(a) Each authorized risk retention group shall, on or before March 1 of each year, file with the commissioner on forms prescribed by the commissioner a statement for the preceding calendar year showing all premiums paid to the risk retention group for risks insured within this state.

(b) Coincident with the filing of the report, each authorized risk retention group shall submit to the Treasurer of State through the commissioner, as a tax imposed for the privilege of transacting business as a risk retention group within this state, a tax of four percent (4%) on all premiums paid for coverages within this state to the risk retention group within the preceding calendar year as shown by the annual statement filed with the commissioner.

(c) Agents or brokers shall report in an annual statement and pay the four percent (4%) tax on or before March 1 of each year for the premiums for risks which they have placed within the preceding calendar year with or on behalf of a risk retention group not authorized to do business in this state by a subsisting certificate of registration issued by the commissioner.

(d) Any risk retention group, agent, or broker who fails to file the annual statement or fails to remit the tax as provided by law on March 1 when the tax is due shall be liable for a fine of one hundred dollars ($100) for each day of delinquency commencing with March 1. However, for good cause shown, the commissioner, after a written request, may grant a reasonable extension of time within which the statement may be filed and the tax paid. The tax may be collected by distraint, or the tax and fine may be covered by an action instituted by the commissioner in any court of competent jurisdiction. The commissioner shall pay to the Treasurer of State any fine so collected.