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Captive
Insurance Program

Dissolution


Documents required for Captive Dissolution:


Dissolution Request Cover Sheet needs to be submitted as part as required dissolution documents: Download H1 Form Here

The captive company must notify the Captive Bureau in writing of its intent to dissolve, including the reason for dissolution, and provide:

  • Consent of Board of Directors or Managing Members authorizing the dissolution
  • Current year Annual Report
  • Proof of Premium Tax payments for prior year as well as the current year when dissolution request is being filed
    • IMPORTANT NOTE All Premium Tax Forms and Payment are mailed to
                    DOI Captive Tax
                    1351 West North Street
                    Suite 101
                    Dover, DE 19904
  • Provide the department with an affidavit from the owner that includes the following statements that:
    • all liabilities have been settled: insurance and/or reinsurance policies have been terminated, no claims are outstanding as well as that Captive has no further obligations under any policies, including without limitation the reinsurance pool arrangements in which it previously participated – Download Template Letter Here
    • all liabilities have been settled with the Department – Download Template Letter Here

The dissolution can waive the following regulatory compliance items:

  • Actuarial Opinion
  • Audited Financial Statements
  • Financial Examination (Request must be received prior to start of field work)
* The contact number for the Delaware Division of Corporations is (302) 739-3077.  
 

Documents required for Series Dissolution:


Dissolution Request Cover Sheet needs to be submitted as part as required dissolution documents: Download H2 Form Here

The Series Captive Insurance Company must notify the Captive Bureau in writing of its intent to dissolve, including the reason for dissolution, and provide:

  • Consent of Board of Directors or LLC Managing Members authorizing the dissolution
  • Current year Annual Report
  • Proof of Premium Tax payments for prior year as well as the current year when dissolution request is being filed
    • IMPORTANT NOTE All Premium Tax Forms and Payment are mailed to
                    DOI Captive Tax
                    1351 West North Street
                    Suite 101
                    Dover, DE 19904
  • Provide the department with an affidavit from the owner that includes the following statements that:
    • all liabilities have been settled: insurance and/or reinsurance policies have been terminated, no claims are outstanding as well as that Captive has no further obligations under any policies, including without limitation the reinsurance pool arrangements in which it previously participated – Download Template Letter Here
    • all liabilities have been settled with the Department – Download Template Letter Here

The dissolution can waive the following regulatory compliance items:

  • Actuarial Opinion
  • Audited Financial Statements
  • Financial Examination (Request must be received prior to start of field work)

Please check the requirements for dissolution as written in the LLC and Series Agreements.


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