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

Discount Health Care Program Operator Forms

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

TDI Form Number Description File Format Language
FIN524

Discount Health Care Program Operator Marketers Form

Use this form to provide a list of the marketers authorized to sell or distribute the program operator's program under the program operator's name, and a list of the marketing entities authorized to private label the program operator's programs.

EXCEL English
FIN525

Discount Health Care Program Operator Surety Bond Form

Use this form of an original surety bond in the principal amount of $50,000 to show Financial Responsibility. Rev. 01/2019

PDF English
FIN526

Discount Health Care Program Operator Biographical Certificate Form

Discount Health Care Program Operator Biographical Certificates. Follow the instructions within the form for completion. Rev 01/2019

PDF English
FIN527

Discount Health Care Program Operator Registration Form

Form for Registration as a Discount Health Care Program Operator. Rev. 01/2019

PDF English

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