Washington State Office of the Insurance Commissioner

Financial statements filed during 2010

Filing checklists for financial statements

Fraternal Beneficial Societies This link opens a PDF document. Filing checklist (92 KB).

Health (HCSC, HMO and multiple employer welfare arrangement only) This link opens a PDF document. Filing checklist (92 KB).

Form IC-13A-HC / IC-14-HMO
This link opens a PDF document. Form (1 MB).
This link opens a PDF document. Instructions (20 KB).

WSHIP assessment report.

Supplemental data input Link goes to a secure site..

Life, Accident & Health Insurers including health (X) blank This link opens a PDF document. Filing checklist (64 KB).

WSHIP assessment report.

Supplemental data input Link goes to a secure site..

Property & Casualty insurers including health (X) blank This link opens a PDF document. Filing checklist (100 KB).

WSHIP assessment report.

Special data calls site.

Risk Retention Groups This link opens a PDF document. Filing checklist (88 KB)

Surplus Lines Submit premium tax forms online:
E-Tax Login

Contact:
Kriscinda Hansen
360-725-7032
taxes@oic.wa.gov

Mail financial statements and supplements to:
Office of Insurance Commissioner
810 Third Avenue, Suite 650
Seattle, WA 98104-1615

Contact:
Ken Combs
206-464-5311
KenC@oic.wa.gov

Title Filing checklist (80 KB)


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