Insurance Regulatory Examiners Society
(please print)

Mr. Mrs. Ms.

Name

State, Agency Name *

Mailing Address

Phone E-mail address

*Under the IRES bylaws, AIE and CIE designations may be awarded only to individuals who meet the Society's membership definition, which requires that the individual spend 75% or more of his/her time working for an insurance regulatory agency (whether as an employee or a contractor).

I hereby certify that I meet IRES qualifications for individual membership and that I spend at least 75% of my time working for an insurance regulatory agency.

I began full-time insurance regulatory work in (month/year): (You must have at least two years of full-time regulatory work to seek accreditation. Effective August 1, 2002, this will change to a three-year work requirement for CIE applications.)

If you have been an IRES member for less than 2 years, you must send proof of when you began regulatory work.

Designation Applied for:

Accredited Insurance Examiner (AIE)

Certified Insurance Examiner (CIE)

The curriculum for which I am seeking credit is:

LIFE-HEALTH PATH

PROPERTY-CASUALTY PATH

Life-health courses -- to achieve AIE Property-casualty courses -- to achieve AIE
To achieve CIE, complete the above, plus
Cross-training in property-casualty
To achieve CIE, complete the above, plus
Cross-training in life-health

Details of the Society's accreditation curriculum, as specified by the NAIC, is detailed on the back of this form. You must enclose your proof of completion for these courses.

I hereby attest that I am currently a member of the Insurance Regulatory Examiners Society and that I am enclosing documentation for the Accreditation Committee. I authorize the Insurance Regulatory Examiners Society and persons acting on its behalf to obtain such other and further information as may be necessary to verify the information provided in this application and to evaluate my eligibility for the designation applied for. I further authorize any educational institution, governmental agency, employer, supervisor or any other organization or person that has records or knowledge of my eligibility to give such information to the Society.

Signature Date


Your application MUST be accompanied by two items:
1) A recent shapshot or photo of you. We cannot process your application without this. Any informal back & white or color shapshot is fine. Please no group photos!
2) A very, very short biographical sketch of no more than 75 words -- summarizing your current regulatory position and duties and a few lines of your choosing about academic background, family and civic or hobby activities. Do not send a resume.

Mail to: Insurance Regulatory Examiners Society, 130 N. Cherry, Suite 202, Olathe, KS 66061

913-768-4700 FAX 913-768-4900

Regulators having a minimum of two years of fulltime regulatory experience and who have
obtained a CPCU, CLU or FLMI designation will be granted the AIE designation.
You must send proof of designation along with this application.

Circle the number next to each course below you have successfully completed.
You must also attach with this application the completion certificates for each course.

AIE, Must Take Any 8 – may take in any order

INS 22 Personal Insurance
INS 23 Commercial Insurance
CPCU 4 Commercial Liability Risk Management & Insurance
CPCU 5 Insurance Company Operation
CPCU 6 The Legal Environment of Insurance
CPCU 7 Management
CPCU 9 Economics
IR 201 Insurance Regulation
AIAF 111 Insurance Accounting
AIC 34,35 or 36 Claims (may only count 1)


CIE, Must Take Any 4 – may take in any order

FLMI 280 Principles of Life & Health Insurance
FLMI 290 Life & Health Insurance Company Operations
FLMI 320 Marketing Life & Health Insurance
FLMI 340 Information Management in Insurance
AIRC 410 Regulatory Compliance - Companies, Producers & Operations
AIRC 420 Regulatory Compliance - Insurance and Annuity Product


AIE, Must Take Any 8 – may take in any order

FLMI 280 Principles of Life & Health Insurance
FLMI 290 Life & Health Insurance Company Operations
FLMI 310 Legal Aspects of Life and Health Insurance
FLMI 320 Marketing Life & Health Insurance
FLMI 330 Management of Organizations and Human Resources
FLMI 340 Information Management in Insurance
FLMI 361 Accounting & Financial Reporting in Life and Health
ICA C3 The Claims Environment
(Choose either ICA C3 or ICA C1)
ICA C1 Medical and Dental Aspects of Claims (candidate may choose either ICA C3 or ICA C1)
AIRC 410 Regulatory Compliance - Companies, Producers & Operations
AIRC 420 Regulatory Compliance - Insurance and Annuity Product


CIE, Must Take Any 4 – may take in any order

INS 21 Principles of Insurance
CPCU 5 Insurance Company Operation
CPCU 6 The Legal Environment of Insurance
IR 201 Insurance Regulation
AIC 34,35 or 36 Claims (may only count one)



Insurance Institute of America
American Institute for Chartered Property and Casualty Underwriters
LOMA, Life Management Institute The American College (CLU, ChFC)
720 Providence Road
Malvern, PA 19355-0770
610-644-2100
Office of the Registrar
2300 Windy Ridge Pkwy., Ste 600
Atlanta, GA 30339
770-951-1770
Bryn Mawr, PA 19010
610-526-1000
INS, AIC, CPCU, AIAF & IR Courses ICA & FLMI Courses HS Courses