Medical Stop Loss Accrued Premium Tax Reconciliation Report Details

Effective

Policy effective date.

Contract

Contract number.

Policyholder

Policyholder name.

Policyholder state.

Report Period

Period of time covered by the report.

Gross Premium

Gross premium amount.

Premium tax rate, expressed as a percentage.

Premium Tax Accrued

Tax owed on the premium as of the reporting period. Product of Gross Premium and %.

Disbursed

Taxes paid out.

Closed

Documentation pending.

Due

Taxes due as of the reporting period.