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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:  Provide website link to listing of current healthcare providers versus attaching a listing.

Email Preferred Provider Plan Reporting form with attachments to