STATE OF WASHINGTON
MIKE KREIDLER Phone: (360) 725-7202
STATE INSURANCE COMMISSIONER Fax: (360) 586-2022
RISK PURCHASING GROUP
Applying for Registration as a Risk Purchasing Group in Washington
The application file consists of the application, service of process form, and a link to the applicable
Washington statutes and regulations. [While it is the case that generally speaking, the Washington law
mirrors the federal law of 15 USC §3901 et seq. (the LRRA of 1986), there are some differences.]
Should you have questions regarding the application, the application process, or the applicable law,
please contact us as soon as possible.
The application packet is designed to be downloaded and saved to your hard drive. You should be able to
“tab” through the Word application document and enter necessary information, which you will then save
and print. There is no application or annual fee imposed for registration.
After signature by the authorized officer, the application form, along with all required documentation and
any cover letter need to be scanned into a single Adobe pdf document for electronic submission via
The email subject line must state “Purchasing Group Application of <your company’s legal
The email address to be used is CompanySupervisionFilings@oic.wa.gov.
Attach the pdf to the email and send.
For all questions or requests for additional information, please contact the Company Licensing Specialist:
Susan Baker at (360) 725-7232 or by email at SusanB@oic.wa.gov.
Company Supervision Division
Mailing Address: PO Box 40259 ● Olympia, WA 98504-0259
Street Address: 5000 Capitol Boulevard ● Tumwater, WA 98501