| TYPE OF LICENSEE |
I |
BE |
D |
S |
| Agent (see Producer) |
|
|
|
|
| Bail Bond Agent (Surety) Application |
|
|
D |
S |
| Broker (see Producer) |
|
|
|
|
| Casualty Claim Adjuster Application |
I |
BE |
D |
S |
|
Casualty Claim Adjuster Replacement Renewal Form
(available one month prior to license expiration date) |
I |
BE |
|
|
|
Certified Insurance Consultant Application (Life & Health) (THIS IS NOT A PRODUCER) |
I |
BE |
D |
S |
|
Certified Insurance Consultant Application (Property & Casualty) (THIS IS NOT A PRODUCER) |
I |
BE |
D |
S |
|
Continuing Education Providers, Courses & Instructors (Instructions) |
I |
BE |
|
|
|
Fraternal Insurance Agent Application |
I |
|
|
S |
| Life Producer Registration to Act as a Life Settlement Broker |
I |
|
D |
S |
| Life Settlement Broker Application |
I |
BE |
D |
S |
|
Life Settlement Provider Application |
|
BE |
D |
S |
|
Medical Discount Plan License Application |
|
BE |
|
S |
| Motor Vehicle Physical Damage Appraiser (MVPD) Application |
I |
BE |
D |
S |
| Motor Vehicle Physical Damage Appraiser (MVPD) Renewal Application |
I |
BE |
|
|
| Pharmacy Benefits Manager (PBM) Certificate of Registration (Instruction and Application) |
|
BE |
|
S |
| Pharmacy Benefits Manager (PBM) Exemption Form |
|
BE |
|
S |
| Prelicense Education Providers (Instructions) |
I |
|
|
|
|
Preferred Provider Network License Application |
|
BE |
D |
S |
| Premium Finance Company Application |
|
BE |
|
|
| Producer Electronic License Application NONRESIDENT ONLY |
I |
BE |
D |
S |
| Producer Electronic Renewal Form NONRESIDENT ONLY |
I |
BE |
|
|
Producer Replacement Renewal and Late Renewal
(Late renewal is used if your CE was not completed on time or you didn't pay on time) |
I |
BE |
|
|
| Producer Resident and Nonresident Application |
I |
BE |
|
|
| Public Insurance Adjuster Application |
I |
BE |
D |
S |
| Reinsurance Intermediary Broker Application |
I |
BE |
D |
S |
| Reinsurance Intermediary Manager Application |
I |
BE |
D |
S |
| Rental Car Company Permit Application |
|
BE |
|
S |
| Risk Retention Group |
|
BE |
|
S |
| Surplus Lines Insurance Broker Application |
I |
BE |
|
S |
| Title Agent: License not available in Connecticut refer to Connecticut General Statute §38a-401 |
I |
|
|
S |
|
Third Party Administrator Application |
|
BE |
|
|
|
Utilization Review Company License Application |
|
BE |
|
S |