Licensing & Forms

 
A A A

Licensing, Annual Filings, and File Upload:

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

Captive Application Process

Before submitting an application to form a new captive insurance company, interested parties should 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. If necessary, meet with the Department to obtain guidance and "buy-in" on the initial plan.

The applications in this link require a Windows operating system that is more recent than Windows XP. If you can not meet this requirement, please contact us for assistance. Additionally, the applications work best with a Chrome browser.

Captive Application

Captive Feasibility Study

Captive Renewal Forms

Captive Annual Statement Forms

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

The forms in this link require a Windows operating system that is more recent than Windows XP. Additionally, the forms work best using a Google Chrome browser.

***ATTENTION*** Currently on the Annual Statement form, for the roll forward of Prior Year numbers to take place the system applies two criteria and must recognize the same Organizational ID number and User ID as the same individual who submitted the previous year's annual statement. We are working to have the same User ID requirement removed, and allow the roll forward to take place solely based on recognition of the Organizational ID. As this is a limitation on our online system, we will not be requiring the Prior Year column be completed on the current annual statement (for repeat filers) should you be experiencing this issue due to the submission by an alternate individual.

Annual Filing Forms

Online Filing Instructions

Service 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 can not meet this requirement, please contact us for assistance. Additionally, the applications work best with a Chrome browser.

Provider Applications

File Upload System

Please select the link below to go to the new secure file upload system for submitting documents and requests to the Department rather than through email communication.

The applications in this link require a Windows operating system that is more recent than Windows XP. If you can not meet this requirement, please contact us for assistance. Additionally, the applications work best with a Chrome browser.

File Upload

To access the electronic applications and 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 “Create Account” option and follow the instructions to create your Utah-ID account user ID and password.