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Indiana Department of Insurance

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IDOI > Company/Entity Financial Compliance > Other Entities Initial Registration Requirements > Preferred Provider Organization (PPO) Preferred Provider Organization (PPO)

I.C. 27-8-11-5

State law requires that each person organizing a preferred provider plan must file with the Commissioner before March 1 of each year a statement, under oath, with information regarding the preferred provider plan. 

Download the Preferred Provider Plan Reporting form.

Note:  Should the listing of providers be more than fifty pages please submit the information on a CD.

Send the completed application and information to:

Company Registrations
Financial Services Division
Indiana Department of Insurance
311 West Washington Street, Suite 300
Indianapolis, Indiana 46204-2787