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CA Department of Insurance

Special Report and Filing Requirements

The following special reports are required by the California Insurance Code or California Code of Regulations.  If you have data to report for the specified years, please download the Excel Workbook from this website and use it to complete your reporting.  For the Signature Page when required, you can download a copy, and have it signed and saved/scanned back to a pdf file.  If you are unable to scan your signature page to a pdf, you could submit it by regular mail to the address listed below.

We are no longer requiring companies to print out the reporting forms.  You can e-mail them to:

If supplemental documents are required, you can mail them to:

California Department of Insurance
Rate Specialist Bureau
300 South Spring Street, 11st Floor
Los Angeles, CA  90013

If you have a question specific to the data call, please e-mail it to the specific e-mail address mentioned above.  You should include your name, company name, telephone number, and e-mail address in all correspondence with the CDI.  For questions regarding insurance rate filings, please call (415) 538-4300 in SF or (213) 346-6707 in LA, or visit the Department's Public Viewing Room.

[2009 | 2010 | 2011 | 2012 | 2013 | 2014]

 

Year 2014 Reporting Forms

FORM TITLE & INSTRUCTION DUE DATE DOWNLOAD FORMAT

CA Title Insurance Statistical Plan & Income Statement [CIC 12401.5]

send to: RSBtitle@insurance.ca.gov

5/31/2014

Instructions (pdf)
Statistical Plans (xls)

CA Marketing System Survey

send to: RSBmktsys@insurance.ca.gov

6/30/2014

Cover Letter (pdf)
Signature Page (pdf)
Form (xls)

CA Earthquake Probable Maximum Loss Questionnaire - [CCR Title 10 §2307, pdf]

sent to: RSBeqpml@insurance.ca.gov

Primary Carriers - 6/30/2014
Reinsurers - 8/31/2014
Retrocesssionaires - 9/30/2014

Instructions (pdf)
Cover Letter (pdf)
Signature Page (pdf)
Form A (xls)
Form B (xls)
Form X (pdf)
EQ Zones/Zip Code List (xls)

CA Earthquake Premium, Exposure & Policy Count Data Call - [CIC §10089.13(a)]

send to: RSBeqexp@insurance.ca.gov

3/10/2014 Cover Letter (pdf)
Signature Page (pdf)
Data Collection Workbook (xls)
Workbook Instructions (pdf)

CA Credit Property & Credit Unemployment - [CIC 779.36]

send to: RSBcredit@insurance.ca.gov

7/1/2014 Credit Property (xls)
Credit Unemployment (xls)
CA Child Care Report Not required this year. None
CA Legal Professional Liability Insurance Report Not required this year. None
CA Medical Professional Liability Insurance Report Not required this year. None
Survey of Bail Bond Business Data Call Not required this year. None

 

Year 2013 Reporting Forms

FORM TITLE & INSTRUCTION DUE DATE DOWNLOAD FORMAT
CA Title Insurance Statistical Plan & Income Statement [CIC 12401.5]

send to: RSBtitle@insurance.ca.gov
5/31/2013 Instructions (pdf)
Statistical Plans (xls)

CA Marketing System Survey

send to: RSBmktsys@insurance.ca.gov

6/30/2013

Cover Letter (pdf)
Signature Page (pdf)
Form (xls)

CA Earthquake Probable Maximum Loss Questionnaire - [CCR Title 10 §2307, pdf]

sent to: RSBeqpml@insurance.ca.gov

Primary Carriers - 6/30/2013
Reinsurers - 8/31/2013
Retrocesssionaires - 9/30/2013

Instructions (pdf)
Cover Letter (pdf)
Signature Page (pdf)
Form A (xls)
Form B (xls)
Form X (pdf)
EQ Zones/Zip Code List (xls)

CA Earthquake Premium, Exposure & Policy Count Data Call - [CIC §10089.13(a)]

send to: RSBeqexp@insurance.ca.gov

3/12/2013 Cover Letter (pdf)
Signature Page (pdf)
Data Collection Workbook (xls)
Workbook Instructions (pdf)

CA Credit Property & Credit Unemployment - [CIC 779.36]

send to: RSBcredit@insurance.ca.gov

7/1/2013 Credit Property (xls)
Credit Unemployment (xls)
CA Child Care Report Not required this year. None
CA Legal Professional Liability Insurance Report Not required this year. None
CA Medical Professional Liability Insurance Report Not required this year. None
Survey of Bail Bond Business Data Call Not required this year. None

Year 2012 Report Forms

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FORM TITLE & INSTRUCTION DUE DATE DOWNLOAD FORMAT
CA Title Insurance Statistical Plan & Income Statement [CIC 12401.5]

send to:  RSBtitle@insurance.ca.gov
5/31/2012 Instructions (pdf) - Amended
Statistical Plans (xls) - Amended

CA Marketing System Survey

send to:  RSBmktsys@insurance.ca.gov

6/30/2012

Cover Letter (pdf)
Signature Page (pdf)
Form (xls)

CA Earthquake Probable Maximum Loss Questionnaire - [CCR Title 10 §2307, pdf]

sent to:  RSBeqpml@insurance.ca.gov

Primary Carriers - 6/30/2012
Reinsurers - 8/31/2012
Retrocesssionaires - 9/30/2012
Instructions (pdf)
Cover Letter (pdf)
Signature Page (pdf)
Form A (xls)
Form B (xls)
Form X (pdf)
EQ Zones/Zip Code List (xls)

CA Earthquake Premium, Exposure & Policy Count Data Call - [CIC §10089.13(a)]

send to:  RSBeqexp@insurance.ca.gov

 3/12/2012 Cover Letter (pdf)
Signature Page (pdf)
Data Collection Workbook (xls)
Workbook Instructions (pdf)

CA Credit Property & Credit Unemployment - [CIC 779.36]

send to:  RSBcredit@insurance.ca.gov

7/1/2012 Credit Property (xls)
Credit Unemployment (xls)
CA Child Care Report - [CIC 1864]

send to:  RSBchildcare@insurance.ca.gov

 5/1/2012 Instructions (pdf)
Form (xls)
 CA Legal Professional Liability Insurance Report Not required this year. None
 CA Medical Professional Liability Insurance Report Not required this year. None
 Survey of Bail Bond Business Data Call Not required this year. None


Year 2011 Reporting Forms

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FORM TITLE & INSTRUCTION DUE DATE DOWNLOAD FORMAT

CA Marketing System Survey

send to:  RSBmktsys@insurance.ca.gov

6/30/2011 Cover Letter (pdf)
Signature Page (pdf)
Form (xls)

CA Child Care Report - [CIC 1864]

send to:  RSBchildcare@insurance.ca.gov

5/1/2011 Instructions (pdf)
Form (xls)

CA Credit Property & Credit Unemployment - [CIC 779.36]

send to:  RSBcredit@insurance.ca.gov

7/1/2011 Credit Property (xls)
Credit Unemployment (xls)

CA Earthquake Probable Maximum Loss Questionnaire - [CCR Title 10 §2307, pdf]

sent to:  RSBeqpml@insurance.ca.gov

Primary Carriers - 6/30/2011
Reinsurers - 8/31/2011
Retrocesssionaires - 9/30/2011
Instructions (pdf)
Cover Letter (pdf)
Signature Page (pdf)
Form A (xls)
Form B (xls)
Form X (pdf)
EQ Zones/Zip Code List (xls)

CA Earthquake Premium, Exposure & Policy Count Data Call - [CIC §10089.13(a)]

send to:  RSBeqexp@insurance.ca.gov

3/10/2011 Cover Letter (pdf)
Signature Page (pdf)
Data Collection Workbook (xls)
Workbook Instructions (pdf)

CA Legal Professional Liability Insurance Report - [CIC §11555.2]

send to:  RSBLegal@insurance.ca.gov

7/1/2011 Instructions (pdf)
Form (xls)

CA Medical Professional Liability Insurance Report - [CIC §11555.2]

send to:  RSBMedical@insurance.ca.gov

7/1/2011

Instructions (pdf)
Form (xls)

Survey of Bail Bond Business Data Call Not Required at this time. None
 

Year 2010 Reporting Forms


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FORM TITLE & INSTRUCTION DUE DATE DOWNLOAD FORMAT
CA Marketing System Survey - Revised

send to:  RSBmktsys@insurance.ca.gov
6/30/2010 Cover Letter - Revised (pdf)
Signature Page - Revised (pdf)
Form - Revised (xls)
CA Child Care Report - [CIC 1864]

send to:  RSBchildcare@insurance.ca.gov
5/1/2010 Instructions (pdf)
Form (xls)
CA Credit Property & Credit Unemployment - [CIC 779.36]

send to:  RSBcredit@insurance.ca.gov
7/1/2010 Credit Property (xls)
Credit Unemployment (xls)
CA Earthquake Probable Maximum Loss Questionnaire - [CCR Title 10 §2307, pdf]

send to:  RSBeqpml@insurance.ca.gov
Primary Carriers - 6/30/2010
Reinsurers - 8/31/2010
Retrocesssionaires - 9/30/2010
Instructions (pdf)
Cover Letter (pdf)
Signature Page (pdf)
Form A (xls)
Form B (xls)
Form X (pdf)
EQ Zones/Zip Code List (xls)
CA Earthquake Premium, Exposure & Policy Count Data Call - [CIC §10089.13 (a)]

send to:  RSBeqexp@insurance.ca.gov
3/10/2010 Cover Letter (pdf)
Signature Page (pdf)
Data Collection Workbook (xls)
Workbook Instructions (pdf)
CA Legal Professional Liability Insurance Report - [CIC §11555.2]

send to:  RSBLegal@insurance.ca.gov
7/1/2010 Instructions (pdf)
Form (xls)
CA Medical Professional Liability Insurance Report - [CIC §11555.2]

send to:  RSBMedical@insurance.ca.gov
7/1/2010 Instructions (pdf)
Form (xls)
Survey of Bail Bond Business Data Call
Not required at this time.
None.

Year 2009 Reporting Forms


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FORM TITLE & INSTRUCTION DUE DATE DOWNLOAD FORMAT
CA Marketing System Survey

send to: RSBmktsys@insurance.ca.gov
6/30/2009 Cover Letter (pdf)
Signature Page (pdf)
Form (xls)
CA Child Care Report - [CIC 1864]

send to: RSBchildcare@insurance.ca.gov
5/1/2009 Instructions (pdf, 102 kb)
Form (xls, 80 kb)
CA Credit Property & Credit Unemployment - [CIC 779.36]

send to:  RSBcredit@insurance.ca.gov
7/1/2009 Credit Property (xls, 162 kb)
Credit Unemployment (xls, 168 kb)
CA Earthquake Probable Maximum Loss Questionnaire - [CCR Title 10 §2307, pdf, 36 kb]

send to:  RSBeqpml@insurance.ca.gov
Primary Carriers - 6/30/2009
Reinsurers - 8/31/2009
Retrocesssionaires - 9/30/2009
Instructions (pdf, 423 kb)
Cover Letter (pdf, 184 kb)
Signature Page (pdf, 78 kb)
Form A (xls, 148 kb)
Form B (xls, 78 kb)
Form X (pdf, 48 kb)
EQ Zones/Zip Code List (xls, 482 kb)
CA Earthquake Premium, Exposures & Policy Count Data Call- [CIC §10089.13 (a)]

send to:  RSBeqexp@insurance.ca.gov
March 10, 2009 Cover Letter (pdf, 124 kb)
Signature Page (pdf, 80 kb)
Data Collection Workbook (xls, 55 kb)
Workbook Instructions (pdf, 129 kb)
CA Legal Professional Liability Insurance Report - [CIC §11555.2]

send to:  RSBlegal@insurance.ca.gov
7/1/2009 Instructions (pdf, 68 kb)
Form (xls, 140 kb)
CA Medical Professional Liability Insurance Report - [CIC §11555.2]

send to:  RSBmedical@insurance.ca.gov
7/1/2009 Instructions (pdf, 68 kb)
Form (xls, 140 kb)
Survey of Bail Bond Business Data Call Not required at this time. None.

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