Pennsylvania Statutes Title 71 P.S. State Government § 240.12A. Insurance Department (Adm. Code § 612-A)

(1)

Insurance companies, associations or exchanges

(i)

Valuation of life insurance policies based on a per thousand dollar value of such insurance

․․․․․$.01 with

a minimum

charge of

$15.00

(ii)

Filing copy of charter or amendment of a domestic, foreign or alien company, association or exchange

․․․․․․․․300.00

(iii)

Filing annual statement or other statement of a domestic, foreign or alien company, association or exchange

․․․․․․․․750.00

(iv)

License fee for a domestic, foreign or alien company, association or exchange or any duplicate license

․․․․․․․․100.00

(v)

License for a rating organization․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․

․․․․․․․․․50.00

(vi)

Examination of a domestic, foreign and alien company․․․․․․․․․․․․․․․․․․․․․

․․․․Expense of

examination

(vii)

Filing and review of merger agreements of domestic, foreign and alien companies

․․․․․․․․400.00

(viii)

Filing and review of conversion plan from mutual company to stock company

․․․․․․2,500.00

(ix)

Filing and review of conversion plan from stock company to mutual company

․․․․․․2,500.00

(x)

Filing and review of proposed exchange of shares of stock․․․․․․․․․․․․․․․․

․․․․․․․․600.00

(xi)

Filing and review of material in connection with a proposed acquisition or offer to acquire capital stock of a domestic insurance company or insurance holding company

․․․․․․2,500.00

(xii)

Filing and review of registration statement by an insurance member of an insurance holding company

․․․․․․․․400.00

(xiii)

For each amendment to such registration statement․․․․․․․․․․․․․․․․․․․․․․․․

․․․․․․․․200.00

(xiv)

Issuance of a certificate of compliance, deposit or surety․․․․․․․․․․․․․․․

․․․․․․․․․20.00

(xv)

Any other certificate issued by the department․․․․․․․․․․․․․․․․․․․․․․․․․․․

․․․․․․․․․20.00

(xvi)

Filing and review of qualifications of an insurer to issue variable annuities

․․․․․․․․400.00

(xvii)

Certification of each copy of any paper filed with department․․․․․․․․․․․․

․․․․․․․․․20.00

plus .20

per page

(xviii)

Copy of any paper filed with department on a per/page basis․․․․․․․․․․․․․․

․․․․․․․․․․ .25

(xix)

Copy of annual statement pages․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․

․․․․․․․․․․2.00

(xx)

Domestic company license application․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․

․․․․․․2,500.00

(xxi)

Foreign/alien license application․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․

․․․․․․2,500.00

(xxii)

Qualification of insurer to issue variable life contracts․․․․․․․․․․․․․․․․

․․․․․․․․400.00

(xxiii)

Return of increase or decrease or stated capital․․․․․․․․․․․․․․․․․․․․․․․․․

․․․․․․․․200.00

(xxiv)

Reinsurance and assumption agreement․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․

․․․․․․․․300.00

(xxv)

Request to pay extraordinary dividends․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․

․․․․․․․․200.00

(xxvi)

Surplus line binding authority agreement․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․

․․․․․․․․200.00

(xxvii)

Duplicate of agency or broker record․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․

․․․․․․․․․20.00

(2)

Agents and brokers:

(i)

Each listing for written examination of applicants for licenses as agents, brokers, public adjusters or public adjuster solicitors

․․․․․․․․․10.00

(ii)

For license of an applicant qualified through prior examination․․․․․․․․․․․․

․․․․․․․․․․5.00

(iii)

For agent's license․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․

․․․․․․․․․10.00

(iv)

For annual renewal of agent's license or for a replacement or duplicate of such license

․․․․․․․․․10.00

(v)

For each additional variable annuity power in an agent's license on a per annuity basis

․․․․․․․․․․5.00

(vi)

Individual insurance broker license․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․

․․․․․․․․․20.00

(vii)

Insurance broker license in the name of a corporation or copartnership․․․․․

․․․․․․․․․25.00

(viii)

For each broker's license issued in the name of qualified individual active members or officers of a copartnership or corporation on a per license basis

․․․․․․․․․25.00

(ix)

For certification of an agent or broker license․․․․․․․․․․․․․․․․․․․․․․․․․․․․

․․․․․․․․․10.00

(x)

Surplus line agent:

(A)

Initial license․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․

․․․․․․․․100.00

(B)

Annual renewal․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․

․․․․․․․․100.00

(C)

Annual certificate of eligibility․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․

․․․․․․․․․10.00

(D)

Examination fee․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․

․․․․․․․․․10.00

(3)

Fraternal benefit societies:

(i)

Filing copy of charter of a domestic, foreign or alien society, in addition to any fee for filing such charter with the Department of State

․․․․․․․․․70.00

(ii)

The filing of an annual or other statement․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․

․․․․․․․․750.00

(iii)

License to society or certified copy or duplicate thereof․․․․․․․․․․․․․․․․․

․․․․․․․․․80.00

(iv)

Each listing for written examination of an applicant for license as an agent

․․․․․․․․․10.00

(v)

Each applicant for such licenses for which an examination is not required․

․․․․․․․․․․5.00

(vi)

Agent's license for each domestic or foreign society, for life or accident and health lines, or any combination thereof, regardless of the number of powers, excepting variable annuities for which licensed

․․․․․․․․․10.00

(vii)

Copy of any paper filed in the department․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․

․․․․․․․․․10.00

per page․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․

․․․․․․․․․․․.25

(viii)

Any certificate required․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․

․․․․․․․․․10.00

(ix)

Making examinations․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․

․․․․Expense of

examination

(x)

Filing and reviewing agreements of merger of domestic, foreign and alien societies

․․․․․․․․400.00

(xi)

Filing and review of a plan of conversion from a fraternal benefit society to a mutual company and for filing each amendment to registration statement

․․․․․․․․400.00

(xii)

For issuing a certificate of compliance, deposit or surety or any other certificate required to be issued by the department

․․․․․․․․․20.00

(xiii)

Filing and review of qualification of a society to issue variable annuities

․․․․․․․․400.00

(xiv)

Certificate of an agent's license or for duplicate or replacement licenses

․․․․․․․․․10.00

(xv)

Any other certificate issued by the division of agents․․․․․․․․․․․․․․․․․․․․

․․․․․․․․․10.00

(xvi)

Each renewal of license as an individual agent․․․․․․․․․․․․․․․․․․․․․․․․․․․․

․․․․․․․․․10.00

(xvii)

Each additional variable annuity power in such license․․․․․․․․․․․․․․․․․․․․

․․․․․․․․․․5.00

(4)

License and annual renewal for manager or exclusive general agent for domestic insurance company

․․․․․․․․400.00

(5)

Motor vehicle physical damage appraiser:

(i)

Initial license․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․

․․․․․․․․․55.00

(ii)

Annual renewal․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․

․․․․․․․․․55.00

(6)

Professional bondsman license:

(i)

Initial license․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․

․․․․․․․․100.00

(ii)

Annual renewal․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․

․․․․․․․․100.00

(7)

Public adjustors and solicitors for companies

(i)

Public adjustor:

(A)

Initial license․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․

․․․․․․․․100.00

(B)

Annual renewal․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․

․․․․․․․․100.00

(ii)

Public adjustor solicitor:

(A)

Initial license․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․

․․․․․․․․․50.00

(B)

Annual renewal․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․

․․․․․․․․․50.00

(8)

Workmen's Compensation Security Fund assessment:

(i)

Stock company, mutual carrier and reciprocal exchange․․․․․․․․․․․․․․․․․․․․․․․․

․․1% of annual

net written

premiums

(9)

Annual company appointment fee as defined and regulated by section 671-A act of May 17, 1921 (P.L. 789, No. 285),¹ known as “The Insurance Department Act of 1921”

․․․․․․․․․․․․․․․15.00

(10)

Insurance producer license fees:

(i)

Amended license․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․

․․․․․․․․․․․․․․․25.00

(ii)

Certified license history․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․

․․․․․․․․․․․․․․․25.00

(iii)

Duplicate license․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․․

․․․․․․․․․․․․․․․25.00