Licensing & Forms

 
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Licensing & Forms

Find license applications for potential providers and forms for the feasibility study and annual statement documents in this area.

Captive Application Process

In order to obtain an application, interested parties must first complete some preliminary steps as follows:

  1. Conduct a self assessment to make a preliminary determination as to whether a captive insurance company is right for your business,
  2. Obtain a qualified consultant to provide advice and conduct a feasibility study (see below for guidance),
  3. Meet with the Department to obtain guidance and buy-in on the initial plan, and
  4. Make an on-line request to the Department for an application.

It is imperative that these steps be completed before an application is filled out. Because these steps are so critical to the success of any captive, the Department limits access to the captive application forms until it is satisfied that this process has been completed. After we have met with the principles and the initial plans appear feasible, access to the application process will be provided by email.

Captive Feasibility Study

Captive Renewal Forms

The following forms require the FormDocs application to use. Please download the following instructions in PDF format that will help you install and begin using the FormDocs forms.

Provider Applications

Please select the link below to go to the new electronic application forms and select "Register Here" if you do not already have a Utah-ID account.

The applications in this link require a Windows operating system that is more recent than Windows XP. If you do not meet this requirement, please contact us for one of the applications.

Application Forms

To access the electronic forms indicated in this section, you will need a Utah-ID account log in. If you do not have a Utah-ID account, click on the link above and instead of directly logging in, select the “Register Here” link from the left side and follow the instructions to create your user ID and password.