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Fingerprint and Biographical Affidavit Requirements - Industry UCAA
Fingerprint and Biographical Affidavit Requirements

A link to the Application instructions for Primary Application, Section II, Filing Requirement Item 13;  Expansion Application, Section II, Filing Requirement Item 12; and Corporate Amendment Application Section V, Filing Requirement Item 9 and Section VI, Filing Requirement Item 6.

Group cover letters can be submitted with Biographical affidavits that are used for officer/director changes and for expansion and corporate amendment applications (The affiant and notary signatures on the biographical affidavit  must be within 6 months of the date of submission) for companies listed on the group cover letter and are under the same group code. Only the NAIC cover letter can be submitted with a UCAA. Unless otherwise noted below all uniform states accept the group cover letter when a biographical affidavit is required.

Last Updated: 11/16/2022
Updates to the information will be noted with a “ * ” next to the state name and edits will be italicized and bolded. 

State

Domiciliary Requirements
Licensure (Primary) and

After Licensure

Non-Domestic Requirements
For Licensure 
(Expansion) OR
Corporate Amendment Application

Non-Domestic Requirements
After Licensure 
(Updates only)

State Contact Information
AL

Licensure: NAIC Biographical Affidavit AND Independent Third-Party Verification
After Licensure: NAIC Biographical Affidavits are required for changes in Officers, Directors or Key Managerial Personnel.
Disclaimer of Control: Allowed

NAIC biographical affidavit and Independent Third-Party Verification.

If requested a NAIC biographical affidavit is required for new officers/directors of foreign insurers, within 15 days of request.

Biographical Affidavit and Third-Party Verification Reports: 
admissions@insurance.alabama.gov
AK

Licensure: NAIC Biographical Affidavit and Independent Third-Party Verification
After Licensure: NAIC Biographical Affidavits are not required.
Disclaimer of Control: Allowed

NAIC Biographical Affidavit and Independent Third-Party Verification
NOTE: Verification reports should be sent to the state at the time of submission of the application. Reports received without an application pending will be destroyed.

NAIC biographical affidavit is not required for new officers or directors.
 

Biographical Affidavit: 
Primary, Expansion Applications/Redomestications:
Jeffery Bethel
P: (907) 269-7919
F: (907) 269-7898
jeffery.bethel@alaska.gov

Corporate Amendments Applications:
Kevin Richard
P: (907) 269-7903
F: (907) 269-7910
kevin.richard@alaska.gov

Third-Party Verification Reports:
Secure email to:
jeffery.bethel@alaska.gov
kevin.richard@alaska.gov
OR
Mail to:
Alaska Division of Insurance
550 W 7th Avenue, Suite 1560
Anchorage, AK 99501-3567

AZ

Licensure: NAIC Biographical Affidavit AND Independent Third-Party Verification
After Licensure: NAIC Biographical Affidavits are required for changes in Officers, Directors or Key Managerial Personnel.
Disclaimer of Control: Allowed

NAIC Biographical Affidavit AND Independent Third-Party Verification.

NAIC Biographical Affidavit is not required for new officers or directors.

Biographical Affidavit
Erica Bowsher erica.bowsher@difi.az.gov

Third-Party Verification Reports:
financialfilings@difi.az.gov

AR

Licensure: NAIC Biographical Affidavit and Independent Third-Party Verification.
After Licensure: NAIC Biographical Affidavits are required for changes in Officers, Directors or Key Managerial Personnel.
Disclaimer of Control: Not Allowed

NAIC Biographical Affidavit and Independent Third-Party Verifications.

NAIC Biographical Affidavits are not required for new officers or a director, assuming the domestic state is reviewing changes.

Biographical Affidavit and Third-Party Verification Reports:
Kimberly Johnson
Insurance.Finance@arkansas.gov 

CA

Licensure (Primary): Fingerprints and NAIC Biographical Affidavits.  Please contact California's Department of Insurance directly at (415) 538-4035 to request the necessary fingerprint live scan
After Licensure: NAIC Biographical Affidavits are required for changes in Officers, Directors or Key Managerial Personnel.
Disclaimer of Control: Allowed

NAIC Biographical Affidavit and Fingerprint live scans, please contact California's Department of Insurance directly at (415) 538-4035 to request the necessary fingerprint live scan, forms and information.

NAIC Biographical Affidavit and Finger print live scan is required for new officers, directors within a reasonable time.

Biographical Affidavit: 
CAB-SF-Intake@insurance.ca.gov or
415-538-4035

Third-Party Verification Reports:
Not Applicable - State Completes

CO

Licensure: NAIC Biographical Affidavit, Fingerprints and Independent Third-Party Verification. 
After Licensure: NAIC Biographical Affidavits are required for changes in Officers, Directors or Key Managerial Personnel.
Disclaimer of Control: Allowed

NAIC Biographical Affidavits and Independent Third-Party Verification reports for all foreign companies.

NAIC Biographical Affidavit is not required for new officers or directors.

Biographical Affidavit and Third-Party Verification Reports:
Cindy Hathaway
dora_ins_corporateaffairs@state.co.us
 
CT

Licensure: NAIC Biographical Affidavits and Independent Third-Party Verification.
After Licensure: NAIC Biographical Affidavits are required when there is a change in Officers, Directors or Key Managerial Personnel.
Disclaimer of Control: Not Allowed

Expansion: NAIC Biographical Affidavits and Independent Third-Party Verification.
License/Corporate Amendment: NAIC Biographical Affidavits are required for new officers/directors if not previously provided.

A NAIC Biographical Affidavit is required for new officers/directors as soon as possible.

Biographical Affidavit: 

Third-Party Verification Reports:

DE

Licensure: NAIC Biographical Affidavit and Third-Party Verification.
After Licensure: NAIC Biographical Affidavits are required for changes in Officers, Directors or Key Managerial Personnel.
Disclaimer of Control: Not Allowed

NAIC Biographical Affidavit.

NAIC biographical affidavit is not required for new officers or directors. A letter of notification is required for any changes in officers submitted electronically to berg@delaware.gov within 60 days of change. Include NAIC number, business address, phone number, email address. 

Biographical Affidavit: 

Third-Party Verification Reports:

*DC

Licensure: NAIC Biographical Affidavits and Independent Third-Party Verification.
After Licensure: NAIC Biographical Affidavits are required for changes in Officers, Directors or Key Managerial Personnel.
Disclaimer of Control: Allowed

NAIC Biographical Affidavit and Independent Third-Party Verification

NAIC biographical affidavit is not required for new officers or directors.

Biographical Affidavit and Third-Party Verification Reports:
Nathaniel Kevin Brown
Director - Financial Examinations, Insurance Bureau
Department of Insurance, Securities and Banking
1050 First Street, NE, Suite 801
Washington, DC 20002
Telephone (202)442-7785 
Nathaniel.Brown@dc.gov
FL

Licensure: NAIC Biographical Affidavit, Independent Third-Party Verification and Fingerprint Cards (Fingerprint LiveScan available for Florida Residents Only). Refer to State Specific Requirements for Fingerprint Procedures. Please contact the Office of Insurance Regulation at (850) 413-2575 to request the necessary fingerprint cards or FPRequest@floir.com. Effective August 16, 2007, Florida no longer requires credit reports with the background investigations.
Disclaimer of Control: Allowed

NAIC Biographical Affidavit, Independent Third-Party Verification and Fingerprint Cards (Fingerprint LiveScan available for Florida Residents Only). Refer to State Specific Requirements for Fingerprint Procedures. Please contact the Office of Insurance Regulation at (850) 413-2575 to request the necessary fingerprint cards or FPRequest@floir.com. Effective August 16, 2007, Florida no longer requires credit reports with the background investigations.

A NAIC biographical affidavit is required for new key officers.
 

Biographical Affidavit: 
Life & Health Companies:
Joe Erhart, Applications Coordinator
Phone 850-413-5066
Email joe.erhart@floir.com)

Property & Casualty Companies:
Patty Spudeck
Applications Coordinator
Phone 850-413-2578 
Email patty.spudeck@floir.com 

Third-Party Verification Reports:
bkgrnd-inv@floir.com

*GA

Licensure: NAIC Biographical Affidavit and Independent Third-Party Verification
After Licensure: NAIC Biographical Affidavit and Independent Third-Party Verification report are required for changes in Officers, Directors or Key Managerial Personnel.
Disclaimer of Control: Not Allowed

NAIC Biographical Affidavit and Independent Third-Party Verification

Contact state for requirements.

Biographical Affidavit: 
RegServices@oci.ga.gov

Third-Party Verification Reports:
RegServices@oci.ga.gov and 
pcoppel@oci.ga.gov

HI

Licensure: NAIC Biographical Affidavit and Independent Third-Party Verification
After Licensure: A NAIC Biographical Affidavit and Independent Third-Party Verification report is required for changes in Officers, Directors or Key Managerial Personnel.
Disclaimer of Control: Allowed

NAIC Biographical Affidavit and Independent Third-Party Verification

NAIC Biographical Affidavit is required for new Officers when filing for Mergers and Acquisitions only.

Biographical Affidavit and Third-Party Verification Reports:
I
rene Baek
Insurance Examiner
State of Hawaii Department of Commerce & Consumer Affairs
Insurance Division
335 Merchant Street, Room 213, Honolulu, HI 96813
Email: ibaek@dcca.hawaii.gov
(808) 586-8151
ID

Licensure: NAIC Biographical Affidavit and Independent Third-Party Verification
After Licensure: NAIC Biographical Affidavit and Independent Third-Party Verification report is required for changes in Officers, Directors or Key Managerial Personnel.
Disclaimer of Control: Not Allowed

NAIC Biographical Affidavit and Independent Third-Party Verification

A NAIC Biographical Affidavit and Independent Third-Party Verification report is not required for new Officers or Directors provided the company files annual and quarterly financial statements electronically with the NAIC. Foreign insurers licensed in Idaho are not required to file separate notices of changes in officers and directors.

Biographical Affidavit and Third-Party Verification Reports:
companyactivities@doi.idaho.gov
IL

Licensure: NAIC Biographical Affidavits with original signatures required for all domestic companies’ Officers and Directors.  Independent Third-Party Verification Reports are required for all Officers and Directors. 
After Licensure: NAIC Biographical Affidavits with original signatures are required for changes in Officers or Directors; Independent Third-Party Verification are required for new Officers or Directors. Notification of a change in officers or directors is required within 30 days.
Disclaimer of Control: Not Allowed

NAIC Biographical Affidavits for all foreign companies (original signatures for Expansion Applications). Independent Third-Party Verification Reports are required for each Officer and Director of the applicant.   

NAIC Biographical Affidavit is required for new officers or directors. Notification of a change in officers or directors is required within 30 days.  Independent Third-Party Verifications are required for new officers and directors.

Biographical Affidavit: 
Property/Casualty Companies:
Amy Trader
amy.trader@illinois.gov

Life, Accident & Health Companies:
Pearl Stanulis
pearl.stanulis@illinois.gov

Third-Party Verification Reports:
Mail to:
320 West Washington
Springfield, IL 62767

IN

Licensure: Indiana Biographical Affidavits with electronic signature which complies with the electronic transaction act (IETA)   (IC 26-2-8-108) and Independent Third-Party Verification required for all domestic companies
After Licensure: Electronically signed Indiana Biographical Affidavits are required for changes in Officers, Directors or Key Managerial Personnel.
Disclaimer of Control: Allowed

Indiana Biographical Affidavits with electronic signature which complies with electronic transaction act (IETA) (IC 26-2-8-108) and Independent Third-Party Verification.

Note: Electronic signatures from commercially available software, such as Docusign or Esign, are acceptable. “Check the Box” signatures or “Rubber Stamp” signatures Do Not Comply.

Notification of a change in officers or directors is required within 30 days.

An Indiana Biographical Affidavits and Independent Third-Party Verification upon request for new officers or directors.

Biographical Affidavit: 

Third-Party Verification Reports:

IA

Licensure: NAIC Biographical Affidavit and Independent Third-Party Verification
After Licensure: Biographical Affidavits are required for changes in Officers, Directors or Key Managerial Personnel.
Disclaimer of Control: Allowed

NAIC Biographical Affidavit and Independent Third-Party Verification.

NAIC Biographical Affidavit is not required for new Officers or Directors.

Biographical Affidavit and Third-Party Verification Reports:
Shelby Hollett
shelby.hollett@iid.iowa.gov
or
Iowa Insurance Division Attn: Shelby Hollett 1963 Bell Avenue Des Moines, Iowa 50315
KS

Licensure: NAIC Biographical Affidavit and Independent Third-Party Verification.
After Licensure: NAIC Biographical Affidavit for changes in Officers and Directors as listed on page one of the annual statement within 30 days after the changes or actions become effective or are otherwise finalized.
Disclaimer of Control: Allowed

Expansion - NAIC Biographical Affidavit and Independent Third- Party Verification.

NAIC  Biographical Affidavit is not required for new Officers and Directors. Notification required via the Kansas Insurance Department Company Desktop system of any change in President or Corporate Secretary.

Biographical Affidavit and Third-Party Verification Reports:
Patrick J. Mulvihill, FLMI
Admissions Coordinator/Principal Financial Analyst
Kansas Insurance Department
patrick.mulvihill@ks.gov
785-296-5350

Third-party background reports should be sent electronically (via e-mail) to the following state contact:
Patrick J. Mulvihill, FLMI
patrick.mulvihill@ks.gov

KY

Licensure: NAIC Biographical Affidavit and Independent Third-Party Verification
After Licensure: Biographical Affidavits are required for changes in Officers, Directors or Key Managerial Personnel.
Disclaimer of Control: Allowed
Group Cover Letter: Not Acceptable

NAIC Biographical Affidavit and Independent Third-Party Verification.

NAIC Biographical Affidavit is required for new President’s only, within 30 days.

Biographical Affidavit and Third-Party Verification Reports:
Gina Metts
Gina.Metts@ky.gov
LA

Licensure: Complete Biographical Affidavits (Form 11) on most current form for all Officers and Directors. Independent Third-Party Verifications required for all Officers and Directors. Domestic applicants must submit fingerprints in compliance with the state requirements. More information on fingerprint requirements at http://www.ldi.la.gov/industry/company-licensing/application-forms/ucaa/primary-application.
Disclaimer of Control: Allowed

Expansion Application: Complete Biographical Affidavits (Form 11) on most current form for all Officers and Directors. Independent Third-Party Verifications required for all Officers and Directors.
Corporate Amendment Applications: Complete Biographical Affidavits (Form 11) on any new Officers and Directors added as a result of the transaction.

Completed Biographical Affidavits (Form 11) on the most current form must be submitted for all “Senior Officers” as defined by state law and for all Directors within sixty days of election or appointment. Independent Third-Party Verifications are not required. For information on how to file see http://www.ldi.la.gov/industry/company-licensing/new-officers-and-directors-for-foreign-and-alien-insurers.

Biographical Affidavit and Third-Party Verification Reports:
Tangela Byrd
Insurance Manager
Louisiana Department of Insurance
1702 North 3rd Street (70802)
P.O. Box 94214
Baton Rouge, LA 70804-9214
Tangela.Byrd@ldi.la.gov
ME

Licensure: NAIC Biographical Affidavits and Independent Third-Party Verification.
After Licensure: NAIC Biographical Affidavits are required for new Officers, Directors or Key Managerial Personnel.
Disclaimer of Control: Not Allowed

NAIC Biographical Affidavit and Independent Third-Party Verification.

NAIC Biographical Affidavit is NOT required for new Officers or Directors.  Letter of notification for changes/updates is also NOT required.

Biographical Affidavit and Third-Party Verification Reports:
Lauri Cooper
laurelyn.s.cooper@maine.gov
or
USPS Mailing Address (incl. overnight express)
34 State House Station
Augusta, ME  04333

Physical Delivery Address (such as FedEx and UPS)
76 Northern Ave. 
Gardiner, ME  04345

MD

Licensure: NAIC Biographical Affidavits and Independent Third-Party Verification.
After Licensure: NAIC Biographical Affidavits with original signatures are required for changes in Officers, Directors. Independent Third-Party Verifications are required for new Officers or Directors. Notification of a change in Officers or Directors is required within 3-days.
Disclaimer of Control: Not Allowed

NAIC Biographical Affidavit certified by Independent Third-Party Verification.

NAIC Biographical Affidavit is not required for new Officers or Directors.

Biographical Affidavit and Third-Party Verification Reports:
Victoria Claros
Mailing address:
Maryland Insurance Administration
200 St. Paul Place, Suite 2700
Baltimore, Maryland 21202

Email address: Colicensing.mia@maryland.gov

MA

Licensure:  NAIC Biographical Affidavit and Independent Third-Party Verifications
After Licensure: NAIC Biographical Affidavits are required for changes in Officers, Directors or Key Managerial Personnel.
All questions should be directed to companies.mailbox@mass.gov.
Disclaimer of Control: Allowed, pending consideration

NAIC Biographical Affidavit required for Officers and Directors of all Applicant Companies.

NAIC Biographical Affidavits are not required for new Officers and Directors of foreign companies. In lieu of biographies a letter of notification is required for any changes in Officers or Directors submitted electronically to Companies.Mailbox@Mass.gov

Biographical Affidavit: 
companies.mailbox@mass.gov

Third-Party Verification Reports: 
Not Required

MI

Licensure: NAIC Biographical Affidavit and Independent Third-Party Verification.
After Licensure: NAIC Biographical Affidavit and Independent Third-Party Verification are required for changes in Officers, Directors or Key Managerial Personnel.
Disclaimer of Control: Allowed

Expansion: NAIC Biographical Affidavits and Independent Third-Party Verifications are required.
Corporate Amendments: NAIC Biographical Affidavits and Independent Third-Party Verifications are NOT required.

NAIC Biographical Affidavits and Independent Third-Party Verifications are NOT required.

Biographical Affidavit and Third-Party Verification Reports:
Linda Martin, Application Coordinator, 517-284-8756 or martinl@michigan.gov

If reports cannot be sent electronically, hard copies should be sent to:
Linda Martin, Application Coordinator
Michigan Department of Insurance and Financial Services
Office of Insurance Evaluation
P. O. Box 30220
Lansing, MI 48909
OR
530 W. Allegan St., 7th Fl.
Lansing, MI 48933

MN

Licensure:  NAIC Biographical Affidavit and Independent Third-Party Verifications are required for Primary Applications. Signatures must be original.
After Licensure: Only the Biographical Affidavit is required.
Disclaimer of Control: Not Allowed

NAIC Biographical Affidavit and Independent Third-Party Verifications are required for Expansion Applications only. Signatures must be original.

NAIC Biographical Affidavit and Independent Third-Party Verifications are not required for new officers and directors.

Biographical Affidavit: 
Jenn Gagner, Applications Coordinator or Jennifer Price, Licensing Director, at companylic.commerce@state.mn.us

Third-Party Verification Reports:
Send to Jenn Gagner, Applications Coordinator at companylic.commerce@state.mn.us

MS

Licensure:  NAIC Biographical Affidavit and Independent Third-Party Verifications are required for Primary Applications. Signatures must be original.
After Licensure: Only the Biographical Affidavit is required.
Disclaimer of Control: Not Allowed

NAIC Biographical Affidavit

NAIC Biographical Affidavit is not required for new Officers or Directors. A letter of notification is required for any changes in Officers or Directors submitted electronically to filings@mid.ms.gov.

Biographical Affidavit: 
Chad Bridges
Email: Chad.Bridges@mid.ms.gov Phone #: 601-359-2136

Third-Party Verification Reports:
Electronic Method Preferred: Email: filings@mid.ms.gov or Chad.Bridges@mid.ms.gov

MO

Licensure: NAIC Biographical Affidavit and Independent Third-Party Verification.
Disclaimer of Control: Allowed, but must be submitted as a separate filing for consideration

NAIC Biographical Affidavit and Independent Third-Party Verification.

NAIC Biographical Affidavits are not required for new Officers or Directors.  A letter of notification is required for any changes in Officers and Directors submitted to the Admissions Specialist. 

Biographical Affidavit: 
InsuranceSolvency@insurance.mo.gov
(573)526-4877

Third-Party Verification Reports:
Third party verification reports should be sent in a secure fashion.  We prefer to establish box accounts where the vendors can upload the reports.  Each box account is specific to the vendor.  Contact our Division at InsuranceSolvency@insurance.mo.gov to set up an account.    

MT

Licensure: NAIC Biographical Affidavit
After Licensure: NAIC Biographical Affidavits are required for changes in Officers, Directors or Key Managerial Personnel.
Disclaimer of Control: Allowed

NAIC Biographical Affidavit

Group Cover Letter: Not Acceptable

NAIC Biographical Affidavit is not required for new Officers or Directors.

Biographical Affidavit and Third-Party Verification Reports:
Kari Leonard 
kleonard2@mt.gov 
406-444-2895

NE

Licensure: NAIC Biographical Affidavit and Independent Third-Party Verification.
After Licensure: NAIC Biographical Affidavits are required for changes in Officers, Directors or Key Managerial Personnel.
Disclaimer of Control: Not Allowed

NAIC Biographical Affidavit and Independent Third-Party Verification.

NAIC Biographical Affidavit is not required for new Officers or Directors.

Biographical Affidavit and Third-Party Verification Reports:
Lori Bruss 
lori.bruss@nebraska.gov
*NV

Licensure: NAIC Biographical Affidavit and Independent Third-Party Verification
After Licensure: NAIC Biographical Affidavits and Independent Third-Party Verifications are required for changes in Officers, Directors and Key Managerial Personnel.
Disclaimer of Control: Allowed

Expansion: Listing of Officers, Directors and Key Managerial Personnel.

Listing required within 90 days, indicating new Officers, Directors and Key Managerial Personnel.

Biographical Affidavit and Third-Party Verification Reports:
finances@doi.nv.gov
*NH

Licensure: NAIC Biographical Affidavit
After Licensure: NAIC Biographical Affidavits are required for changes in Officers, Directors or Key Managerial Personnel.
Disclaimer of Control: Allowed

NAIC Biographical Affidavit

NAIC Biographical Affidavit is not required for new Officers or Directors.

Biographical Affidavit and Third-Party Verification Reports:
linda.m.zalinskie@ins.nh.gov
NJ

Primary and After Licensure P&C:  NAIC Biographical Affidavit and criminal history record check by the New Jersey State Police. Contact the Department to request the necessary forms (Solvency Regulation 609-292-5350).
Primary and After Licensure L&H: NAIC Biographical Affidavit and Independent Third-Party Verification.
Disclaimer of Control: Not Allowed

P&C: NAIC Biographical Affidavit
L&H: NAIC Biographical Affidavit and Independent Third-Party Verification.

P&C and L&H: NAIC Biographical Affidavit and a letter of notification is required for any changes in Officers or Directors.

Biographical Affidavit and Third-Party Verification Reports:
June Duggan
june.duggan@dobi.nj.gov

NM

Licensure: NAIC Biographical Affidavit and Independent Third-Party Verification.
After Licensure: NAIC Biographical Affidavits submitted in hard copy for changes in Officers/Directors.
Disclaimer of Control: Not Allowed

NAIC Biographical Affidavit and Independent Third-Party Verification

A letter of notification is required for any changes in Officers and Directors.

Biographical Affidavit and Third-Party Verification Reports:
​​​​​Ursula Almada
Ursula.Almada@state.nm.us

Victoria Baca
Victoriaa.Baca@state.nm.us

NY

Licensure: NAIC Biographical Affidavit and fingerprints, fingerprinting Instructions: https://www.dfs.ny.gov/apps_and_licensing/
fingerprinting_procedure

Disclaimer of Control: Not Allowed

NAIC Biographical Affidavit and Fingerprint Cards

Fingerprinting Instructions:
https://www.dfs.ny.gov/apps_and_licensing/
fingerprinting_procedure

Contact State for Requirements.

Fingerprinting Instructions: https://www.dfs.ny.gov/apps_and_licensing/
fingerprinting_procedure

Biographical Affidavit: 

Property and Casualty Insurers  
PropertyInsuranceCompanyLicensingUnit@dfs.ny.gov
Life Insurers – Agbu, Victor (DFS)
Victor.Agbu@dfs.ny.gov
Health Insurers
HealthBureauRegulatory@dfs.ny.gov

Third-Party Verification Reports:
Not Applicable

NC

Licensure: NAIC Biographical Affidavit and Fingerprint Cards
After Licensure: NAIC Biographical Affidavits are required for changes in Officers, Directors or Key Managerial Personnel.
Disclaimer of Control: Allowed

NAIC Biographical Affidavit

NAIC Biographical Affidavit is not required for new Officers or Directors.

Biographical Affidavit and Third-Party Verification Reports:
Scott Wicker
Scott.Wicker@ncdoi.gov
919-807-6142

Third-Party Verification reports are not required by North Carolina, however, in the event the company chooses to send the reports, send to Scott Wicker. 

ND

Licensure: NAIC Biographical Affidavit and Independent Third-Party Verification
After Licensure: NAIC Biographical Affidavits are required for changes in Officers, Directors or Key Managerial Personnel.
Disclaimer of Control: Not Allowed

Expansion: NAIC Biographical Affidavit and Independent Third-Party Verification

Group Cover Letter: Not Acceptable

NAIC Biographical Affidavit is not required for new Officers or Directors.

Biographical Affidavit: 
​​​Matt Fischer
mattfischer@nd.gov 
or
Nichole Feldman
nrfeldman@nd.gov

Third-Party Verification Reports:
colicexam@nd.gov

OH

Licensure: NAIC Biographical Affidavit and Independent Third-Party Verification
After Licensure: NAIC Biographical Affidavits are required for changes in Officers, Directors or Key Managerial Personnel.
Disclaimer of Control: Allowed

NAIC Biographical Affidavit and Independent Third-Party Verification

NAIC Biographical Affidavit is not required for new Officers or Directors.

Biographical Affidavit and Third-Party Verification Reports:

Cam Piatt
clyde.piatt@insurance.ohio.gov 
614 728-1074

OK

Licensure: NAIC Biographical Affidavit and Independent Third-Party Verification – no fingerprints.
After Licensure: NAIC Biographical Affidavits and Independent Third-Party Verifications are required for changes in Officers, Directors or Key Managerial Personnel.
Disclaimer of Control: Not Allowed, would have to be submitted as a separate filing

Expansion:  NAIC Biographical Affidavit and Independent Third-Party Verification is required – no fingerprints.
Corporate Amendment:  Oklahoma will rely on the review of Biographical Affidavits by the domiciliary regulator; therefore no NAIC Biographical Affidavit will be required for new Officers or Directors of foreign/alien companies.

Informational filing only written on company letterhead.  Oklahoma will rely on the review of Biographical Affidavits by the domiciliary regulator; therefore no NAIC Biographical Affidavit will be required for new Officers or Directors of foreign/alien companies.  A PDF copy of the letter can be emailed to UCAA@oid.ok.gov to eliminate paper and postage. 

Biographical Affidavit and Third-Party Verification Reports:
Kayla Lowe-Whitlow UCAA@oid.ok.gov for Insurers.Jeanette Pearce RIS@oid.ok.gov for Regulated Industries and

 

OR

Licensure:  Biographical Affidavit
After Licensure: NAIC Biographical Affidavits are required for changes in Officers, Directors or Key Managerial Personnel.
Disclaimer of Control: Not Allowed

Biographical Affidavit for all Officers and Directors of the company as listed on the jurat page of the filed statement.

NAIC Biographical Affidavit is not required for new Officers or Directors.

Biographical Affidavit and Third-Party Verification Reports:
Email: orinsreg.ins@dcbs.oregon.gov 
Phone number: 503-947-7982
PA

Licensure:  NAIC Biographical Affidavit
After Licensure: NAIC Biographical Affidavits are required for changes in Officers, Directors or Key Managerial Personnel.
Disclaimer of Control: Allowed

NAIC Biographical Affidavit

Neither NAIC Biographical Affidavits nor any other notification is required for new Officers or Directors of admitted foreign insurers.

Biographical Affidavit: 
Diana L. Sherman
Director, Company Licensing & Analysis
1345 Strawberry Square
Harrisburg, PA 17120
Phone: 717.503.5462
Email: disherman@pa.gov

Third-Party Verification Reports:
Not Required

PR

Licensure: NAIC Biographical Affidavit and Independent Third-Party Verification
After Licensure: NAIC Biographical Affidavits are required for changes in Officers, Directors or Key Managerial Personnel.
Disclaimer of Control: 

N/A

N/A

Biographical Affidavit and Third-Party Verification Reports:
Glorimar Santiago
gsantiago@ocs.pr.gov
RI

Licensure:  NAIC Biographical Affidavit.
After Licensure: NAIC Biographical Affidavits are required for changes in Officers, Directors or Key Managerial Personnel.
Disclaimer of Control: Allowed

Rhode Island will no longer require the Independent Third-Party Verifications. Rhode Island will only require the NAIC Biographical Affidavit.

NAIC Biographical Affidavit is required for new Officers and Directors within a reasonable time frame.

Biographical Affidavit and Third-Party Verification Reports:
Katherine Ortiz
Katherine.Ortiz@dbr.ri.gov
SC

Licensure: NAIC Biographical Affidavit and Independent Third-Party Verification
After Licensure: NAIC Biographical Affidavits are required for changes in Officers, Directors or Key Managerial Personnel.
Disclaimer of Control: Allowed

Expansion: NAIC Biographical Affidavit and Independent Third-Party Verification
Corporate Amendment: NAIC Biographical Affidavit is not required for new Officers or Directors

NAIC Biographical Affidavit is not required for new Officers or Directors.

Biographical Affidavit and Third-Party Verification Reports:
Deonna Rogers
drogers@doi.sc.gov
SD

Licensure:  NAIC Biographical Affidavit
After Licensure: NAIC Biographical Affidavits are required for changes in Officers, Directors or Key Managerial Personnel.
Disclaimer of Control: Allowed

DO NOT SUBMIT: Biographical Affidavits or employee organizational charts for foreign insurance companies. They are not required of foreign companies at any time.

NAIC Biographical Affidavit is not required for new Officers or Directors.

Biographical Affidavit: 
Domestics should contact their individual financial analyst or johanna.nickelson@state.sd.us

Third-Party Verification Reports:
Johanna Nickelson
Assistant Director Company Solvency and Licensing
SD DLR/Division of Insurance
124 S. Euclid Ave., 2nd Floor
Pierre, SD 57501
 

TN

Licensure: NAIC Biographical Affidavit
After Licensure: NAIC Biographical Affidavits are required for changes in Officers, Directors or Key Managerial Personnel.
Disclaimer of Control: Allowed

Expansion: NAIC Biographical Affidavit
Corporate Amendment: None to Tennessee (if filed with the domiciliary state)

None to Tennessee (if filed with the domiciliary state)

Biographical Affidavit and Third-Party Verification Reports:
TN domestics and redoms-into-TN: 
Hui Wattanaskolpant
hui.wattanaskolpant@tn.gov

Foreign expansions and foreign insurers: 
Phil Adams
phil.adams@tn.gov

TX

Licensure: Submit biographical information pursuant to UCAA instructions and requirements. For fingerprint card information, please see Domestic requirements.  
Fingerprints are needed for TX domestic companies- top executive officers and directors; Texas strongly recommends submitting digital fingerprint cards, as the cards are accurate and processing time is much faster. Ink print cards require longer processing times and are very susceptible to inaccuracies that may require multiple submissions.
Disclaimer of Control: Not Allowed

Submit biographical information pursuant to UCAA instructions and requirements. For fingerprint card information, please see Foreign requirements. Fingerprints are needed for; TX foreign companies- top three executive officers (i.e. Pres/CEO, Treasurer/CFO, Secretary/General Counsel). Texas strongly recommends submitting digital fingerprint cards, as the cards are accurate and processing time is much faster. Ink print cards require longer processing times and are very susceptible to inaccuracies that may require multiple submissions.

NAIC Biographical Affidavit and fingerprint card are required for new key Officers within 30 days.

Biographical Affidavit: 
Laura Weld
laura.weld@tdi.texas.gov

Third-Party Verification Reports:
CLRBioUpdate@tdi.texas.gov

UT

Licensure: NAIC Biographical Affidavit and Independent Third-Party Verification.
After Licensure: NAIC Biographical Affidavit and Independent Third-Party Verification are required for changes in Directors, Officers and Key Managerial Personnel of domestic company or ultimate controlling person.
Disclaimer of Control: Allowed

NAIC Biographical Affidavit and Independent Third-Party Verification.

A letter is required listing changes for additions and/or removals.
Additions: Name, Position, effective start date.
Removals: Name, Position, effective separation date and state “for cause” or “not for cause.”
Emails preferred over postal mail.

Biographical Affidavit and Third-Party Verification Reports:
Jay Sueoka
jsueoka@utah.gov
or
company-renewals@utah.gov
VT

Licensure: NAIC Biographical Affidavit; Third-Party Verification may be required.
After Licensure Updates: NAIC Biographical Affidavit; Independent Third-Party Verification may be required.
Disclaimer of Control: Not Allowed

For Licensure Expansion:  NAIC Biographical Affidavit.
Corporate Amendments: NAIC Biographical Affidavit is not required for new Officers or Directors.

After Licensure Updates: NAIC Biographical Affidavit is not required for new Officers or Directors.

Biographical Affidavit: 
(802)-828-2470
or
dfr.complic@vermont.gov

Third-Party Verification Reports:
Contact state if requested

VA

Licensure: NAIC Biographical Affidavit and Independent Third-Party Verification.
After Licensure: NAIC Biographical Affidavits are required for changes in Officers, Directors or Key Managerial Personnel.
Disclaimer of Control: Allowed

Expansion: NAIC Biographical Affidavit and Independent Third-Party Verification are required.

Corporate Amendment: NAIC Biographical Affidavit and Independent Third-Party Verification are NOT required.

NAIC Biographical Affidavit and Independent Third-Party Verification are not required for new Officers or Directors.

Biographical Affidavit and Third-Party Verification Reports:
Kevin McClain
Financial Analyst
Direct Line: (804) 371-9432
Kevin.McClain@scc.virginia.gov
WA

Licensure: NAIC Biographical Affidavit and Independent Third-Party Verification.
After Licensure: NAIC Biographical Affidavits are required for changes in Officers, Directors or Key Managerial Personnel. Domestic insurers must file a biographical affidavit every thirty-six months after the last biographical affidavit filed.
Disclaimer of Control: Allowed

NAIC Biographical Affidavit and Independent Third-Party Verification.

NAIC Biographical Affidavit is not required for new Officers or Directors.

Biographical Affidavit: 
Mark Durphy
mark.durphy@oic.wa.gov
or
Ron Pastuch
ron.pastuch@oic.wa.gov

Third-Party Verification Reports:
clc@oic.wa.gov

*WV

Licensure:  NAIC Biographical Affidavit is required.
After Licensure: NAIC Biographical Affidavit is required for new officers and/or directors AND amendments to officers and/or directors.
Disclaimer of Control: Not Allowed

Expansion: NAIC Biographical Affidavit is required.

After Licensure: NAIC Biographical Affidavit and Notifications are not required for new Officers and/or Directors OR amendments to Officers and/or Directors.

Biographical Affidavit: 
Financial Conditions Unit
P: (304) 558-2100
oicfinancialconditions@wv.gov

*Please do not email Bio's to the above email. They can be viewed in UCAA or sent to:
WV Offices of the Insurance Commissioner
Financial Conditions Unit
PO Box 50540
Charleston, WV  25304

Third-Party Verification Reports:
Third-Party Verification Reports are not required.

WI

Licensure: NAIC Biographical Affidavit required (but not fingerprints or Independent Third-Party Verifications)
After Licensure: NAIC Biographical Affidavit required for any changes in Directors, Officers or Key Managers (but not fingerprint or Independent Third-Party Verifications). 
Disclaimer of Control: Allowed

Expansion: NAIC Biographical Affidavit required (but not fingerprints or Independent Third-Party Verifications)
Corporate Amendment: NAIC Biographical Affidavits are required for the office of President and/or Chief Executive Officer (CEO) only, or the changes of those officers. Independent Third-Party Verifications are not required. 

Written notices for any changes in the company president or secretary. (Bios, Fingerprints and Independent Third-Party Verifications are not required.)

Biographical Affidavit: 
Suzanne Vinmans
suzanne.vinmans@wisconsin.gov
or
Mark McNabb
mark.mcnabb@wisconsin.gov
or
Christopher Martin
christopherj.martin@wisconsin.gov

Third-Party Verification Reports:
Contact the state if requested

WY

Licensure: NAIC Biographical Affidavit and Independent Third-Party Verification.
After Licensure: NAIC Biographical Affidavits are required for changes in Officers, Directors or Key Managerial Personnel.
Disclaimer of Control: Not Allowed

Expansion: NAIC Biographical Affidavit and Independent Third-Party Verification.
Corporate Amendment: NAIC Biographical Affidavit are required for the office of President and/or Chief Executive Officer (CEO) only, or the changes of those officers. Independent Third-Party Verifications are NOT required. 

NAIC Biographical Affidavit is only required for new President/CEO, within 90 days.

Biographical Affidavit and Third-Party Verification Reports:
Doug Melvin
doug.melvin@wyo.gov