Policy, Form and Rate Filing Transmittal Form

[LOGO] Jim Poolman Commissioner of Insurance DEPARTMENT OF INSURANCE STATE OF NORTH DAKOTA # BULLETIN 2003-5 TO: All Companies Transacting the Business of Insurance FROM: Jim Poolman, Commissioner DATE: November 24, 2003 Jim Poolman SUBJECT: Policy, Form and Rate Filing Transmittal Form The North Dakota Insurance Department in Bulletin 98-1 introduced form “Policy, Form and Rate Filing - ND 1000”. Per Bulletin 98-1 this form is required to be used when filing a hard copy policy, form or rate filing with the Department under the prior approval statutes. The purpose of this bulletin is to advise companies that while we continue to require a transmittal form with each hard copy filing, the Department will accept either the National Association of Insurance Commissioner’s (NAIC) new Uniform Filing Transmittal Form or the ND 1000 form. It will not be necessary to submit both. The NAIC forms can be found at www.naic.org/rates_forms/trans_docs.htm. Instructions for each form can be found at this site as well. Forms are downloadable. Form “Property & Casualty Transmittal Document PC TD-1” is designed for property and casualty submissions. Form “Life, Accident & Health, Annuity, Credit Transmittal Document (Revised 11/21/2002)” is designed for life, health, annuity and credit submissions. The North Dakota Insurance Department continues to develop its internal programs and systems in keeping with the NAIC speed to market initiative and goals. It is anticipated that when the Department has successfully completed and tested the revised systems, it will then require the use of the NAIC transmittal form and discontinue the use of ND 1000. Companies will be notified by bulletin when this will happen. JP/njb 600 EAST BOULEVARD DEPT 401 • BISMARCK, ND 58505-0320 • (701) 328-2440 • FAX (701) 328-4880 Consumer Hotline: 1-800-247-0560 • Relay North Dakota 1-800-366-6888 (TTY) insuranc@state.nd.us