Annual Report Filing Requirements

GEORGE DALE Commissioner of Insurance State Fire Marshal LEE HARRELL Deputy Commissioner [LOGO] STATE OF MISSISSIPPI Mississippi Insurance Department 501 N. West Street 1001 Woolfolk Building (39201) Post Office Box 79 Jackson, Mississippi 39205-0079 (601) 359-3569 http://www.doi.state.ms.us ## MISSISSIPPI DEPARTMENT OF INSURANCE BULLETIN NO. 2005-1 January 28, 2005 TO: All Licensed Third Party Administrators RE: Annual Report Filing Requirements Miss. Code Ann. § 83-18-27 (Rev. 1999) sets forth the requirements for Third Party Administrators (hereinafter "TPA") with regard to the filing of their annual reports and states as follows: 1.) Each administrator shall file an annual report for the preceding calendar year with the Commissioner on or before March 1 of each year, or within such extension of time therefore as the Commissioner for good cause may grant. The report shall be in the form and contain such matters as the Commissioner prescribes and shall be verified by at least two (2) officers of the administrator. 2.) The annual report shall include the complete names and addresses of all insurers with which the administrator had an agreement during the preceding fiscal year. 3.) At the time of filing its annual report, the administrator shall pay a filing fee as required by the Commissioner. Please note that an update has been made to the filing requirements. By March 1 of each year, annual reports for the calendar year ending December 31 of the prior year are due for all TPA's that were licensed as of that date. The annual reports, which must include at least a Balance Sheet and Income Statement, may be prepared by a Certified Public Accountant or generated by the TPA. The annual reports must also contain original signatures of two officers of the TPA verifying that the annual reports are true and correct and have been prepared on a GAAP basis. ear are due for all TPA's that were licensed as of that date. The annual reports, which must include at least a Balance Sheet and Income Statement, may be prepared by a Certified Public Accountant or generated by the TPA. The annual reports must also contain original signatures of two officers of the TPA verifying that the annual reports are true and correct and have been prepared on a GAAP basis. Also, attached to the annual report shall be a complete list of names and addresses of all insurers with which the administrator had an agreement during the preceding fiscal year. The annual reports for calendar year ending December 31, 2004 will be required to be filed with this Department by March 1, 2005. A filing fee of one hundred dollars ($100.00) must be paid at the time of filing. I hereby withdraw Bulletins 94-4 and 96-1. Respectfully, George Dale George Dale Commissioner of Insurance