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• Insurance Holding Companies Forms (14 VAC 5-260)
  • In portable document format (PDF)
    • Form A (pdf) - Instructions for Application for Approval of Acquisition of Control of or Merger with a Domestic Insurer
    • Form B (pdf) - Instructions for Insurance Holding Company System Annual Registration Statement
    • Form C (pdf) - Instructions for Summary of Registration Statement
    • Form D (pdf) - Instructions for a 38.2-1331 Prior Notice and Application for Approval of Certain Transactions
    • Form E (pdf) - Instructions for an Acquisition Statement Reporting Competitive Impact Data
    • Form F (pdf) - Instructions for Notice of Dividends and Distributions to Shareholders Pursuant to 38.2-1330 C of the Code of Virginia
  • In Micrsoft Word format (doc)
    • Form A (doc) - Instructions for Application for Approval of Acquisition of Control of or Merger with a Domestic Insurer
    • Form B (doc) - Instructions for Insurance Holding Company System Annual Registration Statement
    • Form C (doc) - Instructions for Summary of Registration Statement
    • Form D (doc) - Instructions for a 38.2-1331 Prior Notice and Application for Approval of Certain Transactions
    • Form E (doc) - Instructions for an Acquisition Statement Reporting Competitive Impact Data
    • Form F (doc) - Instructions for Notice of Dividends and Distributions to Shareholders Pursuant to 38.2-1330 C of the Code of Virginia
• Certified Reinsurers
  • Form CR-F
    • Instructions for Form CR-F
  • Form CR-S
    • Instructions for Form CR-S
• Credit Insurance Experience Exhibit
  • Credit Insurance Experience Exhibit Filing Instructions
  • Credit Insurance Experience Exhibit Questionnaire
  • Company Filing Portal
• External Review Forms
  • Independent Review Organization Forms
    • IRO Application – Form 216-E (doc) (7/11)
    • IRO Application – Form 216-E (pdf) (7/11)
    • IRO External Review Annual Report – Form 216-G (doc) (7/11)
    • IRO External Review Annual Report – Form 216-G (pdf) (7/11)
  • Health Carrier Form
    • Health Carrier External Review Annual Report – Form 216-F (doc) (7/11)
    • Health Carrier External Review Annual Report – Form 216-F (pdf) (7/11)
  • Self-insured ERISA Plan Form
    • Self-insured Plan Opt-in for External Review – Form 216-H (doc) (7/11)
    • Self-insured Plan Opt-in for External Review – Form 216-H (pdf) (7/11)