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• Accredited Reinsurer Packet[pdf]
• Agreement to Maintain Special Deposit due to non-qualified Report of Examination[pdf]
• Application for Risk Purchasing Group [pdf]
• Application for Risk Retention Group [pdf]
• Charitable Gift Annuity Notification[pdf]
• Group Self-Insurance Packet[pdf]
• Individual Self-Insurance Packet[pdf]
• Renewal Application for Workers' Compensation Self Insurance Packet[pdf]
• Insurance Company Licenses[pdf]
• Third-Party Administrators Packet[pdf]
• Prepaid Limited Health Service Organization[pdf]
• Requirements for Alien Surplus Lines Companies[pdf]
• Requirements for Foreign Surplus Lines Companies[pdf]
• Workers Compensation TPA Application Packet [pdf]

• Acquisition of Company [pdf]
• Addition of Class of Business [pdf]
• Affidavit of Lost or Misplaced Certificate of Authority [pdf]
• Amendments to Certificate of Authority[pdf]
• Company Conversion [pdf]
• Company Merger [pdf]
• Medical Malpractice Expense Reporting Forms {pdf]
• Merger & Redomestication Requirements[pdf]
• MEWA Application [pdf]
• Name Change [pdf]
• Prescription Drug Discount Plan Registration [doc] (NEW!)
• Procedures for Filing Surplus Lines Affidavits & Premium Taxes
• Service of Process[pdf]
• Statutory Address Change [pdf]

• Utilization review certification form [pdf]

• Warrantor's Initial Registration (Vehicle Protection Act) [doc] [pdf]

• Warrantor's Registration Renewal [doc] [pdf]
• Workers Compensation Indemnity Agreement Form [pdf]

  
  

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