SERVICE CONTRACT PROVIDERS

The Wyoming Department of Insurance is granted authority to regulate service contract providers per W.S. § 26-49-101 ↗ et seq.

All providers of service contracts sold in Wyoming must register with the Wyoming Department of Insurance. A list of active companies can be requested by emailing Tammy Rathburn.

REGISTRATION FORMS

Service Contract Provider Registration Form*

Corporate Amendment Procedures*

Service Contract Provider Bond Form*

Service Contract and Reimbursement Insurance Policy Checklist*

Registered Service Contract Providers are allowed to market service contracts without submitting forms for review or approval by the Department. Please reference the Service Contract and Reimbursement Policy Checklist* to ensure your forms are in compliance. Contract & Reimbursement Policy Questions should be directed to Tammy Rathburn.

Specimen copies of service contract forms are required as supporting documentation with new registration applications. All service contracts and reimbursement insurance policies must comply with Wyoming laws, regulations and department policy requirements.

Service Contract Providers should be aware of the record keeping requirements in W.S. § 26-49-107 ↗. Also, as provided in W.S. § 26-49-110 ↗ the commissioner may conduct examinations and request copies of accounts, books and records concerning service contracts.

RENEWAL INSTRUCTIONS

Our Document Submission Portal↗ is open. Contact Tammy Rathburn for your license and/or PIN.

Please submit the following by September 1:

Current balance sheet and income statement.
The Faithful Performance Verification Form*, documenting your compliance with the requirements of W.S. § 26‑49‑103(d).
Proof of registration with the Wyoming Secretary of State↗. All trade names registered with the Secretary of State must be listed on the faithful performance form.
Annual renewal fee of $200. Payments should be made electronically via Sircon↗
An itemized listing of service contract forms including form name, form number and edition date.
*NEW* Service Contract Provider Checklist and Attestation*.
Copies of any new reimbursement policies if the insurer has changed.

If you wish to withdraw your registration, please return the invoice with a letter of explanation, including the last date that any service contracts were in force in Wyoming.

Renewal questions should be directed to Tammy Rathburn.