DELEG - Life, Accident & Health Insurers

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Forms for Filing Financial Statements Introduction
The forms listed below are financial filing statements for: Life, Accident and Health Insurers/Fraternal Benefit Societies/United States Branches of Non-US Insurers

For questions about the annual statements, quarterly statements, and Michigan supplemental forms, contact OFIS - Office of Financial Evaluation at (517) 241-4490 or toll free at (877) 999-6442.

Authorized Reinsurers

• Companies for which Reinsurance Credits are Allowed PDF icon

Forms for Filing Financial Statements

• FIS 0063 PDF icon
Valuation of Section 411 Trusteed Assets Under Section 901 - Life and A&H

• FIS 0079 PDF icon
Fraternal Benefit Society Qualifying Assets Under Section 901

• FIS 0081 PDF icon
Life, Accident and Health Insurers Qualifying Assets Under Section 901

• FIS 0082 PDF icon
Non-Insurance Entity Qualifying Assets Under Section 901(1)

• FIS 0318 PDF icon
Complaint and Grievance Summary for Health Carriers FIS 319 was merged into FIS 0318.

• FIS 0322 PDF icon
Michigan Health Insurance Enrollment, Premiums and Losses


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