Connecticut Insurance Department Forms

This document is for renewing a Medical Discount Plan (MDP) license in Connecticut.

This document is a template for a captive insurance company irrevocable letter of credit in Connecticut. It outlines the terms and conditions for establishing a letter of credit to secure the obligations of the captive insurance company. Use this document if you are setting up a captive insurance company in Connecticut and need to provide a letter of credit.

This form is used to request an external review in the state of Connecticut. It allows individuals to seek a review of a decision made by their health insurance company.

This document is for Connecticut residents who need to update their registration for Risk Purchasing Groups.

This type of document is used when an individual voluntarily gives up ownership or possession of a property or asset in the state of Connecticut.

This document is used to request a letter of clearance in the state of Connecticut.

This form is used for requesting a change in residency status in the state of Connecticut.

This Form is used for requesting a name change in the state of Connecticut.

This form is used for updating the "Doing Business As" (DBA) information in Connecticut.

This form is used for updating your address in Connecticut.

This form is used for updating the information of a Designated Responsible Licensed Producer (DRLP) in the state of Connecticut.

This form is used for certifying exceptions to the Connecticut Insurance Data Security Law.

This form is used for reporting cybersecurity incidents in the state of Connecticut. It helps to document and track security breaches and attacks.

This Form is used for the annual certification of insurance companies in Connecticut to ensure compliance with the state's data security laws.