Skip to Top Main Navigation Skip to Left Navigation Skip to Content Area Skip to Footer
Texas Department of Insurance
Topics:   A B C D E F G H I J K L M N O P Q R S T U V W X Y Z All

Life Health Small Group Certification Forms

If the form is a fillable PDF, learn how to enable all fillable form features.

TDI Form Number Description File Format Language
LAHR330

Small Employer Carrier Status Certification

PDF English
LAHR334

Form Number 1212 Cert Actuarial Annual Small Employer Health Benefit Plan Actuarial Certification - Figure 47

PDF English
LAHR335

Form Number 1212 CERT DATA Annual Small Employer Health Benefit Plan Report

PDF English
LAHR337

Large Employer Carrier Status Certification

PDF English

For more information, contact: LifeHealth@tdi.texas.gov