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Insurance Commissioner & Department of Insurance

DELAWARE DEPARTMENT OF INSURANCE



Premium Tax Forms

 ANNUAL FEES ASSESSMENT FORM**

** ONLY for HMO/DPO/HSC Companies

This form is specifically designed for DPOs, HMOs, and HSCs.  The form reflects that although these companies are exempt from paying premium taxes to the State of Delaware, the companies are subject to an Annual Statement filing fee and Certificate of Authority annual continuation fee as indicated on the form (18 Del. C., '701), and are assessed the annual Delaware Insurance Fraud Prevention Bureau fee (18 Del. C.,  '2415).  Please follow all instructions as indicated on the form.


Last Updated: Tuesday, 06-Jan-2009 14:12:45 EST
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