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New Mexico Insurance Premium Life and Health Annual Return
Extracted from PDF file 2023-new-mexico-form-trd-41393.pdf, last modified February 2022Insurance Premium Life and Health Annual Return
New Mexico Taxation and Revenue Department Insurance Premium Life and Health 20____ Annual Return TRD-41393 REV 02/08/2022 NAIC NUMBER: STREET/BOX: FEIN, SSN, or ITIN: CITY, STATE, ZIP E-MAIL: CONTACT NAME: PHONE: WHO MUST FILE: Taxpayers (Insurers) subject to Premium Tax and Health Insurance Premium Surtax as outlined in the Insurance Premium Tax Act must file the Form TRD-41393, Insurance Premium Life and Health (IPH) Annual Return. The insurance premium tax estimated payments and returns are due on or before the 15th day of the month following the close of the calendar quarter. Estimated payments must be one-fourth of the payment made during the previous calendar year or one-fifth of the actual payment due for the current calendar year, whichever is greater. The final adjustment for payments due for the prior year shall be made with the return filed on April 15th. E-FILE: You must e-file and e-pay IPH using the Department’s Taxpayer Access Point (TAP) website at https:// tap.state.nm.us. This program has an electronic file (e-file) mandate. If for some reason you are unable to file the return electronically through TAP you are able to request a waiver or exception for e-filing using the Forms RPD41351, E-File Waiver Request Form and RPD-41350, E-File Exception Request Form. Tax Period: q Month Day Check if amended Year through Month Day FOR DEPARTMENT USE ONLY Year Reason for amending: Life Premium Tax 1. Direct Written Premiums (as reported on Schedule T of the NAIC Annual Statement)............................................................. 1. Less exempt premiums: 2. Premiums paid by Political Subdivisions........................................................................................................................ 2. 3. Dividends paid or credited to policyholders.................................................................................................................... 3. 4. Premiums received from authorized companies for reinsurance................................................................................... 4. 5. Net Life Premiums (subtract the sum of lines 2-4 from line 1)................................................................................................ 5. 6. New Mexico Premium Tax Rate..................................................................................................................................... 6. 7. Total Life Premium Tax Due (multiply line 5 by line 6)......................................................................................................... 7. 3.003% Less Payments Applied: 8. Total Premium Tax Payments made (Quarters 1-4) ......................................................................................................... 8. 9. Life Premium Tax Due (subtract line 8 from line 7).............................................................................................................. 9. Health Premium Tax 10. Direct Written Premiums (as reported on Schedule T of the NAIC Annual Statement)............................................................. 10. 11. Human Services Department (HSD) Taxable Premiums................................................................................................ 11. 12. Total Direct Written Premiums (add line 10 and 11)........................................................................................................... 12. Less exempt premiums: 13. Premiums paid by Political Subdivisions........................................................................................................................ 13. 14. Medicare Title XVIII Premium ........................................................................................................................................ 14. 15. Medicare Part D............................................................................................................................................................. 15. 16. Federal Employees Health Benefits Program (FEHBP)................................................................................................. 16. 17. Dividends paid or credited to policyholders.................................................................................................................... 17. 18. Premiums received from authorized companies for reinsurance................................................................................... 18. 19. Net Premiums (subtract lines 13-18 from line 12)................................................................................................................. 19. 20. New Mexico Premium Tax Rate .................................................................................................................................... 20. 3.003% 21. Total Health Premium Tax Due (multiply line 19 by line 20)................................................................................................. 21. Health Credits and Payments 22. Final Medical Insurance Pool (MIP) Assessment........................................................................................................... 22. 23. Less MIP credits allowed at 50% (multiply line 22 by 50%)................................................................................................ 23. 24. Final Medical Insurance Pool (MIP) Assessment........................................................................................................... 24. 25. Less MIP credits allowed at 75% (multiple line 24 by 75%)................................................................................................ 25. 26. Net Premium Tax Liability (add Line 23 and Line 25, subtract from 21).................................................................................. 26. Continue on the next page. ***This program has an electronic filing mandate. An e-file exception or waiver can be requested to submit a paper return.*** NAME OF INSURER: New Mexico Taxation and Revenue Department TRD-41393 REV 02/08/2022 Insurance Premium Life and Health 20____ Annual Return (page 2) NAIC: Less Payments Applied: 27. Total Premium Tax Payments made (Quarters 1-4) ......................................................................................................... 27. 28. Health Premium Tax Due (subtract line 27 from line 26)...................................................................................................... 28. Health Insurance Premium Surtax 29. Health Insurance Premiums as reported on line 19 (enter the amount on line 19)............................................................. 29. Less all excluded premiums: 30. Premiums from Vision and Dental Only Contracts of nonprofit health plan contracts................................................... 30. 31. Total Net Taxable Surtax Premiums (subtract line 30 from line 29)..................................................................................... 31. 32. Surtax Rate................................................................................................................................................................... 32. 33. Total Surtax Due (multiply line 31 by line 32)...................................................................................................................... 33. Less Payments Applied: 34. Total Surtax Payments made (Quarters 1-4).................................................................................................................... 34. 35. Surtax Due (subtract line 34 from 33)................................................................................................................................ 35. Total Tax Due 36. Tax Due (add lines 9, 28 and 35)....................................................................................................................................... 36. 37. Penalty.......................................................................................................................................................................... 37. 38. Interest.......................................................................................................................................................................... 38. 39. Total Amount Due ......................................................................................................................................................... 39. REQUIRED DOCUMENTS: Every taxpayer filing this return is required to submit a copy of the New Mexico Business Page from the Annual NAIC statement and the Schedule T from the Annual NAIC statement. Taxpayers who file New Mexico Medical Insurance Pool (MIP) must submit a copy of the Annual MIP Statement and proof of MIP payments. Taxpayer's Signature I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Authorized Signature Title Date Phone Number ***This program has an electronic filing mandate. An e-file exception or waiver can be requested to submit a paper return.*** FEIN/SSN/ITIN: REV 02/08/2022 New Mexico Taxation And Revenue Department INSURANCE PREMIUM TAX RETURN INSTRUCTIONS • TRD-41396 Insurance Premium Life and Health • TRD-41394 NOTE: Instructions for quarterly returns are combined with the form. Please refer to forms listed above for detailed instructions. WHO MUST FILE Every taxpayer, insurer, and surplus lines broker subject to the provisions of the Insurance Premium Tax Act shall pay any applicable fees and charges as are required under the Insurance Code. Companies that have written zero premiums are still required to file both quarterly and annual premium tax returns. Lines of business may not be combined on a single return. Premium tax returns must be submitted for each line of business in which the company is licensed to transact business. ANNUAL PREMIUM TAX RETURNS As specified in NMSA 1978, Section 7-40-7(A) The final adjustment for payments due for the prior year shall be made with the return filed on April 15, at which time all taxes for that year are due. Forms: Insurance Premium Life and Health • TRD-41393 Insurance Premium Casualty, Property, and Vehicle • TRD-41395 This program has an electronic file (e-file) mandate. If for some reason you are unable to file the return electronically through TAP you are able to request a waiver or exception for e-filing using the Forms RPD-41351, E-File Waiver Request Form and RPD-41350, E-File Exception Request Form. DUE DATE: To be accepted as timely filed annual premium and surtax reports must be submitted online on or before April 15th. REQUIRED DOCUMENTS Every taxpayer filing this return is required to submit a copy of the New Mexico Business Page from the Annual NAIC statement and the Schedule T from the Annual NAIC statement. Taxpayers who file New Mexico Medical Insurance Pool (MIP) must submit a copy of the Annual MIP statement and proof of MIP payment. Important: Balances and Credits have been removed from all returns. Any overpayments will require RPD-41071, Application for Refund, to be submitted to the department along with supporting documents and an Amended Return if applicable. COMPLETED RETURNS All fields in the form must be completed. No field should be left blank. For numeric fields requiring a balance, mark the field as zero if there no activity or balance related to that field. PAYMENTS The estimated payments shall be equal to at least onefourth of the payment made during the previous calendar year or one-fifth of the actual payment due for the current calendar year, whichever is greater. Refer to FYI 401, Special Payment Methods for more information. Make the check or money order payable to New Mexico Taxation and Revenue Department. Mail the payment and all required documentation to Taxation and Revenue Department, P.O. Box 5557, Santa Fe, NM 87502 Email: [email protected]. Certified or overnight mailing address: Attn-Insurance Premium Tax, 1200 S. St. Francis Drive, Santa Fe, New Mexico 87504. For forms to be considered complete, they must be signed, with the Title and Date entered by Authorized Representative. QUARTERLY PREMIUM TAX RETURNS As specified in NMSA 1978, Section 7-40-7(A), for each calendar quarter, an estimated payment of the premium tax and the health insurance premium surtax shall be made on: Quarterly Filing Period Begins Period Ends 1 January 1st March 31st 2 April 1st June 30th 3 July 1st 4 October 1st NOTE: When you provide a check as payment, you authorize us to use information from your check to make a onetime electronic fund transfer from your account. When we use information from your check to make an electronic fund transfer, funds may be withdrawn from your account as soon as the same day you make your payment. Due Date April 15th July 15th September 30th October 15th December 31st January 15th Note: Insurance Premium Surplus Lines Tax- see Form TRD-41397, Insurance Premium Surplus Lines Tax Quarterly Return for filing instructions. Forms: Insurance Premium Casualty, Property, and Vehicle 1 ***This program has an electronic filing mandate. An e-file exception or waiver can be requested to submit a paper return.*** NEW LEGISLATION Effective January 1, 2020 under new legislation the Insurance Premium Tax Act was created transferring the duty to collect Insurance Premium Taxes to the Taxation and Revenue Department. REV 02/08/2022 New Mexico Taxation And Revenue Department INSURANCE PREMIUM TAX RETURN INSTRUCTIONS Line 16. Federal Employees Health Benefits Program (FEHBP). Enter premiums. Line 17. Dividends paid or credited to policyholders. Line 18. Premiums received from authorized companies for reinsurance. Line 2. Premiums paid by Political Subdivisions. Enter the amount of premiums received by political subdivisions. Line 19. Net Premiums. Subtract Lines 13-18 from Line 12. Enter amount here. Line 3. Dividends paid or credited to policyholders. Enter the amount of dividends paid or credited to policyholders. Line 20. New Mexico Premium Tax Rate. Rate is 3.003%. Line 21. Total Health Premium Tax Due. Multiply Line 19 by Line 20. Enter amount here. Line 4. Premiums received from authorized companies for reinsurance. Enter the amount of premiums received from authorized companies for reinsurance. Line 5. Net Premiums. Subtract the sum of Lines 2-4 from Line 1. Enter amount here. Line 22. Final Medical Insurance Pool (MIP) Assessment. Enter MIP Assessment figures as presented on the MIP Invoice. Supporting documents required: Annual Statement and proof of payments. Line 6. New Mexico Premium Tax Rate. Rate is 3.003%. Line 23. Less MIP credit at 50%. Multiply Line 22 by 50%. Line 7. Total Life Premium Tax Due. Multiply Line 5 by Line 6. Enter amount here. Line 24. Final Medical Insurance Pool (MIP) Assessment. Enter MIP Assessment figures as presented on the MIP Invoice. Line 8. Total Estimated Quarterly Payments made. Enter total Premium Tax Payments made from Quarters 1-4. Line 25. Less MIP credit at 75%. Multiply Line 24 by 75%. Line 9. Life Premium Tax Due. Subtract Line 8 from Line 7. Line 26. Net Premium Tax Liability. Add Line 23 and Line 25, subtract from Line 21. Line 10. Direct Written Premiums. Enter the Direct Written Premiums as reported on the Schedule T and the New Mexico Business page from the NAIC Annual Statement for health premium tax. Supporting Documents Required: Schedule T and the New Mexico Business Page of the NAIC Annual Statement. Line 27. Total Estimated Quarterly Payments made. Enter total Premium Tax Payments made from Quarters 1-4. Line 28. Health Premium Tax Due. Subtract Line 27 from Line 26. Line 29. Health Premiums as Reported on Line 19. Enter the amount from line 19. Line 11. Human Services Department Taxable Premiums. Enter taxable premiums received through the Human Services Department as “Pass Through” Premiums on Medicaid contracts. Line 30. Premiums from Vision and Dental Only Contracts of nonprofit health plan contracts. Line 12. Total Direct Written Premiums. Enter sum of Lines 10 and 11. Line 31. Total Net Taxable Surtax Premiums. Subtract line 30 from line 29. Line 13. Premiums paid by Political Subdivisions. Enter amount of premiums paid by Political Subdivisions. Line 32. Surtax Rate. Tax Year Line 14. Medicare Title XVIII Premium. Enter Medicare Title XVII Premiums. Line 15. Medicare Part D. Enter Medicare Part D Premiums. 2 Tax Rate Before December 31, 2021 1.00% Starting January 1, 2022 3.75% ***This program has an electronic filing mandate. An e-file exception or waiver can be requested to submit a paper return.*** Line Instructions Line 1. Direct Written Premiums. Enter the Direct Written Premiums as reported on the Schedule T and the New Mexico Business page from the NAIC Annual Statement for life premium tax. Supporting Documents Required: Schedule T and the New Mexico Business Page of the NAIC Annual Statement. REV 02/08/2022 New Mexico Taxation And Revenue Department INSURANCE PREMIUM TAX RETURN INSTRUCTIONS ***This program has an electronic filing mandate. An e-file exception or waiver can be requested to submit a paper return.*** Line 33. Total Surtax Due. Multiply Line 31 by Line 32. Line 34. Total Surtax Payments made throughout year. Enter total Surtax payments made from Quarters 1-4. Line 35. Surtax Due. Subtract Lines 34 from Line 33. Enter total amount here. Line 36. Tax Due. Add Lines 9, 28 and 35. Enter amount here. Line 37. Penalty. Add penalty if the entity fails to file timely or to pay the amount on Line 36 when due. Calculate the penalty by multiplying the amount on Line 36 by 2%, then by the number of months or partial months for which the return or payment is late, not to exceed 20% of the tax due. Penalty for failure to file or pay on time may not be less than $5.00. Line 38. Interest. Interest accrues daily on the unpaid principal of tax due, and it can change on a quarterly basis. You can find the effective annual and daily interest rates on the Department's web page at www.tax.newmexico.gov or by contacting the Department. Line 39. Total Amount Due. Enter the total of Lines 36, 37, and 38. Pay this amount. 3
Form TRD-41393
More about the New Mexico Form TRD-41393 Individual Income Tax TY 2023
Taxpayers subject to Premium Tax and Health Insurance Premium Surtax are required to file form TRD-41393. This form has an e-file mandate, and you must file either form RPD-41351 or RPD-41350 to request a waiver or exception from filing online
We last updated the Insurance Premium Life and Health Annual Return in February 2024, so this is the latest version of Form TRD-41393, fully updated for tax year 2023. You can download or print current or past-year PDFs of Form TRD-41393 directly from TaxFormFinder. You can print other New Mexico tax forms here.
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TaxFormFinder has an additional 80 New Mexico income tax forms that you may need, plus all federal income tax forms.
| Form Code | Form Name |
|---|---|
| Form PIT-ES | Estimated Payment Voucher |
| Form PIT-1 | Personal Income Tax Return |
| Income Tax Instructions | Individual Income Tax Instructions |
| Form PIT-RC | Rebate & Credit Schedule |
| Form PIT-ADJ | Schedule of Additions & Deductions and Exemptions |
View all 81 New Mexico Income Tax Forms
Form Sources:
New Mexico usually releases forms for the current tax year between January and April. We last updated New Mexico Form TRD-41393 from the Taxation and Revenue Department in February 2024.
About the Individual Income Tax
The IRS and most states collect a personal income tax, which is paid throughout the year via tax withholding or estimated income tax payments.
Most taxpayers are required to file a yearly income tax return in April to both the Internal Revenue Service and their state's revenue department, which will result in either a tax refund of excess withheld income or a tax payment if the withholding does not cover the taxpayer's entire liability. Every taxpayer's situation is different - please consult a CPA or licensed tax preparer to ensure that you are filing the correct tax forms!
Historical Past-Year Versions of New Mexico Form TRD-41393
We have a total of two past-year versions of Form TRD-41393 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:
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