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:
- Conduct a self assessment to make a preliminary determination as to whether a captive insurance company is right for your business,
- Obtain a qualified consultant to provide advice and conduct a feasibility study (see below for guidance),
- Meet with the Department to obtain guidance and buy-in on the initial plan, and
- 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
To access the electronic forms indicated in this section, you must have Adobe Reader version 7.0 or higher. If your computer operating system will not accommodate this version please contact Travis Wegkamp of the Utah Insurance Department at 801-537-9294.
