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Regulated Industry Service License/Registration/Permit Type Contact List
| Discount Medical Plan Organizations (DMPO) Pharmacy Benefit Managers (PBM) Multiple Employer Welfare Associations (MEWA) Purchasing Groups Third-Party Administrators (TPA) Viatical Settlement Providers (VSP) |
jeanette.pearce@oid.ok.gov (405) 521-6651 |
| Home Service Contract Provider Registrations Interlocals Motor Service Club Professional Employer Organizations (PEO) Service Warranty Companies Vehicle Protection Product Warranty Companies (VPP) |
gregory.ennis@oid.ok.gov (405) 522-4611 |
| Cemetery Merchandise Trust Charitable Gift Annuities Perpetual Care Cemeteries Prepaid Funeral Benefits |
ashia.turner@oid.ok.gov(405) 522-4756 |
Division Assistance (405) 521-2828, option 7 or (405) 521-6651
11-1-16 Electronic Filing Notice to Funeral Homes
CPI Increase for 2019
Sellers Notice to the Insurance Commissioner
Assumption Affidavit
Biographical Affidavit
Instructions for Completing Irrevocable Letter of Credit
Bond Form
Trust Agreement Form
Non-Specified Contract For The Deposit Of Money
Guaranteed Contract for Merchandise and Service
Irrevocable Pre-Paid Funeral Benefits Contract
Insurance Assignment Form
Application to Withdraw Funds Deposited for Prepaid Funeral Benefits
Application to Transfer Pre-need Funds
Termination of Contract/Withdraw of Funds
Request for Withdrawal of Accrued Interest
Prepaid Funeral Frequently Asked Questions
List of Active, Registered Oklahoma CPAs involved in Peer Review Program(as of 10/14/2013)
- Motor Service Club Licensing Requirements
- Motor Service Club Checklist and Application – New Company
- Motor Service Club License Renewal Application & Checklist
- Motor Service Affidavit
- Declaration of Liability as Surety on Guaranteed Arrest Bond Certificates
- Motor Service Club Bond
- Motor Service Club Bond Questionnaire
- Motor Service Club Electronic Filing Notice
- Electronic Filings Mandate – PEO’s
- Exemption PEO Application/Renewal Registration
- Full PEO Application/Renewal Registration
- Group PEO Application/Renewal Registration
- What is a PEO
- PEO Bond Form
- Oklahoma Registered PEOs
- Biographical Affidavit Template
- Bulletin 2012-01
- Bulletin 2012-01 Addendum
- Letter of Compliance Template-Full PEO
- Letter of Compliance Template-Group PEO
- Workers Compensation Questionnaire
Third-Party Administrator Licensing Information
- Third-Party Administrator Application Instructions
- Third-Party Application Requirement Checklists
- Third-Party Administrator Bond Form
- Third-Party Administrator License Renewal Instructions(for license renewal only)
- Third-Party Administrator License Surrender Form
- Third-Party Administrator Contact Change Form
- Third-Party Administrator Name Change Form
Third-Party Administrator Annual Report Information
- Viatical Settlement Provider Application
- Initial Application Checklist
- Renewal Application ChecklistANNUAL REPORT: Title 36 O.S. § 405536(A): Each Viatical Settlement Provider shall file with the Insurance Commissioner on or before March 1 of each year an annual statement containing information as the commissioner may prescribe by regulation.”
- Viatical Settlement Provider Certification Form (VSPB 001)
- Viatical Settlement Provider Report Oklahoma Insured Only Instructions (VSP 002)
- Individual Mortality Report— Oklahoma Insureds Only Instructions (VSP 003)
