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

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.

Expansion: NAIC Biographical Affidavit and Independent Third-Party Verifications.

Form A:  NAIC Biographical Affidavit and Independent Third-Party Verifications.

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

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

NAIC Biographical Affidavit AND Independent Third-Party Verification.

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

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

Expansion: NAIC Biographical Affidavit and Independent Third-Party Verifications.
Foreign Corporate Amendment: NAIC Biographical Affidavit and Independent Third-Party Verifications.

Per Rule 7, 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
501-371-2680
Insurance.Finance@arkansas.gov 

After Licensure: NAIC Biographical Affidavits and Fingerprints are required for changes in Officers, Directors or Key Managerial Personnel.

Disclaimer of Control: Allowed

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

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.

Third-Party Verification Reports:

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. 

Third-Party Verification Reports:

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

A NAIC biographical affidavit is required for new key officers.
 

Property & Casualty Companies:
Wesley White
Applications Coordinator
Phone 850-413-5225 
Email wesley.white@floir.com

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

Contact state for requirements.

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

NAIC Biographical Affidavit and Independent Third-Party Verification.

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

Expansion: NAIC Biographical Affidavit and Independent Third-Party Verification.
Foreign Corporate Amendment: NAIC Biographical Affidavit.

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.

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:
Illinois Department of Insurance             attn: Corporate Regulation Section  
320 West Washington
Springfield, IL 62767

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

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.

Application Submissions
Expansion
Connie Wright
(317) 232-1994
Cowright1@idoi.in.gov

Corporate Amendment
Annette Gunter
(317) 232-2428
agunter@idoi.in.gov

Updates
Heather Brewer
(317) 232-2390
hbrewer@idoi.in.gov

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

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

NAIC  Biographical Affidavit is not required for new Officers and Directors. Notification required via SBS of any change in President or Corporate Secretary.

Third-party background reports should be sent electronically (via e-mail) to the following state contact:
Tish Becker
tish.becker@ks.gov

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

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-direc….

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

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

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

Email address: Colicensing.mia@maryland.gov

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. 

Third-Party Verification Reports: 
Not Required

Expansion: NAIC Biographical Affidavit dated within 6 months of filing application and Independent Third-Party Verification Report required.
Corporate Amendments: NAIC Biographical Affidavit and Independent Third-Party Verification Report not required.

NAIC Biographical Affidavit and Independent Third-Party Verification not required.

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

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

Expansion: NAIC Biographical Affidavit
Foreign Corporate Amendment: 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.

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

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 InsuranceSolvency@insurance.mo.gov. 

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.    

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

Biographical Affidavit and Third-Party Verification Reports upload to: https://transfer.mt.gov/Home/Login

Contact:
Tavin Mogus
tmogus@mt.gov 
406-444-3469

Expansion: UCAA biographical affidavit and 3^rd party verification but no fingerprints
Foreign Corporate Amendment:  UCAA biographical affidavits

Notification of officer and director updates is required but no biographical affidavits need to be submitted.

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

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

NAIC Biographical Affidavit

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

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:
UCAANotifications@dobi.nj.gov

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

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. 

Third party verification reports should be sent directly to NY DFS by the third-party vendor using the DFS Portal (an account is not required). A copy of the biographical affidavit is required to be included with the report. 

State Email Contacts:  
Property and Casualty 
Health  
Life 

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

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. 

Group Cover Letter: Not Acceptable

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

Third-Party Verification Reports:
colicexam@nd.gov

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

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. 

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

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

N/A

Expansion: Rhode Island will no longer require the Independent Third-Party Verifications. Rhode Island will only require the NAIC Biographical Affidavit.
Foreign Corporate Amendment: No

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

Expansion: NAIC Biographical Affidavit and Independent Third-Party Verification are required.
Foreign Corporate Amendment: NAIC Biographical Affidavit is not required for new Officers or Directors
Disclaimer of Control: Allowed

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

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

Expansion: Do Not submit Biographical Affidavits or employee organizational charts for Foreign Insurance companies. They are not required of Foreign insurance companies at any time.

NAIC Biographical Affidavits are not required for new Officers or Directors

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

None to Tennessee (if filed with the domiciliary state)

Initial application must include all Directors and the Chief Executive Officer, President, Executive Director, Secretary, Treasurer, Chief Financial Officer/Controller, Chief Operating Officer, Medical Director (if applicable), and any individuals that own 10% or more, beneficial ownership in the Applicant Company and the Applicant Company’s ultimate controlling person,  pursuant to UCAA instructions and requirements. Fingerprint receipts from Identogo and Third-Party Verifications are needed for President, Secretary, Treasurer, Chief Financial Officer/Controller, or equivalent positions, and any individuals that own 10% or more, beneficial ownership in the Applicant Company and the Applicant Company’s ultimate controlling person.

If the most recent Jurat page  reflects the current Officers and Directors, NAIC Biographical Affidavit and fingerprint receipts do not need to be submitted. If the Jurat page is not up to date, NAIC Biographical Affidavit and fingerprint receipts are required for new key Officers within 30 days.

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

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.

For Licensure Expansion:  NAIC Biographical Affidavit.  Background reports are not required.
Corporate Amendments: NAIC Biographical Affidavit is not required.

Not Required

Third-Party Verification Reports:
Contact state if requested

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

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 Third-Party Verification are not required for new Officers or Directors.

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

WV Offices of the Insurance Commissioner
Financial Conditions Division
(304) 558-2100
oicfinancialconditions@wv.gov

*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 Division
PO Box 50540
Charleston, WV  25305-0540

Third-Party Verification Reports:
Third-Party Verification Reports are required.

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

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.