Documents & Services

Use the dropdown menus below to find our most popular forms, publications and online services.

Forms

--Select One-- Address/Name Change Form - Producer Affidavit of Exempt Status-Workers Comp Application-Excess Lines Agent Application for Certificate of Authority-HMO Application for Certificate of Registration-Pharmacy Benefits Manager Application for Certificate of Registration-Third Party Administrator Application for Certificate-Utilization Review Organization Application- Kansas Standardized Credentialing Application-NAIC Uniform for Individual Adjuster Application New/Renewal-Continuing Care Provider Application New/Renewal-Prepaid Dental Service Plan Application New/Renewal Non-Resident Producer Licensing Application New/Renewal Non-Resident Agency Licensing Application-Resident Producer License Application-Resident Agency Licensing Application-Risk Retention Group Application-Small Employer Health Benefit Plan Application Qualifying Bond-Prepaid Dental Service Plans Application-Uniform Certificate of Authority-Kansas Forms Application-Uniform Certificate of Authority-NAIC Forms Application-Viatical Representative/Broker License VL-1 Auto Shoppers Worksheet Change of Agency Status Form AG11 Complaint Form Formulario de Quejas del Consumidor Continuing Care Provider-Annual Disclosure Statement Excess Lines Statement & PRF Instructions Excess Lines Statement of Insured Fingerprint Waiver Form Homeowners Claim Settlement Checklist Kansas Alternative Mediation Program Form Motor Vehicle Accident Checklist Non Kansas Domiciled Risk Excess Lines Placement Tax Packet Producer-Clearance Letter Producer-Course Submission Producer-Duplicate License Producer-Home State Certification Producer-KCE-4 Form Producer-NAIC Reciprocity Filing Form Producer-Printout of Record Professional Employer Organization Initial Application Form Rate and Form Filing Checklists Risk Purchasing Group-Change Form Risk Retention Group-Consent to Service Process Form Risk Purchasing Group-Registration Packet SERFF 2016-State Dental Attestations Forms SERFF 2016-State Medical Attestations Form SERFF 2015-State Dental Attestations Forms SERFF 2015-State Medical Attestations Form Viatical Company Appointment/Cancellation Form

Publications

--Select One-- ABCs of Insurance Annual Report Auto and Home Insurance and Shoppers Guide Before and After the Storm, Advice for Kansas Insurance Consumers Consumer Complaint Counts (Index) Discount Health Plans Firefighter Relief Act Fund Benefits Brochure Firefighter Survivor’s Assistance Handbook Health Insurance in Kansas Health Savings Accounts (HSA) Home and Auto Insurance and Shoppers Guide How to file a complaint Independent Medical Review Insurance Information for the Small Business Owner Investing in a Viatical Settlement Kansas Firefighter Relief Act Handbook & Best Practices KID Building brochure Kansas Insurance Department’s Mediation Review Kansas Long-Term Care Insurance and Shoppers Guide Kansas Medicare Supplement Insurance Shoppers Guide Kansas Open Records Act brochure Kansas Partnership for Long-Term Care brochure Life Insurance and Annuity Basics Personal Home Inventory Prompt Pay Act brochure Tax Credits for Health Insurance Title Insurance for Real Estate Understanding Annuities What to Know About Viatical Settlements before you Sell Your Policy What to do When Disaster Strikes Checklist Workers Compensation Fiscal Year Reports