| Alphabetical List |
| Title |
Form # |
| Affidavit for Lost Certificate of Authority |
2361 |
| Application for Amended Certificate of Authority: Word, PDF |
3305 |
| Instructions |
|
| Application for Certificate of Authority |
| Domestic Home Protection |
|
| Domestic Insurer |
|
| Foreign or Alien Home Protection Insurer |
|
| Health Care Service Contractor (HCSC) |
|
| Insurance Companies |
|
|
|
|
|
| Application for Certificate of Registration for Legal Expense Organization |
2167 |
| Instructions |
| Application for Permit to Organize Insurer with or without Capital Stock: Word, PDF |
3106 |
| Application for Renewal of Certificate of Registration for Legal Expense Organization |
2170 |
| Application for Reservation of Name |
|
|
| Change of Registered Office and Registered Agent |
| Insurer |
3310 |
| Instructions |
| Legal Expense Organization: Word, PDF |
2169 |
|
| Designation of Registered Office and Registered Agent |
| Insurer |
3309 |
| Legal Expense Organization |
2168 |
| Discount Medical Plan Organizations |
| Discount Medical Plan Organization Application: Word,
PDF |
4782 |
| Discount Medical Plan Organization Renewal: Word,
PDF |
4793 |
| Appointment of Insurance Commissioner for Legal Service: Word,
PDF |
4779 |
|
| External Review Referral Request |
3430 |
| Financial Statement for Legal Expense Organization:
Word,
PDF |
2164 |
| Form I.S.S. and instructions: Word,
PDF |
2035 |
| Form C.S.S. and instructions: Word,
PDF |
2036 |
| Health
Benefit Plan Report |
|
|
Instruction Guidelines |
| Health
Enrollment Report Form |
|
| Health
Care Service Contractor Bond |
3117 |
| Home
Protection Insurer Bond |
2805 |
| Legal Expense Insurance List of Sales &
Marketing Representatives: Word,
PDF |
2166 |
|
| Life Settlement Provider Application Packet |
Disclosure
Statement for Life Settlement Contracts
(Provider) |
3012 |
Application for License as Life Settlement
Provider: Word,
PDF
|
3015 |
Life
Settlement Broker Appointment/Affiliation Notice
|
3025 |
|
| Life
Settlement Provider Bond |
3359 |
| Medical/Dental Negligence Claim Report: Word,
PDF |
1962 |
| Multiple Employer Welfare Arrangement Bond:
Word,
PDF |
3630 |
| Obligor of Home Service Agreement Bond: Word,
PDF |
3443 |
| Obligor of Service Contracts Registration Application:
Word,
PDF |
2851 |
| Instructions |
| OIGA Assessment Recoupment: 2007,
2006 |
|
| Oregon
Biographical Affidavit |
3095 |
| Oregon Special Schedule P: Excel,
PDF
|
3112 |
| For Insurers authorized to write workers'
compensation |
| Organizational
Bond |
3094 |
|
| Patient Protection Reporting Forms |
| Grievance Annual Report: Word,
PDF |
3241 |
| Quality Assessment Annual Summary: Word,
PDF |
3239 |
| Network Adequacy Annual Summary: Word,
PDF |
3237 |
| Utilization Review Annual Summary: Word,
PDF |
3238 |
|
Prompt
Payment Data Report
For health insurers and health care service
contractors |
3431 |
| Instructions |
| Qualifying Bond for Legal Expense: Word,
PDF |
2165 |
| Rating Organization License Application: Word,
PDF |
3246 |
Rating Organization
Amended License Application: Word,
PDF |
3247 |
| Security Deposit Release General Request: Word,
PDF |
3461 |
| Security Deposit Release Request For Workers' Compensation:
Word,
PDF |
2944 |
| Surplus Lines Licensee Affidavit for Purchasing
Groups: Word, PDF |
3928 |
