Mississippi: NIPR Paper Licensing

MISSISSIPPI: PAPER LICENSING

This page provides state-specific checklists, application forms and contacts for paper resident and non-resident licensing in the State of Mississippi.

Non-Resident Licensing Checklist for Business Entities

Organizational Documents

Business entities must register with the MS Secretary of State before engaging in the business of insurance before or after being licensed.
Submit Letter of Certification from domiciliary state if information cannot be accessed through the NAIC producer database
Third Party Administrator (TPA), Reinsurance Intermediary, and Viatical Settlement: see instructions on state specific form
Managing General Agent (MGA); Supervising General Agent (SGA): submit list of companies appointed with and letter of appointment for each
If SGA serves as Credit LHA, then complete Mississippi form Credit Life and Credit Disability SGA Appointment form

Other Requirements

Attach a check* or money order for $200 (Adjuster, TPA, Viatical Settlement Provider, Insurance Producer Entity, Limited Lines Insurance Producer Entity, Limited Lines Credit Insurance Producer Entity); $100 (SGA Entity, MGA Entity) *Checks made payable to Mississippi Insurance Department.
In reference to question 25 on the business application, Mississippi does not require the designated/responsible licensed producer be an officer, director or partner of the business entity.
Only one license is required for an entity. Other branch locations do not need to obtain a separate license but must be listed upon initial application.
LHA Limited Partnership: all partners must be licensed (non-resident or resident Mississippi license)
Only one license is required for an entity, but all branch locations must be listed upon initial application.

Note: All Insurance Producer and MGA entity licenses expire every other year on May 31. Adjusting entities expire every May 31. Viatical and SGA entities expire every Dec. 31. TPA entities expire annually on the issue date.

Non-Resident Licensing Checklist for Individuals

Appointment Requirements

Insurers must file appointments electronically or use a MS appointment form within 15 days of signing a contract with a producer. Appointment forms do not have to be submitted with license applications.

Other Requirements

Attach a check* or money order for $100 (Insurance Producer, Limited Lines Insurance Producer, Limited Lines Credit Insurance Producer); $50 (Adjusters) *Checks made payable to Mississippi Insurance Department.

Resident Licensing Checklist for Business Entities

Organizational Documents

Submit Mississippi Secretary of State Certificate of Existence/Authority
Submit Articles of Incorporation, Partnership Agreements, Certificate of Formation for LLC
Sole Proprietorship: residents must provide documentation from the Secretary of State's office
Third Party Administrator (TPA), Reinsurance Intermediary, and Viatical Settlement: see instructions on state specific form
Managing General Agent (MGA); Supervising General Agent (SGA): submit list of companies appointed with and letter of appointment for each
If SGA serves as Credit LHA, then complete Mississippi form Credit Life and Credit Disability SGA Appointment form

Other Requirements

Attach a check* or money order for $200 (Adjuster, TPA, Viatical Settlement Provider, Insurance Producer Entity, Limited Lines Insurance Producer Entity, Limited Lines Credit Insurance Producer Entity); $100 (SGA Entity, MGA Entity) *Checks made payable to Mississippi Insurance Department.
In reference to question 25 on the business application, Mississippi does not require the designated/responsible licensed producer be an officer, director or partner of the business entity.
Adjusting entities complete "other" block
LHA Limited Partnership: all partners must be licensed (non-resident or resident Mississippi license)

DISCLAIMER

The National Insurance Producer Registry ("NIPR") populates the State Matrix of Business Rules ("State Matrix") with information provided directly from participating state insurance departments. Participating states are encouraged to provide updated information when appropriate. NIPR does not guarantee the completeness, accuracy or adequacy of the information in the State Matrix. The information in the State Matrix does not constitute legal advice and use of this information is at user's own risk and responsibility. Any questions regarding the interpretation of the rules or the accuracy of the information should be directed to the appropriate state insurance department.

Uniform Application for Business Entities

PDF

WORD

Uniform Application for Individuals

paper_licensing_uniform_app_individuals.pdf

paper_licensing_uniform_app_individuals.docx

NON-RESIDENT LICENSING

Mississippi accepts the Uniform Licensing Application for nonresident business entities and individuals.

RESIDENT LICENSING

Mississippi accepts the Uniform Licensing Application for resident business entities.