Office of Insurance and Safety Fire CommissionerJohn F. King
Commissioner
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How to Become an Approved Captive Manager in the State of Georgia


Prior to operating as a captive manager in the State of Georgia, each captive manager must first obtain approval from the Department.  In order to obtain approval from the Department, captive managers should do the following:

  1. Review O.C.G.A. §§ 33-41-1 et seq. and Georgia Regulation 120-2-45 in order to become familiar with the Georgia laws and rules directly related to the regulation of captive insurance companies and captive managers in the State of Georgia.

  2. Pay the $50 filing and processing charge to the Georgia Insurance Department.

  3. Submit an Application to Serve as Manager of Captive Insurance Company (GID-279-RS).

  4. Submit the Biographical Affidavit with Background Reports for Captive Manager (GID-415-RS).
    • Only the individual principally responsible for management of the Captive Insurance Company accounts needs to submit a biographical affidavit and a background report.
      • PLEASE NOTE: If this individual submitted a biographical affidavit and background report for review as part of a Third Party Administrator application within the past 12 months, such individual is not required to submit Form GID-415-RS.
    • A list of independent third parties that furnish background investigation reports in compliance with UCAA Best Practices/Guidelines for Background Investigations can be found at http://www.naic.org/documents/industry_ucaa_third_party.pdf.
      • PLEASE NOTE: The captive manager applicant must order the background report DIRECTLY from the company performing the background investigation.  Reports should be sent directly to the Department from such company.  The Department does NOT order the background investigations.  These reports can take anywhere from a few weeks to a month or longer to complete, so please be sure to start this process as early as possible.

  5. Submit the Citizenship Affidavit Form (GID-276-EN) AND a Secure and Verifiable Form of Identification
    • Information regarding this requirement can be found on the Department’s website at http://www.oci.ga.gov/Enforcement/Citizenship.aspx.
    • PLEASE NOTE: Only the individual principally responsible for the management of the Captive Insurance Company accounts needs to submit a citizenship affidavit form and a secure and verifiable form of identification.

  6. A hard copy of the application package must be submitted to the Department for review via mail or courier to the following:

    STANDARD MAIL
    Georgia Department of Insurance
    ATTN: Director, Captive Insurance Division
    P.O. Box 935138
    Atlanta, GA 31193-5138

    OVERNIGHT MAIL OR BY COURIER
    Wells Fargo
    Georgia Department of Insurance
    ATTN: Director, Captive Insurance Division
    Lockbox # 935138
    3585 Atlanta Ave
    Hapeville, GA 30354
     

  7. An application package will not be deemed complete and will not be reviewed until the Applicant has submitted all required materials as set forth above.  While an application is pending, it is the responsibility of the Applicant to keep all required contact information, statements, documents, and materials current.

  8. After the application package is deemed complete and the Captive Insurance Division begins its review, Applicant may be required to submit additional information as deemed appropriate by the Department.

  9. Here is a quick link to all forms required to be submitted when obtaining approval as a captive manager in the State of Georgia.

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