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Company Admission Applications - Health Insuring Corporations

Filing requirements for an Ohio Certificate of Authority application as a Health Insuring Corporation (HIC) are contained in Ohio Revised Code section 1751.02 et. seq. For application forms and instructions, please refer to Ohio form INS9032 which is available from the Ohio Department of Insurance homepage at  which are available from the Ohio Department of Insurance homepage at www.insurance.ohio.gov under “ODI Forms.” All other insurance companies should use the appropriate UCAA Primary or Expansion Application when filing for an Ohio Certificate of Authority. See Company Admission Application - Uniform Certificate of Authority Application on this website for additional information. 

NAIC UCAA Biographical Affidavits (UCAA Form 11) must be submitted with all applications for an Ohio Certificate of Authority, including HIC applications. UCAA Form 11, “Biographical Affidavit,” can be found under “Forms” at www.naic.org/industry_ucaa.htm. For additional information see Biographical Affidavits

The Ohio Department of Insurance also requires verification of all biographical affidavits by independent third parties used for verification in Ohio. Note that the Ohio list differs from the NAIC list. Not all NAIC approved independent third parties indicated a willingness or ability to provide this service to Ohio. Verifications must be sent to the Ohio Department of Insurance at the address below directly by the independent third party. 

Questions regarding HIC applications 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 Assessment
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