Licensing & Forms
Licensing, Annual Filings, and File Upload
Find license applications for potential providers and forms for the feasibility study and annual statement documents in this area.
Captive Application Process
Before submitting an application to form a new captive insurance company, interested parties should first complete some preliminary steps as follows:
- Conduct a self assessment to make a preliminary determination as to whether a captive insurance company is right for your business.
- Obtain a qualified consultant to provide advice and conduct a feasibility study (see below for guidance).
- If necessary, meet with the Department to obtain guidance and “buy-in” on the initial plan.
The applications in this link require a Windows operating system that is more recent than Windows XP. If you can not meet this requirement, please contact us for assistance. Additionally, the applications work best with a Chrome browser.
Captive Feasibility Study
Captive renewal forms
- Captive Renewal opens in a new tab
- Make Annual Payment (below) – YouTube Pay Online opens in a new tab (https://youtu.be/qzZ3tMYVxNE)
- Print Renewal Certificate (below) – YouTube Print Online opens in a new tab (https://youtu.be/YCkOxH1NHXU)
$25 fee assessed for physical check processing per Utah Admin Code R590-102-21(3) opens in a new tab
Non-electronic payment processing fee – assessed on a non-electronic payment when the department has provided an electronic payment process and stated the electronic process is the preferred process for receiving a payment – due with each non-electronic payment or by the due date on the invoice: $25
Captive Online Annual Statement Forms
Please select the link below to go to the new electronic annual filing forms and select “Register Here” if you do not already have a Utah-ID account.
The forms in this link require a Windows operating system that is more recent than Windows XP. Additionally, the forms work best using a Google Chromestrong> browser.
Annual Filing Forms opens in a new tab – Due March 1st every year
- Annual Statement opens in a new tab ‘AS‘
- Statement of Economic Benefit to the State of Utah opens in a new tab ‘SEB‘
***ATTENTION Managers*** The link below is to a short presentation for Captive Managers (and other service providers or Captive owners) to utilize at any time as a reminder of when and what annual filings are due and UID’s accepted methods and templates for completing them. The presentation will provide information such as what tools are available, deadlines, waivers, exceptions, etc.
- Reminder for Captive Managers opens in a new tab – (Out of date) In this presentation you will find helpful information explaining in breif detail what we expect as Regulators from our Service Providers throughout the year.
File upload system
Please select the link below to go to the new secure file upload system for submitting documents and requests to the Department rather than through email communication.
The applications in this link require a Windows operating system that is more recent than Windows XP. If you can not meet this requirement, please contact us for assistance. Additionally, the applications work best with a Chrome opens in a new tab browser.
File Upload opens in a new tab
To access the electronic applications and forms indicated in this section, you will need a Utah-ID account log in. If you do not have a Utah-ID account, click on the link above and instead of directly logging in, select the “Create Account” option and follow the instructions to create your Utah-ID account user ID and password.