Covid 19 Premium Refund Reporting

For Report of Reporting Period: April, May, and June 2021

The California Department of Insurance ("Department") is extending the reporting periods in Bulletin 2020-3 to cover the month of April, May, and June of 2021 with respect to Premium Refunds, Credits, and Reductions in Response to the COVID-19 Pandemic. Insurers writing business in the lines of insurance identified in Bulletin 2020-3 must submit a report to the Department no later than July 30, 2021 that covers the month of April, May, and June reflecting any premium relief, or if any premium relief was provided during these months.

As stated in Bulletin 2020-3, the report must include "all actions taken and contemplated future actions to refund premium in response to or consistent with this Bulletin.  The report shall include California-specific information and an explanation and justification for the amount and duration of any premium refund, and how those measures reflect the actual or expected reduction of exposure to loss." 

To satisfy this reporting requirement, Excel Reporting Form Applications have been created and can be downloaded below.  The report must be completed and returned to RSBCovid19PR@insurance.ca.gov no later than July 30, 2021.  If no premium relief is provided during the current quarterly reporting period, or no supplemental premium relief is being provided for the months of April through June 2021, submitted reports must indicate that no premium relief was provided to policyholders with an explanation of the reason(s) why no premium relief was provided.

Who is Required to File?

• All admitted and nonadmitted property & casualty and workers compensation insurers who operate in California, including those insurers who provided no premium refunds during the reporting period.

What are the Reporting Requirements?

• Cover Page - To be filled out by all CA admitted and nonadmitted companies, and companies transacted through a surplus line broker.
• Questionnaire - To be filled out by all CA admitted and nonadmitted companies, and companies transacted through a surplus line broker.
• Explanatory Memorandum - To be filled out only by companies that write in one of the six lines identified in the Bulletin and/or other line(s) impacted by the COVID-19 pandemic regardless whether a refund is involved.
• Worksheet - To be filled out only by companies that write in one of the six lines identified in the Bulletin and/or other line(s) impacted by the COVID-19 pandemic when a refund is involved.

Reporting Forms and Instructions Download

Incuding Prior Reporting Periods' Forms and Instructions for your reference:

Where to return your completed Forms and supporting documents?

• Completed Forms contained in the Excel file and other supporting documents should be submitted to the Rate Specialist Bureau of the California Department of Insurance at email address:  RSBCovid19PR@insurance.ca.gov.
• Any questions, please feel free to e-mail RSBCovid19PR@insurance.ca.gov.

A current Acrobat Reader is needed to view documents in PDF. Visit our Free Readers and Apps page.