3 Alaska Admin. Code § 21.188

Current through September 25, 2024

Section 3 AAC 21.188 - Enterprise risk report

The ultimate controlling person of an insurer required to file an enterprise risk report under AS 21.22.060(n) shall furnish the required information on Form F, made a part of this section in substantially the following form:

FORM F

ENTERPRISE RISK REPORT

Filed with the Insurance Division/Department of the State of _______

_________________________

(Name of Registrant)

On behalf of the Following Insurance Companies

Name Address

__________________________________________________________________________________________

Date: ______________, 20 _____

Name, Title, Address, Electronic Mail Address, and telephone number of Individual to Whom Notices and Correspondence Concerning This Statement Should Be Addressed:

__________________________________________________________________________________________

ITEM 1. ENTERPRISE RISK

The Registrant, to the best of its knowledge and belief, shall provide information regarding the following areas that could produce enterprise risk as defined in AS 21.22.200 provided the information is not disclosed in the Insurance Holding Company System Annual Registration Statement filed on behalf of itself or another insurer for which it is the ultimate controlling person:

(a) any material developments regarding strategy, internal audit findings, compliance, or risk management affecting the insurance holding company system;

(b) acquisition or disposal of insurance entities and reallocating of existing financial or insurance entities within the insurance holding company system;

(c) any changes of shareholders of the insurance holding company system exceeding 10 percent or more of voting securities;

(d) developments in various investigations, regulatory activities, or litigation that may have a significant bearing or impact on the insurance holding company system;

(e) the business plan of the insurance holding company system and summarized strategies for the next 12 months;

(f) identification of material concerns of the insurance holding company system raised by a supervisory college, if any, in the last year;

(g) identification of insurance holding company system capital resources and material distribution patterns;

(h) identification of any negative movement, or discussions with rating agencies which may have caused, or may cause, potential negative movement in the credit ratings and individual insurer financial strength ratings assessment of the insurance holding company system (including both the rating score and outlook);

(i) information on corporate or parental guarantees throughout the holding company and the expected source of liquidity should the guarantees be called upon; and

(j) identification of any material activity or development of the insurance holding company system that, in the opinion of senior management, could adversely affect the insurance holding company system.

The Registrant may attach the appropriate form most recently filed with the United States Securities and Exchange Commission, provided the Registrant includes specific references to those areas listed in Item 1 for which the form provides responsive information. If the Registrant is not domiciled in the United States, it may attach its most recent public audited financial statement filed in its country of domicile, provided the Registrant includes specific references to those areas listed in Item 1 for which the financial statement provides responsive information.

ITEM 2. OBLIGATION TO REPORT

If the Registrant has not disclosed any information under Item 1, the Registrant shall include a statement affirming that, to the best of its knowledge and belief, it has not identified enterprise risk subject to disclosure under Item 1.

ITEM 3. SIGNATURE AND CERTIFICATION

Signature and certification are required as follows:

SIGNATURE

Under the requirements of AS 21.22.060, ________ has caused this report to be signed on its behalf in the City or Community of ____________and State of ______________on the day of __________, 20___.

(SEAL)

____________________

(Name of Applicant)

By ___________

(Name) (Title)

Attest:

____________________

(Signature of Officer)

____________________

(Title)

CERTIFICATION

The undersigned deposes and says that the undersigned has duly executed the attached report dated _____________, 20 _____, for and on behalf of _______________ (Name of Applicant); that the undersigned is the _______________ (Title of Officer) of the company; and that the undersigned is authorized to execute and file the instrument. The undersigned further says that the undersigned is familiar with the instrument and the contents of it and that the facts stated in it are true to the best of the undersigned's knowledge, information, and belief.

(Signature)

_______________________

(Type or print name below)

______________________

3 AAC 21.188

Eff. 11/26/2015, Register 216, January 2016

Authority:AS 21.06.090

AS 21.22.060

AS 21.22.130