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Company Admission Applications — Uniform Certificate of Authority Application

All insurance companies other than Health Insuring Corporations (HIC) should use the appropriate Uniform Certificate of Authority Application (UCAA) Primary or Expansion Application when filing for an Ohio Certificate of Authority. Instructions and forms for the UCAA can be found at the National Association of Insurance Commissioners’ (NAIC) website at www.naic.org/industry_ucaa.htm. For instructions regarding filing for an Ohio Certificate of Authority as a Health Insuring Corporation, please refer to Company Admission Application - Health Insuring Corporations.

The Primary Application should be used by newly forming Ohio insurance companies seeking a Certificate of Authority in Ohio and for insurers not currently licensed in Ohio wishing to redomesticate to Ohio. Please contact the Ohio Department of Insurance for additional filing requirements.

The Expansion Application should be submitted by all other insurance companies already licensed elsewhere.

Companies applying only for reinsurance authority may follow the same procedures as direct-writing applicants (i.e., file an expansion application), or file an application pursuant to Ohio Revised Code 3901.62 as an accredited reinsurer, trusteed reinsurer, or certified reinsurer.

NAIC UCAA Biographical Affidavits (UCAA Form 11) must be submitted with all UCAA Primary and Expansion Applications and with all HIC applications for an Ohio Certificate of Authority. UCAA Form 11, “Biographical Affidavits,” can be found under “Forms” at www.naic.org/industry_ucaa.htm.

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 HIC, Primary and Expansion Applications should be addressed to Office of 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.

Corporate Amendment Applications questions should be addressed to Office of Risk Assessment at Risk.Assessment@Insurance.ohio.gov or (614) 644-2647. Send Corporate Amendment Applications to Risk Assessment at the address above.

The State of Ohio is an Equal Opportunity Employer

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