TBD Terrorism Risk Insurance Program: Small Insurers

Collection of Data from Property and Casualty Insurers for Reports Concerning the Terrorism Risk Insurance Program

2025 Draft Data Call Small Insurers.xlsx

Small Insurers Insurer Group Affliations

OMB: 1505-0257

Document [xlsx]
Download: xlsx | pdf

Overview

Affiliations
Premium (Juris.)
Standalone Terrorism (US)
Cyber (US)
Exposure Bases (Juris.)
Places of Worship (US)
Reinsurance (US)
PRA Notice

Sheet 1: Affiliations
B C

G H
3 NAIC Group Code Insurer Group Name

3 Total 2023 Policyholder Surplus

4



4 Total 2023 TRIP-Eligible DEP (all lines)



















B C D




8 NAIC Company Code Insurance Company Name Type of Insurer




9







10







11







12







13







14







15







16







17







18







19







20







21







22







23







24







25







26







27







Sheet 2: Premium (Juris.)
Jurisdiction:




2













B C D E F G H
5 TRIP-Eligible Line of Coverage NAIC Line (Commercial Only) Total 2024 TRIP-Eligible DEP (all policies) Total 2024 TRIP-Eligible DEP (Terrorism Risk Coverage Declined) Total 2024 TRIP-Eligible DEP (Terrorism Risk Coverage Provided for Disclosed $0 Charge) Total 2024 TRIP-Eligible DEP (Terrorism Risk Coverage Provided with a Premium Charged) Total 2024 DEP Charged for Terrorism Risk Coverage
6 Fire 1 $-



7 Allied Lines 2.1 $-



8 Commercial Multiple Peril (non-liability portion) 5.1 $-



9 Commercial Multiple Peril (liability portion) 5.2 $-



10 Ocean Marine 8 $-



11 Inland Marine 9 $-



12 Workers' Compensation 16 $-



13 Excess Workers' Compensation 17.3 $-



14 Other Liability 17 $-



15 Products Liability 18 $-



16 Aircraft (all perils) 22 $-



17 Boiler and Machinery 27 $-



18 TOTALS
$- $- $- $- $-








































Sheet 3: Standalone Terrorism (US)
B C
2 Element Amount
3 2024 DEP for Standalone Terrorism Policies
4 Portion of 2024 DEP Providing Coverage for Losses for Certified Acts of Terrorism under TRIP
5 Portion of 2024 DEP Providing Coverage for Losses Arising from Other (Non-Certified) Acts of Terrorism
6 2024 Number of Standalone Terrorism Policies Issued
7 2024 Number of Standalone Terrorism Policies Issued Providing Coverage for Losses for Certified Acts of Terrorism Under TRIP
8 2024 Property Insurance Exposure for Standalone Terrorism Policies Providing Coverage for Losses for Certified Acts of Terrorism Under TRIP
9 Total 2024 Limits of Liability for Standalone Terrorism Policies Providing Coverage for Losses for Certified Acts of Terrorism Under TRIP

Sheet 4: Cyber (US)
B C D E
2 Element Standalone Cyber Cyber Coverage provided as part of a Package Policy Totals
3 Total 2024 TRIP-Eligible DEP (All Cyber Policies)

$-
4 Total 2024 Cyber DEP in TRIP-Eligible Lines of Insurance (Terrorism Risk Coverage Declined)

$-
5 Total 2024 Cyber DEP in TRIP-Eligible Lines of Insurance (Terrorism Risk Coverage Provided)

$-
6 Total 2024 TRIP-Eligible DEP Charged for Terrorism Risk Coverage Under Cyber Policies

$-
7 Total 2024 Non-TRIP-Eligible DEP (All Cyber Policies)

$-
8 Total 2024 Number of Cyber Policies Issued in TRIP-Eligible Lines of Insurance

0
9 Total 2024 Number of Cyber Policies Issued (Terrorism Risk Coverage Provided)

0
10 Total 2024 Number of Cyber Policies Issued in Non-TRIP-Eligible Lines of Insurance

0
11 Total 2024 Number of all Cyber Policies Issued

0
12 Total 2024 Number of all Cyber Policies Issued to Small Policyholders (100 or fewer employees or less than $10 million in revenue)

0
13 Total 2024 Number of all Cyber Policies Issued to Medium Policyholders (101-500 employees or $10-$100 million in revenue)

0
14 Total 2024 Number of all Cyber Policies Issued to Large Policyholders (501 or more employees or moer than $100 million in revenue)

0
15 Total 2024 DEP of all Cyber Policies Issued to Small Policyholders (100 or fewer employees or less than $10 million in revenue)

$-
16 Total 2024 DEP of all Cyber Policies Issued to Medium Policyholders (101-500 employees or $10-$100 million in revenue)

$-
17 Total 2024 DEP of all Cyber Policies Issued to Large Policyholders (501 or more employees or more than $100 million in revenue)

$-
18 Total 2024 Policy Limits for Cyber Policies Issued in TRIP-Eligible Lines of Insurance

$-
19 Total 2024 Policy Limits for Cyber Policies Issued in TRIP-Eligible Lines of Insurance Providing Coverage for Losses for Certified Acts of Terrorism Under TRIP

$-
20 Total 2024 Policy Limits for Cyber Policies Issued in Non-TRIP-Eligible Lines of Insurance

$-
21 Total 2024 Policy Limits for Cyber Extortion under Cyber Policies Issued in TRIP-Eligible Lines of Insurance

$-
22 Total 2024 Policy Limits for Ransom Payments for Cyber Extortion under Cyber Policies Issued in TRIP-Eligible Lines of Insurance

$-
23 Total 2024 Policy Limits for Cyber Extortion under Cyber Policies Issued in Non-TRIP-Eligible Lines of Insurance

$-
24 Total 2024 Policy Limits for Ransom Payments for Cyber Extortion under Cyber Policies Issued in Non-TRIP-Eligible Lines of Insurance

$-
25 Total 2024 Direct Losses Paid for Cyber Extortion under all Cyber Policies Issued

$-
26 Total 2024 Direct Losses Incurred for Cyber Extortion under all Cyber Policies Issued

$-
27 Total 2024 Direct Losses Paid for Cyber Extortion (Ransom Payment or Reimbursement Only) under all Cyber Policies Issued

$-
28 Total 2024 Number of Claims Associated with Payments reported in Line 27

$-
29 Total 2024 Direct Defense and Loss Containment Amounts Paid for Cyber Extortion under all Cyber Policies Issued

$-
30 Total 2024 Direct Defense and Loss Containment Amounts Incurred for Cyber Extortion under all Cyber Policies Issued

$-

Sheet 5: Exposure Bases (Juris.)
Jurisdiction:










2

























B C D E F G H I J K L M N
5 TRIP-Eligible Line of Coverage NAIC Line (Commercial Only) Total 2024 TRIP-Eligible Property Exposure (Terrorism Risk Coverage Provided) Total 2024 TRIP-Eligible Property Exposure (Terrorism Risk Coverage Provided and NBCR Risks Not Excluded) Total 2024 Policyholder Deductibles for TRIP-Eligible Property Policies (Terrorism Risk Coverage Provided) Total 2024 TRIP-Eligible Property Exposure (Terrorism Risk Coverage Declined) Total 2024 Policyholder Deductibles for TRIP-Eligible Property Policies (Terrorism Risk Coverage Declined) Total 2024 Limits of Liability for TRIP-Eligible Policies (Terrorism Risk Coverage Provided) Total 2024 TRIP-Eligible Limits of Liability (Terrorism Risk Coverage Provided and NBCR Risks Not Excluded) Total 2024 Policyholder Deductibles for TRIP-Eligible Liability Policies (Terrorism Risk Coverage Provided) Total 2024 Liability for TRIP-Eligible Policies (Terrorism Risk Coverage Declined) Total 2024 Policyholder Deductibles for TRIP-Eligible Liability Policies (Terrorism Risk Coverage Declined) Total 2024 Payroll for TRIP-Eligible Policies (Terrorism Risk Coverage Provided)
6 Fire 1










7 Allied Lines 2.1










8 Commercial Multiple Peril (non-liability portion) 5.1










9 Commercial Multiple Peril (liability portion) 5.2










10 Ocean Marine 8










11 Inland Marine 9










12 Workers' Compensation 16










13 Excess Workers' Compensation 17.3










14 Other Liability 17










15 Products Liability 18










16 Aircraft (all perils) 22










17 Boiler and Machinery 27










18 TOTALS
$- $- $- $- $- $- $- $- $- $- $-










































Sheet 6: Places of Worship (US)
C D E F G H I J K L M N O

Property Liability Workers' Compensation All Categories
3 Code Description Total 2024 DEP Charged for Terrorism Risk Coverage Total 2024 TRIP-Eligible DEP (Terrorism Risk Coverage Declined) Total 2024 TRIP-Eligible DEP (Terrorism Risk Coverage Provided) Total 2024 TRIP-Eligible DEP Total 2024 DEP Charged for Terrorism Risk Coverage Total 2024 TRIP-Eligible DEP (Terrorism Risk Coverage Declined) Total 2024 TRIP-Eligible DEP (Terrorism Risk Coverage Provided) Total 2024 TRIP-Eligible DEP Total 2024 DEP Charged for Terrorism Risk Coverage Total 2024 TRIP-Eligible DEP Total 2024 TRIP-Eligible DEP
4 NAICS 813110 Religious Organizations


$-


$-

$-
5 SIC 8661 Religious Organizations


$-


$-

$-
6 ISO 0900 (Property)
41650 (Liablity)		 Religious Organizations


$-


$-

$-
7 Other
Places of Worship


$-


$-

$-
8

TOTALS: $- $- $- $- $- $- $- $- $- $- $-

Sheet 7: Reinsurance (US)
B C D
2 Element Response Description or Explanation (if any)
3 Size of TRIP 2024 Deductible (Cell H4 of Insurer Group Affiliations Chart x 20%)

4 Total 2024 Limits Any One Loss of Purchased Treaty Reinsurance Covering TRIP Loss

5 Total 2024 Aggregate Limits of Purchased Treaty Reinsurance Covering TRIP Loss

6 2024 Attachment Point Any One Loss of Purchased Treaty Reinsurance Covering TRIP Loss

7 2024 Co-Participation Share of Purchased Treaty Reinsurance Covering TRIP Loss

8 Total 2024 Limits Any One Loss of Purchased Treaty Reinsurance Covering Natural Catastrophe Loss

9 Total 2024 Aggregate Limits of Purchased Treaty Reinsurance Covering Natural Catastrophe Loss

10 2024 Attachment Point Any One Loss of Purchased Treaty Reinsurance Covering Natural Catastrophe Loss

11 2024 Co-Participation Share Any One Loss of Purchased Treaty Reinsurance Covering Natural Catastrophe Loss

12 Any Reinsurance Exclusions for TRIP Certified Foreign Acts of Terrorism?

13 Any Reinsurance Exclusions for TRIP Certified Domestic Acts of Terrorism?

14 Reinsurance for NBCR WC Exposures Resulting from Certified Acts of Terrorism?

15 If Yes, 2024 Limits Any One Loss of NBCR Reinsurance for Certified Acts of Terrorism involving WC Loss

16 If Yes, 2024 Attachment Point Any One Loss of NBCR Reinsurance for Certified Acts of Terrorism involving WC Loss

17 If Yes, 2024 Co-Participation Share (if any) Any One Loss of NBCR Reinsurance For Certified Acts of Terrorism involving WC Loss

18 Reinsurance for NBCR Property Loss Resulting from Certified Acts of Terrorism?

19 If Yes, 2024 Limits Any One Loss of NBCR Reinsurance for Certified Acts of Terrorism involving Property Loss

20 If Yes, 2024 Attachment Point Any One Loss of NBCR Reinsurance for Certified Acts of Terrorism involving Property Loss

21 If Yes, 2024 Co-Participation Share (if any) Any One Loss of NBCR Reinsurance for Certified Acts of Terrorism involving Property Loss

22 Reinsurance for NBCR Liability Loss Resulting from Certified Acts of Terrorism?

23 If Yes, 2024 Limits Any One Loss of NBCR Reinsurance for Certified Acts of Terrorism involving Liability Loss

24 If Yes, 2024 Attachment Point Any One Loss of NBCR Reinsurance for Certified Acts of Terrorism involving Liability Loss

25 If Yes, 2024 Co-Participation Share (if any) Any One Loss of NBCR Reinsurance for Certified Acts of Terrorism involving Liability Loss

26 Any Other Reinsurance Exclusions Specifically Applicable to Certified Acts of Terrorism Under TRIP?

27 ZIP Code Associated with Largest Probable Maximum Loss (PML)

28 Largest PML at a Single Location (Amount)

Sheet 8: PRA Notice
Notice under the Paperwork Reduction Act

We estimate it will take you about 32 hours to complete this form. However, you are not required to provide the information requested unless a valid OMB control number is displayed on the form. Any comments or suggestions regarding this form should be sent to the Terrorism Risk Insurance Program Office, Department of the Treasury, 1500 Pennsylvania Avenue NW, Room 1410 MT, Washington, DC 20220. Do not send completed forms to this address. Submit forms according to instructions provided at www.tripsection111data.com.
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