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Annual Statement Notice and Foreign License Renewal Process

For any questions regarding filings please e-mail the Company Licensing Section at the Massachusetts Division of Insurance at companies.mailbox@mass.gov

Table of Contents

Annual Statement Notice

Adobe Acrobat Reader is required to view some of the documents on the Annual Statement Notice. A free copy of the Reader may be downloaded from the Adobe website.
 

Please be advised that there have been changes to these instructions from the prior year. Read this notice and all referenced instructions, checklists and notes carefully before proceeding with the filing.

This notice contains instructions for filing the 2019 Annual Statement with the Commonwealth of Massachusetts, Division of Insurance.  Unless otherwise indicated, all filings must comply with 2019 NAIC Annual Statement Instructions for your type of company, including any required quarterly filings; and the NAIC’s Accounting Practices and Procedures Manual.


For any questions or information regarding filing with the NAIC, the 2019 NAIC Annual Statement Instructions, or the NAIC's Accounting Practices and Procedures Manual, please refer to the NAIC website.The required checklist for each company type specifies the filing dates for all required filings with the Commonwealth of Massachusetts.  All schedules must be securely attached to the appropriate pages or bound separately.  

All required Annual Statements must be subscribed and sworn before a notary by at least two principal officers of the company.


Company Renewal and Filing Fees


LICENSE RENEWAL & FILING FEE PAYMENT MAILING ADDRESS


Checks are to be made payable to the Commonwealth of Massachusetts Division of Insurance and mailed with a completed Lock Box and License Application Renewal Form  (if applicable) to:
Division of Insurance
Annual Filing Fee / Company License Renewal
P.O. Box 370039
Boston, MA 02241-0739

 

ANNUAL STATEMENT MAILING ADDRESS

Commonwealth of Massachusetts
Division of Insurance
Company Licensing Section
1000 Washington St, Suite 810
Boston, MA 02118-6200

This address is to be used for mailing all items except payments, lock box forms, and license renewal applications.
 

PENALTY

M.G.L. Chapter 175, Section 26, provides for a penalty of $100 per day if the Annual Statement, and all other related filings, are not received in the proper form and by the date required. In addition, any company that neglects to file in the proper form, and by the date required, may be required to cease writing new business as long as the filing deficiency continues.

 

 

REINSURANCE CREDIT

Credit for reinsurance must be recorded in accordance with the provisions of M.G.L. Chapter 175, Section 20A. For a list of Licensed and/or Approved Companies in Adobe click here  , for Microsoft Excel click here  .

  

CERTIFICATES OF COMPLIANCE

Domestic Insurance Companies that would like to request Certificates of Compliance   to be effective January 1, 2020 should mail their request to Amy Blue at the Annual Statement Mailing Address.

 

WORKERS' COMPENSATION SCHEDULE C-1 and WORKERS' COMPENSATION DEPOSITS

All foreign insurers authorized for Workers' Compensation in Massachusetts that have an AM Best rating of "A-" or higher are not required to file a Workers' Compensation Schedule C-1 and are not required to maintain a Workers' Compensation deposit in accordance with the calculation in the Workers' Compensation Schedule C-1. The required Workers' Compensation deposit for these companies is $50,000.00.

All foreign insurers authorized for Workers' Compensation in Massachusetts that have an AM Best rating of "B++"or lower are required to file a Workers' Compensation Schedule C-1 and are required to maintain a Workers' Compensation deposit in accordance with the calculations in the Workers' Compensation Schedule C-1.

 

Company Renewal and Filing Fees

NON REFUNDABLE FEES

Domestic Companies
(Except for Health Maintenance Organizations)

No Fees Required

Licensed Foreign Companies without Designation 51 or 54

 

Annual Filing Fee

$150.00

License Renewal Fee

$250.00
  $400.00
   

Licensed Foreign Companies with Designation 51 or 54
(This does not include Designations 54BX through 54G):

 

Annual Filing Fee

$150.00

License Renewal Fee

$279.00
  $429.00
   

Surplus Lines Insurers, Accredited Reinsurers, Approved Reinsurers, or Eligible Alien Unauthorized Insurers

 

Annual Filing Fee

$150.00
   
   

Fraternal Benefit Societies

 

Annual Statement Filing Fee

$ 6.00

License Renewal Fee

$25.00
  $31.00
   
Risk Retention Groups  

License Renewal Fee
(Due July 1, 2020)

$125.00 
 

Accredited Reinsurers - Filing Checklists & Instructions

Eligible Alien Unauthorized Insurers

Eligible Alien Unauthorized Insurers are required to file the following with the Massachusetts Division of Insurance:

 

All companies: CPA Audited Financial Report to be filed 120 days after their fiscal year-end.

 

Companies that have a December 31st fiscal year-end must inform the Massachusetts Division of Insurance by March 31st whether they will:

1) make a preliminary filing (balance sheet and income statement) by March 31st and make a complete filing (Jurat Page, IID Financial Filing Format, Interrogatories, Loss Certification) by July 31st; or

2) forego the preliminary filing and make a complete filing (Jurat Page, IID Financial Filing Format, Interrogatories, Loss Certification) by May 15th.

 

For additional information e-mail Amy Blue of the Massachusetts Division of Insurance at Amy.Blue@mass.gov

 

Fraternal Companies - Filing Checklists & Instructions

HMOs - Filing Checklists & Instructions

Health Entities - Filing Checklists & Instructions

Service Contract Providers - Filing Checklist & Instructions

(To be filed within 120 days of the close of the Company’s fiscal year)

 

A current financial statement that indicates a balance sheet and statement of operations on a GAAP basis, certified by an Independent Certified Public Accountant

 

A report listing the number of service contracts issued during the preceding fiscal year, the number of contracts canceled or expired during the preceding year, the number of contracts in effect at year-end, and the amount of service contract fees received during the year

Life Accident and Health Insurers - Filing Checklists & Instructions

Property and Casualty Insurers - Filing Checklists & Instructions

Risk Retention Groups - Filing Checklists & Instructions

RRGs are governed by their state of domicile and are generally required to file with Massachusetts whatever documents are required by their state of domicile.  In addition RRGs are required to file NAIC Biographical Affidavits with the Commonwealth of Massachusetts, a revised Massachusetts Checklist, and any other additional information required by the Commonwealth of Massachusetts.  However, if the RRG files its annual statement with the NAIC it is only required to submit a signed Jurat Page on or before March 1 (or later date if granted an extension by its state of domicile).

 

RRGs are not required to file quarterly statements with the Commonwealth of Massachusetts, Division of Insurance.

 

The following Renewal Application documents will be mailed to each RRG in the summer of each year. 

Risk Retention Group Annual Registration Application Form

Supplement to the NAIC Uniform Group Registration Form for Registration as a Risk Retention Group

Risk Retention Group – Notice and Registration

 

 

For additional information e-mail Matthew Mancini at the Massachusetts Division of Insurance at Matthew.Mancini@mass.gov.

Self Insurance Groups - Filing Checklists & Instructions

2019 Annual SIG Statement Notice

For information please e-mail Brian Knowlton at the Massachusetts Division of Insurance at Brian.Knowlton@mass.gov

 

Surplus Lines Companies - Filing Checklists & Instructions

Title Companies - Filing Checklists & Instructions

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