Blank Kentucky 74A118 PDF Form

Blank Kentucky 74A118 PDF Form

The Kentucky 74A118 form is a crucial document used for reporting the monthly insurance surcharge imposed by the Commonwealth of Kentucky. This form must be filed by all insurers, including domestic, foreign, and alien insurers, who are subject to Kentucky's insurance premiums tax. Timely and accurate completion of the 74A118 form ensures compliance with state regulations and helps avoid penalties.

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The Kentucky 74A118 form is a crucial document for insurers operating within the Commonwealth of Kentucky. This form serves as the Monthly Insurance Surcharge Report, which must be submitted to the Department of Revenue for each reporting period beginning April 1, 2010, and onward. Insurers are required to report total premiums collected, including assessments and other charges, while also detailing amounts that are exempt from the surcharge. The form includes sections for calculating the surcharge due, penalties for late submissions, and interest on overdue payments. It is essential for insurers to accurately complete this form, as it affects their compliance with KRS 136.392, which mandates the collection of a surcharge on insurance premiums. Additionally, the form outlines specific exemptions for certain policyholders, such as government entities and nonprofit organizations. Timely filing is critical; insurers must submit the form and remit any due surcharges by the 20th of each month to avoid penalties. Understanding the details of the 74A118 form is vital for maintaining compliance and ensuring that all collected surcharges are reported accurately.

Document Sample

74A118 (1-22)

MONTHLY INSURANCE

Commonwealth of Kentucky

SURCHARGE REPORT

DEPARTMENT OF REVENUE

 

For Periods Beginning

 

4/1/2010 and After

FOR OFFICIAL USE ONLY -- STA. 61

___4 ___5 /___ ___/___ ___

Tax Mo. Yr.

Account Number ___ ___ ___ ___ ___

Check Here if Amended Return

Check Here if Surplus Lines

See reverse for information or call the Department of Revenue, (502) 564-4810.

Name and Address (Required)

Report for Month of

/ 20

Mo.

NAIC

FEIN __ __ – __ __ __ __ __ __ __

1.Total premiums (including those premiums not subject to surcharge deducted on Lines 2B and 2C), assessments and other charges collected on risk

located in Kentucky (exclude municipal taxes)

$ __________________________

2.Less amounts not subject to surcharge:

A. Premiums returned to policyholders on terminated policies

 

(on policies with payments received after 3/31/10)

$

______________________________

B.

Premiums collected for:

 

 

 

Accident and health insurance

$

______________________________

 

Federal insured crop insurance

$

______________________________

 

Federal insured flood insurance

$

______________________________

 

Reinsurance

$

______________________________

 

Title insurance

$

______________________________

 

Workers compensation

$

______________________________

C.

Premiums collected from:

 

 

 

Federal government

$

______________________________

 

Resident nonprofit educational and charitable

 

 

 

institutions (501(c)(3)status)

$

______________________________

 

Resident nonprofit religious institutions for real,

 

 

 

tangible and intangible property coverage only

$

______________________________

 

State and local government for real property coverage only

$

______________________________

 

D. Total amount not subject to surcharge

$ __________________________________

3.

Amount subject to surcharge (line 1 minus line 2D)

$ __________________________________

4.

Surcharge due at current rate (line 3 times .018)

$ __________________________________

5.

Penalty (see reverse)

$ __________________________________

6.

Interest (see reverse)

$ __________________________________

7.

Amount due (add lines 4, 5 and 6)

$ __________________________________

8.

Adjustments (attach supporting documentation)

$ __________________________________

9.

Total amount due (line 7 plus or minus line 8)

$ __________________________________

 Paid online. Confirmation No. ________________

Make check payable to Kentucky State Treasurer and mail return with payment to:

Kentucky Department of Revenue

Mailing Address: P.O. Box 1303, Frankfort, KY 40602-1303

Overnight Address: 501 High Street, Frankfort, KY 40601-2103

I, the undersigned, a principal officer of the above-named company, certify that I have examined this report and it is, to the best of my knowledge and belief, a true, correct and complete report.

Principal Officer’s Information

Preparer’s Information

Signature _______________________________________________

Signature _______________________________________________

Print Name _____________________________________________

Print Name _____________________________________________

Title ___________________________________________________

Title ___________________________________________________

Telephone Number _______________________________________

Telephone Number _______________________________________

E-mail Address __________________________________________

E-mail Address __________________________________________

Date___________________________________________________

Date___________________________________________________

GENERAL INFORMATION

KRS 136.392 requires that every domestic, foreign and alien insurer, other than life and health insurers, which is subject to or exempted from Kentucky insurance premiums taxes as levied pursuant to the provisions of either KRS 136.350, 136.370 or 136.390, shall charge and collect a surcharge at the current rate upon each $100 of premium, assessments or other charges, except for whether the charges are designated as premiums, assessments or otherwise.

Every insurer is required to file for each period, whether filing monthly or annually, even if no premiums were collected.

The insurance premium surcharge shall be collected by the insurer from its policyholders at the same time and in the same manner that its premium or other charge for the insurance coverage is collected. When claiming a deduction for premiums returned to a policyholder, the surcharge must also be returned to the policyholder.

No insurer or its agent shall be entitled to any portion of any premium surcharge as a fee or commission for its collection.

On or before the 20th day of each month, each insurer shall report and remit to the Department of Revenue, on the required forms, all premium surcharge monies collected during the preceding monthly accounting period less any monies returned to policyholders on policies terminated by either the insured or the insurer. Insurers with an annual liability of less than $1,000 for each of the previous two calendar years may report and remit to the Department of Revenue all premium surcharge monies collected on a calendar year basis on or before the 20th day of January of the following year.

Account Number For Surplus Lines

Multi-Brokers—File under agency name and their FEIN number.

Single Broker—File under agency name and their FEIN number. If no FEIN number, use your Department of Insurance (DOI) number.

The penalty for failure to file an insurance premium surcharge report by the due date is 2 percent of the surcharge due for each 30 days or fraction thereof that the report is late (maximum 20 percent). The minimum penalty is $10. (KRS 131.180 (1))

The penalty for failure to pay the insurance premium surcharge by the due date is 2 percent of the surcharge due for each 30 days or fraction thereof that the payment is overdue (maximum 20 percent). The minimum penalty is $10. (KRS 131.180 (2))

Interest at the “tax increase rate” is applied to all insurance premium surcharge liabilities not paid by the original due date of the report. The computation period is from the original due date of the report to the date of payment. (KRS 131.183 (1))

Report on line 1 only those premiums that have been collected.

NOTE: Refunds or credits can only be taken on premiums returned to policy holders on terminated policies, not on exempt premiums such as worker’s compensation insurance. Refund requests must be made in writing.

Types of Policyholders Exempt or Partially Exempt from the Insurance Premium Surcharge pursuant to KRS 136.392(5):

The federal government;

Resident educational and charitable institutions qualifying under Section 501(c)(3) of the Internal Revenue Code;

Resident nonprofit religious institutions for real, tangible, and intangible property coverage only;

State government for coverage of real property; or

Local governments for coverage of real property.

Also, Exempt from the Insurance Premium Surcharge:

Premiums received by life and health insurers pursuant to KRS 136.392(1);

Municipal premium taxes pursuant to KRS 136.392(1);

Premiums received for accident and health insurance;

Premiums received for federal insured crop insurance;

Premiums received for federal insured flood insurance;

Premiums received for reinsurance;

Premiums received for title insurance; or

Premiums received for workers’ compensation insurance.

Premiums collected for surety and bonds on public works projects are subject to the surcharge if the contractor is the policyholder. The fact that a governmental entity may be the obligee has no bearing on the application of the surcharge.

File Specifics

Fact Name Description
Form Purpose The Kentucky 74A118 form is used for reporting the monthly insurance surcharge collected by insurers on premiums and other charges related to risks located in Kentucky.
Governing Laws This form is governed by KRS 136.392, which outlines the requirements for insurers regarding the collection and reporting of insurance premium surcharges.
Filing Frequency Insurers must file the 74A118 form monthly or annually, even if no premiums were collected during the reporting period.
Penalty for Late Filing If the form is not filed by the due date, a penalty of 2% of the surcharge due is applied for each 30 days late, up to a maximum of 20%.
Exemptions Certain entities, such as the federal government and nonprofit institutions, are exempt from the insurance premium surcharge as specified in KRS 136.392(5).
Payment Instructions Payments should be made payable to the Kentucky State Treasurer and sent to the Kentucky Department of Revenue at the specified mailing address.

How to Use Kentucky 74A118

Completing the Kentucky 74A118 form requires careful attention to detail. Each section must be filled out accurately to ensure compliance with state regulations. After submitting the form, it is essential to monitor for any notifications or requests for additional information from the Department of Revenue.

  1. Obtain the Kentucky 74A118 form from the Department of Revenue or an authorized source.
  2. Fill in the Tax Month and Year in the designated fields.
  3. Enter your Account Number in the appropriate box.
  4. If applicable, check the box for Amended Return or Surplus Lines.
  5. Provide your Name and Address in the required section.
  6. Indicate the Report for Month by filling in the month and year.
  7. Complete the NAIC and FEIN sections with the correct information.
  8. In line 1, report the total premiums collected, including assessments and other charges, excluding municipal taxes.
  9. On line 2, list the amounts not subject to surcharge, breaking it down into the required categories (A, B, C).
  10. Calculate the Total amount not subject to surcharge and enter it on line 2D.
  11. Determine the Amount subject to surcharge by subtracting line 2D from line 1 and write the result on line 3.
  12. Calculate the Surcharge due at the current rate (line 3 times .018) and enter it on line 4.
  13. Complete lines 5 and 6 for any Penalty and Interest due, as applicable.
  14. Add lines 4, 5, and 6 to find the Amount due and write it on line 7.
  15. If there are any adjustments, enter the amount on line 8 and attach supporting documentation.
  16. Calculate the Total amount due by adding or subtracting line 8 from line 7, and enter the result on line 9.
  17. Indicate payment method by checking the appropriate box and providing the confirmation number if paid online.
  18. Sign and date the form in the designated areas for both the principal officer and the preparer.
  19. Mail the completed form and payment to the Kentucky Department of Revenue at the specified address.

Your Questions, Answered

  1. What is the Kentucky 74A118 form?

    The Kentucky 74A118 form, also known as the Monthly Insurance Surcharge Report, is a document that insurance companies must file with the Kentucky Department of Revenue. It is used to report premiums, assessments, and other charges collected on risks located in Kentucky. This form is essential for ensuring compliance with Kentucky's insurance premium surcharge requirements.

  2. Who is required to file the 74A118 form?

    All domestic, foreign, and alien insurers, except for life and health insurers, are required to file this form. This includes those who are subject to or exempted from Kentucky insurance premiums taxes. Even if no premiums were collected during the reporting period, insurers must still submit the form.

  3. When is the 74A118 form due?

    The form must be submitted on or before the 20th day of each month. This deadline applies to all insurers regardless of their collected premiums. Insurers with an annual liability of less than $1,000 for the previous two calendar years can opt to file annually, with the deadline being January 20 of the following year.

  4. What information is required on the form?

    The form requires several key pieces of information, including:

    • Total premiums collected (excluding municipal taxes)
    • Amounts not subject to surcharge, such as premiums returned to policyholders
    • Calculations for the surcharge due
    • Any penalties or interest incurred
    • Adjustments with supporting documentation
  5. What happens if the form is filed late?

    If the 74A118 form is not filed by the due date, a penalty of 2% of the surcharge due will be applied for each 30-day period or fraction thereof that the report is late, up to a maximum of 20%. The minimum penalty is $10. It's crucial to adhere to the filing deadline to avoid these penalties.

  6. Are there any exemptions from the insurance premium surcharge?

    Yes, certain policyholders are exempt or partially exempt from the surcharge. These include:

    • The federal government
    • Resident educational and charitable institutions with 501(c)(3) status
    • Nonprofit religious institutions for specific property coverage
    • State and local governments for real property coverage

    Additionally, premiums collected for life and health insurance, municipal taxes, and specific types of insurance like workers’ compensation are also exempt.

  7. What should be done if a premium is returned to a policyholder?

    When a premium is returned to a policyholder, the corresponding surcharge must also be returned. It’s important to document this properly on the 74A118 form. Refund requests should be made in writing, and only premiums returned on terminated policies can be deducted.

  8. How can payments be made for the surcharge due?

    Payments for the surcharge can be made online or by check. If paying by check, it should be made payable to the Kentucky State Treasurer. The completed form and payment should be mailed to the Kentucky Department of Revenue at the specified addresses provided on the form.

Common mistakes

  1. Missing Information: Failing to fill in all required fields, such as the account number or name and address, can lead to delays in processing.

  2. Incorrect Amounts: Reporting inaccurate premium amounts can result in penalties. Ensure that the figures on line 1 reflect only the premiums collected.

  3. Improper Deductions: Claiming deductions for premiums not subject to surcharge without proper documentation can lead to issues. Be sure to include all necessary supporting documents.

  4. Missing Signatures: Not signing the form can cause it to be rejected. Both the principal officer and the preparer must provide their signatures.

  5. Late Submission: Submitting the form after the due date can incur penalties. It's important to submit on or before the 20th day of each month.

  6. Incorrect Payment Method: Not following the payment instructions can lead to complications. Make checks payable to the Kentucky State Treasurer and ensure they are mailed to the correct address.

Documents used along the form

The Kentucky 74A118 form is essential for reporting monthly insurance surcharges to the Department of Revenue. Along with this form, several other documents are often required to ensure compliance with Kentucky's insurance regulations. Below is a list of commonly used forms and documents that may accompany the 74A118.

  • Kentucky 74A119 Form: This form is used for annual insurance premium surcharge reporting. Insurers must provide a comprehensive summary of surcharges collected throughout the year, allowing for annual reconciliation.
  • Supporting Documentation: Insurers must attach documentation to substantiate any deductions claimed on the 74A118 form, such as records of premiums returned to policyholders or details on exempt premiums.
  • Payment Confirmation Receipt: If the surcharge payment is made online, a confirmation receipt should be included with the 74A118 form to verify payment has been processed.
  • Penalty and Interest Calculation Worksheet: This worksheet helps calculate any penalties or interest due for late filings or payments, ensuring accurate reporting on the 74A118 form.
  • Tax Exemption Certificates: These certificates may be necessary for policyholders who are exempt from the insurance premium surcharge, such as certain nonprofit organizations or government entities.
  • Amended Return Form: If corrections are needed after submitting the 74A118, an amended return form must be filed to reflect the changes accurately.
  • Correspondence with the Department of Revenue: Any written communication regarding inquiries or clarifications about the surcharge reporting process should be documented and retained for reference.

These forms and documents play a critical role in ensuring that insurers meet their reporting obligations accurately and on time. Proper documentation helps avoid penalties and ensures compliance with state regulations.

Similar forms

The Kentucky 74A118 form is similar to the IRS Form 941, which is used by employers to report payroll taxes. Both forms require detailed reporting of collected amounts, such as premiums or wages, and deductions that are not subject to the associated tax or surcharge. The 941 form includes sections for reporting employee wages, tips, and other compensation, as well as federal income tax withheld and social security taxes. Like the 74A118, it also has provisions for adjustments and penalties for late filing or payment, ensuring compliance with tax obligations.

Another comparable document is the Florida Form DR-908, which is the state’s insurance premium tax return. This form serves a similar purpose by requiring insurers to report premiums collected and calculate the corresponding tax owed to the state. Both forms include sections for exemptions and deductions, allowing insurers to account for amounts that do not contribute to the taxable base. The DR-908 form also mandates timely submission and outlines penalties for late filings, paralleling the requirements found in the Kentucky 74A118.

The New York State Insurance Department's Form 2 is another document akin to the Kentucky 74A118. This form is utilized by insurance companies to report their premium taxes and surcharges. Both forms share a focus on accurately reporting collected premiums and identifying amounts that are exempt from taxation. Additionally, they require a certification from a principal officer of the company, ensuring accountability and accuracy in the reported figures. Both documents emphasize the importance of timely submissions and detail the consequences of non-compliance.

Lastly, the California Form 100, or Corporation Franchise or Income Tax Return, is also similar in nature. While primarily focused on corporate income tax, it requires businesses to report revenue, deductions, and calculate tax liabilities, much like the Kentucky 74A118. Both forms necessitate thorough documentation of collected amounts and provide for adjustments or penalties based on compliance. Each form aims to ensure that entities fulfill their respective tax obligations while offering a structured process for reporting and payment.

Dos and Don'ts

When filling out the Kentucky 74A118 form, it is essential to follow certain guidelines to ensure accuracy and compliance. Here’s a list of things you should and shouldn’t do:

  • Do check the appropriate boxes for amended returns or surplus lines.
  • Do include all required information, such as your name, address, and account number.
  • Do report only the premiums that have been collected during the reporting period.
  • Do accurately calculate the amounts subject to surcharge and ensure all calculations are clear.
  • Do attach any necessary supporting documentation for adjustments made.
  • Don’t leave any sections blank; all fields must be filled out as required.
  • Don’t include amounts that are exempt from the surcharge in your total premiums reported.
  • Don’t forget to sign and date the form before submission.
  • Don’t submit the form late; be aware of the due date to avoid penalties.
  • Don’t assume that refunds or credits can be claimed for exempt premiums; only terminated policies qualify.

By adhering to these guidelines, you can ensure a smoother process when completing the Kentucky 74A118 form.

Misconceptions

The Kentucky 74A118 form is essential for insurers operating in Kentucky, but several misconceptions exist regarding its use and requirements. Here are four common misunderstandings:

  • All insurers must file the form monthly. While many insurers are required to submit the Kentucky 74A118 form on a monthly basis, those with an annual liability of less than $1,000 for the previous two calendar years can file annually instead. This option can ease the reporting burden for smaller insurers.
  • Only premiums collected are reported. Some believe that only premiums collected should be reported on the form. However, the form also requires insurers to account for assessments and other charges collected on risks located in Kentucky, providing a more comprehensive view of the insurer's financial activity.
  • Filing is unnecessary if no premiums were collected. A common misconception is that insurers do not need to file the form if they collected no premiums during the reporting period. In fact, all insurers must file the form regardless of whether premiums were collected or not, ensuring compliance with state regulations.
  • Penalties apply only for late payments. Many individuals think that penalties are only incurred for late payments of the surcharge. In reality, there are penalties for failing to file the form by the due date as well. Both late filings and late payments can result in penalties, highlighting the importance of timely compliance.

Understanding these misconceptions can help insurers navigate their obligations more effectively and avoid potential penalties.

Key takeaways

The Kentucky 74A118 form is essential for insurers operating in Kentucky to report their monthly insurance surcharge. Below are key takeaways regarding the completion and usage of this form:

  • The form must be completed for each reporting period, even if no premiums were collected.
  • Insurers must include total premiums collected, excluding municipal taxes, on line 1 of the form.
  • Specific amounts not subject to the surcharge should be detailed on line 2, including returned premiums and certain types of insurance.
  • The amount subject to the surcharge is calculated by subtracting the total not subject to surcharge (line 2D) from total premiums (line 1).
  • Insurers must remit the surcharge due at the current rate, which is calculated as line 3 multiplied by 0.018.
  • Penalties and interest may apply for late submissions or payments, with specific rates outlined in the form instructions.
  • Supporting documentation is required for any adjustments made to the reported amounts.
  • Exemptions from the surcharge exist for certain policyholders, including government entities and nonprofit organizations.
  • All payments and the completed form should be submitted to the Kentucky Department of Revenue by the 20th of each month.