2021-22 Annual Statements and New York Supplement Filing Instructions & Forms

In compliance with the 2021 New York Annual Statement and Supplement filing requirements, each of the submissions listed below contains a complete set of general and specific instructions as well as blank forms and other related supplemental/addendum forms.

• Accident and Health Insurer
• Article 43 Corporation
• Fraternal Benefit Society
• Health Maintenance Organization (HMO)
• Life Insurer
• Property Insurer
• Title Insurer

See also NAIC website

2021-2022 New York Annual Statement and Supplement Filing Blanks

To download the latest New York Statement and Supplement blank forms, use the links below. These are available in PDF format unless otherwise specified. 

• Accident and Health Insurer - Annual
• Article 43 Corporation - Annual
• Fraternal Benefit Society
• Health Maintenance Organization - Annual
• Life Insurer
• Property Insurer

Addenda to New York Supplement - Schedule F and S:

• Schedule F: Property Insurance Companies authorized in New York as of Dec. 31, 2021
• Schedule S: Life Insurance Companies authorized in New York as of Dec. 31, 2021