Minnesota Nonadmitted Insurance Premium Tax Return for Direct Procured Insurance

Nonadmitted Insurance Premium Tax Return for Direct Procured Insurance
2023 IG255, Nonadmitted Insurance Premium Tax Return for Direct Procured Insurance
*226301*

2023 IG255, Nonadmitted Insurance Premium Tax Return
for Direct Procured Insurance
Due March
	 1, 2024

Check if: 	

Print or Type

Name of Insured	
Mailing Address 		

Check if New Address

City 		

State	

ZIP Code	

I am licensed to obtain insurance from nonadmitted insurers	

No Activity Return
Contact Person

Daytime Phone	

Fax Number

Email Address	

Website Address

Check if you are a purchasing group

to

from

Amended Return 	

Minnesota Tax ID (required)	

1	 Total gross premiums paid (from page 2, Column G)  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 1	

Calculate Amount Due/Overpaid

2	 Total return premiums received (from page 2, Column H)  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 2	
3	 Taxable gross premiums paid (subtract line 2 from line 1)  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 3	
4	 Tax rate is 2% (0.02)  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 4	

.02

5	 Total gross premiums tax due (multiply line 3 by line 4)  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 5	
6	 Penalty (see instructions)  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 6	
7	Interest (see instructions)  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 7	
8	 TOTAL AMOUNT DUE (or overpaid) (add lines 5 through 7)  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 8	
If you owe additional tax:
Payment method:

Electronic payment

Check (payable to Minnesota Revenue; write MN tax ID number on check; attach voucher)

Enter amount paid
Date paid
(If amount paid is different from amount due on line 8, attach an explanation.)
	

If you overpaid: Overpayments will be refunded.

Sign Here

I declare that this return is correct and complete to the best of my knowledge and belief.
Signature of Insured or Officer of Corporation		
Signature of Preparer	

Mail to:
Minnesota Department of Revenue
Mail Station 1780
600 N. Robert Street
St. Paul, MN 55145-1780

Print Name of Preparer	

Date	

Daytime Phone

Date	

Daytime Phone

I authorize the
Minnesota Department
of Revenue to discuss
this tax return with the
preparer.

IG255
Page 2

2023 Nonadmitted Insurance Premium Tax Return for Direct Procured Insurance
Name of insured						

List all policies where Minnesota is the home state of the Insured.

	
	
	

A	B	

C	

NAIC			
Number	
Name of Insurer	
Policy Number	

D	

Date of Coverage 	
to
(from

)	

Minnesota Tax ID Number

E	 F	

Nonadmitted Insurance	
Company Type*	

Amount	
Insured	

Subtotal
(if more than one page)
Total
*	Use one of the following code numbers to indicate the insurer type.
	 1 	Surplus Lines Insurer	
2 	Captive Insurance Company	

3 	Other Form of Nonadmitted Insurer

G	H

Gross	
Premiums Paid	

Return
Premiums

2023 Form IG255 Instructions
For insurance tax laws, see Minnesota Statutes, Chapter 297I at www.leg.state.mn.us.
Captive Insurance Tax Filing Requirement: As explained in more detail below, when a company pays premium to a captive insurance
company and Minnesota is the “home state” of the insured (see “Rules from the Nonadmitted and Reinsurance Reform Act, M.S. 297I.01,
subd. 10a, and M.S. 297I.05, subd. 7” below), the company must report those premiums on Form IG255.
Minnesota Voluntary Disclosure Program: This program helps qualifying individuals and business with unreported tax comply with
Minnesota tax laws. For more information about the Minnesota Voluntary Disclosure Program, go to www.revenue.state.mn.us and enter
“Voluntary” in the search box.
You must complete and file Form IG255 if you are a person, firm, corporation or purchasing group buying insurance directly from a
“nonadmitted insurer,” which is defined as an “insurer not licensed to engage in the business of insurance in Minnesota” (M.S. 297I.01, subd.
10e). The definition of nonadmitted insurer includes, but is not limited to, surplus lines insurers and captive insurance companies. Whenever
you purchase insurance directly from a nonadmitted insurer and Minnesota is the home state of the insured (see “Rules from the Nonadmitted
and Reinsurance Reform Act, M.S. 297I.01, subd. 10a, and M.S. 297I.05, subd. 7” below), you must complete and file Form IG255. A
“captive insurance company” is defined in M.S. 290.01, subd. 5c. An “other nonadmitted insurer” is any other nonadmitted insurer required
to report premium on Form IG255.
If you purchased nonadmitted insurance through a broker that is not licensed by the Minnesota Department of Commerce, you must report
these premiums as directly procured premiums from a nonadmitted insurer on Form IG255.
If you purchased surplus lines insurance, which is a form of nonadmitted insurance, through a licensed surplus lines broker, the surplus lines
insurance is not directly procured and the broker is responsible for completing and filing Form IG 260, Nonadmitted Insurance Premium Tax
for Surplus Lines Brokers.

Rules from the Nonadmitted and Reinsurance Reform Act, M.S. 297I.01, subd. 10a, and M.S.
297I.05, subd. 7
The federal Nonadmitted and Reinsurance Reform Act of 2010 (“NRRA”) permits only the insured’s home state to require payment of
premium tax for nonadmitted insurance. Through M.S. 297I.01, subd. 10a, Minnesota adopted the NRRA definition of home state. As
provided under M.S. 297I.01, subd. 10a and M.S. 297I.05, subd. 7:

•	 For a business, home state means the state in which an insured maintains its principal place of business. For an individual, home stat
means the individual’s principal residence. If more than one insured from an affiliated group are named insureds on a single nonadmitted
insurance contract, home state means the home state of the member of the affiliated group with the largest percentage of premium attributed
to it under the insurance contract.
•	 100% of gross premiums are taxable in Minnesota, with no allocation of tax to other states, when Minnesota is the home state of the
insured.
•	 If 100% of the insured risk is located outside of Minnesota, then the insured’s home state is the state to which the greatest percentage of the
insured’s taxable premium for that insurance risk is allocated.

Due Date

You must file Form IG255 and pay any tax due by March 1 of the following year. (M.S. 297I.30, subd. 1)
The U.S. postmark date, or date recorded or marked by a designated delivery service, is considered the filing date (private postage meter
marks are not valid). When the due date falls on a Saturday, Sunday or legal holiday, returns and payments electronically made or postmarked
on the next business day are considered timely. When a return or payment is late, the date it is received at the Department of Revenue is
treated as the date filed or paid.
Extension for Filing Return. If good cause exists, you may request a filing extension.

Instructions
Check Boxes

At the top of the form, check if the return is:
•	an Amended Return: Check only if you are amending a previously filed return for the same period. Include all original and corrected
policies on the amended return.
•	a No Activity Return: Check only if you did not purchase any insurance directly from nonadmitted insurers during the year.

Continued

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2023 Form IG255 Instructions (Continued)
IG255 Page 2 Instructions

Complete page 2 BEFORE page 1.
A.	 NAIC Number
	 If the nonadmitted insurer has an NAIC number, enter it here.
B. 		Name of Insurer
	 The name of the insurer.
C.		Policy Number
	 Enter the policy number.
D.		Date of Coverage
	 Enter the policy coverage date.
E.		Nonadmitted Insurance Company Type
Identify the type of nonadmitted insurer from which the policy was directly procured. If the policy was directly procured from a surplus
lines insurer, identify the insurer as a “surplus lines insurer.” If you directly procured nonadmitted insurance because you paid premiums
to a captive captive insurance company, identify the insurer as a “captive insurance company.” If you directly procured nonadmitted
insurance because you paid premiums to a form of nonadmitted insurer that is not a surplus lines insurer or a captive insurance company,
identify the insurer as an “Other Form of Nonadmitted Insurer.”
	
	
	

1.	 Surplus Lines Insurer
2.	 Captive Insurance Company
3.	 Other Form of Nonadmitted Insurer

F.	 Amount Insured
	 Enter the amount insured.
G.	Gross Premiums Paid
	 Enter all premiums paid by an insured with a home state of Minnesota. (See the prior page of instructions for guidance when determining
the “home state” of an insurance contract.)
H.	Return Premiums
	 Enter all return premiums received. Include a note indicating on which return the original policy was reported.

Payments

Electronic Payments

If your total insurance taxes and surcharges for the last 12-month period ending June 30 is $10,000 or more, you are required to pay your tax
electronically in all subsequent years.
You must also pay electronically if you are required to pay any Minnesota business tax electronically, such as sales or withholding tax.
To pay electronically, go to the department’s website at www.revenue.state.mn.us and log in. You will need your ID number, and bank
routing and account numbers. When paying electronically, you must use an account not associated with any foreign banks.
If you use other electronic payment methods, such as ACH credit method or Fed Wire, instructions are available on our website or by calling
our Business Registration Office at 651-282-5225 or 1-800-657-3605.

Check Payments

If you are not required to pay electronically and you choose to pay by check, you must mail a personalized payment voucher along with your
estimated tax payment to help ensure the payment is credited correctly. Go to www.revenue.state.mn.us and select Make a Payment. Select
Check or Money Order. Use the Payment Voucher System to create a voucher.
When you pay by check, your check authorizes us to make a one-time electronic fund transfer from your account. You will not receive your
canceled check.
Note: If no amount is due or if you pay electronically, do not send in a voucher.

Penalties and Interest

Late payment. If you do not pay all the tax due by the due date, a late payment penalty is due. The penalty is 5% of the unpaid tax for any
part of the first 30 days the payment is late, and 5% for each additional 30-day period, up to a maximum of 15%.
Late filing. Add a late filing penalty to the late payment penalty if your return is not filed by the due date. The penalty is 5% of the unpaid
tax. When added to the late payment penalty, the maximum combined penalty is 20%.
Payment method. If you are required to pay electronically and do not, an additional 5% penalty applies to payments not made electronically,
even if a paper check is sent on time.
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Continued

2023 Form IG255 Instructions (Continued)
Interest. You must pay interest on the unpaid tax plus penalty from the due date until the total is paid. The interest rate for calendar year 2024
is 8%. The rate may change for future years. To figure how much interest you owe, use the following formula with the appropriate interest
rate:

Interest = (tax + penalty) × # of days late × interest rate ÷ 365

Mailing Your Return

Mail your return and all required attachments to:
Minnesota Department of Revenue
Mail Station 1780
600 N. Robert St.
St. Paul, MN 55145-1780
For express deliveries, use our street address:
Minnesota Department of Revenue
600 N. Robert St.
St. Paul, MN 55101

Business Information Changes

Be sure to let us know within 30 days if you change mailing addresses, phone numbers or any other business information. To do so, go to our
website, log in to e-Services and update your profile information.
By notifying us, we will be able to let you know of any changes in Minnesota tax laws and filing requirements.

Information and Assistance
Website:	www.revenue.state.mn.us
Email: 	 [email protected]
Phone:	 651-556-3024

This information is available in alternate formats.
For questions about licensing and regulations, contact the Minnesota Department of Commerce:
Website:	www.mn.gov/commerce
Email: 	 [email protected]
Phone:	 651-539-1599 or 1-800-657-3978
Fax:	
651-539-0107

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