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Pennsylvania Free Printable Gross Premiums Tax - Domestic Casualty, Fire or Life Insurance Companies (RCT-121A) for 2024 Pennsylvania Gross Premiums Tax Report

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Gross Premiums Tax Report
Gross Premiums Tax - Domestic Casualty, Fire or Life Insurance Companies (RCT-121A)

IMPORTANT: FILL IN FORM MUST BE DOWNLOADED ONTO YOUR COMPUTER PRIOR TO COMPLETING FILL IN FORM USING ALL CAPS.DO NOT USE DASHES (-) OR SLASHES (/) IN ANY FIELD. ENTER DATES AS MMDDYYYY. USE WHOLE DOLLARS ONLY. 1211022105 OFFICIAL USE ONLY rct-121A MOD 03-23 (FI) Date Received (Official Use Only) PAge 1 of 3 gross Premiums tAX - Domestic cAsuALtY, fire or Life insurAnce comPAnies START c Tax Year Begin: Revenue ID Federal ID (FEIN) ➜ Parent Corporation (FEIN) Tax Year End: 12/31/20_ _ Due Date: April 15 Please select correct letter in drop down Taxpayer Name Check to Indicate a Change of Address Amended Report (Include REV-1175.) First Report New PLHIGA Credit As Originally Registered with PA Dept. of Insurance: Domestic Casualty = A Domestic Fire = B Domestic Life = C First Line of Address Second Line of Address City State ZIP Phone Final Report (See Instructions.) Email Out of Existence Date: use whoLe DoLLArs onLY 1a. 1b. 1c. 1d. 2. 3. 4. 5. 6. 7. 8. 9. 10. Domestic Casualty Gross Premiums Tax (Page 2, Line 15) Domestic Fire Gross Premiums Tax (Page 2, Line 15) Domestic Life Gross Premiums Tax (Page 2, Line 15) Total Insurance Premiums Tax Liability (Line 1a plus Line 1b plus Line 1c) Total Estimated Payments Total Payments Carried Forward From Prior Year Return Total “Restricted” Tax Credits Total Credit: (Line 2 plus Line 3 plus Line 4) Tax Due: (If Line 1d is more than Line 5, enter the difference here.) Remittance Overpayment: (If Line 5 is more than Line 1d, enter the difference here.) Refund: (Amount of Line 8 to be refunded after offsetting all unpaid liabilities) Transfer: (Amount of Line 8 to be credited to the next tax year after offsetting all unpaid liabilities) 1a. 1b. 1c. 1d. 2. 3. 4. 5. 6. 7. 8. 9. 10. 1211022105 corporate officer information: Officer Last Name Social Security Number of Officer Officer First Name Title of Officer Phone Email I affirm under penalties prescribed by law, this report, including any accompanying schedules and statements, has been examined by me and to the best of my knowledge and belief is a true, correct and complete report. If this report is an amended report, the taxpayer hereby consents to the extension of the assessment period for this tax year to one year from the date of filing of this amended report or three years from the filing of the original report, whichever period last expires, and agrees to retain all required records pertaining to that tax and tax period until the end of the extended assessment period, regardless of any statutory provision providing for a shorter period of retention. For purposes of this extension, an original report filed before the due date is deemed filed on the due date. I am authorized to execute this consent to the extension of the assessment period. signature of officer Date Signature of Officer – Please sign after printing Reset Entire Form RETURN TO TOP NEXT PAGE PRINT FORM FILL IN FORM USING ALL CAPS.DO NOT USE DASHES (-) OR SLASHES (/) IN ANY FIELD. ENTER DATES AS MMDDYYYY. USE WHOLE DOLLARS ONLY. 1211022205 rct-121A MOD 03-23 (FI) Revenue ID PAge 2 of 3 AttAch A coPY of the PennsYLVAniA Business PAge AnD scheDuLe t of the AnnuAL rePort fiLeD with the PennsYLVAniA insurAnce DePArtment use whoLe DoLLArs onLY c casualty and fire insurance 1. 2. 3. 4. 5. Gross Direct Premiums Received less Cancellations and Premiums Returned Extraordinary Medical Benefit Premiums (Include footnote, see instructions.) Dividends to Policy Holders Other Deductions (Attach Schedule.) Taxable Fire and Casualty Premiums (Line 1 minus Lines 2, 3 and 4) 1. 2. 3. 4. 5. Life insurance 6. 7. 8. 9. Gross Life Premiums (Direct Written Basis) Dividends to Policy Holders Other Deductions (Attach Schedule.) Taxable Life Premiums (Line 6 minus Lines 7 and 8) 6. 7. 8. 9. Accident and health insurance 10. 11. 12. 13. 14. 15. Gross Direct Accident and Health Premiums Dividends to Policy Holders Other Deductions (Attach Schedule.) Taxable Accident and Health Premiums (Line 10 minus Lines 11 and 12) Total Taxable Premiums (Add Lines 5, 9 and 13) Tax (Line 14 times tax rate - See Instructions.) 10. 11. 12. 13. 14. 15. if registered with the PA Department of insurance as a casualty insurance company, enter Line 15 on Page 1, Line 1a. if registered with the PA Department of insurance as a fire insurance company, enter Line 15 on Page 1, Line 1b. if registered with the PA Department of insurance as a Life insurance company, enter Line 15 on Page 1, Line 1c. 16. 17. 16. State of Domicile 17. NAIC Number 1211022205 Preparer’s information: Firm Name Firm FEIN Address City State ZIP Individual Preparer Name Phone Email Social Security Number or PTIN I affirm under penalties prescribed by law, this report, including any accompanying schedules and statements, has been prepared by me and to the best of my knowledge and belief is a true, correct and complete report. signature of Preparer Date Signature of Preparer – Please sign after printing Reset Entire Form PREVIOUS PAGE NEXT PAGE PRINT FORM FILL IN FORM USING ALL CAPS.DO NOT USE DASHES (-) OR SLASHES (/) IN ANY FIELD. ENTER DATES AS MMDDYYYY. USE WHOLE DOLLARS ONLY. 1211022305 rct-121A MOD 03-23 (FI) Revenue ID PAge 3 of 3 rct-121A PLhigA cALcuLAtion worKsheet schedule of guaranteed Premiums Accident & Health Life Annuity Guaranteed Non-Guaranteed Total guaranteed Premiums are those premiums in which the premium rates are guaranteed during the continuance of the respective policies without a right exercisable by the company to increase said premium rates. 40 P.S. § 991.1711(b) Use the PA Business Page for the year immediately preceeding the year of the assessment to complete the Schedule of Guaranteed Premiums. PLhigA credit calculation Accident & Health Amount Prior Year Class B Assmnt. Date Life Amount Annuity Amount Total of Assessments Guaranteed Premiums Total Premiums Proportion of Qualified Premiums = (carry to six decimal places) Total of Assessment Total Credits Allowed X Proportion of Qualified Premiums = Accident & Health X = Life X = Annuity Prior Year class-A Administrative Assessment X 1.000000 = X 1.000000 = Total Credit Allowed totAL total credit Allowed Per Year Total Credit Allowed X 20% = X 20% = Total Credit Per Year (Limited to 2% Tax) Carry to Current Year Total Below in order to claim a credit, you must complete the above calculations AnD include a copy of the assessment summary, assessment detail, proof of payment paying the assessment and PA Business Page and schedule t for the year immediately preceding the year of the assessment. failure to complete the worksheet and provide the required documentation will result in the denial of the credit. history of Prior credits Already Approved Amount Previously Approved Assessment Year Current Year Total Total credits. Enter on Page 1, Line 4 1211022305 Reset Entire Form PREVIOUS PAGE 1211022305 NEXT PAGE PRINT FORM THIS PAGE DOES NOT PRINT instructions for rct-121A Gross Premiums Tax - Domestic Casualty, Fire or Life Insurance Companies RCT-121A IN 10-23 HIGHLIGHTS ● The RCT-121A can now be filed electronically at mypath.pa.gov. ● All RCT-121A gross premiums taxpayers are required to make an annual estimated prepayment of tax. Failure to do so will result in an assessment of Underpayment Interest and could result in the taxpayer losing operating authority in the state of Pennsylvania. current, non-year-specific tax form, completing all sections of the form. REV-1175, Schedule AR (explanation for amending), must be included when filing an amended report. ● Worksheet for PLHIGA calculation (Page 3 of RCT121A). In order to claim a credit for a PA Life and Health Insurance Guaranty Association Assessment, the PLHIGA calculation worksheet (Schedule of Guaranteed Premiums and PLHIGA Credit Calculation) must be completed. ANNUAL REPORT CHECKLIST Make sure you include the following to file your annual report properly and completely: ● Negative amounts must be written using a minus sign preceding the number. Do not use parentheses. ● Complete RCT-121A, Gross Premiums Tax Report for Domestic Casualty Fire or Life Insurance Companies Associations or Exchanges ● Copy of the Pennsylvania Business Page ● Copy of Schedule T from the annual report ● Corporate officer’s signature on Page 1 and preparer’s signature and PTIN on Page 2 (if applicable) ● History of Prior Credits Already Approved Section added to PLHGIA Calculation Worksheet. Complete this section with credits claimed for the current year plus prior 4 years to arrive at your total PLHIGA credit claimed on Page 1 of this report. IMPOSITION, BASE AND RATE Gross premiums tax is imposed on insurance companies at a rate of 2 percent of gross premiums received from business conducted in Pennsylvania. For more information, see the Act of March 4, 1971 (P.L. 6, No.2). GENERAL INFORMATION Extraordinary medical benefit premiums for coverage under 75 Pa.C.S. § 1715(a) (1.1) are not subject to the tax (See 75 Pa.C.S. § 1798.1(c)). For further guidance, refer to the “Estimated Payment Instructions” on Page 3. REMINDER ● Reports should NOT be mailed to the PA Department of Insurance – this will delay the processing of your report and does not satisfy the filing requirements. Please see the payment and mailing information section to find the correct mailing address for the PA Department of Revenue. ● All payments of $1,000 or more must be made electronically or by certified or cashier’s check remitted in person or by express mail courier. ● Use only whole dollars when preparing tax reports. ● The REV-423, estimated payment coupon, and REV426, extension coupon, can be filed electronically through myPATH at mypath.pa.gov. These coupons are also available on the department's website at revenue.pa.gov. NOTE: The automatic PA extension provided by Act 52 of 2013 to those with valid federal extensions DOES NOT apply to this tax. ● The penalty imposed for failure to file timely reports is now a minimum of $500, regardless of the determined tax liability, plus an additional 1 percent of any determined tax liability over $25,000. ● Use ONLY the most current, non-year-specific tax form and instructions for filing ALL years. If an amended report must be filed, taxpayers must use the most To claim the deduction for extraordinary medical benefit premiums, you must include the policy numbers and premium amounts for any deduction taken. Schedule T should also include a footnote to report the premiums. The following may be deducted from taxable premiums: ● Amounts returned on policies cancelled or not taken ● Premiums received for reinsurance ● The portion of advanced premiums, premium deposits or assessments returned in cash, or credited to members or policyholders upon the expiration or termination of their contracts (in the case of mutual insurance companies, associations, exchanges and stock companies with participating features) ● Notes and other obligations received by mutual insurance companies to secure contingent premium liabilities to the extent that no assessment has been made and collected against the notes or obligations. Companies exempt from the tax include title insurance companies subject to the title insurance and trust companies shares tax; purely mutual beneficial associations whose funds for the benefit of members and families or heirs are made up entirely of the contributions from their members and the accumulated interest on those contributions; corporations organized under the Non-profit Hospital www.revenue.pa.gov PREVIOUS PAGE RCT-121A NEXT PAGE 1 Plan Act of 1937 (Act of June 21, 1937, (P.L. 1948, No.378); and corporations organized under the Nonprofit Medical, Osteopathic, Dental and Podiatry Service Corporation Act of 1939 (Act of June 27, 1939, (P.L. 1125, No.399) Act of 1937 (Act of June 21, 1937, (P.L. 1948, No. 378)); and corporations organized under the Nonprofit Medical, Osteopathic, Dental and Podiatry Service Corporation Act of 1939 (Act of June 27, 1939, (P.L. 1125, No.399). REVENUE ID, FEDERAL EMPLOYER IDENTIFICATION NUMBER (FEIN), PARENT CORPORATION FEIN, NAME, AND ADDRESS The Revenue ID number, FEIN, name, and complete mailing address must be provided. If the taxpayer is a subsidiary of a corporation, the parent corporation’s FEIN must be provided. Also provide the telephone number and email. TAX YEAR Enter month, day, and year (MMDDYYYY) for the tax year beginning and enter year (YY) for the tax year end. REPORT DUE DATE This report is due April 15 for the preceding year ended Dec. 31. If April 15 falls on a Saturday, Sunday, or holiday, the report is due the next business day. The penalty imposed for failure to file timely reports is now a minimum of $500, regardless of the determined tax liability, plus an additional 1 percent of any determined tax liability over $25,000. ADDRESS CHANGE Enter “Y” in the block on Page 1 if the address of the corporation has changed from prior tax periods. The current mailing address should be reflected on the report. AMENDED REPORT Enter “Y” in the block on Page 1 if you are filing an amended report to add, delete or adjust information. Provide documentation to support all changes being made. An amended report should only be filed if an original report was filed previously for the same period. An amended report must be filed within three years of the filed date of the original report. The department may adjust the tax originally reported based on information from the amended report. The taxpayer must consent to extend the assessment period. If the amended report is timely filed and the taxpayer consented to extend the assessment period, the time period in which to assess tax will be the greater of three years from the filed date of the original report or one year from the filed date of the amended report. Regardless of the tax year being amended, taxpayers must use the most current non-year-specific tax form, completing all sections of the report. This includes those sections originally filed and those sections being amended. All tax liabilities should be recorded on Page 1. Taxpayers must check the Amended Report check box on Page 1 and include Schedule AR, REV-1175, with the report. FIRST REPORT Enter “Y” in the block on Page 1 if this is the taxpayer’s first PA gross premiums tax filing. 2 RCT-121A PLHIGA CREDIT Enter “Y” in the block on Page 1 if the taxpayer is claiming a new PA Life and Health Insurance Guaranty Association Credit. Complete the PLHIGA Calculation Worksheet on Page 3. The following credits are available against gross premiums tax: ● PA Life and Health Insurance Guaranty Association (PLHIGA) Credit CAUTION: In order to claim a credit for a ° PA Life and Health Insurance Guaranty Association Assessment, the PLHIGA calculation worksheet (Schedule of Guaranteed Premiums and PLHIGA Credit Calculation) must be completed. Submit a copy of the assessment summary and assessment detail. Provide proof of payment indicating the assessment was paid. Include a copy of the Pennsylvania Business Page and Schedule T for the year immediately preceding the year of the assessment. Also include a schedule with a detailed breakdown of all PLHIGA credits claimed on RCT-121A, Page 1, Line 4. NOTE: This credit is only available for policies that guarantee premium rates without a right exercisable by the company to increase said premium rates. ● Neighborhood Assistance Program Tax Credit ● Educational Improvement Tax Credit ● PA Property and Casualty Insurance Guaranty Association (PIGA) Credit credits are not available until there have been ° PIGA sufficient billings to create a credit. Billings must exceed 1 percent of the base year. For additional information, please contact the PA Property and Casualty Insurance Guaranty Association at 215-568-1007. ● Research Enhancement and Protection Tax Credit FINAL REPORT ● Enter “Y” in the block on Page 1 if this report will be the final report filed with the department. Indicate the effective date of the event as MMDDYYYY. ● Include information from the Pennsylvania Insurance Department verifying the taxpayer’s insurance license expired, was cancelled, or not renewed. ● Include a copy of the regulatory authority’s approval of the merger, dissolution, plan of reorganization, and/or articles of merger. ● Provide the Revenue ID and FEIN of the surviving entity, if applicable. CORPORATE OFFICER INFORMATION A corporate officer must sign and date the tax report. The signature must be original; photocopies or faxes will not be accepted. Print the first and last name, title, Social Security number, telephone number, and email of the corporate officer. www.revenue.pa.gov PREVIOUS PAGE NEXT PAGE PREPARER’S INFORMATION Paid preparers must sign and date the tax report. If the preparer works for a firm, provide the name, FEIN, and address of the firm along with the name, telephone number, email, and PTIN/SSN of the individual preparing the report. If the preparer is an individual without any association to a firm, provide the name, address, telephone number, email, and PTIN/SSN of the individual preparing the report. ESTIMATED PAYMENT INSTRUCTIONS The full amount of the required prepayment for gross premiums tax is due on or before March 15 of the reported year. Tax remaining due at the close of the taxable year must be paid on or before April 15 of the following year. Mail the estimated payment coupon, REV-423, separately from all other forms. If you have questions regarding estimated payments, email the department at [email protected]. ESTIMATED PAYMENT SAFE HARBOR The gross premiums tax prepayment MUST be equal to 90 percent of the current tax year liability. However, taxpayers are eligible to use the “safe harbor” option in the event they cannot accurately estimate their current year liability. The prepayment requirement will be satisfied if the taxpayer prepays an amount equal to 100 percent of their “safe harbor” tax year liability. The “safe harbor” tax year is the second preceding year to the current tax year. For example, the “safe harbor” year for purposes of making the 2019 estimated prepayment is tax year 2017. EXTENSION REQUEST DUE DATE To request a due date extension of up to 60 days to file the annual report, you must file an extension request by the original report due date. You can request an extension on mypath.pa.gov or by sending the REV-426. However, an extension of time to file does not extend the deadline for payment of tax and an extension request must be accompanied by payment of taxes owed for the taxable year for which the extension is requested. Mail the extension coupon separately from all other forms. A taxpayer using an electronic method to make a payment with an extension request should not submit the extension coupon. Do not use the extension coupon to remit other unpaid liabilities within the account. PAYMENT AND MAILING INFORMATION All payments of $1,000 or more must be made electronically or by certified or cashier’s check mailed to: PA DEPARTMENT OF REVENUE PO BOX 280404 HARRISBURG PA 17128-0404 Tax returns and certified or cashier’s check may be remitted in person or by express mail courier. Mail payments and returns to the following address: PA DEPARTMENT OF REVENUE 1854 BROOKWOOD ST HARRISBURG PA 17104 Payments under $1,000 may be remitted by mail, made payable to the PA Department of Revenue. Mail payments, extension requests and returns to the following address: PA DEPARTMENT OF REVENUE PO BOX 280427 HARRISBURG PA 17128-0427 Failure to make a payment by an approved method will result in the imposition of a 3 percent penalty of the tax due, up to $500. For more information on electronic filing options, visit mypath.pa.gov. NOTE: Reports should NOT be mailed to the PA Department of Insurance – this will delay the processing of your report and does not satisfy the filing requirements. CURRENT PERIOD OVERPAYMENT If an overpayment exists on Page 1 of RCT-121A, the taxpayer must instruct the department to refund or transfer overpayment as indicated below. REFUND Identify the amount to refund from the current tax period overpayment. Prior to any refund, the department will offset current period liabilities and other unpaid liabilities within the account. TRANSFER Identify the amount to transfer from the current tax period overpayment to the next tax period for estimated tax purposes. Prior to any transfer, the department will offset current period liabilities and other unpaid liabilities within the account. NOTE: If no option is selected, the department will automatically transfer any overpayment to the next tax year for estimated tax purposes after offsetting current period liabilities and other unpaid liabilities within the account. REQUESTS FOR REFUND OR TRANSFER OF AVAILABLE CREDIT Requests for refund or transfer of available credit from prior periods can be requested on company letterhead, signed by an authorized representative, and emailed to [email protected]. Please do not duplicate requests for refund and/or transfer by submitting both RCT-121A and written correspondence. CONTACT INFORMATION ● For additional information regarding electronic payments visit the departments Online Customer Service Center at revenue.pa.gov. ● Questions regarding payments or refunds, email [email protected]. ● General business tax questions, visit the department's Online Customer Service Center at revenue.pa.gov. ● Business taxpayers and tax practitioners have the ability to receive and view department issued electronic statement of accounts and correspondence electronically by visiting mypath.pa.gov. www.revenue.pa.gov PREVIOUS PAGE RCT-121A NEXT PAGE 3 LINE INSTRUCTIONS LINE 2 RCT-121A should be completed in the following order: Enter the extraordinary medical benefit premiums. To claim the deduction for extraordinary medical benefit premiums, you must include the policy numbers and premium amounts for any deduction taken. PA Business Page must also include a footnote to report the premiums. STEP 1 Complete the taxpayer information and any applicable questions at the top of Page 1. If claiming a PLHIGA credit, you must check the box on Page 1. STEP 2 Indicate the type of insurance company on Page 1 Domestic Casualty, Domestic Fire or Domestic Life. This is based on the company’s original registration with the Pennsylvania Insurance Department. This information is required. STEP 3 Enter the Revenue ID number and other taxpayer information in the designated fields at the top of each page. LINE 3 Enter the dividends to policy holders from the Pennsylvania business page. LINE 4 Enter any other deductions. A schedule detailing all other deductions must be provided. LINE 5 STEP 4 Complete Page 2. TAXABLE FIRE AND CASUALTY PREMIUMS Enter the difference of Line 1 minus Lines 2, 3 and 4. STEP 5 Complete Page 1, Lines 1 through 10. LIFE INSURANCE STEP 6 Complete the corporate officer information section, sign, and date at the bottom of Page 1. STEP 7 Complete the preparer information section, sign, and date at the bottom of Page 2, if applicable. STEP 8 Mail the completed report and any supporting schedules to the PA Department of Revenue. PAGE 2 CALCULATION OF TAXABLE PREMIUMS Domestic casualty and domestic fire insurers will use Lines 1 through 5. Domestic life insurers will use Lines 6 through 13. CASUALTY AND FIRE INSURANCE LINE 1 DIRECT PREMIUMS Enter the difference of total direct premiums written reported on the Pennsylvania business page less ocean marine premiums less accident and health premiums. Ocean marine premiums are reported on the RCT-124 and accident and health premiums are reported below on Line 10. The direct premiums written as reported on the Pennsylvania business page already includes the adjustment for returned and cancelled policies. OR CASH BASIS Enter the direct premiums received; provide a schedule of taxable premiums. Show the beginning and ending receivables and any other deductions or additions. 4 RCT-121A LINE 6 GROSS LIFE PREMIUMS (DIRECT WRITTEN BASIS) Enter the total life premiums from the Pennsylvania business page. LINE 7 Enter the dividends to policy holders from the Pennsylvania business page. LINE 8 Enter any other deductions. A schedule detailing all other deductions must be provided. LINE 9 TAXABLE LIFE PREMIUMS Enter the difference of Line 6 minus Lines 7 and 8. ACCIDENT AND HEALTH INSURANCE LINE 10 GROSS DIRECT ACCIDENT AND HEALTH PREMIUMS Enter the total accident and health premiums from the Pennsylvania business page. LINE 11 Enter the dividends to policy holders from the Pennsylvania business page. LINE 12 Enter any other deductions. A schedule detailing all other deductions must be provided. LINE 13 TAXABLE ACCIDENT AND HEALTH PREMIUMS Enter the difference of Line 10 minus Lines 11 and 12. www.revenue.pa.gov PREVIOUS PAGE NEXT PAGE LINE 14 TOTAL TAXABLE PREMIUMS Enter the sum of Lines 5, 9, and 13. LINE 15 TAX Multiply Line 14 by 0.02. Carry the tax to RCT-121A Page 1, Line 1a, 1b or 1c (This is based on the company’s original registration with the Pennsylvania Insurance Department). LINE 16 Enter the company’s state of domicile. LINE 17 Enter the company’s NAIC number. PAGE 3 PLHIGA CALCULATION WORKSHEET SCHEDULE OF GUARANTEED PREMIUMS Guaranteed Premiums are those premiums in which the premium rates are guaranteed during the continuance of the respective policies without a right exercisable by the company to increase said premium rates. GUARANTEED Use the PA Business Page for the year immediately preceding the year of the assessment to determine the amount of premiums for each type of assessment. (Accident & Health, Life and Annuity). NON-GUARANTEED Use the PA Business Page for the year immediately preceding the year of the assessment to determine the amount of premiums for each type of assessment. (Accident & Health and Life). NOTE: All Annuity premiums are treated as guaranteed premiums. TOTAL Enter the total of guaranteed and non-guaranteed premiums for each column. PLHIGA CREDIT CALCULATION ASSESSMENT DATE AND AMOUNT Enter the date of the Class B assessment and the amount of assessment for each type (Accident & Health, Life, Annuity), paid during the previous year. Do not include Class A Assessments in this section. Enter Class A Assessments in the Total Credits Allowed section. TOTAL OF ASSESSMENTS Enter the total of each column. GUARANTEED PREMIUMS Enter amount of premiums from Schedule of Guaranteed Premiums for each type. TOTAL PREMIUMS Enter total premiums from Schedule of Guaranteed Premiums for each type. PROPORTION OF QUALIFIED PREMIUMS Divide Guaranteed Premiums by Total Premiums for each type. Carry to six decimal places. TOTAL CREDITS ALLOWED Enter Total of Assessment and Proportion of Qualified Premiums for each type. Multiply Total of Assessment by Proportion of Qualified Premiums to calculate Total Credit Allowed. Enter the Class-A Administrative Assessment paid during the previous year. TOTAL Add Total Credit Allowed column. TOTAL CREDIT ALLOWED PER YEAR Enter Total figure from Total Credit Allowed column and multiply by 20 percent to calculate credit amount per year. HISTORY OF PRIOR CREDITS ALREADY APPROVED Enter each prior year and amount of credit for the previous four years credits already approved by the Department of Revenue, if applicable. Enter the current year amount from Total Credit Per Year. Include the Total Credit in the amount on Page 1, Line 4. The total amount of PLHIGA credit cannot exceed the current year Gross Premiums tax liability. www.revenue.pa.gov PREVIOUS PAGE RCT-121A RETURN TO PAGE 1 5
Extracted from PDF file 2023-pennsylvania-form-rct-121a.pdf, last modified June 2012

More about the Pennsylvania Form RCT-121A Other TY 2023

We last updated the Gross Premiums Tax Report in February 2024, so this is the latest version of Form RCT-121A, fully updated for tax year 2023. You can download or print current or past-year PDFs of Form RCT-121A directly from TaxFormFinder. You can print other Pennsylvania tax forms here.


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Other Pennsylvania Other Forms:

TaxFormFinder has an additional 174 Pennsylvania income tax forms that you may need, plus all federal income tax forms.

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Form Sources:

Pennsylvania usually releases forms for the current tax year between January and April. We last updated Pennsylvania Form RCT-121A from the Department of Revenue in February 2024.

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Historical Past-Year Versions of Pennsylvania Form RCT-121A

We have a total of thirteen past-year versions of Form RCT-121A in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:


2023 Form RCT-121A

Gross Premiums Tax - Domestic Casualty, Fire or Life Insurance Companies (RCT-121A)

2022 Form RCT-121A

Gross Premiums Tax - Domestic Casualty, Fire or Life Insurance Companies (RCT-121A)

2021 Form RCT-121A

Gross Premiums Tax - Domestic Casualty, Fire or Life Insurance Companies (RCT-121A)

2020 Form RCT-121A

Gross Premiums Tax - Domestic Casualty, Fire or Life Insurance Companies (RCT-121A)

2019 Form RCT-121A

Gross Premiums Tax - Domestic Casualty, Fire or Life Insurance Companies (RCT-121A)

2017 Form RCT-121A

Gross Premiums Tax Report -- Domestic Casualty, Fire or Life Insurance Companies (RCT-121-A) -- Print Only Version

2016 Form RCT-121A

Gross Premiums Tax Report -- Domestic Casualty, Fire or Life Insurance Companies (RCT-121-A) -- Print Only Version

Forms/Publications 2015 Form RCT-121A

Gross Premiums Tax Report -- Domestic Casualty, Fire or Life Insurance Companies (RCT-121A)

Forms/Publications 2014 Form RCT-121A

Gross Premiums Tax Report -- Domestic Casualty, Fire or Life Insurance Companies (RCT-121-A)

Gross Premiums Tax Report -- Domestic Casualty, Fire or Life Insurance Companies (RCT-121-A) 2013 Form RCT-121A

Gross Premiums Tax Report -- Domestic Casualty, Fire or Life Insurance Companies (RCT-121-A)

Gross Premiums Tax Report -- Domestic Casualty, Fire or Life Insurance Companies (RCT-121-A) 2012 Form RCT-121A

Gross Premiums Tax Report -- Domestic Casualty, Fire or Life Insurance Companies (RCT-121-A)

2011 Gross Premium Tax Report -- For Domestic Casualty, Domestic Fire or Domestic Life Insurance Companies, Associations or Exchanges (RCT-121-A) 2011 Form RCT-121A

2011 Gross Premium Tax Report -- For Domestic Casualty, Domestic Fire or Domestic Life Insurance Companies, Associations or Exchanges (RCT-121-A)


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