State Requirements

Applicant must include business fax number and business email address.

All submitted phone numbers must be exactly 10 digits.

Applicant must be licensed in applicant's home state.

Applicant applying for, or already holding, the property and casualty lines of authority (LOAs) in Alaska may not also apply for personal lines LOA. Personal lines is already covered by the property and casualty LOAs in Alaska.

• This applies across license classes. If property and casualty are held on any license class, applicant is not allowed to apply for personal lines.

Applicant applying for viatical settlement representative, broker or provider license, must hold an active insurance producer license for life, variable annuity and variable life.

Applicant is required to enter exactly one (1) Designated Responsible Licensed Producer (DRLP) on the application and have an active resident or non-resident license in Alaska. Applicant may not enter more than one DRLP.

DRLP must cumulatively cover the LOAs requested on the application. To be valid LOAs, DRLP LOAs must be active and be associated with the same license class as the applicant license class.

If applicant responds "yes" to one of the background questions please submit supporting documents electronically via NIPR's Attachments Warehouse. The documents may also be submitted to the state via mail, email, or fax.

Applications not completed within four (4) months from the date filed will be considered withdrawn and new application forms and fees will be required pursuant to Alaska Statute 21.27.040(f).

Note that any other form of insurance, such as a consumer credit insurance policy as defined in AS 21.57.160, a third party Guaranteed Asset Protection (GAP) or Debt Cancellation or Suspension product, pre-paid maintenance, exterior/interior protection, theft protection, or other type of protection not within the definition of a service contract under AS 21.03.021 may not be solicited, sold, or negotiated under the motor vehicle service contract provider license issued under AS 21.61. A separate insurance producer or limited lines credit insurance producer license may be required.

Third-Party Administrator (TPA) Applicant Requirements

• All third party administrator applicants must submit or be aware of the following requirements. Documents can be submitted using the mailing address referenced in the State Contact Information section.

• All basic organizational documents of the third-party administrator, including articles of incorporation, articles of association, partnership agreement, trade name certificate, trust agreement, shareholder agreement and other applicable documents and all endorsements to the required documents.

• Bylaws, rules, regulations and similar documents regulating the internal affairs of the administrator.

• The names, mailing addresses, physical addresses, official positions and professional qualifications of persons who are responsible for the conduct of affairs of the third-party administrator, including the members of the board of directors, board of trustees, executive committee or other governing board or committee, the principal officers in the case of a corporation or the partners or members in the case of a partnership or association, shareholders holding directly or indirectly ten (10) percent or more of the voting securities of the third-party administrator and any other person who exercises control or influence over the affairs of the third-party administrator.

• Certified (audited) financial statements for the prior two (2) years prepared by an independent certified public accountant that establish that the applicant is solvent, that the applicant's system of accounting, internal control and procedure is operating effectively to provide reasonable assurance that money is promptly accounted for and paid to the person entitled to the money. If the applicant submits a consolidated statement, a consolidating worksheet for the applicant must also be included.

• A statement describing the business plan including information on staffing levels and activities proposed in this state and in other jurisdictions and provide details establishing the third-party administrator's capability for providing a sufficient number of experienced and qualified personnel in the areas of claims handling, underwriting, and record keeping.

• Identify the key personnel who supervise or have responsibility over personnel performing TPA functions.

Pharmacy Benefit Manager Applicants

All Pharmacy Benefit Applicants are required to submit the following documentation to the NIPR attachment warehouse

1. All basic organizational documents of the Pharmacy Benefit Manager, including articles of incorporation, articles of association, articles of organization, partnership agreement, trade name certificate, trust agreement, shareholder agreement and other applicable documents and all endorsements to the required documents.
2. Bylaws, operating agreement, rules, regulations and similar documents regulating the internal affairs of the benefit manager.
3. The names, mailing addresses, physical addresses, official positions and professional qualifications of persons who are responsible for the conduct of affairs of the Pharmacy Benefit Manager, including the members of the board of directors, members of the limited liability company or partnership, board of trustees, executive committee or other governing board or committee, the principal officers in the case of a corporation or the partners or members in the case of a partnership or association, shareholders holding directly or indirectly 10 percent or more of the voting securities of the Pharmacy Benefit Manager and any other person who exercises control or influence over the affairs of the Pharmacy Benefit Manager.
4. Certified (audited) financial statements for the prior two years prepared by an independent certified public accountant that establish that the applicant is solvent, that the applicant's system of accounting, internal control and procedure is operating effectively to provide reasonable assurance that money is promptly accounted for and paid to the person entitled to the money. (If the applicant submits a consolidated statement, a consolidating worksheet for the applicant must also be included.)
5. A statement describing the business plan including information on staffing levels and activities proposed in this state and in other jurisdictions and provide details establishing the Pharmacy Benefit Manager’s capability for providing a sufficient number of experienced and qualified personnel in the areas of claims handling, underwriting, and record keeping.
6. Identify the key personnel who supervise or have responsibility over personnel performing Pharmacy Benefit Manager functions.