Illinois Administrative Code › Title 50 - INSURANCE › Part 652 - REGISTRATION OF INSURERS › ILLUSTRATION F - Form F - Enterprise Risk Report - Initial, Annual or Amendment

Current through Register Vol. 48, No. 28, July 12, 2024
FORM F
ENTERPRISE RISK REPORT
Filed with the Insurance Department of the State
				of ______________________
By
__________________________________________________________________
Name of Registrant/Applicant
On Behalf of/Related to the Following Insurance
				Companies
Name and Address
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
Date: _________________, 20 ______
Name, Title, Address and Telephone Number of Individual to Whom
				Notices and Correspondence Concerning This Statement Should Be
				Addressed:
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
ITEM 1. ENTERPRISE RISK
The Registrant/Applicant, to the best of its knowledge and
				belief, and in a manner appropriate to the nature, scale and complexity of the
				operations of the insurance holding company system, shall provide information
				regarding the following areas that could produce enterprise risk as defined in
				Section 131.14 b of the Illinois Insurance Code, provided that 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:
* Any material developments regarding strategy, internal audit
				findings, compliance or risk management affecting the insurance holding company
				system;
* Acquisition or disposal of insurance entities and
				reallocating of existing financial or insurance entities within the insurance
				holding company system;
* Any changes of shareholders of the insurance holding company
				system exceeding 10 percent or more of voting securities;
* Developments in various investigations, regulatory activities
				or litigation that may have a significant bearing or impact on the insurance
				holding company system;
* Business plan of the insurance holding company system and
				summarized strategies for the next 12 months;
* Identification of material concerns of the insurance holding
				company system raised by a supervisory college (a group established by the
				Director to determine a company's compliance with Article VIII1/2 of the Code
				(Insurance Holding Company Systems)), if any, in the last year;
* Identification of insurance holding company system capital
				resources and material distribution patterns;
* Identification of any negative movement, or discussions with
				rating agencies that 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);
* Information on corporate or parental guarantees throughout
				the holding company and the expected source of liquidity should those
				guarantees be called upon; and
* 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/Applicant may attach the appropriate form most
				recently filed with the U.S. Securities and Exchange Commission, provided the
				Registrant/Applicant includes specific references to those areas listed in Item
				1 for which the form provides responsive information. If the
				Registrant/Applicant is not domiciled in the U.S., it may attach its most
				recent public audited financial statement filed in its country of domicile,
				provided the Registrant/Applicant 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/Applicant has not disclosed any information
				pursuant to Item 1, the Registrant/Applicant shall include a statement
				affirming that, to the best of its knowledge and belief, it has not identified
				enterprise risk subject to disclosure pursuant to Item 1.