FILING FEES – PRIMARY AND EXPANSION …

1 FILING FEES PRIMARY AND EXPANSION APPLICATIONS. The following table shows the fees charged by each state for FILING either a PRIMARY or EXPANSION Uniform Application. Please note that, due to retaliatory statutes, the ultimate amount of fees you pay in any state may be more than the amount indicated below. = This information has been updated by the state department of Insurance State FILING Fees Payee Instructions AL $1,005 or retaliatory, whichever is greater, due upon Alabama DOI Mail $1,750 check with application. approval. Box 303351 Richard L. Ford $1,750 nonrefundable application examination fee due Montgomery, AL 36130 (334) 241-4151. at FILING . AK $2,250 or retaliatory, whichever is greater. Division of Insurance Mail check with application. State of Alaska 550 West 7th Avenue, Suite 1560. Anchorage, AK 99501-3567. AZ PRIMARY Application: Arizona Department of Insurance $ Application fee Arizona Department of Insurance Financial Affairs Division $ per individual for fingerprint card processing Arizona Department of Insurance 100 N.

2 15th Ave., Suite 102. fee Phoenix, AZ 85007-2624. EXPANSION Application: $ Application Fee Arizona Department of Insurance Articles of Incorporation $ FILING Fee Arizona Corporation Commission AR $1,000 or retaliatory, whichever is greater Arkansas DOI Kimberly S. Johnson Finance Division Insurance Examiner 1200 West Third (501) 371-2680. Little Rock, AR 72201-1904 CA PRIMARY App: EXPANSION App: Insurance Commissioner State of CA. $4,233 $4,233 Corp. Affairs Bureau 45 Fremont Street, 24th Floor San Francisco, CA 94105. CO $500 nonrefundable processing fee Payable to: Mail checks with application. Colorado Division of Insurance 2018 National Association of Insurance Commissioners 1 06/25/2018. State FILING Fees Payee Instructions CT $220 for FILING all documents prerequisite to the Treasurer State of Connecticut Fee should NOT be included with the issuance of a license. application. An invoice will be sent to the Health Care Centers $1,350 applicant for appropriate FILING fee.

3 ( PRIMARY Apps only). DE $1,000 (or retaliatory, whichever is greater) for FILING Make checks payable to: All UCAA PRIMARY and EXPANSION applications application for initial Certificate of Authority, must be filed in hard copy form with fees and including all documents submitted as part of such Delaware Department of Insurance submitted to the Department. application. 841 Silver Lake Boulevard Dover, DE 19904 $150 (or retaliatory, whichever is greater) issuance fee content/uploads/sites/15/2017/07/schedfe et for the Certificate of Authority, if application is approved. $750 Fraud Fund Fee if applicable. DC $500 Make checks payable to: Denise Parker District of Columbia Treasurer Insurance Licensing Specialist (202)442-7815. Mail Fees To: c/o DC Treasurer, Box 92180 Mail Correspondence To: Washington, DC 20092 Department of Insurance and Securities Regulation 1050 First Street, NE, Suite 801. Washington, DC 20002.

4 FL PRIMARY * & EXPANSION App: Make checks payable and mail directly to: Applicants are required to include the $1,500 FILING Fee Department of Financial Services following codes on each check: $1,000 Company License Tax. Box 6100. Tallahassee, Florida 32314-6100 PRIMARY & EXPANSION App: PRIMARY App: $1,500 FILING Fee Codes: B/T-C, TY/CL- $25 Permit FILING Fee 10/06, F/T-F. $1,000 Company License Tax Codes: B/T-C, *If a redomestication and company is already licensed TY/CL-10/30, F/T-L. in Florida and license tax is current, $1,500 FILING fee PRIMARY App: only. $25 Permit FILING Fee Codes: B/T-C, TY/CL-10/08, F/T-F. GA $600 or retaliatory fee, whichever is greater Georgia DOI Application fee should accompany application. Suite 604, West Tower 2 MLK, Jr. Drive Atlanta, GA 30334. 2018 National Association of Insurance Commissioners 2 06/25/2018. State FILING Fees Payee Instructions HI Effective May 28, 2015 Make check payable to: Contacts: Initial Application Fee $900 Department of Commerce and Consumer (due at time of application) Affairs.

5 Sally D. Bautista, Insurance Examiner Certification and Agency Exam. Section C/A Issuance Fee $600 (808) 586-7414. Service Fee for current year $600 Fax#: (808) 586-3873. (due before issuance of C/A) Andrew Chow, Insurance Examiner Phone: (808) 586-8150. Fax: (808) 586-3873. ID Surplus less than $10M: $1,000 Idaho Department of Insurance Surplus greater than $10M, but less than $100M: 700 West State Street 3rd Floor $2,500 Box 83720. Surplus greater than $100M: $4,500 Boise, ID 83720-0043. IL FILING all documents for EXPANSION Illinois Department of Insurance Mail check with application. Application/Admission $5,000 320 West Washington FILING all documents for PRIMARY Application/IL Springfield, IL 62767. Domestic $2,000. IN See Schedule of Fees at Indiana DOI Mail check with application. 311 W. Washington, Suite 300. Indianapolis, IN 46204-2787. IA Application FILING Fee: Larger of $50 or retaliatory Iowa Insurance Division amount Two Ruan Center Certificate of Authority Issuing Fee: Larger of $50 or 601 Locust, 4th Floor retaliatory amount Des Moines, IA 50309-3738.

6 Desk Audit Fee in Accordance w/ : Larger of $2,000 or retaliatory amount KS Larger of $500 or retaliatory amount, nonrefundable Checks are made payable to the Mail check with application. fee due at the time of application submission. Kansas Insurance Department. Annual Statement FILING Fee $100 If the larger admission fee is $500, additional Certificate of Authority Fee $10 fees will be required only if the Certificate of Due prior to the issuance of COA Authority is approved. If the larger admission fee is the retaliatory amount, no additional fees will be required. 2018 National Association of Insurance Commissioners 3 06/25/2018. State FILING Fees Payee Instructions KY Domestic Companies Checks are made payable to Charter Documents $100 Kentucky State Treasurer and forwarded with Original Certificate of Authority $500 the application. Total $600. Foreign Companies Annual Statement $100. Charter Documents $100.

7 Original Certificate of Authority $500. Total $700. Or retaliatory fee, whichever is greater. LA Application fee is calculated as follows: Checks are made payable to the Louisiana Department of Insurance. Certificate of Authority $2,500 The check for Policy Form Review must be a Recordation of Articles of Incorporation $25 separate check. Total Fee to be submitted $2,525. ME PRIMARY App: $1,000 Make Checks Payable to: EXPANSION App: $1,000 Treasurer, State of Maine Fees are retaliatory per Title 24-A, , 428. Mail to: Maine Bureau of Insurance 34 State House Station Augusta, ME 04333. MD Maryland's required Certificate of Authority FILING fee Maryland Insurance EXPANSION App: is $1,225 subject to retaliatory provision as set forth in Administration Please include a letter from domiciliary Section 6-303 of the Insurance Article of the 200 St. Paul Place, Suite 2700 jurisdiction setting forth FILING requirements Annotated Code of Maryland.

8 Baltimore, MD21202-2272 and fees for FILING an application and issuance of an original Certificate of Authority, pay the Dollar amounts for fees are set forth in the Insurance greater fees. Article of Annotated Code of Maryland in Sections 2- 112, and 2-113. Fees for Health Maintenance Victoria Claros Organizations are set forth in Section 19-709 of Director of Company Licensing Article Health General of the Annotated Code of 410-468-2134. Maryland. 2018 National Association of Insurance Commissioners 4 06/25/2018. State FILING Fees Payee Instructions MA PRIMARY App: $1,000 Checks payable to: Application fee should be mailed with the EXPANSION App: The Commonwealth of Massachusetts application. If the application is filed Examination Fee $1,000 Division of Insurance electronically the check for the respective Charter Admission Fee $125 FILING fees must be accompanied by an Annual Statement FILING Fee $150 Massachusetts Division of Insurance explanatory cover letter.

9 Total Application Fees $1,275 Financial Surveillance Unit Attn: Amy Blue Licensing Coordinator 1000 Washington Street, Suite 810. Boston, MA 02118-6200. MI PRIMARY & EXPANSION Apps: Make checks payable to The State of Application FILING fees must accompany the Application FILING Fee $500 Michigan application. The issuing fees will be billed if or Retaliatory whichever is the greater amount the applicant is approved for licensure. Department of Insurance and Financial Certificate of Authority Issuing Fee $25 Services or Retaliatory whichever is the greater amount Office of Insurance Evaluation Mason Building, 7th Floor PRIMARY App: 530 W. Allegan Street Articles of Incorporation Review Fee $25 Lansing, MI 48933. (Domestic Only) OR. Department of Insurance and Financial Services Office of Insurance Evaluation Box 30220. Lansing, MI 48909-7720. MN PRIMARY & EXPANSION Apps: Minnesota Department of Commerce Application Fee $1,500 85 7th Place East, Suite 280.

10 In addition, the Company is also billed a desk audit St. Paul, MN 55101-2198. charge. EXPANSION App: Upon licensing the company will be billed $ for a Property and Casualty Company (including Title Companies) or $1, for a Life Company. 2018 National Association of Insurance Commissioners 5 06/25/2018. State FILING Fees Payee Instructions MS PRIMARY App: MS Insurance Department Mail check with application. Other licensing $200 Box 79 fees will be requested at the time of licensing. EXPANSION App: Jackson, MS 39205-0079. $1,000. HMO - $5,000 Or: 1001 Woolfolk State Office Building 501 N. West Street Jackson, MS 39201. MO Admission Fee - $ DIFP Mail check with application. Rm. 530, HST Bldg. 301 W. High Street Include notation on check stating company Jefferson, MO 65101 name and Application fee . MT $1,900 or retaliatory, whichever is greater. Commissioner of Insurance Submit payment with the application payable State of Montana to the Commissioner of Insurance State of 840 Helena Avenue Montana Helena, MT 59601.