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STATE OF TENNESSEE DEPARTMENT OF COMMERCE AND INSURANCE FINANCIAL AFFAIRS SECTION / ANALYTICAL UNIT 0576 500 JAMES ROBERTSON PARKWAY NASHVILLE, TENNESSEE 37243 (615) 741-1670 TO: PREPAID LIMITED HEALTH
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Individuals who have insurance policies or contracts that require quarterly premium payments.
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Business owners or organizations that have insurance coverage with a quarterly premium fee structure.
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Individuals or entities who have enrolled in a premium-based membership or subscription service that collects fees on a quarterly basis.
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Quarterly premium fee form is a reporting document used to report and pay the quarterly premium fees for certain insurance policies.
Insurance companies or policyholders who hold insurance policies subject to quarterly premium fees are required to file the quarterly premium fee form.
To fill out the quarterly premium fee form, you need to provide information about the insurance policies subject to the fees, including policy details and the calculated premium fees, as well as your contact and payment information.
The purpose of the quarterly premium fee form is to report and pay the quarterly premium fees for insurance policies subject to these fees.
The quarterly premium fee form requires reporting of policy details such as policy numbers, types of policies, and premium amounts. It also includes information about the policyholders and the calculation of the premium fees.
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