Report of Premiums for Assessment Purposes

Instructions for Completing the Revised LA Report of Premiums Written

The new reporting form categories are based on the NAIC line items reported on the Annual Statement – Exhibit of Premiums and Losses (Statutory page 14) page 19.LA for Louisiana.

Report of Premium Form

Select Single if you are reporting for a single company’s Report of Premiums.
Select Group if you are combining two or more companies’ Report of Premiums.

If you are using Google Chrome or IE Edge, you may need to turn off your pop-up blocker to print the forms.

Remember to attach a copy of the Annual Statement – Exhibit of Premiums and Losses (Statutory page 14), page 19.LA to your Report of Premiums when you submit the Report.

The due date for the Report is August 6, 2018.

Premium reports are verified by PIAL by comparing them with the Annual Statement.

If you have any questions, please contact Edie Koonce by email at [email protected] or call at 504.836.7998.