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Annual Statement Checklists, Annual and Quarterly Filing Instructions and Other Instruction Letters

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DOMESTIC AND FOREIGN STATEMENT FILINGS FOR 2022: Company filings may be sent electronically in .pdf format to DomesticAnnual@dobi.nj.gov  for Domestic Company filings and ForeignAnnual@dobi.nj.gov for Foreign Company filings. Electronic signatures will be accepted.

Please ensure the subject line reads as follows: Due date of Filing(s), Company Name, NAIC# (i.e. 3/1, 4/1 or 6/1 Filings). Please note, the assigned analyst may reach out at a future date to request missing documents and or hard copies. Please do not email the analyst directly.

All checks should be mailed directly to the Department at the address on the Annual Statement Checklists.

All Licensed Companies
 
Checklists

Instruction Letters

Health Entities
2019 Annual Business Plan (DOBI Risk Management Questionnaire)
Dental Plan Organizations (DPO)
Dental Service Corporations (DSC)
Health Maintenance Organizations (HMO)
Health Service Corporations (HSC)
Life and Health Companies Filing the Health Blank
Multiple Employer Welfare Arrangement (MEWA)
Organized Delivery Systems (ODS)

Certifications
 
Bulletins

Individual Health Coverage (IHC) Program

Action required by April 1, 2022

 
Small Employer Health Benefits (SEH) Program

Action required by April 1, 2022

 
Medicare Supplement Under 50 Coverage Plan
 
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New Jersey Department of Banking and Insurance