurance policies and contracts written in, or covering risks located in this state. Nebraska - Nebraska Residents if # of lives exceeds 500 New Hampshire - Premiums written, procured, or received in the state North Dakota - Gross direct premiums, assessments, membership, subscriber and policy fees, finance and service charges, less return premiums, refunds, and abatements. Ohio - ORC 5729.02 and 5725.18:"(P) remiums received [by an authorized insurance company] from policies covering risks within this state…" Oregon - the consideration paid by insureds to an insurer for policies of insurance, includes all premiums, assessments, dues and fees received or derived or obligations taken South Carolina - Total premiums "written" by the company. Section 38-7-20- SC Code of Laws South Dakota - Premium collected on risks located in the state Tennessee - Premium on residents of the State Utah - "total premium received … from insurance covering propoerty or risks located in this state: West Virginia - …policies covering risks resident, located or to be performed in this state. 5 b. Does the state define premium as i. Premium paid Alaska Arkansas Arizona California Georgia Idaho Illinois Indiana ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 All Premium Adm L P/C H Life Premium P & C Premium Health Premium Annuity Premium HMO X X X Yes X X X X No X X Yes X X X X No Yes X X X X No Yes X X X X No Yes No X X Yes X X No X X X X X X X X X X X X X X X X X 18 of 41 Iowa Kansas Kentucky Louisiana Maine Mississippi Montana Nevada NRS 680B.032 New Hampshire North Carolina Ohio Pennsylvania Rhode Island South Carolina Utah Vermont - Life and Accident & Health Washington 25 All Premium Adm L P/C H X X X X X X X X X X X X X X X X X 12 13 25 Yes X No X X X X X X X Life Premium P & C Premium Health Premium X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X 14 11 12 13 13 12 25 25 25 Yes X No X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X Yes X No X x X X X X X X X Yes X No X X Annuity Premium HMO X X X X X X X ii. Premium written Alaska Arizona California Delaware DC Idaho Illinois Iowa Kentucky Louisiana Maine Missouri Montana Nebraska Nevada New Hampshire New Mexico North Carolina North Dakota - Per reference on Reconciled Tax Statement ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 Yes No X X X Yes X No X X X X X X X X X X X X X X X X X X X X X X X X X 19 of 41 Ohio Oklahoma Oregon Rhode Island South Carolina Utah Vermont - Property & Casualty Virginia Washington West Virginia - 33-43-3(i) Wisconsin 30 All Premium Adm L P/C H X X X X X X X X X X X X 21 9 30 Yes No Life Premium P & C Premium Health Premium X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X 21 9 24 6 23 7 30 30 30 Yes No Yes No Yes No Annuity Premium X X HMO X X X X X X X iii. Other ____________________________ Alabama - Other _§27-4A-2 (8) PREMIUMS. All amounts received in cash or otherwise on risks in this state as consideration for contracts of insurance, less all of the following: a. Insurance premiums returned. b. Reinsurance premiums from insurance companies authorized to do business in Alabama and subject to the premium tax provided for in Chapter 4 of Title 27. c. Dividends paid, applied, or left with the company to accumulate at interest. Premiums shall not include: (i) annuity considerations; or (ii) charges by title insurers for abstracting, record searching, certificates as to the record title, escrow and closing services and other related services, or the costs and expenses of examinations of title. Arizona California - The law defines premiums as premium received however, companies have the option to file as premium written subject to pending regulations. Colorado - No definition Connecticut - The tax is payable on the total net direct premiums received by the insurance company from policies written on property or risks located or resident in Connecticut. Florida : gross amount of such receips Hawaii - The Gross Direct Premiums as reported on Sch T/ State Page are reported for tax purposes. Idaho - premium received Iowa - premium received Kentucky - Generally, on premium receipts for business done in state Louisiana - " All sums charged, received or deposited" Maryland - Premiums allocable to State as calrified in Code of MD Regs.31.06.01 Montana Nevada - Net Direct Considerations Written New Hampshire - written, procured or received Yes No Yes No X X X X X X X X X X X X X X X X X X X X X X X X X X X X X ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 20 of 41 All Premium Adm L P/C H Ohio - Ohio statutes generally state "premiums received" or "premium rate payments received" as reported in the Annual Statement (A/S). However, premiums received are not reported in the A/S. Ohio Attorney General opinion further clarifies that ODI Superintendent has the authority to specify premiums written as reported in the A/S in determining premiums subject to tax. Rhode Island South Dakota - premium collected Tennessee - both paid and written Utah - "Total premium received" Wyoming - Total direct premium income received per Wyo. Stat. 26-4-103 Life Premium P & C Premium Health Premium Annuity Premium HMO X X X X X X X X X X X X X X X X ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 21 of 41 All Premium Adm L P/C H 5 c. Does your definition of premium, for premium tax calculation purposes, require the splitting of group contract premium? Alabama Alaska Arkansas Arizona Colorado California Connecticut Delaware DC Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Missouri Mississippi Montana Nebraska Nevada - NRS 680B.030 (1) … Policies and contracts covering property, subjects or risks located, resident or to be performed in this State, with proper proportionate allocation of premiums as to such persons, property, subjects or risks in this State insured under policies and contracts covering persons, preoperty, subjects or risks located or resident in more than one state. New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 Life Premium P & C Premium Health Premium Yes X X No Yes X X No Yes X X No Annuity Premium Yes No X X HMO Yes X X No Yes X X No X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X 22 of 41 Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming 51 All Premium Adm L P/C H X X X X X X X X X X X X X X X 12 42 30 Life Premium P & C Premium Health Premium X X X X X X X X X X X X X X X X X X X X X X X X X X X X 12 42 30 X 12 42 X X X X X X 30 X 12 42 X X X X X X 30 Annuity Premium X HMO X X X If yes, is it based on: i. Residence Alabama Alaska Delaware Idaho Louisiana Maryland - Based on size of contract Montana Nebraska - If lives exceeds 500 New Mexico Oklahoma Tennessee West Virginia Wyoming - Insurance Department Regulations, Chapter 38 13 Yes X X X X X No Yes X X X X X X No Yes X X X X X No Yes X X X X X X No Yes No X Yes X No X X X X X X X 7 12 Yes X X X 5 X 8 12 Yes X X X X X X X X X X X X 4 X 7 12 Yes X X X X X X X 5 X 8 12 Yes X X X X X X 4 X X ii. Property location Alabama Alaska DC ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 No No No No Yes No X X Yes X X No X 23 of 41 Idaho Louisiana Maine Montana New Mexico Oklahoma Tennessee West Virginia Wyoming - Insurance Department Regulations, Chapter 38 12 All Premium Adm L P/C H X X X X X X X X X X 7 5 12 Yes X X No Life Premium P & C Premium Health Premium X X X X X X X X X X X X X X X X X X X X X X X X X X X 7 5 8 4 7 5 12 12 12 Yes X X No Yes X X No Yes X X No Annuity Premium HMO X X iii. Employment location Alabama Alaska Idaho Louisiana Maine Montana New Mexico Tennessee West Virginia 9 Yes No X Yes X No 2 9 X X X X X X X 7 2 9 X X X X X X X 7 2 9 X X X X X X X 7 2 9 X X X X X X X 7 iv. Other, please specify _________________________ Alabama - premiums received by the insurer for business done in this state, whether the same was actually received by the insurer in this state or elsewhere Arizona - See responses to 4.c. and reference to "… covering propoerty, subjects or risks located, resident or tho be performed in theis state…" California - The law does not require the splitting of group contract premiums however, the NAIC Rule of 500 applies wherein for groups of less than 500, premiums are allocated to the state of the group policy holder. For groups of 500 or more, premiums are allocated to the state of residence of each individual certificate holder of the group. Connecticut - no position on this issue. Nevada - ALL three - Statute reference and wording included above North Dakota - Issue has not been specifically addressed Ohio - Other, please specify: Ohio computes premium tax on Schedule T. According to A/S instructions, companies must state at the bottom of Schedule T their bases for allocation of premiums. Ohio generally accepts companies' allocations when their bases are stated on Schedule T and are reasonable. ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 24 of 41 All Premium Adm L P/C H Are the following assessments calculated on the same defined premium amount as is done for premium tax? a. Guaranty fund. Alabama Alaska Arkansas Arizona Colorado California Connecticut Delaware DC Florida Georgia Hawaii - P&C Insurers - Hawaii Ins. Guaranty Assn. - see HRS 431:16-105 (definitions of net direct written premiums); HIGA deducts dividends from the premiums for assessment purposes. Life/A&H insurers Hawaii Life and Disability Ins. Guaranty Assn. see HRS 431:16-205 (definition of premiums). Idaho Illinois - (although not identical language) Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada - (NRS 687A.060 1c) New Hampshire New Jersey New Mexico New York X X X X X X X X X 6. Life Premium P & C Premium Health Premium Annuity Premium HMO Yes X X No X X X X X X Yes X X No X Yes X X No X Yes X X No X Yes No Yes No X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 25 of 41 All Premium Adm L P/C H North Carolina - Guaranty fund is traxed the same as all other insurance companies. However, monies collected are kept by the Guaranty Fund and not remitted tdo the Department of Revenue. North Dakota Ohio Oklahoma Oregon - Limited to the lines of insurance guaranted by the funds Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming - Prem. received per W.S. 26-42-107(d). Net direct written prem. per W.S. 26-31-107. 51 X X X X X X X X X X X X X X X 28 41 13 Life Premium P & C Premium Health Premium X X X X X X X X X X X X X X X X 30 41 11 X X X 30 41 11 X X X X X X X X X X 29 41 12 X X X X X X X X X X X X X X X X X X X Annuity Premium HMO X X X X X X X X X X X X If no, please explain and/or give the premium definition used: _______________________ Alaska - Alaska Life and Health Insurance Guaranty Association (Life/Health/Annuity) "..premium received on business in this state…" AS 21.79.070(c) Alaska - Alaska Insurance Guaranty Association (Property/Casualty) "..net direct written premiums of each member insurer for the last year…" AS 21.80.060(a)(3)(A) Arizona - Unclear if premium amount is identical. Guaranty Fund uses different definitions in AS - 20-66(7) and 20-681(5) California - CIC 1063.14(a) - Premiums Charged Colorado - No definition given Delaware - 18 Del. C Ch 42 & Ch 44 Kentucky - L&H =KRS 304.36-050(9) and 36.080(1); P&C 304.42-090(3)(b) Mississippi - written premium Montana - Health based on premium received rather than written Nebraska - Annuity Contracts ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 26 of 41 Pennsylvania If no, please explain and/or give the premium definition used: __Under the Pennsylvania Property & Casualty Insurance Guaranty Association Act, Assessments are based on the net direct written premiums of the member insurer for the preceding calendar year. Using Statutory Page 14, premiums are taken from Column 1 - Direct Premiums Written less Column 3 - Dividends Paid on the following lines of business: 1 Fire 2.1 Allied Lines 3 Farmowners multiple peril 4 Homeowners multiple peril 5.1 Commercial multiple peril (non-liability portion) 5.2 Commercial multiple peril (liability portion) 9 Inland marine 11 Medical malpractice 12 Earthquake 17 Other liability 18 Products liability 22 Aircraft (all perils) 26 Burglary and theft 27 Boiler and machinery 31 Aggregate write-in for other lines of business As well as the Auto Lines: 19.1 to 21.2. South Dakota - See adjustments made by the L, H & A Guaranty Association Model Act Assessment Base Reconciliation Exhibit in the Annual Statement. Virginia - net direct written premiums excludes dividends paid or credited to policyholdrs under the Guaranty Association statutes in Virginia, (Chapters 16 and 17 of Title 38.2 of the Code of Virginia). While the premium tax definition does not allow for the deduction of dividends paid. Wyoming - Our administrators obtain premium info directly from other sources (NOLHGA, NAIC). b. Other assessment (e.g. fair plan, fire, workers compensation, health, etc.). Alabama Alaska - Comprehensive Health Insurance Association (High Risk) " … major medical premiums received from or on behalf of state residents.." AS 21.21.55.220 Alaska - Workers Compensation Assigned Risk Pool - premiums written in such state as shown by the records of the National Council on Compensation Insurance. Plan of Operations, Paragraph 9. Arkansas Arizona California Colorado DC Florida - workers compensation Hawaii - Worker's Compensation Special Compensation Fund Assessment Hawaii - Insurance Regulation Fund Assessment Illinois - yes for fair plan. No for fire, which is based on gross premiums rather than net. ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 All Premium Adm L P/C H Life Premium P & C Premium Health Premium Annuity Premium HMO Yes X No Yes No Yes No Yes No Yes No Yes No X X X X X X X X X X X X X X X X X X X 27 of 41 Indiana Iowa Kentucky Louisiana - Fire Maine Maryland - N/A; outside of MD Ins. Adm. Area of jurisdicition. Mississippi Missouri Montana Nebraska Nevada New Hampshire New Mexico North Dakota Ohio Oklahoma Oregon Rhode Island South Carolina - Various - according to the individual assessment Tennessee Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming 39 All Premium Adm L P/C H X X X X X X Life Premium P & C Premium Health Premium Annuity Premium HMO X X X X X X X X X X X X X X X X X X X X 18 30 X 12 3 5 2 6 8 2 4 6 2 X X X X X X X X X X X i. Please list ______________________________________________________ Alabama - Alabama Health Insurance Plan Arkansas - CHIP POOL - Health Premiums Written Arizona - Fraud fund, Health Care Appeals Fund, Market Assistance Program California - all of the above examples DC - L & H Guaranty fund; P&C Guaranty fund : Workers Comp; Health Kentucky - Assigned Claims KRS 304.39-17(l) Maine - Workers Compensation and Fire Mississippi - varies - assessment/participation based on proporation of premium written; assessment amount established by statute Montana - Health - premium received ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 28 of 41 All Premium Adm L P/C H Nebraska - Workers Compensation Nevada - Fraud Assessment, Workers Compensation New Hampshire - workers compensations _ paid losses North Dakota - Comprehensive Health Associatino of North Dakota (CHAND) Ohio - Auto Insurance Plan, Fair Plan Oklahoma - Workers Compensation Oregon - fire marshall tax, funding assessment for OID Utah - Workers Compensation Virginia - Bureau of Insurance Maintenance Assessment, Fire, Flood, Heat and Fraud Washington - FAIR Plan and Fire assessments are based on written premium West Virginia - Fair Plan and Workers Compensation surcharge. Wyoming - Wyo. Health Ins. Pool (WHIP), and Wyo. Small Emp. Health Rein. Prog. (WSEHRP)__ ii. If no, please explain and/or give the premium definition used: _____________________ Arkansas - Health Premiums only for CHIP Pool Arizona - See response to number7 below. California - Not subject to premium tax in CA. Nebraska - losses New Hampshire - Insurance Department Administrative Assessment Oregon - WCD Premium Assessment uses earned premium Utah - Premium Income Received Wyoming - Premiums written (WHIP) 7. If assessments are levied on something other than premium, please describe___________________________ Arizona - based on lines of business Kentucky - Fair Plan KRS 304.35-030(l) Mississippi - reger 6. b. ii Nevada - Cost Stabilization based on appropriated funds determined by Legislature divided by P/C Carriers per NAC 679B.158 Assessment of NAIC - set dollar amount by legislature NAC 680B.070. Oregon - Oregon Medical Insurance Pool assessment is based on # of lives. South Dakota - "losses paid" for subsequent injury fund Wyoming - Premium tax liability (WSEHRP) X Life Premium P & C Premium Health Premium Annuity Premium HMO Comments: _________________________________________________________________________________________________________________________________________ Alaska - Annuity premiums are not taxed. ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 29 of 41 Arkansas - 26-57-601 premium tax (et. seq.) 23-61-703 cfrf 23-63-102 retaliatory tax 23-62-107 wet marine 23-63-1614 captive 23-73-105 fmaa 23-75-119 hms 23-76-131 hmo 23-91-226 legal insurance 23-100-104 fraud fee 26-57-614 fprf 11-9-303 workers comp Arizona _ Comments: Regarding 5.b.iii. - We find at least 3 definitions in ARS Title 20. See ARS 20661(7) and 20-681(5) in our P/C and L/D Guaranty Fund articles, respectively, and also "Premium Defined" in Chapter 5 The Insurance Contract, Article 1 In General, subsection 20-1103 which states "Premium" is the consideration for insurance, by whatever name called. All Premium Adm L P/C H Life Premium P & C Premium Health Premium Annuity Premium HMO DC - (1) HMO premium tax effective January 1, 2009 )DC Official Code 31-3401) (2) L&H Guaranty Fund administered by DC L&H Guarant Fund (DC Offcial Code 31 - 5401); (3) Workers Compensation assessment administered by DC Department of Employment Services (DC Official Code 32 -1541); (4) Health assessment administered by DC Department of Health (DC Official Code 44-301.9) Georgia - Guaranty fund, fair plan, workers comp are calculated and assessed by other agencies. Hawaii - For Hawaii premiums tax filings, the insurers report the direct premiums as reported in the Schedule T and State page. The P&C premiums are written while the Life/A&H can either be written or received (pre the NAIC Annual Statement Instructions). Maine - Answers to questions 1 - 5 and 6b provided by Richard Truman in Revenue Services Montana - workers compensation assessment based on benefit and loss payments New Hampshire - Q 5a. Iv. And 5b. i. Are not premiums "paid to a company" the same as premiums "received" by the company? Would "received" be a better descsription than "paid to"? Q. 5a. V. NH taxable premiums are defined as ".. All such premium… written, procured, or received in this state Shall be deemed written on property, subjects or risks located, resident or to be performed in this state except…" premiums properly allocated and a tax paid to another state, and premiums written outside the United States of America. Q. 5. c. There is no explicit language that requires the splitting of group contract premuims. If received in NH, the entire prmeium is taxable unless it is properly allocated to and a tax paid to another state. ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 30 of 41 All Premium Adm L P/C H Life Premium P & C Premium Health Premium Annuity Premium HMO Ohio - The basis for reporting premiums by state in Schedule T and state pages should be uniform by state and should be defined by the NAIC. The main problems Ohio sees are: (1) Employer group accident & health policies where employees are issued certificates and reside in other states, i.e. location of employer vs. residence of insureds; (2) Individual cross-border issues i.e. location of agent or insured vs. situs of risk; (3) Group life insurance policies where master policy is marketed and issued to a group or a non-fraternal association located in one state, which then issues individual certificates to association members in other states, and (4) Life insurance policy renewal payments where the policyholder has moved to a different state where the insurer is not licensed, i.e. are renewal premiums to be reported in the new state of residence, even though not authorized? Which Department has the authority to tax the premiums or is any state taxing these premiums? Also, Medicare prescription drug premiums need to be broken out, since they are exempt from tax and are not stated separately in the state pages. Tennessee - for details on the Life and A&H guaranty fund please ocntact Renee Birdwell 615-242-8758 ad P&C Guaranty fund contact Ivy Neimann 615-242-6839. Utah - Our answers are based on responses from the Utah Attorney General's Office and the Utah State Tax Commission. There is no Utah case law regarding the allocation of premium tax in Utah. Please see the attached Word file for the Utah Attorney General's opinion regarding the Utah statute and case law from other states that may have bearing on how a similar case would be decided in Utah. Vermont - The definitions and instructions currently used to define taxable premiums are being reviewed and may be clairifed in the near future. Wyoming - Our Department has always collected premium taxes on a direct written basis from data located on the State Pages in the Annual Statement. ** x - indicates a response based on the state's other responses to the survey. ** Alabama Responder's Contact Information Name: Richard Ford Department/State: Alabama Department of Insurance Telephone Number: 334-241-4155 Email Address: rebecca.nesheim@alaska.gov; gloria.glover@alaska.gov Alaska Responder's Contact Information Name: Rebecca Nesheim/ Gloria Glover Department/State:Alaska Division of Insurance Telephone Number: 907-465-2584 / 907-269-7903 Email Address: rebecca.nesheim@alaska.gov; gloria.glover@alaska.gov Arizona Responder's Contact Information Name: Kelly Stephens Department/State:Arizona Division of f Insurance Telephone Number: 602-364-3964 Email Address: kstephens@azinsurance.gov ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 31 of 41 All Premium Adm L P/C H Arkansas Responder's Contact Information Name: Pat Looney Department/State:Arkansas Insurance Department Telephone Number: 501-371-2613 Email Address: pam.looney@arkansas.gov California Responder's Contact Information Name: David Langenbacher Department/State: State of California Department of Insurance Telephone Number: 213-346-6364 Email Address: langenbacherD@insurance.ca.gov Colorado Responder's Contact Information Name: Ray Akers Department/State: Colorado Div of Insurance Telephone Number: 303-894-7836 Email Address: ray.akers@dora.state.co.us Connecticut Responder's Contact Information Name: Kathy Belfi Department/State: Connecticut Department of Insurance Telephone Number: 860-297-3968 Email Address: Kathy.Belfi@ct.gov Delaware Responder's Contact Information Name: Ann Fletcher, Tax Coordinator Department/State: Delaware Insurance Department Telephone Number: 302-674-7383 Email Address: ann.fletcher@state.de.us District of Columbia Responder's Contact Information Name: Alvin James Department/State: Department of Insurance, Securities and Banking; District of Columbia Telephone Number: 202-442-7772 ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 Life Premium P & C Premium Health Premium Annuity Premium HMO 32 of 41 All Premium Adm L P/C H Email Address: alvin.james@dc.gov Florida Responder's Contact Information Name: Stephen Szyupula Department/State:Florida Office of Insurance Regulation. Telephone Number: 850-413-3825 Email Address: steve.szypula@floir com Georgia Responder's Contact Information Name: M. Linda Brooks Department/State: Georgia Department of Insurance Telephone Number: 404-656-7551 Email Address: lbrooks@oci.ga.gov Hawaii Responder's Contact Information Name: Susan Hansen Department/State: State of Hawaii, Dept of Commerce & Consumer Affairs, Insurance Division Telephone Number:808-586-7381 Email Address: shansen@dcca.hawaii.gov Idaho Responder's Contact Information Name: Kathy Miller Department/State: Idaho Department of Insurance - Premium Tax Section Telephone Number: 208-334-4282 Email Address: kathy.miller@doi.idaho.gov Illinois Responder's Contact Information Name: ___John P. O'Brien__ Department/State: Illinois Division of Insurance Telephone Number: _____217-782-0055 Email Address: John.P.Obrien@illinois.gov Indiana Responder's Contact Information Name: Dynthia D. Donovan ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 Life Premium P & C Premium Health Premium Annuity Premium HMO 33 of 41 All Premium Adm L P/C H Department/State: Indiana Department of Insurance Telephone Number: 317-232-2408 Email Address: cdonovan@idoi.in.us Iowa Responder's Contact Information Name: Donna Flamm Department/State: Iowa Insurance Division Telephone Number: 515-242-5178 Email Address: donna.flamm@iid.iowa.gov Kansas Responder's Contact Information Name: Sabrina Wells Department/State: Kansas Department of Insurance Telephone Number: 785-291-3191 Email Address: swells@ksinsurance. org Kentucky Responder's Contact Information Name: David Hurt Department/State: Kentucky Department of Insurance Telephone Number: 502-564-6082 Email Address: david.hurt@ky.gov Louisiana Responder's Contact Information Name: Tommy Coco Department/State: Louisiana Department of Insurance Telephone Number: 225-342-1012 Email Address: tcoco@ldi.state.la.us Maine Responder's Contact Information Name:Kendra Godbout Department/State: BOI/Maine Telephone Number: 207-624-8495 Email Address: Kendra.l.godbout@maine.gov Maryland ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 Life Premium P & C Premium Health Premium Annuity Premium HMO 34 of 41 All Premium Adm L P/C H Responder's Contact Information Name: Chineta Alford Department/State: Maryland Insurance Administration Telephone Number: 410-468-2152 Email Address: calford@mdinsurance.state.md.us Mississippi Responder's Contact Information Name: _Debra Vernon Department/State: __Mississippi Telephone Number: ___601.359.5343 Email Address: ___Debra.Vernon@mid.state.ms.us Missouri Responder's Contact Information Name: Lillian Hand Department/State: Missouri Department of Insurance, Financial Institutions and Professional Registration Telephone Number: 573-526-1589 Email Address: Lillian.Hand@Insurance.mo.gov Montana Responder's Contact Information Name: Steve Matthews Department/State: Examinations/Montana Telephone Number: 406-444-4372 Email Address: smatthews@mt.gov Nebraska Responder's Contact Information Name: Martha Hettenbaugh Department/State: Nebraska Insurance Department Telephone Number: 402-471-2201 Email Address: martha.hettenbaugh@nebraska.gov Nevada Responder's Contact Information Name: Peggy Willard-Ross Department/State: Nevada Division of Insurance Telephone Number: 775-687-4270 Ext 241 Email Address: pwillard@doi.state.nv.us ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 Life Premium P & C Premium Health Premium Annuity Premium HMO 35 of 41 All Premium Adm L P/C H New Hampshire Responder's Contact Information Name: Charles E. Burdette, Tax Administrator Department/State: New Hampshire Telephone Number: 603-271-7973- Ext 225 Email Address: Charles.Burdette@ins.nh.gov New Mexico Responder's Contact Information Name: Raymond Valdez Department/State: NM Department of Insurance, Public Relations Commission Telephone Number: 505-827-4506 Email Address: raymon.valdez@state.nm.us North Carolina Responder's Contact Information Name: James. A. Riddick Department/State: North Carolina Telephone Number: 919-733-5633ext. 240 Email Address: jriddick@ncdoi.com North Dakota Responder's Contact Information Name: ___Carole Kessel, Chief Examiner Department/State: North Dakota Department of Insurance Telephone Number: 707-328-9602 Email Address: ckessel@nd.gov Ohio Responder's Contact Information Name: Gary W. Burchfield Department/State: Ohio Department of Insurance Telephone Number: 614-728-1074 Email Address: gary.burchfield@ins.state.oh.us Oklahoma Responder's Contact Information Name: _Dwight DeJear Department/State: Oklahoma Insurance Department ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 Life Premium P & C Premium Health Premium Annuity Premium HMO 36 of 41 All Premium Adm L P/C H Telephone Number: 405-522-0891 Email Address: swight.dejear@oid.state.ok.gov Oregon Responder's Contact Information Name: Lynette Hadley for Russell Latham, Chief Examiner Department/State: Oregon Insurance Department Telephone Number:503-947-7046 Email Address: lynette.m.hadley@state.or.us Pennsylvania Responder's Contact Information Name: Steve Johnson Department/State: Pennsylvania Insurance Department Telephone Number: 717-783-2142 Email Address: stjohnson@state.pa.us Rhode Island Responder's Contact Information Name: Leo Lebeuf Department/State: RI Division of Taxation Telephone Number: 401-574-8983 Email Address: llebeuf@tax.ri.gov South Carolina Responder's Contact Information Name: Mary B. Sturke Department/State: Department of Insurance, State of South Carolina Telephone Number: 803-737-6082 Email Address: msturkie@doi.sc.gov South Dakota Responder's Contact Information Name: Seth Doyle Department/State: South Dakota Division of Insurance Telephone Number: 605-773-3563 Email Address: seth.doyle@state.sd.us Tennessee Responder's Contact Information ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 Life Premium P & C Premium Health Premium Annuity Premium HMO 37 of 41 All Premium Adm L P/C H Name: Mark Brothers Department/State: Tennessee Dept. of Commerce and Insurance Telephone Number: 615-741-1633 Email Address: mark.brother@state.tn.us Utah Responder's Contact Information Name: Jake Garn Department/State: Utah Insurance Department Telephone Number: 801-538-3811 Email Address: jwgarn@utah.gov Vermont Responder's Contact Information Name: Kenneth L. McGuckin ; Merradee Lyons Department/State: Vermont Insurance Department ; Department of Taxes - Vermont Telephone Number: 802-828-4849 ; 802-828-6837 Email Address: kmcguckin@bishca.state.vt.us ; merradee.lyons@state.vt.us Virginia Responder's Contact Information Name: Keith D. Kelley Department/State: Bureau of Insurance / Virginia Telephone Number: 804-371-9333 Email Address: keith.kelley@scc.virginia.gov Washington Responder's Contact Information Name: Patrick H. McNaughton Department/State:Washington State Office of the Insurance Commissioner Telephone Number: 206 464-6624 Email Address: PATM@OIC.WA.GOV West Virginia Responder's Contact Information Name: J. Leah Cooper Department/State: West Virginia Telephone Number: 304-558-2100 ext. 1184 Email Address: leah.cooper@wvinsurance.gov. Life Premium P & C Premium Health Premium Annuity Premium HMO ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 38 of 41 All Premium Adm L P/C H Wisconsin Responder's Contact Information Name: Roger Peterson Department/State: Wisconsin Department of Insurance Telephone Number: 608-267-4384 Email Address: Roger.Peterson@wisconsin.gov Wyoming Responder's Contact Information Name: Linda L. Johnson Department/State: Wyoming Telephone Number: 307-777-5619 Email Address: ljohns1@state.wy.us Life Premium P & C Premium Health Premium Annuity Premium HMO ec978a7f-ebf5-4276-adb5-817662af2831.xls 8/21/2009 39 of 41 Alabama Alaska Arizonia Arkansas California Colorado Connecticut Delaware Disctrict of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Masscheusetts Maryland Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X Washington West Virginia Wisconsin Wyoming X X X X