AIR AMBULANCE MEMBERSHIP ORGANIZATIONS

The Wyoming Department of Insurance regulates air ambulance membership organizations pursuant to authority granted in W.S. §26-43-301 et seq. Air ambulance membership organizations are organizations that offer memberships where persons can pay fees or dues in exchange for discounted air ambulance service or access to discounted service from other air ambulance providers. The statutes provide for the regulation of air ambulance membership organizations by the Insurance Commissioner and requires organizations to seek a certificate of registration from the Commissioner before operating in Wyoming and requires an annual renewal. 

The Insurance Commissioner may suspend or revoke a certificate of registration if an air ambulance membership organization misrepresents its services, engages in unfair practices, or fails to fulfill its obligations to members. The Commissioner may impose a civil penalty or issue a cease-and-desist order. 

The statutes specify what fees and charges an air ambulance membership organization may charge to its members and requires organizations to provide certain notices and disclosures to members and prospective members regarding memberships that the organization offers and imposes requirements on the advertisements of air ambulance membership organizations. 

In order to apply to sell Air Ambulance Memberships to the citizens of Wyoming all of the forms below must be submitted in paper copy with a check for the $500 application fee to:

Wyoming Department of Insurance
ATTN: Air Ambulance Registration
106 E. 6th Ave.
Cheyenne, WY 82002

The application will be considered incomplete if all of the forms below are not submitted alongside payment.

FORMS

Initial Application*
Surety Bond Form*
Biographical Affidavit*
Surety Bond & Reserve Worksheet*

Wyoming requires all annual filing forms to be submitted electronically through our Document Submission Portal↗. The company license number or NAIC ID and PIN can be found on the company's renewal notice.

***Annual filings will not be accepted as complete/renewed until all forms are submitted and all fees are paid***

Please upload the following each year prior to August 30:

1. Renewal Application*

2. Annual Report Form*

3. Reserve Account Balance Sheet

4. Surety Bond

5. Surety Bond & Reserve Worksheet* - required pursuant to W.S. § 26-43-305(f)

6. List of SERFF numbers for marketing materials and membership contracts

7. Supporting documentation (O&D biographical affidavits, copy of paid invoice, etc...)

8. Annual filing fee of $300

• Wyoming requires payments be made electronically via Sircon ↗. To use this service you must be a Sircon account holder. If you do not have a Sircon account you may establish one through their carrier signup page ↗.

Annual renewal invoices will be generated and delivered electronically to the mailing address contact on record. Pursuant to W.S. § 26-3-114(e), all air ambulance membership organizations are required to inform the Department of any contact information changes, including address, phone number, and email address, within 30 days of the change. To file a change, please use the Company Address Change Portal. The license number and PIN required to access the portal can be found on the renewal notice.