Skip to Content

Translate | Disclaimer

Domestic Life Insurers and Domestic Fraternal Organizations

The following is being made available by the Department for the benefit of all life insurance companies and fraternal benefit societies doing business in New York and all insurers holding a certificate from the Superintendent as being accredited for the reinsurance of life insurance, annuities, or accident and health insurance.

The category Industry-Wide Letters and Inquiries is applicable to all licensed life insurers, accredited reinsurers and fraternal benefit societies. All remaining categories are applicable only to Domestic Life Insurance Companies and Domestic Fraternal Benefit Organizations.

Domestic Life Insurance Companies and Domestic Fraternal Benefit Organizations are anually required to provide, according to §4217 and §4516, year-end valuation submissions to the Life Bureau Reserve Section. These forms and instructions can be found below under the categories Year-End Instructions, Questionnaires and Checklists, Electronic Data Processing Forms and Instructions, and Analysis of Valuation Reserves.

Submissions should be sent via email to:

ALBLIF@dfs.ny.gov

or by mail to:

Mr. Michael D. Cebula
Deputy Chief Life Actuary
Life Bureau – Reserve Section
New York State Department of Financial Services
One Commerce Plaza
Albany, New York 12257

For additional information or questions, please contact: (518) 474-7929.

TopicContact
Filing Requirements Jennifer Roig
AOMs Mark J. Greene
Formula ReservesDwight Hazzard
EDPJennifer Roig

Industry-Wide Letters & Inquiries

Actuarial Opinions and Memoranda

Documents Release Date Link(s)
Special Considerations - Reserves 10/10/2014 PDF
AOM & Risk Based Capital Checklist 12/31/2013

PDF

Word

Actuarial Opinion Requirements -Reserves 12/31/2013 PDF

Formula Reserves

Documents Release Date Link(s)
Application of Regulation 128 to Variable Annuities with Guaranteed Living Benefits & Pension Products 01/07/2009 PDF
Application of Regulation 128 to Variable Annuities with Guaranteed Living Benefits 10/31/2007 PDF
Requirements for Group Life Waiver of Premium Reserves 06/02/2005 PDF
Requirements for using the 2001 CSO Mortality Table 12/13/2004 PDF

Liquidity

Documents Release Date Link(s)
Liquidity and Severe Mortality Inquiry - 12/31/2013 02/10/2014 Word
Tables and Top Ten   Excel

Year-End Instructions, Questionnaires and Checklists

Document Release Date Link(s)
Department Cover letter dated 11/26/2013 to the Annual Mailing for 12/31/2013 Reserves 11/26/2013 PDF
Notice regarding Accumulation-type Annuity Formatting for 12/31/2003 Reserves 11/06/2003 PDF
Instructions for Filing Valuations: 2013 Year-End Statutory Valuation 12/02/2013

PDF

Word

General Account Questionnaires & Checklists

Documents PDF links Word links
Accident and Health Reserve Questionnaire PDF Word
Accumulation-Type Annuity Questionnaire PDF Word
Group Life Insurance Questionnaire PDF Word
Interest Sensitive Life Questionnaire PDF Word
Structured Settlements and Fixed Payment Annuity Questionnaire PDF Word
Valuation Filing Check-list PDF Word

Separate Account Questionnaires & Checklists

Documents PDF Links Word Links
Annuity Questionnaire PDF Word
Interest Sensitive Life Questionnaire PDF Word
Valuation Filing Check-List PDF Word

EDP Formats & Instructions

Categories Instructions External Labels Excel Links
Annuities – Accumulation-Type PDF Word PDF Word n/a
Annuities – Structured Settlement and Immediate Annuity PDF Word PDF Word Aggregate Test Worksheet
Interest Sensitive Life PDF Word PDF Word n/a
Traditional Life PDF Word PDF Word n/a
EDP Reconciliation n/a n/a n/a n/a Sample EDP Reconciliation

Analysis of Valuation Reserves

Categories General Account AoVR Separate Account AoVR
Domestic Life Insurance Company PDF Word PDF Word
Fraternal Benefit Society PDF Word n/a n/a

Updated 10/27/2014

About DFS

Contact DFS

Reports & Publications

Licensing

Connect With DFS

DFS Facebook page

Follow NYDFS on Twitter

AccessibilityContact UsDisclaimerPrivacy PolicySite MapPDF Reader Software