NAIC & DFS Annual Statement Checklist and Instructions

Title Companies 2023-2024

COMPANY NAME:NAIC Company Code:
Contact:Telephone:
REQUIRED FILINGS IN THE STATE OF: NEW YORK Filings Made During the Year 2024
(1)
Check- List
(2)
Line #
(3)
REQUIRED FILING FOR THE ABOVE STATE
(4)
NUMBER OF COPIES*
(5) DUE DATE(6) FORM
SOURCE**
(7) APPLICABLE NOTES
DomesticForeign
StateNAICState
  I. NAIC FINANCIAL STATEMENTS      
 1Annual Statement (8 ½” x 14”)

EF***

EO

xxx

3/1NAIC 
 1.1Printed Investment Schedule detail (Pages E01-E29)

EF***

EO

xxx

3/1NAIC 
 2Quarterly Financial Statement (8 ½” x 14”)

EF***

EO

xxx

5/15,
8/15,
11/15
NAIC 
         
  II. NAIC SUPPLEMENTS      
 11Actuarial Opinion

EF***

EO

xxx

3/1Company 
 12Investment Risk Interrogatories

EF***

EO

xxx

4/1NAIC 
 13Management Discussion & Analysis

EF***

EO

xxx

4/1Company 
 14Schedule SIS

1

N/A

N/A

3/1NAICSee NOTE O
 15Supplemental Compensation Exhibit

1

N/A

N/A

3/1NAICSee NOTE O
 16Supplemental Schedule of Business Written By Agency

EF***

EO

xxx

4/1NAIC 
         
  III. ELECTRONIC FILING REQUIREMENTS      
 61Annual Statement Electronic Filing

xxx

1

xxx

3/1NAIC 
 62March .PDF Filing

xxx

1

xxx

3/1NAIC 
 63Supplemental Electronic Filing

xxx

1

xxx

4/1NAIC 
 64Supplemental .PDF Filing

xxx

1

xxx

4/1NAIC 
 65Quarterly Statement Electronic Filing

xxx

1

xxx

5/15,
8/15,
11/15
NAIC 
 66Quarterly .PDF Filing

xxx

1

xxx

5/15,
8/15,
11/15
NAIC 
 67June .PDF Filing

xxx

1

xxx

5/31NAIC 
         
  IV. AUDIT/INTERNAL CONTROL RELATED REPORTS      
 81Accountants Letter of Qualifications

EF***

EO

N/A

5/31Company 
 82Audited Financial Reports

EF***

EO

xxx

5/31Company 
 83Audited Financial Reports Exemption Affidavit

1

N/A

N/A

5/31CompanySee NOTE O
 84Communication of Internal Control Related Matters
Noted in Audit

EF***

EO

xxx

5/31Company 
 85Independent CPA (change)

1

N/A

N/A

See Note
P

CompanySee NOTE P
 86Management’s Report of Internal Control Over
Financial Reporting

1

N/A

1

5/31CompanySee NOTE O
 87Notification of Adverse Financial Condition

1

N/A

1

See Note
Q

CompanySee NOTE Q
 88Request for Exemption to File

1

N/A

N/A

Prior to
12/31
CompanySee NOTE O
 89Relief from the five-year rotation requirement for
Lead audit partner

1

EO

N/A

Prior to
12/31
CompanySee NOTE O
 90Relief from the one-year cooling off period for
Independent CPA

1

EO

N/A

Prior to
12/31
CompanySee NOTE O
 91Relief from the Requirements for Audit Committees

1

EO

N/A

Prior to
12/31
CompanySee NOTE O
 92Report of Significant Deficiencies in Internal Controls

1

N/A

1

5/31CompanySee NOTE O
         
  V. STATE REQUIRED FILINGS      
 101Corporation Franchise Tax to Dept. of Taxation (copy
to Insurance Department)

1

0

1

3/15StateSee NOTE N
 102Annual Call

1

0

1

3/1StateSee NOTE O
 

103

103(a)

Signed Notarized Jurat (NAIC Blank) Signed Notarized Jurat (Quarterly)

1

1

0

0

0

0

3/1

5/15,
8/15,
11/15

NAIC / StateSee NOTE K
 104Form B-Holding Company Registration Statement

1

0

15/1CompanySee NOTE R
 105Corporate Governance Annual Disclosure****

1

0

16/1CompanySee NOTE R
 106Form F-Enterprise Risk Report *****

1

0

14/30CompanySee NOTE S
 107ORSA******

1

0

012/1CompanySee NOTE S
 108Qualifications of CPA – Section 89.5(e)(2) of DFS Insurance Regulation 118

1

0

15/31CompanySee NOTE T
 109Cybersecurity Certification of Compliance

1

0

14/15CompanySee NOTE U
 110Group Capital Calculation (File with lead state only)

1

0

06/30CompanySee NOTE R

* If XXX appears in this column, this state does not require this filing, if hard and / or electronic copy is filed with the state of domicile and if the data is filed electronically with the NAIC. If N/A appears in this column, the filing is required with the domiciliary state. EO (electronic only filing).

** If Form Source is NAIC, the form should be obtained from the appropriate vendor.

*** If EF appears in this column, electronic filings (“EF”) to the NAIC are equivalent to filing with DFS. The Department reserves the right to request hard copies.

**** The Corporate Governance Annual Disclosure is required to be filed annually by authorized insurers. The Corporate Governance Annual Disclosure is a state filing only and should not be submitted by the company to the NAIC. For more information, please refer to Regulation 215 (11 NYCRR 90).

***** A Form F filing is required to be filed annually by a New York domestic insurer that is not part of a group and meets a specified premium threshold. For groups, it must be filed by the ultimate holding company for an Article 15 group and by the parent domestic insurer in an Article 16 group. 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. For more information, please refer to Regulation 203 (11 NYCRR 82) on the NYCRR.

****** An ORSA Summary Report is required to be filed annually by a New York domestic insurer that meets a specified premium threshold and/or where the New York domestic insurer is a member of a group that meets a specified premium threshold. The ORSA Summary Report is a state filing only and should not be submitted by the company to the NAIC. For more information, please refer to Regulation 203 (11 NYCRR 82) on the NYCRR.

 NOTES AND INSTRUCTIONS(A-U APPLY TO ALL FILINGS)
ARequired Filings Contact Person:

Mr. Gilbert Denton, Senior Insurance Examiner
New York State Department of Financial Services
Property Bureau – 4th Floor
One State Street
New York, NY 10004
(212) 480-4669

E-mail: [email protected] 
When answering by e-mail, please include telephone number

BMailing Address:N/A
CMailing Address for Filing Fees:N/A
DDelivery Instructions:If the due date falls on a weekend, or a legal holiday, then the filing must be submitted  by the end of the next business day.
ELate 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.

New York statute does not provide for any extensions in the filing deadlines for Annual Statements. Further, extensions for the filing of audited financial statements are only provided upon written application by the insurer to the superintendent, and such extension is only granted if the superintendent finds that compliance would constitute a financial or organizational hardship, as provided in Section 307(b)(3) of the Insurance Law.

FOriginal Signatures:“Wet” or electronic signatures are required.
GSignature/Notarization/Certification:Appropriate notarization required on the actual document.
HAmended Filings:

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

All amendments to your Annual Statement are required to be filed electronically with the NAIC.

IExceptions from normal filings:Only accepted in accordance with the Department’s prior Instructions.
JBar 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. In addition, the Department requires the Audited Financial Statements and the documents submitted pursuant to Regulation 118 to be bar coded. General Bar Coding instructions and a full listing of New York required bar coded forms are included on the web site.
KSigned Jurat:All domestic title insurance companies licensed in New York are required to file an electronic copy  of the signed notarized Annual Statement jurat page and Quarterly Statement jurat pages through the Department’s Insurance Company and Fraternal Benefit Society Filings Portal.
LNONE Filings:All parts of the Annual Statement except those schedules identified as N/A on the checklist 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 reports marked "None".
MFilings new, discontinued or modified materially since last year:Please review checklist for the changes made this year.
NCorporation Franchise Tax to Dept. of Taxation

Mail the CT-33NL return and payment to: NYS Corporation Tax
PO Box 15181
Albany NY 12212-5181

Also mail a copy to:
NYS Department of Financial Services
Office of Financial Management
One Commerce Plaza
Albany, NY 12257

OThe filings identified in items # 14, 15,  83, 86, 88, 89, 90, 91  92 and 102.File electronically through the Department’s Insurance Company and Fraternal Benefit Society Filings Portal.
PIndependent CPA (change)

Provide updated information (name, address, telephone number and e-mail address) within 60 days of any change in CPA. See Regulation 118, Section 89.4(c) for additional reporting requirements if the CPA is dismissed or resigns.

File electronically through the Department’s Insurance Company and Fraternal Benefit Society Filings Portal.

QNotification of Adverse Financial Condition

Required to be furnished, in writing, to the Superintendent, within five business days of any determination by the CPA that the Company has materially misstated its financial condition as reported to the superintendent as of the balance sheet currently under audit or that the Company does not meet the minimum capital or surplus requirement of the insurance law as of that date.

File electronically through the Department’s Insurance Company and Fraternal Benefit Society Filings Portal.

RForm B-Holding Company Registration Statement, Corporate Governance Annual
Disclosure and Group Capital Calculation
File electronically through the Department’s Insurance Company and Fraternal Benefit Society Filings Portal.
SForm F-Enterprise Risk Report and ORSAFile electronically through the Department’s Insurance Company and Fraternal Benefit Society Filings Portal.
TQualifications of CPA –
Section 89.5(e)(2) of DFS Insurance Regulation 118

The company shall provide a statement 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.

File electronically through the Department’s Insurance Company and Fraternal Benefit Society Filings Portal.

UCybersecurity Certificate of ComplianceFile electronically through the Department’s Cybersecurity Portal.

 

General Instructions

For Companies to Use Checklist

Please Note: This state’s instructions for companies to file with the NAIC are included in this Checklist. The NAIC will not be sending their own checklist this year.

Electronic filing is intended to include filing via the Internet or filing via diskette with the NAIC. Companies that file with the NAIC via the Internet are not required to submit diskettes 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 submitting information to the state.

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 the .pdf file for the annual statement, detail for investment schedules and all supplements due March 1. 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 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. The Blanks (E) Task Force modified the 1999 Annual Statement Instructions to waive paper filings of certain NAIC supplements and certain investment schedule detail, if such investment schedule data is available to the states via the NAIC database. The checklists reflect this action taken by the Blanks (EX4) Task Force. XXX appears in the “Number of Copies” “Foreign” column for the appropriate schedules and exhibits. Some states have chosen to waive printed quarterly and annual statements from their foreign insurers and to rely upon the NAIC database for these filings. This waiver could include supplemental annual statement filings. The XXX in this column might signify that the state has waived the paper filing of the annual statement and all supplements.

Column (5) (Due Date)

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

Column (6) (Form Source)

This column contains one of three words: “NAIC,” “State,” or “Company,” If this column contains “NAIC,” the company must obtain the forms from the appropriate vendor. If this column contains “State,” the state will provide the forms with the filing instructions (generally, on its web site). 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.