nd.gov - The Official Portal for North Dakota State Government
North Dakota: Legendary. Follow the trail of legends
North Dakota Insurance Department
Jon Godfread, Commissioner
Twitter Flickr YouTube RSS
communications prescription shic healthcare enforcement compliance forms special
consumers producers companies

General instructions
Applicable to all insurer types

Every stock and mutual insurance company, nonprofit health service corporation, health maintenance organization, prepaid legal service organization and risk retention group (with 26 or more resident members/insureds) must file:

  • A quarterly tax statement and pay any applicable tax by the dates stated on the forms. (May 30, August 29, November 29)
  • A reconciled tax statement and pay any applicable tax or minimum tax filing fee by March 1 annually.

Failure to file any statement or pay any applicable tax or mimimum tax filing fee by the date required subjects the company to a penalty pursuant to N.D.C.C. § 26.1-03-17(3). You must file statements even if no tax is due.

Explicit instructions are found on the second page of each statement. Please review prior to completion of the forms.

If you have questions related to these filings, please contact:

600 E. Boulevard Ave.
State Capitol, fifth floor
Dept. 401
Bismarck, ND 58501
701.328.4880 fax

Premium Tax - Estimated Tax Form SFN 11051
Premium Tax - Reconciled Tax Form SFN 11050

North Dakota Insurance Department
600 E. Boulevard Ave.
Bismarck, ND 58505-0320
Phone 701.328.2440
Toll free 800.247.0560
Fax 701.328.4880

Copyright © 2018 North Dakota Insurance Department
Contact us
About us
RSS feeds
Site map
Privacy policy
Security policy