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Welcome to the
Office of Insurance Regulation

Company Admissions

Discount Medical Plan Organization

NOTICE: FormOIR-C1-905 "Instructions for Furnishing Background Investigative Reports", has been revised. Applications submitted after January 1, 2005 that do not follow the revised instructions may be returned as incomplete.

ALL FORMS

APPLICATION FOR LICENSE DISCOUNT MEDICAL PLAN ORGANIZATION (DMPO)

OIR-C1-1606

APPLICATION FOR LICENSE DISCOUNT MEDICAL PLAN ORGANIZATION (DMPO)

OIR-C1-144

SERVICE OF PROCESS CONSENT & AGREEMENT

OIR-C1-903

INVOICE - REQUEST FOR PAYMENT OF FINGERPRINT CHARGES

OIR-C1-938

FINGERPRINT CARD INSTRUCTIONS

OIR-C1-905

INSTRUCTIONS FOR FURNISHING BACKGROUND INVESTIGATIVE REPORTS

OIR-C1-1423

BIOGRAPHICAL AFFIDAVIT

OIR-C1-1298

MANAGEMENT INFORMATION FORM - COMPLETE LIST OF OFFICERS, DIRECTORS, AND SHAREHOLDERS (10% OR MORE)