Utah Insurance Department Forms

This document is the application form for obtaining a license as a Professional Employer Organization (PEO) in the state of Utah. A PEO is an entity that provides human resources services, such as payroll processing and employee benefits, to small and medium-sized businesses. The application process for a PEO license in Utah involves meeting certain requirements and being licensed through an assurance organization.

This document is an appendix to the Utah Life Settlement Provider Initial Application. It is specific to the state of Utah.

This document is used for applying for a small operation license as a professional employer organization in the state of Utah.

This document is for Professional Employer Organizations in Utah that are not licensed through an Assurance Organization.

This document provides a checklist and certification for the content of an antifraud plan in Utah for life settlement transactions. It ensures that the necessary measures are in place to prevent fraud in the life settlement industry.

This document is used for applying to become a pharmacy benefit manager in Utah.

This document is an application and checklist for an Independent Review Organization in the state of Utah. It provides a step-by-step guide for organizations seeking to become an Independent Review Organization and ensures that all necessary requirements are met.

This Form is used for applying as a service contract provider, home warranty provider, or vehicle protection product warranty provider in the state of Utah.

This Form is used to request an independent review in the state of Utah. It allows individuals to seek a review of a decision made by a state agency or government entity.

This form is used for applying to become a Rate Service Organization in the state of Utah.

This form is used for requesting authorization for a group health insurance plan through a bona fide employer association in Utah.

This document provides instructions for completing the Utah Accident & Health Survey (ASO Supplement). It is completed by individuals in Utah and provides information about accidents and health insurance coverage.