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Should the Whole Dollar Method be Used?

$3,000,000 of such members pro rata share. If the total offsets do not

exceed $3,000,000 in a year, the Department of Revenue will calculate

Yes. All amounts must be rounded off to the nearest dollar.

each members’ pro rata share to determine the amount of refund due

Federal Audit

each member and issue a refund to each member.

If your company has undergone a federal audit for some prior year,

Line 11. Economic Opportunity Area Credit. Enter the amount of

you must report any changes on Massachusetts Form CA-6, Applica-

Economic Opportunity Area credit claimed this year from Schedule

tion for Abatement/Amended Return, within three months after the

EOA, line 9. Attach a completed Schedule EOAC to this return. For

final determination of the correct taxable income by the IRS. Other-

more information, contact the Massachusetts Office of Business De-

wise, you will be subject to a penalty. Answering “yes” to this question

velopment at One Ashburton Place, Room 2101, Boston, MA 02108.

does not relieve the company of this filing obligation.

Line 12. Full Employment Program Credit. A qualified employer

Preferred Provider Deduction

participarting in the Full Employment Program may claim a credit of

An organization that has entered into a preferred provider arrangement

$100 per month of eligible employment per employee. The maximum

and has been approved by the Commissioner of Insurance may de-

amount of credit that may be applied in all taxable years with respect

duct those premiums relating to preferred provider arrangements if

to each employee is $1,200. Attach Schedule FEC to this return. For

they have been included in line 8 of Premium Excise Calculation in

more information, contact the Department of Transitional Assistance,

this return and reported on Form 176-I, Preferred Provider Gross Rev-

600 Washington Street, Boston, MA 02111.

enue Excise Return. These premiums are deducted on Premium Ex-

cise Calculation, line 10.

Line 13: Low-Income Housing Credit. To claim the Low-Income

Housing credit, documentation must be completed and enclosed with

Computation of Excise

the return. For further information on this credit, contact the DHCD,

Line 1. Enter the amount of life premiums subject to tax in Massachu-

Division of Private Housing, at (617) 727-7824.

setts from Premium Excise Calculation, line 7. If amount is negative,

enter “0.”

Line 15. Any corporation that wishes to contribute any amount to the

Natural Heritage and Endangered Species Fund may do so on his

Lines 2 and 5. Use the back of Form 63-20-23 to calculate your ex-

form. This amount is added to the excise due. It increases the amount

cise using the same method and rate used by the state in which you

of the corporation’s payment or reduces the amount of its refund.

are incorporated and would be imposed on a like Massachusetts in-

surance company, or its agents, if doing business to the same extent.

The Natural Heritage and Endangered Species Fund is administered

If the computation in the state of your incorporation is in every respect

by the Department of Fisheries, Wildlife and Environment Law En-

the same as your Massachusetts computation, a statement to that ef-

forcement to provide for conservation programs for rare, endangered

fect should be made. Retaliatory tax provisions are provided under

and nongame wildlife and plants in the Commonwealth.

MGL Chapter 63, Section 24A.

Line 24. If line 16 is larger than line 20, enter the balance due in line

Line 4. Enter the amount of total net direct accident and health premi-

24. Payment in full is due on or before March 15, 2004.

ums subject to tax in Massachusetts from Premium Excise Calcula-

Line 25. Any company that has an underpayment of estimated tax will

tion, line 12. If the amount is negative, enter “0.”

incur a penalty on the underpayment for the period of the underpay-

Line 7: Recapture. If the corporation is required to recapture any

ment. Attach a copy of Form M-2220. For more information, refer to

amount of previously claimed EOA Credit or Low-Income Housing

the section, “When Are Estimated Tax Payments Required?”

Credit, complete Schedule H-2 and enter the result in line 7 of the re-

Any company that fails to file a timely return will be subject to a late

turn. Current year credits can then be used to offset the total excise

filing penalty of 1% per month, or fraction thereof, and a late payment

due which will include the recapture amount.

penalty of ¹ ₂% per month, or fraction thereof, on the amount required

Line 9: Initiative credit. A company shall be allowed a credit against

to be shown as the tax due on the return. For more information, refer

the premium tax equal to 1.5 percent of such company’s total capital

to the section, “What Are the Penalties for Late Returns?”

contribution in excess of their full proportionate share which shall mean

Line 26. Any company that fails to pay its tax when due will be sub-

an investment in the Massachusetts Life Insurance Company Com-

ject to interest on the unpaid balance. For more information, refer to

munity Investment Initiative.

the section, “What Are the Penalties for Late Returns?”

This credit is effective for tax years in which the aggregate cumulative

Line 27. Enter the total payment due. Checks for this amount should

investment in the Massachusetts Life Insurance Community Invest-

be made payable to the Commonwealth of Massachusetts. Checks

ment Initiative reaches 100 million or the tax year 2004, whichever

should have the company’s federal identification number written in the

is later.

lower left corner.

Line 10: Credit for member insurers of the Massachusetts Life

Signature

and Health Insurance Guaranty Association. Enter 10% of the

assessment for each of five years following the year in which the as-

When the form is complete, it must be signed by the treasurer or as-

sistant treasurer. If you are signing as an authorized delegate of the

sessment was paid. If the sum of offsets exceeds $3,000,000, the

excess may be carried forward and may be used in a year in which

appropriate corporate officer, check the box in the signature section

the $3,000,000 is not exceeded. If the total offsets exceed $3,000,000

and attach a Massachusetts Form M-2848, Power of Attorney. The

in a year, the Department of Revenue will assess each member with

form should be mailed to: Massachusetts Department of Revenue,

an additional tax equal to the amount of the offset which exceeds

PO Box 7052, Boston, MA 02204.

Form 63-20-23 - Premium Excise Return For Foreign Life Insurance Companies On Life, Accident And Health Business - 2003 Page 4

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