Delaware Department of Insurance Forms

This form is used for pharmacists in Delaware to appeal decisions made by the licensing board or other regulatory bodies. It allows them to present their case and request a review of the decision.

This form is used for appealing a decision made by a PBM (Pharmacy Benefits Manager) in the state of Delaware. It allows individuals to provide a response to the PBM's decision and present their case for reconsideration.

This form is used for surrendering a license in the state of Delaware.

This document provides a report on medical negligence claims in Delaware. It outlines the relevant Delaware law, specifically 18 Del. C. 6820, related to medical negligence claims.

This document is used for setting up an escrow agreement in the state of Delaware.

This document provides a quarterly report on the pharmacy benefits manager in Delaware.

This document is used for preparing a checklist for obtaining a domestic license in Delaware, which is the home state.

This document is used for reporting the loss of a Pharmacy Benefit Manager (PBM) certificate in the state of Delaware.

This document is a tax report used for self-procured surplus lines in the state of Delaware. It pertains to independent procurement premium taxes.

This document is a questionnaire used to assess the workplace safety program in Delaware. It helps employers evaluate the effectiveness of their safety measures and identify areas for improvement.

This document is a request for waiver for the submission of affordability standards data in Delaware.