Search Icon

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-A3-477Continuing Care Minimum Liquid Reserve Calculation

Donor Annuity Reporting

OIR-A3-1209Sworn Statement in Lieu of Annual Statements for Issuers of Donor Annuity Agreements
Donor Annuity Filing Guide
Donor Annuity Filing Instructions

Home Warranty Reporting

OIR-A3-440Home Warranty Annual Tax (*)
OIR-A3-491Home Warranty Annual Report
OIR-A3-1073Home Warranty Renewal (*)

Legal Expense Insurance Reporting

OIR-A3-479 Legal Expense Insurance Annual Report
OIR-A3-1077Legal Expense Insurance Renewal (*)

Motor Vehicle Manufacturer Reporting

OIR-A3-1984Motor Vehicle Manufacturer Annual Report

Motor Vehicle Service Agreement Reporting

OIR-A3-467Motor Vehicle Service Agreement Annual Report
OIR-A3-467LRMotor Vehicle Service Agreement Renewal

Premium Finance Reporting

OIR-A3-107Premium Finance Annual Report
OIR-A3-1563Premium Finance Renewal (*)

Service Warranty Reporting

OIR-A3-456Service Warranty Annual Report

 

OIR-A3-110Service Warranty Renewal (*)

 

OIR-A3-458Service Warranty (Publicly Traded) Annual Report
OIR-A3-955Service Warranty Manufacturer Renewal (*)
Insurance Administrator Reporting
OIR-A3-975Insurance Administrator Annual Report

Viatical Settlement Provider Reporting

OIR-A3-1288Viatical 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

OIR-A3-974

Continuing Care Retirement Community Periodic Report

OIR-A3-1245

Provisional Continuing Care Retirement Community Sales & Financial Report

Home Warranty Quarterly Reporting

OIR-A3-492

Home Warranty Quarterly Report

Insurance Administrator Reporting

OIR-A3-975

Insurance Administrator Quarterly Report

Legal Expense Reporting

OIR-A3-481

Legal Expense Quarterly Report

Motor Vehicle Service Agreement Reporting

OIR-A3-466

Motor Vehicle Service Agreement Quarterly Report

Premium Finance Reporting

OIR-A3-107

Premium Finance Quarterly Report

Service Warranty (Publicly Traded) Reporting

OIR-A3-457

Service Warranty Quarterly Report

OIR-A3-458

Service Warranty (Publicly Traded) Quarterly Report

Other Forms for Specialty Insurers

OIR-A3-476

Application for Expansion of a Certificated Facility

OIR-A3-969

Contractual Liability Policy (Model)

OIR-A3-1130

Criteria for 651.035(4)(b) Allowance

OIR-A3-455

Home and Service Warranty Association Surety Bond

OIR-A3-478

Legal Expense Insurance Corporation Surety Bond

OIR-A3-453

Premium Finance Company Surety Bond

OIR-A3-1162

Premium Finance Disclosure

OIR-A3-1241

Provider Escrow Certification

OIR-A3-1283

Renewal and Replacement Reserve Escrow Agreement

OIR-A3-1082

Request for Periodic Report Waiver

OIR-A3-475

Verification of Release of Escrow Funds

OIR-A3-1068

Waiver of MLR Requirement

OIR-A3-1284

Withdrawal of Renewal and Replacement Reserve

Viatical, Life Settlements and Life Expectancy Providers

(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.