The New York DFS Captive Insurance Company Application is the licensing packet that every company forming a captive insurer in New York must submit to the New York State Department of Financial Services before it can write a single policy. The application is governed by New York Insurance Law Article 70 and the Captive Insurance Unit’s published guidance, and it asks for a complete picture of the proposed captive’s owners, operations, capital, and risks.
A clean, complete filing usually moves through review in 60 to 120 days, while a sloppy one can sit in correction for six months or longer. According to NYDFS Captive Insurance Unit reports, New York licenses fewer than 200 active captives, and roughly one in three first-time applications is returned for material deficiencies on the Plan of Operation, the pro forma financials, or the biographical affidavits.
Here is what you will learn in this guide:
- 📝 How every section of the New York captive application packet works, line by line
- 🏢 Which captive type (pure, group, agency, RRG, SPFC, branch) fits your facts
- 💰 The exact capital, surplus, and fee numbers required under Article 70
- 📂 The full list of attachments, affidavits, and pro formas you must gather first
- ⚖️ The most common mistakes that get applications rejected and how to avoid them
What the Form Is and Who Must File It
The New York DFS Captive Insurance Company Application is a multi-part licensing packet, not a single one-page form. It is the gateway document required under Insurance Law § 7002 for any entity that wants to be authorized as a captive insurer domiciled in New York. The packet bundles a cover application, a Plan of Operation, five-year pro forma financial statements, biographical affidavits for every officer and director, organizational charts, draft policy forms, reinsurance agreements, and a feasibility study.
Any company that wants to insure the risks of its parent and affiliates inside New York must file this packet. That includes pure captives, group captives, agency captives, risk retention groups, special purpose financial captives, and branch captives of foreign captives. The filer is usually the proposed captive itself, acting through its organizers, with help from a licensed captive manager and outside counsel.
NYDFS will not accept the packet from a shell entity that has no organizers identified, no capital plan, and no named captive manager. The Captive Insurance Unit reviews each filing under the standards in 11 NYCRR Part 80 and the published Article 70 framework. Failing to file before writing business is a violation of Insurance Law § 1102 and can trigger cease-and-desist orders, restitution, and civil penalties.
Before You Start: Documents and Information You Need
Before you open the application, gather every supporting document the Captive Insurance Unit will demand. Missing items are the single largest cause of delay, and the Unit will not “hold” an incomplete file open while you scramble.
- Certificate of incorporation or organizational charter. This proves the captive is a legal entity in New York and matches the name used on the application.
- Bylaws or operating agreement. The Unit reads these to confirm voting rights, board structure, and conflicts policies.
- Five-year pro forma financial statements. These project premiums, losses, expenses, surplus, and investments, and they anchor the entire feasibility analysis.
- Feasibility study. A signed actuarial study from a qualified actuary that justifies premium levels, loss picks, and capital adequacy.
- Biographical affidavits. Use the NAIC Biographical Affidavit (Form 11) for every officer, director, and 10%+ owner.
- Organizational chart. Shows the parent, the captive, every affiliated insured, and any service providers.
- Draft policy forms. Each line of coverage you plan to write needs a sample policy that complies with New York form requirements.
- Reinsurance agreements. Drafts or term sheets for any fronting, quota share, or excess-of-loss treaties.
- Investment policy statement. Spells out how the captive will invest premiums consistent with Insurance Law § 7004.
- Capitalization plan. Bank letters or escrow letters showing the source and timing of paid-in capital and free surplus.
Each of these matters because the Captive Insurance Unit reads them as a single integrated story. If your pro forma assumes a 65% loss ratio but your feasibility study assumes 80%, the file gets returned. If your biographical affidavit omits a 2014 NASD settlement, the Unit will find it and ask why.
Where to Get the Form and How to Access It
The current application packet lives on the NYDFS Captive Insurance Companies page. The Department publishes the packet in PDF and Word formats and updates it as Article 70 and Part 80 change. Always check the revision date printed at the bottom of the cover page before you start typing, because using an outdated packet is grounds for rejection on first review.
You can also request the packet by emailing the Captive Insurance Unit at captive@dfs.ny.gov or by calling the Unit through the main DFS line. Many applicants instead work through a New York–licensed captive manager who keeps the latest packet on file and pre-fills the boilerplate sections. A captive manager is not legally required, but Part 80 expects the captive to identify one before licensing.
The packet is filed in paper form by mail or courier to the Captive Insurance Unit at One State Street, New York, NY 10004. Some supplemental filings, including post-license annual statements, move through the DFS Portal, but the initial application is still a paper-first process. Keep a full color PDF copy of every page you mail, because the Unit’s review notes will reference your pagination.
Step-by-Step: How to Fill Out the New York Captive Application Line by Line
The packet is organized as a cover application followed by attachments. Each block below maps to a section of the cover application and the most-asked items in the Plan of Operation. Use the exact section names printed on the current packet, and write entries in black ink or typed text.
Section 1: Type of Captive Being Formed
This field asks which captive structure under Insurance Law § 7002 you are forming. Check exactly one box: pure captive, group captive, agency captive, risk retention group, special purpose financial captive, or branch captive. The choice drives every later requirement, including capital minimums and permitted lines of business.
To answer it, match your fact pattern to the statutory definitions. A pure captive insures only its parent and affiliates. A group captive insures a defined group of insureds with a common sponsor. An agency captive reinsures risks placed by a controlling insurance agency. A risk retention group operates under the federal Liability Risk Retention Act and writes liability coverage for its members. A special purpose financial captive supports securitized insurance risk transfer. A branch captive is a U.S. branch of an alien captive.
For example, Acme Manufacturing Holdings, Inc. checks “Pure Captive” because it will only insure its 14 wholly owned subsidiaries. The nuance is mixed business: if any non-affiliate risk slips in, you have a group captive, not a pure captive, and your capital requirement jumps. The most common mistake is checking “Pure Captive” while planning to write a small slice of unrelated employee benefits risk, which forces a re-file as a group captive. The misconception is that “captive” is one license; it is not, and the box you check defines the rest of your filing.
Section 2: Proposed Captive Name
This field asks for the exact legal name the captive will use. The name must include a corporate identifier (Inc., Corp., LLC) and must not mislead the public into thinking the captive is a commercial insurer. NYDFS clears the name against existing licensees before accepting the filing.
Type the name exactly as it will appear on the certificate of incorporation. Avoid words like “Bank,” “Trust,” or “Mutual” unless the structure supports them. Reserve the name with the New York Department of State before filing, because a name conflict at the State level kills the filing.
For example, Hudson River Pure Captive Insurance Company, Inc. is acceptable. The nuance is foreign-language names, which need an English translation in the application. The most common mistake is filing under a working name that does not match the certificate of incorporation, which forces a re-file. The misconception is that DFS can “fix” a name later; it cannot, and you will repaper your charter to fix it.
Section 3: Home Office Address in New York
This field asks for the physical New York address of the captive’s principal office. Article 70 requires a real New York presence, not a mail drop. The address feeds service of process, examination logistics, and tax situs.
Enter a full street address with suite or floor, the city, and the ZIP code. A registered agent address is not enough on its own. Most captives list their captive manager’s New York office as the principal place of business.
For example, Empire Pure Captive, Inc. lists One State Street, 19th Floor, New York, NY 10004, which is its captive manager’s address. The nuance is a parent that wants to use its corporate headquarters; that is fine if the headquarters is in New York and books and records will be kept there. The most common mistake is listing a P.O. Box, which the Unit rejects. The misconception is that a Delaware holding company can list its Wilmington address; it cannot for New York licensing.
Section 4: Lines and Classes of Insurance
This field asks which kinds of insurance the captive will write. The answer must align with the kinds permitted under Insurance Law § 7003 for the captive type you chose. Common lines include general liability, products liability, workers’ compensation, professional liability, and property.
List each line in plain English and tie it to the parent’s risk inventory. Workers’ compensation in a pure captive requires either direct issuance with extra capital or a fronted structure with an admitted carrier. Personal lines are not permitted.
For example, Acme Pure Captive lists general liability, products liability, and property tied to the parent’s manufacturing operations. The nuance is medical stop-loss, which sits between health and reinsurance and triggers extra review. The most common mistake is listing “all property and casualty,” which is too broad and gets bounced. The misconception is that a captive can write health insurance for employees the same way a commercial insurer can; New York treats employee health captives carefully under Insurance Law § 7003.
Section 5: Capital and Surplus
This field asks how much paid-in capital and free surplus the captive will hold at licensing. Insurance Law § 7004 sets the floors, and the Unit can raise them based on risk. For a pure captive, the statutory minimum is $250,000 in paid-in capital plus $250,000 in free surplus, for $500,000 total.
Enter the proposed amounts in U.S. dollars and attach a bank letter or escrow letter dated within 30 days of filing. The funds must be in a New York–chartered bank or a bank acceptable to the Superintendent. Letters of credit are allowed for some structures but not all.
For example, Liberty Group Captive shows $500,000 paid-in capital and $250,000 free surplus, totaling $750,000, which matches the group captive minimum. The nuance is risk-based add-ons; if your pro forma shows volatile lines, the Unit will demand more. The most common mistake is funding the account after submission, which fails the “on-deposit at licensing” rule. The misconception is that capital can be a parental guarantee; New York wants real, segregated funds.
Section 6: Officers, Directors, and Owners
This field asks for the full slate of governance. List every director, officer, and any person owning 10% or more of the captive or its parent. Each named person must submit an NAIC Biographical Affidavit with a third-party background verification.
Type each person’s full legal name, title, percentage ownership, and home address. The board must include at least one New York resident, a requirement the Unit enforces strictly. Independent directors are encouraged for group captives and RRGs.
For example, Maria Lopez is listed as Chair, 0% ownership, resident of Albany, NY. The nuance is dual-hatted officers; if your CFO is also the captive’s CFO, disclose it. The most common mistake is omitting the New York resident director, which delays licensing until the board is reconstituted. The misconception is that biographical affidavits can be self-verified; they cannot, and a third-party vendor must verify them.
Section 7: Captive Manager
This field asks who will manage the day-to-day operations. New York expects every captive to have a captive manager identified at the time of application. The manager is responsible for books, records, regulatory filings, and acting as the Unit’s main point of contact.
Enter the manager’s firm name, lead contact, address, phone, email, and the date the management agreement begins. Attach the management agreement as an exhibit. The manager should be on the NYDFS list of recognized captive managers.
For example, Aon Insurance Managers (USA) Inc. is listed with a New York office and a five-year management agreement. The nuance is self-management by a parent’s risk team, which is allowed but invites extra scrutiny. The most common mistake is leaving this section “TBD,” which is an automatic deficiency. The misconception is that a non-New York manager works the same; the Unit prefers a New York–based manager or one with a clear New York presence.
Section 8: Plan of Operation
This is the heart of the packet. The Plan of Operation describes the captive’s business model, target insureds, lines of business, underwriting guidelines, claims handling, reinsurance, investments, and exit plan. Part 80 requires a level of detail that reads more like a business plan than a form answer.
Write the Plan as a standalone document, paginated and signed. Include narrative sections plus tables that tie back to the pro formas. Address every Part 80 element, in order, with headings that match the regulation.
For example, Hudson River Pure Captive submits a 38-page Plan of Operation with sections on coverage, underwriting, retention, reinsurance, and surplus management. The nuance is amendments; any later change to the Plan is a “material change” requiring NYDFS approval under Insurance Law § 7005. The most common mistake is copying a Vermont or Cayman Plan and filing it in New York unchanged, which the Unit catches immediately. The misconception is that the Plan can be short; useful Plans run 25 to 60 pages.
Section 9: Pro Forma Financial Statements
This field asks for five years of projected balance sheets, income statements, and cash-flow statements. The pro formas must reflect the Plan of Operation and the feasibility study assumptions. The Unit reads them with an actuary and a financial analyst.
Use the NAIC statement format and project monthly for year one and annually for years two through five. Tie premium income to the parent’s actual exposure base. Tie losses to the feasibility study’s expected loss pick.
For example, Liberty Group Captive projects $8.4 million in year-one written premium with a 62% loss ratio and 18% expense ratio. The nuance is investment income, which the Unit will haircut if your assumed yields are aggressive. The most common mistake is mismatched numbers between the Plan, the feasibility study, and the pro formas. The misconception is that pro formas can be “directional”; they must reconcile to the dollar.
Section 10: Feasibility Study and Actuarial Opinion
This field requires a signed feasibility study by a qualified actuary, typically an FCAS or MAAA credential holder. The study justifies premium adequacy, loss reserves, and capital. It is the single most scrutinized exhibit.
Attach the full study with the actuary’s signed opinion and credentials. Include data sources, loss development, trend assumptions, and sensitivity tests. Make sure the actuary is independent of the captive manager.
For example, Empire Risk Retention Group attaches a 64-page study by Milliman, Inc. signed by an FCAS. The nuance is data thin lines, where the actuary must use industry data with explicit caveats. The most common mistake is a study that “blesses” pre-set premium numbers rather than deriving them. The misconception is that an in-house finance team can write the study; New York wants an external, credentialed actuary.
Section 11: Reinsurance Program
This field asks how the captive will cede risk. Describe each treaty by reinsurer, structure, attachment point, limits, and collateral. Attach drafts or term sheets.
List every reinsurer’s NAIC code, domicile, and rating. Unauthorized reinsurers must post collateral consistent with 11 NYCRR Part 125. Fronting arrangements should name the fronting carrier and the ceding commission.
For example, Acme Pure Captive fronts through AIG with a 100% quota share back to the captive, collateralized by a $4 million letter of credit. The nuance is finite reinsurance, which gets extra review. The most common mistake is naming an unrated reinsurer with no collateral plan, which is rejected. The misconception is that fronting eliminates the need to file; it does not.
Section 12: Investment Policy
This field asks how premiums and surplus will be invested. Article 70 captives have more flexibility than commercial insurers but must still follow a written policy. The Unit looks for liquidity, diversification, and a match between asset and liability durations.
Attach the board-approved investment policy statement. Identify the custodian and investment manager. Cap exposures by issuer, sector, and rating.
For example, Hudson River Pure Captive limits non-investment-grade bonds to 5% of surplus and uses BNY Mellon as custodian. The nuance is parent-affiliate loans, which are permitted with limits but trigger close review. The most common mistake is a vague “we will invest prudently” policy with no caps. The misconception is that captives can invest like hedge funds; New York will push back hard.
Section 13: Filing Fees and Signatures
This field is the cover page sign-off. Insurance Law and the fee schedule require a non-refundable application fee, currently $1,000 for most captive types. The application must be signed by an authorized officer under penalty of perjury.
Sign in blue ink with full legal name and title, and date the signature. Attach a check payable to the Superintendent of Financial Services or follow current payment instructions. Submit the original plus the number of copies requested in the packet cover letter.
For example, Maria Lopez, Chair, signs 5/14/2026 and attaches a $1,000 check. The nuance is fee changes; always verify the current fee on the DFS captive page. The most common mistake is an unsigned application, which is treated as not filed. The misconception is that an electronic signature is fine; original wet signatures are still expected.
Three Filled-Out Examples Using Real Scenarios
Use these scenarios as a model for how a clean application looks across different captive types.
Scenario 1: Acme Manufacturing — Pure Captive
| Form Section | What Acme Enters |
|---|---|
| Type of Captive | Pure Captive |
| Proposed Name | Acme Pure Captive Insurance Company, Inc. |
| Home Office | One State Street, 19th Fl, New York, NY 10004 |
| Lines of Insurance | General liability, products liability, property |
| Capital and Surplus | $250,000 paid-in + $250,000 free surplus |
| Officers/Directors | 5 directors including 1 NY resident |
| Captive Manager | Marsh Captive Solutions, New York office |
| Plan of Operation | 42-page Plan tied to Acme’s 14 affiliates |
| Pro Formas | $6.2M Y1 premium, 60% loss ratio |
| Application Fee | $1,000 check to Superintendent |
Scenario 2: Liberty Trade Association — Group Captive
| Form Section | What Liberty Enters |
|---|---|
| Type of Captive | Group Captive |
| Proposed Name | Liberty Trade Group Captive, Inc. |
| Home Office | 230 Park Ave, Suite 1500, New York, NY 10169 |
| Lines of Insurance | General liability, professional liability |
| Capital and Surplus | $500,000 paid-in + $250,000 free surplus |
| Members | 38 association members, all NY-domiciled |
| Captive Manager | Aon Insurance Managers (USA) Inc. |
| Plan of Operation | 51-page Plan with member underwriting rules |
| Reinsurance | 50% quota share with Munich Re |
| Application Fee | $1,000 check to Superintendent |
Scenario 3: MedPath Health System — Risk Retention Group
| Form Section | What MedPath Enters |
|---|---|
| Type of Captive | Risk Retention Group |
| Proposed Name | MedPath RRG, Inc. |
| Home Office | 200 Madison Ave, 8th Fl, New York, NY 10016 |
| Lines of Insurance | Medical professional liability only |
| Capital and Surplus | $1,000,000 paid-in + $1,000,000 free surplus |
| Members | 12 affiliated hospitals and physician groups |
| Captive Manager | WTW Captive Management |
| Feasibility Study | 78-page Milliman study, FCAS-signed |
| Reinsurance | $5M xs $1M with Lloyd’s syndicate |
| Application Fee | $1,000 check to Superintendent |
How to File the Completed Form
The initial New York captive application is a paper-first filing. Send the original packet plus the number of copies the cover letter specifies (usually two) by mail or overnight courier to the Captive Insurance Unit at the NYDFS New York City office, One State Street, New York, NY 10004. Use a trackable courier so you have proof of delivery.
The application fee is a $1,000 check payable to the Superintendent of Financial Services, paid at the time of filing under Insurance Law § 7002. Some structures, like SPFCs, carry higher costs because of the added review. Keep a stamped copy of the cover letter as your proof of filing.
The Unit acknowledges receipt by email within about two weeks and assigns an analyst. Expect 60 to 120 days to license, longer if the file has gaps. Post-license annual statements, premium tax returns, and amendments move through the DFS Portal or the captive analyst’s email, depending on the filing type.
For in-person delivery, the Unit accepts hand-delivered packets at One State Street during business hours. Fax filings are not accepted for the initial application. Email-only filings are also not accepted for the initial license, although the Unit may ask for follow-up materials by email after the file is opened.
What Happens After You File
Once the Unit receives the packet, an analyst opens a file, logs the fee, and runs an initial completeness check. If the packet is materially incomplete, you will get a deficiency letter within two to four weeks listing every missing item. Your response clock is usually 30 days, and the file may be closed if you miss it.
If the packet is complete, the analyst pairs with an actuary and a financial examiner to dig into the Plan of Operation, the feasibility study, and the pro formas. Expect rounds of follow-up questions on capital, reinsurance, and governance. Be ready to revise the Plan and re-run pro formas more than once.
When the file is ready, the Superintendent issues a license under Insurance Law § 7002, and the captive can begin writing covered business on its effective date. The Unit also sets the captive’s annual statement schedule, premium tax filing, and examination cycle. The first NYDFS examination typically falls within three to five years.
Mistakes to Avoid When Filling Out the Form
- Filing the wrong captive type. A pure captive that writes any unrelated risk is misclassified, and the file will be sent back for a re-file as a group captive.
- Using an outdated packet. Older versions reference repealed sections, and the Unit rejects them on first review.
- Skipping the New York resident director. Part 80 expects at least one New York resident on the board, and missing this stalls licensing.
- Underfunding capital at filing. Funds must be on deposit before licensing, not “shortly after.”
- Inconsistent numbers. When the Plan, the feasibility study, and the pro formas disagree, the file is returned.
- Generic Plan of Operation. A copied Vermont or Cayman Plan flags the file as unserious.
- Unverified biographical affidavits. Self-verified affidavits are not acceptable; a third-party vendor must verify.
- Missing reinsurance collateral plan. Unauthorized reinsurers without collateral fail Part 125.
- Vague investment policy. “Prudent investor” with no caps is a deficiency every time.
- Missing wet signature. The Unit treats unsigned applications as not filed, and your fee may not be refunded.
- Wrong payee on the fee check. Checks payable to anything other than “Superintendent of Financial Services” are returned.
- No captive manager identified. “TBD” in Section 7 is an automatic deficiency.
Do’s and Don’ts
- Do confirm the packet revision date on the NYDFS captive page before drafting, because filing on an old version means re-filing.
- Do pre-clear the captive’s name with the Department of State so the certificate of incorporation matches the application.
- Do engage a New York–licensed captive manager early, because the Unit expects one named on Day 1.
- Do tie the Plan, the feasibility study, and the pro formas to the same numbers, since the Unit cross-checks them.
- Do budget 90 to 120 days for review, plus time to respond to deficiency letters.
- Do send the packet by trackable courier so you have proof of delivery.
- Don’t file with “TBD” in any field, because it reads as not ready.
- Don’t rely on a parental guarantee in place of paid-in capital, since New York wants real funds.
- Don’t use an alien reinsurer without a collateral plan that meets Part 125.
- Don’t sign electronically when the cover page calls for a wet signature.
- Don’t copy a Vermont Plan of Operation, because Article 70 is not Vermont’s Title 8.
- Don’t ignore the New York resident director rule, since it is a hard licensing condition.
Pros and Cons of Filing on Your Own vs. With Help
| Filing Approach | What to Weigh |
|---|---|
| Pro: Pro se filing is cheaper upfront | You save on captive manager and counsel fees, which can run $75K to $250K. |
| Pro: You learn the program | Your team builds in-house captive expertise for future filings. |
| Pro: Direct relationship | You speak directly with the Captive Insurance Unit analyst. |
| Pro: Faster internal alignment | No external coordination on edits or strategy calls. |
| Pro: Custom Plan | You write a Plan of Operation tailored to your business. |
| Con: Steep learning curve | Article 70 and Part 80 are nuanced and unforgiving. |
| Con: Higher rejection risk | First-time pro se filings often hit multiple deficiency letters. |
| Con: Actuary still required | You cannot self-write the feasibility study, so cost is still real. |
| Con: Time drain on executives | Officers spend weeks on the packet rather than the business. |
| Con: No safety net | A licensed captive manager catches errors before they become deficiencies. |
FAQs
Do I need a New York resident director on the captive’s board?
Yes. Part 80 expects at least one New York resident on the board of directors at the time of licensing, and the Unit will hold the file until that condition is met.
Can a pure captive write any unrelated third-party risk?
No. A pure captive insures only its parent and affiliates, and writing any unrelated risk reclassifies it as a group captive with higher capital and broader filing requirements.
Is the $1,000 application fee refundable if the application is denied?
No. The application fee is non-refundable under the NYDFS fee schedule, even if the Superintendent denies the license or the applicant withdraws.
Can I use a P.O. Box in Section 3 for the home office address?
No. New York requires a real physical New York address for the principal office, and a P.O. Box entry will be returned as a deficiency.
Do I need a captive manager identified at the time of filing?
Yes. Section 7 requires the captive manager’s name, address, and management agreement at filing, and “TBD” entries are treated as automatic deficiencies.
Can I sign the application electronically?
No. New York still expects an original wet-ink signature on the cover application, and electronic signatures are not accepted for the initial license filing.
Does the capital have to be on deposit when I file?
Yes. Insurance Law § 7004 requires paid-in capital and free surplus to be on deposit at the time of licensing, supported by a recent bank or escrow letter.
Can a parental guarantee replace paid-in capital?
No. New York wants real, segregated funds in a qualified bank, and a parental guarantee alone does not satisfy the minimum capital and surplus requirements.
Do unauthorized reinsurers need to post collateral?
Yes. Under 11 NYCRR Part 125, unauthorized reinsurers must post acceptable collateral, typically a clean, irrevocable letter of credit from a qualified U.S. bank.
Can I write personal lines coverage in a New York captive?
No. Article 70 captives are designed for commercial and affiliate risks, and personal lines like private auto or homeowners are not permitted.
Does the feasibility study need a credentialed actuary?
Yes. The study must be signed by a qualified actuary, typically an FCAS or MAAA credential holder, and an in-house finance team cannot substitute for external sign-off.
Is the initial application filed through the DFS Portal?
No. The initial captive license application is filed in paper form by mail or courier to the Captive Insurance Unit, although ongoing filings may move through the DFS Portal after licensing.
Related reading
- How to Fill Out Michigan DIFS Captive Insurance Company Application + FAQs
- How to Fill Out Pennsylvania Captive Insurance Application (w/Examples) + FAQs
- How to Fill Out the Association Captive Application (w/Examples) + FAQs
- How to Fill Out the Delaware Captive Insurance Company Application + FAQs
- How to Fill Out the Montana Captive Insurance Company Application + FAQs
- How to Fill Out the Pure Captive Insurance Application (w/Examples) + FAQs