Annual Underwriting Information Report

The due date to submit your agency’s underwriting information is January 14, 2025.
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The Report is separated into five sections; each can be completed independently of the other and saved separately. They have been designed to allow multiple people from the same member organization to complete pages simultaneously. Most pages have instructions that can be accessed by clicking on “View page instructions” in the upper right corner on of the page. The instructions have been prepared to ensure the consistency of responses. Also, to assist you in completing this form, some of the information from your most recent report is included on the page. In addition, your previous five reports can be accessed from your “Member Information” page.

If you need assistance with your username or password, contact Claims and Insurance Director Paul Zeglovitch.

California JPIA