Fillable Form M11h - Insurance Premium Tax Return For Hmos 2012 (Page 2 of 3) in pdf

2012 Insurance Premium Tax Return for HMOs Instructions

Includes instructions for Form M11H

For insurance tax laws, see Minnesota Statutes, Chapter 297I at

What’s New

Extension for Filing Return. If good cause

and you choose to pay by check, you must

exists, you may request a filing extension.

mail a personalized M27 payment voucher

Healthy Minnesota Contribution

along with your estimated tax payment to

Program

Check Boxes

help ensure the payment is credited cor-

The Healthy Minnesota program was

rectly. Download the M27 voucher from our

enacted under the 2011 Minnesota Session

At the top of the form, check if the return is:

website, type in the required information

Laws, 1st Special Session, chapter 9, Article

• an Amended Return: Check only if you

while the form is on the screen and print

6, section 73 (Minnesota Statutes, section

are amending a previously filed return

a copy. A personalized scan line will be

256L.031). Certain MinnesotaCare enrollees

for the same period. Include all original

printed on the bottom using the informa-

who are adults without children will be part

and corrected premiums on the amended

tion you entered.

of the Healthy Minnesota program, effective

return.

July 1, 2012. Since MinnesotaCare payments

When you pay by check, your check autho-

are subject to tax, all payments made to en-

• for No Activity: Check only if you did not

rizes us to make a one-time electronic fund

tities, other than MCHA, and all premiums

have any tax activity during the year.

transfer from your account, and you may

are taxable.

not receive your canceled check.

Payments

Before You File

If you make your payments electronically,

Electronic Payments

do not send in the M27 vouchers.

You Need a Minnesota Tax ID

If your total insurance taxes and surcharges

Your Minnesota tax ID is the seven-digit

If you do not pay the correct amount of

for the last 12-month period ending June 30

number you’re assigned when you register

estimated tax by the due dates and your tax

is $10,000 or more, you are required to pay

with the Department of Revenue. You must

liability is more than $500, you may have to

your tax electronically.

include your Minnesota tax ID on your

pay an additional charge for underpaying.

return so that your filing and any payments

You must also pay electronically if you’re

Complete the worksheet on page 2.

you make are properly credited to your

required to pay any Minnesota business tax

account.

electronically, such as withholding tax.

Overpayments from prior years or prior

estimated overpayments should be applied

If you don’t have a Minnesota tax ID, apply

To pay over the Internet, go to the depart-

before underpayment charges are figured.

online at or call

ment’s website at

651-282-5225 or 1-800-657-3605.

and login to e-Services. If you don’t have

Return Payment

Internet access, call 1-800-570-3329 to

If there is an amount due on Form M11H,

It is also important to enter your federal ID

pay by phone. You’ll need your user name,

either pay it electronically or by check.

number and NAIC number on your return,

password and bank routing and account

but not in place of your Minnesota tax ID

If you are not required to pay electroni-

numbers. When paying electronically, you

number.

cally and choose to pay by check, you must

must use an account not associated with any

complete a Form PV52 payment voucher

foreign banks.

Filing Requirements

and include it with your check when you file

If you use other electronic payment

Any health care provider organized as a

Form M11H. Download the PV52 voucher

methods, such as ACH credit method or

nonprofit health plan corporation, health

from our website, type in the required infor-

Fed Wire, instructions are available on our

maintenance organization or community

mation while the form is on the screen and

website or by calling Business Registration

integrated service network that writes pre-

print a copy. A personalized scan line will

Office at 651-282-5225 or 1-800-657-3605.

miums in Minnesota must file Form M11H,

be printed on the bottom of the voucher

Insurance Premium Tax Return for HMOs.

using the information you entered.

Estimated Tax Payments

If your estimated premium tax is more than

(M.S. 297I.05, subd. 5)

When you pay by check, your check autho-

$500, you must make installment payments

rizes us to make a one-time electronic fund

Due Date

based on the entire estimated amount. To

transfer from your account, and you may

avoid an additional charge for underpaying

File Form M11H with all required attach-

not receive your canceled check.

the tax, your payments must be made on

ments and pay any tax due by March 1.

Note: If no amount is due or if you pay elec-

time and be at least one-fourth of the prior

Payment extensions are not allowed.

tronically, do not send in Form PV52.

year’s total annual tax liability, or one-fourth

The U.S. postmark date, or date recorded or

of 80 percent of the current year’s total an-

Penalties and Interest

marked by a designated delivery service, is

nual tax liability.

considered the filing date (private postage

Late Payment. If you don’t pay all the tax

Estimated payments are due quarterly on

meter marks are not valid). When the due

due by the due date, a late payment pen-

March 15, June 15, Sept. 15 and Dec. 15.

date falls on a Saturday, Sunday or legal

alty is due. The penalty is 5 percent of the

When the due date falls on a weekend or

holiday, returns and payments electroni-

unpaid tax for any part of the first 30 days

legal holiday, payments made electronically

cally made or postmarked the next business

the payment is late, and 5 percent for each

or postmarked on the next business day are

day are considered timely. When a return

additional 30-day period, up to a maximum

considered timely.

or payment is late, the date it is received at

of 15 percent.

the Department of Revenue is treated as the

If you are not required to pay electronically

date filed or paid.

Continued

Form M11h - Insurance Premium Tax Return For Hmos 2012 Page 2

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