On the License Application Forms page of this section you'll find application forms for admission as a captive insurance company together with a sample letter of credit form and biographical affidavit form.
The application form must be filled out in its entirety. No incomplete package of material will be accepted.
If letters of credit are used to meet capital and surplus requirements FORM E702 - Irrevocable Letter of Credit must be adhered to by the institution issuing the letter of credit. Copies should be made and enclosed as required by the application. Each affidavit must be filled out in its entirety and no substitute for this form will be accepted.
Financial Regulation C-81-2 requires that an independent certified public accountant, approved by the Commissioner, audit the captive annually. It is incumbent upon the applicant to select an accountant who meets the requirements of Regulation C-81-2. You may ask the Department if your CPA is currently approved. CPA Application form is available.
CERTIFICATION OF RESERVES
Financial Regulation C-81-2 requires that loss reserves and loss expense reserves be certified by a Fellow of the Casualty Actuarial Society, a member in good standing of the American Academy of Actuaries or an individual who has demonstrated his competence in loss reserve evaluation and has been approved by the Commissioner. It is incumbent upon the applicant to select a member or individual who meets the requirements of this regulation. Actuary Application form is available.
All applications will be reviewed by one of the 12 review firms appointed by the Commissioner. The firms' duties are of an advisory nature only and final approval or disapproval of an application will be made by the Commissioner only.
Pure, Association and Industrial Insured captives will file an annual statement on a Vermont Captive Insurance Company form established by the Commissioner. Risk Retention Groups and Special Purpose Financial Insurers will file an annual statement on the NAIC form currently in use by the insurance industry.
LOCATION OF CAPTIVE RECORDS
All books, records, and other information necessary for a statutory examination should be located in Vermont.
APPLICATION TURNAROUND TIME: Approximately 30 Days from Receipt