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Life and Health Financial Oversight

Managed Care

List of Managed Care Forms

Form # Form Title
OIR-A2-949 Annual Report - Contracts Issued and Outstanding
OIR-A2-950 Annual Report - Damage Claims and Medical Injury
OIR-A2-1083 Annual Report Filing Fee
OIR-A1-1671 Annual Report - Discount Medical Plan Organization (DMPO)
OIR-C1-905 Instructions for Investigative Reports
OIR-D0-516 Holding Company Registration Statement
  Emergency Claims Review Form 
OIR-C1-938 Fingerprint Card Instructions
OIR-C1-1423 Biographical Affidavit
Qtr - D Quarterly Supplement Prepaid Expenses
Qtr - G Quarterly Supplement Surplus Notes 
  Legal Entity Grid