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To begin the process of obtaining an RRE ID, enter information about the RRE’s company or organization on the RRE Profile Information page. You will later be asked to provide information specific to your Authorized Representative (AR).
Required fields are noted in the application by an asterisk.
| Field | Description |
|---|---|
| Company EIN/TIN | The IRS-assigned employer identification number (EIN) or tax identification number (TIN) associated with the organization reflected under this Section 111 registration. If you have more than one TIN, you may submit this registration with any one of those TINs. If you will be requesting multiple RRE IDs, you may use the same TIN for each or different TINs. If the RRE you are registering is a foreign entity that does not have an IRS-assigned EIN/TIN, you may use a fake or pseudo-TIN in the format of 9999xxxxx where 'xxxxx' is a 5-digit number created by the RRE. |
| Company Name | The company name associated with this Section 111 registration. |
| Company Address | - |
| Street 1 | Company or working mailing address of your RRE. |
| Street 2 | Additional address information. Optional. |
| City | City of the RRE. |
| State | State of the RRE. If the RRE does not have a mailing address in the United States, select “Foreign Country” in the state field and leave the other address fields blank. |
| Zip Code | Five-digit ZIP code and ZIP+4 extension (optional) for the RRE. |
| NAIC Number | The five-digit company code assigned to your company by the National Association of Insurance Commissioners (NAIC). If you are not registered with the NAIC, then you do not need to complete this field. If you have more than one NAIC company code, you may submit this registration with any one of those NAIC company codes. |
| Company Telephone | Telephone number of your corporate office. Telephone number is not required for foreign RREs, but can be provided if a U.S. number is available. |
| Company Fax | Facsimile number of your corporate office. |
| Reporter Type | Type of Section 111 RRE. Click to select either the Group Health Plan (GHP) or the Liability/No Fault/Workers' Compensation radio button. |
Click Continue to submit this information and proceed to the next page in the New Registration process.
Click Previous to return to the previous page.
September 2024
This page was last modified on: September 2024
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