| Form A – MERGERS OR ACQUISITIONS OF DOMESTIC INSURANCE COMPANIES |
| Guidance: |
Ohio Administrative Code 3901-3-01, which clarifies Ohio Revised Code (ORC) section 3901.321. |
| Additional forms required to support filing: |
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| Filing Format: |
- File one signed hardcopy of each Form A filing with the Department.
- File one additional copy with the Department electronically on CD ROM or diskette in Portable Document Format (PDF), labeled appropriately.
Note: In the event the filing of past Annual Statements is required, the requirement may be met by reference to the NAIC database. |
| Additional resources: |
Please refer to Material Transactions Review Criteria for additional information and review criteria forms designed to streamline the review process. |
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| Form B – REGISTRATION AND SUBSEQUENT FILINGS BY INSURERS UNDER AN INSURANCE HOLDING COMPANY |
| Guidance: |
Ohio Administrative Code 3901-3-02, which clarifies ORC sections 3901.33. Also refer to ORC section 3901.37(A). |
| Additional forms required to support filing: |
When applicable under the Administrative Code, some Form B filings require:
- Biographical Affidavits on NAIC UCAA Form 11, which can be found under "Forms" at www.naic.org/industry_ucaa.htm with the following exclusions:
- Do NOT submit UCAA Form 11 Supplemental Information exhibits with any Form B filing. They are not required.
- Do NOT submit third-party verification of biographical information with any Form B filing. They are not required.
- Do NOT submit "Disclosure and Authorization Concerning Background Reports" with any Form B Biographical Affidavits. They are not required.
See Ohio Administrative Code 3901-3-02 for additional information. |
| Filing Format: |
- File one signed hardcopy of each Form B statement with the Department.
- File one additional copy with the Department electronically on CD ROM or diskette in Portable Document Format (PDF), labeled appropriately.
|
| Additional resources: |
Please refer to Material Transactions Review Criteria for additional information and review criteria forms designed to streamline the review process. |
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| EXTRAORDINARY DIVIDENDS OR DISTRIBUTIONS |
| Guidance: |
ORC sections 3901.33, 3901.34(C), 3901.37(B) and see form INS7239. |
| Filing Format: |
File one signed hardcopy with the Department. |
| Additional resources: |
Please refer to Material Transactions Review Criteria for additional information and review criteria forms designed to streamline the review process. |
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| FORM D-TRANSACTIONS BETWEEN AFFILIATES |
| Guidance: |
Ohio Administrative Code 3901-3-03, which clarifies ORC section 3901.341. Also refer to ORC sections 3901.33, 3901.34 and 3901.37(A). |
| Filing Format: |
- File one signed hardcopy with the Department.
- File all electronic attachments as required by Ohio Administrative Code 3901-3-03(D)(2) on CD ROM or diskette in Portable Document Format (PDF), labeled appropriately.
|
| Additional resources: |
Please refer to Material Transactions Review Criteria for additional information and review criteria forms designed to streamline the review process. |