760 IAC 1-15.1-3 - Forms; general requirements
Authority: IC 27-1-3-7
Affected: IC 27-1-23
Sec. 3.
(a) A person
required to file or amend a statement regarding a proposed acquisition of
control under IC
27-1-23-2
shall furnish the required information on Form A as provided in section 4 of
this rule.
(b) An insurer required
to file or amend a registration statement under IC
27-1-23-3
shall furnish the required information on Form B as provided in section 5 of
this rule.
(c) An insurer required
to file an annual registration statement under IC
27-1-23-3
is also required to furnish the information required on Form C as provided in
section 6 of this rule and shall file a Form C with the commissioner.
(d) An insurer required to give notice of a
proposed transaction under IC
27-1-23-4
shall furnish the required information on Form D as provided in section 7 of
this rule.
(e) If:
(1) a domestic insurer, including any person
controlling a domestic insurer, is proposing a merger or acquisition under IC
27-1-23-2.5;
or
(2) a nondomiciliary insurer
licensed to do business in this state is proposing a merger or acquisition;
that person shall file a preacquisition notification form, Form E. No
preacquisition notification form need be filed if the acquisition is beyond the
scope of IC
27-1-23-2.5(c).
In addition to the information required by Form E, the commissioner may require
an expert opinion as to the competitive impact of the proposed
acquisition.
(f) Forms A
through F are intended to be guides in the preparation of the statements
required by IC
27-1-23-2
through IC
27-1-23-4.
They are not intended to be blank forms that are to be filled in.
(g) The statements 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 the coverage of the items.
(h) All instructions, whether appearing under
the items of the forms or elsewhere, 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.
(i) Three (3) complete copies of each
statement, including exhibits and all other papers and documents filed as part
thereof, shall be filed with the commissioner by personal delivery or mail
addressed to:
Insurance Commissioner
Department of Insurance
311 West Washington Street, Suite 300
Indianapolis, Indiana 46204
At least one (1) of the copies shall be signed in the manner prescribed on the form. Unsigned copies shall be conformed. If the signature of any person is affixed pursuant to a power of attorney or other similar authority, a copy of the power of attorney or other authority shall also be filed with the statement.
(j) Statements should be prepared on paper
eight and one-half (8 1/2) inches by eleven (11) inches in size and preferably
bound at the top left hand corner. Exhibits and financial statements, unless
specifically prepared for the filing, may be submitted in their original
size.
(k) If a hearing is requested
on a consolidated basis, in addition to filing the Form A with the
commissioner, the acquiring person shall file a copy of Form A with the NAIC in
electronic form.
(l) All copies of
any statement, financial statement, or exhibit shall be clear, easily readable,
and suitable for review and reproduction. Debits in credit categories and
credits in debit categories shall be designated so as to be clearly
distinguishable as such on photocopies.
(m) Statements, attached exhibits, and all
other documents filed with the commissioner shall be in the English language,
and monetary values shall be stated in United States currency. If any exhibit
or other paper or document filed with the statement is in a foreign language,
it shall be accompanied by a translation into the English language and any
monetary value shown in a foreign currency normally shall be converted into
United States currency.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.