A Sole Proprietor is determined by the Social Security Number (SSN) on the Schedule C; always considered a single owner.

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1 Sole Proprietor A Sole Proprietor is determined by the Social Security Number (SSN) on the Schedule C; always considered a single owner. Current Schedule C must be submitted unless not available due to the length of time in business OR California Business License Current Schedule C must be submitted unless not available due to the length of time in business OR California Business License OR Fictitious Business Name Filing. California Business License OR Fictitious Business Name Filing When less than six (6) enrolling, group must show proof of compensation (draw checks). In business > 1 year Current Schedule C must be submitted unless not available due to the length of time in business. (if less than 5 medically enrolling) Schedule C (for preceding calendar year) OR Current California Business License OR Fictitious Business Name Filing dated prior to requested effective date. In business < 3 months California Business License OR Fictitious Business Name Filing In business > 3 months Current Schedule C must be submitted unless not available due to the length of time in business OR California Business License OR Fictitious Business Name Filing Current Schedule C OR Fictitious Business Name Filing OR California Business License.

2 Sole Proprietor A Sole Proprietor is determined by the Social Security Number (SSN) on the Schedule C; always considered a single owner. 1-9 enrolling or family only groups: California Business License listing the owner s name AND an IRS or Sec. of State letter indicating the issued tax ID number. In business > 1 year 1-9 enrolling or family only groups: IRS Schedule C (Form 1040) Note: Groups comprised only of family members must provide separate tax documentation. A DE-9C may also be required with current legal and/or tax documents if ownership is in question.

3 Corporations Corporations established out-of-state also require a Certificate of Qualification or Statement by Foreign Corporation. C-Corp: IRS form 1120 Statement of Info (filed and stamped listing all officers) Articles of Incorporation (filed and stamped listing all officers) S-Corp: IRS form 1120 S Schedule K with Schedule E Statement of Info (filed and stamped listing all officers) Articles of Incorporation (filed and stamped listing all officers) Statement of Information (substitutes include a C-Corp Form 1120, S-Corp Schedule K-1 or 1120S, listing the names of all officers) OR Statement by Domestic Stock OR Articles of Incorporation filed and stamped listing names of all officers. : Articles of Incorporation filed and stamped listing names of all officers OR Statement of Information, listing owners/offices with State Endorsement stamp AND When less than six (6) enrolling, group must show proof of compensation (draw checks). In business > 1 year: IRS Schedule K-1 (Form 1120s) for all enrolling Owners/Officers OR W-2. (required if less than 5 medically enrolling) Statement of Information listing owners/partners with State Endorsement stamp prior to requested effective date OR Schedule E for preceding calendar year to include owners/partners name OR Articles of Incorporation with State Endorsement dated prior to requested effective date. In business < 3 months: Articles of Incorporation filed and stamped AND Corporate meeting minutes listing all officer s names. In business > 3 months: Statement of Information filed and stamped IRS Form 1120 listing all owners and percentage of stock owned OR Articles of Incorporation filed and stamped listing names of all officers OR Statement by Domestic Stock Corporation / Statement of Information (an unstamped document may be accepted with a printout from the California Business Portal if at least one officer listed is also listed on the printout as the Agent for Service of Process. The signature date must also be consistent with the filing date. Otherwise, the document must be stamped or contain a pre-printed file number from the State.) AND Statement of Designation by Foreign Corporation.

4 Corporations Corporations established out-of-state also require a Certificate of Qualification or Statement by Foreign Corporation. S-Corps and C-Corps In business <1 year: 1-9 enrolling or family only groups: Articles of Incorporation AND an IRS or Sec. of State letter indicating the issued tax ID number. In business > 1 year (S-Corps): IRS Schedule K-1 (Form 1120s) for all enrolling and/or waiving Owners/Officers In business > 1 year (C-Corps): IRS Form 1120 (pages 1 & 2) AND IRS 1120 Schedule G AND IRS Form 1125E, which includes all owners. If 1120 does not list all owners, a letter from CPA identifying owners and percent of ownership is required. Note: Groups comprised only of family members must provide separate tax documentation. A DE-9C may also be required with current legal and/or tax documents if ownership is in question.

5 Partnerships Partnership Agreement and Federal Tax ID Appointment Letter Partnership Agreement and Federal Tax ID Appointment Letter Partnership Agreement filed and stamped and signed by all partners OR Business license OR DBA filing When less than six (6) enrolling, group must show proof of compensation (draw checks). In business > 1 year IRS Schedule K-1 (Form 1065) for each enrolling partner OR Tax extensions are not permitted (if less than 5 medically enrolling) Legal Notarized Partnership Agreement dated and notarized prior to the requested effective date OR Schedule K-1 (1065 Partner's Return) for preceding calendar year. In business < 3 months Partnership Agreement filed and stamped and signed by all partners OR Federal Tax ID Appointment letter In business > 3 months IRS Schedule K-1 (Form 1065) for each enrolling partner OR Partnership Agreement AND Federal Tax ID Appointment letter (if Schedule K-1 is not yet available) Current Schedule K-1 (1065 Partner's Return) OR Statement of Partnership Authority OR Partnership Agreement; deemed acceptable per underwriter s discretion OR Fictitious Business Name Statement listing both names OR Tax Certificate listing both names.

6 Partnerships 1-9 enrolling or family only groups: Partnership Agreement filed and stamped and signed by all partners In business > 1 year: IRS Schedule K-1 (Form 1065) for each enrolling and/or waiving partner OR Partnership Agreement signed by all partners Note: Groups comprised only of family members must provide separate tax documentation. A DE-9C may also be required with current legal and/or tax documents if ownership is in question.

7 Limited Partnerships (LP) LPs established out-of-state also requires a Foreign Limited Partnership Application for Registration (form # LP-5) filed and stamped by the Secretary of State. IRS form 1120 S Schedule K with Schedule E Partnership agreement Partnership Agreement and Federal Tax ID Appointment Letter. Partnership Agreement filed and stamped and signed by all partners OR Business license OR DBA filing When less than six (6) enrolling, group must show proof of compensation (draw checks). In business > 1 year: IRS Schedule K-1 (Form 1065) for each enrolling partner OR Tax extensions are not permitted (if less than 5 medically enrolling) Legal Notarized Partnership Agreement dated and notarized prior to the requested effective date OR Schedule K-1 (1065 Partner's Return) for preceding calendar year. Limited Partners of a LP are not eligible for coverage unless they appear on a DE-9C. Schedule K-1 (1065 Partner's Return) OR Certificate of Limited Partnership OR Partnership Agreement; deemed acceptable per underwriter s discretion OR Fictitious Business Name Statement showing both names OR Tax Certificate showing both names AND Foreign LP Application of Registration. Limited Partnerships are not underwritten by.

8 Limited Liability Partnership (LLP) LLPs established out-of-state also requires a Registered LLP Certificate of Registration (Form #LLP-1) filed and stamped by the Secretary of State. IRS form 1120 S Schedule K with Schedule E Partnership agreement Partnership Agreement and Federal Tax ID Appointment Letter. Partnership Agreement filed and stamped and signed by all partners OR Business license OR DBA filing When less than six (6) enrolling, group must show proof of compensation (draw checks). In business > 1 year: IRS Schedule K-1 (Form 1065) for each enrolling partner OR Tax extensions are not permitted (if less than 5 medically enrolling) Legal Notarized Partnership Agreement dated and notarized prior to the requested effective date OR Schedule K-1 (1065 Partner's Return) for preceding calendar year. Certificate of Limited Partnership with state endorsement stamp prior to the requested effective date. Limited Partners of a LP are not eligible for coverage unless they appear on a DE-9C. Schedule K-1 (1065 Partner's Return) OR Registered Limited Liability Partnership Registration OR Partnership Agreement; deemed acceptable per underwriter s discretion OR Fictitious Business Name Statement showing both names OR Tax Certificate showing both names AND LLP Certificate of Registration. 1-9 enrolling or family only groups: Partnership Agreement filed and stamped and signed by all partners In business >1 year: IRS Schedule K-1 (Form 1065) for each enrolling and/or waiving partner OR Partnership Agreement signed by all partners Note: Groups comprised only of family members must provide separate tax documentation. A DE-9C may also be required with current legal and/or tax documents if ownership is in question.

9 Limited Liability Corporation (LLC) LLCs established out-of-state also require a LLC Application of Registration (Form #LLC-5) filed and stamped by the Sec. of State. IRS form 1040 with Schedule K-1 form 1065 Statement of Information stamped and filed Articles of Organization (with Operating Agreement) stamped and filed Statement of Information stamped and filed by state of California prior to the date required for GI OR Articles of Organization (with Operating Agrmt) stamped and filed by state of California prior to date required for GI Articles of Organization (with Operating Agrmt) stamped and filed by state of California prior to date required for GI OR Statement of Information stamped and filed by state of California prior to the date required for GI. < 6 enrolling: groups must show proof of compensation (draw checks) In business > 1 year Schedule C OR Schedule F (if less than 5 medically enrolling) Schedule K-1 (1065 Partner's Return) OR LLC Statement of Info listing owners/partners with State Endorsement stamp prior to requested effective date. In business < 3 months Articles of Organization (with Operating Agrmt) stamped and filed by state of California prior to date required for GI OR Statement of Information stamped and filed by state of California prior to the date required for GI. In business > 3 months Current Schedule C (single member LLC) OR Articles of Organization (with Operating Agrmt) or Statement of Information (if Schedule K-1 or Schedule C are not yet available) Schedule K-1 (1065 Partner's Return) OR IRS Form 1120 listing all owners and percentage of stock owned OR Articles of Organization (with Operating Agrmt) stamped and filed by state of California prior to date required for GI OR Statement of Information (an unstamped document may be accepted with a printout from the California Business Portal if at least one officer listed is also listed on the printout as the Agent for Service of Process. The signature date must also be consistent with the filing date. Otherwise, the document must be stamped or contain a preprinted file number from the State.) AND LLC Application of Registration.

10 Limited Liability Corporation (LLC) LLCs established out-of-state also require a LLC Application of Registration (Form #LLC-5) filed and stamped by the Sec. of State. 1-9 enrolling or family only groups: LLC Operating Agreement signed by all managers/members/parties AND an IRS or Sec. of State letter indicating the issued tax ID number. In business > 1 year LLC Operating Agreement signed by all managers/members/parties OR Copies of appropriate tax returns (requirements based on how LLC was formed see Partnership or Sole Proprietorship) Note: Groups comprised only of family members must provide separate tax documentation. A DE-9C may also be required with current legal and/or tax docu-

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