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The application must identify all lines of insurance (Form 3) the Applicant Company must identify the lines of business it is requesting authority to transact and identify the lines of business that the Applicant Company is currently licensed to transact and is transacting in its current domiciliary jurisdiction. The certification and attestation form (Form 2R) 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's name and the instructions for submitting the filing fee are included in the Domestic Filing Fees chart. Attach a copy of payment in the jurisdiction attachments section of the electronic portal.

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 and the classes of insurance the Applicant Company is authorized to transact in all other jurisdictions. 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 each Uniform State. This chart also provides a contact person or a link to state-specific forms or RBC requirements and instructions. Attach an explanation of the Applicant Company’s compliance with the capital and surplus requirements in the jurisdiction attachments section of the electronic portal.

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. Documentation explaining how the Applicant Company meets or is meeting the statutory deposit requirements in the jurisdiction attachments section of the electronic portal. 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 in the jurisdiction attachments section of the electronic portal.  

The plan of operation has three components, a brief narrative, proforma financial statements/projections (Form 13) and a completed Questionnaire (Form 8). The narrative should include significant information not captured as part of the Questionnaire that the Applicant Company submits in support of the application, such as the reason for redomestication. 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. Provide 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 when applied to the redomestication application is projected data. The proforma workbook should be the same business type as the financial statement blank filed with the �����о����ٷ�. As such, the projected amounts need not balance with historical �����о����ٷ� financial filings. The projected data, however, should be relevant to the Applicant Company’s history of growth and losses as contemplated by the �����о����ٷ� Accounting Practices and Procedures Manual. 

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 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. Attach the completed Proforma and all relevant attachments in the required proforma section. 

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 appendices referenced in the HCA filings, and the most recent Corporate Governance Annual Disclosure, include any updates if the disclosure has not been restated. Include all attachments and any amendments up to the application filing date and include copies of all advisory, management and service agreements. 

In some states, the Applicant Company is required to join one or more ratings, 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, in the jurisdiction attachments section of the electronic portal.

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 attach a 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 as part of the Holding Company Questionnaire.

Members of a holding company system must complete the debt-to-equity information as Item 10 of the application. The application must include a comprehensive debt-to-equity ratio statement that includes the following information.

A. Provide the 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.

The Applicant Company should attach a statement setting forth whether 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). 

Some states have additional requirements for these custody agreements, beyond those called for in the Handbook. Attach the statement and copies of the custody agreements in the jurisdiction attachments section of the electronic portal. 

Most states have requirements to disclose information to the public under the Public Records Act. To meet these public disclosure requirements certain items must accompany the application. While these documents may or may not be part of the substantive review, please be sure to include the required documents with the application. The Public Records Package chart contains requirements for financial and operational filings. An Applicant Company seeking to redomesticate should provide both financial and operational documents for the application state. Attach all documents required by the application state in the jurisdiction attachments section of the electronic portal.  

A. The Applicant Company is required to submit 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 attach 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 under the Management Information Section of the application.  

Include a copy of the Applicant Company’s most recent annual statement as filed in the current state of domicile including all statements and supplements in accordance with the Annual Statement Instructions, including the Statement of Actuarial Opinion and Management’s Discussion and Analysis. The annual statement should be signed and verified and include an original certification from the state insurance regulatory agency of the Applicant Company’s domiciliary state. 

Include one copy of the Applicant Company’s annual statement for the two (2) preceding years in addition to the most recent annual statement. 

Property/Casualty insurers must attach the Insurance Expense Exhibit, Accident and Health Policy Experience Exhibit and/or Schedule P to the annual statement.  

Life insurers must include a Certificate of Valuation from the domiciliary state insurance regulatory agency. 

Members of a holding company system must attach a copy of the most recent consolidated annual statement, if filed with its current state of domicile. Submit the annual statement, with the necessary attachments, in the jurisdiction attachments section of the electronic portal. 

Include one (1) copy of each quarterly statement that follows the most recent annual statement. In addition, the Applicant Company must immediately forward any new quarterly statements that become available while the application is pending to all states in which applications are pending. Submit the quarterly statements in the jurisdiction attachments section of the electronic portal. 

Include a Risk-Based Capital Report, submitted in the level of detail required by the �����о����ٷ�, in the jurisdiction attachments section of the electronic portal. Please note that the states will maintain confidentiality of these reports. 

Include a CPA Audit Report, performed by a certified public accountant that is not an employee of the Applicant Company. Submit the CPA Audit Report as Item 18 of the application. Some states allow exemptions to this requirement for small insurers. Please contact the states individually regarding exemptions. 

The application must include a copy of the Applicant Company’s most recent Report of Financial Examination from its domiciliary state. The Applicant Company must also note all more recent examinations completed by any state, including market conduct examinations, and provide a description of each examination. Refer to the Reports of Examination Requirements chart for the exam “as of” date. Attach the Report of Financial Examination and a list of more recent examinations with descriptions in the jurisdiction attachments section of the electronic portal.  

If available, include a state issued Certificate of Compliance with the application. Please refer to the Certificate of Compliance and Certificate of Deposit Requirements chart for specific requirements for the date of issuance of the Certificate of Compliance from the file date of the application. The current domiciliary state must complete the Certificate of Compliance. A copy can be submitted in the jurisdiction attachments section of the electronic portal, the domiciliary state will receive an email notification to provide a certificate of compliance and deposit as part of the state-to-state communication in the electronic portal.  

If applicable, include the most recent Corporate Governance Annual Disclosure, include any updates if the disclosure has not been restated. Submit the Registration Statement and Annual Disclosure in the jurisdiction attachments section of the electronic portal.

Some jurisdictions may have additional requirements before a Certificate of Authority is issued. Before completing a UCAA Redomestication Application, the Applicant Company should review the list of requirements on the State-Specific Requirements for the application state. Include any state-specific requirements in the jurisdiction attachments section of the electronic portal.

Redomestication Application Section III
How to File – Redomestication Portal 
 

Authenticate User ID  

Log into the application via the electronic link:  

The user will be asked to authenticate their user ID via OKTA, once authenticated the user will see the application icon on their ID dashboard.  

Once logged into the application the user will default to the application dashboard. After the user ID has been authenticated, the following link can be used:   

If the user is a consultant or part of a holding company structure, contact UCAA administration staff (ucaa@naic.org) to have those company codes associated to their user id.

Create Redomestication Application 

From the drop-down menu, select Redomestication and then the create button to the left. 

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The User will have the option to create a redomestication application for companies that are authorized/ associated to their User ID. The company should file redomestication applications to states where they are currently licensed.  

Application Requirements 

If the company has submitted an expansion application that is currently being reviewed, they should select pending and provide the expansion application tracking number. Companies that are not licensed will need to submit an application or reach out to the application jurisdiction. 

Once the application is created, if applicable the group code and group name will populate on the general information page of the application and the debt to equity and holding company questionnaire will become a requirement of the application. 

If the company is part of a holding company structure, but does not qualify for an �����о����ٷ� group code, identify the owner of 10% or more control over the insurer on the management information section and complete the Debt to Equity and Holding Company Questionnaire.  

Management Information 

Summary page 

All sections of the application must be completed before the Submit button is available under Actions on the application summary page.  

When the application is created, it will default to the summary page which contains pertinent information regarding the application. The summary page provides the 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 application 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 application 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 certification. If not approved, the state will provide details of why the application was not approved included with the RFI. 

Certification: The jurisdiction has confirmed the company details and may issue a new certificate of authority. The state will also confirm the effective date of the redomestication.  

Withdraw: If the state recommends to non-approve the redomestication,  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 data onto the appropriate application form. The symbol to the left will indicate the status of each requirement.  

NOTE:  

Unless otherwise stated under state specific requirements, the User should upload pdf format for all attached documents, for the porforma financial statement upload both excel and pdf. files. 

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 Signatory Information is generated from the list of Officers/Directors entered on the Management Information section of the application. Only officers (president, secretary, or treasurer) that are eligible to sign the Certification and Attestation will be listed in the drop-down menu.  If applicable, the Uniform Consent to Service of Process will have a specific drop-down menu, the signatures of the certification and attestation and board resolution.  

The application will automatically be submitted to the intended application jurisdiction once the officer of the company has reviewed the DocuSign PDF and signed the Certification and Attestation page and, if applicable, the uniform consent to service of process certificate and attestation and the board resolution.

During the state review process, the facilitator or lead reviewer may submit a request for clarification or pertinent information needed to their review of the application. When the state reaches out to the company via an RFI, the application substatus will change from “in progress” to “paused”.  A paused status means that the state is waiting on information from the company to move forward with their review.  

To create an RFI, select the create button in the upper right corner of the screen. All open or closed RFIs will remain on the RFI summary screen.  

As a user you do not need to identify the recipient, the system automatically knows which regulator to send your inquiry to, depending on where the application is in the review process, either the state facilitator or reviewer.  

The audit history allows the company user to track the progress of the application as it is completed.  When more than one user updates information in any of the application sections it saves the information in the audit history.  

The status of the application can be followed by viewing the status bar throughout the review process.  

Pending State Acceptance – the state is reviewing the contents of the application to ensure all required information is available to begin the review process.  

Review Assignment – A lead reviewer has been assigned, and tasks may be assigned to other areas of the department that specialize in the review of legal, financial or securities.  

Recommendation – Pending Certification – the application has been approved and the state has issued a consent order of items that needs to be completed prior to the certificate of authority being issued to the company.  

The company may amend their application at any time after an application has been signed and submitted to the state. The initiate amendment button is active during the pending state acceptance to review statuses and even when the application has been placed in a “paused” substatus. Select “initiate amendment” under Actions. 

Provide a thorough explanation as to why the application is being amended. This explanation will be provided in an RFI to the state, so they are aware that the application is being amended.  

If the company decides to withdrawal an application instead of amending, the amendment can be cancelled.  

A usage fee is required to amend the application. Use the “submit application” button to submit the amendment. The sections that were edited will highlight with a green check mark.  

Before the application can be submitted for signature a cover letter will be created and a detailed explanation should be provided for each section that was edited.  

Once the application is signed and submitted to the state, the status will return to its original point in the review process and both complete versions of the application are available to view and download from the “View Application Documents” located on the summary page below the Actions.  

Select Generate Zip and then the download zip link to view the zip file, located on the left header of the view documents. The application files and attachments are sorted into sections. The download file will include all RFI communication with the state and the original pdf version of the signed application .  Click on each folder to view the application template and attachments for each section. Each version of the application can be zipped and downloaded.  

If the User needs to change their password, select the drop-down menu in the upper right corner of the webpage when logged in.  

The User will be prompted to verify their password, enter the current password or temporary password if one was provided. For security reasons, okta will send a push notification to ensure the correct user is updating the password. Complete the okta security, the user will be prompted to edit their personal information .  

Before you can change your password, complete the Forgotten Password Question, for future assistance when locked out or if the password is forgotten.