TO: All Insurers
FROM: Linda Ruthardt, Commissioner of Insurance
DATE: September, 1996
RE: Completion Instructions for Lockbox Filing Fee Form SRB-LB-1 (09/96)

Attached is the "SRB-LB-1" form to be used in conjunction with the Division's new lockbox filing fee collection program. This program is intended to help the Division process form and rate filings more promptly, accurately, and efficiently. Your assistance in implementing this program is very much appreciated. Although insurers may begin following these procedures immediately if they wish, it is expected that all insurers will be using the new lockbox program by no later than November 1, 1996.

Please complete the attached form whenever preparing to submit a form or rate filing to the Division. Two separate mailings will be required. One copy of the completed form should be attached as a cover sheet to your form or rate filing and mailed to the Division of Insurance. Please indicate in the address whether this is a Life, Health, or Property & Casualty filing, as follows:

[Life] [Health] [Property & Casualty] Policy Review Section
Massachusetts Division of Insurance
470 Atlantic Avenue
Boston, MA 02210-2223

A second copy of the completed SRB-LB-1 form, without the attached filing materials, should be mailed with the filing fee (in the form of a check payable to the Commonwealth of Massachusetts) directly to the following address:

Division of Insurance -- SRB
c/o Bank of Boston
P.O. Box 3812
Boston, MA 02241-3812

Please note the following: (1)the date must be entered in the exact format specified on the form; (2) a separate lockbox filing fee form should be completed for each form or rate filing; (3) each check sent to the bank should be accompanied by a separate form; (4) form and rate filings should not be combined; and (5) fees for form and rate filings should not be combined. Lockbox checks for amounts other than $75.00 (form filing) or $150.00 (rate filing) will be returned and will result in a delay in processing.

These instructions apply only to fees owed on form filings and rate filings.