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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).

(6) | " (1) | 0 (666) | 1 (1504) | 2 (88) | 3 (3) | 4 (7) | 5 (8) | 6 (20) | 7 (45) | 8 (107) | 9 (536) | > (1) | A (175) | B (22) | C (140) | D (44) | E (20) | F (275) | G (19) | H (57) | I (83) | J (2) | K (1) | L (58) | M (175) | N (83) | O (22) | P (229) | Q (1) | R (207) | S (53) | T (34) | U (13) | V (4) | W (66) | Y (3) | (1)
Title Last updatedsort ascending Attachments
File a Complaint with Us 08/08/2019 (Fri)
Form E-100: Application for Life and Health Administrator Registration 08/08/2019 (Mon)
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PDF icon Form E-100 TPA New Application 20190809.pdf1.72 MB
Form L-191: License Renewal Application for an Individual 12/07/2019 (Mon)
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PDF icon form_l-191_0.pdf314.72 KB
FY 2020 Agency Strategic Plan 12/07/2019 (Thu)
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PDF icon FY 2020 Agency Strategic Plan85.7 KB
Form L-176: Insurance License Application for a Business Entity 03/07/2019 (Fri)
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PDF icon L-176-Form-and-Instructions_20190712.pdf477.29 KB
Fingerprinting Services 12/06/2019 (Mon)
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PDF icon FingerprintServices_201906.pdf172.34 KB
Filing a Complaint 03/06/2019 (Fri)
Form L-CRT: Letter of Certification Request 09/06/2019 (Fri)
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PDF icon form_l-crt_e_.pdf999.65 KB
Form E-MRR.I: Annual Statement Filing Instructions 08/05/2019 (Fri)
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PDF icon Mechanical Reimbursement Reinsurer Annual Instructions E-MRRI (3).pdf143.37 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 CU 1621: Credit Property/Credit Unemployment Certification of Rates 02/04/2019 (Mon)
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PDF icon CU 1621 Certification Form.pdf694.38 KB
Form E-MG.CEDE: Supplementary Schedule F-3 09/04/2019 (Mon)
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PDF icon Mortgage Guaranty Cede E-MG.CEDE (2).pdf167.38 KB
Form F101: Fraud Referral Form 05/04/2019 (Sat)
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PDF icon Form F-101: Fraud Referral Form219.47 KB
Form L-192: License Renewal Application for a Business Entity 02/04/2019 (Tue)
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File l-192_20190402.docx81.02 KB
Form L-CRT: Certification Letter Request 02/04/2019 (Tue)
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PDF icon form_l-crt_e_04022019.pdf999.65 KB
Form L-177: Report of a Change to Members, Officers or Directors 01/02/2019 (Wed)
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PDF icon Form L-177618.01 KB
Form E-LIFECARE.AMEND: Amendment to Annual Report 12/01/2019 (Tue)
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PDF icon Life Care Provider Annual Report Amendment E-LIFECARE.AMEND_.WebVersion.pdf703.64 KB
FINANCIAL REPORTING - FOREIGN/ALIEN: Mutual Aid Association 12/01/2019 (Tue)
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PDF icon Mutual Aid Association Filing Requirements697.04 KB
FOREIGN INSURER: Title Insurer 03/01/2019 (Fri)
FOREIGN INSURER: Service Corporation (HMDO) 03/01/2019 (Fri)
FOREIGN INSURER: Risk Retention Group 03/01/2019 (Fri)
FOREIGN INSURER: Prepaid Legal Insurer 03/01/2019 (Fri)
FOREIGN INSURER: Mortgage Guaranty Insurer 03/01/2019 (Fri)
FOREIGN INSURER: Life/Disability/Health Insurer 03/01/2019 (Fri)
FOREIGN INSURER: HMDO Service Corporation 03/01/2019 (Fri)
FOREIGN INSURER: Health Care Services Organization 03/01/2019 (Fri)
FOREIGN INSURER: Fraternal Benefit Society 03/01/2019 (Fri)
Form E-UCLDR: Unaffiliated Credit Life & Disability Reinsurer Annual Fees Report 11/01/2019 (Fri)
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PDF icon Form E-UCLDR (v. 20181217)366.26 KB
Form E-MRR.AS: Annual Statement Filings Worksheet 09/12/2018 (Thu)
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PDF icon Form E-MRR.AS 1.11 MB
Form E-503-TPA: Affidavit of Lost Certificate of Registration 03/12/2018 (Tue)
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PDF icon Form E-503-TPA Affidavit of Lost Certificate of Registration.pdf983.69 KB
Form E-200: TPA Registration Application Checklist 02/12/2018 (Tue)
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PDF icon TPA Form E-200_20160721.pdf927.57 KB
Form E-100-A: Life and Health Administrator Registration Addendum 02/12/2018 (Tue)
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PDF icon Form E-100-A TPA New Application Addendum.pdf762.14 KB
Form E-115: Life and Health (Third-party) Administrator Information Update 02/12/2018 (Tue)
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PDF icon TPA Form E-1151.46 MB
Form E-111: Renewal Application for Life and Health Administrator Registration 02/12/2018 (Tue)
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PDF icon Form E-111 TPA Renewal Application.pdf1.41 MB
Form E-100-B: Life and Health Administrator Biographical List 02/12/2018 (Tue)
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PDF icon Form E-100-B TPA Biographical List.pdf767.11 KB
Form L-WAV: Fee Waiver Request 02/12/2018 (Tue)
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PDF icon Form L-WAV164.4 KB

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