Uniform Certificate of Authority Application (UCAA)

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UCAA Corporate Amendments Application

An existing insurer uses the Uniform Certificate of Authority Corporate Amendments Application for requesting amendments to its Certificate of Authority. A Uniform State is one that is committed to using the Uniform Certificate of Authority (UCAA) review process for company licensing and admissions.

The applicant can use the Corporate Amendments Application to file more than one change in the same submission. The applicant should mark all changes it files on the application form and submit all items required for those changes.

In the following pages, you will find a detailed explanation of the various requirements, along with instructions designed to assist you with preparing and submitting the necessary documentation to obtain regulatory approval. Each state's review process may follow slightly different time lines to complete a comprehensive and detailed operational and financial review of the applicant's business. It is the goal of all Uniform States to complete their review of the Corporate Amendments Applications within 60 calendar days of receipt. The 60-day review process includes two weeks to determine if the application is complete and acceptable for filing. During the remaining time-span, the application will receive a financial and operational review. The state may not achieve the 60-day processing goal in instances where the application requires substantial follow-up, or in states with limited resources or in instances when applicants file applications during peak business periods such as year-end and annual statement filing periods.

Based on the circumstances of a particular application, it may be necessary for the reviewing state to request additional information. Typically, the state will request any additional information within 30 days after it accepts the application.

This UCAA Corporate Amendments Application has eleven sections designed to guide you through the licensing process.

  1. Application Review Process
  2. Adding and Deleting Lines of Business Filing Requirements
  3. Name Change Filing Requirements
  4. Redomestication of a Foreign Insurer Filing Requirements
  5. Change of City within the State of Domicile Filing Requirements
  6. Change of Address/Contact Notification Filing Requirement
  7. Merger of Two or More Foreign Insurers
  8. Proposed/Completed Change of Control of Foreign Insurers
  9. Amended Articles of Incorporation
  10. Amended Bylaws
  11. Statement of Withdrawal/Complete Surrender of Certificate of Authority Application
  12. How to File

The goal of the UCAA is to provide a streamlined approval process. However, some states have state-specific filing requirements based on either statutory requirements or internal procedures. All applicants must be familiar with the insurance laws of the state to which they submit an application. Please see State Pages on the UCAA website for information about how to obtain a copy of the laws, regulations and bulletins for the state in which you will file.

If you have any questions about the uniform amendment process, a list of contact names, addresses and telephone numbers is available on the UCAA website. It is highly recommended that you contact each state with any questions before submitting your application for review.

Section I
Application Review Process

The Corporate Amendments Application of the UCAA provides a uniform process for gaining the necessary regulatory approvals for modifications to an insurer’s Certificate of Authority. It is the goal of each Uniform State to process all Corporate Amendments Applications within 60 calendar days of receipt. The 60-day review process includes two weeks to determine if the application is complete and acceptable for filing. During the remaining time-span, the application will receive a financial and operational review. The states may not achieve the 60-day processing goal in instances where the application requires substantial follow-up, or in states with limited resources or in instances when the applicant files applications during peak business periods such as year-end and annual statement filing periods.

Based on the circumstances of a particular application, it may be necessary for the reviewing state to request additional information. Typically, the state will request any additional information that it needs within 30 days after the state accepts the application.

Proprietary Information

Both regulators and applicants should note that the applicant might deem confidential any communications with insurance regulatory agencies in conjunction with the Corporate Amendments Application concerning proprietary information about the applicant. States may only share information determined to be confidential with other persons as authorized by law. By law, the state will not disclose to the public any information determined to be proprietary and trade secret. Each applicant needs to expressly identify all information in the application and in any subsequent correspondence that the applicant considers proprietary or trade secret.

The UCAA website explains the requirements and filing process for the Corporate Amendments Application. Please do not hesitate to contact the appropriate state regulators with any questions before filing any Uniform Application.

Step One: Filing Your Application
Processing Goal: 2 Weeks

An insurer may submit Corporate Amendments Applications anytime during the year. The state immediately reviews Corporate Amendments Applications to ensure that the applicant submits these in the required format as outlined in Sections II through XI.

Generally, within two weeks from the date the state receives the application, the state notifies the applicant whether or not it has accepted the application for filing. If the state accepts the application for filing, it will assign an official filing date.

The state will contact the applicant if it does not accept the application for filing due to a deficiency in the application’s format. Depending upon the nature of the deficiency, the state may give the applicant two weeks from the date of receipt of notification from the department reviewing the application to correct the deficiency. The state will return applications that are deficient and not accepted to the applicant.

Step Two: Application Review
Processing Goal: 60 Days

A Corporate Amendments Application will undergo a rigorous financial and operational review in the state to which you have submitted application. While the goal of each state is to complete this review in 60 days, the state cannot guarantee this time frame. Due to varying levels of resources available in each state, a substantive review of the Corporate Amendments Application may take longer than 60 days in some cases. Furthermore, if the state needs additional information to complete a substantive review of an application, the review may also take longer to complete. Once the state makes a request for additional information, it suspends the 60-day goal until the state receives the requested information. That said, the purpose of the Corporate Amendments Application is to streamline application processing and the states will make every effort to process a Corporate Amendments Application as quickly as possible.

At the conclusion of the substantive review by the reviewing state, the state will grant the applicant an amendment to the Certificate of Authority, allow the applicant to withdraw the application, or will deny the application.

If the state denies the application, the state will notify the applicant and provide a detailed explanation for the denial. After the denial, if the applicant wishes to re-file a Corporate Amendments Application, the state will require a new application and filing fee.

Section II
Filing Requirements (Adding and Deleting Lines of Business)

This section provides a guide to understanding the focus of each document of the Corporate Amendments Application. However, there typically are multiple purposes for documents. Therefore, it is important that applications be complete.

All documents submitted in support of the application must be current. However, in certain instances, some states have limited latitude to accept older documents. Please contact states individually if you have questions about a specific document.

All forms required for the Corporate Amendments Application are located on the UCAA website.

Table of Contents

  1. Application Form and Attachments
  2. Filing Fee
  3. Articles of Incorporation
  4. Bylaws
  5. Minimum Capital and Surplus Requirements
  6. Statutory Deposit Requirements
  7. Plan of Operation
  8. Statutory Membership(s)
  9. Certificate of Compliance
  10. State-Specific Information
  11. Deleting Lines of Business
1.  Application Form and Attachments
The application must identify all lines of insurance that the applicant is requesting authority to add or delete from an existing Certificate of Authority, as identified by the applicant’s plan of operation. Submit a completed checklist (Form 1C), and an original executed application form (Form 2C) and the company’s original Certificate of Authority or an affidavit of lost Certificate of Authority (Form 15) as Item 1 of the application. Submit a completed Lines of Insurance (Form 3) as Item 5 of the application. The UCAA website contains a chart of individual state requirements. All Forms for the Corporate Amendments Application are located in the Forms Section on the UCAA website. A cover letter may be included as a component of Item 1 of the application.

2.  Filing Fee
The application must include a filing fee for the state to which you are submitting the application. The payee name and the instructions for submitting the filing fee are included in the Filing Fees chart located on the UCAA website. Submit a copy of the applicant’s check as Item 2 of the application.

3.  Articles of Incorporation
Indicate the location of the language within the Articles that allows the applicant to write this line (e.g., Page #, section #, etc., of the Articles of Incorporation). In addition:

  • If the Articles have changed because of this application, file the amended Articles.
  • If the most recently filed (in the state for which you are applying) Articles of Incorporation have not changed because of this application, do not file the Articles. Simply state that the current articles are already on file in the state to which this application relates.

Include as Item 3 of your application.

4.  Bylaws
Insurers should have previously filed the most current version of their Bylaws.
  • If the Bylaws have changed because of this application, file the amended Bylaws.
  • If the most recently filed (in the state for which you are applying) Bylaws have not changed because of this application, do not file the Bylaws. Simply state that the current bylaws are already on file in the state to which this application relates.

Include as Item 4 of your application.

5.  Minimum Capital and Surplus Requirements
The application will need to show that the applicant meets the state’s statutory minimum capital and surplus requirements for the requested amendment to its Certificate of Authority. In some states, the minimum capital and surplus requirements are determined by the classes of insurance that the applicant is requesting authority to transact and the classes of insurance the applicant is authorized to transact in all other jurisdictions. The state will determine the level of surplus required after considering the applicant’s product line, operating record and financial condition. Compliance with the statutorily prescribed minimum surplus requirement may not be sufficient for all applicants. The chart located on the UCAA website identifies the minimum capital and surplus requirements for each Uniform State. This chart also provides a contact person or a link to a state-specific format or RBC requirements and instructions. Submit an explanation of the applicant’s compliance with the capital and surplus requirements as Item 5 of the application.

Minimum Capital and Surplus Requirements

6.  Statutory Deposit Requirements
A statutory deposit may be required for the requested modification. The chart located on the UCAA website provides state-specific requirements and identifies those states that require a Statutory Deposit. Unless otherwise indicated the Statutory Deposit is for the benefit of all policyholders. Applicants should submit as Item 6 of the application, documentation explaining how the applicant has met or will meet the statutory deposit requirements.

7.  Plan of Operation
The plan of operation has three components, a brief narrative, pro-forma financial statements/projections and a completed Questionnaire (Form 8C). The narrative should include significant information not captured as a part of the Questionnaire that the company submits in support of the application. Provide a company-wide three-year pro-forma balance sheet and income statement. For the lines the applicant is requesting, provide three-year premium and loss projections by line for the state in which the applicant has requested lines of business. 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. Submit the completed Questionnaire and all attachments as Item 7 of the application.

8. Statutory Memberships
In some states, applicants are required to join one or more rating, guarantee or other organizations before transacting insurance. Generally, the applicant's authorized lines of insurance govern statutorily mandated memberships. The chart of statutory membership requirements is located on the UCAA website. Please be sure to check with the state to which you have submitted an application to inquire about any statutory memberships that may be required before transacting insurance. Submit documentation supporting membership application(s), in states where required, as Item 8 of the application.

9.  Certificate of Compliance
Include a Certificate of Compliance with the application. We suggest that the issuance of the Certificate of Compliance (Form 6) be no more than 6 months from the filing date of the application. The current domiciliary state must complete the Certificate.

Submit as Item 9 of the application.

10.  State-Specific Information
Some jurisdictions may have additional requirements that applicants must meet before the state can amend a Certificate of Authority. Before completing a UCAA Corporate Amendments Application, the applicant should review a listing of requirements for the state to which the applicant is applying.

State Information

Include as Item 10 of the application.

11.  Deleting Lines of Business
Complete Section II of Form 8C (questions 22-25) documenting the following:

  • Utilizing the information contained in Form 3 list all of the lines of business that the company is requesting to delete from its Certificate of Authority.
  • Provide a detailed explanation for the company’s request to delete these lines of business.
  • For each state, indicate the number of policyholders by line of business that will be non-renewed or cancelled if the sate approves the company’s request to delete lines of business.

The UCAA website contains a chart of individual state requirements. Provide documentation that complies with all requirements for removal of lines of business from the Certificate of Authority listed as Item 11 of the application.

Deleting Lines of Business

Section III
Filing Requirements (Name Change)

This section provides a guide to understanding the focus of each document of the Corporate Amendments Application. However, documents typically serve multiple purposes. Therefore, it is important that applications be complete.

All documents submitted in support of the application must be current. However, in certain instances, some states have limited latitude to accept older documents. Please contact states individually if you have questions about a specific document.

All forms required for the Corporate Amendments Application are located on the UCAA website.

Table of Contents

  1. Application Form and Attachments
  2. Filing Fee
  3. Articles of Incorporation
  4. Bylaws
  5. Service of Process
  6. State of Domicile Approval
  7. State-Specific Information
  8. Name Approval

1. Application Form and Attachments
The applicant must submit a completed checklist (Form 1C), an original executed application form (Form 2C) and the company’s original certificate of authority or an affidavit of lost certificate of authority (Form 15) as Item 1 of the application. All Forms for the Corporate Amendments Application are located in the Forms Section on the UCAA website. A cover letter may be included as a component of Item 1 of the application.

2. Filing Fee
Include a filing fee for each state to which you are submitting the application. The payee name and the instructions for submitting the filing fee are included in the Filing Fees chart located on the UCAA website. Submit a copy of the applicant’s check as Item 2 of the application.

3. Articles of Incorporation
Indicate the location of the language within the Articles that reflects the new name. (e.g., Page #, section #, etc., of the Articles of Incorporation). In addition:

  • If the Articles have changed because of this application, file the amended Articles.
  • If the most recently filed (in the state for which you are applying) Articles of Incorporation have not changed because of this application, do not file the Articles. Simply state that the current Articles are already on file in the state to which this application relates.

Include as Item 3 of your application.

4. Bylaws
Insurers should have previously filed the most current version of their Bylaws.

  • If the Bylaws have changed because of this application, file the amended Bylaws.
  • If the most recently filed (in the state for which you are applying) Bylaws have not changed because of this application, do not file the Bylaws. Simply state that the current bylaws are already on file in the state to which this application relates.

Include as Item 4 of your application.

5. Service of Process
If there are in effect changes to information captured on the Uniform Consent to Service of Process and the Resolution Authorizing Appointment of Attorney (Form 12), submit one original fully executed Uniform Consent to Service of Process form (Form 12) or the appropriate state-specific form for these states: California, Massachusetts, Missouri, Virginia and Wisconsin. Pennsylvania does not accept Service of Process and does not require Form 12.

Include as Item 5 of your proposed transaction or completed transaction application.

6. State of Domicile Approval (Foreigns Only)
Provide a copy of the name change approval from the applicant’s state of domicile.

Include as Item 6 of your application.

7. State-Specific Information 
Some jurisdictions may have additional requirements that the applicant must meet before the state can amend a Certificate of Authority. Before completing a UCAA Corporate Amendments Application, the applicant should review a listing of requirements for the state to which the applicant is applying.

State Information

Include as Item 7 of the application.

8. Name Approval 
Each state has different guidelines and procedures for name approval. The Name Approval chart located on the UCAA website is intended to serve as a guide for the various name approval requirements of each Uniform State. Applicants should check with each state separately to ensure compliance with all applicable name approval requirements. Where applicable, submit evidence of name approval request as Item 8 of your application.

The applicant must notify the NAIC once the domiciliary state approves the name change prior to preparation of the electronic application. Email approval to: FDRCCREQ@NAIC.ORG 

Section IV
Filing Requirements (Redomestication of a Foreign Insurer)

This section provides a guide to understanding the focus of each document of the Corporate Amendments Application. However, documents typically serve multiple purposes. Therefore, it is important that applications be complete.

All documents submitted in support of the application must be current. However, in certain instances, some states have limited latitude to accept older documents. Please contact states individually if you have questions about a specific document.

All forms required for the Corporate Amendments Application are located on the UCAA website.

Table of Contents

  1. Application Form and Attachments
  2. Filing Fee
  3. Articles of Incorporation
  4. Bylaws
  5. Statutory Deposit Requirement
  6. Uniform Consent to Service of Process
  7. State of Domicile Approval (Foreigns Only)
  8. State-Specific Information

1. Application Form and Attachments
Submit a completed checklist (Form 1C), and an original executed application (Form 2C) and the company’s original certificate of authority or an affidavit of lost certificate of authority (Form 15) as Item 1 of the application.  A cover letter may be included as a component of Item 1 of the application.

2. Filing Fee
Include a filing fee for each state to which you are submitting the application. The payee name and the instructions for submitting the filing fee are included in the Filing Fees Chart located on the UCAA website. Submit a copy of the applicant’s check as Item 2 of the application.

3. Articles of Incorporation
Indicate the location of the language within the Articles that reflects the redomestication. (e.g., Page #, section #, etc., of the Articles of Incorporation). In addition:

  • If the Articles have changed because of this application, file the amended Articles.
  • If the most recently filed (in the state for which you are applying) Articles of Incorporation have not changed because of this application, do not file the Articles. Simply state that the current Articles are already on file in the state to which this application relates.

Include as Item 3 of your application.

4. Bylaws
Insurers should have previously filed the most current version of their Bylaws.

  • If the Bylaws have changed because of this application, file the amended Bylaws.
  • If the most recently filed (in the state for which you are applying) Bylaws have not changed because of this application, do not file the Bylaws. Simply state that the current bylaws are already on file in the state to which this application relates.

5. Statutory Deposit Requirement
A Statutory deposit may be required for the requested modification. The chart located on the UCAA website provides state-specific requirements and identifies those states that require a Statutory Deposit. Unless otherwise indicated the Statutory Deposit is for the benefit of all policyholders. Applicants should submit as Item 5 of the application, documentation explaining how the applicant has met or will meet the statutory deposit requirements.

6. Uniform Consent to Service of Process
If there are in effect changes to information captured on the Uniform Consent to Service of Process and the Resolution Authorizing Appointment of Attorney (Form 12), submit one original fully executed Uniform Consent to Service of Process form (Form 12) or the appropriate state-specific form for these states: California, Massachusetts, Missouri, Virginia and Wisconsin. Pennsylvania does not accept Service of Process and does not require Form 12.

Include as Item 6 of your proposed transaction or completed transaction application.

7. State of Domicile Approval (Foreigns Only)
Provide a copy of the redomestication approval from the applicant’s state of domicile.

Include as Item 7 of your application.

8. State-Specific Information 
Some jurisdictions may have additional requirements that the applicant must meet before the state can amend a Certificate of Authority. Before completing a UCAA Corporate Amendments Application, the applicant should review a listing of requirements for the state to which you are applying.

State Information

Include as Item 8 of the application.

Section V
Filing Requirements (Change of City within the State of Domicile)

This section provides a guide to understanding the focus of each document of the Corporate Amendments Application. However, documents typically serve multiple purposes. Therefore, it is important that applications be complete.

All documents submitted in support of the application must be current. However, in certain instances, some states have limited latitude to accept older documents. Please contact states individually if you have questions about a specific document.

All forms required for the Corporate Amendments Application are located on the UCAA website.

Table of Contents

  1. Application Form and Attachments
  2. Filing Fee
  3. Articles of Incorporation
  4. Bylaws
  5. Service of Process
  6. State of Domicile Approval (Foreigns Only)
  7. State-Specific Information

1. Application Form and Attachments
The applicant must submit a completed checklist (Form 1C), and an original executed application (Form 2C) and the company’s original certificate of authority or an affidavit of lost certificate of authority (Form 15) as Item 1 of the application.  A cover letter may be included as a component of Item 1 of the application.

2. Filing Fee
The application will need to include a filing fee for the state to which you are submitting the application. The payee name and the instructions for submitting the filing fee are included in the Filing Fees Chart located on the UCAA website. Submit a copy of the applicant’s check as Item 2 of the application.

3. Articles of Incorporation
Indicate the location of the language within the Articles that reflects the change of city. (e.g., Page #, section #, etc., of the Articles of Incorporation). In addition:

  • If the Articles have changed because of this application, file the amended Articles.
  • If the most recently filed (in the state for which you are applying) Articles of Incorporation have not changed because of this application, do not file the Articles. Simply state that the current Articles are already on file in the state to which this application relates.

Include as Item 3 of your application.

4. Bylaws
Insurers should have previously filed the most current version of their Bylaws.

  • If the Bylaws have changed because of this application, file the amended Bylaws.
  • If the most recently filed (in the state for which you are applying) Bylaws have not changed because of this application, do not file the Bylaws. Simply state that the current bylaws are already on file in the state to which this application relates.

Include as Item 4 of your application.

5. Service of Process
If there are in effect changes to information captured on the Uniform Consent to Service of Process and the Resolution Authorizing Appointment of Attorney (Form 12), submit one original fully executed Uniform Consent to Service of Process form (Form 12) or the appropriate state-specific form for these states: California, Massachusetts, Missouri, Virginia and Wisconsin. Pennsylvania does not accept Service of Process and does not require Form 12.

Include as Item 5 of your proposed transaction or completed transaction application.

6. State of Domicile Approval (Foreigns Only)
Provide a copy of the approval from the applicant’s state of domicile.

Include as Item 6 of your application.

7. State-Specific Information 
Some jurisdictions may have additional requirements that the applicant must meet before the state can amend a Certificate of Authority. Before completing a UCAA Corporate Amendments Application, the applicant should review a listing of requirements for the state to which you are applying.

State Information

Include as Item 7 of the application.

Section VI
Filing Requirements (Change of Address/Contact Notification)

This section provides a guide to understanding the focus of each document of the Corporate Amendments Application. However, documents typically serve multiple purposes. Therefore, it is important that applications be complete.

All documents submitted in support of the application must be current. However, in certain instances, some states have limited latitude to accept older documents. Please contact states individually if you have questions about a specific document.

All forms required for the Corporate Amendments Application are located on the UCAA website.
Please read the following Instructions before proceeding in completing Corporate Amendments Application Section VI.

Instructions

Applicants should complete the Corporate Amendments Application Section VI as a courtesy filing in conjunction with other changes or to notify regulatory officials of address changes or contact person changes applicable to your Company.

Table of Contents

  1. Application Form and Attachments
  2. State-Specific Information

1. Application Form and Attachments
The Change of Address/Contact Notification is located on the UCAA website. Submit a completed Change of Address/Contact Notification (Form 14).

2. State-Specific Information   
Some jurisdictions may have additional requirements that applicants must meet before the state can amend a Certificate of Authority. Before completing a UCAA Corporate Amendments Application, the applicant should review a listing of requirements for the state to which you are applying.

State Information

Include as Item 12 of the application.

Section VII
Filing Requirements (Merger of Two or More Foreign Insurers)

This section provides a guide to understanding the focus of each document of the Corporate Amendments Application. However, documents typically serve multiple purposes. Therefore, it is important that applications be complete.

All documents submitted in support of the application must be current. However, in certain instances, some states have limited latitude to accept older documents. Please contact states individually if you have questions about a specific document.

Please read the following Instructions before proceeding in completing Corporate Amendments Application Section VII. Section VII may not be applicable.

Instructions

The Corporate Amendments Application Section VII is for notifying states that a merger involving a licensed company is taking place. Section VII provides for submission of the information on the surviving company that changed due to the merger and the surrender of any certificates of authority for non-surviving companies. Section VII is not applicable for filing in a state if either insurer involved in the merger is a domestic insurer in that state or if either insurer is licensed in California. California has a state application for prior consent of a merger involving a licensed insurer.

For each admitted state for any one of the merging companies, please proceed through the steps given below to determine the appropriate filing for the situation in each state. The steps may result in one Corporate Amendments filing going to several states to report the merger. That filing would include corporate documents that changed due to the merger, if any, and surrender of the non-surviving company’s certificate of authority. In some cases, applicant may need to submit the UCAA expansion application to some states to obtain a license that allows the surviving insurance company to operate.

Step One:

  1. Is insurer A licensed as a foreign insurer in this state?

  2. Is insurer B licensed as a foreign insurer in this state?

    If you answered Yes to both questions, then proceed to Step Two.

    If you answered No to both questions, then no filing in this state is required. Do not complete the UCAA Corporate Amendments Application. In order to conduct business in this state post-merger, the surviving insurer will need to complete the UCAA Expansion Application located on the UCAA website.

    If you answered Yes to one question and No to the other question, then go to Step Two unless the surviving insurer after the merger is not authorized as a foreign insurer in this state, in which case, you go to Step Three.

Step Two:

For the surviving insurer after the merger:

   1.      What lines of business does the surviving insurer intend to write in this state?

   2.      Is the surviving insurer currently authorized to write all of these lines of business, including variable products, in this state?

If Yes to question 2, then complete Section VII of the UCAA Corporate Amendments Application.

If No to question 2, then complete Section VII and Section II (Adding and Deleting Lines of Business) of the UCAA Corporate Amendments Application located on the UCAA website for those lines that the insurer is not currently authorized to transact in this state.

Step Three:

If you have been directed to this step, then the surviving insurer post-merger is not currently authorized to conduct business in this state. In order to conduct business in this state, the surviving insurer will need to complete the UCAA Expansion Application. For further information and clarification, please contact the individual listed as the contact for this state for the UCAA Expansion Application.

Table of Contents

  1. Application Form and Attachments
  2. Filing Fee
  3. Articles of Incorporation/Articles of Merger
  4. Bylaws
  5. Minimum Capital and Surplus Requirements
  6. Statutory Deposit Requirements
  7. Plan of Operation
  8. Statutory Membership(s)
  9. NAIC Biographical Affidavits
  10. Service of Process
  11. State of Domicile Approval
  12. State-Specific Information

1.  Application Form and Attachments
The applicant must submit a completed checklist (Form 1C), an original executed application (Form 2C) and the company’s original certificate of authority or an Affidavit of Lost Certificate of Authority (Form 15) as Item 1 of the application.  A cover letter may be included as a component of Item 1 of the application.

2.  Filing Fee
The application will need to include a filing fee for the state to which the applicant is submitting. The payee name and the instructions for submitting the filing fee are located on the UCAA website. Submit a copy of the applicant’s check as Item 2 of the application.

3.  Articles of Incorporation/Articles of Merger
Indicate the location of the language within the Articles of the surviving insurer that reflects the merger. (e.g., Page #, section #, etc., of the Articles of Incorporation). In addition:

  • If the Articles have changed because of this application, file the amended Articles.
  • If the most recently filed (in the state for which you are applying) Articles of Incorporation have not changed because of this application, do not file the Articles. Simply state that the current articles are already on file in the state to which this application relates.

Include as Item 3 of your application.

4.  Bylaws
The surviving insurer should have previously filed the most current version of their Bylaws.

  • If the Bylaws have changed because of this application, file the amended Bylaws.
  • If the most recently filed (in the state for which you are applying) Bylaws have not changed because of this application, do not file the Bylaws. Simply state that the current bylaws are already on file in the state to which this application relates.

Include as Item 4 of your application.

5.  Minimum Capital and Surplus Requirements
The application will need to show that subsequent to the merger, the applicant meets the state’s statutory minimum capital and surplus requirements for the requested amendment to its Certificate of Authority. Submit an explanation of how the applicant complies with the capital and surplus requirements as Item 5 of the application. In some states, the minimum capital and surplus requirements are determined by the classes of insurance that the applicant is requesting authority to transact and the classes of insurance the applicant is authorized to transact in all other jurisdictions. The level of surplus required will be determined after considering the applicant’s product line, operating record and financial condition. Compliance with the statutorily prescribed minimum surplus requirement may not be sufficient for all applicants. The chart located on the UCAA website identifies the minimum capital and surplus requirements for each Uniform State. This chart also provides a contact person or a link to a state-specific format or RBC requirements and instructions.

Minimum Capital and Surplus Requirements

6.  Statutory Deposit Requirements
A statutory deposit may be required for the requested modification. The Statutory Deposit chart located on the UCAA website provides state-specific requirements and identifies those states that require a Statutory Deposit. Unless otherwise indicated the Statutory Deposit is for the benefit of all policyholders. Applicants should submit as Item 6 of the application documentation explaining how the applicant has met or will meet the statutory deposit.

7.  Plan of Operation
If the business plan of the surviving insurer will change because of the merger, submit a plan of operation; otherwise, a statement that the business plan will not change will suffice. The plan of operation contains two components, a brief narrative and pro-forma financial statements/projections (Form 13). The narrative should include significant information in support of the application. 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 pro forma (Form 13) is located on the UCAA website. Submit the narrative and completed pro forma and all attachments as Item 7 of the application.

8.  Statutory Memberships
In some states, applicants are required to join one or more rating, guarantee or other organizations before transacting insurance. Generally, the applicant's authorized lines of insurance govern statutorily mandated memberships. The Statutory Membership chart is available at on the UCAA website. Please be sure to check with the state to which you have submitted an application to inquire about any statutory memberships that may be required before transacting insurance. Documentation supporting membership application(s) should be submitted, in states where required, as Item 8 of the application.

9. NAIC Biographical Affidavits

  1. The applicant is required to submit an NAIC Biographical Affidavit 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 must submit an NAIC Biographical Affidavit on behalf of all officers, directors and key managerial personnel of the applicant and individuals with a ten percent (10%), or more, beneficial ownership in the applicant and the applicant's ultimate controlling parent (Affiant).

  2. 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 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.

  3. The NAIC Biographical Affidavit requests information with respect to your employment history, education, personal information and character. The NAIC 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 a background investigation on the Affiant.

  4. The NAIC 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.

  5. The NAIC Biographical Affidavit is used to evaluate the suitability, competency, character and integrity of the Affiant in connection with an applicant'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 NAIC Biographical Affidavit as a tool to perform a background investigation to determine an individual's fitness and propriety. The background investigation 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 shall use the background investigation to create a background report (the "Background Report").

  6. The Disclosure & Authorization Form is valid for a maximum of one year. Additionally, an Affiant may revoke the authorization at any time by delivering a written revocation to the applicant. Refer to the Disclosure & Authorization Form for further information.

  7. The Background Reports are subject to the Fair Credit Reporting Act ("FCRA"). Pursuant to FCRA, the state departments of insurance and an applicant who is seeking admission are "users" of consumer reports. The FCRA requires that the applicant provide the Affiant with a copy of the "Summary of Your Rights Under the Fair Credit Reporting Act." Applicants 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) website at http://www.ftc.gov/bcp/edu/pubs/consumer/credit/cre35.pdf.

  8. Applicants 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 Third-Party Vendors should maintain the Background Reports procured under the Disclosure & Authorization Form as confidential. A copy of FCRA is located at http://www.ftc.gov/enforcement/rules/rulemaking-regulatory-reform-proceedings/fair-credit-reporting-act.

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

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

    Refer to the UCAA website for a list of currently approved Independent Third-Party vendors/CRA's

    NAIC Biographical Affidavits must be completed on the most current form [Word | PDF], in effect the time the affidavit was signed and the affiant shall not sign the Affidavits more than one year before the date the insurer files the application.

    Submit original NAIC Biographical Affidavits that contain the Disclosure & Authorization Form to the state department(s) of insurance as Item 9 of your application.

10. Uniform Consent to Service of Process
If there are in effect changes to information captured on the Uniform Consent to Service of Process and the Resolution Authorizing Appointment of Attorney (Form 12), submit one original fully executed Uniform Consent to Service of Process form (Form 12) or the appropriate state-specific form for these states: California, Massachusetts, Missouri, Virginia and Wisconsin. Pennsylvania does not accept Service of Process and does not require Form 12.

Include as Item 10 of your proposed transaction or completed transaction application.

11. State of Domicile Approval
Provide a copy of the approval from each insurer’s state of domicile, including a copy of the Merger Agreement, and sample Assumption Certificate, if any.

Include as Item 11 of your application.

The applicant must notify the NAIC once the domiciliary state approves the merger prior to preparation of the electronic application.  Email approval to: FDRCCREQ@NAIC.ORG 

12.  State-Specific Information
Some jurisdictions may have additional requirements that the applicant must meet before the state can amend the Certificate of Authority. Before completing a UCAA Corporate Amendments Application, the applicant should review a listing of requirements for the state to which you are applying.

State Information

Include as Item 12 of the application.

Section VIII
Filing Requirements (Proposed/Completed Change of Control of Foreign Insurers)

This section provides a guide to understanding the main focus of each document of the Corporate Amendments Application. However, documents are typically used for multiple purposes. Therefore, it is important that applications be complete.

All documents submitted in support of the application must be current. However, in certain instances, some states have limited latitude to accept older documents. Please contact states individually if you have questions about a specific document.

All forms required for the Corporate Amendments Application are located in the Forms Section on the UCAA website.

Please read the following Instructions before in completing Corporate Amendments Application Section III.

Instructions

The Corporate Amendments Application Section VIII provides for submission of proposed change of control transaction information (proposed transaction) and a second filing of actual information after the change of control is complete (completed transaction). Section VIII is not applicable for filing in a state if the insurer is a domestic insurer in that state. 

Table of Contents

  1. Application Form and Attachments
  2. Filing Fee
  3. Articles of Incorporation
  4. Bylaws
  5. Plan of Operation
  6. NAIC Biographical Affidavits
  7. Uniform Consent to Service of Process
  8. State of Domicile Approval
  9. State-Specific Information

1. Application Form and Attachments
A completed checklist (Form 1C), and an original executed application (Form 2C) must be submitted as Item 1 of the application for a proposed transaction and again for a completed transaction. Include the previous and new group code if applicable. All Forms for the Corporate Amendments Application are located in the Forms Section on the UCAA website.

2. Filing Fee
The application may need to include a filing fee for the state to which the application is submitted. The payee name and the instructions for submitting the filing fee are located in the Schedule of Fees chart referenced below. Submit a copy of the applicant’s check as Item 2 of the application.

3. Articles of Incorporation
If the Articles have changed as a result of the change of control, file the amended Articles. If the most recently filed (in the state for which you are applying) Articles of Incorporation have not changed, do not file the Articles. Simply state that the current articles are already on file in the state to which this application relates. If it is expected that the applicant will submit revised Articles of Incorporation in the completed transaction filing, please state that in the proposed transaction filing at Item 3.

Include as Item 3 of your application.

4.  Bylaws
If the Bylaws have changed, file the amended Bylaws.

If the most recently filed (in the state for which you are applying) Bylaws have not changed, do not file the Bylaws. Simply state in Item 4 that the current bylaws are already on file in the state to which this application relates. If it is expected that the applicant will submit revised Bylaws in the completed transaction filing, please state that in the proposed transaction filing at Item 4.

Include as Item 4 of your application.

5.  Plan of Operation
If the business plan of the insurer will change as a result of the change of control transaction, a plan of operation must be submitted; otherwise, a statement that the business plan will not change will suffice and should be submitted as item 8 of the application. The plan of operation is made up of two components; a brief narrative, and pro-forma financial statements/projections (Form 13). The narrative should include significant information in support of the application. 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 pro forma (Form 13) is located in the Forms Section on the UCAA website. Submit the narrative and completed pro forma and all attachments as Item 5 of the application.

6. NAIC Biographical Affidavits

  1. A. The applicant is required to submit an NAIC Biographical Affidavit (Form 11) in connection with the proposed transaction filing for all newly proposed officers, directors and key managerial personnel of the applicant, any new individuals with a ten (10) percent or more beneficial ownership and the new ultimate controlling parent. An NAIC Biographical Affidavit must be submitted 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 must submit an NAIC Biographical Affidavit on behalf of all officers, directors and key managerial personnel of the applicant and individuals with a ten percent (10%), or more, beneficial ownership in the applicant and the applicant's ultimate controlling parent (Affiant), if the information currently on file with the regulator is not current.

  2. 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 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.

  3. The NAIC Biographical Affidavit requests information with respect to your employment history, education, personal information and character. The NAIC 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 a background investigation on the Affiant.

  4. The NAIC 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.

  5. The NAIC Biographical Affidavit is used to evaluate the suitability, competency, character and integrity of the Affiant in connection with an applicant'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 NAIC Biographical Affidavit as a tool to perform a background investigation to determine an individual's fitness and propriety. The background investigation 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 shall use the background investigation to create a background report (the "Background Report").

  6. The Disclosure & Authorization Form is valid for a maximum of one year. Additionally, an Affiant may revoke the authorization at any time by delivering a written revocation to the applicant. Refer to the Disclosure & Authorization Form for further information.

  7. The Background Reports are subject to the Fair Credit Reporting Act ("FCRA"). Pursuant to FCRA, the state departments of insurance and an applicant who is seeking admission are "users" of consumer reports. The FCRA requires that the applicant provide the Affiant with a copy of the "Summary of Your Rights Under the Fair Credit Reporting Act." Applicants 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) website at http://www.ftc.gov/bcp/edu/pubs/consumer/credit/cre35.pdf.

  8. Applicants 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 Third-Party Vendors should maintain the Background Reports procured under the Disclosure & Authorization Form as confidential. A copy of FCRA is located at http://www.ftc.gov/enforcement/rules/rulemaking-regulatory-reform-proceedings/fair-credit-reporting-act.

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

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

    Refer to the UCAA website for a list of currently approved Independent Third-Party vendors/CRA's

    NAIC Biographical Affidavits must be completed on the most current form [Word | PDF], in effect the time the affidavit was signed and the affiant shall not sign the Affidavits more than one year before the date the insurer files the application.

    Submit original NAIC Biographical Affidavits that contain the Disclosure & Authorization Form to the state department(s) of insurance as Item 6 of your application.

7.  Uniform Consent to Service of Process
If there are in effect changes to information captured on the Uniform Consent to Service of Process and the Resolution Authorizing Appointment of Attorney (Form 12), submit one original fully executed Uniform Consent to Service of Process form (Form 12) or the appropriate state-specific form for these states: California, Massachusetts, Missouri, Virginia and Wisconsin. Pennsylvania does not accept Service of Process and does not require Form 12. Include as Item 13 of your proposed transaction or completed transaction application.

If the most recently filed (in the state for which you are applying) Uniform Consent to Service of Process form (Form 12) has not changed, do not file the form. Simply state in Item 7 that the current information is already on file in the state to which this application relates.

8. State of Domicile Approval
Provide a copy of the approval from each insurer’s state of domicile when the change of control is completed.

Include as Item 8 of your completed transaction application.

9. State-Specific Information
Some jurisdictions may have additional requirements that must be met before a proposed change of control can be completed. For example, some states require the filing of a Form E (Pre-Acquisition Notification Form Regarding the Potential Competitive Impact of a Proposed Merger or Acquisition by a Non-Domiciliary Insurer Doing Business in this State or by a Domestic Insurer) at least 30 days before the completion of a change of control transaction. In addition some states may require a Holding Company Act Form B amended statement after completion of the change of control transaction. Before completing a UCAA Corporate Amendments Application the applicant should review a listing of requirements for the state to which you are applying.

State Information

Include as Item 9 of the application.

Section IX
Filing Requirements (Amended Articles of Incorporation)

This section provides a guide to understanding the main focus of each document of the Corporate Amendments Application. However, documents are typically used for multiple purposes. Therefore, it is important that applications be complete.

This section is intended for submission of amended articles of incorporation that are not a result of changes addressed in other areas of the Corporate Amendment Application (e.g. change in number of shares or par value).

All documents submitted in support of the application must be current. However, in certain instances, some states have limited latitude to accept older documents. Please contact states individually if you have questions about a specific document.

All forms required for the Corporate Amendments Application are located in Forms Section on the UCAA website.

Table of Contents

  1. Application Form and Attachments
  2. Filing Fee
  3. Articles of Incorporation
  4. Bylaws
  5. State of Domicile Approval
  6. State-Specific Information

1. Application Form and Attachments
A completed checklist (Form 1C), and an original executed application (Form 2C) must all be submitted as Item 1 of the application. All Forms for the Corporate Amendments Application are located in the Forms Section on the UCAA website. A cover letter may be included as a component of Item 1 of the application.

2. Filing Fee
The application will need to include a filing fee for the state to which the application is submitted. The payee name and the instructions for submitting the filing fee are included in the Schedule of Fees Chart located below. Submit a copy of the applicant’s check as Item 2 of the application.

3. Articles of Incorporation
Indicate the location of the language within the Articles that reflects the change. (Page #, section #, etc., of the Articles of Incorporation).

Include as Item 3 of your application.

4. Bylaws
Insurers should have previously filed the most current version of their Bylaws.

  • If the Bylaws have changed as a result of this application, file the amended Bylaws.
  • If the most recently filed (in the state for which you are applying) Bylaws have not changed as a result of this application, do not file the Bylaws. Simply state that the current bylaws are already on file in the state to which this application relates.

Include as Item 4 of your application.

5. State of Domicile Approval (Foreigns Only)
Provide a copy of the amended articles of incorporation approval from the applicant’s state of domicile.

Include as item 5 of your application.

6. State-Specific Information
Some jurisdictions may have additional requirements that must be met before a Certificate of Authority can be amended. Before completing a UCAA Corporate Amendments Application the applicant should review a listing of requirements for the state to which you are applying. 

State Information

Include as Item 6 of the application.

Section X
Filing Requirements (Amended Bylaws)

This section provides a guide to understanding the main focus of each document of the Corporate Amendments Application. However, documents are typically used for multiple purposes. Therefore, it is important that applications be complete.

This section is intended for submission of amended bylaws that are not a result of changes addressed in other areas of the Corporate Amendment Application.

All documents submitted in support of the application must be current. However, in certain instances, some states have limited latitude to accept older documents. Please contact states individually if you have questions about a specific document.

All forms required for the Corporate Amendments Application are located in Forms Section on the UCAA website.

Table of Contents

  1. Application Form and Attachments
  2. Filing Fee
  3. Bylaws
  4. State of Domicile Approval
  5. State-Specific Information

1. Application Form and Attachments
A completed Checklist (Form 1C), and an original executed application Form 2C must all be submitted as Item 1 of the application. All Forms for the Corporate Amendments Application are located in the Forms Section on the UCAA website. A cover letter may be included as a component of Item 1 of the application.

2. Filing Fee
The application will need to include a filing fee for the state to which the application is submitted. The payee name and the instructions for submitting the filing fee are included in the Schedule of Fees Chart located below. Submit a copy of the applicant’s check as Item 2 of the application.

3. Bylaws
Indicate the location of the language within the Bylaws that reflects the change. (Page #, section #, etc., of the Bylaws).

Include as Item 3 of your application.

4. State of Domicile Approval (Foreigns Only)
Provide a copy of the amended bylaws approval from the applicant’s state of domicile.

Include as item 4 of your application.

5. State-Specific Information
Some jurisdictions may have additional requirements that must be met before a Certificate of Authority can be amended. Before completing a UCAA Corporate Amendments Application the applicant should review a listing of requirements for the state to which you are applying.

State Information

Include as Item 5 of the application.

Section XI
Filing Requirements (Statement of Withdrawal/Complete Surrender of Certificate of Authority)

This section provides a guide to understanding the focus of each document of the Corporate Amendments Application. However, there typically are multiple purposes for documents. Therefore, it is important that applications be complete.

All documents submitted in support of the application must be current. However, in certain instances, some states have limited latitude to accept older documents. Please contact states individually if you have questions about a specific document.

All forms required for the Corporate Amendments Application are located on the UCAA website.

Table of Contents

  1. Application Form and Attachments
  2. Filing Fee
  3. Statement of Withdrawal and Attachments
  4. State-Specific Information

1. Application Form and Attachments
The application must identify the reason for withdrawal. Submit a completed Checklist (Form 1C), and the original Certificate of Authority or an affidavit of lost Certificate of Authority (Form 15) as Item 1 of the application. All forms for the Corporate Amendments Application are located on the UCAA website. A cover letter may be included as a component of Item 1 of the application.

2. Filing Fee 
The application must include a filing fee for the application state, if required. The payee name and instructions for submitting a filing fee are located in the Foreign Withdrawal chart located on the UCAA website. Submit a copy of the applicant’s check as Item 2 of the application.

3. Statement of Withdrawal and Attachments 
The application must include a completed Statement of Withdrawal (Form 17).

Include attachments to the Statement of Withdrawal as Item 3 of the application.

4. State-Specific Information 
Some jurisdictions may have additional requirements that applicants must meet before the state can cancel a Certificate of Authority. Before completing a UCAA Corporate Amendments Application, the applicant should review a listing of requirements for the state to which the applicant is withdrawing.

State Information

Include as Item 4 of the application.

Section XII
How to File

To facilitate the prompt review of the Corporate Amendments Application, please ensure that the application adheres to the formatting instructions provided in this section. The states will not accept for filing applications that fail to meet these formatting requirements. Section XII will address the following areas:

  1. Communication Between Applicant and Agency
  2. Questions
  3. Application Checklist
  4. Application and Supporting Documents
  5. Address for Submission of Application
  6. Updates/Changes
  7. Filing Fee
  8. Forms
  9. State-Specific Information 

1. Communication Between Applicant and Agency
Once a state accepts a Corporate Amendments Application for filing, the state will notify the applicant of the official filing date and agency contact person. The state will provide the names, addresses, e-mail (if available) and telephone numbers of the individual(s) assigned to the application.

Before receiving the name of the agency contact person, an applicant may contact the agency personnel listed on the chart located on the UCAA website to obtain information regarding the status of a Corporate Amendments Application.

State UCAA Contacts

2. Questions
Sections II – XI Filing Requirements, provide detailed guidelines regarding both the type and format of information required for the Corporate Amendments Application. For additional information, or clarification, applicants may use the contact names provided on the UCAA website.

3. Application Checklist
The application checklist (Form 1C) in the Forms Section is a guide for assembling a complete application. Complete the checklist prior to submitting a Corporate Amendments Application for review. Attach a completed checklist to the top of your application.

4. Application and Supporting Documents
Submit one copy of the checklist, completed application and all supporting documentation to the reviewing state. Louisiana and New York require two (2) complete copies. California requires two (2) complete copies for each change. Each item identified in Sections II – XI of the Filing Requirements should have a cover sheet as specified below.

Each cover sheet should be on paper suitable for use as a cover sheet, such as binder divider pages.

Tab each cover sheet on the right-hand side of the page with a number corresponding to the document’s Item number in the Corporate Amendments Application Checklist.

If a particular item is not included with the cover sheet, attach a written explanation stating the reason the item has not been included to the cover sheet. Set forth below are examples of why you may not attach a particular item to the cover sheet.

  • "Item not applicable to this application for the following reason ... (state reason)"
  • "Item has been attached separately because of size."

5. Address for Submission of Application
Submit your application by mailing it to the appropriate address noted in the chart located on the UCAA website.

State Mailing Addresses

6. Updates/Changes
Applicants are responsible for informing states of any significant changes that occur or that you discover during the application review period. Examples of significant changes include: changes in officers and directors, material acquisition or disposal of assets, changes in reinsurance, acquisition of the insurer, regulatory actions taken against the insurer, change in current business plan, etc.

Applicants must supply revised forms promptly if any changes occur which materially affect the accuracy of the forms filed in support of the application.

7. Filing Fee
Please see Schedule of Filing Fees, located on the UCAA website, to determine the correct fee and filing instructions for the state in which you are applying.

State Filing Fees

8. Forms
All forms are available in the Forms Section on the UCAA website.

9. State-Specific Information

Some jurisdictions may have additional requirements that the applicant must meet before the state can amend the Certificate of Authority. Before completing a UCAA Corporate Amendments Application, the applicant should review a listing of requirements for the state to which you are applying.

State Information