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