SELF-INSURED QUARTERLY TAX REPORT INFORMATION 2008, FORM 103 Administrative & Special Fund Tax
Workers Compensation insurers who were required to pay a tax of at least $2,000 for the preceding calendar year are required to file a quarterly report and pay the taxes calculated therein or an amount equal to 25% of the tax paid or required to be paid for the preceding calendar year. A.R.S. § 23-961(L). Net Taxable Premium, line A1 of the quarterly tax form, can be found in the "Premium Tax Calculation" statement described as Line A, Net Taxable Premium, Form 100. This amount is used in determining Administrative Fund and Special Fund Taxes due. The taxes are calculated as follows: 1. Administrative Tax - Effective January 1, 2008, three percent under A.R.S. § 23-961(L) 1 of the Net Taxable Premium. A quarterly payment, as described above, is required to be made. Special Fund Tax - Effective January 1, 2008, one and one-half percent under A.R.S. § 23-1065(A)1 of the Net Taxable Premium. A quarterly payment, as described above, is required to be made.
NOTE: Self-Insures Quarterly filings are due as listed on the form. Self-Insures annual filings are due by February 15 and annual tax payments are due by March 31 of each year. Either one of two methods may be used to calculate the quarterly taxes. However, the same method must be used for all quarters. If using method II, please contact the Industrial Commission Staff at 602-542-1836, to receive the correct forms and instructions. Penalty and interest will be assessed on quarterly payments that are not paid when due per A.R.S. § 23-961 (N). Penalty is the greater of twenty-five dollars or five percent of the tax due plus interest at the rate of one percent per month from the date the tax was due.
The Industrial Commission may direct the payment into the state treasury of not to exceed one and onehalf per cent of all premiums received by the state compensation fund and private insurance carriers during the immediately preceding calendar year. The same percentage shall be assessed against self-insurers based on the total cost to the self-insured employer as provided in § 23-961, subsection J. Such assessments shall be computed on the same premium basis as provided for in § 23-961, subsections J, K, & L and shall be no more than is necessary to keep the Special Fund actuarially sound. Such payments shall be placed in a special fund within the administrative fund to provide, at the discretion of the commission, such additional awards as may be necessary to enable injured employees to accept the benefits of any law of the state or of the United States, or both jointly, for promotion of vocational rehabilitation of persons disabled in industry.)