| UCAA Application |
We may use the services
of financial analysts and/or examiners to assist us in our review of
the application. The applicant will be invoiced for such services
and payment is due as the services are performed.
UCAA Applications
UCAA applications are
processed in accordance with Arizona Licensing Time Frames laws and
rules:
Primary
Arizona domiciled entities seeking admission to Arizona as an insurer should file a UCAA Primary application.
The instructions and forms can be found at http://www.naic.org/industry_ucaa.htm.
Do the following:
- Check name availability with Cary Cook, Insurer Licensing Manager, at (602) 364-3986 or
.
- Draft the Articles of Incorporation
to comply with A.R.S. §§ 10-202 and 20-705. If the Articles
provide that the capital stock will be non-assessable, the qualifying
statement "except as provided by Article 14, Section 11 of the Constitution
of the State of Arizona" must be included in the Articles.
- Submit the original and at
least two exact copies of the Articles of Incorporation to Mr. Cary
Cook, Insurer Licensing Manager. The Arizona Department of Insurance
will review, stamp, and return the Articles to you.
- File the Arizona Department
of Insurance approved Articles directly with the Arizona Corporation
Commission (ACC). Go to www.cc.state.az.us for ACC filing information.
- Submit the NAIC's UCAA Primary
Application supplemented with:
- An originally certified (by
the ACC) copy of the ACC filed, Arizona Department of Insurance approved,
Articles of Incorporation.
- Copies of the ACC's Disclosure
Statements.
- An Affidavit of Publication
indicating that the Articles of Incorporation were published at least
six (6) times in a newspaper having a general circulation in the County
in Arizona of the corporation's known place of business. A.R.S.
§ 20-706.B.
- Proof that the certified Articles
were recorded in the office of the County Recorder in each county in
Arizona in which the Applicant proposes to transact business.
A.R.S. § 20-706.A.
- Originally executed NAIC Biographical
Affidavits and Fingerprint Cards in lieu of independent third party
certified Background Reports. Call the Financial Affairs Division
at (602) 364-3988 to request Fingerprint Cards and instructions.
Do not use cards from other sources. They will be rejected.
Primary for a foreign insurer domesticating to Arizona
Foreign insurers seeking domestication to Arizona should file a UCAA Primary application. The instructions and forms can be found at http://www.naic.org/industry_ucaa.htm.
Do the following:
- Check name availability with Cary Cook, Insurer Licensing Manager, at (602) 364-3986 or
.
- Draft the Articles of Domestication
to comply with A.R.S. §§ 10-222 and 20-705. If the Articles
provide that the capital stock will be non-assessable, the qualifying
statement "except as provided by Article 14, Section 11 of the Constitution
of the State of Arizona" must be included in the Articles.
- Submit the original and at
least two exact copies of the Articles of Domestication to Mr. Cary
Cook, Insurer Licensing Manager. The Arizona Department of Insurance
will review, stamp, and return the Articles to you.
- File the Arizona Department
of Insurance approved Articles directly with the Arizona Corporation
Commission (ACC). Go to www.cc.state.az.us for ACC filing information.
- Submit the NAIC's UCAA Primary
Application supplemented with:
- An originally certified (by
the ACC) copy of the ACC filed, Arizona Department of Insurance approved,
Articles of Incorporation.
- Copies of the ACC's Disclosure
Statements.
- An Affidavit of Publication
indicating that the Articles of Domestication were published at least
three (3) times in a newspaper having a general circulation in the County
in Arizona of the corporation's known place of business. A.R.S.
§ 10-224.
- Proof that the certified Articles
were recorded in the office of the County Recorder in each county in
Arizona in which the Applicant proposes to transact business.
A.R.S. § 20-706.A.
- Originally executed NAIC Biographical
Affidavits and Fingerprint Cards in lieu of independent third party
certified Background Reports. Call the Financial Affairs Division
at (602) 364-3988 to request Fingerprint Cards and instructions.
Do not use cards from other sources. They will be rejected.
- A complete plan of domestication
including a certified copy of the Shareholder and the Board of Directors
resolutions authorizing the domicile change, and the targeted effective
date.
Expansion
Foreign insurers seeking admission to Arizona should file a UCAA Expansion application. The instructions and forms can be found at http://www.naic.org/industry_ucaa.htm.
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| Non UCAA Applications |
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Obtain the following types of applications by calling (602) 364-3986 or by emailing ccook@azinsurance.gov.
| |
| Accredited Reinsurer |
| Conversion of Business Type |
| Health Care Services Organization - Domestic - UCAA Supplement |
| Health Care Services Organization - Foreign - UCAA Supplement |
| Hospital, Medical, Dental, Optometric Service Corporations - UCAA Supplement |
| Life Care Contract Provider |
| Prepaid Dental Plan Organization - Domestic - UCAA Supplement |
| Prepaid Dental Plan Organization - Foreign - UCAA Supplement |
| Redomestication of an Arizona Insurer to another State |
| Senior Residential Entrance Fee Contract Provider |
| Unaffiliated Credit Life and Disability Reinsurer |
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Contact
| |
| Cary W. Cook, Insurer Licensing Manager |
| Financial Affairs Division |
| Arizona Department of Insurance |
| 2910 North 44th Street, Suite 210 |
| Phoenix, AZ 85018 |
| (602) 364-3986 |
| ccook@azinsurance.gov |
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