FIS 0277 (05 10) Michigan Office of Financial and Insurance Regulation-2025

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  1. Click ‘Get Form’ to open the FIS 0277 (05/10) in the editor.
  2. Begin by entering the name of the applicant in the designated field at the top of the form.
  3. For each county in your requested service area, identify and list the categories of health professionals. Fill in the corresponding number of health professionals for each category.
  4. If applicable, specify categories of health professionals by specialty. Use the provided fields to list up to ten specialties.
  5. Complete the Officer Certification section by signing and dating it. Ensure that you provide your name, title, telephone number, and email address accurately.
  6. Lastly, include contact information for a designated person if different from the authorized representative.

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Anita Fox - Director at Michigan Department of Insurance and Financial Services | LinkedIn.
DIFS regulates banks, credit unions, insurance companies, insurance agents, insurance agencies, mortgage licensees, and consumer finance-related entities.
DIFS regulates the business of insurance transacted in Michigan. Our authority pertains to contracts issued in Michigan. DIFS accepts complaints from parties involved in the contract, such as the insured, policyholder, or certificate holder.
DIFS Director Anita Fox on House Republican Budget. (LANSING, MICH) Today, Michigan Department of Insurance and Financial Services (DIFS) Director Anita Fox released the following statement in response to the Michigan House Republicans budget proposal.
Resident individual producer licenses are perpetual as long as the licensee is compliant with Continuing Education credit requirements as described on the Insurance Licensee Continuing Education FAQ web page.