Office of Health Care Statistics

Upcoming Public Meetings

All Payer Registration

Pursuant to Utah Administrative Rule R428-15-9 titled "Carrier Registration", each carrier shall initially register with the Office of Health Care Statistics by completing the online form found below. All carriers shall annually register by September 1 of each year.

Company Information (Organization Paying or Processing Claim) Full Company Name:

Street City Zip Code

Doing Business in Utah as:

Street City Zip Code

State of Domicile: Date Commenced Business in Utah:

NAIC Code Approximate Number of Utah Residents Covered (Health Insurance):

Are you renewing your registration? Yes No

Contacts Administrative Contact Person

Title

Phone Number Fax Number E-mail Address

Technical Contact Person

Title

Phone Number Fax Number E-mail Address

Person Completing this Registration Form Title

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Last updated: March 7, 2013