B-0025-16

To: All Insurance Companies, Corporations, Exchanges, Mutuals, Reciprocals, Associations, Lloyds, or Other Insurers Licensed to Write Private Passenger Nonfleet Automobile, Homeowners Multiple Peril, Workers' Compensation, Commercial Fire and Allied Lines, Commercial Multiple Peril, General Liability, Boiler and Machinery, Commercial Crime, Commercial Glass, Medical Professional Liability, or Miscellaneous Professional Liability Insurance in the State of Texas

Re: Call for Annual Experience – 2016 Call for Annual Experience – 2016 Workers' Compensation Deductible Plans

The Texas Department of Insurance issues the attached mandatory data call under Texas Insurance Code, Sections 2251.003, 2251.008, and 38.001. This data call is the basis for a report that TDI is required to submit annually to the governor, lieutenant governor, the speaker, the Legislature, and the public.

You must respond to this data call using the instructions linked to this bulletin no later than February 10, 2017. You also must retain underlying data, individual source documents, and other information used to develop your response until at least February 10, 2019.

You must complete the data call using the interactive PDF forms included as a link in this bulletin. These forms require Adobe Acrobat 7.0 or higher, or a compatible version of Adobe Reader.

Submit separate forms for each company in your group licensed for one or more lines of business covered in this data call.

If you are unable to download the forms or have any questions concerning this data call, please contact Vicky Knox by phone at 512-676-6686, or by email at PCDataCallAnnual@tdi.texas.gov.

Enclosures:

Affidavit and instructions

Interactive PDF form