Form 25-205 - Computation Of Non-Taxable Premiums Page 2
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2Form 25-205 (Rev.11-03/10)
ADDITIONAL INFORMATION
Pursuant to House Bill 2292, 2003 Texas Legislature, Regular Session, premiums and revenues received from the State Treasury for insurance
coverage on Medicaid and the Children’s Health Insurance Program (CHIP) are subject to premium and maintenance taxes beginning
September 1, 2003, and will result in a split tax year.
Item 2(c) Premiums reported in Column C should be excluded from the tax base for calculation of maintenance taxes (Form 25-102). See instructions
for maintenance tax (Form 25-300) for Item 7.
Enrollees for whom revenues are reported in Column B should be excluded from the tax base for calculation of maintenance taxes (Form
25-102). See instructions for maintenance tax (Form 25-300) for Items 13, 14 and 15.
Item 2(d) The premiums reported under this item must be supported by a separate itemized schedule indicating the names of the municipalities,
counties, or hospital districts of Texas and the amount of premium received for each policy. A copy of the trust agreement must also be
maintained to substantiate the exemption claimed. Premiums from a municipality, county or hospital district employee group are exempted
only if they are paid from a single nonprofit trust.
Item 3
Premiums reported in Columns A and C and enrollees paying revenues in Column B should be excluded from the tax base for calculation
of maintenance taxes (Form 25-102). See instructions for maintenance tax (Form 25-300) for Items 7, 8, 13, 14, and 15.
Item 4
The premiums reported under this item must be supported by a separate itemized schedule indicating the names of the colleges/universities
and the amount of premiums received from each.
Premiums reported in Columns A and C and enrollees paying revenues in Column B should be excluded from the tax base for calculation
of maintenance taxes (Form 25-102). See instructions for maintenance tax (Form 25-300) for Items 7, 8, 13, 14, and 15.
Item 5
The premiums reported under this item must be supported by a separate itemized schedule indicating the names of the insureds and the
amount of premiums received from each.
Premiums reported in Columns A and C and enrollees paying revenues in Column B should be excluded from the tax base for calculation
of maintenance taxes (Form 25-102). See instructions for maintenance tax (Form 25-300) for Items 7, 8, 13, 14, and 15.
Item 6
Title 8, Chapter 1576, Texas Ins. Code, (*Former Art. 3.50-4A), Group Long-Term Care Insurance for Public School Employees and Title
8, Chapter 1577, Texas Ins. Code, (*Former Art. 3.50-4A), Required Availability of Insurance for School District Employees and Retirees,
provide optional coverage for permanent life insurance, long-term care insurance, short-term loss of salary because of disability.
Item 7
The premiums reported under this item must be supported by maintaining a sample copy of the policy issued from which the premium
was received.
Item 9
Article 27.05, Texas Insurance Code, provides premium tax exemption for a children's health benefit plan. The insurer of a children's health
plan is not subject to the premium tax imposed by Article 4.11 of the Texas Insurance Code or the tax on revenues imposed under Section
33, Texas Health Maintenance Organization Act (Article 20A.33, Texas Insurance Code), with respect to money received and coverage
provided under that plan.
The additional information required must be maintained by the taxpayer and made available upon request by the Comptroller. Failure to
provide the information upon request will result in the disallowance of the exemption claimed.
*Articles recodified by Acts 2001, 77th Leg., ch. 1419, § 31, effective June 1, 2003.
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