IC 27-8-11-5: Preferred provider plans; filing sworn statement

Sec. 5. Each person that organizes a preferred provider plan under this chapter shall file with the commissioner before March 1 of each year a statement, under oath, upon a form prescribed by the commissioner that covers the preceding calendar year and includes the following:

(1) The name and address of each person that has organized a preferred provider plan.

(2) The names and addresses of the providers with whom the preferred provider plan has entered into agreements under section 3 of this chapter.

(3) The geographical area, by counties, within which the preferred provider plan provides or arranges for health care services for insureds, members or enrollees.

(4) The number of insureds, members or enrollees covered by the agreements listed in subdivision (2).