ACORD Forms Notification Service October 2017 Bulletin
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1 ACORD Forms Notification Service October 2017 Bulletin ACORD P&C and Life/Annuity/Health Form Changes and Additions The following pages include both a List of new and recently revised ACORD forms and an Explanation of the Changes made. Beginning in 2013, we made an enhancement to our filing and forms release processes. Whenever possible, new and revised ACORD forms will be made available one to six months in advance of the form effective date. In these instances, companies will have this additional time to implement the forms into their systems before the current versions are replaced. Both the current versions and the revised future effective date versions will be found on the Forms Download page at The effective date included on the footer of all forms will match the date the form must be used in all jurisdictions in order to ensure compliance with our filings. Also on the ACORD website on the Forms Download page, there is a menu item listed on the left entitled, Related Forms. This link will open an excel file which lists Parent forms and their children (the forms that may or should be attached to the Parent form). This file will be updated any time new ACORD forms are added to the current library. Copies of the forms referenced in this announcement can be downloaded in the formats you need at To download forms, you will need to sign-in as an ACORD member with your user name and password. Once you are signed in, click on the Forms button, and then click on Download Forms to access the ones you need. If you need assistance, a sample of a form, or are an agent / broker who would like to join the Advantage Program, please call Member Services at (800) , Option 2 or us at memberservices@acord.org. If you do not wish to receive this notification, please send an to memberservices@acord.org requesting that we unsubscribe you to this Forms Notification Service. ACORD Forms Notification
2 ACORD Forms Release Form Number Replaces Title For Use on or after: REVISIONS Regulatory Change P&C- 133 (2017/12) 133 (2016/03) Workers Compensation Insurance Plan Assigned Risk Section 12/01/2017 X P&C 64 RI (2018/01) 66 RI (2017/12) 64 RI (2012/07) 66 RI (2012/07) Rhode Island Joint Reinsurance Association, Application for Homeowners Insurance Inspection and Placement Rhode Island Joint Reinsurance Association, Application for Dwelling Fire Insurance Inspection and Placement 1/01/ /01/2017 NEW P&C- P&C WITHDRAWN Life & Annuity 759 (2015/12) Important Notice Regarding Replacement Model Regulation States 68 Electronic Delivery Supplement ACORD Forms Release
3 (2016/06) E-label corrections 50 FL (2017/12) Format Improvements 212 (2017/09) Florida Automobile Insurance Card (FIG changes and E-Label change for Rental Car Coverage) Commercial Umbrella Underlying Schedule (E-Label, Mapping, Tabbing functions and FIG changes to this form have been made) ACORD Forms Release
4 EXPLANATION OF CHANGES P&C FORMS New Forms Country Wide 133 (2017/12) WORKERS COMPENSATION INSURANCE PLAN Assigned Risk Section 1. On page three, deletes and replaces it with the applicable statute T.C.A (7). 2. Revises date of form. RI 64 (2018/01) RHODE ISLAND JOINT REINSURANCE ASSOCIATION Application for Homeowners Insurance Inspection and Placement 1. On first page, deletes please type or print clearly. 2. Takes out box on right hand corner stating approved or rejected. 3. Deletes section and box to check if applying for immediate coverage via fax. 4. Adds Application # in place of policy # 5. Adds insured address 6. Deletes Prem Group 7. On second page, remove policy number from top of page and delete cell 8. Removes cell and text Annual Tentative Premium, Install plan Check Box and Down- Payment box 9. Adds new questions to section 9 of General Information, with Yes No indicators, and for questions B and C, fields to indicate values. 10. Revises copyright dates to 2018 and date of form. ACORD Explanation of Changes
5 RI 66 (2017/12) RHODE ISLAND JOINT REINSURANCE ASSOCIATION Application for Dwelling Fire and Personal Liability Insurance Inspection and Placement 1. On first page, deletes please type or print clearly. 2. Takes out box on right hand corner stating approved or rejected. 3. Deletes section and box to check if applying for immediate coverage via fax. 4. Adds Application # in place of policy # 5. Adds insured address 6. Deletes Prem Group 7. On second page, remove policy number from top of page and delete cell 8. Removes cell and text Annual Tentative Premium, Install plan Check Box and Down- Payment box 9. Adds new questions to section 9 of General Information, with Yes No indicators, and for questions B and C, fields to indicate values. 10. Revises copyright dates to 2017 and date of form. Form Enhancements 1. 50FL (2017/12) Florida Automobile Insurance Card FIG was updated to reflect name of the form and E-Label was changed for Rental Car Coverage and is reflected in the FIG (2017/09) Commercial Umbrella Underlying Schedule On the fillable versions, font size was reduced to increase room to enter information. Tab functionality was improved and changes were made to the FIG to reflect the improvements made to the tabbing functions and their associated e-labeling. These are not new form editions. The static text of the forms have not changed. ACORD Explanation of Changes
6 Withdrawn 68 (2016/06) ELECTRONIC DELIVERY SUPPLEMENT ACORD is withdrawing this form effective November 1, Withdrawn LIFE & ANNUITY 759 (2015/12) IMPORTANT NOTICE REGARDING REPLACEMENT MODEL REGULATION STATES ACORD is withdrawing this form effective November 1, ACORD Explanation of Changes
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