LIFE, ACCIDENT AND HEALTH INSURERS

 

REQUIRED FILINGS IN VIRGINIA                                                Filings Made During the Year 2014

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 (8½ "x14")

1

EO

N/A

3/1

NAIC

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

 

 

II.  NAIC SUPPLEMENTS

 

 

 

 

 

 

 

10

Accident & Health Policy Experience Exhibit

1

EO

N/A

4/1

NAIC

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

 

11

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

 

12

Actuarial Certification Related to Hedging required by Actuarial Guideline XLIII

1

EO

N/A

3/1

Company

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

 

13

Actuarial Certification Related to Reserves required by Actuarial Guideline XLIII

1

EO

N/A

3/1

Company

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

 

14

Actuarial Certification regarding use 2001 Preferred Class Table

1

EO

N/A

3/1

Company

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

 

14.1

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

1

EO

N/A

4/30

Company

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

 

15

Actuarial Opinion

1

EO

N/A

3/1

Company

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

 

16

Actuarial Opinion on X-Factors

1

EO

N/A

3/1

Company

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

 

17

Actuarial Opinion on Separate Accounts Funding Guaranteed Minimum Benefit

1

EO

N/A

3/1

Company

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

 

18

Actuarial Opinion on Synthetic Guaranteed Investment Contracts

1

EO

N/A

3/1

Company

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

 

19

Actuarial Opinion required by Modified Guaranteed Annuity Model Regulation

1

EO

N/A

3/1

Company

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

 

20

Analysis of Annuity Operations by Lines of Business

1

EO

N/A

4/1

NAIC

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

 

21

Analysis of Increase in Annuity Reserves During Year

1

EO

N/A

4/1

NAIC

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

 

22

Credit Insurance Experience Exhibit

1

EO

1

4/1

NAIC

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

 

23

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

 

24

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

1

EO

N/A

4/1

NAIC

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

 

25

Health Care Exhibit's Allocation Report Supplement

1

EO

N/A

4/1

NAIC

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

 

26

Interest Sensitive Life Insurance Products Report

1

EO

N/A

4/1

NAIC

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

 

27

Investment Risks Interrogatories

1

EO

N/A

4/1

NAIC

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

 

28

Life, Health & Annuity Guaranty Assessment Base

Reconciliation Exhibit

N/A

EO

N/A

4/1

NAIC

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

 

29

Life, Health & Annuity Guaranty Assessment Base Reconciliation Exhibit Adjustment Form

N/A

EO

N/A

4/1

NAIC

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

 

30

Long Term Care Experience Reporting Forms

1

EO

N/A

4/1

NAIC

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

 

31

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

 

32

Management Discussion & Analysis

1

EO

N/A

4/1

Company

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

 

33

Medicare Supplement Insurance Experience Exhibit

1

EO

N/A

3/1

NAIC

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

 

34

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

 

35

Reasonableness of Assumptions Certification required by Actuarial Guideline XXXV

1

EO

N/A

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

Company

 

 

36

Reasonableness and Consistency of Assumptions Certification required by Actuarial Guideline XXXV

1

EO

N/A

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

Company

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

 

37

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

1

EO

N/A

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

Company

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

 

38

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

1

EO

N/A

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

Company

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

 

39

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

1

EO

N/A

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

Company

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

 

40

Risk-Based Capital Report

1

EO

N/A

3/1

NAIC

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

 

41

RBC Certification Required Under C-3 Phase I

1

EO

N/A

3/1

Company

A,B,E,F,J,K

 

42

RBC Certification Required Under C-3 Phase II

1

EO

N/A

3/1

Company

A,B,E,F,J,K

 

43

Schedule SIS

1

N/A

N/A

3/1

NAIC

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

 

44

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

1

EO

N/A

3/1

Company

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

 

45

Statement on par/non-par policies - Exhibit 5 Int. 1 & 2

1

EO

N/A

3/1

Company

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

 

46

Supplemental Compensation Exhibit

1

N/A

N/A

3/1

NAIC

A,B,E,F,J,K

 

47

Supplemental Schedule O

1

EO

N/A

3/1

NAIC

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

 

48

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

 

49

Workers' Compensation Carve Out Supplement

1

EO

N/A

3/1

NAIC

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

 

 

III.  ELECTRONIC FILING REQUIREMENTS

 

 

 

 

 

 

 

50

Annual Statement Electronic Filing

N/A

EO

N/A

3/1

NAIC

 

 

51

March .PDF Filing

N/A

EO

N/A

3/1

NAIC

 

 

52

Risk-Based Capital Electronic Filing

N/A

EO

N/A

3/1

NAIC

 

 

53

Risk-Based Capital .PDF Filing

N/A

EO

N/A

3/1

NAIC

 

 

54

Separate Accounts Electronic Filing

N/A

EO

N/A

3/1

NAIC

 

 

55

Separate Accounts .PDF Filing

N/A

EO

N/A

3/1

NAIC

 

 

56

Supplemental Electronic Filing

N/A

EO

N/A

4/1

NAIC

 

 

57

Supplemental .PDF Filing

N/A

EO

N/A

4/1

NAIC

 

 

58

Quarterly Statement Electronic Filing

N/A

EO

N/A

5/15, 8/15, 11/15

NAIC

 

 

59

Quarterly .PDF Filing

N/A

EO

N/A

5/15, 8/15, 11/15

NAIC

 

 

60

June .PDF Filing

N/A

EO

N/A

6/1

NAIC

 

 

 

IV.  AUDITED FINANCIAL STATEMENTS

 

 

 

 

 

 

 

71

Accountants Letter of Qualifications

1

EO

N/A

6/1 or 6/30

Company

A,B,E,F,J,O

 

72

Audited Financial Reports

1

EO

N/A

6/1 or 6/30

Company

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

 

73

Audited Financial Reports Exemption Affidavit

1

N/A

1

3/1

State

A,B,E,F,J,O

 

74

Communication of Internal Control Related Matters Noted in Audit

1

N/A

1

within 60 days after filing the annual Audited Financial Report

Company

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

 

75

Independent CPA (Change)

1

N/A

1

Within 5 business days of change

Company

A,B,E,F,J,O

 

76

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

 

77

Notification of Adverse Financial Condition

1

N/A

1

Within 5 business days of receipt

Company

A,B,E,F,O

 

78

Request for Exemption to File

See Line 73

N/A

See Line 73

3/1

Company

A,B,E,F,J,O

 

79

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

1

EO

1

3/1

Company

A,B,E,F,J,O

 

80

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

1

EO

1

3/1

Company

A,B,E,F,J,O

 

81

Relief from the Requirements for Audit Committees

1

EO

1

3/1

Company

A,B,E,F,J,O

 

 

V.  STATE REQUIRED FILINGS

 

 

 

 

 

 

 

101

Certificate of Compliance

N/A

N/A

1

3/1

Dom. State

A,B,E,J,O

 

102

Certificate of Deposit

N/A

N/A

1

3/1

Dom. State

A,B,E,J,O

 

103

Certificate of Reserve Valuation

N/A

N/A

1

8/1

Dom. State

A,B,E,J,O

 

104

Filings Checklist

N/A

N/A

N/A

State

 

 

105

Premium Tax/Assessment Filings:

SEPARATE FILINGS - DIFFERENT ADDRESSES

1

N/A

1

3/1

State

See Note D

 XXXX

106

State Filing Fees

N/A

N/A

N/A

 

 

 

 XXXX

107

Signed Jurat

N/A

N/A

N/A

 

 

L

 

108

Actuarial Opinion Memorandum

1

N/A

N/A

3/1

Company

A,B,E,F,J

 

109

Actuarial Opinion Memorandum Regarding X Factors

1

N/A

N/A

3/1

Company

A,B,E,F,J

 

110

Analysis of Excess Capital & Surplus Investments Report

1

N/A

N/A

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

State

A,B,E,F,J

 

111

Application for Renewal of License

1

N/A

1

3/1

State

A,B,E,F,J

 

112

Insurance Holding Company System Annual Reg. Stmt.

1

N/A

N/A

4/30

Company

A,B,E,F,J

 

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

Regulatory Asset Adequacy Issues Summary (No form)

1

N/A

1

3/15

Company

A,B,E,F,J,O

 

116

[Report of Assets Pledged, Hypothecated or Encumbered]

1

N/A

N/A

3/1

State

A,B,E,F,J

 

117

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 now have a portal which will allow 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/Assessments Filings:

 

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

 

The PREMIUM LICENSE TAX FORMS must be obtained from

www.tax.virginia.gov/insurance

and be submitted to the Department of Taxation.

 

ASSESSMENT FORMS may be obtained from

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

These filings may be submitted via regular mail or via courier delivery as follows:

 

Regular Mailing:

State Corporation Commission

TAA Insurance 2

P.O. Box 759064

Baltimore, MD  21275-9064

 

Courier Delivery:

State Corporation Commission

TAA Insurance 2

Lockbox 759064

7175 Columbia Gateway Drive

Columbia, MD  21046

Questions re: ASSESSMENT FILINGS should be directed to the State Corporation Commission's Assessments Division at 804-371-9096.

 

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

 

 

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.

A CERTIFICATE OF DEPOSIT is ONLY required from insurers that do not maintain a deposit with the Treasurer of Virginia.

 

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:

 

 

 

See Note D

 

O

Foreign Company Filing Requirements:

 

All foreign companies and accredited reinsurers, excluding Health Maintenance Organizations (HMOs) and Dental Plan Organizations (DPOs), that file their NAIC annual statement blank, annual audited finanical 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.

 

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

 


General Instructions

For Companies to Use Checklist

VIRGINIA

 

Please Note:  This checklist represents, IN GENERAL, the annual renewal and related filings required in Virginia.   The NAIC will not be sending their own checklist.

 

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.    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.  (Virginia does not exempt all printed detail.)

 

The March .PDF Filing is the .pdf file 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 Risk-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 all 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 supplemental schedules and exhibits 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 on the Bureau's 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.