Instructions to Complete Regulation No. 60 Online Report Form

The Department has established an electronic database on its web-site that lists the appropriate contact person(s) at each insurer that should be notified in each instance when a replacement is likely to occur. If you wish to change the information posted on the web-site you need to complete an online report form.

The following are the instructions to request a change of the information reported on the web-site for your company:

  1. Enter the previous contact person or area’s e-mail address. (Required)
  2. Enter the Company name.
  3. Enter the 5 digit NAIC Number.
  4. In the type of business box, enter the type of business for the contact person. If the Company is designating only one contact person to receive all Regulation 60 notifications enter “all”. If more than one contact person, please designate what type of business this contact person will receive notifications for. (E.g. universal life, variable annuity, flexible annuity, etc.).
  5. Enter the name of the contact person.
  6. If the Company does not wish to have one person receive all of the Regulation 60 notifications, but instead wishes to have the notifications sent to a designated area, enter that area here. The Company is still required to provide the information in items 4, 10 and 11, which will be for the Department’s internal use only.
  7. Enter the street address of the contact person or area. If more than one line is needed for the street address, use the Address2 line for additional information.
  8. Enter the City of the contact person or area.
  9. Enter the State of the contact person or area.
  10. Enter the Zip Code of the contact person or area.
  11. Enter the Title of the contact person.
  12. Enter the E-mail address of the Contact person.
  13. Enter the Phone No. of the contact person or area.
  14. If Company accepts facsimile notification from replacing company, enter the Fax No. of the contact person or area.

If the information entered is correct, click on the submit button to complete. You will be contacted via e-mail to confirm the corrected information prior to a change being made to the information reported in the web-site.