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Title Last updated Attachments
Filing a Health Care Appeal 01/09/2020 (Fri)
Frequently Asked Questions and Key Facts about Health Insurance Rate Review 11/11/2020 (Thu)
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PDF icon FAQsfinal26ap11.pdf239.71 KB
Form E-NAIC.HEALTH: Annual Filing Checklist 03/11/2020 (Tue)
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PDF icon E-NAIC.HEALTH.pdf233.39 KB
Form E-NAIC.TITLE: Annual Filing Checklist 03/11/2020 (Tue)
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PDF icon E-NAIC.TITLE_.pdf214.08 KB
Form E-LSPS: Life Settlement Provider Annual Statement 03/11/2020 (Tue)
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PDF icon Life Settlement Provider Annual Statement E-LSPS.pdf1.31 MB
Form E-651: Checklist for Application for Life Care Provider Permit 04/11/2020 (Tue)
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PDF icon AdmLifeCareE651.pdf134.47 KB
Form E-653: Checklist for Change from a Provisional Permit to Life Care Provider Permit 04/11/2020 (Tue)
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PDF icon AdmLifeCareE653.pdf133.7 KB
Form E-654: Application for Life Care Provider Permit Change 04/11/2020 (Tue)
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PDF icon Life Care Provider Permit Change Application E-654.pdf807.44 KB
FORM ER001 FOREIGN RISK RETENTION GROUP FILING INSTRUCTIONS 03/11/2020 (Mon)
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PDF icon Foreign RRG Filing Instructions E-R001.pdf162.55 KB
Form ER001: Filing Instructions 03/11/2020 (Mon)
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PDF icon Foreign RRG Filing Instructions E-R001.pdf162.55 KB
Form ER002: Registration Application 03/11/2020 (Mon)
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PDF icon Foreign RRG Registration Application E-R002.pdf845.24 KB
Form E-CR-I: Certified Reinsurer Instructions 04/11/2020 (Mon)
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PDF icon Cert Rein E-CR-I Instructions.pdf139.8 KB
Form E-CR-F Instructions 04/11/2020 (Mon)
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PDF icon Cert Rein E-CR-F Instructions.pdf112.47 KB
Form E-CR-S Instructions 04/11/2020 (Mon)
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PDF icon Cert Rein E-CR-S Instructions.pdf136.33 KB
Form ER002: FOREIGN RFG REGISTRATION APPLICATION 10/11/2020 (Tue)
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PDF icon Foreign RRG Registration Application E-R002.pdf845.24 KB
Form EXSAPP: Application for Workers' Compensation Deposit Reduction - Instructions 03/11/2020 (Thu)
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PDF icon EXSAPP.pdf138.72 KB
Form E125-CD: Certificate of Deposit Transmittal 03/11/2020 (Thu)
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PDF icon E125CD.pdf119.39 KB
Form E126LOC: Request for Release of Letter of Credit 03/11/2020 (Thu)
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PDF icon E126LOC.pdf129.55 KB
Form E126-CD: Request for Release of Certificate of Deposit 03/11/2020 (Thu)
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PDF icon E126CD.pdf139.99 KB
Form E150 - Assignment of Certificate of Deposit or Time Deposit to Arizona State Treasurer 03/11/2020 (Thu)
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PDF icon E150.pdf125.07 KB
Form E184: Instructions for the Completion of the Form A Statement Regarding the Acquisition of Control of, or Merger with, a Domestic Insurer 04/11/2020 (Mon)
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PDF icon Holding Co Form A E-184.pdf175.44 KB
Form E185: Outline for Compliance with Insurance Holding Company Systems Reporting Requirements 04/11/2020 (Mon)
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PDF icon Holding Co Instructions E-185.pdf208.74 KB
Form E185B: Instructions for the Completion of the Form B Registration Statement 04/11/2020 (Mon)
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PDF icon Holding Co Form B E-185B.pdf172.03 KB
Form E185C: Instructions for the Completion of the Form C Summary of Registration Statement 05/11/2020 (Mon)
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PDF icon Holding Co Form C E-185C.pdf156.53 KB
Form E185CHB: Instructions for a Change to Form B Registration Statement 05/11/2020 (Mon)
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PDF icon Holding Co Form B Change E-185CHB.pdf155.17 KB
Form E185CHC: Instructions for a Change to Form C Summary of Registration Statement 05/11/2020 (Mon)
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PDF icon Holding Co Form C Change E-185CHC.pdf155.26 KB
Form E185XD: Instructions for Approval of Extraordinary Dividends and Other Distributions 05/11/2020 (Mon)
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PDF icon Holding Co Extraordinary Dividends E-185XD.pdf157.05 KB
Form E185D: Instructions for the Completion of the Form D Prior Notice of a Transaction Pursuant to A.R.S. § 20-481.12 05/11/2020 (Mon)
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PDF icon Holding Co Form D E-185D.pdf168.35 KB
Form E185F: Instructions for the completion of the Enterprise Risk Report 05/11/2020 (Mon)
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PDF icon Holding Co Form F E-185F.pdf157.84 KB
FORM E-DIRCOMWAIVER: Arizona Domestic Insurers Board of Directors and/or Committees Waiver Application 05/11/2020 (Mon)
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PDF icon Holding Co Directors Committees Waiver E-DIRCOMWAIVER.pdf109.52 KB
Form E185F: Instructions for the Completion of the Enterprise Risk Report 05/11/2020 (Mon)
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PDF icon Holding Co Form F E-185F.pdf157.84 KB
Form E185E: Instructions for the Completion of the Pre-acquisition Notification Form 05/11/2020 (Mon)
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PDF icon Holding Co Form E E-185E.pdf156.65 KB
Form E-178: Certificate of Disclosure 05/11/2020 (Mon)
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PDF icon Certificate of Disclosure E-178 web version.pdf1018.01 KB
Form E-AFR.GFE: Audited Financial Report Exemption Guidelines 05/11/2020 (Mon)
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PDF icon Audited Financial Report Guidelines for Exemptions E-AFR-GFE web version.pdf4.46 MB
Form E-AFR.OHE: Audited Financial Report Organizational Hardship Exemption Guidelines and Sample Affidavit 05/11/2020 (Mon)
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PDF icon Audited Financial Report Organizational Hardship Exemption E-AFR-OHE web version.pdf4.48 MB
Form E-AFR.IC.RE: Audited Financial Report Internal Control Filings Transmittal Reinsurer 05/11/2020 (Mon)
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PDF icon Audited Financial Report Internal Control Filings E-AFR.IC_.RE web version.pdf4.31 MB