Companies Filing Health Annual Statement Blank
NAIC OPTins
Annual renewal fees and premium taxes are required to be filed electronically via the NAIC OPTins system in accordance with Bulletin 264. OPTins helps facilitate the processing of quarterly estimated tax, annual premium tax and annual renewal fee filings. Utilizing OPTins allows a company to schedule submission of filings prior to or on the due date. A company will need to allow at least 6-8 weeks for setting up an account in the OPTins system. To obtain detailed information and setting up an account visit NAIC OPTins
State Required Forms
- Analysis of Operations by Line of Business
- Annual Company Profile Questionnaire
- Annual Minimum Net Worth Calculation Form HMO and LSHMO
- Basket Clause Form (Paragraphs 19 & 20) (Domestic Only)
- Certificate of Advertising Compliance
- Corporate Governance Template
- Cybersecurity Annual Certification of Compliance
- Grievance Procedures & Appeals Reporting Form
- Foreign Investments and Other Structured Securities [IC 27-1-12-2(b)(17A), (17B) & (30A)]
- Foreign Investments and Mortgage Backed Securities Report [IC 27-1-13-3(c)(9), (17) & (19)
- Health Care Exhibit Supplement Waiver Instructions and Form
- Quarterly Minimum Net Worth Calculation Form HMO and LSHMO
- Statement of Condition-Form to complete is based on company type not type of annual statement blank filing
- Statement of Condition (Life Companies)
- Statement of Condition (Non-Life Companies)
- Supplemental Report #2 - Point of Service
- Year-End Deposit Requirements Instructions & Forms