Forms and Publications

Welcome to the forms and publications database

The tables below contain materials the Department publishes for various reasons. You can use the links above to jump to a specific section. In this database, you will find:

  • Forms used for licensing, reporting, and other functions
  • Reports published annually and from time to time
  • Brochures for consumers about various insurance-related topics

You can filter the database using the dropdown menus, or search for part of a file name. Please note that you can select more than one option in the filters.

Forms

DocumentCategoryLicensee type
Individual Resident License ApplicationLicensingProducer
Individual Non-Resident License ApplicationLicensingProducer
Individual License Renewal ApplicationLicensingProducer
Individual License Reinstatement ApplicationLicensingProducer
Individual/Agency Change Request FormLicensingAgency, Producer
Clearance Letter Request FormLicensingProducer
Business Entity Resident License ApplicationLicensingAgency, Company
Business Entity Non-Resident License ApplicationLicensingAgency, Company
Business Entity License Renewal ApplicationLicensingAgency, Company
Business Entity License Reinstatement ApplicationLicensingAgency, Company
Notice of Addition/Termination of Designee to Agency LicenseLicensingAgency, Producer
Resident Bail Bond Business Entity License ApplicationLicensingAgency, Bail Bond
Instructions & Filing Form for Title Organization LicenseLicensingAgency, Title
Third-Party Administrator (TPA) Bond FormLicensingTPA
Licensing, Rule AttachmentInsurer
Licensing, Rule AttachmentInsurer
Form C: Summary of Changes to Registration Statement [Rule R590-70]Licensing, Rule AttachmentInsurer
Form D: Prior Notice of a Transaction [Rule R590-70]Licensing, Rule AttachmentInsurer
Licensing, Rule AttachmentInsurer
Form F: Enterprise Risk Report [Rule R590-70]Licensing, Rule AttachmentInsurer
Medicare Supplement Refund Calculation Form [Rule R590-146]Reporting, Rule AttachmentInsurer, Health
Reporting, Rule AttachmentInsurer, Health
Reporting, Rule AttachmentInsurer, Health
Form for Reporting Medicare Supplement Policies [Rule R590-146]Reporting, Rule AttachmentInsurer, Health
Supplemental Form for Renewal of Utah Bail Bond Agency LicenseLicensing, Rule AttachmentAgency, Bail Bond
A & H Bona Fide Employer Association Group Authorization [Rule R590-220]Filing, Rule AttachmentInsurer, Health
A & H Discretionary Group Authorization [Rule R590-220]Filing, Rule AttachmentInsurer, Health
A & H Filing Certification [Rule R590-220]Filing, Rule AttachmentInsurer, Health
A & H Group Questionnaire [Rule R590-220]Filing, Rule AttachmentInsurer, Health
Appendix A: Utah Life Settlements Initial Application Checklist [Rule R590-222]Licensing, Rule AttachmentLife Settlement Provider
Appendix B: Utah Life Settlement Provider Annual Report [Rule R590-222]Reporting, Rule AttachmentLife Settlement Provider
Appendix E: Utah Life Settlement Provider Renewal Application [Rule R590-222]Licensing, Rule AttachmentLife Settlement Provider
Workers Compensation Loss Cost Multiplier Filing Form [Rule R590-225]Filing, Rule AttachmentWorkers Compensation
Utah Insurer Loss Cost Multiplier Filing Form [Rule R590-225]Filing, Rule AttachmentInsurer, Property & Casualty
Filing Certification [Rule R590-226, R590-227]Filing, Rule AttachmentInsurer, Life, Annuity
Group Questionnaire [Rule R590-226, R590-227]Filing, Rule AttachmentInsurer, Life, Annuity
Discretionary Group Authorization [Rule R590-226, R590-227]Filing, Rule AttachmentInsurer, Life, Annuity
Credit Life and Credit Accident & Health Filing Certification [Rule R590-228]Filing, Rule AttachmentInsurer, Credit Life, Credit Health
Credit Life and Credit Accident & Health Report Check-Off List [Rule R590-228]Reporting, Rule AttachmentInsurer, Credit Life, Credit Health
Utah Individual Health Insurance Application [Rule R590-247]Rule AttachmentInsurer, Health
Utah Small Employer Health Insurance Application [Rule R590-247]Rule AttachmentInsurer, Health
Producer Agreement and Compensation Disclosure [Rule R590-247]Rule AttachmentInsurer, Producer, Health
Independent Review Request [Rule R590-261]Rule AttachmentConsumer, Health
Independent Review Organization (IRO) Application [Rule R590-261]Licensing, Rule AttachmentIRO
All Payer Claims Database Opt-In Form [Rule R590-262]Rule AttachmentInsurer, Producer, Consumer, Health
Utah Stop-Loss Experience Report [Rule R590-268]Reporting, Rule AttachmentInsurer
Large Customer Compensation Disclosure Form [Rule R590-272]Reporting, Rule AttachmentProducer
Pharmacy Benefit Manager (PBM) Application [Rule R590-282]Licensing, Rule AttachmentPBM
Mandate Defrayal Data Template [Rule R590-283]Reporting, Rule AttachmentInsurer, Health
Dual Licensee Request Form [Rule R592-5]Licensing, Rule AttachmentProducer, Title
Dual Licensee Expedited Request Form [Rule R592-5]Licensing, Rule AttachmentProducer, Title
Title Office/Manager Change – Office Report Form [Rule R592-10]Reporting, Rule AttachmentAgency, Title
Title Insurance Producer Annual Report Form [Rule R592-11]Reporting, Rule AttachmentAgency, Producer, Title
Motor Club Renewal FormLicensingMotor Club

Reports

DocumentCategorySubcategoryYear
DTR Report March 2024PharmacyDrug Transparency Report2024
DTR Report February 2024PharmacyDrug Transparency Report2024
DTR Report January 2024PharmacyDrug Transparency Report2024
2023 Statutory Deposit ReportInsurerStatutory Deposits2023
2022 Statutory Deposit ReportInsurerStatutory Deposits2022
PPI Report 2023PharmacyPharmacy Premium Impact Report2023
PPI Report 2022PharmacyPharmacy Premium Impact Report2022
PPI Report 2021PharmacyPharmacy Premium Impact Report2021
2023 Annual Comparison TablesAuto, HomeComparison Report2023
2022 Annual Comparison TablesAuto, HomeComparison Report2022
2021 Annual Comparison TablesAuto, HomeComparison Report2021
2020 Annual Comparison TablesAuto, HomeComparison Report2020
2019 Annual Comparison TablesAuto, HomeComparison Report2019
2023 Pharmacy Premium Impact ReportPharmacyPremium Impact Report2023
2022 Pharmacy Premium Impact ReportPharmacyPremium Impact Report2022
2021 Pharmacy Premium Impact ReportPharmacyPremium Impact Report2021
DTR Report January 2023PharmacyDrug Transparency Report2023
DTR Report February 2023PharmacyDrug Transparency Report2023
DTR Report March 2023PharmacyDrug Transparency Report2023
DTR Report April 2023PharmacyDrug Transparency Report2023
DTR Report May 2023PharmacyDrug Transparency Report2023
DTR Report June 2023PharmacyDrug Transparency Report2023
DTR Report July 2023PharmacyDrug Transparency Report2023
DTR Report August 2023PharmacyDrug Transparency Report2023
DTR Report September 2023PharmacyDrug Transparency Report2023
DTR Report October 2023PharmacyDrug Transparency Report2023
DTR Report November 2023PharmacyDrug Transparency Report2023
DTR Report December 2023PharmacyDrug Transparency Report2023
DTR Report January 2022PharmacyDrug Transparency Report2022
DTR Report February 2022PharmacyDrug Transparency Report2022
DTR Report March 2022PharmacyDrug Transparency Report2022
DTR Report April 2022PharmacyDrug Transparency Report2022
DTR Report May 2022PharmacyDrug Transparency Report2022
DTR Report June 2022PharmacyDrug Transparency Report2022
DTR Report July 2022PharmacyDrug Transparency Report2022
DTR Report August 2022PharmacyDrug Transparency Report2022
DTR Report September 2022PharmacyDrug Transparency Report2022
DTR Report October 2022PharmacyDrug Transparency Report2022
DTR Report November 2022PharmacyDrug Transparency Report2022
DTR Report December 2022PharmacyDrug Transparency Report2022
2022 Annual ReportDepartmentAnnual Report2022
2021 Annual ReportDepartmentAnnual Report2021
2020 Annual ReportDepartmentAnnual Report2020
2019 Annual ReportDepartmentAnnual Report2019
2018 Annual ReportDepartmentAnnual Report2018
2017 Annual ReportDepartmentAnnual Report2017
2016 Annual ReportDepartmentAnnual Report2016
2015 Annual ReportDepartmentAnnual Report2015
2014 Annual ReportDepartmentAnnual Report2014
2013 Annual ReportDepartmentAnnual Report2013
2023 Health Insurance Market ReportHealthHealth Market Report2023
2022 Health Insurance Market ReportHealthHealth Market Report2022
2021 Health Insurance Market ReportHealthHealth Market Report2021
2020 Health Insurance Market ReportHealthHealth Market Report2020
2019 Health Insurance Market ReportHealthHealth Market Report2019
2018 Health Insurance Market ReportHealthHealth Market Report2018
2017 Health Insurance Market ReportHealthHealth Market Report2017
2016 Health Insurance Market ReportHealthHealth Market Report2016
2015 Health Insurance Market ReportHealthHealth Market Report2015
2014 Health Insurance Market ReportHealthHealth Market Report2014
Affordable Insulin Study (2020)HealthOther2020
Utah In Vitro Fertilization and Genetic Testing Report (2022)HealthOther2022
2022 Market Share ReportDepartmentMarket Share Report2022
2021 Market Share ReportDepartmentMarket Share Report2021
2020 Market Share ReportDepartmentMarket Share Report2020
2019 Market Share ReportDepartmentMarket Share Report2019
2018 Market Share ReportDepartmentMarket Share Report2018
2017 Market Share ReportDepartmentMarket Share Report2017
2016 Market Share ReportDepartmentMarket Share Report2016
2015 Market Share ReportDepartmentMarket Share Report2015
2014 Market Share ReportDepartmentMarket Share Report2014
2013 Market Share ReportDepartmentMarket Share Report2013
FY2023 Division Annual ReportFraudAnnual Report2023
Who Me?: Who Commits Insurance Fraud and WhyFraudCoalition Against Insurance Fraud Report2023
The Impact of Insurance Fraud on the US EconomyFraudCoalition Against Insurance Fraud Report2022
Globalization of Insurance FraudFraudCoalition Against Insurance Fraud Report2021
Workers Compensation Insurance Fraud in AmericaFraudCoalition Against Insurance Fraud Report2022
Four Faces of FraudFraudCoalition Against Insurance Fraud Report2017

Note regarding online retention periods: The Reports database provides a rolling archive of reports for the following durations:

  • Annual Reports: 10 years, plus the current year
  • Comparison Tables: 5 years
  • Market Share Reports: 10 years, plus the current year
  • Statutory Deposits: 2 years

Records outside these periods may be available by GRAMA request.

Note regarding Market Share Report zip files: These reports include the top 20 companies with the highest percentage of insurance sold in Utah in each specific line.  Older reports may not contain the same market share information that later reports include. Generally, reports will contain most of the following lines:
  • Aggregate Write-Ins
  • Aircraft
  • Allied Lines
  • Annuities
  • Boiler & Machinery
  • Burglary & Theft
  • Collectively Renewable Accident & Health
  • Commercial Auto
  • Commercial Multiple Peril
  • Credit
  • Credit A&H
  • Credit Life
  • Crop
  • Earthquake
  • Farmowners
  • Federal Employee Health Benefit
  • Fidelity
  • Financial Guaranty
  • Fire
  • Flood
  • Fraternal Life
  • Group Accident & Health
  • Group Life
  • Homeowners
  • Individual Accident & Health
  • Industrial Life
  • Inland Marine
  • Medical Malpractice
  • Mortgage Guaranty
  • Ocean Marine
  • Ordinary Life
  • Other Liability
  • Private Crop
  • Private Passenger Auto
  • Products Liability
  • Property Totals
  • Surety
  • Warranty
  • Workers’ Compensation
  • Workers’ Compensation – Excess

Brochures

DocumentCategoryLanguageSourceNotes
What is Insurance Fraud?FraudEnglishUtah Insurance Department
Insurance Agent FraudFraud, LicenseesEnglishUtah Insurance Department
Health Insurance FraudFraud, HealthEnglishUtah Insurance Department
Homeowners Insurance FraudFraud, HomeEnglishUtah Insurance Department
Contractor and Homeowners Insurance FraudFraud, HomeEnglishUtah Insurance Department
Automotive Insurance FraudFraud, AutoEnglishUtah Insurance Department
Auto Accident Victim RecruitmentFraud, AutoEnglishUtah Insurance Department
¿Que es el Fraude de Seguros?FraudeEspañolDepartamento de Seguros de Utah
Fraude de un Agente de SegurosFraude, AgenteEspañolDepartamento de Seguros de Utah
El Fraude de Seguros de SaludFraude, SaludEspañolDepartamento de Seguros de Utah
Propietarios Fraude de SegurosFraude, CasaEspañolDepartamento de Seguros de Utah
Contratista y Dueño de Casa Fraude de SeguroFraude, CasaEspañolDepartamento de Seguros de Utah
El Captar y Atraer Víctimas de Accidentes AutomovilísticosFraude, AutoEspañolDepartamento de Seguros de Utah
“Fight Fake Insurance” Message PointsFraudEnglishNAIC
Protect Yourself: Buying Insurance on the InternetFraudEnglishNAIC
Consumer Alert: Long Term Care Insurance Fact SheetLong-Term CareEnglishNAIC
Fraud, HealthEnglishNAIC
HealthEnglishNAIC
Consumer Alert: Tips for Saving Money on Auto InsuranceAutoEnglishNAIC
A Shopper's Guide to Long-Term Care InsuranceLong-Term CareEnglishNAIC
Deferred Annuity Buyers GuideLife, AnnuityEnglishNAIC
Deferred Annuity Fixed Buyers GuideLife, AnnuityEnglishNAIC
Deferred Annuity Variable Buyers GuideLife, AnnuityEnglishNAIC
A Consumer's Guide to Auto InsuranceAutoEnglishNAIC
Consumer Alert: Tips for Saving Money on Auto InsuranceAutoEnglishUtah Insurance Department
Putting Down Roots in Earthquake CountryDisaster PreparednessEnglishUtah Seismic Safety Commission
Echando Raíces en Tierra de TerremotosPreparación para desastresEspañolComisión de Seguridad Sísmica de Utah
A Consumer's Guide to Earthquake InsuranceDisaster PreparednessEnglishNAIC