Form SS-4PR Indianapolis Indiana 2020-2025

Form SS-4PR Indianapolis Indiana: What You Should Know

Information line Hours: Monday-Friday, 8:30 a.m. to 5:00 p.m. EST. Indiana Secretary of State — Finding the Correct Forms — IN.gov Department of Health and senior agencies — Office of Indiana Health Insurance Marketplace A) Form 8-1-06 is for insurance agents who sell, distribute, exchange, or administer health insurance within Indiana with health care coverage issued by a health plan that has enrolled in the health plan market. A health insurance plan is defined as any self-funded or self-regulated plan and any health insurance coverage, other than a qualified health plan, under which the issuer is required to offer coverage in the State of Indiana. This form serves as the official verification of an insurance agent's coverage status. Issuing agencies should not be confused with insurance carriers. See Form 8-1-01 to determine if an agent is an insurance carrier. See Forms 10-K and 10-Q, Form 843R,  Form 938-EZ (Form 843R) and Form 938-EEZ (Form 843EZ). Health plans that are regulated by the federal government and are located in Indiana do not generally require an Indiana agent.  B) Form 836 is for consumers who obtain their health insurance coverage from a broker, health insurance carrier, or insurance agent, and who provide their name, address, and telephone number in order to make a claim for assistance or to find a health plan in the market. An Indiana consumer who receives a Form 836 may choose to use this form as the basis of a state government-covered claim or report, but may not submit an Indiana Form 836 as a written submission to the U.S. Internal Revenue Service (IRS) or a State Medicaid Plan. See Forms 836 for more information. The Indiana Department of Insurance and Department of Financial Services, in writing to the Director of the Division of Insurance on August 23, 2017, requested the following information. D) Information Required The following information is necessary to verify the identity of the applicant. If the applicant's information on file with the Office is incomplete, all future applications for enrollment will be subject to further review. Incomplete information means any of the following: You can use this information ONLY as a basis to verify, without being required to submit additional information.

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