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Washington State Office of the Insurance Commissioner

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Annual LTC compliance filing form

Per RCW 48.83.130 and WAC 284.17.262, insurers must certify annually to the commissioner that each resident and nonresident licensee involved in the transaction of long term care insurance in Washington has completed an approved long term care education course.

The form must be completed and submitted regardless of whether policies were issued or not issued during this time period. The compliance form must be completed and returned on or before March 31, each year.

Please direct any questions to joem@oic.wa.gov.

Annual Filing of Compliance for Long Term Care Education Requirements Form (PDF)


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Reporting requirements for surplus line insurers

Please send the following to the Insurance Commissioner's Office:
    1. Jurat (statutory statement lead sheet with statutory statement contact information),
    2. Washington premiums written (p. 20),
    3. Schedule T,
    4. Any Changes in Service of Process (as they occur).

You may submit these items via:

Regular mail
E-mail
Fax

Attn: Mary Tunis
P. O. Box 40257
Olympia, WA 98504-2019
MaryT@oic.wa.gov
360-586-2019
You need to also send the following to the Surplus Line Association of Washington:
    1. Statutory Statement (9" x 14" size) including Page 20 state page for Washington State,
    2. Actuarial Opinion,
    3. Copy of domiciliary Certificate of Authority,
    4. Management discussion & Analysis,
    5. Quarterly Updates, when available,
    6. Audited Financial Statement, when available,
    7. IRIS results, when available, 
    8. The latest triennial DOI examinations results, and either a 10-K or 10-Q report.

Questions?

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PhoneIcon Call 360-725-7144




Updated 04/25/2012

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