Enmienda a la Solicitud de Renovación del Certificado de Autoridad

OFICINA DEL ^COMISIONADO W DE SEGUROS (SOBIERNO DE PUERTO RICO 14 de abril de 2026 CARTA CIRCULAR NÜM.: CC-2026-2063-CIS A TODOS LOS ASEGURADORES INTERNACIONALES Y ASEGURADORES INTERNACIONALES MULTIESTATALES (MULTISTATE INTERNATIONAL INSURERS) BAJO EL CAPÍTULO 61 DEL CÓDIGO DE SEGUROS DE PUERTO RICO ENMIENDA A LA SOLICITUD DE RENOVACIÓN DEL CERTIFICADO DE AUTORIDAD La Oficina del Comisionado de Seguros de Puerto Rico, en el ejercicio de sus facultades regulatorias y con el propósito de mantener actualizados los formularios y requisitos aplicables bajo el Capítulo 61 del Código de Seguros de Puerto Rico, ha revisado y enmendado la Solicitud de Renovación del Certificado de Autoridad (Form CIS RNW), aplicable a los Aseguradores Internacionales y a (os Aseguradores Internacionales Multíestatales. Como parte de esta enmienda/ toda entidad deberá incluir evidencia de los activos mantenidos en Puerto Rico/ conforme a lo dispuesto en ei Artículo 61.080(6) del Código de Seguros de Puerto Rico, así como el monto de la prima suscrita y/o asumida correspondiente al año precedente/ conforme a lo requerido en el formulario enmendado. En el caso de los Aseguradores Internacionales Multiestatales, la Oficina del Comisionado de Seguros podrá requerir, como parte det proceso de evaluación, evidencia de coordinación y comunicación con los reguladores de las jurisdicciones en las cuales la entidad propone suscribir o asumir riesgos, incluyendo, cuando corresponda, información relacionada con la elegibilidad o participación en asociaciones de garantía aplicables. Nada de lo dispuesto en esta Carta Circular se interpretará como un reconocimiento automático de elegibilidad o reciprocidad en otras jurisdicciones de los Estados Unidos. La clasificación y tratamiento regulatorio de los Aseguradores Internacionales y de los Aseguradores Internacionales Multiestatales dependerá del cumplimiento con las leyes y requisitos aplicables en cada jurisdicción. PO Box 195415, San Juan, Puerto Rico 00919 787-304-8686 - ' www.ocs.pr.gov CC-2026-2063-CIS Página 2 Esta Carta Circular entrará en vigor fnmediatamente a su emisión y será aplicable a todas tas solicitudes de renovación de Certificados de Autoridad sometidas para el año fiscal 2026-2027/ y años subsiguientes. Toda documentación presentada deberá cumplir estrictamente con los requisitos y enmiendas aquí dispuestas. Se requiere estricto cumplimiento con lo dispuesto en esta Carta Circular/ cuyo incumplimiento podrá conllevar la imposición de sanciones conforme ai Código de Seguros de Puerto Rico. Cordíalmente, Lccia-Su^íte M. Del Valle Leca donada de Seguros |i COMMISSIONER ^ti OF INSURANCE INTERNATIONAL INSURER/MULTISTATE INTERNATIONAL INSURER APPLICATION FOR RENEWAL OF THE CERTIFÍCATE OF AUTHORIZATION GENERAL INSTRUCTIONS In accordance with Article 61.230(2) of the Insurance Code of Puerto Rico and Article 15 of Rule LXXX of the Regulation of the Insurance Code of Puerto Rico/ which governs the Operatíons of International Insurers and Multistate International Insurers/ each licensed International Insurer and Multístate International Insurer shall renew its Certifícate of Authority annually/ on or before June 30th/ inTmediately following fche date of issue or renewal. Payment of corresponding charges must be in the form of money order or a certified check/ payable to the Secretary of the Treasury of Puerto Rico. In addition/ and pursuant to the governing laws and regulations of the Insurance Code of Puerto Rico/ the Commissioner has the discretion and powers to refuse to renew/ revoke or suspend the authorization of an International Insurer or Multistate International Insurer. The Commissioner of Insurance may also impose fiiies and/or penalties/ and refuse to further renew/ revoke/ or suspend the certifícate of authority of an International Insurer or Multistate International Insurer/ if it is not renewed by June 30th. This form must be filled out in its entirety and/ when submitted/ it should have attached all material requested together with the corresponding payment. A response to each item(s) is necessary in order for your application to be considered complete. If any question(s) is inapplicable to your particular situation/ please clearly indícate so by marking //N/A// in the space provided. All fields must be filled out (complete). Renewal forwarding mailíng address for the Puerto Rico Insurance CoiTmiissioner s Office: PO Box 195415/ San Juan/ PR 00919-5415 Renewal physical delivery address: World Plaza Building - 9th Floor/ 268 Muñoz Rivera Ave./ San Juan/ PR 00919 "ENTERNATIONAL INSURER'S OR MULTISTATE INTERNATIOiNAL 1NSURER1S NAME: FORM FOR RENEWAL OF TIIE CERTIFÍCATE OF AUTHORITY FOR THE YEAR: INTERNATIONAL INSURANCE CENTER PLEASE TYPE ALL INFORMATION SECTION A: GENERAL INFORMATION We submit the followixig hiíormation in compliance with the laws and regulatíons of Chapter 61 of the Insurance Code of Puerto Rico/ to obtain the renewal of our certifícate of authority to transact insurance business as an ínternatíonal Insurer or MuÍtístate ínternatíonal Insurer for the year 1. Intemational Insurer/ Multistate International Insurer Entity Information: Name: Postal Address: Headquarters Address: Telephone: _ Fax: Email: 2. Corporate Id Number (FEIN Number): 3. NAIC Group Number (if applicable): 4. Authorized Principal Representative Information: Name: Address: TeÍephone: _ Fax: Email: 5. Contact Person(s) Informatíon Regarding This Application: Name(s): Address: Telephone: _ Fax: Emaü: Office of the Commissioner of Insurance FORM CIS-RNW Iníernational Insurance Center Rev. 04-2026 World Plaza Building - 9th Floor, 268 Muñoz Rivera Avenue, San Juan PR 00918 Page 2 of 5 PO Box 195415, San J'Íian, PR 00919-5415 INTERNATIONAL INSURER'S OR MULTISTATE INTERNAT10NAL INSUREIfS NA ME: FORM FOR RENEWAL OF THE CERTIFÍCATE OF AÜTHORH Y FOR THE YEAR; INTERNATIONAL INSURANCE CENTER 6. International Insurer/Muítistate Internationai Insurer: President/s Information Name: Telephone: _ Email: 7. International Insurer/MuItistate Internatíonal Insurer: Treasurer/s Information Name: Telephone: _ Email: 8. Intemational ínsurer/Multistate International Insurer; Secretary s Information Name: Telephone: _ Email: 9. indícate type of authorization being renewed (please check): Class 1 _ CIass 2 _ Cíass 3 CÍass 4 CÍass 5 CIass 6 Class 3M Class 4M Class 5M 10. Picase provide any information about any business other than insurance business that the International Insurer/Multistate International ínsurer propases to carry: (Picase use a sepárate sheet/ if necessary) 11. Include evidence of assets in Puerto Rico in compliance with Árdele 61.080(6) of the Insurance Code of Puerto Rico. Office of the Commissioner of Insurance FORM CIS-RNW International Insurance Ceníer Rev. 04-2026 World Plaza Building - 9th Floor, 268 Muñoz Rivera Avenue/ San Juan PR 00918 Page 3 of 5 PO Box 195415, San Juan, PR 00919-5415 INTERNATIONAL INSURER'S OR MULTISTATE INTERNATIONAL 1NSURER'S NAME; FORM FOR RENEWAL OF TIIE CERTIHCATE OF AÜTHORH V FOR THE YEAR: INTERNATIONAL INSURANCE CENTER SECTION B: PEES Pursuant to Article 15 of Rule LXXX of the Regulation and Article 61.050(10) of the Insurance Code of Puerto Rico/ the ínternational ínsurer/Multistate International ínsurer will pay/ on the date of each renewal/ on or before June 30lh/ an annual contribution pursuant to the ranges of written premium and/or assumed premium set forth as follows: PREMIUMS WRITTEN/ASSUMED AMOÜNT TO BE PAID 1. No more than $25/000/000 $5/000.00 2. More than $25/000/000 but less than $50/000/000 $10/000.00 3. More than $50/000/000 but less than $75/000/000 $20/000.00 4. More than $75/000,000 but less than $100/000/000 $35/000.00 5. More than $100/000/000 but less than $150/000/000 $50/000.00 6. More than $150/000,000 but less than $250/000/000 $65/000.00 7. More than $250/000/000 $75/000.00 Please indicate check number/ amouiit of annual conh*ibution paid and premium written/ assumed: Check Number: Amount of annual contribution: Amount of Premium Written/Assumed: _ Preceding fiscal year: Office of íhe Commissioner of Insurance FORM CIS-RNW Internationai Insurance Center Rev. 04-2026 World Plaza Building - 9? Floor, 268 Muñoz Rivera Avenue, San Juan FR 00918 Page 4 oí 5 PO Box 195415, San fuan, FR 00919-5415 INTERNATIONAL INSURER'S OR MULTISTATE INTERNAT10NAL 1NSURER'S NAME: FORM FOR RENEVVAL OF THE CERTIFÍCATE OF AUTHORn Y FOR THE YEAR: ^TERNATIONAL INSURANCE CENTER SBCTION C: CERTIFICATION I certify that the informatíon given in this application is true and correct and that all estímales given are true estimates based upon the facts that have been carefully considered and assessed. Furthermore/ I affinii that pursuant to Article 61.050(9), the applicant shall notify the Commissioner of ínsurance in an expedited manner and in writing/ of any change in the information submitted as part of this application within ten (10) days of said change. If applicant is a Protected Cell International Insurer/ I further acknowledge that all financia! records of the Protected Cell Company/ includmg records pertaining to protected cells/ shall be available for inspection or examination by the Commissioner or the Commissioner s designee. Name: Date: Signature: (DIRECTOR) AffidavÍt No. Personally appeared before me the above named personally known to me/ who/ being duly sworn/ deposes and says thafc he/she executed the above uistrument and that the statemenís ana answers contained therein are true and correct to the best of his/her knowledge and belief. Subscribed and sworn to before me this _ day of _, 20, NOTARY PUBLIC Office oí íhe Conmússíoner of Insurance FORM CIS-RNW International hisurance Center Rev. 04-2026 World Plaza Building - 9th Floor, 268 Muñoz Rivera Avenue, San Juan PR 00918 Page 5 of 5 PO Box 195415, San Juan/ PR 00919-5415