Form A

Form A

The Form A application is based from information  that will allow the on-line entry of data for persons wishing to acquire control of or merge a domestic insurer, otherwise known as a "Form A" filing.  The purpose of this database is to facilitate the communication of actions taken by the States on all Form A filings and  facilitate the coordination of Form A reviews in an attempt to avoid the duplication of regulatory processes via a web based tool.  This database will assist insurance regulators by producing a streamlined regulatory process that maintains the integrity of State holding company laws, while being responsive to a dynamic and evolving industry.  The specifications for the database were designed by members of the Group Solvency Issues (E) Working Group and the National Treatment and Coordination (E) Working Group.

The Form A system includes a variety of options:  

iSite+ Login: Access to Form A

After logging into iSite+, the Form A application is under the Applications tab .

The Form A Main Screen will only display the open filings for the last 24 months for the state associated with the user's login ID. Details for each filing can be viewed by clicking the link in the FILING NO. column.  Users with the Form A edit role will have a Start a New Form A button on the right of the Main Screen for entering a new Form A record.

View Open Filings

To view a current filing, simply click the Filing Number and the detail for that fling will display.  The "Filing Number" is a number assigned to each Form A entry by the NAIC, not the states.  This unique identifier is assigned automatically by the system so that unique data may be stored in the NAIC data tables. The filing number is assigned by the system whenever a new filing is saved.  Any user may look at a filing regardless of role assignment. 

Filing Details

Entity

Target Entity Information  - The domestic insurer is the insurer that is being acquired or merged.  The control of that company is being changed.

Acquiring Entity  - The company or individual that is acquiring or merging with the domestic insurer mentioned above.

Applicant's Other Filing (link) - displays other filings for this acquiring party.

State of Domicile Information -   The state of domicile for the insurer being acquired or merged.  The Form A is filed with the state of domicile of the company being acquired.

Directors and Officers

The directors and officers listed on the company's Jurat page are stored in the company demographics table. For each target company, the directors and officers will prepopulate onto the Directors and Officers page within the Form A database.

Status Information

The status information displays the status information and history of all status changes and comments. This page also includes status options, effective status dates, and any comments. 

Lead State

The Lead State Information page has several key elements that may not be relevant for every Form A filing created. The purpose of this page is to consolidate important information for multi-state Form A filings.

Create New Filing

New filings are recorded from the Form A Main Screen.  The Form A edit role must be assigned to the user's login ID in order to add new filings.  To add a new Filing, type a valid NAIC Company Code in the blank next to the Start a new Form A button, then click the button. (Refer to the User Guide for more information on creating a Form A filing)

Query Existing Filings

The Search Filings button is located on the right of the Form A Main Screen.  The search filing option provides the user with a variety of choices for searching the Form A database of filings.  States are encouraged to utilize the query facility to identify acquiring parties among new Form A filings and Form A's filed in other states. 

Click the Search Filings button.

 Users may search using the following criteria:

  • Select Search Type
    • COCODE
    • Entity Name
    • Group Code
    • Individual
    • Officer

(Enter Search Value based off the search type selection.)

  • Enter Date Range
  • Status
    • Pre-conversion - filings from the old Form A database prior to January 29,2016, with a status that is not supported in the new database.
    • Under review
    • Approved
    • Approved with stipulation
    • Transaction closed
    • Withdrawn
    • Denied
    • Transaction not close
  • State of Domicile