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CAUTION:
This tax return must
be filed electronically.
Paper versions of this return
will not be accepted.
If you have questions about filing electronically,
contact us at 617-887-6367.
See https://www.mass.gov/info-details/dor-e-filing-and-payment-
requirements for further information about our electronic filing and
payment requirements.
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Massachusetts Department of Revenue
Form 63-20P
Premium Excise Return for Life Insurance Companies 2020
For calendar year 2020.
Name of company Federal Identification number State of incorporation
Mailing address
City/Town State Zip Phone number
Name of treasurer
Fill in if:
Amended return (see “Amended Return” in instructions) Federal amendment Federal audit
Enclosing Schedule TDS Final return Initial return Name change Address change
Fill in if federal government has changed your taxable income for any prior year which has not yet been reported to Massachusetts
Excise calculation
Domestic life insurers. Enclose a copy of Schedule T of NAIC annual statement.
11 Taxable life premiums (from Part 1, line 10). . . . . . . . . . . . . . . . . . . . . . . . . . . .02= × 00 1
12 Net value of policies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .0025 = × 2
13 Applicable measure (from line 1 or line 2). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3. . . .
14 Taxable accident and health premiums (from Part 1, line 11). . . . . . . . . . . . . . .02= × 00 4
15 Credit recapture (enclose CreditE-FileRecapture Schedule). .Only. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5. . . .
16 Excise due before credits. Add lines 3 through 5. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6. . . .
Foreign life insurers. Enclose a copy of Schedule T of NAIC annual statement.
17 Taxable life premiums (from Part 2, line 7). . . . . . . . . . . . . . . . . . . . . . . . . . . . .02= × 00 7
18 Retaliatory computation (from Part 3, col. a). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8. . . .
19 Applicable measure (enter the larger of lines 7 or 8). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9. . . .
10 Taxable accident and health premiums (from Part 2, line 12). . . . . . . . . . . . . .02= × 0010
11 Retaliatory computation (from Part 3, col. b). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11.
12 Applicable measure (enter the larger of lines 10 or 11). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12. .
13 Credit recapture (enclose Credit Recapture Schedule). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13. .
14 Excise due before credits. Add lines 9, 12 and 13. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14. .
Paper returns will not be accepted.
Declaration
Under penalties of perjury, I declare that to the best of my knowledge and belief, this return and enclosures are true, correct and complete.
Signature of appropriate corporate officer (see instructions)Date Social Security numberPhone number
Signature of paid preparer Date Employer Identification numberAddress
If you are signing as an authorized delegate of the appropriateSeecorporate officer,TIRfill in oval 16-9 for more information.and enclose Massachusetts Form M-2848, Power of
Attorney. The Privacy Act Notice is available upon request. Mail to Massachusetts Department of Revenue, PO Box 7052, Boston, MA 02204.
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2020 FORM 63-20P, PAGE 2
Name of company Federal Identification number State of incorporation
Excise calculation (cont’d.)
Credits. Do not claim any credit here if claimed on Form 63-23P.
15 Enter 1.5% of company’s capital contribution in excess of the full proportionate share in the Massachusetts life
insurance company community investment initiative. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15. .
16 Enter 1.5% of proportionate share of cost of equity securities and outstanding principal balance of debt securities
constituting of qualified investments of Massachusetts Capital Resource Company (enclose computation). . . . . . . . .16.
17 Enter 10% of Massachusetts Life and Health Insurance Guaranty Association assessment paid in the prior years
(see instructions). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17. .
18 Other credits (from Credit Manager Schedule). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18. .
19 Total credits. Add lines 15 through 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19. .
Excise after credits
20 Excise due before voluntary contribution. Subtract line 19 from line 6 or line 14, whichever applies. Not less than 0. .20.
21 Voluntary contribution for endangered wildlife conservation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21.
22 Total excise plus voluntary contribution. Add lines 20 and 21. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22. .
Payments
23 2019 overpayment applied to 2020 estimated tax. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23. .
24 2020 Massachusetts estimated tax payments (do not include amount from line 23). . . . . . . . . . . . . . . . . . . . . . . . . . .24.
25 Payments made with extension.E-File. . . . . . . . . . . . . . . . . . . . .Only. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25. .
26 Payment with original return. Use only if amending return. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26. .
27 Pass-through entity withholding. . . . . . . . . . . . . . . . . . . . . Payer Identification number3 27
28 Refundable credits (from Credit Manager Schedule). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28. .
29 Total payments. Add lines 23 through 28. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29. .
Refund or balance due
30 Amount overpaid. If line 29 is greater than line 22, subtract line 22 from line 29. Otherwise, go to line 33. . . . . . . . . . . 30
31 Amount overpaid to be credited to 2021 estimated tax. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31.
32 Amount overpaid to be refunded. Subtract line 31 from line 30. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32. .
33 Balance due. Subtract line 29 from line 22. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33. .
34a M-2220 penalty. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34a. .
34b Other penalties. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34b. .
34 Total penalty. AddPaperlines 34a and 34b. . . . . . . . . .returns. . . . . . . . . . . . . . . . . . . . . . . . . . .will. . . . . . . . . . . . . .not. . . . . . . . . . . .34.be. . accepted.
35 Interest on unpaid balance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35. .
36 Total payment due at time of filing. Add lines 33, 34 and 35. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36. .
See TIR 16-9 for more information.
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2020 FORM 63-20P, PAGE 3
Name of company Federal Identification number State of incorporation
3 3
Part 1. Domestic life premium excise calculation
— Life insurance — — Accident and health insurance —
b. d.
Jurisdictions where Jurisdictions where
a. no insurance c. no insurance
Massachusetts excise paid Massachusetts excise paid
11 All new and renewal (direct) premiums
for Massachusetts residents. . . . . . . . .31
12 Dividends applied to:
Purchasea paid-up additions. . . . . . 32a
Shortenb premium paying period. . . 32b
13 Total add lines 1 through 2b. . . . . . . .3. . .
Deductions. Include only what has been returned as receipts on this return or on a previous return.
14 Returned premiums but not including
cash surrender values (enclose
schedule). . . . . . . . . . . . . . . . . . . . . . . .34
15 Premiums for company employees’
group life and accident and health
plans if included in line 1*. . . . . . . . . . .35
16 Gross premiums for authorized pre-
ferred provider arrangements.E-File. . . . . . .36 Only.
17 Dividends:
Paida in cash. . . . . . . . . . . . . . . . . . 37a
Appliedb in reduction of renewal
premiums. . . . . . . . . . . . . . . . . . . . 37b
Leftc to accumulate at interest. . . . . 37c
Appliedd to purchase paid-up
additions. . . . . . . . . . . . . . . . . . . . .37d
Appliede to shorten premium paying
period. . . . . . . . . . . . . . . . . . . . . . .37e
18 Total deductions. Add lines 4 through
7e. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
19 Amount taxable. Subtract line 8 from
line 3. . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
10 Total life amount taxable. Add line 9, columns a and b. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10. .
Paper returns will not be accepted.
11 Total accident and health amount taxable. Add line 9, columns c and d. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11. .
*Premiums under the company employees’ group plans for annuity consideration and retirement benefits shall not be deducted.
See TIR 16-9 for more information.
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2020 FORM 63-20P, PAGE 4
Name of company Federal Identification number State of incorporation
3 3
Part 2. Foreign life premium excise calculation
Life premiums
11 All new and renewal direct premiums for all policies of life insurance allocable to Massachusetts. . . . . . . . . . . . . .3.1. .
12 Dividends applied to:
Purchasea paid-up additions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32a
Shortenb premium paying period. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32b
13 Total gross direct premiums. Add lines 1, 2a and 2b. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3.3. . .
14 Returned premiums but not including cash surrender values. Enclose itemized supporting schedule. . . . . . . . . . .3. .4.
15 Dividends:
Paida in cash. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35a
Appliedb in reduction of renewal premiums. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35b
Leftc to accumulate at interest. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35c
Appliedd to purchase paid-up additions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35d
Appliede to shorten premium paying period. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35e
16 Total deductions. Add lines 4 through 5e. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3.6. . .
17 Taxable premiums. Subtract line 6 from line 3. Enter result on page 1, line 7. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3.7. .
E-File Only.
Accident and health premiums
18 Total net direct premiums for insurance of property or interests in Massachusetts. . . . . . . . . . . . . . . . . . . . . . . . . .3.8. . .
19 Dividend deduction. Premiums returned or credited to policyholders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3. .9. .
10 Premium deduction. Gross premiums for authorized Preferred Provider arrangements. . . . . . . . . . . . . . . . . . . . . . .3.10
11 Total deductions. Add lines 9 and 10. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3.11.
12 Taxable amount. Subtract line 11 from line 8. Enter result on page 1, line 10. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3.12
13 Fill in if net direct premiums are reported in line 8
14 Fill in ifall dividends claimed as a deduction in line 9 have been included as taxable premiums in line 10 on this return or on a previous Massachusetts
return
Paper returns will not be accepted.
See TIR 16-9 for more information.
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2020 FORM 63-20P, PAGE 5
Name of company Federal Identification number State of incorporation
3 3
Part 3. Computation of retaliatory tax
Use the space below to calculate your excise using the identical method and the same rate used by the state in which you are incorporated in taxing a
like Massachusetts insurance company, or its agents, if doing business to the same extent. If the computation in the state of your incorporation is in every
respect the same as your Massachusetts computation, a statement to that effect should be made.
a. Life computation
E-File Only.
b. Accident and health computation
Paper returns will not be accepted.
See TIR 16-9 for more information.
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