Specialty Product Administration
The Office of Insurance Regulation (Office) regulates various insurance related industries including, but not limited to Auto, Home and Service Warranties, Premium Finance Companies, Legal Expense Insurance, Third Party Administrators, Continuing Care Retirement Communities and Viatical Settlements. The Office licenses entities, examines them for compliance with applicable laws and rules and monitors their financial condition for the protection of the public from insolvency risks and unethical business practices. The Office reviews the financial statement filings of licensed companies and conducts periodic on-site financial and market conduct examinations to ascertain whether the condition of the company warrants rescission of its license. The Office currently monitors approximately 1,400 specialty entities.
Annual Statement Forms
The Forms provided here are for informational purposes only. All licensed companies must file electronically via the Industry Portal and the Regulatory Electronic Filing System (REFS). A User Guide and a Tutorial for filing electronically is available and can be accessed at /OIR_Required_Filing_Reporting.htm, with additional information provided in the Informational Memorandum shown on the same webpage. Licensed companies must report electronically via the Industry Portal.
* Forms marked with an Asterisk (*) should be printed, completed and mailed to the address provided thereon. When filing in REFS, companies should scan and upload a copy of the completed Form with their electronic filing.
Continuing Care Reporting
OIR-A3-470 | Continuing Care - Annual Report |
OIR-A3-477 | Continuing Care Minimum Liquid Reserve Calculation |
Donor Annuity Reporting
OIR-A3-1209 | Sworn Statement in Lieu of Annual Statements for Issuers of Donor Annuity Agreements Donor Annuity Filing Guide Donor Annuity Filing Instructions |
Home Warranty Reporting
OIR-A3-440 | Home Warranty Annual Tax (*) |
OIR-A3-491 | Home Warranty Annual Report |
OIR-A3-1073 | Home Warranty Renewal (*) |
Legal Expense Insurance Reporting
OIR-A3-479 | Legal Expense Insurance Annual Report |
OIR-A3-1077 | Legal Expense Insurance Renewal (*) |
Motor Vehicle Manufacturer Reporting
OIR-A3-1984 | Motor Vehicle Manufacturer Annual Report |
Motor Vehicle Service Agreement Reporting
OIR-A3-467 | Motor Vehicle Service Agreement Annual Report |
OIR-A3-467LR | Motor Vehicle Service Agreement Renewal |
Premium Finance Reporting
OIR-A3-107 | Premium Finance Annual Report |
OIR-A3-1563 | Premium Finance Renewal (*) |
Service Warranty Reporting
OIR-A3-456 | Service Warranty Annual Report
|
OIR-A3-110 | Service Warranty Renewal (*)
|
OIR-A3-458 | Service Warranty (Publicly Traded) Annual Report |
OIR-A3-955 | Service Warranty Manufacturer Renewal (*) |
Insurance Administrator Reporting
OIR-A3-975 | Insurance Administrator Annual Report |
Viatical Settlement Provider Reporting
OIR-A3-1288 | Viatical Settlement Provider Annual Report (form is currently subject to litigation) |
Periodic or Quarterly Statement Forms
The Forms provided here are for informational purposes only. All licensed companies must file electronically via the Industry Portal and the Regulatory Electronic Filing System (REFS). A User Guide and a Tutorial for filing electronically is available and can be accessed at /OIR_Required_Filing_Reporting.htm, with additional information provided in the Informational Memorandum shown on the same webpage. Licensed companies must report electronically via the Industry Portal.
Continuing Care Retirement Community Reporting
Continuing Care Retirement Community Periodic Report | |
Provisional Continuing Care Retirement Community Sales & Financial Report |
Home Warranty Quarterly Reporting
Home Warranty Quarterly Report |
Insurance Administrator Reporting
Insurance Administrator Quarterly Report |
Legal Expense Reporting
Legal Expense Quarterly Report |
Motor Vehicle Service Agreement Reporting
Motor Vehicle Service Agreement Quarterly Report |
Premium Finance Reporting
Premium Finance Quarterly Report |
Service Warranty (Publicly Traded) Reporting
Service Warranty Quarterly Report | |
Service Warranty (Publicly Traded) Quarterly Report |
Other Forms for Specialty Insurers
Application for Expansion of a Certificated Facility | |
Contractual Liability Policy (Model) | |
Criteria for 651.035(4)(b) Allowance | |
Home and Service Warranty Association Surety Bond | |
Legal Expense Insurance Corporation Surety Bond | |
Premium Finance Company Surety Bond | |
Premium Finance Disclosure | |
Provider Escrow Certification | |
Renewal and Replacement Reserve Escrow Agreement | |
Request for Periodic Report Waiver | |
Verification of Release of Escrow Funds | |
Waiver of MLR Requirement | |
Withdrawal of Renewal and Replacement Reserve |
Viatical, Life Settlements and Life Expectancy Providers
- Licensed Viatical Settlement Providers
- Registered Life Expectancy Providers
- Criminal, Civil, and Regulatory Actions
(Note: Viewing some documents in these links requires Adobe Acrobat.)
For more information or assistance regarding home warranty, prepaid legal, auto warranty, motor vehicle manufacturer, premium finance, service warranty or manufacturer warranty, please call (850) 413-3148.
For more information or assistance regarding continuing care retirement communities, donor or charitable gift annuities, insurance administrators, viatical settlement providers and life expectancy providers, please call (850) 413-3153.