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Medicare supplement refund calculation data call index page

Reporting period - January 1, 2017, to December 31, 2017.

Report due date - May 31, 2018

This page contains the following sections:

Background information

As specified by 28 TAC §3.3307(f), issuers are required to submit refund calculation forms for all Medicare supplement policies to TDI annually. An issuer must submit a report even if they did not have any Medicare supplement business written or policies or certificates in force in Texas during the reporting year.



Technical Instructions (PDF)

Insurers required to file the Medicare Supplement Refund Calculation Form must complete the data call using the interactive PDF Refund Calculation Form. The reporting form contains fillable fields that must be completed electronically using Adobe Reader 9.0 or higher. TDI recommends downloading the form before entering any data. Insurers attempting to complete the form while it's open in an internet browser may have problems. The reporting form includes required fields (outlined in red) that insurers must complete before submitting the form. In addition, when insurers attempt to submit the reporting form, warning messages may appear concerning data inconsistencies. In an effort to reduce the number of reports with data errors, TDI asks insurers to review each warning message and make revisions as necessary to ensure the data is accurate.

Reporting form

Refund Calculation Form (PDF)


Additional resources

Medicare Supplement Data Call FAQs (PDF)

For more information, contact:

Last updated: 6/8/2018