Rule: 69O-136.100 Prev   Up   Next

Rule Title: Forms Incorporated by Reference
Department: DEPARTMENT OF FINANCIAL SERVICES    Add to MyFLRules Favorites
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Division: OIR – Insurance Regulation
Chapter: APPLICATION PROCEDURES FOR COMPANIES SEEKING TO DO BUSINESS IN FLORIDA

Latest version of the final adopted rule presented in Florida Administrative Code (FAC):

VIEW_RULE Effective Date: 1/7/2024
History Notes: Rulemaking Authority 624.308(1), 624.413(1), 628.461(13), 628.4615(15), 628.535 FS. Law Implemented 624.307(1), 624.34, 624.404, 624.413, 624.424(6), 624.501, 624.5091, 626.9928, 628.451, 628.461, 628.4615, 628.471, 628.801, 634.252, 634.3073, 634.4085, 636.065, 641.255, 641.416, 642.032, 651.024, 651.0245 FS. History–New 7-21-22, Amended 1-7-24.
References in this version: Ref-14435 Service of Process Consent & Agreement
Ref-14436 Application for Acquisition of Controlling Stock, Ownership Interest, Assets, or Control of a Florida Specialty Insurer; Merger or Consolidation
Ref-14437 Instructions for Furnishing Background Investigative Reports
Ref-14438 Application for Acquisition of Controlling Stock of a Florida Domestic Insurer
Ref-14439 Fingerprint Payment and Submission Procedure
Ref-14441 Uniform Certificate of Authority Application (UCAA) Biographical Affidavit
Ref-14442 Disclaimer of Control - Individual
Ref-14443 Disclaimer of Control - Entity
Ref-14444 Uniform Certificate of Authority Application (UCAA) Uniform Consent to Service of Process
Ref-14445 Disclaimer of Control – Investment Companies
Ref-14446 Management Information Form
Ref-14448 UCAA Proforma Financial Statements, Property and Casualty Insurance Company
Ref-14450 UCAA Proforma Financial Statements, Health
Ref-14593 UCAA Proforma Financial Statements, Title Insurance Company
Ref-16192 OIR-B1-PCR3, Filing requirements Advisory Organization
Ref-16193 OIR-B2-1093, Small Employer Carrier’s Application to Become a Risk Assuming Carrier or a Reinsuring Carrier, as Required by Section 627.6699(9), Florida Statutes
Ref-16194 OIR-C1-0500, UCAA Biographical Affidavit Addendum Blank
Ref-16195 OIR-C1-0501, UCAA Biographical Affidavit Addendum Education
Ref-16196 OIR-C1-0502, UCAA Biographical Affidavit Addendum Employment
Ref-16197 OIR-C1-0503, UCAA Biographical Affidavit Addendum General
Ref-16198 OIR-C1-0504, UCAA Biographical Affidavit Addendum Licenses
Ref-16199 OIR-C1-0505, UCAA Biographical Affidavit Addendum Professional
Ref-16200 OIR-C1-0506, UCAA Biographical Affidavit Addendum Residence
Ref-16201 OIR-C1-0507, UCAA Biographical Affidavit Addendum Societies
Ref-16202 OIR-C1-0508, “Uniform Certificate of Authority Application (UCAA) Affidavit of Lost Certificate of Authority
Ref-16203 OIR-C1-0509, Uniform Certificate of Authority Application (UCAA) Biographical Affidavit Cover Letter Holding Company Structure
Ref-16206 OIR-C1-0510, “Uniform Certificate of Authority Application (UCAA) Corporate Amendments Application Application to Amend Certificate of Authority
Ref-16208 OIR-C1-0511, Uniform Certificate of Authority Application (UCAA) Corporate Amendments Application Checklist for Corporate Amendments Application Only
Ref-16210 OIR-C1-0512, Uniform Certificate of Authority Application Questionnaire for Adding or Deleting Lines of Business to an Existing Certificate of Authority
Ref-16212 OIR-C1-0520, Uniform Certificate of Authority Application (UCAA) Primary Application Checklist for Primary Application Only
Ref-16213 OIR-C1-0521, Uniform Certificate of Authority Application (UCAA) Primary Application
Ref-16214 OIR-C1-0522, “Uniform Certificate of Application (UCAA) Change of Mailing Address/Contact Notification Form
Ref-16216 OIR-C1-513, Application for Registration as a Risk Retention Group
Ref-16217 OIR-C1-515, Application for Registration as a Risk Purchasing Group
Ref-16227 OIR-C1-845, Application for Certificate of Authority Commercial Self-Insurance Fund
Ref-16228 OIR-C1-908, Application for Permit Domestic Reciprocal Insurer
Ref-16229 OIR-C1-916, Application for Eligibility as a Surplus Lines Insurer
Ref-16230 OIR-C1-1413, Uniform Certificate of Authority Application (UCAA) Expansion Application
Ref-16231 OIR-C1-1414, Uniform Certificate of Authority Application (UCAA) Expansion Application Checklist For Expansion Application Only
Ref-16232 Form OIR-C1-1416, Uniform Certificate of Authority Application (UCAA) Lines of Insurance
Ref-16233 OIR-C1-1422, Uniform Certificate of Authority Application Questionnaire
Ref-16234 OIR-C1-1424, Uniform Certificate of Authority Application
Ref-16235 OIR-C1-1522, Primary Application Florida Specific Information
Ref-16237 OIR-C1-2069, Letter of Notification
Ref-16238 Form OIR-C1-2176, Letter of Notification/Registration to Operate as a Non-US Based (Alien) Insurer (also referred to as “Offshore Insurer”) in Florida Pursuant to Section 624.402(8), Florida Statutes
Ref-16239 OIR-C1-PCR1, Application for License Rating Organization
History of this Rule since Jan. 6, 2006
Notice /
Adopted
Section Description ID Publish
Date
View Text Withdrawal
69O-136.006
......
Domestic Insurers Filing for an Application for Permit and Subsequent Certificate of Authority, Health Maintenance Organizations, Multiple-Employer Welfare Arrangements, Continuing Care Contracts, Prepaid .... 28746452 9/11/2024
Vol. 50/178
View Text Proposed
69O-136.006
......
To implement 2024-182, Laws of Florida, incorporate all forms in Chapter 69O-136, F.A.C., into Rule 69O-136.100, F.A.C., and update the lists of forms required to be submitted with each application. 28445364 6/13/2024
Vol. 50/116
View Text Development
69O-136.006
......
Rule 69O-136.006 is amended and Rules 69O-136.070 and 69O-136.075 are created to implement Chapter 2024-182, L.O.F., regarding changes to Chapter 629 regulating reciprocal insurers. The changes also incorporate all forms .... 28363205 5/15/2024
Vol. 50/96
View Text Final
69O-136.100
Forms Incorporated by Reference 27890039 Effective:
01/07/2024
View Text Correction
69O-136.002
......
Foreign and Alien Insurers Filing for a Certificate of Authority, Surplus Lines, Domestic Insurers Filing for an Application for Permit, Redomestication Procedure, Domestic Insurers Filing for a Certificate .... 27800023 11/20/2023
Vol. 49/225
View Text Proposed
69O-136.002
......
OIR is updating chapter 69O-136. 27585362 9/25/2023
Vol. 49/186
View Text Development
69O-136.002
......
OIR is updating Chapter 69O-136. 27355569 7/21/2023
Vol. 49/141
View Text Final
69O-136.100
Forms Incorporated by Reference 26044032 Effective:
07/21/2022
View Text Proposed
69O-136.080
......
69O-136.080 and 69O-136.090 concern the acquisition and mergers of insurers and specialty insurers and incorporates the required forms in 69O-136.100. 25741780 4/8/2022
Vol. 48/69
View Text Development
69O-136.080
......
Rules 69O-136.080 and 69O-136.090, F.A.C. concern the acquisition of insurers and specialty insurers and incorporates the required forms in Rule 69O-136.100 F.A.C. 25390252 12/23/2021
Vol. 47/247
View Text Withdrawal
69O-136.080
......
Mergers and Acquisition of Controlling Stock of a Florida Domestic Insurer, Merger, Consolidation, or Acquisition of Controlling Stock, Ownership Interests, Assets, or Control of a Specialty Insurer, .... 25358921 12/14/2021
Vol. 47/240
View Text Public Hearing
69O-136.080
......
The Office of Insurance Regulation is holding a hearing for public input on the notice of change published for proposed rule 69O-136.100 and ....
  Monday, October 4, 2021, 3:00 p.m.
  Access via telephone at (850)413-1558 and enter conference ID# ....
24831726 8/3/2021
Vol. 47/149
View Text Change
69O-136.100
Forms Incorporated by Reference 24795739 7/26/2021
Vol. 47/143
View Text Proposed
69O-136.080
......
69O-136.080 and 69O-136.090 concern the acquisition and mergers of insurers and specialty insurers and incorporates the required forms in 69O-136.100. 24512305 5/10/2021
Vol. 47/90
View Text Development
69O-136.080
......
69O-136.080 and 69O-136.090 concern the acquisition of insurers and specialty insurers and incorporates the required forms in 69O-136.100. 24181632 2/5/2021
Vol. 47/24