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NEW ADDRESS
Arizona Department of Insurance
100 North 15th Avenue, Suite 261
Phoenix, AZ  85007-2630

Starting July 1, 2020, we will be the
Department of Insurance and Financial Institutions (DIFI).
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Titlesort ascending Last updated Attachments
FY 2021 Agency Budget Request 01/09/2019 (Tue)
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PDF icon IDA-AGENCY_BUDGET_REQUEST-FY2021.pdf1.74 MB
FY 2020 INSURER ANNUAL ASSESSMENT INVOICES ARE AVAILABLE 04/01/2020 (Thu)
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PDF icon Assessment Letter for Specified Assessment Date 20190712.pdf9.91 MB
FY 2020 Agency Strategic Plan 12/07/2019 (Thu)
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PDF icon FY 2020 Agency Strategic Plan85.7 KB
FY 2020 Agency Budget Request 01/09/2019 (Tue)
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PDF icon FY2020AgencyBudgetRequest.pdf2.04 MB
FY 2019 INSURER ANNUAL ASSESSMENT INVOICES ARE AVAILABLE 02/09/2018 (Wed)
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PDF icon AssessmentNoticesFY2019_20180710.pdf10.22 MB
Frequently Asked Questions and Key Facts about Health Insurance Rate Review 10/12/2014 (Sat)
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PDF icon FAQsfinal26ap11.pdf239.71 KB
Frequently Asked Questions About Rate Increases 10/12/2016 (Tue)
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PDF icon Consumer FAQs health insurance rates 11.30.16.pdf143.36 KB
Fraud Unit News: Undercover Sting Leads to Arrest for Insurance Fraud 09/11/2015 (Mon)
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PDF icon Press Release 20151002 - Donald Parra.pdf20.08 KB
Forma Para Pedir Asistencia 04/03/2015 (Tue)
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PDF icon Forma para Pedir Asistencia (3).pdf2.24 MB
Form SOONBDRR: Surprise Out-of-Network Billing Dispute Resolution Request 02/02/2020 (Thu)
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PDF icon SOONBDR_RequestForm_Fillable.pdf2.15 MB
Form SOONBDRIST: Informal Settlement Teleconference Outcome 02/01/2020 (Fri)
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PDF icon SOONBDRIST.pdf882.06 KB
Form SOONBDRIST-S: Informal Settlement Conference Scheduling Details 03/01/2020 (Fri)
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PDF icon Form SOONBDRIST-S151.98 KB
Form SOONBDRFI-P: Request for Information - Healthcare Provider 03/01/2020 (Fri)
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PDF icon Form SOONBDRFI-P2.34 MB
Form SOONBDRFI-I: Request for Information - Insurer 03/01/2020 (Fri)
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PDF icon Form SOONBDRFI-I (v. 20190207)2.25 MB
Form SL-112: Application for Domestic Surplus Lines Insurer Designation 10/02/2020 (Wed)
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PDF icon Form SL-112 Domestic Surplus Lines Insurer.pdf806.07 KB
Form RT: Retaliation Report 01/12/2014 (Tue)
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File e-rt_20141215.xlsx76.06 KB
Form RSO31010: License Application for a Rate Service Organization 01/08/2018 (Fri)
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Microsoft Office document icon RateSerOrgapp31010.doc37 KB
Form RO31010: License Application for a Rating Organization 09/12/2014 (Sat)
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Microsoft Office document icon RatingOrgApp31010.doc35.5 KB
Form RO31010: License Application for a Rating Organization 01/08/2018 (Fri)
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Microsoft Office document icon RatingOrgApp31010.doc35.5 KB
Form P-VOC: Life Settlement: Verification of Coverage for Life Insurance Policies 04/11/2016 (Thu)
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PDF icon p-voc.pdf198.39 KB
Form P-LSDO: Life Settlement: Provider/Broker Disclosures to Owner 04/11/2016 (Thu)
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PDF icon p-lsdo.pdf998.7 KB
Form P-LSC: Life Settlement Provider: Contract Checklist 09/11/2014 (Thu)
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PDF icon p-lsc.pdf144.34 KB
Form P-LSBD: Life Settlement Broker: Disclosures to Owner and Provider 04/11/2016 (Thu)
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PDF icon p-lsbd.pdf41.64 KB
Form P-LSA: Life Settlement Provider/Broker Disclosures to Owner; Affiliations 09/11/2014 (Thu)
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PDF icon p-lsa.pdf969.43 KB
Form LTCPP-AZ Attachment C: Post-purchase Notice 03/12/2014 (Mon)
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PDF icon LTCPP_POST-PURCHASE_NOTICE.pdf110.03 KB
Form LTCPP-AZ Attachment B: Pre-purchase Notice 03/12/2014 (Mon)
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PDF icon LTCPP_PRE-PURCHASE_NOTICE.pdf139.46 KB
Form LTCPP-AZ Attachment A: Insurer Certification Form 03/12/2014 (Mon)
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PDF icon LTCPP_INSURER_CERTIFICATION_FORM_2-4-10_rvsd.pdf267.45 KB
Form L-WAV: Fee Waiver Request 02/12/2018 (Tue)
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PDF icon Form L-WAV164.4 KB
Form L-TEMP: Application for a Temporary Insurance License 01/08/2018 (Fri)
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PDF icon l-temp_20180618.pdf63.23 KB
Form L-SURR: License Surrender Request 01/08/2018 (Fri)
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PDF icon l-surr_20180618.pdf1.02 MB
Form L-PRV: Application for Provisional License 03/04/2020 (Thu)
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PDF icon l-prv_20200415_1530.pdf323.51 KB
Form L-PFD: Petition for Determination 01/08/2018 (Fri)
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PDF icon Form L-PFD216.64 KB
Form L-NAV: Application for Navigator or Certified Application Counselor License 01/08/2018 (Fri)
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PDF icon form_l-nav.pdf600.85 KB
Form L-LTD: Limited License Authority Application 10/05/2019 (Tue)
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PDF icon l-ltd_20180618.pdf240.58 KB
Form L-LSB: Life Settlement Broker Application 01/08/2018 (Fri)
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PDF icon l-lsb_20180618.pdf87.3 KB
Form L-LOC: Branch Locations 01/08/2018 (Fri)
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PDF icon l-loc_20180618.pdf1.03 MB

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