Annual long-term care (LTC) compliance filing form

Per RCW 48.83.130 (www.apps.leg.wa.gov) and WAC 284.17.262 (www.apps.leg.wa.gov), insurers must certify annually to the commissioner that each resident and non-resident licensee involved in the transaction of long-term care insurance in Washington state has completed an approved long-term care education course.

The form (PDF, 60KB) must be completed and submitted regardless of whether policies were issued or not issued during this time period. The compliance form must be completed and returned on or before March 31 each year. Please email any questions to our education analyst.

Annual Filing of Compliance for Long Term Care Education Requirements Form (PDF, 60KB)

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Reporting requirements for surplus-line insurers

Please send the following to the Office of the Insurance Commissioner:

1. Jurat (statutory statement lead sheet with statutory statement contact information),
2. Washington premiums written (Page 20),
3. Schedule T, and
4. Any changes in Service of Process (as they occur).

You may submit these items via:

You need to also send the following to the Surplus Line Association of Washington (www.surpluslines.org):

1. Statutory Statement (9" x 14" size), including Page 20 (state page) for Washington state,
2. Actuarial opinion,
3. Copy of domiciliary certificate of authority,
4. Management discussion and analysis,
5. Quarterly updates, when available,
6. Audited financial statement, when available,
7. IRIS results, when available,
8. The latest triennial DOI examinations results, and
9. Either a 10-K or 10-Q report.

Updated 01/22/2013