S T A T E  OF 
 V E R M O N T   
Department of Banking, Insurance,
Securities & Health Care Administration
89 Main St.   Montpelier, VT 05620-3101  Main Phone:  802-828-3301
 

Banking Division   Insurance Division  Securities Division  Health Care Administration  Captive Insurance Division


Questions?
Contact Company Licensing  
by e-mail
 

 802-828-2470

 

Insurers providing accident and health lines of business:
Notice of expanded reporting requirements for the 2008 Annual Statement Supplemental Filing (ASSR)

 

Insurance Division


 FOR FILING IN CALENDAR YEAR 2008:
Traditional Insurance Company
2008 Vermont Annual Statement Filing 
Instructions & Forms

Below are forms for the period ending December 31, 2008 and for the first three quarters of 2009 for insurance companies required by statute to file with the department.  Included are forms for remitting Annual Statement Filings and license (or authorization) renewal fees.

Please note: the instructions on this page do NOT apply to Vermont captive insurers or foreign risk retention groups.
> For annual filing instructions applicable to Captive Insurers, please click here.
> For annual filing instructions pertaining to Foreign Risk Retention and Risk Purchasing Groups, please click here.

INDEX OF 2008 FORMS FOR FILING IN 2009:
 
  2008 - Section 1: General Instructions

  2008 - Section 2:  Annual Fee Calculation

  2A Annual Fees for L&H, P&C, Health, Surplus Lines, and Title Insurers
  2B Annual Fees for Fraternal Societies
  2C Annual Fees for Accredited Reinsurers
  2008 - Section 3: Health Care Administration Supplemental Filing (Annual Statement Supplement) 
  2008 - Section 4: Vermont Mandatory Reporting (Liquor Liability Report)   
  2008 - Section 5: Checklists - 2008 Filings with Notes
  5A Life, Accident & Health
  5B Property and Casualty
  5C Health Entities (Insurers, HDMI's & HMO's)
  5D Title Insurers
  5E Fraternal Benefit Societies
  5F Foreign Surplus Lines Insurers
  5G Foreign Accredited Reinsurers
  5H Alien Surplus Lines Insurers
  5I Alien Accredited Reinsurers
  5J Viatical Settlement Providers