Uniform Certificate of Authority Application
Redomestication Application
Are you redomesticating to a new state?
The Redomestication Application is used when an existing insurer is making an application to redomesticate to another state.
Instructions
Redomestication Application Instructions
The Redomestication Application of the Uniform Certificate of Authority Application (UCAA) is designed for use for an existing insurer making an application to redomesticate to another licensed state. A Uniform State is one that is committed to using the UCAA review process for company licensing and admissions.
The UCAA Redomestication Application has three sections designed to guide the Applicant Company through the licensing process:
I. Application Review Process
II. Filing Requirements
III. How to File
The goal of the UCAA is to provide a streamlined approval process. However, some states have state-specific filing requirements based on statutes or internal procedures. The uniform states are working to eliminate non-essential state-specific requirements. All Applicant Companies must be familiar with the insurance laws of the state to which they submit an application. Please see the UCAA charts for information related to obtaining a copy of the laws, regulations and bulletins for the state in which an application is filed.
If the Applicant Company has any questions about the uniform admission process, a list of contact information is provided on the Addresses and Contacts Information for Submission of Application chart. It is highly recommended that the Applicant Company review the state charts, the application instructions and review the Frequently Asked Questions (FAQs) prior to contacting each state with any questions before submitting the application for review.
I. Application Review Process
Redomestication Application Section I
Application Review Process
Processing Goal: 90 Days
It is the goal of each Uniform State to process all Redomestication Applications within 90 calendar days with receipt of a complete application. The 90-day review process includes two weeks to determine if the application is complete and acceptable for filing. A completed application includes all required information detailed in the redomestication application instructions, any state specific requirements and filing fees. During the remaining time-span, the application will receive a financial and operational review. A state may not achieve the 90-day processing goal in instances where the application requires substantial follow-up, or in states with limited resources, or in instances when the Applicant Company files an application during peak business periods such as year-end and annual statement filing periods. Due to varying levels of resources available in each state the review may take longer than 90 days to complete. Anytime the state requests additional information, the state suspends the 90-day goal until it receives the requested information.
Based on the circumstances of a particular application, it may be necessary for the reviewing state to request additional information. Typically, a state will request any additional information it needs within 30 days after the state accepts the application. For more detail regarding the review process, refer to the Company Licensing Best Practices Handbook.
Proprietary Information
Both regulators and the Applicant Company might deem confidential any communications with insurance regulatory agencies in conjunction with the Redomestication Application concerning proprietary information about the Applicant Company. States may only share information determined to be confidential with other persons as authorized by law. By law, the state will not disclose to the public any information determined to be proprietary or trade secret. Each Applicant Company needs to expressly identify all information, in the application and in any subsequent correspondence, that the Applicant Company considers proprietary or trade secret.
The Applicant Company should review the state chart information, and FAQs prior to contacting the appropriate state regulators with any questions before filing any application.
Step One: Filing An Application
The Applicant Company may submit Redomestication Applications anytime during the year. The state immediately reviews Redomestication Applications to ensure that the Applicant Company is licensed in their state and submits the application in the required format as outlined in these instructions.
Generally, within two weeks from the date the state receives the application, the state will notify the Applicant Company whether the state has accepted the application for filing. If the state accepts the application for filing, it will assign an official filing date.
If the state does not accept the application for filing due to a deficiency in the application’s format, the state will contact the Applicant Company. Depending upon the nature of the deficiency, the state may give the Applicant Company two weeks from the date of receipt of notification from the department reviewing the application to correct the deficiency. Some states may return to the Applicant Company any applications that are deficient and not accepted for filing.
Step Two: Application Review
A Redomestication Application will undergo a rigorous financial and operational review in the state to which the Applicant Company submitted the application. The purpose of the Redomestication Application is to streamline application processing and the state will make every effort to process a Redomestication Application as quickly as possible.
At the conclusion of the substantive review by the reviewing state, the state will grant the Applicant Company a Certificate of Authority or Amend its current Certificate of Authority as a domestic company, allow the Applicant Company to withdraw the application, or will deny the application.
If the application is denied, the state will notify the Applicant Company and provide a detailed explanation for the denial. After the denial, if the Applicant Company wishes to re-file a Redomestication Application, the state will require a new application and filing fee.
If the application is approved and a Certificate of Authority is reissued, the Applicant Company should contact the NAIC via email of its change in domiciliary state.
II. Filing Requirements
Redomestication Application Section II
Filing Requirements
This section provides a guide to understanding the focus of each document of the Redomestication Application. It is important that applications be complete.
All documents submitted in support of the application must be current. However, in certain instances, some states have limited latitude to accept older documents, although generally no more than five (5) years old. Please contact the states individually if there are questions about a specific document.
All forms and instructions required to complete the Redomestication Application are available under the Redomestication Application tab. The Applicant Company can access the electronic Redomestication application for submission. A redomestication is the process whereby any insurer organized under the laws of any state may become a domestic insurer that transfers its domicile to another state by merger or consolidation or any other lawful method.
Application Form and Attachments
The application must identify all lines of insurance (Form 3) the Applicant Company must identify the lines of business it is requesting authority to transact and identify the lines of business that the Applicant Company is currently licensed to transact and is transacting in its current domiciliary jurisdiction. The certification and attestation form (Form 2R ) must be electronically signed. The application can only be submitted when all required information is provided.
Form 3 Line of Business Matrix
Life Questionnaire Questions
If any of the questions are answered yes, additional details should be attached.
Question 1. Is the Applicant Company applying for authority for a separate account?
A. Statement of the investment policy of the separate account, and the procedures for changing such policy
B. Copy of the variable annuity prospectus as filed with the SEC unless the separate account is not required to file a registration under the federal securities law
C. A description of any investment advisory services contemplated relating to Separate Accounts
D. Board of Directors resolution authorizing the creation of the separate account
E. Statement specifying the standards of conduct with respect to the purchase or sale of investments of separate accounts (i.e. Board resolution)
Question 2. Is the Applicant Company is applying for authority to write Variable Annuities?
A. Copy(ies) of any third-party management or service contracts
B. Commission Schedules
C. Five-year sales and expense projections
D. A statement from the Applicant Company's actuary describing reserving procedures including the mortality and expense risks which the Applicant Company will bear under the contract
E. Copies of the variable annuity laws and regulations of the state of domicile
F. Copy(ies) of the variable annuity contract(s) and application(s)
Question 3. Is the Applicant Company is applying for authority to write Variable Life Insurance?
A. Copy(ies) of variable life policy(ies) the Applicant Company intends to issue
B. Name and experience of person(s) or firm(s) proposed to supply consulting, investments, administrative, custodial or distribution services to the Applicant Company
C. Disclose whether each investment advisor i) is registered under the Investment Advisers Act of 1940, or ii) is an investment manager under the Employee Retirement Income Security Act of 1974, or iii) whether the Applicant Company will annually file required information and statements concerning each investment advisor as required by its domiciliary state
D. Copies of the variable life insurance laws and regulations of the state of domicile
E. A statement from the Applicant Company’s actuary describing reserving procedures including the mortality and expense risks which the Applicant Company will bear under the contract
F. Standards of suitability or conduct regarding sales to policyholders
Question 4. If the Applicant Company is applying for authority to write Life Insurance, has the Applicant Company at any time in any jurisdiction while operating under its present management, or at any time within the last five years irrespective of changes in management, taught or permitted its agents to sell insurance by using any of the following devices, or representations resembling any of the following:
A. “Centers of influence” and “advisory board”
B. A charter or founder’s policy
C. A profit sharing plan
D. Only a limited number of a certain policies will be sold in any given geographical area
E. “Profits” will accrue or be derived from mortality savings, lapses and surrenders, investment earnings, savings in administration
F. A printed list of several large American or Canadian insurers showing the dollar amounts of "savings", "profits" or "earnings" they have made in such categories
Filing Fee
The application must include a filing fee for the state in which an application is being submitted. The payee's name and the instructions for submitting the filing fee are included in the Domestic Filing Fees chart. Attach a copy of payment in the jurisdiction attachments section of the electronic portal.
Minimum Capital and Surplus Requirements
The application must show that the Applicant Company meets the state’s statutory minimum capital and surplus requirements. In some states, the minimum capital and surplus requirements are determined by the classes of insurance that the Applicant Company is requesting authority to transact and the classes of insurance the Applicant Company is authorized to transact in all other jurisdictions. The state will determine the level of surplus required after considering the Applicant Company’s product line, operating record and financial condition. Compliance with the statutorily prescribed minimum surplus requirement may not be sufficient for all applicants. Review the chart that identifies the Minimum Capital and Surplus Requirements for each Uniform State. This chart also provides a contact person or a link to state-specific forms or RBC requirements and instructions. Attach an explanation of the Applicant Company’s compliance with the capital and surplus requirements in the jurisdiction attachments section of the electronic portal.
Statutory Deposit Requirements
The domiciliary state may require a statutory deposit. The Statutory Deposit Requirements chart provides state-specific requirements and identifies those states that require a Statutory Deposit. Documentation explaining how the Applicant Company meets or is meeting the statutory deposit requirements in the jurisdiction attachments section of the electronic portal. Unless otherwise indicated, the Statutory Deposit is for the benefit of all policyholders.
Name Approval
Each state has different guidelines and procedures for name approval. The Name Approval Requirements chart is intended to serve as a guide for the various name approval requirements of each Uniform State. The Applicant Company should check with the state to ensure compliance with all applicable name approval requirements. Where applicable, attach evidence of name approval request in the jurisdiction attachments section of the electronic portal.
Plan of Operation
The plan of operation has three components, a brief narrative, proforma financial statements/projections (Form 13) and a completed Questionnaire (Form 8). The narrative should include significant information not captured as part of the Questionnaire that the Applicant Company submits in support of the application, such as the reason for redomestication. The proforma is one of the three (3) components in the Plan of Operation. The proforma is available for Life, Property/Casualty, Health and Title companies. Provide a company-wide, three-year proforma balance sheet and income statement. For the lines requested, provide three-year premium and loss projections by line for the application state. Projections must support all aspects of the proposed plan of operation, including reinsurance arrangements and any delegated function agreements. Include the assumptions used to arrive at these projections.
The proforma when applied to the redomestication application is projected data. The proforma workbook should be the same business type as the financial statement blank filed with the NAIC. As such, the projected amounts need not balance with historical NAIC financial filings. The projected data, however, should be relevant to the Applicant Company’s history of growth and losses as contemplated by the NAIC Accounting Practices and Procedures Manual.
The proforma should be completed by statutory accounting or financial reporting professionals that should be available to answer any questions or concerns from reviewing regulatory staff. The proforma is completed on an annual basis, typically for a three-year time period, however, some states may require five years. The proforma should start with the first full year of operation that the Applicant Company anticipates actively writing business in the state receiving the application. The proforma excel workbook is password protected and cannot be modified. When projecting five years, two workbooks will be required. Attach the completed Proforma and all relevant attachments in the required proforma section.
Proforma Financial Statements
Main Questionnaire Questions
Question 1. I hold the following position(s) with the Applicant Company:
Question 2. A. Has the Applicant Company transferred or encumbered any portion of its assets or business, or has its outstanding capital stock been directly or indirectly pledged?
B. Has the Applicant Company merged or consolidated with any other company within the last five years?
Question 3. Is the Applicant Company presently negotiating for or inviting negotiations for any transaction described above?
Question 4. Has the Applicant Company ever changed its name?
Question 5. A. Has the Applicant Company undergone a change of management or control since the date of its latest annual statement filed in support of this application?
B. Does the Applicant Company contemplate a change in management or any transaction that would normally result in a change of management within the reasonably foreseeable future?
Question 6. Has the Applicant Company's certificate of authority to do business in any state been suspended or revoked within the last ten years?
B. Has the Applicant Company’s application for admission to any state been denied within the last ten years?
Question 7. Has any person who is presently an officer or director of Applicant Company been convicted on, or pleaded guilty or nolo contendere to, an indictment or information in any jurisdiction charging a felony for theft, larceny or mail fraud or, of violating any corporate securities statute or any insurance statute?
Question 8. Is the Applicant Company presently engaged in a dispute with any state or federal regulatory agency?
Question 9. Is the Applicant Company a plaintiff or defendant in any legal action other than one arising out of policy claims?
Question 10. Does the Applicant Company intend to purchase investment securities through any investment banking or brokerage house or firm from whom any of Applicant Company's officers, directors, trustees, investment committee members or controlling stockholders receive a commission on such purchases?
Question 11. Is the Applicant Company a:
A. Bank
B. Bank holding company, subsidiary, or affiliate
C. Financial holding company
D. Other financial institution
Question 12. Has the Applicant Company, since its inception, done any of the following:
A. Made a loan to an entity owned or controlled directly or through a holding corporation by one or more of Applicant Company’s officers, directors, trustees, or investment committee members, or to any such person?
B. Sold or transferred any of its assets or property, real or personal, to any such entity or person?
C. Had its outstanding capital stock directly or indirectly pledged for the debt of an affiliate?
D. Purchased securities, assets, or property of any kind from an entity owned or controlled by one or more of the Applicant Company’s officers, directors, trustees, or any persons who have authority in the management of the Applicant Company's funds (including a controlling stockholder)?
Question 13. Executive Management Information
A. Attach an organizational depiction (in the format of a flow chart) showing the various executive management, directors and officers and related material functions that require internal control oversight of the Applicant Company, with the name and official title of those responsible for those offices/functions and the portions of the organization they oversee.
B. Material functions should include, but are not limited to, underwriting, claims adjustment/payments, premium accounting, claims accounting, marketing, financial reporting, and investment management. Note any executive or key staff that has access to funds or bank accounts. Submit a map or narrative explaining where offices are/ or will be geographically located and the approximate number of employees at each location. The attachments should include the following information:
1. Designate any common facilities and/or any of the above functions that are shared with affiliate
2. Designate any of the above office/functions that are delegated to third parties
3. Attach copies of signed agreements for office functions delegated to either affiliates or third parties
4. As applicable, attach a separate chart reflecting any other management positions (if different than what was noted above) that exercise control over insurance operations in other jurisdiction where the Applicant Company is seeking admission
5. Attach any similar information that was submitted to lenders or investment partners
6. Attach a copy of the Applicant Company’s investment policy (required for primary and redomestication applications only)
Question 14. Provide a detailed description of the Applicant Company’s sales techniques. The description attached should include the following information:
1. Information regarding recruitment and training of sales representatives
2. Identification as to whether the Applicant Company will be a direct writer or will use agents, brokers, or a combination thereof
3. Explanation of the compensation and control to be provided by the Applicant Company to its agents, brokers, or sales personnel
4. Sample copies of any agreements entered into between the Applicant Company and its agents or brokers
5. If the Applicant Company will use a specific agency or managing general agent, identification of the agency or managing general agent and a copy of the agreement for this arrangement
6. Sample contract forms of all types used and remuneration schedule, including those for general agents, if any
Question 15. Explain the following:
1. The product lines currently sold or planned by the Applicant Company,
2. Specialty line or lines currently sold and planned,
3. Captive business,
4. The Applicant Company’s marketing plan, including a description of the financial, corporate or other connections productive of insurance,
5. The Applicant Company’s current and expected competition (both regionally and nationally), and
6. How each state in which admission has been requested fits into the marketing plan. General description of the classes to be transacted is not an adequate response. For example, if the Applicant Company plans to market credit life and disability products tailored for use by credit unions, simply stating that it will transact credit life and disability is inadequate.
Question 16. Provide a detailed description of the advertising that will be used by the Applicant Company to market its products in each state. Include a detailed explanation as to how the Applicant Company will develop, purchase, control and supervise its advertising.
Question 17. Provide a detailed explanation of each of the following:
A. How the Applicant Company’s policies will be underwritten, including the issuance of policies and endorsements
B. How policies will be canceled
C. How premiums and other funds will be handled
D. How personnel will be trained, supervised, and compensated
Question 18. Attach a detailed explanation how the Applicant Company will adjust and pay claims, include the following:
A. Describe how the Applicant Company will train, supervise, and compensate the personnel handling claims adjusting and claims payment
B. Provide detailed information as to how and by whom claim reserves will be set and modified
C. Will the Applicant Company pay any representative given discretion as to the settlement or adjustment of claims whether in direct negotiation with the claimant or in supervision of the person negotiating, a compensation which is in any way contingent upon the amount of settlement of such claims?
Question 19. Does the Applicant Company have any reinsurance contracts which contracts that in effect provide that Applicant Company will reimburse or indemnify the Reinsurer for losses payable there under?
Question 20. Does any salaried employee or officer, exclusive of a director, presently have in force a license as an insurance broker issued by this Department of Insurance? If yes, attach a copy of his/her license and indicate position held with applicant.
Question 21. Does the Applicant Company have outstanding unexercised stock options?
A. If yes, to whom and in what number of shares?
B. If options are outstanding for a number of shares greater than 10% of the number of shares presently issued and outstanding, a copy of the option form and of the plan pursuant to which they were granted are attached.
Question 22. Are any of the Applicant Company's policies being sold in connection with a mutual fund or investment in securities?
Question 23. Does the Applicant Company pay, directly or indirectly, any commission to any officer, director, actuary, medical director or any other physician charged with the duty of examining risks or applications?
Question 24. Does the Applicant Company have any permitted practices allowed by its current state of domicile?
Question 25. Does the Applicant Company’s current state of domicile prescribe any practices of the Applicant Company that are not in accordance with:
A. Laws, regulations or bulletins of proposed state of domicile
B. Reserving requirements of proposed state of domicile
C. NAIC guidelines
Question 26. Will the Applicant Company’s investments comply with the investment laws, regulations or bulletins of the proposed state of domicile?
Question 27. Does the Applicant Company have any outstanding surplus notes?
Holding Company Act Filings
If the Applicant Company is a member of a holding company system, the application must include either the most recent Holding Company Act (HCA) filings, including the Annual Form B Registration Statement and related Form F or a statement substantially similar to the NAIC Insurance Holding Company System Regulatory Act (#440). The filing should include all attachments, exhibits appendices referenced in the HCA filings, and the most recent Corporate Governance Annual Disclosure, include any updates if the disclosure has not been restated. Include all attachments and any amendments up to the application filing date and include copies of all advisory, management and service agreements.
Holding Company Questionnaire Questions
Question 1. A. Attach and make a part hereof an affidavit by an executive officer of the Applicant Company who knows the facts listing the principal owners (10% or more of the outstanding shares) of such holding corporation by name and residence address, business occupation and business affiliations.
B. Attach the following: Holding Company Files such as 10 Q, Ultimate Controlling party information (HCA Filing or the Annual Form B registration statement or Form F), SEC Filings, Consolidated GAAP Financial Statement, CPA Audit Report.
Question 2. Is the Applicant Company owned, operated or controlled, directly or indirectly, by any other state or province, district, territory or nation or any governmental subdivision or agency?
Question 3. If a parent, subsidiary and/or affiliated insurer is admitted for the classes of insurance requested in the pending application, please differentiate the products and/or markets of the Applicant Company from those of the admitted insurer(s).
Question 4. Is the Applicant Company a member of a group of companies that shares any of the following:
A. Common facilities with another company or companies
B. Services (e.g. accounting personnel for financial statement preparation)
C. Or, is a party to a tax allocation agreement in common with another company.
Statutory Memberships
In some states, the Applicant Company is required to join one or more ratings, guarantee or other organizations before transacting insurance. Generally, the Applicant Company’s authorized lines of insurance govern statutorily mandated memberships. Review the Statutory Membership Requirements chart prior to contacting the licensure state about any required statutory memberships before transacting insurance. Attach documentation supporting membership application(s) as indicated, in states where required, in the jurisdiction attachments section of the electronic portal.
SEC Filings or Consolidated GAAP Financial Statement
If the Applicant Company, its parent or its ultimate holding company has made a filing or registration with the U.S. Securities and Exchange Commission (SEC) in connection with a public offering within the last three years, or filed an 8K, 10K or 10Q within the last 12 months, the application must note that the filing, including any supplements or amendments, is available electronically from the SEC. If the Applicant Company, its parent or its ultimate holding company is not publicly traded, the application must attach a copy of the Applicant Company’s most recent Consolidated GAAP financial statement. Attach the notice of SEC filings or copy of a Consolidated GAAP statement as part of the Holding Company Questionnaire.
Debt-to-Equity Ratio Statement
Members of a holding company system must complete the debt-to-equity information as Item 10 of the application. The application must include a comprehensive debt-to-equity ratio statement that includes the following information.
A. Provide the consolidated outside debt to consolidated equity ratio on a GAAP basis for the holding company. *
Debt Duration | Debt Amount ($) | Debt to Consolidated Equity Ratio |
Up to 5 years | ||
Up to 10 years | ||
Up to 20 years |
B. Provide the most recent consolidated holding company financial statement.
C. State if the holding company, on a consolidated basis, has a tangible net worth: a) for the past three years; b) at present; and c) provide projections with assumptions for a three-year period.
D. The Applicant Company must clearly substantiate the sources of repayment of any debt, including, but not limited to, whether the source of repayment is independent from the future income of the insurers.
E. Calculate the debt service (as reported in D above) required of each insurer as a percentage of the Applicant Company’s capital and surplus.
F. List the assets of the holding company, if any, that are pledged to fund the debt service or debt repayment of an affiliate or parent (include the assets or stock of any insurer subsidiaries)
G. List any guarantees (personal or otherwise) from the shareholders for repayment of the debt.
*Some states may require re-statement based upon statutory equity.
Custody Agreements
The Applicant Company should attach a statement setting forth whether any of the Applicant Company’s stocks, bonds, or other physical or book entry securities are in the physical possession of another entity.
If any of the Applicant Company’s stocks, bonds or other securities are not in the Applicant Company’s actual physical possession or in a safe deposit box under the exclusive control of the Applicant Company (except as shown in the Schedule of Special Deposits in the Applicant Company’s Annual Statement), the application must include the written agreement with each entity holding and/or administering these securities. The written agreement should include appropriate safeguards for the handling of the securities, in accordance with those specified in the NAIC Financial Condition Examiners Handbook (Handbook).
Some states have additional requirements for these custody agreements, beyond those called for in the Handbook. Attach the statement and copies of the custody agreements in the jurisdiction attachments section of the electronic portal.
Public Records Package
Most states have requirements to disclose information to the public under the Public Records Act. To meet these public disclosure requirements certain items must accompany the application. While these documents may or may not be part of the substantive review, please be sure to include the required documents with the application. The Public Records Package chart contains requirements for financial and operational filings. An Applicant Company seeking to redomesticate should provide both financial and operational documents for the application state. Attach all documents required by the application state in the jurisdiction attachments section of the electronic portal.
NAIC Biographical Affidavit (Biographical Affidavit)
A. The Applicant Company is required to submit an NAIC Biographical Affidavit (Form 11) in connection with pending or future application(s) for licensure or a permit to organize with a department of insurance in one or more states. The Applicant Company must attach an NAIC Biographical Affidavit on behalf of all officers, directors and key managerial personnel of the Applicant Company and individuals with a ten percent (10%), or more, beneficial ownership in the Applicant Company and the Applicant Company’s ultimate controlling person (“Affiant”).
B. The UCAA defines “Independent Third-Party” as:
- A consumer reporting agency (“CRA”) overseen by the Federal Trade Commission (“FTC”) and, therefore, subject to the FCRA, which have been vetted and is currently on the approved list;
- Has the ability to perform international background investigations; and
- One whose officers and directors have no material affiliation with the Applicant Company other than stock ownership amounting to less than one percent (1%) of total stock outstanding, unless prior approval is given by the department of insurance to which application is being made.
C. The NAIC Biographical Affidavit requests information with respect to the Affiant’s employment history, education, personal information and character. The NAIC Biographical Affidavit also includes the Disclosure and Authorization Concerning Background Reports (the “Disclosure & Authorization Form”). The signature of the Affiant on the Disclosure & Authorization Form permits an Independent Third-Party to conduct an independent third-party verification on the Affiant.
D. The NAIC Biographical Affidavit includes three types of the Disclosure & Authorization Form. There are three different Disclosure & Authorization Forms since certain state laws, regulations and rules require different kinds of disclosures and wording within such form. An Affiant must sign the corresponding Disclosure & Authorization Form(s) for the respective state(s) where the Affiant has lived or worked within the last ten (10) years. Refer to the Disclosure & Authorization Forms for further information.
E. The NAIC Biographical Affidavit is used to evaluate the suitability, competency, character and integrity of the Affiant in connection with an Applicant Company’s pending or future application(s) for licensure or a permit to organize with a department of insurance in one or more states.
The Independent Third-Party uses information contained in the NAIC Biographical Affidavit as a tool to perform an independent third-party verification to determine an individual’s fitness and propriety. The independent third-party verification may contain information bearing on the Affiant’s character, general reputation, personal characteristics, mode of living and credit standing (if required by the state). The Independent Third-Party Vendor shall use the independent third-party verification to create a background report (the “Background Report”).
F. The Disclosure & Authorization Form is valid for a maximum of six months. Additionally, an Affiant may revoke the authorization at any time by delivering a written revocation to the Applicant Company. Refer to the Disclosure & Authorization Form for further information.
G. The Background Reports are subject to the Fair Credit Reporting Act (“FCRA”). Pursuant to FCRA, the state departments of insurance and an Applicant Company who is seeking admission are “users” of consumer reports. The FCRA requires that the Applicant Company provide the Affiant with a copy of the “Summary of Your Rights Under the Fair Credit Reporting Act.” The Applicant Company should provide a copy of the “Summary of Your Rights under the Fair Credit Reporting Act” to each Affiant. This summary can be found at the Federal Trade Commission (“FTC") website. Background Reports are valid for six months from the signature date of the affidavit. Any alteration to the original biographical affidavit or updated signature will require a newly prepared background report.
H. The Applicant Company and state departments of insurance are required to comply with FCRA, especially as it relates to confidentiality of the information contained in such consumer reports. To the extent required by law, the states and Independent Third-Party Vendors should maintain the Background Reports procured under the Disclosure & Authorization Form as confidential. A copy of the FCRA is located here.
I. The department of insurance in the state where an Applicant Company files, or intends to file, an application and the Applicant Company may require the Background Report. An Affiant who desires a copy of their Background Report may request a copy from the Applicant Company or the CRA as indicated on the Disclosure & Authorization Form. Refer to the Disclosure & Authorization Form for further information.
J. Please check state requirements for those states that require additional background information, such as fingerprints, in place of, or in addition to, NAIC Biographical Affidavits. If applying in one of those states, necessary fingerprints and processing fees should be included.
Refer to the list of currently approved Independent Third-Party Vendors for Background Reports.
NAIC Biographical Affidavits must be completed on the most current form, in effect at the time the affidavit was signed and the Affiant shall not sign the Affidavits more than six months before the date the Applicant Company files the application. Each question on the biographical affidavit must have a response. If an answer is “None”, then so state. Incomplete biographical affidavits could delay the background investigation report and result in a delay of the application review by the state.
Submit original Biographical Affidavits (Form 11) that contain the Disclosure & Authorization Forms to the state department(s) of insurance under the Management Information Section of the application.
Disclaimer of Control, Biographical Affidavit, Group Cover Letter and Addendum Pages
Form 9 - Disclaimer of Control
Form 11 - Biographical Affidavit
Form 11a - Biographical Affidavit Group Cover Letter
Form 11b - Biographical Affidavit Addendum - Residence
Form 11b - Biographical Affidavit Addendum - Education
Form 11b - Biographical Affidavit Addendum - Employment
Form 11b - Biographical Affidavit Addendum - Licenses
Form 11b - Biographical Affidavit Addendum - Professional Societies
Form 11b - Biographical Affidavit Addendum - General
Form 11b - Biographical Affidavit Addendum - Blank
Annual Statement with Attachments
Include a copy of the Applicant Company’s most recent annual statement as filed in the current state of domicile including all statements and supplements in accordance with the Annual Statement Instructions, including the Statement of Actuarial Opinion and Management’s Discussion and Analysis. The annual statement should be signed and verified and include an original certification from the state insurance regulatory agency of the Applicant Company’s domiciliary state.
Include one copy of the Applicant Company’s annual statement for the two (2) preceding years in addition to the most recent annual statement.
Property/Casualty insurers must attach the Insurance Expense Exhibit, Accident and Health Policy Experience Exhibit and/or Schedule P to the annual statement.
Life insurers must include a Certificate of Valuation from the domiciliary state insurance regulatory agency.
Members of a holding company system must attach a copy of the most recent consolidated annual statement, if filed with its current state of domicile. Submit the annual statement, with the necessary attachments, in the jurisdiction attachments section of the electronic portal.
Quarterly Statements
Include one (1) copy of each quarterly statement that follows the most recent annual statement. In addition, the Applicant Company must immediately forward any new quarterly statements that become available while the application is pending to all states in which applications are pending. Submit the quarterly statements in the jurisdiction attachments section of the electronic portal.
Risk-Based Capital Report
Include a Risk-Based Capital Report, submitted in the level of detail required by the NAIC, in the jurisdiction attachments section of the electronic portal. Please note that the states will maintain confidentiality of these reports.
Independent CPA Audit Report
Include a CPA Audit Report, performed by a certified public accountant that is not an employee of the Applicant Company. Submit the CPA Audit Report as Item 18 of the application. Some states allow exemptions to this requirement for small insurers. Please contact the states individually regarding exemptions.
Reports of Examination
The application must include a copy of the Applicant Company’s most recent Report of Financial Examination from its domiciliary state. The Applicant Company must also note all more recent examinations completed by any state, including market conduct examinations, and provide a description of each examination. Refer to the Reports of Examination Requirements chart for the exam “as of” date. Attach the Report of Financial Examination and a list of more recent examinations with descriptions in the jurisdiction attachments section of the electronic portal.
Certificate of Compliance
If available, include a state issued Certificate of Compliance with the application. Please refer to the Certificate of Compliance and Certificate of Deposit Requirements chart for specific requirements for the date of issuance of the Certificate of Compliance from the file date of the application. The current domiciliary state must complete the Certificate of Compliance. A copy can be submitted in the jurisdiction attachments section of the electronic portal, the domiciliary state will receive an email notification to provide a certificate of compliance and deposit as part of the state-to-state communication in the electronic portal.
Corporate Governance Annual Disclosure
If applicable, include the most recent Corporate Governance Annual Disclosure, include any updates if the disclosure has not been restated. Submit the Registration Statement and Annual Disclosure in the jurisdiction attachments section of the electronic portal.
State-Specific Information
Some jurisdictions may have additional requirements before a Certificate of Authority is issued. Before completing a UCAA Redomestication Application, the Applicant Company should review the list of requirements on the State-Specific Requirements for the application state. Include any state-specific requirements in the jurisdiction attachments section of the electronic portal.
III. How to File
Overview
Redomestication Application Section III
How to File – Redomestication Portal
Authenticate User ID
Log into the application via the electronic link: https://authenticate.naic.org/
The user will be asked to authenticate their user ID via OKTA, once authenticated the user will see the application icon on their ID dashboard.
Once logged into the application the user will default to the application dashboard. After the user ID has been authenticated, the following link can be used: https://cloudapps.naic.org/suite/sites/ucaa
If the user is a consultant or part of a holding company structure, contact NAIC UCAA administration staff (Jane Barr or Crystal Brown) to have those company codes associated to their user id. (jbarr@naic.org or cbrown@naic.org)
Create Redomestication Application
From the drop-down menu, select Redomestication and then the create button to the left.
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The User will have the option to create a redomestication application for companies that are authorized/ associated to their User ID. The company should file redomestication applications to states where they are currently licensed.
Application Requirements
If the company has submitted an expansion application that is currently being reviewed, they should select pending and provide the expansion application tracking number. Companies that are not licensed will need to submit an application or reach out to the application jurisdiction.
Once the application is created, if applicable the group code and group name will populate on the general information page of the application and the debt to equity and holding company questionnaire will become a requirement of the application.
If the company is part of a holding company structure, but does not qualify for an NAIC group code, identify the owner of 10% or more control over the insurer on the management information section and complete the Debt to Equity and Holding Company Questionnaire.
Management Information
Summary page
All sections of the application must be completed before the Submit button is available under Actions on the application summary page.
Summary Page
When the application is created, it will default to the summary page which contains pertinent information regarding the application. The summary page provides the status of the application, as it moves through the various submission and review/approval stages of the application process. While the application is in a Creation status, the substatus will remain in progress until the users submits the application to the intended jurisdiction.
After application submission, the substatus can show “paused” if the state has submitted a request for information (RFI) to the company and the substatus will remain paused until the Applicant Company has responded, via the RFI, with the necessary information to the application jurisdiction.
Manage Designess
The User who creates the application will have access to work in the application. To allow other authorized users access they will need to be added individually. Only individuals with a UCAA ID can be added. When appropriate remove any User as a designee.
Statuses
Creation: an application has been started by the Applicant Company user and is currently being worked on/ completed by the company. (non-submitted)
Submission: Before a PDF of the application forms can be created, a usage fee must be paid. Once payment has been confirmed/ validated, a separate link will appear in the Actions to Submit the Application. A DocuSign envelope will also be created to notify the designated officer or director of the request for signature via email.
Signature: Once the designated officer or director has signed the certification and attestation page it will automatically be sent to the intended jurisdiction. The Applicant Company can recall the signature, or the signatory officer can refuse to sign the document if the application needs to be edited.
Acceptance: Once the intended jurisdiction receives the application, it will review the contents of the application to ensure all requirements have been met. When all requirements are met, the Jurisdiction will accept the application as complete and assign the review to their regulatory team. A lead reviewer will be designated and listed under the Details section of the Summary page.
Review: A lead reviewer and other assigned state reviewers will receive notification that a primary application has been assigned for their review. During this process if there are any questions regarding the application information or attachments the assigned reviewers will contact the Applicant Company via an RFI. The link to the RFI is located at the top, left side of the summary page.
Under the status bar and to the right of the summary page is a section labeled “Action” as the user works throughout the application various actions become available.
When a Lead Reviewer is assigned, they will be identified in the Details section on the Summary page.
The status bar will indicate the status of the application.
Recommendation: the state has completed their review and will make a recommendation to either approve or not approve the application. If approved, the state may prepare and attach a consent order of additional requirements specified in the approval letter with necessary items/information that is required prior to certification. If not approved, the state will provide details of why the application was not approved included with the RFI.
Certification: The jurisdiction has confirmed the company details and may issue a new certificate of authority. The state will also confirm the effective date of the redomestication.
Withdraw: If the state recommends to non-approve the redomestication, the company will need to withdraw their application. When the application is withdrawn the application and all corresponding RFIs will automatically be closed.
Requirements
All application requirements are located on the Summary page under Requirements. Each requirement input screen will populate the company data onto the appropriate application form. The symbol to the left will indicate the status of each requirement.
NOTE:
Unless otherwise stated under state specific requirements, the User should upload pdf format for all attached documents, for the porforma financial statement upload both excel and pdf. files.
Usage Fee
FEES/CHARGES: The company user must pay a transaction fee for use of the electronic UCAA which shall be collected at the time of filing. The NAIC reserves the right to change or modify the transaction fee upon thirty (30) days’ notice to the filer. All fees and charges are non- refundable. NAIC reserves the right to terminate or disable access to UCAA in the event of non-payment of fees or charges.
The Usage fee must be paid before the link to create the Docusign envelop appears in the Actions section.
Signatory Information
The Signatory Information is generated from the list of Officers/Directors entered on the Management Information section of the application. Only officers (president, secretary, or treasurer) that are eligible to sign the Certification and Attestation will be listed in the drop-down menu. If applicable, the Uniform Consent to Service of Process will have a specific drop-down menu, the signatures of the certification and attestation and board resolution.
Application Submission
The application will automatically be submitted to the intended application jurisdiction once the officer of the company has reviewed the DocuSign PDF and signed the Certification and Attestation page and, if applicable, the uniform consent to service of process certificate and attestation and the board resolution.
Request for Information (RFI)
During the state review process, the facilitator or lead reviewer may submit a request for clarification or pertinent information needed to their review of the application. When the state reaches out to the company via an RFI, the application substatus will change from “in progress” to “paused”. A paused status means that the state is waiting on information from the company to move forward with their review.
To create an RFI, select the create button in the upper right corner of the screen. All open or closed RFIs will remain on the RFI summary screen.
As a user you do not need to identify the recipient, the system automatically knows which regulator to send your inquiry to, depending on where the application is in the review process, either the state facilitator or reviewer.
Audit History
The audit history allows the company user to track the progress of the application as it is completed. When more than one user updates information in any of the application sections it saves the information in the audit history.
Application Review Process
The status of the application can be followed by viewing the status bar throughout the review process.
Pending State Acceptance – the state is reviewing the contents of the application to ensure all required information is available to begin the review process.
Review Assignment – A lead reviewer has been assigned, and tasks may be assigned to other areas of the department that specialize in the review of legal, financial or securities.
Recommendation – Pending Certification – the application has been approved and the state has issued a consent order of items that needs to be completed prior to the certificate of authority being issued to the company.
Amend Application
The company may amend their application at any time after an application has been signed and submitted to the state. The initiate amendment button is active during the pending state acceptance to review statuses and even when the application has been placed in a “paused” substatus. Select “initiate amendment” under Actions.
Provide a thorough explanation as to why the application is being amended. This explanation will be provided in an RFI to the state, so they are aware that the application is being amended.
If the company decides to withdrawal an application instead of amending, the amendment can be cancelled.
A usage fee is required to amend the application. Use the “submit application” button to submit the amendment. The sections that were edited will highlight with a green check mark.
Before the application can be submitted for signature a cover letter will be created and a detailed explanation should be provided for each section that was edited.
Once the application is signed and submitted to the state, the status will return to its original point in the review process and both complete versions of the application are available to view and download from the “View Application Documents” located on the summary page below the Actions.
Download Application
Select Generate Zip and then the download zip link to view the zip file, located on the left header of the view documents. The application files and attachments are sorted into sections. The download file will include all RFI communication with the state and the original pdf version of the signed application . Click on each folder to view the application template and attachments for each section. Each version of the application can be zipped and downloaded.
Reset Password
If the User needs to change their password, select the drop-down menu in the upper right corner of the webpage when logged in.
The User will be prompted to verify their password, enter the current password or temporary password if one was provided. For security reasons, okta will send a push notification to ensure the correct user is updating the password. Complete the okta security, the user will be prompted to edit their personal information .
Before you can change your password, complete the Forgotten Password Question, for future assistance when locked out or if the password is forgotten.