Supplemental Filing to Captive Risk Retention Group Annual and Quarterly Statements

Filing Instructions:

To streamline the review process and minimize follow-up inquiries regarding Annual and Quarterly Statements, please provide the following supplemental information at the time of the Tennessee-Domestic Risk Retention Group’s (“RRG”) filing of Annual and Quarterly Statements.

1.      A complete updated plan of operation.

2.      A three-year financial projection for the three years after the year covered in the annual statement. The projection should be submitted using the NAIC’s Form 13 - Proforma Financial Statements (Property/Casualty Companies).

3.      A copy of the RRG’s board meeting minutes for every meeting held during the year covered in the annual statement.

4.      Annual determination disclosure of material relationship and independence, per Tenn. Code Ann. § 56-45-103(d)(1)(B).

5.      A table showing a list of each service provider contract that includes the following information.

a.      Beginning and ending dates of the contract
b.      Amount paid under each service provider contract in the year covered in the annual statement.
c.      Designation of which service provider contract is material.

6.      A table showing a list of compensation or payment paid from the RRG to each board member, consultant, service provider, broken down by quarters of the last four quarters. For each board member, please indicate if that person is an officer of any related entity or service provider. (This table should be submitted to the Department on a quarterly basis, along with the annual and quarterly statement filing.)

7.      Evidence of the Board of Directors’ review and approval of the following.

a.      RRG’s goals and objectives relevant to the compensation of officers and service providers
b.      Officers’ and service providers’ performance in accordance with those goals and objectives.
c.      The continued engagement of the officers
d.      The continued engagement of the material service providers and approval of the amount to be paid.

8.      Information on how the governance standards are being published electronically and a copy of such published governance standards.

9.      List of members/insured as of the end of the reporting year.

The Department would also like to clarify and confirm the following.

10.   For any change to the plan of operation, regardless of how material it is, please file the plan of operation change with the Department.

11.    Any dividend or distribution request must be submitted through NoticeTo.TDCI@tn.gov, per Insurance Bulletin 17-03. Note: The dividend form is being updated and will be available on the TDCI website. In the interim, you may request the form directly from Hui.Wattanaskolpant@tn.gov.

12.     If RRG has the Surplus Note, ensure that Note 13 for Notes to Financial Statements (Capital and Surplus, Dividend Restrictions and Quasi-Reorganizations) discloses all required elements for such surplus note per the P&C Annual Statement Instructions.

13.     Any intercompany agreement between the RRG and any affiliate(s) must be filed and approved by TDCI prior to entering into the agreement.

14.     If the Captive Manager, and/or its affiliate, is acting as a reinsurance intermediary for the RRG, please ensure this service is specifically referenced within the plan of operation, and the Department has the latest agreement that pertains to or references this particular service.

15.     If there is any change to the structure of the holding company system, please be reminded that the TDCI must be notified and approval must be obtained prior to such a change taking effect.

If you have any questions, please do not hesitate to contact your assigned analyst or Hui Wattanaskolpant, Assistant Director of Financial Analysis, at Hui.Wattanaskolpant@tn.gov any time.