9-575. Authorized delegate report; information included.
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9-575. Authorized delegate report; information included.
(a)Each licensee shall submit a report of authorized delegates within 45 days of the end of each calendar quarter. The commissioner is authorized to utilize the nationwide multistate licensing system and registry for the submission of the report required by this subsection if such utilization is consistent with the requirements of this section.
(b)The authorized delegate report shall include, at a minimum, each authorized delegate's:
(1)Company legal name;
(2)taxpayer employer identification number;
(3)principal provider identifier;
(4)physical address;
(5)mailing address;
(6)any business conducted in other states;
(7)any fictitious or trade name;
(8)contact person's name, phone number and email;
(9)start date as the licensee's authorized delegate;
(10)end date acting as the licensee's authorized delegate, if applicable; and
(11)any other information the commissioner reasonably requires regarding the authorized delegate.
(c)This section shall take effect on and after January 1, 2025.