Fillable Form M11h - Insurance Premium Tax Return For Hmos

2017 Form M11H Instructions

(continued)

Interest. You must pay interest on the

Mailing Your Return

or any other business information. To do so,

unpaid tax plus penalty from the due date

to go our website, log in to e-Services and

Mail your return and all required attach-

until the total is paid. The interest rate for

update your profile information. By notify-

ments to: Minnesota Revenue, P.O. Box

calendar year 2018 is 4 percent. The rate

ing us, we will be able to let you know of

1780, St. Paul, MN 55145-1780.

may change for future years.

any changes in Minnesota tax laws and filing

For express deliveries, use our street ad-

requirements.

To figure how much interest you owe, use

dress: 600 N. Robert St., St. Paul, MN

the following formula with the appropriate

Information and Assistance

55101.

interest rate:

Website:

Business Information

Interest =

Email:

insurance.taxes@state.mn.us

(tax + penalty) × # of days late × interest

Changes

Phone:

651-556-3024

rate ÷ 365

Be sure to let us know within 30 days if you

This material is available in alternate for-

change mailing addresses, phone numbers,

mats.

Worksheet Instructions

For questions about licensing and regula-

tions, contact the Minnesota Department of

Also, the second estimated payment will

Step 5

Commerce:

then be underpaid by $100 (assuming that

Payments of estimated tax are applied

Website:

the second payment is $200) until sufficient

against any underpayments of required

Email:

licensing.commerce@state.mn.us

repayments are received to eliminate the

estimated payments in the order that the

Phone: 651-539-1599 or 1-800-657-3978

underpayment.

estimated payments were due.

Fax:

651-539-0107

If more than one payment has been made

For example, if your first estimated pay-

for a required estimated payment, attach a

ment is underpaid by $100 and you deposit

separate computation for each payment.

$200 for your second estimated payment,

$100 of your second payment is applied to

Credit the excess of any overpayment for a

the first estimated payment. The additional

period on step 5 of the next payment period.

charge for the first estimated payment is

computed from the first estimated pay-

Step 10

ment’s due date to the date the second

If there is no underpayment on step 7, enter

payment is made.

“none” on step 10 for that period.

Worksheet: Additional Charge for Underpaying Estimated Tax

1 Enter 80 percent of the total annual tax liability from line 7 of your 2017 Form M11H.

If your tax liability was $500 or less, you do not owe an additional charge. . . . . . . . . . . . . . . . . . . . . . . . . . 1

2 Enter the amount from line 7 of your 2016 Form M11H. If you were not required to file a 2016

return, you do not owe an additional charge. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Due Dates

March 15

June 15

Sept. 15

Dec. 15

3 Enter one-fourth of step 1 or step 2 (whichever is less)

in each column . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

4 Amounts paid on or before the due date for each period. Include

credits applied, such as prior year’s overpayment . . . . . . . . . . . . . . . . . . 4

5 Overpayment of previous installment (see worksheet instructions) . . . 5

6 Add steps 4 and 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

7 Underpayment (or overpayment). Subtract step 6 from step 3 . . . . . . . 7

8 Date underpayment is paid or March 1, 2018, whichever is earlier . . . . . 8

9 Number of days from the due date to the date on step 8 . . . . . . . . . . . . 9

10 Additional charge (step 9 ÷ 365 × interest (see below) × step 7) . . . . . . 10

11 TOTAL. Add amounts in each column on step 10.

Enter the result here and on Form M11H, line 10a . . . . . . . . . . . . . . . . 11

If step 11 is zero, keep this worksheet for your records. Do not send it with your return.

If it is more than zero, attach a copy of the worksheet to your Form M11H.

Interest: 2017 = .04; 2018 = .04

Form M11h - Insurance Premium Tax Return For Hmos - 2017 Page 3

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