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North Dakota Insurance Department
Adam Hamm, Commissioner
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The North Dakota Insurance Department has adopted a standard Filing Checklist format that lists all filings required during the current year from licensed companies.

New filings required in 2015 - applicable to life, accident and health, and fraternal societies: XXX/AXXX Reinsurance Exhibit

Discontinued filings in 2015: None

Materially modified forms for filings in 2015: None

Renewal Statement for Admitted Companies
The Renewal Statement For Admitted Companies must be submitted using the North Dakota Insurance Department's enhanced Online Renewal System.

The Online Renewal System requires payment of the company's renewal fees by one of the following options:
  • ACH credit and wire transfer - your financial institution or accounting department must originate payment. The payment cannot be made using the online system; see the Online Renewal System for further instructions.
  • Payment by check - a completed copy of the renewal statement must be included along with the company's check and postmarked by March 1 to avoid penalties.
If you have questions regarding the ACH credit or wire transfer processes, please contact Laurie Scully at 701-328-2503 or lscully@nd.gov.

Amendments - Please note that the Online Renewal System is designed to accept only originally filed renewal statements. Amended renewal forms cannot be submitted electronically. They must be mailed to the Department. Contact the Department at 701-328-3328 or insurance@nd.gov if in need of an amended renewal form.

Abstract form:
  • Electronic filing of the company's abstract form is required for health entities, life insurers, property and casualty insurers and title companies. Please click on the appropriate abstract form located under Links below or under the Company reporting forms section of the website.
  • March 1 is the deadline for submitting the electronic abstract form.
  • A filing fee of $30 is imposed by N.D.C.C. Section 26.1-01-07 and is included on the Renewal Statement SFN 16354 form.
  • Publication fees are imposed under N.D.C.C. Section 26.1-03-10 and N.D.C.C. Section 46-05-03 and are billed directly to the insurance company by the North Dakota Newspaper Association. Payment of publication fees must be remitted to the North Dakota Newspaper Association.
  • If amended abstract forms are filed after the March 1 deadline, an additional $30 filing fee and any applicable re-publication fees will be payable.
When submitting filings for two or more companies in a single package, all documents must be bundled BY COMPANY, not by document type, in order to expedite processing.

The Department no longer mails Annual Filing Instruction Packages to licensed companies, since all state-specific forms and filing information can be obtained directly from this website. Any licensed insurer that would like to receive the applicable Filing Checklist and state-specific forms should make a specific request to ytkeniston@nd.gov.

The Department will also mail the amended pages for the Fire District Reporting Map to any foreign property and casualty insurer that does not have the ability to download the map from this website.

Only insurers and health maintenance organizations domiciled within the state of North Dakota are required to file a hard copy of their Annual Statement and Quarterly Statements with this Department. Foreign insurers are required to file their Annual Statement and Quarterly Statements electronically with the NAIC.

Please direct any questions to:

Yvonne Keniston
ytkeniston@nd.gov
North Dakota Insurance Department
600 E. Boulevard Ave.
Bismarck, ND 58505-0320
701.328.2440
701.328.4880 fax

 
County Mutual Companies Checklist SFN 53137
Fraternal Societies Checklist SFN 52095
Health Company Abstract of Statement SFN 53892
Health Entities Checklist SFN 52094
Life, Accident and Health Insurers Checklist SFN 52090
Life Company Abstract of Statement SFN 4803
Online Renewal System

Property and Casualty Company Abstract of Statement SFN 4802
Property and Casualty Insurers Checklist SFN 52091
Title Companies Checklist SFN 52092

North Dakota Insurance Department
600 E. Boulevard Ave.
Bismarck, ND 58505-0320
Phone 701.328.2440
Toll free 800.247.0560
Fax 701.328.4880

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