Ariz. Admin. Code § R20-5-1537 - Ex-Medical Plan; Eligibility; Formula; Necessary Information

A. Except as provided in R20-5-1539, a Self-Insurer may elect to use an Ex-Medical for purposes of premium taxes required under A.R.S. §§ 23-961 and 23-1065 if the Self-Insurer's annual net taxable premium exceeds $100,000 and the Self-Insurer operates a medical facility with a program for providing medical, surgical, or hospital services to a majority of the employees of the Self-Insurer or the employees of the members of a Self-Insurance Pool that complies with the requirements of A.R.S. § 23-1070.

B. The Division shall calculate the net taxable premium under an Ex-Medical Plan on a Payroll Classification Code basis as follows: [(payroll multiplied by the Payroll Classification Rate) multiplied by (1 minus the Deviation Rate) multiplied by (1 minus the D-Ratio)] less premium discounts.

C. The Ex-Medical Plan applies only to operations and payroll in Arizona. The Self-Insurer shall combine all operations in Arizona to calculate the premium taxes required under A.R.S. §§ 23-961 and 23-1065.

D. A Self-Insurer shall provide the following in support of using an Ex-Medical Plan:

1. The completed forms required in R20-5-1536(E); and

2. Completed Annual Hospital Report Form for the current tax year.

Notes

Ariz. Admin. Code § R20-5-1537

New section made by final rulemaking at 28 A.A.R. 3435, effective 10/5/2022.