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For Companies > Licensing and Approvals for Prospective Companies > Applications > Discount Med Plan Org
Discount Medical Plan Organization Application
 

Please review RSA 415:I, Discount Medical Plan Organization's current statute, for information and guidance in properly completing application for registration.

Entities that register December 2008 through May 2009 will not need to register again until June 2010.

The following are filing requirements to register as a Discount Medical Plan Organization:

  • Application form Microsoft Word Symbol
  • $300 application fee (non-refundable), make check payable to: Treasurer, State of New Hampshire.

Send the application to the attention of New Hampshire Insurance Department, Financial Regulation Division.

The New Hampshire Insurance Department will notify you when all items necessary are received and the Organization is placed on the approved Discount Medical Plan Organization list.

If you have any questions, please contact Diane Cygan.


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New Hampshire Insurance Department | 21 South Fruit Street, Suite 14 | Concord, NH 03301
Phone 603.271.2261 | Fax 603.271.1406 | Consumer Hotline 1.800.852.3416

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