Indiana Code Title 27. Insurance § 27-17-2-2

(A) A copy of the applicant's organizational documents, such as articles of incorporation, including all amendments.

(B) A copy of the applicant's bylaws or other enabling documents that establish the organizational structure and governance of the applicant.

(C) A list of the names, addresses, official positions, and biographical information of each individual responsible for conducting the applicant's affairs, including each:

(D) A statement generally describing the applicant, the applicant's facilities and personnel, and the medical services for which discounts will be available.

(E) A complete list of all program providers in Indiana available to Indiana cardholders.

(F) A copy of the form of any contract or arrangement between the applicant and a person listed in clause (C).

(G) A copy of the form of any contract between the applicant and a person for the performance on the applicant's behalf of any function, including marketing, administration, enrollment, investment management, and contracting for the provision of medical services to cardholders.

(H) A description of the proposed method of marketing.

(I) A toll free telephone number that program providers and cardholders can use at least forty (40) hours per week during normal business hours to contact the applicant.

(J) A copy of the applicant's cancellation and refund policy.

(K) A description of program provider and cardholder complaint procedures.

(L) The name and address of the applicant's agent for service of process, notice or demand, or an executed power of attorney appointing the commissioner as the attorney of the applicant in Indiana for service of process for a cause of action arising in Indiana.

(M) Other information the commissioner reasonably requires to make the determinations required under this chapter.