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Addresses and Contacts for Submission of Application - Industry UCAA
Addresses and Contacts for Submission of Application

Submit your application to the address listed in the chart below (left side). State Department contact information provided in the chart below (right side).

Updates to the information will be noted with a “*” next to the state name and edits will be italicized and bolded.
Last update: 07/23/2020

State Mailing Address Contact Information
AL

Alabama Department of Insurance
P.O. Box 303351
Montgomery, AL 36130

Or overnight delivery to:
201 Monroe Street, Suite 1700
Montgomery, AL 36104

Primary & Expansion Apps:
Sean Duke
(334) 241-4165
Sean.Duke@insurance.alabama.gov

Richard L. Ford
(334) 241-4151
Richard.Ford@insurance.alabama.gov

Corporate Amendments Apps:
Sean Duke
(334) 241-4165
Sean.Duke@insurance.alabama.gov

AK

Primary & Expansion Apps:
Alaska Division of Insurance
Insurance Financial Examiner
550 West 7th Avenue, Suite 1560
Anchorage, AK 99501-3567

Standard or Overnight Delivery
Use the above address for Anchorage

Corporate Amendments App:
Alaska Division of Insurance
Financial Reports and Audits Section
P.O. Box 110805
Juneau, AK 99811-0805
or
Overnight Delivery (Juneau-Only)
9th Floor, State Office Building
333 Willoughby
Juneau, AK 99801

Primary & Expansion Apps:
Douglas Hartman
(907) 269-7906
douglas.hartman@alaska.gov

Corporate Amendments Apps:
Jeff Bodine
(907) 465-4609
jeff.bodine@alaska.gov

*AZ

Arizona Department of Insurance
Financial Affairs Division
100 N. 15th Ave., Suite 261
Phoenix, AZ  85007-2630

Cary W. Cook
Chief Financial Compliance Officer
(602) 364-3986
ccook@azinsurance.gov

*AR

Arkansas Department of Commerce
Arkansas Insurance Department - Finance Division
1 Commerce Way, Suite 505
Little Rock, AR 72202-2087

Primary Apps and For Adding and Deleting Lines of Business (Domestics) only:
Kimberly S. Johnson, Finance Division
(501) 371-2680
kimberly.johnson@arkansas.gov

Expansion Apps and For Adding and Deleting Lines of Business (Foreign) only:
Kimberly S. Johnson, Finance Division
(501) 371-2680
kimberly.johnson@arkansas.gov

Corporate Amendment Apps:
Legal Division
(501) 371-2820
insurance.legal@arkansas.gov

*CA

California Department of Insurance
Corporate Affairs Bureau
1901 Harrison Street, 6th Floor
Oakland, CA 94612

Pacita Ganzon
(415) 538-4442
Pacita.ganzon@insurance.ca.gov

Imelda Siruno
(415) 538-4451
Imelda.siruno@insurance.ca.gov

*CO

Colorado Division of Insurance
1560 Broadway, Suite 850
Denver, CO 80202

Primary & Expansion Apps:
Cindy Hathaway
Director, Corporate Affairs
(303) 894-7836
cindy.hathaway@state.co.us

Corporate Amendments Apps:
Jacline Nguyen
Financial Examiner II
(303) 894-7475
Jacline.Nguyen@state.co.us

Service of Process:
Christine Gonzales-Ferrer
Compliace Specialist
christine.gonzales-ferrer@state.co.us

CT

State of Connecticut
Insurance Department
Financial Regulations Division
P.O. Box 816
Hartford, CT 06142-0816

Or overnight delivery to:
153 Market Street
Hartford, CT 06103

Company Licensing Section
(860) 297-3814
ctinsdept.financial@po.state.ct.us

DE

Delaware Department of Insurance
1351 West North St., Suite 101
Dover, DE 19904

Primary & Expansion and Corp. Amendments Apps:
Attn: BERG
(302) 674-7330
berg@delaware.gov

DC

Department of Insurance and
Securities Regulation
Attn:  Denise Parker
1050 First Street, NE, Suite 801
Washington, DC 20002

Denise Parker, Insurance Licensing Specialist
(202) 442-7815
denise.parker@dc.gov

Nathaniel Brown, Supervisory Ins. Examiner
(202) 442-7785
nathaniel.brown@dc.gov

FL

For all Life & Health Applications:
Primary, Expansion & Corporate Amendment Apps:
Office of Insurance Regulation
Applications Coordination Section
200 East Gaines Street
Tallahassee, Florida 32399-0326
lhappcoord@floir.com

For all Property & Casualty Applications:
Primary, Expansion & Corporate Amendment Apps:
Office of Insurance Regulation
Applications Coordination Section
200 East Gaines Street
Tallahassee, Florida 32399-0326
pcappcoord@floir.com

Contact:
Joe Erhart
Applications Coordinator – L&H
(850) 413-5066
joe.erhart@floir.com

 

Contact:
Patty Spudeck
Applications Coordinator – P&C
(850) 413-2578
patty.spudeck@floir.com

FL *Applications are required to be submitted electronically; either by utilizing the UCAA Electronic Application or by submitting directly through the Office’s Industry Portal select iApply-Online Company Admissions.
GA

Georgia Department of Insurance
Division of Insurance and Financial Oversight
2 Martin Luther King, Jr. Drive
Suite 604, West Tower
Atlanta, Georgia 30334

Primary Property & Casualty Applications contact:
Chris Taylor, Assistant Division Director
CTaylor@oci.ga.gov

Primary Life & Health Applications contact:
Scott Sanders, Assistant Division Director
SSanders@oci.ga.gov

Expansion Applications/Adding and Deleting LOB contact:
Kimnese Abdul-Salaam, Senior Financial Analyst
Kabdul-salaam@oci.ga.gov

Corporate Amendment Applications:
RegServices@oci.ga.gov

*HI

Primary, Expansion, and Corporate Amendment Applications:
State of Hawaii, Insurance Division
Department of Commerce and Consumer Affairs
Certification and Agency Examination Section
P. O. Box 3614
Honolulu, Hawaii 96811-3614

Or overnight delivery to:
State of Hawaii, Insurance Division
Department of Commerce & Consumer Affairs
Attn:  Certification & Agency Examination Section
335 Merchant Street, Room 213
Honolulu, Hawaii 96813

Expansion & Primary Apps:
Glenn Yamashita, Insurance Examiner II
Phone: (808) 586-8150
Email: gyamshi@dcca.hawaii.gov

Andrew Chow, Insurance Examiner
Phone: (808) 586-3874
Fax: (808) 586-3873
Email: achow@dcca.hawaii.gov

Corporate Amendment Apps:
Gale E. Miyazaki, Insurance Examiner
Phone: (808) 587-6741
Fax: (808) 586-3873
Email: gmiyazak@dcca.hawaii.gov

ID

Idaho Department of Insurance
Attn: Carol Anderson
700 W. State Street, 3rd Floor
Boise, Idaho 83720-0043

Primary & Expansion Apps and For Adding and Deleting Lines of Business:
Carol Anderson
Technical Records Specialist
(208) 334-4309
carol.anderson@doi.idaho.gov

Corporate Amendments App:
Michele Munoz
Technical Records Specialist
(208) 334-4311
michele.munoz@doi.idaho.gov

IL

Illinois Department of Insurance
320 West Washington
Springfield, IL 62767

Amy Stuart (Life & Health)
(217) 782-9694
Amy.stuart@illinois.gov

Marcy Savage (P&C)
(217) 524-0016
Marcy.Savage@illinois.gov

*IN

Indiana Department of Insurance
Financial Services Division
311 West Washington Street, Suite 300
Indianapolis, IN 46204-2787

Primary
Connie Wright (317) 232-1994
cowright1@idoi.in.gov

Expansion Apps:
Connie Wright (317) 232-1994
cowright1@idoi.in.gov

Corporate Amendment Apps:
Annette Gunter 317-232-2428
agunter@idoi.in.gov

Deposits
Britney Tate (317) 232-2383
btate@idoi.in.gov

IA

Iowa Insurance Division
Attn: Chris Chepsoi, Examiner
Two Ruan Center
601 Locust, 4th Floor
Des Moines, IA 50309-3738

Chris Chepsoi, Insurance Company Examiner Senior
(515) 281-4423
chris.chepsoi@iid.iowa.gov

KS

Kansas Insurance Department
1300 SW Arrowhead Road
Topeka, KS 66604

Primary & Expansion Apps:
Pat Mulvihill
Admissions Coordinator
(785) 296-5350
patrick.mulvihill@ks.gov

Deposit Administration:
Sarah K. Smith
Financial Analyst
(785) 296-7819
sarah.smith@ks.gov

Pat Mulvihill
Admissions Coordinator
(785) 296-5350
patrick.mulvihill@ks.gov

Corporate Amendments App:
Licia Haverkamp
Compliance Analyst
(785) 296-7062
licia.haverkamp@ks.gov

*KY

Kentucky Department of Insurance
Financial Standards & Examination Division
PO Box 517
Frankfort, KY 40602-0517

Primary and Expansion App’s.
Rodney Hugle, Asst. Director
(502) 564-6082 ext. 25256 
Rodney.hugle@ky.gov

Corporate Amendments App:
Gina Metts
Financial Standards and Examination Division 
(502) 782-5298
gina.metts@ky.gov

LA

Louisiana Department of Insurance
P.O. Box 94214
Baton Rouge, LA 70804-9214

Or overnight delivery to:
1702 3rd Street
Baton Rouge, LA 70802

Primary & Expansion Apps:
Tangela Byrd, Director
Office of Licensing
Company Licensing Division
(225) 342-5972
Fax: (225) 219-9322
tbyrd@ldi.la.gov

Expansion & Corporate Amendments Apps:
Tangela Byrd, Director
Office of Licensing
Company Licensing Division
(225) 342-5972
Fax: (225) 219-9322
tbyrd@ldi.la.gov

ME

Maine Bureau of Insurance
34 State House Station
Augusta, ME 04333-0034

Overnight/Physical delivery to:
Bureau of Insurance
76 Northern Avenue
Gardiner, ME 04345

Primary Applications:
Vanessa J. Sullivan, Director of Financial Regulation
(207) 624-8452
Vanessa.j.sullivan@maine.gov

Expansion Applications:
Lauri Cooper, Senior Examiner
(207) 624-8464
laurelyn.s.cooper@maine.gov

Corporate Amendment Applications:
Lauri Cooper, Senior Examiner
(207) 624-8464
laurelyn.s.cooper@maine.gov

MD

Maryland Insurance Administration
Company Licensing Unit
200 St. Paul Place, Suite 2700
Baltimore, Maryland 21202

Victoria Claros
Director of Company Licensing
(410) 468-2134
Victoria.claros@maryland.gov

MA

Commonwealth of Massachusetts Division of Insurance
Financial Surveillance and Insurance Licensing
1000 Washington Street, Suite 810
Boston, MA 02118-6200

Primary/Expansion/Corp. Amendment Apps:
John Turchi
Financial and Market Regulation
(617) 521-7701
john.turchi@state.ma.us

MI

Department of Insurance and Financial Services
Office of Insurance Evaluation
Mason Building, 7th Floor
530 W. Allegan Street
Lansing, MI 48933
            or
P.O. Box 30220
Lansing, MI  48909-7720

Linda L. Martin
(517) 284-8756
martinl@michigan.gov

*MN

Minnesota Department of Commerce
Insurance Division
85 7th Place East, Suite 280
St. Paul, MN 55101-2198

Judy Johnson
Application Coordinator
(651) 539-1760
Fax: (651) 539-1550
judith.johnson@state.mn.us

MS

Mississippi Insurance Department
P.O. Box 79
Jackson, MS  39205-0079

Or overnight delivery to:
1001 Woolfolk State Office Building
501 N. West Street
Jackson, MS 39201

Primary & Expansion Apps:
Chad T. Bridges, CFE
Chief Examiner
(601) 359-2136
Chad.Bridges@mid.ms.gov

Corp. Amendments Apps:
Nancy Cross
(601) 359-3571
Nancy.Cross@mid.ms.gov

MO

DIFP
Rm 530, HST Bldg.
301 W. High Street
Jefferson City, MO 65101

Cindy Monroe
Admissions Specialist
(573) 751-4362
Cynthia.Monroe@insurance.mo.gov

*MT

State of Montana
Insurance Department
840 Helena Avenue
Helena, MT 59601

Steve Matthews
(406) 444-4372
smatthews@mt.gov

Deleting Lines of Business and Foreign Withdrawal
Michelle Scaccia
(406) 444-4515
mscaccia@mt.gov

Montana Insurance Department
840 Helena, MT 59601

*NE

Nebraska Department of Insurance
Financial Examination Division
Attn: Kristy Hadden
1135 M St., Suite 300
Lincoln, NE  68508
OR
PO Box 82089
Lincoln, NE 68501-2089

Primary & Expansion Apps:
Kristy Hadden
Company Administrator
(402) 471-0373
Kristy.hadden@nebraska.gov

Corporate Amendments Apps:
Lori Bruss
Staff Assistant II
(402) 471-4045
lori.bruss@nebraska.gov

NV

Department of Business and Industry
Nevada Division of Insurance
Corporate & Financial Affairs
1818 East College Pkwy, Suite 103
Carson City, NV 89706

Primary & Expansion Applications
Laura O’Connor
(775) 687-0745
loconnor@doi.nv.gov

Corporate Amendment Applications
Kathy Kelley
(775) 687-0753
kkelley@doi.nv.gov

Special Deposits:
Denise Costello
(775) 687-0741
dcostello@doi.nv.gov

*NH

Financial Regulation Division
New Hampshire Insurance Department
21 S. Fruit St., Suite 14
Concord, NH 03301

Primary & Expansion & Corporate Amendment Applications
Lisa Cotter, Financial Records Auditor
603-271-2528

Lisa.Cotter@ins.nh.gov   
       

*NJ

Non Life/Health
New Jersey Department of
Banking and Insurance
Attn: Kwame Asare
P.O. Box 325
Trenton, NJ 08625-0325

Life/Health
New Jersey Department of
Banking and Insurance
Attn: June Duggan
P.O. Box 325
Trenton, NJ 08625-0325

Or overnight delivery to:
20 West State Street, 10th Floor
Trenton, NJ 08608

Non Life/Health
Attn: Kwame Asare
(609) 940-7408
Kwame.Asare@dobi.nj.gov

Life/Health
Matthew Lakatos
(609) 940-7454
Matthew.Lakatos@dobi.nj.gov

June Duggan
(609) 940-7410
June.duggan@dobi.nj.gov

All Corporate Amendments Applications
Kwame Asare
(609) 940-7408
Kwame.Asare@dobi.nj.gov

NM

Office of Superintendent of Insurance
Company Licensing Bureau
P.O. Box 1689
Santa Fe, NM 87504-1689

Or overnight delivery to:
1120 Paseo de Peralta, Room 439
Santa Fe, NM  87501

Victoria A. Baca
Company Licensing Bureau
(505) 827-4438
Victoriaa.baca@state.nm.us

Ursula Almada
Company Licensing Bureau
(505) 827-4524
Ursula.almada@state.nm.us

*NY

State of New York Department of Financial Services
Attn: Property Bureau
One Commerce Plaza
Albany, NY 12257

State of New York Department of Financial Services
Attn:  (Life, Health) Bureau*
One State Street
New York, NY 10004

Submit an additional original to:
Office of General Counsel
State of New York Department of Financial Services
One Commerce Plaza
Albany, NY 12257

*Submit to attention of proper bureau for the application business type.

Property
Brian Glaab
(518) 474-6628
Brian.glaab@dfs.ny.gov

Life
Victor Agbu
(212) 480-5040
Victor.agbu@dfs.ny.gov

Health
Warren Youngs
(212) 480-3883
Warren.youngs@dfs.ny.gov

Tom Dudek
(212) 480-5037
Thomas.dudek@nfs.ny.gov

*NC

Primary/ Expansion/ Corporate Amendments Apps:
North Carolina Department of Insurance
Financial Analysis & Receivership Division
1203 Mail Service Center
Raleigh, NC 27699-1203

Or overnight delivery to:
325 N. Salisbury Street
Raleigh, NC  27603

Primary & Expansion Apps:
Attn: Joseph Greene
(919) 807-6182

joseph.greene@ncdoi.gov

Corporate Amendments:
Attn: Sue Ann Webster
Corporate Records Administrator
(919) 807-6164
sueann.webster@ncdoi.gov

ND

North Dakota Insurance Department
Company Licensing
600 E. Boulevard Ave, Dept. 401
Bismarck, ND 58505

Company Licensing and Examinations Division
North Dakota Insurance Department
600 East Boulevard Ave., Dept. 401
Bismarck, ND 58505-0320
(701) 328-2440
colicexam@nd.gov

OH

Ohio Department of Insurance
Office of Risk Assessment
50 W. Town Street, Suite 300
Columbus, OH 43215

Primary & Expansion Apps:
Cameron Piatt
Assistant Chief-Taxes, Admissions and Foreign Analysis
Office of Risk Assessment
(614) 728-1074
Cameron.Piatt@insurance.ohio.gov

Corporate Amendment Apps:
Office of Risk Assessment
(614) 644-2647
risk.assessment@insurance.ohio.gov

*OK

Primary and Expansion Applications – Fee $1,160
Oklahoma Insurance Department
Attn: Financial Division
400 NE 50th Street

Oklahoma City, OK 73105
Division Phone: 405-521-6648
Division Fax: 405-522-2640 or 405-522-4160
Contact Updates – No fee
UCAA Form 14 – Please file electronically through the amendment application portal.

Primary/Expansion Applications
Jacob Kennedy
Financial Analyst
(405) 521-6607
job.kennedy@oid.ok.gov

Corporate Amendments/Statutory Deposits
Michael Parrott
Financial Analyst
(918) 295-3711
Michael.parrott@oid.ok.gov

OR

Oregon Department of Consumer & Business Services
Division of Financial Regulation
350 Winter Street NE
Salem, Oregon 97301-3883

Lauren Bodine
(503) 947-7225
Lauren.N.Bodine@oregon.gov

PA

Pennsylvania Insurance Department
Company Licensing Division
1345 Strawberry Square
Harrisburg, PA 17120

Cressinda Bybee, Chief
Company Licensing Division
(717) 783-2144
cbybee@pa.gov
or
ra-in-companylicense@pa.gov

PR

Mailing Address:
B5 Tabonuco Street Suite 216 PMB 356
Guaynabo, PR 00968-3029

Street Address:
Edificio World Plaza
268 Muñoz Rivera Avenue
San Juan, PR 00918

Primary, Expansion and Corporate Amendments Apps:

Mrs. Glorimar Santiago
Interim Director
Admissions and Financial Analysis Division
(787) 304-4400
gsantiago@ocs.gobierno.pr

RI

RI Insurance Division
1511 Pontiac Avenue, Bldg. 69-2
Cranston, RI 02920

Primary Apps:
Jack Broccoli
Associate Director
Rhode Island Insurance Division
(401) 462-9606
Jack.broccoli@dbr.ri.gov

Expansion Apps:
Petr Petrik
(401) 462-9634
petr.petrik@dbr.ri.gov

Corporate Amendment Apps:
Debra Almeida
(401) 462-9452
Debra.almeida@dbr.ri.gov

SC

South Carolina Department of Insurance
Michael Shull, Chief Financial Analyst
1201 Main St., Suite 1000
Columbia, SC 29201
Or:
P.O. Box 100105
Columbia, SC 29202-3105

Primary Apps:
Michael Shull
Chief Financial Analyst
(803) 737-6188
mshull@doi.sc.gov

Expansion Apps:
Ryan Basnett
(803) 737-6114
rbasnett@doi.sc.gov

Corporate Amendment Apps:
Stacy Johnson
(803) 737-6221
sjohnson@doi.sc.gov

SD

South Dakota Division of Insurance
124 S. Euclid Ave, 2nd FL
Pierre, SD 57501

Patsy Madsen
Company Licensing Specialist
(605) 773-3563
Patsy.madsen@state.sd.us

TN

Tennessee Department of Commerce and Insurance
Attn:  Phil Adams
500 James Robertson Parkway
7th Floor, Analytical Section
Nashville, TN 37243-0576

Phil Adams
(615) 741-6152
Phil.adams@tn.gov

TX

Texas Department of Insurance
Company Licensing and Registration
MC 103-CL
333 Guadalupe
Austin, TX 78701

Company Licensing and Registration Office
(512) 676-6385
General Inquiries: CompanyLicense@tdi.texas.gov
Submit Filings to: CLRFilings@tdi.texas.gov or via UCAA electronic application process

UT

Utah Insurance Department
Examination Division
3110 State Office Building
Salt Lake City, UT 84114

Jay Sueoka
Company Licensing Manager
(801) 538-3814
jsueoka@utah.gov

Dava Neal
(801) 538-3812
dneal@utah.gov 

VT

Department of Financial Regulation, Insurance Division
Company Licensing Section
89 Main Street
Montpelier, VT 05620

Company Licensing Section
(802)828-2470
Dfr.complic@vermont.gov

VA

Virginia State Corporation Commission
Bureau of Insurance
P.O. Box 1157
Richmond, VA 23218

Or Overnight Delivery to:
Tyler Building
1300 E. Main Street
Richmond, VA 23219

Primary & Expansion Apps:
Jim Ware
Principal Insurance Financial Analyst
Company Licensing & Regulatory Compliance
(804) 371-9801
Jim.Ware@scc.virginia.gov

Corporate Amendments Apps:
Gayle Henderson
Office Supervisor
(804) 371-9869
Gayle.Henderson@scc.virginia.gov

WA

Washington State Office of the Insurance Commissioner
P.O. Box 40255
Olympia, WA 98504-0255

Or Overnight delivery to:
5000 Capitol Blvd. SE
Tumwater, WA 98501

Primary & Expansion Apps:
Ron Pastuch
(360) 725-7211
RonP@oic.wa.gov

Corporate Amendments Apps:
Mark Durphy
(360) 725-7193
markd@oic.wa.gov

WV

WV Offices of the Insurance Commissioner
Financial Conditions Division
P.O. Box 50540
Charleston, WV 25305-0540

Financial Conditions Division
(304) 558-2100
oicfinancialconditions@wv.gov

*WI

Office of the Commissioner Of Insurance
P.O. Box 7873
Madison, WI 53707-7873

Or Overnight delivery to:
Office of the Commissioner of Insurance
125 South Webster Street
Madison, WI  53703

Primary Applications:
Michael Mancusi-Ungaro
(608) 267-4555
Michael.MancusiUngaro@wisconsin.gov

Expansion Applications:
Robert McLaughlin
(608) 267-8625

Robert.McLaughlin@wisconsin.gov

Corporate Amendments Applications:
Suzanne Vinmans
(608) 266-9891
suzanne.vinmans@wisconsin.gov

WY

Wyoming Dept. of Insurance
106 East 6th Avenue
Cheyenne, WY 82002

Primary & Expansion Apps:
Samantha Sullivant
Accountant
(307) 777-7318
samantha.sullivant@wyo.gov

G. Douglas Melvin
Chief Examiner
(307) 777-5619
doug.melvin@wyo.gov

Corporate Amendments Apps:
Kristi Alma Jose
(307) 777-7401
kristi.almajose@wyo.gov

G. Douglas Melvin
Chief Examiner
(307) 777-5619
doug.melvin@wyo.gov

 

 

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