Arizona Department of Insurance

Captive Insurer Annual Filing Portal

Welcome captive insurers!

Please use this portal to do two things:

  1. Upload (see "Uploading Instructions" below) all the following files that pertain to your annual filing (except that a domestic risk retention group must file with the NAIC):
    • Captive Insurer Annual Report Jurat Page (pdf)
    • Captive Insurer Annual Report (xls or xlsx)
    • Actuarial Opinion (including Exhibits A and B) (pdf)
    • Actuarial Opinion Exemption or Waiver (pdf)
    • Actuarial Opinion Summary (pdf)
    • Actuarial Opinion Summary Exemption or Waiver (pdf)
    • Management Discussion and Analysis (pdf)
    • Certificate of Disclosure (pdf)
    • Audited Financial Report – Financials (pdf)
    • Audited Financial Report – Letter of Qualification (pdf)
    • Audited Financial Report – Internal Control Letter (pdf)
    • Financial Statement – Parent/Affiliate (pdf)
    • Other (pdf, doc, docx, xls, xlsx, png, jpg, gif)
  2. Pay your annual renewal fee online.

For questions about annual filing requirements, please contact us directly.

Uploading Instructions

Click here for printable instructions
  1. Enter the fiscal year end date and NAIC/license number, and click the [Search] button. The system will display the captive insurer’s name, business type, and entity type. Contact us if displayed information is incorrect.
  2. Complete the “Contact information for this filing” section.
  3. Click the [+ Select Files] button. On the “File Upload” screen, you can drag and drop files from a directory on your computer/network or you can click the [Navigate to files] button, which will open a file explorer window that you can use to locate and select files to be uploaded. You can upload more than one file at a time. Files you selected to upload will be listed under the [+ Select Files] button.
  4. For each file, select the “Document Type” from the dropdown list.
  5. If you assign “Other” as a Document Type, enter text into the “If document type is other, please describe” area to briefly describe the document you are submitting.
  6. After entering information for all documents, click the [Submit] button.
  7. The system will present you a “Success!” report, which you should print and retain as documentation of your filing submission.

Click here to make a payment

Contact information for this filing


Cannot submit page until a valid license number has been entered!