Forms
Premium Tax Forms
Domestic Insurers are required to file the following documents by applicable dates:
- Annual Financial Statement - March 1
- Annual Audit and Examination Fee - March 1
- Annual Fraud Unit Assessment Fee - June 1
- 3 Quarterly Financial Statements - May 15, August 15, and November 15
- Management Discussion and Analysis - April 1
- Audited Financial Statements (CPA Report) - June 1
- Form A (including a $2000 fee)
- Form A Amendment (including a $1000 fee)
- Form A Exemption (including a $1000 fee)
- Form B (including a $500 fee) - June 1
- Form B Exemption (including a $100 fee) - June 1
- Form C (including a $500 fee) - June 1
- Form D (including a $500 fee)
Foreign Insurers are NO LONGER required to file Quarterly Financial statements or
pay the Quarterly Audit and Examination Fee of $100.
Service Contract Provider Forms
All Sections listed on the following pages have instructions. Please download
these instructions along with the required form.
- As standard printed forms, these would be "front and back".
- As PDF Downloads - please make sure you print all of the pages of the form.
Long-Term Care Form
Accredited/Certified Reinsurers Forms
Miscellaneous Forms