31 Dec 2016 NAIC. 21. Long-Term Care Experience Reporting Forms. 1. EO xxx. 4/1. NAIC. 22 N/A. 3/1. NAIC. 33. Supplemental Health Care Exhibit (Parts 1, 2 and 3). 1. EO NAIC. N. 103. Fees Statement and Transmittal Voucher. E/O. 1 Jul 2009 Life, Accident & Health, Annuity, Credit Transmittal Document. 1. Prepared for 3. Insurer Name & Address. Domicile. Insurer. License. Type. NAIC. Group # 11. Submitted Documents. FORMS. Policy. Outline of Coverage. 28 Dec 2016 Accident & Health Policy Experience Exhibit xxx. EO xxx. 4/1 NAIC. O. 21. Long Term Care Experience Reporting Forms xxx. EO xxx. 4/1. NAIC. O. 22 .. Internal Control Filings Transmittal Form E-AFR.IC. Communication of 28 Dec 2016 NAIC. O. 18. Long Term Care Experience Reporting Forms xxx. EO xxx. 4/1. NAIC. O 3/31. NAIC. 25. Supplemental Health Care Exhibit (Parts 1, 2 and. 3) .. of Insurance. P. Internal Control Filings Transmittal Form E-AFR. State Filing Procedures and Forms for Life, Accident & Health, Annuity, and Credit MS State Specific Information (For completing the transmittal document.) 4 Jan 2017 An Index of Texas Department of Insurance Forms. Retention Groups · NAIC Uniform Certificate of Authority Application (UCAA) forms Transmittal Checklists and Forms; Life & Health – Data Collection, HMO Forms and Division of Insurance. Rate & Form Filing. Life/Health Checklists NAIC Transmittal · NAIC Transmittal Instructions · Small Employer Basic and Standard Plan Benefits · Stop Loss Calculation of Company LCM with Expense Constant Form Interactive Life, Accident & Health, Annuity, Credit Transmittal Document [PDF]. Life, Accident & Health, Annuity, [PDF] [Word]. NAIC Loss Cost Bulletins/Forms Annual Statement and Related Filings (NAIC Check-List) for Renewal, Audit and Exam Transmittal form, Retaliatory Statement, and Office Facilities Worksheet 26 Apr 2017 Comprehensive Health Rate and Form Filings (Individual and Small Group) Insurance Rate Filing · NAIC Uniform Transmittal Document.
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