Premium Tax Forms

For the Year Ended December 31, 2017

ALL FORMS HAVE BEEN UPDATED. PLEASE REVIEW THE NEW FORMS CAREFULLY.

This site contains information and Premium Tax forms that are required to be filed with the Department.  Certain company types have not been included as options for download, those company types will receive a complete packet which will be mailed the first week of January 2018.  If you do not find the Premium Tax forms for your company type and you do not receive a packet from the Department by January 15, 2018, please contat Martha Hettenbaugh either by e-mail at martha.hettenbaugh@nebraska.gov or 402-471-2201.

THE DEPARTMENT ENCOURAGES ELECTRONIC FILING THROUGH OPTINS, IF FILING ELECTRONICALLY, YOU MUST USE THE FORMS ON THE OPTINS WEBSITE

Please select your company type from the following list.  Within each company type will be the appropriate forms, a premium tax filing FAQ with information regarding the filing process, and the annual filing checklist.  Each form is a separate file and must be downloaded separately.  If you do not find your line of insurance, please contact Martha Hettenbaugh etiher by e-mail at Martha Hettenbaugh or 402-471-2201.

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