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Office of Insurance Regulation

Company Admissions

Managed Care

Multiple Employer Welfare Arrangements

NOTICE: Form OIR-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 CERTIFICATE OF AUTHORITY MULTIPLE EMPLOYER WELFARE ARRANGEMENTS PACKAGE

OIR-C1-983

APPLICATION FOR CERTIFICATE OF AUTHORITY MULTIPLE EMPLOYER WELFARE ARRANGEMENTS

OIR-C1-984

APPLICATION FOR CERTIFICATE OF AUTHORITY MULTIPLE EMPLOYER WELFARE ARRANGEMENTS INSTRUCTIONS

OIR-C1-985

APPLICATION FOR CERTIFICATE OF AUTHORITY MULTIPLE EMPLOYER WELFARE ARRANGEMENTS CHECK LIST

OIR-C1-486

APPLICATION FOR CERTIFICATE OF AUTHORITY (Multiple Employer Welfare Arrangement)

OIR-C1-980

INVOICE - REQUEST FOR PAYMENT OF APPLICATION FEES

OIR-C1-844

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

OIR-C1-422

BIOGRAPHICAL STATEMENT AND AFFIDAVIT

OIR-C1-450

AUTHORITY FOR RELEASE OF INFORMATION

OIR-C1-905

INSTRUCTIONS FOR FURNISHING BACKGROUND INVESTIGATIVE REPORTS

OIR-C1-938

FINGERPRINT CARD INSTRUCTIONS

OIR-C1-903

INVOICE - REQUEST FOR PAYMENT OF FINGERPRINT CHARGES