Division of Insurance

Company Filings and Forms

The forms are available in Adobe PDF format unless otherwise noted.

For each listing, if applicable, the specific chapter of South Dakota Codified Law (SDCL) associated with the requirement is cited.

Company Type	Form	SDCL
	Application for Licensure
	UCAA Corporate Amendments Application Information webpage
All Insurance Companies	Market Conduct Annual Statement (MCAS)	Bulletin 16-04
Issuers Offering Individual ACA-compliant Health Insurance Plans On- and Off-Exchange	PY2026 Mental Health Parity and Addiction Equity Act (MHPAEA) Self-Compliance Questionnaire	Bulletin 25-02
Insurance Innovation Waivers	Application and Information	58-48
Life, Accident, and Health Insurers and Fraternal Insurers	Checklist for Filings in 2026	58-6
Property Casualty	Checklist for Filings in 2026	58-6
Health Entities	Checklist for Filings in 2026	58-6
Title Companies	Checklist for Filings in 2026	58-6
Holding Company	Form A	58-5A
Holding Company	Form B	58-5A
Holding Company	Form C	58-5A
Holding Company	Form D	58-5A
Holding Company	Form E	58-5A
Holding Company	Form F	58-5A
Licensed Insurance Companies with Active Status Health Line of Authority	Covered Lives Market Survey Form Availability & Due Date: TBD
Life & Health	Publication Statement (See list of companies required to complete the Publication Statement.)	58-6-76
Fire & Casualty	Publication Statement (See list of companies required to complete the Publication Statement.)	58-6-76
Property Casualty, Life/Health, Title	Statement of Deposit	58-7
Health Maintenance Organization	Statement of Deposit	58-7
Nonprofit Agricultural Organization Health Benefit Plan (Self-funded)	Health Benefit Plan Certification Form Annual Filing Requirement	58-1-3.4
Multiple Employer Trust (MET)	MET Application for Authorization	58-18 & 20:06:57
Reinsurer: Accredited, Qualified, Certified, or Reciprocal Jurisdiction	Reinsurer Application and Filing Information	58-14
Risk Retention Group	Registration Packet Annual Filing Checklist Business Written and Premium Tax Report Risk Retention Group Information (webpage)	58-6A
Risk Purchasing Group	Registration Packet	58-6A
Surplus Lines	Surplus Lines Information (webpage) Uniform Surplus Lines Consent to Service of Process Form
Company Appointments and Terminations	Complete through NIPR	58-30
Insurance Companies	Premium Tax Return Filing Information webpage
Insurance Companies	Premium Tax Refund Form	10-44-2 and 10-55A-6
Health	Rate & Form Filing Requirements (webpage)
Property Casualty	Rate & Form Filing Requirements (webpage)
Captive Insurance Companies	Captive Insurance Company Application
Farm Mutuals	Farm Mutual Annual Statement Instructions Farm Mutual Annual Statement Worksheet A - Unearned Premium Reserve Liability Farm Mutual Tax Return (Annual fees & Fire Marshal taxes)
Workers' Compensation Policy Fee	Completed via OPTins by creating a new filing using the Fee Payment Voucher in the State Provided Forms area.	10-44-2 (4)
	Certificate of Authority*
	Certificate of Authority for Foreign Limited Liability Companies*
Medical Malpractice Reporting	Medical Malpractice Claim Report Form (See Bulletin 09-04 for specific information on filing requirements and timeframes.)

* South Dakota Secretary of State forms

Contact the Division of Insurance

Marcia Hultman

Cabinet Secretary

Division of Insurance

Company Filings and Forms