Company Type

Form

Statute

Life, Accident, Health Insurers

Checklist for Filings in 2010

58-6

Property Casualty

Checklist for Filings in 2010

58-6

Health Entities

Checklist for Filings in 2010

58-6

Fraternal Companies

Checklist for Filings in 2010

58-6

Title Companies

Checklist for Filings in 2010

58-6

Holding Company

A

58-5A

Holding Company

B

58-5A

Holding Company

C

58-5A

Holding Company

D

58-5A

Holding Company

E

58-5A

Tax Credit for principal or regional home office

Home Office Credit

58-5-93

Life Health     

Publication Statement

58-6-76

Fire & Casualty         

Publication Statement

58-6-76

Property Casualty, Life/Health, Title            

Statement of Deposit

58-7

Health Maintenance Organization

Statement of Deposit

58-7

Risk Retention Group

Regisration Packet

58-6A

Risk Purchasing Group

Registration Packet

58-6A

Accredited or Qualified Reinsurer

Registration Packet

58-14

Major Medical Health Insurance Companies

Risk Pool- Report of Covered Lives

58-17-126

Insurance Fraud

Suspected Fraudulent Claim Report

58-4A

Company Appointments and Terminations 

Producer or Business Entity Multi Appointment Form 

58-30

Company Appointments and Terminations 

Notice of Termination of Company Appointment 

58-30

Insurance Companies

Premium Tax Refund Form

10-55A-6

Companies Reporting Health Premiums

Annual Grievance Report This report must be filed via SERFF

58-17C-82