Long-Term Care Insurance

Forms

The Office promulgates forms to facilitate the transfer of information from the insurance entities to the Office. These forms have information required by Florida statutes and rules.

Each form has an official form number, which pertains to the agency that generated the form, the area within that agency, and the numeric order of the form being issued. For example, the 11th form issued by the Applications Coordination section would be numbered OIR-C1-11.

Code	OIR Unit
A1	Property & Casualty Financial Oversight
A2	Life & Health Financial Oversight
A3	Specialty Product Review
B1	Property & Casualty Product Review
B2	Life & Health Product Review
B3	Market Investigations
C1	Applications Coordination
D0	Forms with cross-unit usage

OIR-B2-1552 Long-Term Care Insurance Potential Rate Increase Disclosure Form

Appendix A: Rescission Reporting Form For Long-Term Care Policies For The State Of Florida For The Reporting Year 20[ ]

Appendix B: Long Term Care Insurance Personal Worksheet

Appendix C: Things You Should Know Before You Buy Long-Term Care Insurance

Appendix D: Long-Term Care Insurance Suitability Letter

Appendix E: Claims Denial Reporting Form Long-Term Care Insurance For The State Of Florida

Appendix F: Long Term Care Insurance Potential Rate Increase Disclosure Form

Appendix G: Notice To Applicant Regarding Replacement Of Individual Accident And Sickness Or Long-Term Care Insurance

Appendix H: Notice To Applicant Regarding Replacement Of Accident And Sickness Or Long-Term Care Insurance

Appendix I: Long-Term Care Insurance Outline Of Coverage

Appendix J: Long-Term Care Insurance Replacement And Lapse Reporting Form

 

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