Conn. Agencies Regs. § 38a-138-1 - Forms - general requirements
(a) Sections 38a-138-1 to 38a-138-16, inclusive,
and the forms prescribed in the Appendixes A, B, C, D, E and F of sections 38a-138-1 to 38a-138-16, inclusive, of the Regulations of Connecticut State Agencies are
intended to implement the provisions of the Connecticut Insurance Holding Company
System Regulatory Act, sections 38a-129 to 38a-140, inclusive, of the Connecticut
General Statutes. Appendix A of sections 38a-138-1 to 38a-138-16, inclusive, of the
Regulations of Connecticut State Agencies contains "Form A" (Statement Regarding the
Acquisition of Control of or Merger With a Domestic Insurer); Appendix B of sections
38a-138-1 to 38a-138-16, inclusive, of the Regulations of Connecticut State Agencies
contains "Form B" (Insurance Holding Company System Annual Registration Statement);
Appendix C of sections 38a-138-1 to 38a-138-16, inclusive, of the Regulations of
Connecticut State Agencies contains "Form C" (Summary of Changes to Registration
Statement); Appendix D of sections 38a-138-1 to 38a-138-16, inclusive, of the
Regulations of Connecticut State Agencies contains "Form D" (Prior Notice of a
Transaction) and "Form D-1" (Prior Notice Of Dividends On Common Stock And Other
Distributions); Appendix E of sections 38a 138-1 to 38a-138-16, inclusive, of the
Regulations of Connecticut State Agencies contains "Form E" (Pre-Acquisition
Notification Form Regarding Potential Competitive Impact Of A Proposed Merger Or
Acquisition By A Non-Domiciliary Insurer Doing Business In This State Or By A
Domestic Insurer); and Appendix F of sections 38a-138-1 to 38a-138-16, inclusive, of
the Regulations of Connecticut State Agencies contains "Form F" (Enterprise Risk
Report). These forms are intended to be guides in the preparation of the statements
required by sections 38a-130, 38a-135, and 38a-136 of the Connecticut General
Statutes; they are not intended to be blank forms which are to be filled in. Each
form, when filed, shall contain the numbers and captions of all items, but the text
of the items may be omitted provided the answers thereto are prepared in such a
manner as to indicate clearly the scope and coverage of the items. All instructions,
whether appearing under the items of the form or elsewhere therein, are to be
omitted. Unless expressly provided otherwise, if any item is inapplicable or the
answer thereto is in the negative, an appropriate statement to that effect shall be
made.
(b)
(1) A complete submission of Forms A, B, C, D,
D-1, E, and F, including exhibits, and all other papers and documents filed as a
part thereof, shall be electronically filed with the Commissioner via electronic
mail to: CID.FinRegFilings@ct.gov. The subject field of the electronic mail and all
file names shall include the following information in this order and manner:
(A) Filing type (Form).
(B) NAIC Number and legal entity name, or Group
Number and group name, as appropriate.
(C) Document name (Additional, as
needed).
(2) If the
electronic filing is larger than 15mb, the submission shall be transmitted to the
State of Connecticut Insurance Department Financial Regulation Division via secure
electronic means acceptable to the Commissioner, or filed electronically via DVD,
thumb drive, or other media acceptable to the Commissioner, and shall be sent by
personal delivery addressed to:
State of Connecticut Insurance Department
153 Market Street (7th Floor)
Hartford, CT 06103
Attention: Financial Analysis Unit, Financial Regulation Division
or, by U.S. mail addressed to:
State of Connecticut, Insurance Department
P.O. Box 816 Hartford, CT 06142-0816
Attn: Financial Analysis Unit, Financial Regulation Division
(3) Submissions requiring a signature
shall be manually signed in the manner prescribed on the Form. Biographical
supplements shall be included in a separate electronic document so that appropriate
confidentiality may be maintained. If the signature of any person is affixed
pursuant to a power of attorney or other similar authority, a copy of such power of
attorney or other similar authority shall also be filed with the
statement.
(c) If an
applicant requests a hearing on a consolidated basis under section 38a-132(b)(3) of
the Connecticut General Statutes, the applicant shall follow all of the Form A and E
filing procedures in subsection (b) of this section, and shall file a copy of the
Form A with the National Association of Insurance Commissioners (NAIC) in electronic
form.
(d) All electronic submissions of
any Form, statement, financial statements, or exhibits shall be clear, easily
readable, and of suitable quality for printing . Debits in credit categories and
credits in debit categories shall be designated so as to be clearly distinguishable
as such on submissions. Forms and statements shall be made in the English language
and monetary values shall be stated in United States currency. If any exhibit or
other document filed with the statement is in a foreign language, it shall be
accompanied by a certified translation into the English language and any monetary
value shown in a foreign currency normally shall be converted into United States
currency.
Notes
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