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Captive Insurers Do Not Pay an Insurance Premium Tax in Arizona.

A domestic risk retention group must, however, complete the Survey of Arizona Domestic Insurers (Form E-LRTF), and all captive insurers have annual filing requirements.

Form E-LRTF: Local and Regional Taxes and Fees; Survey of Arizona Domestic Insurers

Updated 01/14/2022

Arizona Administrative Code ("AAC") R20-6-205 requires all Arizona domestic insurers to file a complete and accurate response to this survey.

  • Complete all the questions on the INSTRUCTIONS page and furnish the information specified in the "WHAT NEEDS TO BE SUBMITTED" section. 
  • All insurers other than captive insurers must use the NAIC OPTins system (https://www.optins.org) to submit files.
  • A captive insurer has the option of submitting files on a CD-ROM containing the captive insurer's name and NAIC number, or uploading files into the NAIC OPTins system (https://www.optins.org).  The NAIC charges a small fee to file using the OPTins system, but filing by OPTins is easier and saves on postage and the hassle of saving files to a CD-ROM.
  • Files you save on a CD-ROM or upload into an OPTins filing must have filenames that conform to the instructions provided in the NAMING FILES section.

Data from the Survey are used to compute additions to the rates of tax that foreign and alien insurers must use when computing their retaliation obligations.  Therefore, it is absolutely critical that Arizona domestic insurers accurately complete the survey.  Insurers that fail to file timely, complete and accurate responses to the Survey may be subject to administrative action.

Beginning for Tax Year 2015, Arizona-domiciled insurers are not subject to tax/fee retaliation in Hawaii, Massachusetts, Minnesota, New York or Rhode Island, and insurers domiciled in those states are not subject to tax/fee retaliation in Arizona.  Therefore, we are no longer requested information about any of those states in the E-LRTF workbook.

Insurers with questions about the survey should contact the Insurance Tax Unit.

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To report errors with forms or instructions, or to suggest ways to improve them, please send e-mail to our Tax Unit at [email protected].

Captive Insurer