State Requirements

• Commissioner's Memorandum 2021-2LIC
• Commissioner's Memorandum 2021- 3LIC
• Commissioner's Memorandum 2021-6LIC

Applicant must provide a valid business email, address, and business phone number.

A licensee shall apply to the Department of Commerce and Consumer Affairs (”DCCA”) and the Insurance Commissioner for approval of the use or change of a trade name.

Applicant may not enter the following address as the residence or business address:

                                        6140 S Gun Club Rd, STE K6
                                                 Aurora, CO 80016

Reinstatements may be submitted online at www.nipr.com

Reinsurance Intermediary Brokers, Reinsurance Intermediary Managers, and Managing General Agents must actively hold an Insurance Producer license. They can only apply for the reciprocal line of authority (LOA) they maintain on their Insurance Producer license.

• An appointment form does not need to be submitted with the application. However, to §431:9A-114 Appointments: (a) an Insurance Producer shall not act as an agent of an insurer unless the Insurance Producer becomes an appointed agent of that insurer. All Producers will need to be appointed directly through an Insurance Company and appointment termination can only be submitted by an Insurance Company.

Variable applicants must supply HAWAII FINRA CRD number on application. If you need to verify your CRD number, you may use the Broker Search feature found on FINRA’s website.  Applicants must verify that they are registered in Hawaii with FINRA before they can apply for Variable Life & Variable Annuity.

Surplus Lines Broker applicants must apply for both Property and Casualty.

• Go to https://cca.hawaii.gov/ins/producers/forms/ and open TPA CHECKLIST form. Check appropriate boxes on the form and complete the checklist to assure completion of application filing.  A completed checklist and all documents required on the checklist must be submitted via NIPR's Attachments Warehouse.
• Third Party Administrator applicants must enter a valid United States business and mailing address.
• All applications for Third Party Administrator will defer to the state for review.

If an applicant is not a United States citizen, a copy of a valid work permit or permanent resident card must be submitted via NIPR's Attachments Warehouse.

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.

• Pharmacy Benefit Manager, Services Contract Provider, and Vehicle Protect Product Warrantor do not need to submit supporting documents if you answer "yes" to any background questions on the application.

Reinsurance Intermediary Broker (RIB) and Reinsurance Intermediary Manager (RIM) – In order for the license to be issued, the business entity must submit “Form List of RI(s)”.  Go to https://cca.hawaii.gov/ins/producers/forms/ to find “Form List of RI(s)” and submit via NIPR's Attachments Warehouse.

Limited Lines Self-Service Storage Producer (SSS) – In order for the license to be issued, the business entity must submit “Form DP for SSS." Go to https://cca.hawaii.gov/ins/producers/forms/ to find “Form DP for SSS” and submit via NIPR's Attachments Warehouse.

Independent Bill Reviewer (IBR) - In order for the license to be issued, the applicant must submit credentials as a Certified Professional Coder granted by the American Academy of Professional Coders or American Health Information Management Association via NIPR's Attachments Warehouse.

Pharmacy Benefit Manager (PBM) – In order for the registration to be issued, the business entity must submit “Form DP for PBM.”  Go to https://cca.hawaii.gov/ins/producers/forms/ to find “Form DP for PBM” and submit via NIPR's Attachments Warehouse.

Life Settlement Broker – applicant must be actively licensed for Life line of authority for at least one (1) year in their resident/home state.

If an applicant is not a United States citizen, a copy of a valid work permit or permanent resident card must be submitted via NIPR's Attachments Warehouse.

If applicant responds "yes" to one of the background questions, please submit supporting documents electronically via NIPR's Attachments Warehouse.