The Application to Form a Captive Insurance Company is the electronic filing every business must submit to the Utah Insurance Department to get a Certificate of Authority before its captive insurer can write a single policy. It is the gateway document required under Utah Admin. Code R590-238-17, and it is filed under the Captive Insurance Companies Act, Title 31A-37.
A captive lets a parent company insure its own risks instead of buying coverage from an outside carrier. Get the application right and Utah can approve your captive in about 30 days. Get it wrong and you can lose your non-refundable $200 application fee, face long delays, or have the whole filing rejected. Utah is one of the largest captive domiciles in the United States, with hundreds of licensed captives and cells on its books, so the Department reviews these filings closely.
Here is what you will learn in this guide:
- 📋 What the application is, who must file it, and the statute that requires it
- 🗂️ Every document and number you must gather before you open the online portal
- ✍️ A line-by-line walkthrough of each section of the application and its attachments
- 👥 Three full filing examples using real-world business scenarios
- ⚠️ The most common mistakes that delay or sink an application and how to avoid them
What the Form Is and Who Must File It
The Application to Form a Captive Insurance Company is the official request for a license to operate a captive insurer domiciled in Utah. A captive is an insurance company owned by the business or group it insures. Instead of paying premiums to a commercial carrier, a parent company creates its own licensed insurer and keeps the underwriting profit and investment income inside the family of companies. The Utah Insurance Department is the agency that receives, reviews, and approves the application.
Any person or business that wants to form a captive insurer with Utah as its home state must file this application. That includes a single company forming a pure captive to insure only its own risks, a trade group forming an association captive, a sponsor forming a sponsored (cell) captive, and a company forming a special purpose captive for unusual risks. The rule is plain: under R590-238-17, an application to form a company shall be submitted to the commissioner on the official form and filed electronically through the Department’s website.
The statute behind the form is the Captive Insurance Companies Act in Title 31A, Chapter 37. The deadline is set by you, not the state, because you cannot transact business until the commissioner issues a Certificate of Authority. The penalty for skipping the process is severe: writing insurance without a license is unauthorized insurance, which can bring fines and orders to stop business. Each of these pieces connects, the statute requires the license, the license comes from the application, and the application protects policyholders by proving the captive is funded and well managed.
Before You Start: Documents and Information You Need
Captive applications fail more often from missing attachments than from typos. The online portal will not let you finish without the core exhibits, and the Department tests every claim you make. Gather these items before you log in so you are not scrambling mid-filing. The single biggest cost and the single biggest gate is the feasibility study, which can run $40,000 to $100,000 or more and must be done by a qualified consultant.
Use this pre-filing checklist and confirm each item is ready:
- Feasibility study. This is the engineering report that proves the captive can pay claims. Without it the application is incomplete and will not be reviewed.
- Business plan with pro-forma financials. The plan shows your projected premiums, losses, and surplus. A weak plan triggers questions and delays.
- Proof of capital. You need bank confirmation of cash, a cash equivalent, or an approved irrevocable letter of credit. No capital means no Certificate of Authority.
- Biographical affidavits. Each officer and director must complete one. Missing affidavits stall the background review.
- Articles of incorporation or organization. These charter documents prove the entity exists. The Department checks them against your application.
- Utah resident director and registered agent. Utah law requires a Utah-resident board member and a resident registered agent. Naming none can block approval.
- Statement of Economic Benefit to Utah. This shows what the captive brings to the state. Leaving it out makes the file incomplete.
- Utah-ID account login. The whole filing is electronic and needs a Utah-ID account. No login means no access to the portal.
- The $200 application fee. This non-refundable fee is paid at submission. A failed payment holds your filing in limbo.
Each missing item has the same consequence: the clock toward your roughly 30-day approval does not start until the file is complete. Treat the checklist as a gate, not a wish list.
Where to Get the Form and How to Access It
The application is not a paper PDF you mail in. It lives inside the Department’s secure online system, reached through the Licensing & Forms page of the Utah Insurance Department captive site. Under R590-238-17, the complete application, including forms, attachments, and exhibits, must be filed electronically through the Department’s website at insurance.utah.gov/captive.
To reach the form, first create a Utah-ID account. On the Licensing & Forms page, select the captive application link, then choose “Create Account” if you do not already have a Utah-ID. The Department notes the online forms work best in the Google Chrome browser and need a Windows operating system newer than Windows XP. Marcus Webb, the CFO of a Utah trucking firm, creates his Utah-ID first, then opens the application, so he is not locked out at the payment step.
Before you even open the application, the Department recommends three preliminary steps: run a self-assessment to decide whether a captive fits your business, hire a qualified consultant to perform the feasibility study, and, if needed, meet with the Department for early guidance and “buy-in” on your plan. These steps are free to skip, but skipping them is the top reason applications come back with heavy questions. The cite for the current process is R590-238, which is updated quarterly, so always confirm you are using the live online version rather than an old downloaded copy.
Step-by-Step: How to Fill Out the Utah Captive Application Line by Line
The application moves through a set of screens and required exhibits. Below is each major section in the order you meet it, with how to answer, an example, an edge case, a common mistake, and a misconception for every one. Use the exact field labels shown in the portal and on the official exhibits.
Section 1: Applicant Name and Entity Type
This field asks for the legal name of the captive you want to form and the kind of business entity it is. Enter the full legal name exactly as it appears on your articles of incorporation or organization, including the corporate ending such as “Inc.” or “LLC.” Then select the entity type, such as stock corporation, mutual, or limited liability company. Webb Logistics Insurance, Inc. is how Marcus types his captive’s name, matching his Utah charter word for word.
The most common edge case is a name that is still pending with the Utah Division of Corporations. If your name is reserved but not yet filed, note that clearly and attach the reservation. A common mistake is using a “doing business as” name or an abbreviation instead of the legal name, which creates a mismatch the Department must resolve before moving on. People wrongly believe the captive’s name can be anything they like; in truth it must already be cleared and chartered through the Department of Commerce.
Section 2: Captive Type Selection
This field asks which class of captive you are forming. You choose from pure, association, industrial insured, sponsored, special purpose, or branch. Read each definition first, because the type drives your capital floor and what risks you may insure. Marcus selects “pure captive” because Webb Logistics Insurance will insure only the risks of its parent and affiliates.
The edge case here is a group that thinks it needs a pure captive but actually insures unrelated members, which points to an association captive instead. A frequent mistake is choosing a type with a lower capital requirement to save money, then being forced to refile when the Department sees the real risk pool. Many filers believe a pure captive can insure outside customers; under 31A-37-202 a pure captive may insure only its parent, affiliates, or controlled unaffiliated business.
Section 3: Lines of Insurance to Be Written
This field asks what kinds of coverage your captive will issue, such as general liability, property, professional liability, or warranty. List each line you plan to write and tie it to the risks described in your business plan. A medical group’s captive lists “medical professional liability” and “stop-loss health,” matching its feasibility study.
The edge case most filers hit is workers’ compensation. Utah generally bars captives from writing direct workers’ comp, personal auto, and homeowners’ coverage, though the commissioner may allow a captive to reimburse a limited layer or deductible of workers’ comp under 31A-37-202. A common mistake is listing a prohibited line, which forces a rewrite of the application. The misconception is that a captive can write any coverage it wants; it cannot, and listing a banned line signals to the reviewer that the plan was not checked against the statute.
Section 4: Capital and Surplus Verification
This field asks you to state and prove the captive’s paid-in capital. Enter the dollar amount and attach bank confirmation that the funds exist as cash, a cash equivalent, or an approved irrevocable letter of credit. Match the amount to your captive type’s minimum. Webb Logistics Insurance shows $250,000 in a Utah bank account, the floor for a pure captive.
Utah’s current capital floors, drawn from 31A-37-204 and the Department’s published figures, are below.
| Captive Type | Total Capital Requirement |
|---|---|
| Pure captive | $250,000 |
| Association captive (mutual) | $500,000 |
| Industrial insured captive / RRG | $700,000 |
| Sponsored captive | $250,000 (minimum $50,000 from core) |
| Special purpose | Set by the commissioner |
The edge case is using a letter of credit instead of cash; it must be issued by a Utah-chartered bank or a Federal Reserve member bank and approved by the commissioner. The most common mistake is reporting capital you intend to deposit later rather than funds already in place, which is grounds for a hold. People wrongly think capital and surplus are the same thing; the minimums above are paid-in capital, and the commissioner may require added surplus based on your risk under 31A-37-106.
Section 5: Officers, Directors, and Biographical Affidavits
This field asks you to name the people running the captive and to attach a biographical affidavit for each. List every officer and director, then upload a signed affidavit covering their work history, education, and any regulatory or criminal background. Janet Cho, listed as president, attaches a biographical affidavit and consents to a background check.
The edge case is a director who sits on many boards; each affidavit must still be complete and current, not recycled from another filing. A common mistake is leaving an affidavit unsigned or out of date, which pauses the background review and stalls the whole file. The misconception is that only the CEO needs an affidavit; in practice the Department wants one from each officer and director, because it vets the people who will control policyholder money.
Section 6: Utah Resident Director and Registered Agent
This field asks for the Utah-resident board member and the Utah registered agent required by state law. Enter the resident director’s name and the registered agent’s name and Utah street address. Webb Logistics names a Salt Lake City resident to its board and lists a Utah-based registered agent for service of process.
The edge case is an out-of-state parent with no Utah ties; many such filers hire their captive manager or a local professional to fill the resident director seat. The common mistake is naming a registered agent with only a P.O. Box, which does not meet the requirement for a physical Utah address. The misconception is that a captive can be run entirely from another state; Utah requires the principal place of business in Utah, a resident director, and a resident registered agent to conduct business here.
Section 7: Appointment of Commissioner as Attorney for Service of Process
This field is a consent that lets the Utah Insurance Commissioner accept legal papers on the captive’s behalf. Complete and sign the appointment exhibit so lawsuits and official notices can reach the captive through the state. The president signs the appointment so any legal service routes through the commissioner’s office.
The edge case is a foreign or branch captive, which still must appoint the commissioner even though its parent sits abroad. The common mistake is skipping the appointment because it feels like boilerplate, which leaves the file incomplete. The misconception is that the registered agent appointment covers this; it does not, because the commissioner appointment is a separate statutory consent that protects Utah policyholders’ ability to serve process.
Section 8: Feasibility Study Attachment
This field asks you to upload the feasibility study of your business plan. Attach the full study prepared by your qualified consultant, including loss projections, premium calculations, and pro-forma financials. A construction firm uploads a 40-page feasibility study modeling five years of losses and surplus growth.
Under R590-238-17, the Department may test the study by examining the charter, bylaws, minute books, verification of capital and surplus, proof of principal place of business, and the captive’s assets and liabilities. The edge case is a special purpose captive, where the commissioner sets capital after reading this very study. The common mistake is submitting a thin or generic study, which invites deep questions and adds weeks. The misconception is that the study is a formality; it is the heart of the review, because it proves the captive can pay claims.
Section 9: Investment Strategy Description
This field asks how the captive will invest its assets. Describe your investment policy, the types of holdings, and how they keep the captive solvent and liquid. The medical group’s captive describes a conservative mix of Treasuries and investment-grade bonds.
The edge case is an industrial insured captive or risk retention group, which must follow the same investment limits as a traditional insurer under 31A-18-108. The common mistake is leaving the strategy vague, since each captive must file a description with the initial application and update the Department on later changes. The misconception is that captives can invest freely; even the looser captive types are subject to the commissioner disallowing any investment that threatens solvency or liquidity.
Section 10: Statement of Economic Benefit to the State of Utah
This field asks what the captive contributes to Utah, such as fees paid, local service providers used, and meetings held in the state. Complete the Statement of Economic Benefit exhibit with concrete figures and activities. Webb Logistics notes its annual board meeting in Utah and its use of a Utah captive manager and CPA.
The edge case is a brand-new captive with little history; estimate the benefit honestly based on your plan. The common mistake is leaving this exhibit blank, which renders the application incomplete under R590-238. The misconception is that this statement is optional marketing; it is a required filing both at application and again each year before March 1.
Section 11: Signature and Fee Payment
This field is where an authorized person signs the application and pays the $200 application fee. Sign in the manner the form prescribes, and if you sign under a power of attorney, attach a copy of that authority as R590-238-17 requires. Janet Cho signs as president and pays the $200 fee by electronic payment to lock in the filing.
The edge case is a captive manager signing for the owner, which is allowed only with a filed power of attorney. The common mistake is paying by physical check when the Department prefers electronic payment, which can trigger a $25 non-electronic processing fee. The misconception is that the $200 fee is refundable if the application fails; it is not, so confirm the file is complete before you submit.
Three Filled-Out Examples Using Real Scenarios
Below are three named filers carried through the application from start to finish. Each table shows the major sections and what that filer enters.
Scenario 1: Marcus Webb forms a pure captive for his trucking company.
| Form Section | What Marcus Enters |
|---|---|
| Applicant name and entity type | Webb Logistics Insurance, Inc., stock corporation |
| Captive type | Pure captive |
| Lines of insurance | Auto physical damage, general liability, cargo |
| Capital and surplus | $250,000 cash in a Utah bank |
| Officers and directors | Marcus Webb, president; two affiliate officers |
| Utah resident director / agent | Salt Lake City resident director; Utah registered agent |
| Feasibility study | Five-year study from a licensed captive consultant |
| Signature and fee | Marcus signs; pays $200 electronically |
Scenario 2: Dr. Aisha Rahman’s medical group forms a sponsored cell captive.
| Form Section | What Dr. Rahman Enters |
|---|---|
| Applicant name and entity type | Wasatch Medical Cell Captive, LLC cell |
| Captive type | Sponsored captive (cell) |
| Lines of insurance | Medical professional liability, stop-loss health |
| Capital and surplus | Core funds $250,000; cell amount set by sponsor |
| Officers and directors | Sponsor’s officers plus cell participant |
| Utah resident director / agent | Utah-resident director through captive manager |
| Feasibility study | Study modeling malpractice loss layers |
| Signature and fee | Sponsor signs; pays $200; $1,000 cell license fee |
Scenario 3: Janet Cho’s construction firm forms a special purpose captive.
| Form Section | What Janet Enters |
|---|---|
| Applicant name and entity type | Summit Builders Risk SPC, Inc., stock corporation |
| Captive type | Special purpose captive |
| Lines of insurance | Contractor’s professional liability, builder’s risk |
| Capital and surplus | Amount set by commissioner after feasibility review |
| Officers and directors | Janet Cho, president; CFO; outside director |
| Utah resident director / agent | Provo resident director; Utah registered agent |
| Feasibility study | Study supporting unusual project risks |
| Signature and fee | Janet signs; pays $200 electronically |
How to File the Completed Form
There is only one filing channel for the captive application in Utah, and it is electronic. The Department retired paper and email submission, so everything goes through the secure online system on the Licensing & Forms page. Under R590-238-17, a complete application with all forms, attachments, and exhibits must be filed electronically through insurance.utah.gov/captive.
Here is how the online channel works. The portal address is reached from the Licensing & Forms page, where you select the captive application and sign in with your Utah-ID. The application fee is $200 per application, and the accepted method is electronic payment, since the Department charges a $25 fee for non-electronic payments when an electronic option exists. Expected processing runs about 30 days for a complete, clean file, though a thin feasibility study can stretch that out. For proof of filing, save the portal confirmation and a copy of every uploaded exhibit.
Two payments follow approval and matter for planning. Once the commissioner issues the Certificate of Authority, the initial license fee is $7,250 without proration plus a $250 e-commerce fee, for a total of $7,500 ($1,000 for a cell). After that, the same $7,500 renews annually and is due before July 1 each year. Keep these confirmations as proof your license is active.
What Happens After You File
After you submit, the Department reviews your application for completeness and tests your feasibility study against your business plan and corporate records. Reviewers may examine your charter, bylaws, minute books, and verification of capital and surplus under R590-238-17. If they need more, they send questions, and the clock pauses until you answer.
When the review clears, the commissioner issues a Certificate of Authority listing the lines of insurance you may write. Only then can your captive bind policies and collect premiums. Marcus cannot issue a single auto policy until his certificate is in hand, even if his capital is already deposited.
Your obligations do not end at approval. Each year your captive must file an annual report before March 1, a Statement of Economic Benefit by the same date, and an audited financial report by June 30, all spelled out in the Department’s basics page and Title 31A-37. You must also hold a yearly board meeting in Utah, keep your principal place of business in the state, and renew your certificate before July 1. Miss these and your license can lapse.
Mistakes to Avoid When Filling Out the Form
Each line of the application is a chance to slip, so review this list before you submit.
- Using a trade name instead of the legal name. The name mismatch forces the Department to reconcile your filing with your charter.
- Picking the wrong captive type. The wrong type sets the wrong capital floor and can force a full refiling.
- Listing a prohibited line like direct workers’ comp. The reviewer must reject or return the application until the line is removed.
- Reporting capital you have not yet deposited. Unfunded capital is grounds for a hold on the Certificate of Authority.
- Submitting an unsigned biographical affidavit. The background check stalls and your approval clock pauses.
- Naming a registered agent with only a P.O. Box. Utah requires a physical street address, so the filing comes back.
- Skipping the commissioner appointment for service of process. The application is incomplete and cannot move forward.
- Uploading a thin or generic feasibility study. A weak study triggers deep questions and weeks of delay.
- Leaving the Statement of Economic Benefit blank. The omission makes the entire application incomplete.
- Paying by paper check. A non-electronic payment can add a $25 fee and slow processing.
- Forgetting the Utah resident director. Without one, the captive cannot meet Utah’s conditions to do business.
- Using an old downloaded form. The rule updates quarterly, so an outdated version can omit required fields.
Do’s and Don’ts
Do’s
- Do hire a qualified consultant for the feasibility study, because it is the core of the review and proves the captive can pay claims.
- Do create your Utah-ID before you start, so you are not locked out at the payment screen.
- Do match every number to your business plan, since the Department cross-checks figures against your pro-formas.
- Do gather all biographical affidavits up front, because one missing affidavit pauses the whole file.
- Do pay the $200 fee electronically, to avoid the $25 non-electronic processing charge.
- Do confirm your capital is already deposited, since the certificate cannot issue against future funds.
Don’ts
- Don’t list direct workers’ comp, personal auto, or homeowners’ coverage, because Utah generally bars these in a captive.
- Don’t use a P.O. Box for your registered agent, since a physical Utah address is required.
- Don’t submit before the file is complete, because the $200 fee is non-refundable and the clock won’t start.
- Don’t reuse a stale biographical affidavit, as the Department wants current information on each officer.
- Don’t skip the early Department meeting, since “buy-in” on your plan heads off later questions.
- Don’t assume a pure captive can insure outsiders, because it may insure only its parent, affiliates, or controlled unaffiliated business.
Pros and Cons of Filing on Your Own vs. With a Captive Manager
| Filing With a Captive Manager / Consultant | Filing on Your Own |
|---|---|
| Pro: Professional feasibility study meets the Department’s bar, the toughest part of the review | Pro: Saves the manager’s fee, often $30,000 to $40,000+ per year |
| Pro: Manager knows the portal and exhibit requirements, cutting delays | Pro: Full control over every entry and timeline |
| Pro: Provides the Utah resident director and registered agent many parents lack | Pro: Direct relationship with Department staff |
| Pro: Handles annual reports, audits, and renewals after approval | Pro: Deeper in-house understanding of your own risk |
| Pro: Reduces the risk of a rejected filing and a lost $200 fee | Pro: No reliance on a third party’s schedule |
| Con: Adds significant ongoing management cost | Con: A weak feasibility study can sink the application |
| Con: Less hands-on control of the process | Con: Easy to miss a required exhibit or a Utah residency rule |
FAQs
Do I have to file the captive application online?
Yes. Under R590-238-17 the complete application and all exhibits must be filed electronically through the Utah Insurance Department’s captive portal, not by paper or email.
Is the $200 application fee refundable?
No. The $200 application fee is non-refundable, so confirm your file is complete and all exhibits are attached before you submit.
Do I write my captive’s trade name or legal name in the applicant field?
No. You enter the full legal name exactly as it appears on your articles of incorporation, not a trade name or abbreviation, to avoid a charter mismatch.
Can a pure captive insure customers outside my company?
No. A pure captive may insure only the risks of its parent, affiliates, or controlled unaffiliated business under Utah Code 31A-37-202.
Does every officer and director need a biographical affidavit?
Yes. The Department wants a current, signed biographical affidavit from each officer and director so it can vet the people controlling policyholder funds.
Can I use a P.O. Box for my registered agent in Utah?
No. Utah requires a physical resident registered agent address, so a P.O. Box alone will cause the application to be returned.
Do I need a Utah resident on my board?
Yes. Utah law requires the captive to appoint at least one Utah-resident director (or managing member) to conduct business in the state.
Can my captive write workers’ compensation insurance?
No. Captives generally cannot write direct workers’ comp, though the commissioner may allow reimbursement of a limited layer or deductible.
Is the feasibility study really required, or is it optional?
Yes. A feasibility study of your business plan is required with the application, and the Department may test it against your corporate records.
Can a captive manager sign the application for me?
Yes. A manager may sign under a power of attorney, but a copy of that power of attorney must be filed with the application.
Do I report capital I plan to deposit later in the capital field?
No. You report capital already in place, because the commissioner will not issue a Certificate of Authority against funds you have not yet deposited.
How long does Utah take to approve a captive application?
Yes. A complete, clean application is typically reviewed in about 30 days, though a weak feasibility study or missing exhibits will add time.
Do I owe the full $7,500 license fee right away?
No. The $200 fee is due at submission; the $7,250 license fee plus $250 e-commerce fee comes after the commissioner issues your Certificate of Authority.
Can I run my Utah captive entirely from another state?
No. You must keep the captive’s principal place of business in Utah, name a resident director, and appoint a Utah registered agent.