Arizona Administrative Code › Title 20 - COMMERCE, FINANCIAL INSTITUTIONS, AND INSURANCE › Chapter 06 - DEPARTMENT OF INSURANCE AND FINANCIAL INSTITUTIONS - INSURANCE DIVISION › Article 16 - CREDIT FOR REINSURANCE › Part A - CREDIT FOR REINSURANCE › Exhibit D - Form CR-S Instructions

Current through Register Vol. 30, No. 28, July 12, 2024
Part 1 - Section 1.
Reinsurance Assumed Life
					 Insurance, Annuities, Deposit Funds and Other Liabilities Without Life or
					 Disability Contingencies, and Related Benefits Listed by Reinsured Company as
					 of December 31, Current Year Create a spreadsheet with the following columns
					 (total each column 7 through 12):
1.
				  ID Number/Company Code
2. This
				  column is intentionally left blank
3. Effective Date
4. Name of Reinsured
5. Location
6. Type of Reinsurance Assumed
7. Amount of In Force at End of
				  Year
8. Reserve
9. Premiums
10. Reinsurance Payable on Paid and Unpaid
				  Losses
11. Modified Coinsurance
				  Reserve
12. Funds Withheld Under
				  Coinsurance
Each row shall list each insurer for which reinsurance was
					 assumed (life insurance, annuities, deposit funds and other liabilities without
					 life or disability contingencies, and related benefits) for the calendar
					 year.
Part 1 - Section 2.
Reinsurance Assumed
					 Accident and Health Insurance Listed by Reinsured Company as of December 31,
					 Current Year
Please create a spreadsheet with the following columns
					 (total columns 7 through 12):
1. ID
				  Number/Company Code
2. This column
				  is intentionally left blank
3.
				  Effective Date
4. Name of
				  Reinsured
5. Domiciliary
				  Jurisdiction
6. Type of Reinsurance
				  Assumed
7. Premiums
8. Unearned Premiums
9. Reserve Liability Other Than For Unearned
				  Premiums
10. Reinsurance Payable on
				  Paid and Unpaid Losses
11. Modified
				  Coinsurance Reserve
12. Funds
				  Withheld Under Coinsurance
Each row shall list each insurer for which reinsurance was
					 assumed (accident and health insurance) for the calendar year.
Part 2.
Reinsurance Recoverable on Paid and
					 Unpaid Losses Listed by Reinsuring Company as of December 31, Current
					 Year
Create a spreadsheet with the following columns (total each
					 column 6 and 7):
1. ID Number/Company
				  Code
2. This column is
				  intentionally left blank
3.
				  Effective Date
4. Name of
				  Company
5. Location
6. Paid Losses
7. Unpaid Losses
Each row shall list each insurer for which reinsurance on
					 paid and unpaid losses is recoverable.
Part 3 - Section 1.
Reinsurance Ceded Life
					 Insurance, Annuities, Deposit Funds and Other Liabilities Without Life or
					 Disability Contingencies, and Related Benefits Listed by Reinsuring Company as
					 of December 31, Current Year Create a spreadsheet with the following columns
					 (total each column 7 through 14):
1. ID
				  Number/Company Code
2. This column
				  is intentionally left blank
3.
				  Effective Date
4. Name of
				  Company
5. Location
6. Type of Reinsurance Ceded
7. Amount in Force at End of Year
8. Reserve Credit Taken Current
				  Year
9. Reserve Credit Taken Prior
				  Year
10. Premiums
11. Outstanding Surplus Relief Current
				  Year
12. Outstanding Surplus Relief
				  Prior Year
13. Modified Coinsurance
				  Reserve
14. Funds Withheld Under
				  Coinsurance
Each row shall list each insurer for which reinsurance was
					 ceded (life insurance, annuities, deposit funds and other liabilities without
					 life or disability contingencies and related benefits).
Part 3 - Section 2.
Reinsurance Ceded
					 Accident and Health Insurance Listed by Reinsuring Company as of December 31,
					 Current Year
Create a spreadsheet with the following columns (total each
					 column 7 through 13):
1. ID
				  Number/Company Code
2. This column
				  is intentionally left blank
3.
				  Effective Date
4. Name of
				  Company
5. Location
6. Type
7. Premiums
8. Unearned Premiums (Estimated)
9. Reserve Credit Taken other than for
				  Unearned Premiums
10. Outstanding
				  Surplus Relief Current Year
11.
				  Outstanding Surplus Relief Prior Year
12. Modified Coinsurance Reserve
13. Funds Withheld Under Coinsurance
Each row shall list each insurer for which reinsurance was
					 ceded (accident and health insurance).