Licensing Information
- Important Information for Applicant (PDF)
- Application - Form H1 (PDF) or Application - Form H1 (DOC)
- Checklist H2 - Part A (PDF) or Checklist H2 - Part A (DOC)
- Checklist H2 - Part B (PDF) or Checklist H2 - Part B (DOC)
- Uniform Consent to Service of Process Form (PDF) or Uniform Consent to Service of Process Form (DOC)
Fees
- Company Renewal Dates and Fees (PDF)
- Fee schedule (24-A M.R.S.A. § 601)
- HMO Fees www.mainelegislature.org/legis/statutes/24-A/title24-Asec4220.html
- Producer Appointment Renewal Fees (DOC)
- Authorization of Credit Card Payment (PDF) or Authorization of Credit Card Payment (DOCX)
Annual Reporting Requirements
- Annual Statement Filing Instructions and Checklists
- Maine Annual Data Reporting Requirements
- Health Maintenance Organization Annual and Quarterly Financial Statements
Rate and Form Filing Checklists
Status Change Forms (Name Changes, Mergers, Redomestications, Etc.)
- Address Changes (PDF) or Address Changes (DOC)
- Update License Information - Change your address and/or contact information ON-LINE (Maine Only)
- NAIC UCAA Corporate Amendment - Change Address/Contacts - Under ‘Corporate Amendment Forms’, scroll to Form 14. Can be mailed, emailed, or filed electronically through UCAA Electronic application.
- Amended Articles and Bylaw Filings
- Director and Officer Updates and Change Requirements
- Merger Requirements for Two or More Foreign Companies
- Name Change Requirements
- Name Reservation (DOCX)
- Change of Control/Acquisition Requirements
- Redomestication Requirements
Credentialing Extension Application
Requesting Confidential Treatment of Documents
Statutory Requirements
- Title 24-A Chapter 56 - (Health Maintenance Organizations)
- Rule Chapter 191 (DOC) - (Application Submission Requirements)
The documents on this page are also available in hard copy by contacting the Bureau.