- Skip Navigation

Note: This message is displayed if (1) your browser is not standards-compliant or (2) you have you disabled CSS. Read our Policies for more information.

Indiana Department of Insurance

IDOI > Financial Services > Domestic Admission and Redomestication Requirements > Redomestication to Indiana > Limited Service Health Maintenance Organization Limited Service Health Maintenance Organization

Below are items needed for the review of a company requesting to re-domesticate to Indiana. Items #1 - #10 are to be filed in conjunction with the Uniform Certificate of Authority Primary Application.

Uniform Certificate of Authority Primary Application

  1. Foreign Corporations:
    1. Certificate of Authority, from the Secretary of State, to transact business in Indiana
  2. Most recent Annual Statement filing - Basket Clause (investment listing) in accordance with IC 27-13-11 and IC 27-1-13-3(c)(20) for Health Maintenance Organizations.
  3. All affiliated agreements currently in effect.
  4. Return the Company's current Indiana Certificate of Authority.
  5. Provide the Company's reason(s) for re-domestication to Indiana.
  6. A non-objection letter from the Company's current state of domicile, regarding re-domestication to Indiana.
  7. Board of Directors' resolution approving the Company's re-domestication to Indiana.
  8. Oath of Office by the directors and officers originally signed and notarized.

The information requested in the preceding should be delivered to the following:
Admissions Coordinator
Indiana Department of Insurance
311 West Washington Street, Suite 300
Indianapolis, Indiana 46204-2787

Once the Department completes its review, we will prepare a certificate of authority and send it to the contact person listed on the application.