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Biographical Affidavits and Independent Third Parties Used for Verification of Biographical Information

All applications for an Ohio Certificate of Authority must contain biographical affidavits, including those from health insuring corporations. Form 11, ”Biographical Affidavit,” of the NAIC Uniform Certificate of Authority Application should be used for this purpose. Go to "UCAA Forms" at www.naic.org/industry_ucaa.htm to download this form.

The Ohio Department of Insurance also requires independent third-party verification of all biographical affidavits. Verifications must be sent to the Ohio Department of Insurance at the address below directly by the independent third party. A list of independent third parties used for verification of biographical information in Ohio is shown on the NAIC website at www.naic.org/industry_ucaa.htm.

Questions regarding all applications for certificate of authority should be addressed to Risk Assessment at Risk.Assessment@Insurance.ohio.gov or (614) 644-2647.

Send applications to:
Ohio Department of Insurance
Office of Risk Management
50 W. Town Street
Third Floor - Suite 300
Columbus, Ohio 43215

An application for certificate of authority may be submitted at any time throughout the year.

Ohio Department of Insurance
50 W. Town Street, Third Floor - Suite 300
Columbus, Ohio  43215
Mike DeWine, Governor | Jillian Froment, Director
General Info: 614-644-2658 | Consumer Hotline: 800-686-1526
Fraud Hotline: 800-686-1527 | Medicare Hotline: 800-686-1578
ODI Services