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The application must identify all lines of insurance (Form 3) the Applicant Company is requesting authority to transact, as identified by the Applicant Company’s plan of operation. The certification and attestation form (Form 2P) must be electronically signed. The application can only be submitted when all required information is provided.

The application must include a filing fee for the state in which an application is being submitted. The payee name and the instructions for submitting the filing fee are included in the Domestic Filing Fees chart. Submit details of the Applicant Company’s payment in the Jurisdiction attachment section of the application.

The application must show that the Applicant Company meets the state’s statutory minimum capital and surplus requirements. In some states, the minimum capital and surplus requirements are determined by the classes of insurance that the Applicant Company is requesting authority to transact. The state will determine the level of surplus required after considering the Applicant Company’s product line, operating record and financial condition. Compliance with the statutorily prescribed minimum surplus requirement may not be sufficient for all applicants. Review the chart that identifies the Minimum Capital and Surplus Requirements for the submitted Uniform State. This chart also provides additional information regarding RBC requirements and instructions. Attach an explanation of the Applicant Company’s compliance with the capital and surplus requirements in the Jurisdiction attachment section of the application.

The domiciliary state may require a statutory deposit. The Statutory Deposit Requirements chart provides state-specific requirements and identifies those states that require a Statutory Deposit. Attach in the Jurisdiction attachment section, documentation explaining how the Applicant Company meets or is meeting the statutory deposit requirements. Unless otherwise indicated, the Statutory Deposit is for the benefit of all policyholders.

Each state has different guidelines and procedures for name approval. The Name Approval Requirements chart is intended to serve as a guide for the various name approval requirements of each Uniform State. The Applicant Company should check with the state to ensure compliance with all applicable name approval requirements. Where applicable, attach evidence of name approval request when the primary application is created.

The plan of operation has three components, a brief narrative, proforma financial statements/projections (Form 13) and a completed Questionnaire (Form 8P). The narrative should include significant information not captured as part of the Questionnaire that the Applicant Company provides in support of the application, such as the business plan. The proforma is one of the three (3) components in the Plan of Operation. The proforma is available for Life, Property/Casualty, Health and Title companies. Attach a company-wide, three-year proforma balance sheet and income statement. For the lines requested, provide three-year premium and loss projections by line for the application state. Projections must support all aspects of the proposed plan of operation, including reinsurance arrangements and any delegated function agreements. Include the assumptions used to arrive at these projections.

The proforma should be completed by statutory accounting or financial reporting professionals that should be available to answer any questions or concerns from reviewing regulatory staff. The proforma is completed on an annual basis, typically for a full three-year time period, however, some states may require five years. The proforma should start with the first full year of operation that the Applicant Company anticipates actively writing business in the state receiving the application. The proforma excel workbook is password protected and cannot be modified. When projecting five years, two workbooks will be required.

The completed electronic Questionnaires are separated into three components; the main questionnaire applies to all companies, the Holding Company questionnaire only applies to companies that are part of a holding company structure and the life questionnaire applies if the Applicant Company is seeking to write Variable Annuities or Variable Life policies. All supporting attachments should be provided in the questionnaire or in the narrative.

If the Applicant Company is a member of a holding company system, the application must include either the most recent Holding Company Act (HCA) filings, including the Annual Form B Registration Statement and related Form F or a statement substantially similar to the �����о����ٷ� Insurance Holding Company System Regulatory Act (#440). The filing should include all attachments, exhibits and appendices referenced in the HCA filings. Include all attachments and any amendments up to the application filing date and include copies of all advisory, management and service agreements as part of the Holding Company Questionnaire (Form 8HC).

In some states, the Applicant Company is required to join one or more rating, guarantee or other organizations before transacting insurance. Generally, the Applicant Company’s authorized lines of insurance govern statutorily mandated memberships. Review the Statutory Membership Requirements chart prior to contacting the licensure state about any required statutory memberships before transacting insurance. Attach documentation supporting membership application(s) as indicated, in states where required, or acknowledgment of required memberships as a Jurisdiction attachment.

If the Applicant Company, its parent or its ultimate holding company has made a filing or registration with the U.S. Securities and Exchange Commission (SEC) in connection with a public offering within the last three years, or filed an 8K, 10K or 10Q within the last 12 months, the application must note that the filing, including any supplements or amendments, is available electronically from the SEC. If the Applicant Company, its parent or its ultimate holding company is not publicly traded, the application must include an attached copy of the Applicant Company’s most recent Consolidated GAAP financial statement. Attach the notice of SEC filings or copy of a Consolidated GAAP statement in the appropriate questionnaire.

Members of a holding company system must complete debt-to-equity information. The comprehensive debt-to-equity ratio statement includes the following information.

A. Consolidated outside debt to consolidated equity ratio on a GAAP basis for the holding company.*

B. Provide the most recent consolidated holding company financial statement.
C. State if the holding company, on a consolidated basis, has a tangible net worth: a) for the past three years; b) at present; and c) provide projections with assumptions for a three-year period.
D. The Applicant Company must clearly substantiate the sources of repayment of any debt, including, but not limited to, whether the source of repayment is independent from the future income of the insurers.
E. Calculate the debt service (as reported in D above) required of each insurer as a percentage of the Applicant Company’s capital and surplus.
F.  List the assets of the holding company, if any, that are pledged to fund the debt service or debt repayment of an affiliate or parent (include the assets or stock of any insurer subsidiaries)
G. List any guarantees (personal or otherwise) from the shareholders for repayment of the debt.
     *Some states may require re-statement based upon statutory equity.

Most states have requirements to disclose information to the public under a Public Records Act. To meet these public disclosure requirements certain items must be included with the application. While these documents may or may not be part of the substantive review, please be sure to attach the required documents with the application. The Public Records Package chart contains requirements for financial and operational filings. An Applicant Company that is seeking to form a new insurer should include all documents listed in the operational section of the chart for the application state. Attach all documents required as a jurisdiction attachment.

A. The Applicant Company is required to complete an �����о����ٷ� Biographical Affidavit (Form 11) in connection with pending or future application(s) for licensure or a permit to organize with a department of insurance in one or more states. The Applicant  Company must submit an �����о����ٷ� Biographical Affidavit on behalf of all officers, directors and key managerial personnel of the Applicant Company and individuals with a ten percent (10%), or more, beneficial ownership in the Applicant Company and the Applicant Company’s ultimate controlling person (“Affiant”).

B. The UCAA defines “Independent Third-Party” as:

1. A consumer reporting agency (“CRA”) overseen by the Federal Trade Commission (“FTC”) and, therefore, subject to the FCRA, which have been vetted and is currently on the approved list;
2. Has the ability to perform international background investigations; and
3. One whose officers and directors have no material affiliation with the Applicant Company other than stock ownership amounting to less than one percent (1%) of total stock outstanding, unless prior approval is given by the department of insurance to which application is being made.

C. The �����о����ٷ� Biographical Affidavit requests information with respect to the Affiant’s employment history, education, personal information and character. The �����о����ٷ� Biographical Affidavit also includes the Disclosure and Authorization Concerning Background Reports (the “Disclosure & Authorization Form”). The signature of the Affiant on the Disclosure & Authorization Form permits an Independent Third-Party to conduct an independent third-party verification on the Affiant.

D. The �����о����ٷ� Biographical Affidavit includes three types of the Disclosure & Authorization Form. There are three different Disclosure & Authorization Forms since certain state laws, regulations and rules require different kinds of disclosures and wording within such form. An Affiant must sign the corresponding Disclosure & Authorization Form(s) for the respective state(s) where the Affiant has lived or worked within the last ten (10) years. Refer to the Disclosure & Authorization Forms for further information.

E. The �����о����ٷ� Biographical Affidavit is used to evaluate the suitability, competency, character and integrity of the Affiant in connection with an Applicant Company’s pending or future application(s) for licensure or a permit to organize with a department of insurance in one or more states.

The Independent Third-Party uses information contained in the �����о����ٷ� Biographical Affidavit as a tool to perform an independent third-party verification to determine an individual’s fitness and propriety. The independent third-party verification may contain information bearing on the Affiant’s character, general reputation, personal characteristics, mode of living and credit standing (if required by the state). The Independent Third-Party Vendor shall use the independent third-party verification to create a background report (the “Background Report”).

F. The Disclosure & Authorization Form is valid for a maximum of six months.  Additionally, an Affiant may revoke the authorization at any time by delivering a written revocation to the Applicant Company. Refer to the Disclosure & Authorization Form for further information.

G. The Background Reports are subject to the Fair Credit Reporting Act (“FCRA”). Pursuant to FCRA, the state departments of insurance and an Applicant Company who is seeking admission are “users” of consumer reports. The FCRA requires that the Applicant Company provide the Affiant with a copy of the “Summary of Your Rights Under the Fair Credit Reporting Act.” The Applicant Company should provide a copy of the “Summary of Your Rights under the Fair Credit Reporting Act” to each Affiant. This summary can be found at the Federal Trade Commission (“FTC") . Background Reports are valid for six months from the signature date of the affidavit. Any alteration to the original biographical affidavit or updated signature will require a newly prepared background report.

H. The Applicant Company and state departments of insurance are required to comply with FCRA, especially as it relates to confidentiality of the information contained in such consumer reports. To the extent required by law, the states and Independent Third-Party Vendors should maintain the Background Reports procured under the Disclosure & Authorization Form as confidential. A copy of the FCRA is located .

I. The department of insurance in the state where an Applicant Company files, or intends to file, an application and the Applicant Company may require the Background Report. An Affiant who desires a copy of their Background Report may request a copy from the Applicant Company or the CRA as indicated on the Disclosure & Authorization Form. Refer to the Disclosure & Authorization Form for further information.

J. Please check state requirements for those states that require additional background information, such as fingerprints, in place of, or in addition to, �����о����ٷ� Biographical Affidavits. If applying in one of those states, necessary fingerprints and processing fees should be included.

Refer to the list of currently approved Independent Third-Party Vendors for Background Reports.

�����о����ٷ� Biographical Affidavits must be completed on the most current form, in effect at the time the affidavit was signed and the Affiant shall not sign the Affidavits more than six months before the date the Applicant Company files the application. Each question on the biographical affidavit must have a response. If an answer is “None”, then so state. Incomplete biographical affidavits could delay the background investigation report and result in a delay of the application review by the state.

Submit original Biographical Affidavits (Form 11) that contain the Disclosure & Authorization Forms to the state department(s) of insurance in the Management Information Section of the application.

Some jurisdictions may have additional requirements before a Certificate of Authority is issued. Before completing a UCAA Primary Application, the Applicant Company should review the list of requirements on the State-Specific Requirements for the application state. Submit state-specific requirements as a jurisdiction attachment.

Pre-approval Information

Some jurisdictions may have specific pre-approval requirements. Submit copies of all pre-approval documents in the jurisdiction requirements section.

Custody Agreements

The Applicant Company should include a statement setting forth whether or not any of the Applicant Company’s stocks, bonds, or other physical or book entry securities are in the physical possession of another entity.

If any of the Applicant Company’s stocks, bonds or other securities are not in the Applicant Company’s actual physical possession or in a safe deposit box under the exclusive control of the Applicant Company (except as shown in the Schedule of Special Deposits in the Applicant Company’s Annual Statement), the application must include the written agreement with each entity holding and/or administering these securities. The written agreement should include appropriate safeguards for the handling of the securities, in accordance with those specified in the �����о����ٷ� Financial Condition Examiners Handbook (Handbook).

All IDs must be requested from the �����о����ٷ� Helpdesk using the UCAA User ID Request Form, located on the UCAA website. First time users (start-up companies) will only have access to create a Primary Application. For all other users (IDs associated to an existing �����о����ٷ� company code), the primary application will be available in addition to all currently available electronic UCAA.  

Existing UCAA Users will need to first authenticate their UCAA ID in the new environment through this link:

From the Home page, select Primary from the drop down menu and select Create.   

A pop-up box will then display. Enter all required or applicable information:  

• Proposed Company Name;  
• Select the Application Jurisdiction; 
• Attach Name Approval documents if required by the jurisdiction selected; and
• Enter the FEIN (if available)

All required information/fields are identified with an asterisk throughout the application. After the required and applicable fields have been completed, click Create. 

The user will then click on the Go to Application button to proceed to the application. 

The proposed Applicant Company name can be modified after an application has been created.  Select Manage Details, located under the User Profile.  

Only the proposed company name and FEIN can be updated/modified after creation of the application and a reason for that change must be provided.  

The audit history will capture the progress of the application as it is completed, any changes or edits made, requests for information and attachments, and any pertinent details of an amended application. 

When the application is created, it will default to the summary page which contains pertinent information regarding the application. The summary page provides the current status of the application, as it moves through the various submission and review/approval stages of the application process. While the application is in a Creation status, the substatus will remain in progress until the users submits the application to the intended jurisdiction. After submission, the substatus can show “paused” if the state has submitted a request for information (RFI) to the company and the substatus will remain paused until the Applicant Company has responded, via the RFI, with the necessary information to the jurisdiction.  

The User who creates the application will have access to work in the application. To allow other authorized users access they will need to be added individually. Only individuals with a UCAA ID can be added. When appropriate remove any User as a designee.  

Creation: an application has been started by the Applicant Company user and is currently being worked on/ completed by the company. (non-submitted) 
Submission: Before a PDF of the application forms can be created, a usage fee must be paid. Once payment has been confirmed/ validated, a separate link will appear in the Actions to Submit the Application. A DocuSign envelope will also be created to notify the  designated officer or director of the request for signature via email.  
Signature: Once the designated officer or director has signed the certification and attestation page it will automatically be sent to the intended jurisdiction. The Applicant Company can recall the signature, or the signatory officer can refuse to sign the document if the application needs to be edited. 
Acceptance: Once the intended jurisdiction, receives the application, it will review the contents of the application to ensure all requirements have been met. When all requirements are met, the Jurisdiction will accept the application as complete and assign the review to their regulatory team. A lead reviewer will be designated and listed under the Details section of the Summary page. 
Review: A lead reviewer and other assigned state reviewers will receive notification that a primary application has been assigned for their review. During this process if there are any questions regarding the application information or attachments the assigned reviewers will contact the Applicant Company via an RFI. The link to the RFI is located at the top, left side of the summary page.  

Under the status bar and to the right of the summary page is a section labeled “Action” as the user works throughout the application various actions become available.  

 When a Lead Reviewer is assigned, they will be identified in the Details section on the Summary page.  

The status bar will indicate the status of the application.  

Recommendation: the state has completed their review and will make a recommendation to either approve or not approve the application. If approved, the state may prepare and attach a consent order of additional requirements specified in the approval letter with necessary items/information that is required prior to the issuance of a certificate of authority. If not detailing why the application was not approved will be included with the RFI.  
Certification: The jurisdiction has confirmed the company details and will issue the certificate of authority. At this time the state will request that a �����о����ٷ� company code (cocode) be obtained.
Withdraw: If the state has recommended to non-approve the company,  the company will need to withdraw their application. When the application is withdrawn the application and all corresponding RFIs will automatically be closed.  

All application requirements are located on the Summary page under Requirements. Each requirement input screen will populate the company input information onto the appropriate application form. The symbol to the left will indicate the status of each requirement.  

NOTE: Future Enhancement: Each required page will be viewable on the appropriate application form template.  

NOTE: Unless otherwise stated the User should upload pdf format for all attached documents. 

FEES/CHARGES: The company user must pay a transaction fee for use of the electronic UCAA which shall be collected at the time of filing. The �����о����ٷ� reserves the right to change or modify the transaction fee upon thirty (30) days’ notice to the filer. All fees and charges are non- refundable. �����о����ٷ� reserves the right to terminate or disable access to UCAA in the event of non-payment of fees or charges. 

The Usage fee must be paid before the link to create the Docusign envelop appears in the Actions section.
 

The PDF document will be viewable under Documents on the Summary Page. 

Once the jurisdiction receives the application, it will review the contents of the application to ensure all requirements have been met. Once the requirements are confirmed, the application will be accepted as complete and assigned to their regulatory team for review. A lead reviewer will be designated and listed under the Details section of the Summary page. The Applicant Company can correspond directly with the Lead Reviewer through an RFI with any questions. 

The jurisdiction will conduct their review and correspond with the company via the RFI with any questions or comments. The link to create or view the RFI is located in the upper right-hand corner under the User profile information Summary page. 

The company can communicate with the jurisdiction any time during the application process. To initiate communication. Select Create New RFI 

The lead reviewer assigned will automatically receive the RFI, there is no need to type the recipient information. If the filing has not been assigned the RFI will go to the Application Facilitator. Once the application is assign, all RFIs will go directly to the the state reviewers.  

RFIs can only be closed by the individual who has initiated the communication by selecting the Close RFI button located in the upper right hand corner of the application web page.  

RFI’s are created when the application has been approved or not approved by the jurisdiction and details will be attached to the RFI. The Applicant Company should respond via the RFI. If the Applicant Company chooses to withdraw their application for non-approval all open RFIs will automatically be closed.  

The state may reach out to the company to request specific clarification or updates to submitted information via an amendment. The company can amend their application at any time during the review process, and with any substatus of in progress or paused.

The state will receive an email notification that the company has initiated an amendment and will be able to review the explanation given for the amendment.

Once initiated, the amendment version will show in details section, the status will revert back to creation and the requirements will have the edit buttons available. The amendment can be cancelled at any time before it is sent for signature.

Only the items updated/validated will show as completed and will require a detailed explanation of the changes made.

The explanation provided should be thorough and detail every change made, when the cover letter is received by the state it will direct them to the exact changes and not slow down their review.

Each version of the application is available to view and download by selecting View Application Document and then Generate Zip file. The application version will always default to the most current version, use the dropdown arrow to view previous versions.

The applicant company can choose to withdrawal their application at any time after submission or by the request of the jurisdiction reviewer. Select the withdraw icon and provide an explanation for the withdrawal.  Please note that in the window, is the only time the withdrawal process can be cancelled. Once the withdraw button is selected the status will change and no other actions will be available.  

Once the withdraw is confirmed the status bar will change to withdrawal.  

And all actions will be removed. The application can be downloaded from the Documents section.  

Select generate zip link in the top right hand section of the screen and then download zip.  

The zip file is organized by section, each section is identified by form number, select the folder to view pdf appliction form and attachments.  

The application dashboard or UCAA home page has multiple features for sorting, searching, or importing the list of applications. Each column heading can be sorted by ascending or descending order. 

The search bar allows  a user to search for any information included in the columns. You can create specific filtered searches by jurisdiction or status and  then name those searches and save via the filter icon. To do this: 

• Enter your search criteria;  
• Select your search criteria; and  
• View results.  

To save the specific search: 

• Select the filter icon;  
• Select save filter as…. 
• Name your search; and  
• Click save.  

As more applications are converted or created to this portal the search function will be extremely useful.  

Saved filters will appear above the search bar. Filters can be modified at any time.  

Located on the dashboard is a quick access to the certified companies in the User’s authorized company association. Once an application is approved and certified the quick link will show the company name, cocode (if and when added) and the FEIN. Only authorized users for the company can view/access this information.  

On the lower screen of the dashboard is the “my RFIs” list, this communication list will display all ongoing requests for information correspondence with the state for quick access. Email notifications are automatically generated at the time of submission, but for follow up this quick access list will assist with a quick reply without searching for the application tracking number or email notification link.  This section comes with a search bar and filter. All open RFIs will be listed here with the last updated date provided. The subject is a quick link to the communication thread.