FRATERNAL SOCIETIES

 

REQUIRED FILINGS IN VIRGINIA                                                                                                Filings Made During the Year 2017

 

NOTICE:  THE FOLLOWING REPRESENTS, IN GENERAL, THE ANNUAL RENEWAL AND RELATED FILINGS  REQUIRED IN VIRGINIA.  EACH LICENSED COMPANY WILL FIND SPECIFIC REQUIRED FILINGS LISTED IN THE ANNUAL LICENSE RENEWAL AND FINANCIAL FILING SUBMISSION PORTAL.

 

(1)

 

Check-list

(2)

 

Line

#

(3)

 

REQUIRED FILINGS FOR THE ABOVE STATE

(4)

NUMBER OF COPIES

(5)

 

DUE DATE

(6)

FORM SOURCE

(7)

 

APPLICABLE

NOTES

Domestic

Foreign

 

 

 

State

NAIC

State

 

 

 

 

 

I.  NAIC FINANCIAL STATEMENTS

 

 

 

 

 

 

 

1

Annual Statement (8½ "x14")

1

EO

N/A

3/1

NAIC

A,B,E,F,G,H,I,J,K,M,O

 

1.1

Printed Investment Schedule detail (Pages E01 - E27)

1

EO

N/A

3/1

NAIC

A,B,E,F,J,K,M,O

 

2

Quarterly Financial Statement (8½ "x14")

1

EO

N/A

5/15, 8/15, 11/15

NAIC

A,B,E,F,G,H,I,J,K,O

 

3

Separate Accounts Annual Statement (8 ½ "x14")

1

EO

N/A

3/1

NAIC

A,B,E,F,G,H,I,J,K,M,O

 

 

II.  NAIC SUPPLEMENTS

 

 

 

 

 

 

 

11

Accident & Health Policy Experience Exhibit

1

EO

N/A

4/1

NAIC

A,B,E,F,J,K,M

 

12

Analysis of Annuity Operations by Lines of Business

1

EO

N/A

4/1

NAIC

A,B,E,F,J,K,M

 

13

Analysis of Increase in Annuity Reserves During Year

1

EO

N/A

4/1

NAIC

A,B,E,F,J,K,M

 

14

Interest Sensitive Life Insurance Products Report

1

EO

N/A

4/1

NAIC

A,B,E,F,J,K,M

 

15

Long-Term Care Experience Reporting Forms

1

EO

N/A

4/1

NAIC

A,B,E,F,J,K,M

 

16

Management Discussion & Analysis

1

EO

N/A

4/1

Company

A,B,E,F,J,K,O

 

17

Medicare Part D Coverage Supplement

1

EO

N/A

3/1, 5/15, 8/15, 11/15

NAIC

A,B,E,F,J, K,M

 

18

Medicare Supplement Insurance Experience Exhibit

1

EO

N/A

3/1

NAIC

A,B,E,F,J,K,M

 

19

Risk-Based Capital Report

1

EO

N/A

3/1

NAIC

A,B,E,F,G,J,K

 

20

Supplemental Compensation Exhibit

1

N/A

N/A

3/1

NAIC

A,B,E,F,J,K

 

21

Supplemental Health Care Exhibit (Parts 1, 2 and 3)

1

EO

N/A

4/1

NAIC

A,B,E,F,J,K,M

 

22

Supplemental Health Care Exhibit's Allocation Report

1

EO

N/A

4/1

NAIC

A,B,E,F,J,K,M

 

23

Supplemental Investment Risks Interrogatories

1

EO

N/A

4/1

NAIC

A,B,E,F,J,K,M

 

24

Supplemental XXX/AXXX Reinsurance Exhibit

1

EO

N/A

4/1

NAIC

A,B,E,F,J,K,M

 

25

Trusteed Surplus Statement

N/A

EO

N/A

3/1, 5/15, 8/15, 11/15

NAIC

A,B,E,F,I,J,K,M,O

 

 

  Actuarial Related Items

 

 

 

 

 

 

 

26

Actuarial Certification Regarding use 2001 Preferred Class Table

1

EO

N/A

3/1

Company

A,B,E,F,I,J,K

 

27

Actuarial Certification Related Annuity Nonforfeiture Ongoing Compliance for Equity Indexed Annuities

1

EO

N/A

3/1

Company

A,B,E,F,J,K,M

 

28

Actuarial Certification Related to Hedging required by Actuarial Guideline XLIII

1

EO

N/A

3/1

Company

A,B,E,F,J,K,M

 

29

Actuarial Certification Related to Reserves required by Actuarial Guideline XLIII

1

EO

N/A

3/1

Company

A,B,E,F,J,K,M

 

30

Actuarial Memorandum Related to Universal Life with Secondary Guarantee Polices required by Actuarial Guideline XXXVIII 8D

1

N/A

N/A

4/30

Company

A,B,E,F,J,K,M

 

31

Actuarial Opinion

1

EO

N/A

3/1

Company

A,B,E,F,G,I,J,K,O

 

32

Actuarial Opinion on Separate Accounts Funding Guaranteed Minimum Benefit

1

EO

N/A

3/1

Company

A,B,E,F,J,K,M

 

33

Actuarial Opinion on Synthetic Guaranteed Investment Contracts

1

EO

N/A

3/1

Company

A,B,E,F,J,K,M

 

34

Actuarial Opinion on X-Factors

1

EO

N/A

3/1

Company

A,B,E,F,J,K,M

 

35

Actuarial Opinion required by Modified Guaranteed Annuity Model Regulation

1

EO

N/A

3/1

Company

A,B,E,F,J,K,M

 

36

Financial Officer Certification Related to Clearly Defined Hedging Strategy required by Actuarial Guideline XLIII

1

EO

N/A

3/1

Company

A,B,E,F,J,K,M

 

37

Management Certification that the Valuation Reflects Management's Intent required by Actuarial Guideline XLIII

1

EO

N/A

3/1

Company

A,B,E,F,J,K,M

 

38

Regulatory Asset Adequacy Issues Summary (RAAIS) required by Actuarial Opinion and Memorandum Regulation (Model 822), Section 7A(5) (No Form)

1

N/A

1

3/15

Company

A,B,E,F,J,O

 

39

Reasonableness & Consistency of Assumptions Certification required by Actuarial Guideline XXXV

N/A

EO

N/A

3/1, 5/15, 8/15, 11/15

Company

A,B,E,F,J,K,M

 

40

Reasonableness of Assumptions Certification required by Actuarial Guideline XXXV

N/A

EO

N/A

3/1, 5/15, 8/15, 11/15

Company

A,B,E,F,J,K,M

 

41

Reasonableness & Consistency of Assumptions Certification Required by Actuarial Guideline XXXVI (Updated Average Market Value)

N/A

EO

N/A

3/1, 5/15, 8/15, 11/15

Company

A,B,E,F,J,K,M

 

42

Reasonableness & Consistency of Assumptions Certification required by Actuarial Guideline XXXVI (Updated Market Value)

N/A

EO

N/A

3/1, 5/15, 8/15, 11/15

Company

A,B,E,F,J,K,M

 

43

Reasonableness of Assumptions Certification for Implied Guaranteed Rate Method required by Actuarial Guideline XXXVI

N/A

EO

N/A

3/1, 5/15, 8/15, 11/15

Company

A,B,E,F,J,K,M

 

44

RBC Certification Required Under C-3 Phase I

1

EO

N/A

3/1

Company

A,B,E,F,J,K

 

45

RBC Certification Required Under C-3 Phase II

1

EO

N/A

3/1

Company

A,B,E,F,J,K

 

46

Statement on non-guaranteed elements - Exhibit 5 Interr. #3

1

EO

N/A

3/1

Company

A,B,E,F,J,K,M

 

47

Statement on participating/non-participating policies - Exhibit 5, Interr. # 1 & 2.

1

EO

N/A

3/1

Company

A,B,E,F,J,K,M

 

 

III  ELECTRONIC FILING REQUIREMENTS

 

 

 

 

 

 

 

61

Annual Statement Electronic Filing

N/A

EO

N/A

3/1

NAIC

 

 

62

March .PDF Filing

N/A

EO

N/A

3/1

NAIC

 

 

63

Risk Based Capital Electronic Filing

N/A

EO

N/A

3/1

NAIC

 

 

64

Risk Cased Capital .PDF Filing

N/A

EO

N/A

3/1

NAIC

 

 

65

Separate Accounts Electronic Filing

N/A

EO

N/A

3/1

NAIC

 

 

66

Separate Accounts .PDF Filing

N./A

EO

N/A

3/1

NAIC

 

 

67

Supplemental Electronic Filing

N/A

EO

N/A

4/1

NAIC

 

 

68

Supplemental .PDF Filing

N/A

EO

N/A

4/1

NAIC

 

 

69

Quarterly Statement Electronic Filing

N/A

EO

N/A

5/15, 8/15, 11/15

NAIC

 

 

70

Quarterly .PDF Filing

N/A

EO

N/A

5/15, 8/15, 11/15

NAIC

 

 

71

June .PDF Filing

N/A

EO

N/A

6/1

NAIC

 

 

 

IV.  AUDIT/INTERNAL CONTROL RELATED REPORTS

 

 

 

 

 

 

 

81

Accountants Letter of Qualifications

1

EO

N/A

6/1 or 6/30

Company

A,B,E,F,J,O

 

82

Audited Financial Reports

1

EO

N/A

6/1 or 6/30

Company

A,B,E,F,J,K,O

 

83

Audited Financial Reports Exemption Affidavit

1

N/A

1

3/1

State

A,B,E,F,J,O

 

84

Communication of Internal Control Related Matters Noted in Audit

1

EO

N/A

within 60 days after filing the annual Audited Financial Report

Company

A,B,E,F,J,K,M,N,O

 

85

Independent CPA (Change)

1

N/A

1

Within 5 business days of change

Company

A,B,E,F,J,O

 

86

Management's Report of Internal Control Over Financial Reporting

1

N/A

N/A

within 60 days after filing the annual Audited Financial Report

Company

A,B,E,F,J,K,M,O

 

87

Notification of Adverse Financial Condition

1

N/A

1

Within 5 business days of receipt

Company

A,B,E,F,O

 

88

Relief from the five-year rotation requirement for lead audit partner

1

EO

1

3/1

Company

A,B,E,J,O

 

89

Relief from the one-year cooling off period for independent CPA

1

EO

1

3/1

Company

A,B,E,J,O

 

90

Relief from the Requirements for Audit Committees

1

EO

1

3/1

Company

A,B,E,J,O

 

91

Request for Exemption to File Management's Report of Internal Control over Financial Reporting

1

N/A

N/A

Company

A,B,E,F,J,N,O

 

 

V.  STATE REQUIRED FILINGS

 

 

 

 

 

 

 

101

Certificate of Compliance

N/A

N/A

1

3/1

Dom.

State

A,B,E,F,J,O

102

Certificate of Deposit

N/A

N/A

N/A

3/1

Dom. State

A,B,E,F,J,O

 

103

Certificate of Valuation

N/A

N/A

1

3/1

Dom. State

A,B,E,J,O

 

104

Filings Checklist (with column 1 completed)

N/A

N/A

N/A

State

 

 

105

Form B Insurance Holding Company System Annual Reg. Stmt.

1

N/A

N/A

4/30

Company

A,B,E,F,J

 

106

Form F Enterprise Risk Report

1

N/A

N/A

4/30

Company

A,B,E,F,J,Q

 

107

ORSA

1

N/A

N/A

12/1

Company

A,B,E,F,J,N,R

 

108

Premium tax/Assessment filings:

SEPARATE FILINGS - DIFFERENT ADDRESSES

1

N/A

1

State

See Note D

XXXX

109

State Filing Fees

N/A

N/A

N/A

 

 

 

XXXX

110

Signed Jurat

N/A

N/A

N/A

 

 

L

 

111

Analysis of Excess Capital and Surplus Investments Report

1

N/A

N/A

3/1, 5/15, 8/15, 11/15

State

A,B,E,F,J

 

112

Application for Renewal of License (R2B)

1

N/A

1

3/1

State

A,B,E,F,J,O,P

 

113

Managed Care Health Insurance Plan ("MCHIP") Description of Virginia Operations

1

N/A

1

3/1

Company

A,B,E,F,J,O

 

114

Managed Care Health Insurance Plan ("MCHIP") List of Providers

1

N/A

1

3/1

Company

A,B,E,F,J,O

 

115

Report of Assets Pledged, Hypothecated or Encumbered

1

N/A

N/A

3/1

State

A,B,E,F,J

 

116

Request for Information Regarding RIs

1

N/A

N/A

3/1

State

A,B,E,F,J

 


 

 

 

 

NOTES AND INSTRUCTIONS (A-K APPLY TO ALL FILINGS)

 

 

A

Required Filings Contact:

 

BOIFINFILING@SCC.VIRGINIA.GOV


 

B

Annual Renewal and Related Filings Mailing Address:

State Corporation Commission

Bureau of Insurance

Financial Regulation Division

P.O. Box 1157

Richmond, VA  23218



 

We have a portal which allows the electronic submission of many of these required documents at Annual License Renewal and Financial Filing Submission Portal. Insurers must go to the portal and log in to submit documents electronically.

 

Annual Renewal and Related Filings Courier Delivery:

State Corporation Commission

Bureau of Insurance, Financial Regulation Division

1st Floor Mailroom

1300 East Main Street

Richmond, VA  23219

 

C

Mailing Address for Filing Fees:

N/A

 

D

Information for Premium Tax/Assessment Filings:

 

PREMIUM LICENSE TAX FORMS and ASSESSMENT FORMS should NOT be submitted with the Annual Statement and its related filings.

 

PREMIUM LICENSE TAX FORMS and ASSESSMENT FORMS are two separate filings per the information below.

 

The PREMIUM LICENSE TAX FORMS must be obtained from

www.tax.virginia.gov/insurance

and be submitted to the Department of Taxation(TAX). Contact TAX for the correct address.

 

ASSESSMENT FORMS and Instructions must be obtained from

www.scc.virginia.gov/boi/co/assess/filing.aspx

and be submitted to the Bureau of Insurance. See Instructions for the correct address.

 

Questions re: PREMIUM LICENSE TAX FILINGS should be directed to the VA Dept of Taxation at 804-404-4163.

 

Questions re: ASSESSMENT FILINGS should be directed to the State Corporation Commission's Administrative Revenue Management Division at 804-371-9333.

 

 

E

Delivery Instructions:

 

All filings must be postmarked no later than the indicated due date.  If the due date falls on a weekend or holiday, then the postmark deadline is extended to the next business day.

 

F

Late Filings:

Late filings are subject to penalties pursuant to § 38.2-218 of the Code of Virginia.

 

G

Original Signatures:

A printer's reproduction of "live" signatures is acceptable.

 

H

Signature/Notarization/Certification:

Statements must be signed by at least two principal officers of the company.

 

I

Amended Filings:

Any signature requirements for the original filing must be followed for amendments.

 

J

Exceptions from normal filings:

 

Exemptions or extensions are not automatically granted to any company.  Requests must be made prior to the filing due date.

 

K

Bar Codes (State or NAIC):

NAIC Annual Statement Instructions should be followed.

 

L

Signed Jurat:

N/A

 

M

NONE Filings:

NAIC Annual Statement Instructions for Supplemental Interrogatories should be followed.

 

N

Filings new, discontinued or modified materially since last year:

 

The COMMUNICATION OF INTERNAL CONTROL RELATED MATTERS NOTED IN AUDIT is required to be filed in accordance with 14VAC5-270-120. The Communication should contain a description of any unremediated material weaknesses (as defined in SAS No. 112 of the AICPA Professional Standards, Communicating Internal Control Related Matters Identified in an Audit) in the insurer's internal control over financial reporting identified by the accountant during the course of the audit of the financial statements as of the immediately preceding December 31 (so as to coincide with the Audited Financial Report discussed in 14VAC5-270-50 A). The insurer should provide a description of remedial actions taken or proposed to correct any unremediated material weaknesses if the actions are not described in the accountant's communication. If no unremediated material weaknesses were identified, the Communication should so state or the Report on Significant Deficiencies in Internal Control stating such should be filed in lieu of this Communication.

 

Requirements for Domestic Insurers, Health Maintenance Organizations and Dental Plan Organizations:

 

The COMMUNICATION OF INTERNAL CONTROL RELATED MATTERS NOTED IN AUDIT should be submitted to the Bureau within 60 days after the filing of the annual Audited Financial Report AND with the NAIC in accordance with the due date established by the NAIC.

 

Requirements for Foreign and Alien Insurers:

 

The COMMUNICATION OF INTERNAL CONTROL RELATED MATTERS NOTED IN AUDIT should be submitted to the NAIC in accordance with the due date established by the NAIC. The Communication is no longer required to be filed with the Bureau.

 

 

 

See lines 84, 91, and 107.

 

The due date for filing the ORSA has changed from 8/1 to 12/1.

 

O

Foreign and Alien Company Filing Requirements:

 

All foreign and alien companies MUST submit eligible documents electronically via the portal. A "Submit" button is presented if the document is available for portal filing. If there is no "Submit" button presented, then documents should be sent by mail to this Office or to where specified in the portal or on this checklist.

 

All foreign and alien companies and accredited reinsurers that file their NAIC annual statement blank, annual audited financial reports, quarterly financial statements and any supplements related to these documents with the NAIC are exempt from filing a hard copy of these items with this office. These filings should be submitted to the NAIC via electronic media in accordance with the due dates established by the NAIC.

 

 

Health maintenance organizations (HMOs) and dental plan organizations (DPOs) must continue to submit a hard copy of their annual and quarterly statements. Other renewal documents should be submitted through the portal unless otherwise instructed in the portal or on the specific document.

 

 

All items filed should include the Company's NAIC Group Code along with the Company Code.

 

P

Additional Filing Information:

 

Fraternal Benefit Societies have an Application for Renewal of License, Form R2B, which must be filed in hardcopy along with a $20 check made payable to the Treasurer of Virginia for the Annual License Fee.

 

 

 

All items filed should include the Company's NAIC Group Code along with the Company Code.

 

Q

Form F Filing Requirements:

 

For those states that have adopted the NAIC updated Holding Company Model Act, a Form F filing is required annually by holding company groups. Consistent with the Form B filing requirements, the Form F is a state filing only and should not be submitted by the company to the NAIC. Note, however, that this filing is intended to be submitted to the lead state. For more information on lead states, see the following NAIC URL: www.naic.org/public_lead_state_report.htm

 

 

 

 

R

ORSA Filing Requirements:

 

For those states that have 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. Consistent with the Form B filing requirements, the ORSA Summary Report is a state filing only and should not be submitted by the company to the NAIC. Note, however, that this filing is intended to be submitted to the lead state. For more information on lead states, see the following NAIC URL: www.naic.org/public_lead_state_report.htm

 

 

 

 


General Instructions

For Companies to Use Checklist

VIRGINIA

 

Please Note:         This checklist represents, IN GENERAL, the annual renewal and related filings required in Virginia.  Each licensed company is sent specific filing instructions by letter in December.  The NAIC will not be sending their own checklist this year.

 

Electronic filing is intended to be filings submitted to the NAIC via the NAIC Internet Filing Site which eliminates the need for a company to submit diskettes or CD-ROM to the NAIC. Companies are not required to file hard copy filings with the NAIC.

 

Column (1)            (Checklist)

 

Companies may use the checklist to submit to a state, if the state requests it.  Companies should copy the checklist and place an "x" in this column when mailing information to the state.  Virginia does not request the checklist.

 

Column (2)            (Line #)

 

Line # refers to a standard filing number used for easy reference. This line number may change from year to year.

 

Column (3)            (Required Filings)

 

Name of item or form to be filed.

 

The Annual Statement Electronic Filing includes the annual statement data and all supplements due March 1, per the Annual Statement Instructions. This includes all detail investment schedules and other supplements for which the Annual Statement Instructions exempt printed detail.

 

The March .PDF Filing is .pdf files for annual statement data, detail for investment schedules and supplements due March 1.

 

The Risk-Based Capital Electronic Filing includes all risk-based capital data.

 

The Risked-Based Capital .PDF Filing is the .pdf file for risk-based capital data.

 

The Separate Accounts Electronic Filing includes the separate accounts annual statement and investment schedule detail.

 

The Separate Accounts .PDF Filing is the .pdf file for the separate accounts annual statement and investment schedule detail.

 

The Supplemental Electronic Filing includes all supplements due April 1, per the Annual Statement Instructions.

 

The Supplemental .PDF Filing is the .pdf file for all supplements due April 1.

 

The Quarterly Electronic Filing includes the quarterly statement data.

 

The Quarterly .PDF Filing is the .pdf file for quarterly statement data.

 

The June .PDF Filing is the .pdf file for the Audited Financial Statements and Accountants Letter of Qualifications.

 

Column (4)            (Number of Copies)

 

Indicates the number of copies that each foreign or domestic company is required to file for each type of form.  If N/A appears in this column, the filing is not required. "EO" indicates electronic only filing required.

 

Column (5)            (Due Date)

 

Indicates the date on which the company must file the form.

 

Column (6)            (Form Source)

 

If this column contains "NAIC," the company must obtain the forms from the appropriate vendor. If this column contains "State," Virginia will provide the forms with the filing instructions (generally on the website).  If this column contains "Dom. State" the form should be obtained from the state of domicile.  If this column contains "Company," the company, or its representative (e.g., its CPA firm), is expected to provide the form based upon the appropriate state instructions or the NAIC Annual Statement Instructions.

 

Column (7)            (Applicable Notes)

 

This column contains references to the Notes to the Instructions that apply to each item listed on the checklist. The company should carefully read these notes before submitting a filing.