G Original Signatures: Original Signatures required on all filings from domestic companies. . during 2022, to this Department in the same manner as noted above. If the due date falls on a weekend or holiday, then the postmark deadline is extended to the . We use the NAIC filing date or the USPS postmark or courier pick-up date as the date filed. 1 Annual Statement (8 ½" x 14") 0 EO xxx 3/1 NAIC F, G 1.1 Printed Investment Schedule detail (Pages E01-E29) 0 EO xxx 3/1 NAIC 2 Quarterly Financial Statement (8 ½" x 14") The State of Ohio does not require annual filings or Annual Statements as long as the filings required by the National Association of Insurance Commissioners (NAIC) are filed with the NAIC by their due dates. Annual Statement Filing Requirements. The Combined Statement filing fee is due May 1, 2022. . I. NAIC FINANCIAL STATEMENTS 1 Annual Statement (8 ½"x14") 1 EO xxx 3/1 NAIC Note G, H & L 1.1 Printed Investment Schedule detail (Pages E01-E29) 1 EO xxx 3/1 NAIC 2 Quarterly Financial Statement (8 ½" x 14") 1 EO xxx 5/15, 8/15, 11/15 NAIC 3 Separate Accounts Annual Statement (8 ½"x14") 1 EO xxx 3/1 NAIC II. DUE DATE (6) APPLICABLE : Domestic. you may complete the NAIC Annual Statement page entitled "Supplemental Exhibits and Schedules Interrogatories" INSTEAD OF filing reports marked "None". DUE DATE (6) FORM SOURCE** (7) APPLICABLE Domestic Foreign NOTES State NAIC State I. NAIC FINANCIAL STATEMENTS 1 Annual Statement (8 ½"X14") KY EO** EO KY EO* 3/1** NAIC *Jurat page for Foreign only **See Letter E and F 1.1 Printed Investment Schedule detail (Pages E01-E29) KY EO EO 0 3/1* NAIC *See Letter E 2 Quarterly Financial Statement . Up to $25.00 per day -Annual Statement, Annual Fees, Actuarial Opinion, Management Discussion and Analysis or Audited Financial Report. 1, 2022 Annual Statement Filing (Property, Life, Health, Title) Merger/history form, if applicable (Property, Life, Health, Title) (electronic txt file only) Bail Bond Supplement (Property) 1 Annual Statement (8 ½" x 14") EO EO N/A 3/1 NAIC A, E 1.1 Printed Investment Schedule detail (Pages E01-E29) EO EO xxx 3/1 NAIC E 2 Quarterly Financial Statement (8 ½" x 14") EO EO N/A 5/15, 8/15, 11/15 NAIC E 3 Protected Cell Annual Statement EO 0 xxx 3/1 NAIC E Annual Statement: Per IC 27-1-20-21.2, a $500 late fee may be assessed if the Annual Statement is not received in our office on or before the indicated due date. ** For those states that have adopted the NAIC Corporate Governance Annual Disclosure Model Act, an annual . NAIC Annual Statement Instructions. Cancellation refund checks will be processed after August 22, 2022. DUE DATE (6) FORM SOURCE** (7) APPLICABLE Domestic Foreign NOTES State NAIC State I. NAIC FINANCIAL STATEMENTS 1 Annual Statement (8 ½" x 14") KY EO EO KY EO* 3/1** NAIC *Jurat page for Foreign only **See Letter E and F 1.1 Printed Investment Schedule detail (Pages E01-E29) KY EO EO 0 3/1* NAIC *See Letter E Due January 15, 2022. The National Association of Insurance Commissioners (NAIC) held its 2022 Spring National Meeting from March 4 to 8 in Kansas City, Missouri. . 2021 Year-end and 2022 Quarterly Filings Page 3 of 5 The request for an exemption or extension must be submitted in writing not less than ten days prior to the due date in sufficient detail to permit the Director to make an informed . Domestic. filing due date. The Corporate Governance Annual Disclosure is a state filing only and should not be submitted by the company to the NAIC. DUE DATE (6) FORM SOURCE** (7) APPLICABLE Foreign NOTES State NAIC State I. NAIC FINANCIAL STATEMENTS 1 Annual Statement (8 ½" x 14") 1 EO xxx 3/1 NAIC Note G, H & L 1.1 Printed Investment Schedule detail (Pages E01-E29) 1 EO xxx 3/1 NAIC 2 Quarterly Financial Statement (8 ½" x 14") 1 EO xxx 5/15, 8/15, 11/15 110 Annual Statement Filing Fee The Company Licensing Bureau will process the 2022 Annual Statement File Fee. Michigan has adopted the NAIC Corporate Governance Annual Disclosure Model Act . 1.1 Printed Investment Schedule detail (Pages E01-E29) 0 EO xxx 3/1 NAIC 2 Quarterly Financial Statement (8 ½" x 14") 0 EO xxx 5/16, 8/15 , 11/15 NAIC 3 Protected Cell Annual Statement 0 0 xxx 3/1 NAIC 4 Combined Annual Statement (8 ½" x 14") 0 EO xxx 5/2 NAIC Since the NAIC's electronic . If your company writes business in Puerto Rico for any of the MCAS lines of business, you . Filings Made During the Year 2022 (1) Check- List (2) Line # (3) REQUIRED FILING FOR THE ABOVE STATE (4) NUMBER OF COPIES* (5) DUE DATE (6) FORM SOURCE** (7) APPLICABLE NOTES; Domestic Foreign; . ***For those states that have adopted the NAIC Corporate Governance Annual Disclosure . 2021-08 Foreign companies should follow the instructions in the NAIC's Annual . I. NAIC FINANCIAL STATEMENTS . 3/1 PPD, Foreign CI, DI, LD, PC 3/31 HCSO, HMDO : 3/31 Domestic CI, DI, LD, PC . These are available in PDF format unless otherwise specified. Members of the North Carolina Insurance . For 2022, North Dakota is . Mar. This Sidley Update summarizes the highlights from this . Up to $100.00 per day - Quarterly Statements. DUE DATE (6) FORM SOURCE** (7) APPLICABLE . DUE DATE (6) FORM SOURCE** (7) APPLICABLE Domestic Foreign NOTES State NAIC State I. NAIC FINANCIAL STATEMENTS 1 Annual Statement (8 ½" x 14") 1 EO xxx 3/1 NAIC G, H 1.1 Printed Investment Schedule detail (Pages E01-E29) 1 EO xxx 3/1 NAIC 2 Quarterly Financial Statement (8 ½" x 14") 1 EO xxx 5/15, 8/15, 11/15 NAIC Puerto Rico will begin collecting MCAS filings beginning with the 2022 data to be reported on the filing due dates in 2023. DUE DATE (6) FORM SOURCE** (7) APPLICABLE Domestic Foreign NOTES State NAIC State I. NAIC FINANCIAL STATEMENTS 1 Annual Statement (8 ½" x 14") 2 EO 0 3/1 NAIC 1.1 Printed Investment Schedule detail (Pages E01-E29) 2 EO xxx 3/1 NAIC 2 Quarterly Financial Statement (8 ½" x 14") 2 EO 0 5/15, 8/15, 11/15 NAIC DUE DATE (6) FORM SOURCE** (7) APPLICABLE Domestic Foreign NOTES State NAIC State I. NAIC FINANCIAL STATEMENTS 1 Annual Statement (8 ½"X14") 1 EO xxx 3/1 NAIC 1.1 Printed Investment Schedule detail (Pages E01-E29) 1 EO xxx 3/1 NAIC 2 Quarterly Financial Statement (8 ½" x 14") 1 EO xxx 5/15, 8/15, 11/15 NAIC II. The department will invoice approved surplus lines insurers for the $1,000 annual fee. Filing Date 2022-02-24 Filing Number 6291430 Filing Type Annual Report (Due: 4/15/2022) Last updated March 15 2022, 3.43PM (4 months ago) EO : xxx . Foreign. K Bar Codes (State or NAIC): Bar codes are not required by Missouri. The Pet Insurance Model Act, which provides a comprehensive legal framework in which pet . The NAIC is using a streamlined formulaic approach for the calculation of the 2021 annual financial filing . 1.2 Printed Investment Schedule detail (Pages E01-E29) AFF EO xxx 3/1 NAIC M,W 2 Quarterly Financial Statement (8 ½" x 14") AFF EO 0 5/15, 8/15, 11/15 NAIC M,W 3 Protected Cell Annual Statement 1 0 xxx 3/1 NAIC R 4 Combined Annual Statement (8 ½" x 14") AFF EO 0 5/1 NAIC M,W II. Domestic companies should apply at least 30 days prior to the due date and, for extensions, must submit a written request explaining the reason for the delay and detailed "time-line" of any expected component completion dates and contingencies. NAIC SUPPLEMENTS ©2021 National Association of Insurance Commissioners 1 Life . Statements are due 45 days subsequent to the end of each quarter: Quarter Ending Due Date March 31, 2022 May 15, 2022 June 30, 2022 August 15, 2022 Electronic filings, in the form of a zip file in accordance with the NAIC Filing Instructions, should be sent to annstat@aib.org as an email attachment. F Late Filings: Companies will be fined $100 per day for a late filing. ***** Effective July 1, 2017, North Carolina adopted the NAIC updated Risk Management and Own Risk and Solvency Assessment Model Act, a summary report is required annually by insurers and insurance groups above a specified premium threshold. ©2020 National Association of Insurance Commissioners 5 Health . A summary of all changes can be found in the Summary of 2022 Changes document. Annual Statement (8 ½"x14") xxx . and filing fees. supplements due March 1, per the Annual Statement Instructions. DUE DATE (6) FORM SOURCE ** (7) APPLICABLE NOTES Domestic Foreign State NAIC State I. NAIC FINANCIAL STATEMENTS 1 Annual Statement (8 1/2" X 14") 1 EO XXX 3/1 NAIC 1.1 Investment Schedule detail (pages E01-E29) 1 EO XXX 3/1 NAIC 2 Quarterly Financial Statement (8 1/2" X 14") 1 EO XXX 5/15, 8/15, 11/15 NAIC K Bar Codes (State or NAIC): Follow the instructions in the NAIC . Please follow the NAIC Annual Statement Instructions for NAIC bar codes. HCS & HMO - §354.435 Prepaid Dental - §354.720 B. Foreign companies: follow NAIC Annual Statement Instructions. . If your company is granted a waiver or extension, please provide that documentation to FDRadmin@naic.org . The first annual PA CGAD filing due date was June 1, 2020. ***For those states that have adopted the NAIC Corporate Governance Annual Disclosure Model Act, an annual disclosure is required of all insurers or insurance groups by June 1. for Nevada required filings - supply a written copy of any exemption or extension received from your state of domicile at least 10 days prior to the filing due date. Financial Statement Filing. Invoices will be available January 2022, on the Examinations Bureau webpage and the Company Licensing Bureau webpage, which can be found at 2021-22 Annual Statements and New York Supplement Filing Instructions & Forms. LIFE, ACCIDENT AND HEALTH/FRATERNAL INSURERS . Annual Statement Instructions. Signed Jurat pages are not required for foreign insurers. State NAIC State ; I. NAIC FINANCIAL STATEMENTS ; 1 Annual Statement (8 ½"x1 4") EO EO xx x 3/ 1 NAIC A-K, M 1.1 Printed Investment Schedule detail (Pages E01-E29) @ EO EO xxx 3/1 NAIC A-K, M . . Filings Made During the Year 2022: FRATERNAL COMPANIES BEGIN FILING LIFE/FRATERNAL STATEMENT EFFECTIVE WITH FIRST QUARTER, 2019 . The Annual Statement filing fee is due March 1, 2022. NAIC SUPPLEMENTS Although the meeting was held in a hybrid in-person and . . 61 Annual Statement Electronic Filing xxx EO xxx 3/1 NAIC E . Foreign NOTES . 2021 Combined Annual Statement - due May 2, 2022 . The National Association of Insurance Commissioners (NAIC) held its 2022 Spring National Meeting from March 4 to 8 in Kansas City, Missouri. Created Date: 02/14/2022 07:43:00 Title: LIFE, ACCIDENT AND HEALTH INSURERS Last modified by: Diep, Christine Company: later than the indicated due date. Forms & Endorsements. DUE DATE (6) FORM SOURCE ** (7) APPLICABLE ; Foreign NOTES. Annual Statement Instructions . The interest penalty for late filing is 1% of the payment due for each month or part of a month. DUE DATE (6) FORM SOURCE** (7) APPLICABLE . Foreign NOTES ; State NAIC State ; I. NAIC FINANCIAL STATEMENTS ; 1 Annual Statement (8 ½" x 14") 2 EO xxx 3/1 A-R,T-V,X,Y,Z 1.1 Printed Investment Schedule detail (E01-E25) 2 EO xxx 3/1 O . This waiver could include supplemental annual statement filings. DUE DATE (6) FORM SOURCE* * (7) APPLICABLE Domestic ForeigNOTES n State NAIC State I. NAIC FINANCIAL STATEMENTS 1 Annual Statement (8 ½" x 14") 1 EO xxx 3/1 NAIC 1.1 Printed Investment Schedule detail (Pages E01-E29) 1 EO xxx 3/1 NAIC 2 Quarterly Financial Statement (8 ½" x 14") 1 EO xxx 5/15, 8/15, 11/15 NAIC II. Premium tax . 1 . Quarterly Financial Statement (8 ½" x 14") 1 . State NAIC State I. NAIC FINANCIAL STATEMENTS 1 Annual Statement (8 ½"x14") 1 EO xxx 3/1 NAIC 1.1 Printed Investment Schedule detail (Pages E01-E29) 1 EO xxx 3/1 NAIC 2 Quarterly Financial Statement (8 ½" x 14") 1 EO xxx 5/15, 8/15, 11/15 NAIC L Signed Jurat The following statutes govern the individuals who are authorized to sign the Jurat. DUE DATE (6) FORM SOURCE ** (7) APPLICABLE NOTES Domestic Foreign State NAIC State I. NAIC FINANCIAL STATEMENTS 1 Annual Statement (8 1/2" X 14") 1 EO XXX 3/1 NAIC 1.1 Investment Schedule detail (pages E01-E29) 1 EO XXX 3/1 NAIC 2 Quarterly Financial Statement (8 1/2" X 14") 1 EO XXX 5/15, 8/15, 11/15 NAIC . License applications. P & C Annual Statement March 1, 2022 Insurance Expense Exhibit April 4, 2022 Automobile Expense Experience April 21, 2022 Installment Premium Charges May 5, 2022 . DUE DATE (6) FORM SOURCE ** (7) APPLICABLE ; Foreign NOTES. Company's license may be suspended if the annual statement is received more than 30 days late G Original Signatures: DUE DATE (6) FORM SOURCE** (7) APPLICABLE Domestic Foreign NOTES State NAIC State I. NAIC FINANCIAL STATEMENTS 1 Annual Statement (8 ½" x 14") EO EO XXX 3/1 NAIC B(c), G, H(a), I, L, N(a) 1.1 Printed Investment Schedule detail (Pages E01-E29) EO EO XXX 3/1 NAIC B(c), I, N(a) EO : xxx . NE EO 0 EO 3/1 NAIC V 111 Annual Statement Schedule T Page (Page 49-50) EO 0 EO 3/1 NAIC V . 2021-2022 New York Annual Statement and Supplement Filing Blanks. Due Dates . There is no due date for CY 2022. ****For those states that have adopted the NAIC Corporate Governance Annual Disclosure Model Act, an annual disclosure is required of all insurers or insurance groups by June 1. . Column (7) (Applicable Notes) you may complete the NAIC Annual Statement page entitled "Supplemental Exhibits and Schedules Interrogatories" INSTEAD OF filing reports marked .