separator
Skip to Contentseparator HomeseparatorCheck License StatussepartorContact UssepartorRequest for Assistance
Welcome to the California Department of Insurance
Site tools
Decrease font size Increase font size Site map Help Print-friendly version
INSURERS: GRANTS & ANNUITIES - NOTICES & FORMS
Annual Statement Financial Filing Requirements and Instructions 2011 and 2012

The following sections contain Filing Instructions and California specific forms for you to view and download. Please contact the Financial Analysis Division (see below) regarding any forms not provided on this Website. Unless otherwise noted herein, all California filings are to be filed online by utilizing the OASIS (Online Assistance System for Insurer Submittal). Additionally, the original of pages requiring original signatures must be submitted to the department by mail to:

California Department of Insurance
Financial Analysis Division - Financial Records
300 South Spring Street, South Tower, 13th Floor
Los Angeles, CA 90013

Phone: (213) 346-6447 or (213) 346-6409 for G&A Annual Statement Blank inquiry
Phone: (213) 346-6451 for G&A Annuity Agreements inquiry
E-mail: FAD_GA@insurance.ca.gov

Note: Please adjust your left and right margins to zero (0) before selecting the Print button in order to see all text on hard copy.

View Annual/Quarterly Notices

Form No.

Description

Due Date

Printing and Special Instructions

600

G&A - Annuity Agreement Filing Instructions, Transmittal(.doc - 35 kb)

 

G&A - Annuity Agreements Summary Page(s) (xls)

Letter to Societies - December 1, 2007 (doc - 225 kb)

Quarterly in conjunction with G&A Annuity Agreements Filing Instructions (see above), not later than 30 days after each calendar quarter

Use for agreements entered into on or after 1/1/06

Note - submit required forms along with G&A Agreements Summary Page(s), see below.

Not required to be submitted online through OASIS 

Print Format: Letter size; Orientation: Portrait 

601

G&A Annual Statement Blank (xls - 438 kb) Note - Annual Statement blank is updated annually. Please use the above link to complete the Annual Statement. 

120 days After
Calendar/Fiscal Year End

Print Format: Legal size; Orientation: Portrait

Annual Statement must be submitted using the above specifications. Current version of the Annual Statement must be used. Please do not add or delete any cells, rows, or columns on any pages or make any changes to the format of the Annual Statement.  Also do not password protect documents submitted through OASIS.

NOTE- A copy of the Segregated Trust Account's Investment Summary must be submitted as part of the Annual Statement PDF file.

G&A Annual Statement Instructions (doc - 64 kb)

N/A

Annual Statement Instructions are to be used for guidance in completing the Annual Statement.

Authorization for Disclosure of Financial Records (xls - 708 kb)

Same as the Annual Statement

Print Format: Letter size
Orientation: Portrait

Signed original must be sent to the Department's Legal Division at the address given on the form.

 List of Licensed California Grants and Annuities Companies and California Identification Numbers (.pdf 43kb ) 



 

Updated date: 05/16/2012

 

separator