Schedule of Fees

NEBRASKA Good Life. Great Opportunity. DEPARTMENT OF INSURANCE # COVER SHEET Pete Ricketts, Governor CB-38 (Amended) July 26, 2019 ## BULLETIN ### SUBJECT: SCHEDULE OF FEES This guidance document is advisory in nature but is binding on an agency until amended by such agency. A guidance document does not include internal procedural documents that only affect the internal operations of the agency and does not impose additional requirements or penalties on regulated parties or include confidential information or rules and regulations made in accordance with the Administrative Procedure Act. If you believe that this guidance document imposes additional requirements or penalties on regulated parties, you may request a review of the document. Contents of CB-38 (Amended) follow on next page. Bruce R. Ramgo, Director Department of Insurance 1135 M Street, Suite 300 PO Box 82089 Lincoln, Nebraska 68501-2089 OFFICE 402-471-2201 FAX 402-471-4610 www.doi.nebraska.gov NEBRASKA Good Life. Great Opportunity. DEPARTMENT OF INSURANCE July 26, 2019 CB-38 (Amended) Pete Ricketts, Governor # BULLETIN # SUBJECT: SCHEDULE OF FEES Effective immediately, the Department's revised Schedule of Fees is noted below. All companies and licensees must remit on a retaliatory fee basis. All fees must accompany the request for services except for agent appointments which are billed to the company. All correspondence should be sent to the Nebraska Department of Insurance, PO Box 82089, Lincoln, Nebraska 68501-2089. Checks are made payable to Department of Insurance. rtment's revised Schedule of Fees is noted below. All companies and licensees must remit on a retaliatory fee basis. All fees must accompany the request for services except for agent appointments which are billed to the company. All correspondence should be sent to the Nebraska Department of Insurance, PO Box 82089, Lincoln, Nebraska 68501-2089. Checks are made payable to Department of Insurance. | Description | Amount Due | | --- | --- | | Preadmission Review of Documents of a Foreign Insurer, Organization, Fraternal Benefit Society, and Licensing of a Domestic Insurer (not an Assessment Association) – §44-114(11) | $1,000.00 | | Admission fee for Domestic, Foreign or Alien insurers, Statistical Agents, Fraternal Benefit Society, or Advisory Organizations – §44-114(1) | 300.00 | | Renewal of Certificate of Authority – Domestic and Foreign Insurers, including Advisory Organizations and Statistical Organizations – §44-114(4) | 100.00 | | Renewal of Certificate of Authority – Domestic Assessment Associations doing business in less than 31 counties – §44-114(4) | 20.00 | | Renewal of Certificate of Authority – Fraternal Benefit Society – §44-1098 | 50.00 | | Amended Certificate of Authority – §44-114(5) | 100.00 | | Filing of Annual Statements – §44-114(7) | 200.00 | | Filing Certified Copies of Articles of Merger of Licensed Company – §44-114(6) | 50.00 | | Filing each Amendment to Articles of Incorporation §44-114(2) | 20.00 | | Filing Restated Articles of Incorporation – §44-114(3) | 20.00 | Bruce R. Ramge, Director Department of Insurance 1135 M Street, Suite 380 PO Box 82089 Lincoln, Nebraska 68501-2089 1 of 3 OFFICE 402-471-2201 FAX 402-471-4610 www.doi.nebraska.gov CB-38 (Amended) July 26, 2019 ed Company – §44-114(6) | 50.00 | | Filing each Amendment to Articles of Incorporation §44-114(2) | 20.00 | | Filing Restated Articles of Incorporation – §44-114(3) | 20.00 | Bruce R. Ramge, Director Department of Insurance 1135 M Street, Suite 380 PO Box 82089 Lincoln, Nebraska 68501-2089 1 of 3 OFFICE 402-471-2201 FAX 402-471-4610 www.doi.nebraska.gov CB-38 (Amended) July 26, 2019 | Description | Amount Due | | --- | --- | | Hoiding Company Fees – §44-2131 | | | Form A Filing | $1,000.00 | | Form B (initial filing) | 1,000.00 | | Annual Renewal fee | 200.00 | | Application of Domestic Mutual Insurer to Convert to a Stock Insurer – §44-6105 | 1,000.00 | | Organization and Admission fees for Risk Management Pool (intergovernmental, certificate of authority – §44-4307) | 1,000.00 | | Third Party Administrator | | | Admission fee/Certificate of Authority – §44-5812(2) | 200.00 | | Annual Renewal fee – §44-5814(3) | 200.00 | | Multiple Employer Welfare Arrangement | | | Application/Initial Licensing fee – §44-7605 | 1,000.00 | | Annual Renewal fee – §44-7613 | 200.00 | | Captive Insurer | | | Application/Initial Licensing fee – §44-8205 | 500.00 | | Annual Renewal fee – §44-8207 | 500.00 | | Unincorporated Mutual Association Report – §44-114(9) | None | | Reinsurance Intermediary Licensee – §44-5603(6)(a), (6)(b)(ii) | 250.00 | | Utilization Review | | | Certificate of Authority – §44-5420(1) | 300.00 | | Annual Renewal of Certificate of Authority – §44-5424(1) | 100.00 | | Viatical Settlement Provider | | | Initial Application/License – §44-1103(2) | 1,000.00 | | Annual Statement Filing fee – §44-114(7) | 200.00 | | Annual Renewal fee – §44-1103(3) | 100.00 | | Viatical Settlement Broker (Individual and Entity) | | | Initial License – §44-1103(2) | 40.00 | | Annual Renewal fee – §44-1103(3) | 40.00 | | Insurance Producer | | | License (Resident or Non-Resident) – §44-4064(1)(a) | 50.00 | | Late Renewal fee – §44-4064(1)(d) | 40.00 00 | | Annual Statement Filing fee – §44-114(7) | 200.00 | | Annual Renewal fee – §44-1103(3) | 100.00 | | Viatical Settlement Broker (Individual and Entity) | | | Initial License – §44-1103(2) | 40.00 | | Annual Renewal fee – §44-1103(3) | 40.00 | | Insurance Producer | | | License (Resident or Non-Resident) – §44-4064(1)(a) | 50.00 | | Late Renewal fee – §44-4064(1)(d) | 40.00 | | Reinstatement fee – §44-4064(1)(e) | 40.00 | | Business Entity | | | License fee – §44-4064(1) | 50.00 | | Late Renewal fee – §44-4064(1) | 50.00 | | Reinstatement fee – §44-4064(1) | 50.00 | 2 of 3 CB-38 (Amended) July 26, 2019 Description Amount Due | Surplus Lines | | | --- | --- | | 2-Year License, Individual – §44-5504(2) | $250.00 | | Late Renewal fee – §44-5504(3) | 100.00 | | Annual License, Corporate – §44-5504(2) | 250.00 | | Resident Consultant | | | License (individual) – §44-2621 | 50.00 | | Corporate, Partnership, or LLC License – §44-2621 | 50.00 | | Non-Resident Consultant | | | License (individual) – §44-2621 | 50.00 | | Corporate, Partnership, or LLC License – §44-2621 | 50.00 | | Continuing Education | | | Course Approval – §44-3905(1)(a) | 50.00 | | Sponsor Approval – §44-3905(b) | None | | Sponsor Penalty – §44-3905(b) | None | | Annual Appointment of Licensed Agent – §44-4064(1)(b) | 8.00 | | Termination of Appointment – §44-4064(1)(c) | 3.00 | | Pre-Need | | | Seller License – §12-1108 | 100.00 | | Agent License – §12-1115 | 20.00 | | Annual Report fee – §12-1110 | 50.00 | | Certificate of Deposit, Compliance, Valuation, and other Certification – §44-114(8) | 5.00 ea. | | Copies of Official Records or Documents – §44-114(10) | .50/page | Bruce R. Ramge Bruce R. Ramge Director 3 of 3