Instructions for Insurance Intermediaries and Supplementary Intermediaries Operating in Another Member State under the Freedom to Provide Services (FOS) – Form Completion Guidelines

INSTRUCTIONS FOR INSURANCE INTERMEDIARIES AND SUPPLEMENTARY INTERMEDIARIES INTENDING TO CARRY OUT INSURANCE DISTRIBUTION ACTIVITIES IN ANOTHER MEMBER STATE ON THE BASIS OF FREEDOM TO PROVIDE SERVICES - FOS

Intermediaries or supplementary intermediaries may carry out insurance distribution activities for which they have Hanfa's approval in the territory of another member state:

• on the basis of freedom of establishment, or
• in accordance with the freedom to provide services.

Each insurance intermediary and supplementary intermediary intending to conduct business for the first time in another member state on the basis of the freedom to provide services is obliged:

• pursuant to Article 416(1) of the Insurance Act (Official Gazette nos. 30/2015, 112/2018, 63/2020, 133/2020) to notify Hanfa in writing using the form published on its website,
• pursuant to Article 12(47) of the Regulation on the Type and Amount of Fees of the Croatian Financial Services Supervisory Agency (Official Gazette no. 26/2019) to submit proof of payment of the notification fee to the competent supervisory authority of the member state and to the intermediary or supplementary intermediary from the Republic of Croatia regarding the conduct of insurance distribution or reinsurance distribution activities in that member state via a branch, in the amount of 1,000.00 HRK.

Form Completion Instructions:

1. The form must be completed exclusively in English.
2. The form must indicate whether it is an initial notification or a modification of the notification.
3. Under point 1, the first and last name of an individual intermediary/supplementary intermediary or the name of a legal entity intermediary/supplementary intermediary is provided.
4. Under point 2, the Croatian Personal Identification Number (OIB) of the intermediary/supplementary intermediary is provided.
5. Under point 3, the address (street, postal code, city, and country) of an individual intermediary/supplementary intermediary or the registered office address (street, postal code, city, and country) of a legal entity intermediary/supplementary intermediary is provided.
6. Under point 4, the registration number under which the intermediary/supplementary intermediary is listed in the Intermediaries/Supplementary Intermediaries Registers on Hanfa's website is provided.
7. Under point 5, the email address of the intermediary/supplementary intermediary is provided, if applicable.
8. Under point 6, the name of the member state where the intermediary/supplementary intermediary intends to carry out insurance distribution activities on the basis of the freedom to provide services is provided.
9. Under point 7, the category of the intermediary/supplementary intermediary is provided in accordance with the categorization under Article 402 of the Insurance Act.
10. Under point 8, if applicable, the name of the insurance/reinsurance company represented by the intermediary/supplementary intermediary is provided. If not applicable, "N/A (non-applicable)" is entered.
11. Under point 9, the types of insurance for which the intermediary/supplementary intermediary is authorized are listed. 1 For easier navigation, it is recommended to consult the Regulation on the Allocation of Risk Types by Groups and Types of Insurance or Reinsurance.
12. Under point 10, the name of the competent supervisory authority of the home member state – Hanfa – is provided.
13. Under point 11, the address of the online register where the intermediary/supplementary intermediary can be found is provided – it is necessary to enter the link to the online registers of intermediaries/supplementary intermediaries maintained by Hanfa on its website, in which the intermediary/supplementary intermediary is registered.
14. Under point 12, if applicable, the nature of risk and obligations that will be covered by insurance contracts intended to be distributed in the host member state are provided. If not applicable, "N/A (non-applicable)" is entered. 2 For easier navigation, it is recommended to consult the Regulation on the Allocation of Risk Types by Groups and Types of Insurance or Reinsurance.
15. Under point 13, the first and last name, phone number, and email address of the contact person Hanfa may reach regarding the notification are provided.
16. At the bottom of the form, the date, first and last name, and title/position of the person completing the form are provided, along with their signature.
17. The completed form, together with proof of payment of the fee, may be submitted electronically to Passport.Imd@hanfa.hr, by post, or in person at Hanfa's Registry Office on working days from 9 a.m. to 2 p.m.

Note: Pursuant to Article 416(5) of the Insurance Act, if any of the data submitted in the form changes, the insurance intermediary/supplementary intermediary is obliged to notify Hanfa in writing at least one month before implementing the change. In this case, the intermediary/supplementary intermediary must complete the form according to the instructions above, indicate that it concerns a modification of the notification, and submit the form to Hanfa, which will notify the competent authority of the host member state as soon as possible, and no later than one month from the date Hanfa received the data.

Fee Payment Instructions: Initial Notification Amount: 1,000.00 HRK Model: 67 Reference Number: OIB-118-044 IBAN for payment: HR91 2390 0011 1003 29373. Purpose of payment: Initial FOS Notification – Party Name

Note: For notifications regarding changes to the data in the form, the intermediary/supplementary intermediary is not obliged to pay any fee to Hanfa. If an intermediary/supplementary intermediary intends to carry out insurance distribution activities on the basis of the freedom to provide services in multiple member states, it may list several member states in point 6 of the form during the initial notification. In such a case, the intermediary/supplementary intermediary is obliged to pay a single fee for the initial notification.