Louisiana Department of Insurance

Please Note

We are a service company that can help you file with the Louisiana Department of Insurance. We are not associated with this nor any other government agency. We offer paid services and software to help you file. You are not required to purchase our service to file - you may file directly with this agency without using our service.

Contact Information

Physical address:
1702 N. Third Street
Baton Rouge, LA 70802

Mailing address:
P.O. Box 94214
Baton Rouge, LA 70804

Phone: (225) 342-5900

Web: Home Name search File online

Licenses

We track the following licenses with the Louisiana Department of Insurance in order to provide compliance services to our clients. As a client, you see this and other reference data in License Manager in-line with your licenses.

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Louisiana Claim Adjuster Agency License - Non-Resident

Agency:

Louisiana Department of Insurance

Filing Method:	Online
Agency Fee:	$150
Due:	Biennially by March 31.

Type of Review:	Medical Utilization Review
Agency:	Louisiana Department of Insurance
Law:	Louisiana Stat. § 22:2440

Form:	Independent Review Application
Agency Fee:	$500
Required Attachments:	Copy of the Articles of Incorporation, Articles of Association, partnership agreement or other such organizational documents and all amendments thereto of the applicant certified by the proper domiciliary official. The certification must be dated within 90 days of submission. Copy of the by-laws, operating agreement, rules, regulations or similar document of the applicant certified as true and correct by the secretary of the applicant. The certification must be dated within 90 days of submission. Trade name certificate issued by the Secretary of State of Louisiana confirming registration of any trade name with that Office. This item must be supplied by any applicant utilizing a trade name in Louisiana. Completed biographical affidavits for all persons responsible for the conduct of affairs of the applicant. This should include all officers, all directors, all partners (in the case of a partnership), all trustees, all executive committee members and all person(s) owning, directly or indirectly, 10 percent or more of the applicant and any other person who exercises control or influence over the affairs of the applicant. Copy of the procedures manual of the applicant which meets the statutory requirements for making performing external independent reviews. Required only from applicants which are not accredited by URAC. A detailed description of the corporate organizational/ownership structure of the applicant, its parent company and all affiliates. This description should include a chart showing the ownership percentages for any persons owning 10 percent or more of the applicant and all affiliated entities up to and including the ultimate controlling person. The chart must include the state of domicile and the Federal Employer Identification Number (FEIN) for each person.

Filing Method:	File online through NIPR.
Agency Fee:	$100
Due:	Biennially by March 31
Penalties:	$50 fee added for late renewals.

Form:	Professional Employer Organization Initial Registration
Agency Fee:	$500
Notes:	If the PEO or any person acting on its behalf is engaged in the business of soliciting, selling, or negotiating policies of insurance or providing insurance products as part of your PEO services, the applicant must provide the name, address and Louisiana license number of the licensed producer(s) through which insurance business will be conducted.
Required Attachments:	Physical addresses of all principal business establishments of the PEO inside and outside of Louisiana The name, address and Louisiana license number of the license producer(s) through which insurance business will be conducted (if applicable) The full legal name (no initials), social security number, date of birth, state of residence, position with the applicant and the percentage of ownership (if applicable) of the applicant of all natural persons responsible for the conduct of affairs of the applicant. This list should include all officers, all directors, all partners (in the case of a partnership), all trustees, all executive committee members and every natural person owning, directly or indirectly, 10 percent or more of the applicant and any other natural person who exercises control or influence over the affairs of the applicant.

Form:	TPA Registration Application
Filing Method:	Mail or elecotrinc filing.
Agency Fee:	$500
Turnaround:	60 to 90 days.

Form:	Utilization Review Organization (URO) Application
Agency Fee:	$1,500
Notarize:	Required
Required Attachments:	A copy of the articles of incorporation, articles of association, partnership agreement or other such organizational documents and all amendments thereto of the applicant certified by the proper domiciliary official. The certification must be original and dated within 90 days of submission. A copy of the bylaws of the applicant certified as true and correct by the secretary of the applicant, if a corporation; a partner, if a partnership; or other appropriate person. This certification must be within 90 days of submission. A copy of the trade name certificate issued to the applicant by the Louisiana Secretary of State. This item must be supplied by any applicant utilizing a trade name or d/b/a in Louisiana. Completed biographical affidavits for all persons responsible for the conduct of affairs of the applicant. This should include all officers, all directors, all partners (in the case of a partnership), all trustees, all executive committee members and all person(s) owning, directly or indirectly, 10 percent or more of the applicant and any other person who exercises control or influence over the affairs of the applicant. This must include a completed affidavit for the medical director of the applicant. A copy of the applicant’s procedure manual which meets the requirements of Chapter 18 of the Louisiana Insurance Code (La. R.S. 22:2391-2453) for making clinical or medical necessity determinations and resolving disputes in the internal claims and appeals process. A description of procedures used in making adverse determinations that describes all review activities performed for health benefit plans in Louisiana. Samples of the forms of all contracts with health insurance issuers in use or to be used by the applicant. These forms should not include fees charged. A general description of operation of the applicant, which includes a statement that the applicant does not engage in the practice of medicine or act to impinge or encumber the independent medical judgment of treating physicians or health care providers. A completed Statement of Compliance for the forms and procedures submitted with this application. A detailed description of the corporate organizational structure of the applicant, its parent company and all affiliates. This description should include a chart showing the ownership percentages for any persons owning 10% or more of all affiliated entities up to and including the ultimate controlling person.

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Louisiana Department of Insurance

Please Note

Contact Information

Licenses

Louisiana Claim Adjuster Agency License - Non-Resident

Initial Registration

Registration Renewal

Louisiana Claim Adjuster Agency License - Resident

Initial Registration

Registration Renewal

Louisiana Claim Adjuster License - Non-Resident

Initial Registration

Registration Renewal

Louisiana Claim Adjuster License - Resident

Initial Registration

Registration Renewal

Louisiana Consultant License - Non-Resident

Initial Registration

Registration Renewal

Louisiana Consultant License - Non-Resident

Initial Registration

Registration Renewal

Louisiana Consultant License - Resident

Initial Registration

Registration Renewal

Louisiana Consultant License - Resident

Initial Registration

Registration Renewal

Louisiana Independent Review Organization Registration

Initial Registration

Renewal Not Required

Louisiana Insurance Agency License

Initial Registration

Registration Renewal

Louisiana Insurance Agent License

Initial Registration

Registration Renewal

Louisiana Insurance Producer License - Non-Resident

Initial Registration

Registration Renewal

Louisiana Insurance Producer License - Resident

Initial Registration

Registration Renewal

Louisiana Non-Resident Claims Adjuster Agency License

Initial Registration

Registration Renewal

Louisiana Producer Agency License - Non-Resident

Initial Registration

Registration Renewal

Louisiana Producer Agency License - Resident

Initial Registration

Registration Renewal

Louisiana Professional Employer Organization Registration - Dept. of Insurance

Initial Registration

Registration Renewal

Louisiana Public Adjuster Agency License - Non-Resident

Initial Registration

Registration Renewal

Louisiana Public Adjuster Agency License - Resident

Initial Registration

Registration Renewal

Louisiana Public Adjuster License - Non-Resident

Initial Registration

Registration Renewal

Louisiana Public Adjuster License - Resident

Initial Registration

Registration Renewal

Louisiana Third Party Administrator License

Initial Registration

Registration Renewal

Louisiana Utilization Review Organization Registration

Initial Registration

Renewal Not Required

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