Home

News Releases

Annual Reports

Related Links

Contact Us

Financial Statement Filings Checklist and Other Required Filings for Insurance Companies

This page contains all of the required Arkansas Specific forms due in 2012. Download each form separately. Each section is color coded and lists all of the required forms for each type of insurance company.

The financial statement checklists were last updated on January 11, 2012.

LIFE & HEALTH COMPANIES Financial Statement and Other Filings Checklist- (Word) (PDF) Premium Tax Filing Forms Company Financial Regulation Fee (CFRF) Anti Fraud Assessment Advertising Certificate of Compliance Mandatory AR Comprehensive Health Ins Pool Form  AR Domestic Insurers- Affiliated Transaction Form                    ANTI-FRAUD PLAN – Insurance companies licensed in Arkansas must submit an antifraud plan pursuant to [A.C.A. §23-66-510 (a)].  Questions should be directed to Raymond Boyles at 501-371-2790 or raymond.boyles@arkansas.gov.  [Also reference:  Bulletin No. 7-97 and Rule and Regulation 66.]	PROPERTY & CASUALTY COMPANIES Financial Statement and Other Filings Checklist- (Word) (PDF) Premium Tax Filing Forms Company Financial Regulation Fee (CFRF) Anti Fraud Assessment Property and Casualty Guaranty Fund Form New ACTS from 2005 Legislative Session ARRUA Premium Reporting Form- Due Annually, March 1st ARRUA Assessment- Due Annually December 31st Earthquake Market Analysis – Due Annually April 1st AR166- Due Annually May 1st Consumer Credit and Credit Scoring Report- Due annually March 31st ACT 1345 County Fire Loss Annual Report- Due Annually, June 1st Mandatory AR Comprehensive Health Ins Pool Form AR Domestic Insurers- Affiliated Transaction Form                   ANTI-FRAUD PLAN – Insurance companies licensed in Arkansas must submit an antifraud plan pursuant to [A.C.A. §23-66-510 (a)].  Questions should be directed to Raymond Boyles at 501-371-2790 or raymond.boyles@arkansas.gov.  [Also reference:  Bulletin No. 7-97 and Rule and Regulation 66.]
FRATERNAL COMPANIES Financial Statement and Other Filings Checklist- (Word) (PDF) Annual Continuation Form Company Financial Regulation Fee (CFRF) Anti Fraud Assessment Advertising Certificate of Compliance- Mandatory AR Comprehensive Health Ins Pool Form ANTI-FRAUD PLAN – Insurance companies licensed in Arkansas must submit an antifraud plan pursuant to [A.C.A. §23-66-510 (a)].  Questions should be directed to Raymond Boyles at 501-371-2790 or raymond.boyles@arkansas.gov.  [Also reference:  Bulletin No. 7-97 and Rule and Regulation 66.]	TITLE COMPANIES Financial Statement and Other Filings Checklist- (Word) (PDF) Premium Tax Filing Forms Company Financial Regulation Fee (CFRF) Anti Fraud Assessment Mandatory AR Comprehensive Health Ins Pool Form AR Domestic Insurers- Affiliated Transaction Form ANTI-FRAUD PLAN – Insurance companies licensed in Arkansas must submit an antifraud plan pursuant to [A.C.A. §23-66-510 (a)].  Questions should be directed to Raymond Boyles at 501-371-2790 or raymond.boyles@arkansas.gov.  [Also reference:  Bulletin No. 7-97 and Rule and Regulation 66.]
HEALTH COMPANIES Financial Statement and Other Filings Checklist- (Word) (PDF) Premium Tax Filing Forms Company Financial Regulation Fee (CFRF) Anti Fraud Assessment Mandatory AR Comprehensive Health Ins Pool Form AR Domestic Insurers- Affiliated Transaction Form                   ANTI-FRAUD PLAN – Insurance companies licensed in Arkansas must submit an antifraud plan pursuant to [A.C.A. §23-66-510 (a)].  Questions should be directed to Raymond Boyles at 501-371-2790 or raymond.boyles@arkansas.gov.  [Also reference:  Bulletin No. 7-97 and Rule and Regulation 66.]	RISK RETENTION GROUPS Contact Person: Kimberly Johnson Financial Statement and Other Filings Checklist- (Word) (PDF) Premium Tax Filing Forms Mandatory AR Comprehensive Health Ins Pool Form
ACCREDITED AND TRUSTEED REINSURERS Contact Person:Kimberly Johnson Accredited Renewal Information Trusteed Renewal Information Note: Renewal email notifications will be sent to insurers 30 days prior to renewal.	SURPLUS LINES COMPANIES Foreign & Domestic Surplus Lines Contact: Kimberly Johnson Alien Surplus Lines Contact: Carol Stiffler Domestic Surplus Lines - Financial Statement and Other Filings Checklist- (Word) (PDF) Foreign Surplus Lines Insurers- please visit our surplus lines website for more information! Filing Requirements have changed since last year. http://www.insurance.arkansas.gov/finance/surpluslinespage.htm
AUTOMOBILE CLUBS AND/OR ASSOCIATIONS Contact Person: Jan Mills License Renewal Information- Due Annually April 1st Note: Renewals are due on April 1^st each year.	REINSURANCE INTERMEDIARY BROKER AND MANAGER LICENSE Contact Person: Jan Mills License Application- scroll to the bottom of the web page. Renewal Information- Due Annually on January 1st – scroll to the bottom of the web page.

Note: All financial statement filing and Certificate of Renewal fees are included on the premium tax forms. Please do not send a separate check for these two items.

For questions concerning annual filing requirements Click Here or call 501-371-2673 or 501-371-2665.