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Title Last updatedsort descending Attachments
Form 1024A: Insurer Rate Service Organization Reference Filing Adoption Form 08/11/2014 (Fri)
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PDF icon REFERENCE_FILING_ADOPTION_FORM_1024A_(Fillable).pdf30.92 KB
Form 1024B: Insurer Rate Service Organization Calculation of Company Loss Cost Multiplier 08/11/2014 (Fri)
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Microsoft Office document icon CALCULATION_OF_COMPANY_LOSS_COST_MULTIPLIER_1024B.DOC26 KB
Form 1024B: Calculation of Company Loss Cost Multiplier 08/11/2014 (Fri)
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PDF icon CALCULATION_OF_COMPANY_LOSS_COST_MULTIPLIER_1024B_(Fillable).pdf70.68 KB
Form E110: Biographical Affidavit 08/11/2014 (Fri)
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PDF icon E110AZBiographicalAffidavit.pdf321.21 KB
Flooding after Wildfires: Department of Emergency and Military Affairs 06/11/2014 (Sat)
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PDF icon DEMA_PR_re_flooding_after_fires.pdf40.26 KB
Form P-LSA: Life Settlement Provider/Broker Disclosures to Owner; Affiliations 09/11/2014 (Thu)
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PDF icon p-lsa.pdf969.43 KB
Form P-LSC: Life Settlement Provider: Contract Checklist 09/11/2014 (Thu)
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PDF icon p-lsc.pdf144.34 KB
FINANCIAL REPORTING - DOMESTIC: Acquisition/Holding Company Registration 02/12/2014 (Fri)
FINANCIAL REPORTING - DOMESTIC: Life Care Provider 02/12/2014 (Fri)
FINANCIAL REPORTING - DOMESTIC: HMDO Service Corporation 02/12/2014 (Fri)
FINANCIAL REPORTING - DOMESTIC: Mortgage Guaranty Insurer 02/12/2014 (Fri)
FINANCIAL REPORTING - DOMESTIC: Prepaid Dental Plan Organization 02/12/2014 (Fri)
FINANCIAL REPORTING - DOMESTIC: Title Insurer 02/12/2014 (Fri)
FINANCIAL REPORTING - FOREIGN/ALIEN: Accredited Reinsurer 02/12/2014 (Fri)
FINANCIAL REPORTING - FOREIGN/ALIEN: Fraternal Benefit Society 02/12/2014 (Fri)
FINANCIAL REPORTING - FOREIGN/ALIEN: Health Care Services Organization 02/12/2014 (Fri)
FINANCIAL REPORTING - FOREIGN/ALIEN: Life Care Provider 02/12/2014 (Fri)
FINANCIAL REPORTING - FOREIGN/ALIEN: Mortgage Guaranty Insurer 02/12/2014 (Fri)
FINANCIAL REPORTING - FOREIGN/ALIEN: Prepaid Legal Insurer 02/12/2014 (Fri)
FINANCIAL REPORTING - FOREIGN/ALIEN: Title Insurer 02/12/2014 (Fri)
FINANCIAL REPORTING - DOMESTIC: Life & Disability Reinsurer 04/12/2014 (Fri)
FINANCIAL REPORTING: Senior Residential Entrance Fee Contract Provider 09/12/2014 (Fri)
FINANCIAL REPORTING - DOMESTIC: Life/Disability Insurer Filing on a Health Blank 08/12/2014 (Wed)
FINANCIAL REPORTING - DOMESTIC: Property/Casualty Insurer Filing on a Health Blank 08/12/2014 (Wed)
FINANCIAL REPORTING - DOMESTIC: Property/Casualty Insurer Not Filing on a Health Blank 08/12/2014 (Wed)
FINANCIAL REPORTING - DOMESTIC: Life/Disability Insurer Not Filing on a Health Blank 08/12/2014 (Wed)
FINANCIAL REPORTING - DOMESTIC: Unaffiliated Credit Life & Disability Reinsurer 08/12/2014 (Wed)
FINANCIAL REPORTING - FOREIGN/ALIEN: Life/Disability Insurer Not Filing on Health Blank 09/12/2014 (Wed)
FINANCIAL REPORTING - FOREIGN/ALIEN: Property/Casualty Insurer Not Filing on a Health Blank 09/12/2014 (Wed)
FINANCIAL REPORTING - FOREIGN/ALIEN: Property/Casualty Insurer Filing on a Health Blank 09/12/2014 (Wed)
FINANCIAL REPORTING - FOREIGN/ALIEN: Life/Disability Insurer Filing on a Health Form 09/12/2014 (Wed)
Form E110: Biographical Affidavit 07/12/2014 (Thu)
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PDF icon E110AZBiographicalAffidavit.pdf321.21 KB
Form LTCPP-AZ Attachment C: Post-purchase Notice 03/12/2014 (Mon)
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PDF icon LTCPP_POST-PURCHASE_NOTICE.pdf110.03 KB
Form LTCPP-AZ Attachment B: Pre-purchase Notice 03/12/2014 (Mon)
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PDF icon LTCPP_PRE-PURCHASE_NOTICE.pdf139.46 KB
Form LTCPP-AZ Attachment A: Insurer Certification Form 03/12/2014 (Mon)
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PDF icon LTCPP_INSURER_CERTIFICATION_FORM_2-4-10_rvsd.pdf267.45 KB
Form RT: Retaliation Report 01/12/2014 (Tue)
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File e-rt_20141215.xlsx76.06 KB

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Warning - Phishing Scam

We are aware of a phishing scam targeting insurance professionals claiming that the National Association of Insurance Commissioners received a complaint that the professional submitted a falsified claim. This fraudulent email displays the NAIC and CIPR logos, can originate from what appears to be an naic.org or gmail.com email account, and instructs the recipient to click on a link to download the complaint notification.

Certain antivirus products will detect this as a malicious email.  If you receive a similar email and have any concerns, contact the NAIC Service Desk at (816) 783-8500 or [email protected].