Department of
Insurance

Other Entities
Filing Requirements and Instructions

Risk Retention Group:

The following documents are required to process a risk retention group status change:

Name Change:

1. A certified copy of Certificate of Compliance reflecting the new company name issued by the state of domicile.
2. Complete the Information Statement form.

Redomestication:

1. A certified copy of Certificate of Compliance issued by the new state of domicile.
2. Complete the Information Statement form.

For all other status changes, please submit a written notification with a brief explanation.

Purchasing Group:

For all status changes, please submit a written notification with a brief explanation.

Please submit the above documents to:

Naoko Weigelt
Examinations Section
Idaho Department of Insurance
700 West State Street, 3rd Floor
P.O. Box 83720
Boise, ID 83720-0043
(208) 334-4311