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  • FINANCIAL REPORTING - DOMESTIC: Captive Insurer

FINANCIAL REPORTING - DOMESTIC: Captive Insurer

Captive News

5/15/2020:

**Update**

***Notice Regarding the Statutory Requirement for Holding Board Meetings in the State***

Based upon the CDC’s recent recommendations related to the risk of air travel and the need for social distancing to reduce the spread of COVID-19, the ARS 20-1098.01(E)(1) requirement that a captive insurer’s board of directors or subscriber's advisory committee meet at least once each year in this state may be accomplished through the use of a telephonic meeting presided over by the Arizona resident Director.  The need for this advisory will continue to be evaluated for periods beyond September, 2020 as conditions warrant.

4/09/2020:

***Notice Regarding the Statutory Requirement for Holding Board Meetings in the State***

Based upon the CDC’s recent recommendations related to the risk of air travel and the need for social distancing to reduce the spread of COVID-19, through the end of May, 2020, the ARS 20-1098.01(E)(1) requirement that a captive insurer’s board of directors or subscriber's advisory committee meet at least once each year in this state may be accomplished through the use of a telephonic meeting presided over by the Arizona resident Director.  The need for this advisory will continue to be evaluated for periods beyond May 2020 as conditions warrant.

3/22/2017:  The Captive Annual Filing Portal now accepts captive renewal fee payments by credit card (Visa, MasterCard or Discover) or by ACH electronic check!  Please use the portal to pay your fee.  

2/29/2016:  Captive insurers must use Arizona's new secure, encrypted Captive Insurer Annual Filing Portal ("Portal"), available at https://azinsurance.online/upload/captiveannual, to upload all documents pertaining to the annual filing. 

NOTE: Domestic risk retention groups submit most filings directly to the NAIC but will use the Portal to file the signed Jurat page for the annual and quarterly blanks, the actuarial opinion summary, and the Certificate of Disclosure (Form E-178). 

Using the Portal is free, easy, secure, and eliminates the hassle of having to send information by mail on CDs/DVDs.

Contact the Captive Insurance Division at (602) 364-4490 if you have any questions about the Portal or filing requirements.

ANNUAL FILINGS

For Captives Other Than RRGs: Captive Insurer Annual Report and Renewal Fee Transmittal

This form provides a checklist of captive insurer annual filing requirements.  Pay the annual renewal fee via the online portal or mail a check to the Department of Insurance either with this form or a printout of the "Success!" page you receive after uploading Annual Report documents to the Captive Insurer Annual Report Portal. 

NOTE: Domestic captive RRGs have a different checklist.  See Below.
For Risk Retention Groups: Captive Insurer Annual Report and Renewal Fee Transmittal

This form provides a checklist of captive RRG insurer annual filing requirements.  Pay the annual renewal fee via the online portal or mail a check to the Department of Insurance either with this form or a printout of the "Success!" page you receive after uploading Annual Report documents to the Captive Insurer Annual Report Portal.

NOTE: Domestic RRGs will use the Portal to file the annual and quarterly signed Jurat pages, the annual Form E-178, and the actuarial opinion summary, and will continue to file most other documents through the NAIC.

Captive Insurer Annual Report

Complete this form as part of the required annual filing for insurers licensed as (non-RRG) captives, unless instructed by the Department to use a different format. RRGs file using the NAIC Blank.

Captive Insurer Annual Filing Portal Instructions

Captive insurers other than domestic risk retention groups must use Arizona's new Captive Insurer Annual Filing Portal ("Portal"), available at https://azinsurance.online/upload/captiveannual, to upload all documents pertaining to the annual filing. RRGs also use the portal on a limited basis.  This document contains instructions for using the Portal.

Form E-178: Certificate of Disclosure
Insurance Fee Schedule

Fees are nonrefundable upon payment.  ARS § 20-167(A)

CREDIT PROPERTY EXPERIENCE REPORT, ANNUAL STATEMENT SUPPLEMENT
CREDIT LIFE, DISABILITY AND UNEMPLOYMENT EXPERIENCE REPORT

AD HOC FILINGS

Preparing the Management Discussion and Analysis Report

Insurers

  • Licensing/Registration
    • Acquisition and Holding Company Registration
    • Captive Insurer/Domestic RRG
    • Insurer
    • Life Care Provider
    • Life Settlement Provider
    • Premium Finance Company
    • Purchasing Group
    • Rate Service Organization
    • Rating Organization
    • Reinsurer
    • Risk Retention Group - Domestic (Captive Insurer)
    • Risk Retention Group - Foreign
    • Senior Residential Entrance Fee Contract Provider
    • Service Company
    • Surplus Lines Insurer
    • Third Party Administrator (Life/Health)
    • Utilization Review Agent
  • Trust Deposits
  • Financial Reporting for Domestic Entities
    • Acquisition/Holding Company Registration
    • Captive Insurer
    • Health Care Services Organization
    • HMDO Service Corporation
    • Life & Disability Reinsurer
    • Life Care Provider
    • Life/Disability Insurer Filing on a Health Blank
    • Life/Disability Insurer Not Filing on a Health Blank
    • Mechanical Reimbursement Reinsurer
    • Mortgage Guaranty Insurer
    • Prepaid Dental Plan Organization
    • Property/Casualty Insurer Filing on a Health Blank
    • Property/Casualty Insurer Not Filing on a Health Blank
    • Risk Retention Group
    • Title Insurer
    • Senior Residential Entrance Fee Contract Provider
    • Unaffiliated Credit Life & Disability Reinsurer
  • Financial Reporting for Foreign/Alien Entities
    • Accredited Reinsurer
    • Fraternal Benefit Society
    • Health Care Services Organization
    • Life Care Provider
    • Life/Disability Insurer Filing on a Health Form
    • Life/Disability Insurer Not Filing on a Health Blank
    • Mortgage Guaranty Insurer
    • Mutual Aid Association
    • Prepaid Legal Insurer
    • Property/Casualty Insurer Filing on a Health Blank
    • Property/Casualty Insurer Not Filing on a Health Blank
    • Reinsurer
    • Risk Retention Group
    • Title Insurer
  • Life & Health Rates, Forms & Compliance
    • Health Care Appeals
    • Life/Health/Annuity Form Filing Requirements
    • Life/Health/Annuity Advertising Filing Requirements
    • Life/Health/Annuity Rate Filing Requirements
    • Long-term Care
    • Credit Insurance
    • Life Settlement Provider
    • Health Plans Survey (Annual)
    • HIPAA Data Reporting
    • Market Conduct Exam Reports
  • Property & Casualty Rates, Forms & Compliance
    • P&C Rate & Form Filing Requirements
    • Examinations and Analysis Program
    • Market Conduct Exam Reports
    • Motor Vehicle Non-renewals Report
  • Laws, Rules and Bulletins
    • Laws and Rules
    • Rules & Rulemaking
    • Regulatory Bulletins
  • Insurance Fraud
  • Taxes
  • File a Health Care Appeal

Contact Info

Mr. Vincent R. Gosz

Captive Insurance Division
100 N. 15th Avenue, Suite 261
Phoenix, AZ 85007-2630
[email protected]
602-364-4490
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