MAINE BUREAU OF INSURANCE PREFERRED - Maine gov - maine 2025

1. Click ‘Get Form’ to open the MAINE BUREAU OF INSURANCE PREFERRED PROVIDER ARRANGEMENT Annual Registration Form in the editor.
2. Begin with Section I, where you will enter your general information. Fill in your name, address, contact person details, NAIC company code (if applicable), Federal I.D. number, and statutory home city/state.
3. Proceed to Section II to provide details about any third-party administrators. Attach a list of their names and functions, along with copies of any new or modified contracts since March 1, 2013.
4. In Section III, attach your complete audited financial statements for the most recently completed year. If applicable, include documents reviewed by an independent certified public accountant.
5. Continue to Section IV and summarize any changes made since March 1, 2013. This includes coverage provisions and compensation arrangements. Ensure all attachments are clearly labeled.
6. Finally, complete Section V by summarizing your annual experience report including current and projected enrollment data and provider network details.

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