Instructions for Annual Filings

2017 Vermont Annual Financial Statement Filing Instructions & Forms for Traditional Insurance Companies

Below are forms for the period ending December 31, 2017 and for the first three quarters of 2018 for insurance companies required by statute to file with the department.  Included are forms for remitting Annual Statement filings and license (or authorization) renewal fees.

Please note:

The instructions on this page do NOT apply to Vermont Captive Insurers or Foreign Risk Retention Groups.  For annual filing instructions for Captive Insurers or Foreign Risk Retention and Risk Purchasing Groups, please click here.


2017 - Section 1: General Instructions

2017 - Section 2:  Annual Fee Calculation Form

**Please be sure to use the correct form as the fees are different.**

    2A - P&C, L&H, Health, Reciprocals, and Title Insurers

    2B - Fraternal Benefit Societies

    2C - Foreign Accredited Reinsurers

2017 - Section 3: Annual Statement Supplemental Report (ASSR)

2017 - Section 4: Vermont Mandatory Reporting (Liquor Liability Report)

2017 - Section 5: Checklists - Filings with Notes 

    5A - Life, Accident & Health

    5B - Property & Casualty, and Reciprocals

    5C - Health Entities (Insurers, HDMI's & HMO's)

    5D - Title Insurers

    5E - Fraternal Benefit Societies

    5F - Foreign Surplus Lines Insurers - no longer required

    5G - Foreign Accredited Reinsurers

           Regarding NRRA Federal Legislation

    5H - Alien Surplus Lines Insurers - no longer required

    5I - Alien Accredited Reinsurers

    5J - Certified Reinsurers

    5K - Life Settlement Providers

Addendum to Health Insurer Annual Statement

    Health Insurer Annual Statement (Act 152) Spreadsheet


    For Further Information, see Bill S.255 (Act 152)