The Financial Examination team is responsible for conducting on-site financial examinations of all Nebraska domestic insurance companies in accordance with Nebraska Statutes and Regulations, and the NAIC Financial Condition Examiners Handbook. The examinations are conducted to determine the financial condition of the company, its ability to meet and fulfill its obligations, and whether it has complied with the provisions of Nebraska Statutes. 

For questions related to financial exams, please contact:

Assistant Chief Examiner - Field
Skyler Lawyer
Skyler.Lawyer@nebraska.gov

The Financial Analysis team is responsible for conducting in-house audits of all Nebraska domestic insurance companies' financial statements and other supplemental filings as required to monitor the insurers' statutory compliance and solvency on an ongoing basis. The Analysis team takes a risk-focused approach and strives to identify financial issues early to address problems and/or rehabilitate companies prior to insolvency. 

For questions related to financial analysis, please contact:

Assistant Chief Examiner - Analysis
Jennifer Rose, CFE
(402) 471 -0343
jennifer.rose@nebraska.gov 

The Company Administration team is responsible for licensing all insurance companies seeking licensure in Nebraska, as well as, many other miscellaneous company types including but not limited to third-party administrators, risk retention groups, and purchase groups. The team is also responsible for the audit of over 1600 premium tax returns annually and over 1800 surplus lines tax filings quarterly, and the related collection of over $100 million in tax. Additionally, the team monitors and ensures compliance of insurers licensed in Nebraska as well as oversees pre-need burial trusts. 

For questions related to the Company Administration area, please contact the following:

Company Administration
Kristy Hadden
kristy.hadden@nebraska.gov
(402) 471-0373

We have three specialists at the NDOI: holding company, group solvency, and investment. Each of these areas has a specialized part in supporting the Financial Examination and Financial Analysis teams' monitoring of the financial solvency of Nebraska's domestic insurers. The roles of each respective area is as follows:

• Holding Company is responsible for reviewing Forms B, C, D, and F to ensure compliance with Nebraska Statutes and Regulations and the NAIC Accounting Practices and Procedures.
   
• Group Solvency is responsible for coordinating supervisory colleges and monitoring international insurance activities at the NAIC and IAIS.
   
• Investments assist with the ongoing monitoring of insurer investments and investment accounting practices of the insurance industry by reviewing investment portfolios, investment strategies, and working with the NAIC and Securities Valuation Office. 

For questions related to holding company filings, please contact:

Chris Amory, CFE
Holding Company Specialist
chris.amory@nebraska.gov
(402) 471-5351

For questions related to group solvency, please contact:

Anthony Quandt, CFE
Group Solvency Specialist 
anthony.quandt@nebraska.gov
(402) 471-3164

For questions related to investments, please contact:

Andrea Johnson, CFE
Deputy Chief Financial Regulator 
andrea.johnson@nebraska.gov
(402) 471-4641

The Actuarial team performs actuarial review and analysis to ensure that all domestic insurers comply with the American Academy of Actuaries - Actuarial Standards of Practice. The Actuarial team supports other areas of the NDOI through a review of the annual actuarial opinions, assistance with financial examinations, and review of various rate filings including Affordable Care Act (ACA) marketplace and long-term care. 

​For questions related to life business, please contact:

Michael Muldoon, ASA, MAAA
Life and Health Actuarial Examiner 
michael.muldoon@nebraska.gov 
(402) 471-1433

​For questions related to health business, please contact:

Margaret Otto, ASA, MAAA
Life and Health Actuarial Examiner
margaret.otto@nebraska.gov
(402) 471-4631

​For questions related to P&C business, please contact:

Ngyuen Thai
P&C Actuarial Examiner
ngyuen.thai@nebraska.gov
(402) 471-4645

For general questions regarding the Financial Regulation Division of the Nebraska Department of Insurance, please contact:

Staff Assistant
Jillian Sweeney
jillian.sweeney@nebraska.gov
(402) 471-4645

National Association of Insurance Commissioners (NAIC) Website

Secure Portal Link

Portal FAQs:

• The Online Electronical Filing portal is in place for domestic and foreign insurance companies and those filings the Supplemental Compensation Exhibit to securely file their confidential regulatory filings with the Nebraska Department of Insurance. 
   
• Do I need a password?
  • ​No. You are able to upload filings without submitting credentials or creating a password ahead of time. 
     
• ​What needs to be filed? Please refer to the NAIC filing checklist on our website. 
  • ​Domestic and Foreign Companies:
    • ​State Filing Checklist items that are not already filed electronically with the NAIC (notated with 'xxx'). 
    • Biographical affidavits for change/appointment/election of new Board members and officers. 
    • Holding Company filings, which includes Forms B, C, D, & F. 
    • Notice of dividend payments. 
    • Surplus notes requests. 
    • Other correspondence. 
  • ​Supplemental Compensation Exhibits (required by ALL companies, foreign and domestic, licensed in Nebraska)
    • ​SCE instructions
    • Please file separately from the other filings 
       
• ​​How does the portal work?
  • ​Choose your filing type, and input the requested information into the online form. Then, download your file. Click submit. 
  • You will receive an email receipt. 
  • We will receive notification that something has been filed. 

Online Payment Portal

The Department has an online portal to accept payment for various fees. The fees that can be paid through this portal are all UCAA fees, Certificate of Authority issuance fees, Form B filings fees, TPA late filing fees, and Certificate requests. There is also an "Other" category for Department payments that do not fall within the above categories. 

• If an agent works for an agency that holds a surplus lines license, does the agent also need to hold a surplus lines license?
  • ​If all the individual agent's business is placed through a licensed surplus lines agency, and all business is being reported for surplus lines tax purposes through the agency, then in such cases the individual agent does not need to hold a surplus lines license. However, the individual agent must be listed on the corporate surplus lines license in order to transact surplus lines business on behalf of the agency and also hold a current producer license. Neb. Rev. Stat. §44-5503. 
     
• ​What are the licensee's requirements for placing coverage with a non-admitted insurer?
  • ​The producer or licensee is responsible for ensuring that a non-admitted carrier is eligible to write surplus lines business in Nebraska according to the requirements of Neb. Rev. Stat. §44-5508  ​
  • The producer or licensee is responsible for completing due diligence in determining if a risk is unable to be placed in the non-admitted market Neb. Rev. Stat. §44-5510​
• Does Nebraska allow for self-procurement on a non-admitted basis?
  • No, only if the insured meets the definition of an exempt commercial purchaser pursuant to Neb Rev Stat 44-5502 (6)
  •  
  •  
• How do I become authorized as an exempt commercial purchaser?
  • If an insured feels they qualify as an exempt commercial purchaser pursuant to requirements in Neb Rev Stat 44-5502 they should complete this FORM and email it to doi.surpluslines@nebraska.gov

All surplus lines licensees are required to file quarterly reports and pay applicable premium taxes. The tax rate is 3% on gross premiums charged less any return premium taxes. Tax returns with tax due are required to be submitted electronically through OPTins. Additional information can be found on the OPTins website. Returns with no tax due (zero filings) can be made through OPTins or may be emailed to doi.surpluslines@nebraska.gov - Quarterly filings are due as follows:

• First Quarter - June 1
   
• Second Quarter - September 1 
   
• Third Quarter - December 1 
   
• Fourth Quarter - March 1 
   

Quarterly Attestation Statement
 

Surplus Lines Premium Tax Filing Information
 

​Neb. Rev. Stat. §44-5506

• Where does a filer obtain the required forms to file?
  • ​When filing through OPTins, the forms will be located there. If completing a zero filing and emailing the forms can be located here on the OPTins website and doi.surpluslines@nebraska.gov . When submitting the forms through email, the excel file must be submitted as an excel file and not as a PDF. The attestation should be submitted as a PDF. 
     
• ​Are fees included as part of the premium amount when calculating taxes?
  • ​Surplus lines tax is paid on the gross premium. Premium is defined in Neb. Rev. Stat. §77-907. "Premiums shall mean the consideration paid to insurance companies for insurance and shall include policy fees, assessments, dues, or other similar payments..." Any fee paid to the carrier should be included with premium as taxable. Any fee retained by the broker or paid to a third party would not be included with premium as taxable.
     
• ​When is tax due on a policy that is paid in installments?
  • ​Tax is due on premium when it is collected. If a policy is paid in installments such as monthly, the tax would be paid on the premium collected the months included in the reporting period. 
• Is an exempt commercial purchaser required to make quarterly filings?
  • Yes, pursuant to Neb Rev Stat 44-5515 exempt commercial purchasers are required to make quarterly filings and pay tax when applicable just like licensees.

• Does Nebraska maintain a list of approved surplus lines carriers?
  • ​No, Nebraska does not maintain a list of approved surplus lines carriers. To find if a company is eligible for surplus lines in Nebraska, use the following NAIC website. Enter the company name or NAIC number, then "Click for Report Options," go to "Licensing Report" then click on Nebraska. If it indicates the company is Authorized, then it is eligible to write surplus lines in Nebraska. 
     
  • To find if a non-United States Insurance carrier is eligible for surplus lines, click on the following NAIC website, scroll down to Quarterly Listing of Alien Insurers, click on the + and download the most recent listing. 

• Surplus Lines Insurance Act, Neb. Rev. Stat. §44-5501 to 44-5515

Accredited Reinsurers must meet and maintain compliance with the guidelines for registration under Title 210 Nebraska Admin. Code, Chapter 65 §005
 

Initial Application Requirements:

• Properly executed AR-1 Form
   
• Certified copy of the certificate of authority or other acceptable evidence company is licensed to transact insurance or reinsurance in at least one state or port of entry
   
• Copy of annual statement filed with the state of domicile 
   
• Copy of most recent audited financial statement
   
• Maintain at least $20 million in the policyholder's surplus 
   

​Ongoing Filing Requirements:

• Annual and quarterly statements filed with the state of domicile or port of entry 
   
• Audited financial statement
   
• Listing of Nebraska cedents updated quarterly with any changes
   

​Note:

• If statements are available through the NAIC it is not necessary to file a copy with the Department
   
• Statements that are not available through the NAIC should be filed electronically at doi.holdingcompany@nebraska.gov
   
• There are no filing fees associated with accredited reinsurer filings 
   

​List of Nebraska Accredited Reinsurers:

List of Nebraska Accredited Reinsurers

Reinsurers Domiciled in Another State are considered reinsurers domiciled in another state that employs substantially similar standards regarding credit for reinsurance and must meet and maintain compliance with the guidelines for registration under Title 210 Nebraska Admin. Code, Chapter 65 §006
 

Initial Application Requirements:

• Properly executed AR-1 Form
   
• Maintain at least $20 million in policyholder's surplus 
   
• Provide a copy of the respective state's credit for reinsurance standards
  • ​Once the application is received, the Department will review the respective state's credit for reinsurance standards to ensure they are substantially similar 
     

​​Filing Requirements:

• Note: There are no filing fees associated with Reinsurers domiciled in another state filings.
   

​List of Reinsurers Domiciled in Another State:

List of Reinsurers Domiciled in Another State

Trusteed Reinsurers maintain a trust fund in a qualified U.S. financial institution for the payment of claims of its U.S. domiciled ceding insurers. Trusteed Reinsurers must meet and maintain compliance with the guidelines for registration under Title 210 Nebraska Admin. Code, Chapter 65 §007
 

Initial Application Requirements:

• Properly executed AR-1 Form
   
• Trust fund in a qualified U.S. financial institution which consists of appropriate funds in an amount at least equal to the trusteed reinsurer's liabilities attributable to reinsurance ceded by U.S. domiciled insurers. Required supporting documentation:
  • ​Trust Instrument (Deed of Trust)
  • Annual financial statement
  • Certification of the planned termination date of the trust or verification the trust will not expire prior to the following December 31
  • Trust balance statement from Trustee
     
• ​Maintain at least $20 million in policyholder's surplus 
   

​Ongoing Filing Requirements:

• Annual and quarterly financial statements with information substantially the same as is required to be reported on the NAIC Annual Statement form by licensed insurers 
   
• Annual statement from the trustee with the balance of the trust and listing of the trust investments, as well as certification of the planned termination date of the trust investments, as well as a certification of the planned termination date of the trust or verification that the trust will not expire prior to the following December 31st
   
• Quarterly trust statements from the trustee to certify the fair market value of the trust
   
• Copy of any amendment to the Deed of Trust 
   
• Listing of Nebraska cedents updated quarterly with any changes 
   

​Notes:

• Statements should be filed electronically at doi.holdingcompany@nebraska.gov
   
• There are no filing fees associated with trusteed reinsurer filings
   

​List of Nebraska Trusteed Reinsurers:

List of Nebraska Trusteed Reinsurers

Pursuant to Neb. Rev. Stat. §44-416.06 and Title 210 Nebraska Admin. Code, Chapter 65 §008, any unauthorized assuming insurer that meets the Department's requirements may qualify as a Certified Reinsurer. Depending on the financial strength rating granted by the Director, a Certified Reinsurer may be allowed to post less than 100% collateral and still enable an authorized insurer to qualify for full reserve credit with respect to reinsurance contracts renewed or entered into on or after the date the reinsurer becomes certified. 
 

To apply to become a Certified Reinsurer in the state of Nebraska, please complete and submit the Uniform Application Checklist for Certified Reinsurers. 

Application: Uniform Application Checklist for Certified Reinsurers
 

Form CR-1: CR-1 Form
 

NAIC Forms: CR-F Form and CR-S Form
 

Application Notices:

Interested or affected parties will have 30 days from the date the notice is posted to submit written comments and responses to the certified reinsurer applications listed below. The Director will not take final action on an application until at least 30 days after the notice is posted.
 

Pending Applications:

List of Nebraska Certified Reinsurers: 

List of Nebraska Certified Reinsurers

Reciprocal Jurisdiction Reinsurer status eliminates reinsurance collateral requirements for reinsurers that meet and maintain compliance with the guidelines for registration under Neb. Rev. Stat. §44-416.06(7) and Title 210 Nebraska Admin. Code, Chapter 65 §009
 

Passporting Application Requirements:
 

Reciprocal Jurisdiction Reinsurers who have established their Lead State with an NAIC accredited jurisdiction other than Nebraska may request their Reciprocal Jurisdiction Reinsurer status be recognized in Nebraska by filing the following documents with Nebraska:

• Company should be approved through ReFAWG passporting process
   
• Properly executed RJ-1 Form
   
• Copy of the Lead State's approval letter 

Once approved, reciprocal jurisdiction reinsurer statuts in Nebraska is ongoing subject to an annual review by the Lead State and ReFAWG to ensure complaince with applicable requirements.
 

Passporting Renewal Requirements:

Additional information is not required at this time for renewal. Nebraska will rely on the Lead State review and Passporting process to ensure compliance with minimum requirements for renewal status. However, if the Company falls below the minimum requirements or any regulatory action is taken against the Company for noncompliance with applicable laws, the Company is required to provide prompt notice to the Department for consideration of its ongoing status. 
 

​Initial Full Application Requirements:

Reciprocal Jurisdiction Reinsurers who would like Nebraska to act as the Lead State for NAIC Reinsurance Financial Analysis (E) Working Group (ReFAWG) and passporting purposes should file the following:
 

• Application:
  • ​Complete Uniform Checklist for Reciprocal Jurisdiction Reinsurers and file all necessary documents referenced within the application
    • ​ CR-F Form
    • CR-S Form
    • RJ-1 Form
       
• ​​Ongoing Filing Requirements:
  • ​Reciprocal Jurisdiction Reinsurers must have and maintain on an ongoing basis minimum capital and surplus of $250 million or its equivalent and a minimum solvency or capital ratio of RBC 300% or its equivalent
  • The Reciprocal Jurisdiction Reinsurer's supervisory authority must confirm on an annual basis that the reinsurer complies with the requirements noted above
     
• ​Note:​
  • ​Demonstration and confirmation of filing requirements should be filed electronically at doi.holdingcompany@nebraska.gov
  • There are no filing fees associated with Reciprocal Jurisdiction Reinsurer filings
     

​​List of Nebraska Reciprocal Jurisdiction Reinsurers:

List of Nebraska Reciprocal Jurisdiction Reinsurers

As part of the reinsurer certification process, the Director is required to maintain a list of qualified and reciprocal jurisdictions under which an assuming insurer licensed and domiciled in such jurisdiction is eligible to be considered as a certified or reciprocal jurisdiction reinsurer. 
 

Qualified Jurisdictions:

• Bermuda: The Bermuda Monetary Authority (BMA)
   
• France: Autorité Controlê Prudentiel et de Résolution (ACPR)
   
• Germany: German Federal Financial Supervisory Authority (BaFin)
   
• Ireland: Central Bank of Ireland (Central Bank) 
   
• Japan: Financial Services Agency of Japan (FSA) 
   
• Switzerland: The Swiss Financial Market Supervisory Authority (FINMA)
   
• United Kingdom: The Prudential Regulation Authority of the Bank of England (PRA)
   

​Reciprocal Jurisdictions:

• Bermuda: The Bermuda Monetary Authority (BMA)
   
• Japan: Financial Services Agency of Japan (FSA)
   
• Switzerland: The Swiss Financial Market Supervisory Authority (FINMA)

The following links to the NAIC website may be helpful when completing applications:

• ReFAWG Review Process for Passporting Certified and Reciprocal Jurisdiction Reinsurers
   
• Process for Evaluating Qualified and Reciprocal Jurisdictions
   
• NAIC Certified and Reciprocal Jurisdiction Reinsurer Webpage

Please contact Chris Amory if you have any questions regarding the reinsurance information listed on this page:

Chris Amory
Holding Company Specialist
(402) 471-5351
Chris.Amory@nebraska.gov

Any person seeking to acquire "control" of a Nebraska domestic insurer through acquisition or merger must file a Form A in accordance with Neb. Rev. Stat. §44-2126. A public hearing will be held within thirty days of a complete filing, and approval will be issued by the Director of Insurance upon assurance that all requirements of Neb. Rev. Stat. §44-2127 have been met.
 

Please note an exemption from filing a Form A may be made if the requirements of Neb. Rev. Stat. §44-2128 are met.

Filing Requirements 

A person required to file a Form A pursuant Neb. Rev. Stat. §44-2126 shall file all information outlined in the Form A template of Title 210, Nebraska Department of Insurance, Chapter 24, and a filing fee of $1,000 in accordance with Neb. Rev. Stat. §44-2131. 

A summary of the information to be included in the Form A filing is included below:

1. Insurer and Method of Acquisition

2. Identity and Background of Applicant - including nature of business operations if applicable and an organizational chart

3. Identity and Background of Individuals Associated with Applicant - including biographical affidavits of all persons who are directors, executive officers, or owners of 10% or more of the voting securities of the applicant

4. Nature, Source and Amount of Consideration - including a description of consideration and criteria used in determining the amount 

5. Future Plans for Insurers - including any plans for an extraordinary dividend, liquidation, merger, sale of assets and/or material change in business plan, corporate structure or management 

6. Voting Securities to be acquired 

7. Ownership of Voting Rights 

8. Contracts, Arrangements or Understandings with Respect to Voting Securities of Insurer

9. Recent Purchases of Voting Securities 

10. Recent Recommendations to Purchase

11. Agreements with Broker-Dealers

12. Financial Statements and Exhibits - including financial statements, exhibits and three-year financial projections of insurers; annual financial statements of applicant and affiliates for the preceding five years

13. Agreement Requirements for Enterprise Risk Management

14. Signature and Certification - including notarization
 

Where to File

• Filings should be submitted electronically to the attention of the Director of Insurance. 

Guidance 

• Neb. Rev. Stat. §44-2126 to 44-2131
• Chapter 24

​Questions:

Tadd Wegner
Chief Financial Regulator 
(402) 471-8734
Tadd.Wegner@nebraska.gov

A "Disclaimer of Affiliation" may be filed by any person, insurer, or member of a holding company claiming that a person does not, or will not upon taking some proposed action, control another person: 

Filing information:

• What to include:
  • ​The disclaimer shall fully disclose all material relationships and bases for affiliation between the person and insurer as well as the basis for disclaiming such affiliation and shall include the following information as outlined in Title 210, Chapter 24, §017.01
     
    • ​the number of authorized, issued, and outstanding voting securities of the subject
       
    • with respect to the person whose control is denied and all affiliates of such person, the number and percentage of shares of the subject's voting securities which are held of record or known to be beneficially owned, and the number of such shares concerning which there is a right to acquire directly or indirectly
       
    • all material relationships and bases for affiliation between the subject and the person whose control is denied and all affiliates of such person; 
       
    • a statement explaining why such person should not be considered to control the subject 
       
• ​​Where to file:
  • ​Filings should be submitted electronically to the attention of the Director of Insurance
     
• ​Fees:
  • ​There are no fees associated with Disclaimers of Affiliation
     

​​Guidance:

• Neb. Rev. Stat. §44-2132(11)
• Title 210 Chapter 24 §017.01
   

​​​Contact person:
For questions related to filing a Disclaimer of Affiliation, please contact:

Tadd Wegner
Chief Financial Regulator
(402) 471-8734
Tadd.Wegner@nebraska.gov 

Any domestic stock insurance company may merge with another stock insurer after the contract of merger is approved by the Director. The Director shall not approve any such contract of merger unless the interests of the policyholders or shareholders of both parties thereto are properly protected.
 

Filing information:

• What to include:
  • ​Cover Letter outlining the following:
    • ​Parties subject to merger transaction
    • Background of Transaction
    • Nature and Purpose of Transaction
    • Impact on operations and financial condition of domestic insurer 
    • Planned Policyholder Notification and related documentation
  • ​Agreement & Plan of Merger 
  • Board Resolution(s) of each insurer approving transaction
  • Articles of Merger 
  • Most recent quarterly and annual financial statements 
  • Three-year proforma financial statements of surviving entity
     
• ​Where to file:
  • ​Filings should be submitted electronically to the attention of the Director of Insurance
     
• ​Fees:
  • ​The filing fee for filing a merger application is $50
     

​​Guidance

• Neb. Rev. Stat. §44-224.04
   

​Contact person:
For questions related to filing a Merger application, please contact:

Tadd Wegner
Chief Financial Regulator
(402) 471-8734
Tadd.Wegner@nebraska.gov

Form B:

Form B is the registration of insurers authorized to do business in Nebraska and that are members of an insurance holding company system

• Initial Filing:
  • When to file:
    • ​Once an insurer becomes subject to registration, Form B must be filed within 15 days
       
  • ​Where to file:​
    • Filings should be made to the Department's Electronic Filings Portal
       
  • Fees:
    • The initial registration filing fee is $1,000
      
       
• ​Annual Filing: 
  • When to file:
    • ​Due May 1st 
       
  • ​Where to file:​
    • Filings should be made to the Department's Electronic Filings Portal
       
  • ​Fees:
    • Annual filing fee is $200
       

​​Form C: 

• All registration statements must contain a summary outlining all items in the current registration statement representing changes from the prior registration statement
   
• When to file:
  • Due May 1st with Form B filing
     
• ​Where to file:​
  • Filings should be made to the Department's Electronic Filings Portal
     
• ​Fees:
  • ​There are no filing fees associated with the Form C filing. 
    
     

​Form B Amendments:

• When to file:
  • ​Each registered insurer shall keep current the information required to be disclosed in its registration statement (Form B) by reporting all material changes or additions within 15 days after the end of the month in which it learns of each such change or addition.
     
• ​Where to file:
  • ​Filings should be made to the Department's Electronic Filings Portal
     
• ​​Fees
  • ​There are no filing fees associated with Form B Amendments 
     

​Guidance:

• Neb. Rev. Stat. §44-2132 
• Neb. Rev. Stat. §44-2131
• Title 210 Chapter 24
   

Questions:

For questions related to Form B/C, please contact :

Chris Amory 
Holding Company Specialist
(402) 471-5351
Chris.Amory@nebraska.gov 

Description:
A Form D filing is a formal notification of a material transaction involving a domestic insurer and any person in its insurance holding company system that exceeds the materiality standards contained in Neb. Rev. Stat. §44-2133(2)(a) - (e). 

 

A Form D should also be filed for any amendments or modifications of affiliate agreements previously filed. 

 

Filing information:

• When to file:
  • ​Form Ds should be filed at least 30 days prior to entering into such transaction
    
     
• ​What to file:
  • ​Completed Form D (see Title 210 Chapter 24 for example)
  • Copy of Agreement/Amendment 
    
     
• ​​Where to file:
  • Filings should be made to the Department's Electronic Filings Portal
     
• ​Fees:
  • ​There are no filing fees associated with Form D filings 
     

​​Guidance:

• Neb. Rev. Stat. §44-2133
• Title 210 Chapter 24
   

​Questions:
For questions related to the Form D, please contact:

Chris Amory
Holding Company Specialist
(402) 471-5351
Chris.Amory@nebraska.gov 

Description:
Form F is an Enterprise Risk Report that identifies the material risks within an insurance holding company system that could pose enterprise risk to the insurer. 

• The Form F comprises areas that could produce enterprise risk to the insurer. Adequate information should be provided in each of these sections in order to accurately describe any material risks posed to the insurer. Supplemental Information (e.g. SEC Filings, etc.) can be included or referenced to further support any material risk identified. 
   
• Filing Information:
  • ​When to File:
    • ​Due May 1st 
       
  • ​Where to File:
    • ​Filings should be made to the Department's Electronic Filings Portal
       
  • ​Fees:
    • ​There are no filing fees associated with the Form F filing. See Form B section above for annual filing fee information. 
       
• Guidance 
  • ​Neb. Rev. Stat. §44-2132
  • Title 210 Chapter 24 

​​

Questions:
For questions related to the Form F, please contact:

Chris Amory
Holding Company Specialist
(402) 471-5351
Chris.Amory@nebraska.gov 

The Group Capital Calculation (GCC) is a tool developed for use in solvency monitoring. The GCC is an aggregation or grouping of the available financial resources and calculated required capital of all material legal entities in an insurance group. 
 

Except as provided in Neb. Rev. Stat. §44-2132 (13-16), the ultimate controlling person of every insurer subject to registration shall concurrently file with the Form B Registration an annual capital calculation completed in accordance with the group capital calculation instructions. 
 

Filing information:

• When to file:
  • ​Filings are due annually on May 1st. 
    ​
• ​What to file:
  • ​The GCC template can be found on the NAIC's website
     
• ​Where to file:
  • ​Filings should be made to the Department's Electronic Filings Portal
     
• ​Fees:
  • ​There are no fees associated with the GCC filing
     

Guidance: 

• Neb. Rev. Stat §44-2132 (13-16)
• GCC Instructions
   

​Questions:
For questions related to the GCC, please contact:

Anthony Quandt
Group Solvency Specialist
(402) 471-3164
Anthony.Quandt@nebraska.gov 

The ORSA is an internal process undertaken by an insurer or insurance group to assess the adequacy of its risk management and current and prospective solvency positions under normal and severe stress scenarios. An ORSA will require insurers to analyze all reasonably foreseeable and relevant material risks (i.e., underwriting, credit, market, operational, liquidity risks, etc.) that could have an impact on an insurer's ability to meet its policyholder obligations. 
 

Filing information:

• Who should file:
  • ​The insurer has annual direct written and unaffiliated assumed premium, including international direct and assumed premium but excluding premiums reinsured with the Federal Crop Insurance Corporation and Federal Flood Program, of $500,000,000 or more
  • The insurance group of which the insurer is a member has annual direct written and unaffiliated assumed premium including international direct and assumed premium, but excluding premiums reinsured with the Federal Crop Insurance Corporation and Federal Flood Program, of $1,000,000,000 or more 
     
• What to include:
  • ​The insurer of the insurance group shall regularly conduct an own risk and solvency assessment consistent with a process comparable to the own risk and solvency assessment guidance manual. NAIC ORSA Guidance Manual  
     
  • The own risk and solvency assessment shall be conducted no less than annually but also at any time when there are significant changes to the risk profile of the insurer or the insurance group of which the insurer is a member
     
  • Material changes made to the ORSA from year to year should be identified separately as part of the filing
     
• ​Where to file:
  • ​Filings should be made to the Department's Electronic Filings Portal 
     
• ​Fees:
  • ​There are no fees associated with an ORSA filing 
     

​​Guidance:

• Risk Management and Own Risk and Solvency Assessment Act
  • ​Neb. Rev. Stat. §44-9001-9011
  • NAIC ORSA Guidance Manual  

​​Questions:
For questions related to the ORSA, please contact

Jennifer Rose
Assistant Chief Examiner - Analysis
(402) 471-0343
Jennifer.Rose@nebraska.gov

The purpose of the Corporate Governance Annual Disclosure Act (CGAD) is to provide the director a summary of an insurer's or insurance group's corporate governance structure, policies, and practices to permit the director to gain and maintain an understanding of the insurer's or insurance group's corporate governance framework; outline the requirements for completing a corporate governance annual disclosure with the director; and provide for the confidential treatment of the corporate governance annual disclosure and related information that contains confidential and sensitive information related to an insurer's or insurance group's internal operations and proprietary and trade secret information which, if made public, could potentially cause the insurer or insurance group competitive harm or disadvantage. 
 

Filing information: 

• What to include:
  • ​Title 210 Neb. Admin. Code Chapter 88 §005 describes the contents of a Corporate Governance Annual Disclosure 
     
• ​Where to file:
  • ​Filings should be made to the Department's Electronic Filings Portal 
     
• ​Fees:
  • ​There are no fees associated with CGAD filings 
     

​​Guidance:

• Corporate Governance Annual Disclosure Act
  • ​Neb. Rev. Stat. §44-9101-9109
• ​Title 210 Neb. Admin Code Chapter 88
   

​Questions:
For questions related to the CGAD, please contact:

Jennifer Rose
Assistant Chief Examiner - Analysis
(402) 471-0343
Jennifer.Rose@nebraska.gov  

Dividend filing submissions are subject to the requirements of Neb. Rev. Stat. §44-2132 and Title 210 Neb. Admin. Code Chapter 24 §020. Extraordinary dividends are subject to additional requirements of Neb. Rev. Stat. §44-2134 and 44-325. 
 

Filing information:

• ALL dividend submissions should include the following:
  • ​Notice should be received within 5 business days of declaration
  • Amount of the dividend
    • ​Type of consideration
      • ​If other than cash, provide:
        • ​Description of asset
        • Cost
        • Fair market value
        • Explanation of the basis for valuation
           
  • ​​​Date of payment
    • ​Payment date should NOT be within 10 business days from receipt of notice unless approved
       
  • ​Party dividend is payable to 
     
  • Calculation to determine if dividend is ordinary/extraordinary
    • ​Amounts, dates, and forms of payment for dividends declared within the past 12 months​
    • Total surplus as of prior annual statement
    • For Life Insurers:
      • ​Net income from operations of the prior year
    • ​For Non-Life Insurers:
      • ​Net income less realized capital gains for the prior 2 years
      • Dividends paid in the prior 2 calendar years
  • ​​Amount of surplus represented by cumulative unrealized gains or losses disclosed in the Company's note to the financial statements
  • Signed declaration from the Board of Directors or documentation from a senior officer certifying the Board has approved the dividend
     
• ​Additional items to include with extraordinary dividend and distribution submissions:
  • ​Payment date should NOT be within 30 days from receipt of notice unless approved
  • Provide Balance Sheets and Income Statements for all interim periods since the last annual statement
  • Brief statement regarding the purpose for the dividend as well as the effect of the dividend on the surplus of the company
     
• ​Where to file:
  • ​Filings should be made to the Department's Electronic Filings Portal
     
• ​Fees:
  • ​There are no fees associated with dividend filings
     

​​Guidance 

• Neb. Rev. Stat. §44-2132(5)
• Neb. Rev. Stat. §44-2134
• Chapter 24 §020
• Neb. Rev. Stat. §44-325
• Adequacy of surplus
  • ​Neb. Rev. Stat. §44-2136
  • Chapter 24 §021
     

Questions:
For questions related to dividends, please contact:

Jennifer Rose
Assistant Chief Examiner - Analysis
(402) 471-0343
Jennifer.Rose@nebraska.gov