The following applications and renewals are now available to be submitted electronically through NIPR:

The forms are in PDF format. You will need Adobe Acrobat Reader to view them. If you cannot read Excel spreadsheets, download Microsoft Excel Viewer. Check our Filings Section  for instructions on how to make new forms filings.

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Admissions Forms

Application for Certificate of Authority for a Multiple Employer Self-Insured Health Plan (MEWA)

Bail Bond and Surety Recovery Agents Forms

Charitable Gift Annuity

Consumer Fraud Form

HMO/Managed Care Forms

Life and Health Forms

Life Care Provider

Limited Lines Self-Service Storage Insurance Producers

Long-Term Care Partnership Forms

Motor Vehicle Extended Service Contract Provider and Producer Forms

Navigator Forms

Organizational Credit Forms

Pharmacy Benefits Manager

Portable Electronics Insurance Forms

Producer Forms

Property and Casualty Forms

Public Adjuster Forms

Purchasing Group Forms

Reinsurance Intermediary Forms

Service Contract Forms

Statistics Forms

MO 375-0307

Medicare Supplement Insurance Experience Report

MO 375-0359

Commercial Liability Profitability Report and Commercial Liability Closed and Outstanding Claim Form

MO 375-0381

Annual Statement: Page 19 Supplement to Annual Statement

Surplus Lines

Electronic Name and Address Change

Process to be used for all individual and business entity name changes, as well as all address changes within your resident state for immediate updates.

Tax Forms

Third Party Administrator Forms

Title Forms

Title Insurance Companies Forms

Title Insurance Producer/Business Entity Producer Forms

Utilization Review Agents

Vehicle Protection Product Forms

Workers' Compensation Forms

Helpful Links
Contact Us
Missouri Department of Commerce & Insurance Insurance Divisions
Street Address

Harry S Truman State Office Building
301 W. High St., Room 530 
Jefferson City, MO 65101

Mailing Address

PO Box 690
Jefferson City, MO 65102-0690

Correspondence with fees

PO Box 4001
Jefferson City, MO 65102-4001

Main office phone number

(573) 751-4126