A

Required Filings Contact Person:

  Mr. Warren Youngs, Health Bureau
  New York State Department of Financial Services
  One State Street
  New York, NY 10004
  (212) 480-3883

E-mail: [email protected]

When answering by email, please include telephone number.

B

Mailing Address:

Annual Statement and New York Supplement, and related items (hard copies):

  Mr. Thomas Dudek, Health Bureau
  New York State Department of Financial Services
  One Commerce Plaza
  Albany, NY 12257

Audited Annual Statements and Risk Based Capital Report:

  Mr. Thomas Dudek, Health Bureau
  New York State Department of Financial Services
  One Commerce Plaza
  Albany, NY 12257

Quarterly Statement (hard copies):

  Mr. Thomas Dudek, Health Bureau
  New York State Department of Financial Services
  One Commerce Plaza
  Albany, NY 12257

Change in Actuary:

  Mr. Thomas Dudek, Health Bureau
  New York State Department of Financial Services
  One Commerce Plaza
  Albany, NY 12257

CDs (See Note O):

  Mr. William Pow
  Information Technology Systems
  New York State Department of Financial Services
  One State Street
  New York, NY 10004

C

Mailing Address for Filing Fees:

N/A

D

Mailing Address for Premium Tax Payments:

DO NOT include payments with the Annual Statement (See Note S below).

E

Delivery Instructions:

All Department of Financial Services filings must be physically received at the appropriate address as indicated in NOTE B no later than the indicated due date. Companies should file ONLY ONE COMPANY per package.

The Supplement must be bound at the left side in sequential order and it must have a "COVER" page that indicates New York Supplement to the Annual Statement, the FULL Company Name and the Year.  CDs should be labeled.

F

Late Filings:

Failure to timely file any component of an annual, quarterly or NY Supplement filing subjects insurer to penalties set forth in NY Insurance Law Section 307 and 308.

G

Original Signatures:

Actual live signatures required.

H

Signature/Notarization/Certification:

Appropriate notarization required

I

Amended Filings:

Only accepted in accordance with the Department’s prior instructions.

All amendments to your Annual Statement and/or New York Supplement must be provided in hard copy as well as an amended ELECTRONIC filing.

Note: For Amended New York Supplement filings, the entire electronic filing is required.

J

Exceptions from normal filings:

Only accepted in accordance with the Department’s prior instructions.

K

Bar Codes (State or NAIC)

The NAIC Annual Statement and New York Supplement require the use of bar codes on the Jurat page and certain other pages and forms. General Bar Coding instructions and a full listing of New York required bar coded forms are included on the Web site.

L

NONE Filings:

All parts of the Annual Statement except those schedules identified by the use of "xxx" on the checklist and all parts of the New York Supplement must be accounted for.  If there is nothing to report, you may complete the NAIC Annual Statement page entitled "Supplemental Exhibits and Schedules Interrogatories" INSTEAD OF filing duplicate reports marked "None."  Also, you must complete the New York Supplement page entitled "Supplemental   Exhibits and Schedules Interrogatories" if there is nothing to report for those New York Supplement, exhibits or schedules.  You need not file reports marked "None."

M

Investment Schedules:

The New York Department of Financial Services does not follow the Annual Statement Instructions related to investment schedule detail and certain   supplements.  As such, all items are required to be submitted in hard copy format from foreign insurers.

N

Filings new, discontinued or modified materially since last year:

N/A

O

Internet Filing:

Instructions concerning internet filing alternative to filing CD with New York for New York Supplement are set forth in Department Circular Letter No. 4 (2001).

All companies are strongly encouraged to file national form   filings (as identified in items 61, 62, 63, 64, 65, 66, 67, 68 and 69 in the   checklist) with the NAIC preferably via the Internet.  By filing over the Internet or via CD with   the NAIC an insurer will have fulfilled its electronic filing requirement for national forms with New York   and therefore should not file a CD with the Department.

P

Certificate of Compliance:

  Mr. Thomas Dudek, Health Bureau
  New York State Department of Financial Services
  One Commerce Plaza
  Albany, NY 12257

Q

Certificate of Deposit:

  Mr. Thomas Dudek, Health Bureau
  New York State Department of Financial Services
  One Commerce Plaza
  Albany, NY 12257

R

Certificate of Valuation:

  Mr. Thomas Dudek, Health Bureau
  New York State Department of Financial Services
  One Commerce Plaza
  Albany, NY 12257

S

Corporation Franchise Tax to Dept. of Taxation:

A copy of the Corporation Franchise Tax Return (CT-33) should be sent to:

  New York State Department of Financial Services
  Office of Financial Management
  One Commerce Plaza
  Albany,New York 12257

Please note: Any payment due with   the CT-33 should be sent to:

  NYS Department of Taxation and Finance
  Corporation Tax Bureau
  State Campus
  Washington Avenue
  Albany, New York 12227

T

Enterprise Risk Management and Own Risk and Solvency Assessment

Submit electronically through the Department’s Insurance Entity Filings Portal.

Please follow the instructions at: Insurance Entity Filings Portal.

U

Holding Company and Parent Corporation Filings 

Submit electronically through the Department’s Insurance Entity Filings Portal.

Please follow the instructions at: Insurance Entity Filings Portal.

V

Qualifications of CPA - Section 89.5(e)(2) of DFS Insurance Regulation 118

The company shall attach a statement to its audited annual financial statement, when filed, that the CPA does not function in the role of management, does not audit his or her own work, and does not serve in an advocacy role for company.