Long-Term Care Reporting Forms

Last Updated: January 16, 2018

Procedure to Submit Required Annual Market Regulatory Reports to OCI

The following reporting forms are required to be filed with the Office of the Commissioner of Insurance (OCI) annually for all insurers that had long-term care business in force in Wisconsin during the previous calendar year:

Form NumberDescriptionReferenceDue Date
26-301Long-term Care Experience Exhibits. Ins 3.455 (6), Wis. Adm. CodeApril 1
26-301HHybrid Long-term Care Experience Exhibits. Ins 3.455 (6), Wis. Adm. CodeApril 1
26-304Long-term Care Benefit Appealss. Ins 3.55 (5), Wis. Adm. CodeMarch 31
26-304HHybrid Long-term Care Benefit Appealss. Ins 3.55 (5), Wis. Adm. CodeMarch 31
26-305Long-term Care Claim Denialss. Ins 3.46 (21) (f), Wis. Adm. CodeJune 30
26-306Long-term Care Replacement & Lapses. Ins 3.46 (21) (b), Wis. Adm. CodeJune 30
26-307Long-term Care Rescissionss. Ins 3.46 (10) (b) and (j), Wis. Adm. CodeMarch 1
26-307HHybrid Long-term Care Rescissionss. Ins 3.46 (10) (b) and (j), Wis. Adm. CodeMarch 1
26-308Long-term Care Suitabilitys. Ins 3.46 (16) (h), Wis. Adm. CodeJune 30

NOTE: Long-term care riders attached to a life or annuity product are considered hybrid long-term care.

OCI has an online interface for insurance companies to interact with the Wisconsin Market Regulatory Reports and Forms application.

The insurer's Wisconsin Market Regulatory Reports and Forms Security Administrator/Forms Administrator will assign the required long-term care reporting forms to staff for completion. The forms are completed utilizing the online Wisconsin Market Regulatory Reports and Forms application.

For information regarding the Wisconsin Market Regulatory Reports and Forms application, please reference the procedures document.

For any questions, please e-mail ocimrreports@wisconsin.gov. The e-mail should include the company's legal name and NAIC company number.