SECTION 7.1906. Application for Final Certificate of Authority

(a) A multiple-employer welfare arrangement which has received its initial certificate of authority must apply for a final certificate of authority no later than one year after the issuance of its initial certificate of authority. The multiple-employer welfare arrangement shall file an application on the prescribed form and furnish such information as may be required by the commissioner. The application shall include only those items described in paragraphs (1)-(4) of this subsection, as follow:

(1) the names and addresses of:

(A) the association or group of employers sponsoring the multiple-employer welfare arrangement;

(B) the members of the board of trustees or directors, as applicable, of the multiple-employer welfare arrangement;

(C) at least five employers, if the arrangement is not an association, which information shall be retained by the commissioner as confidential;

(2) evidence that the fidelity bond requirements have been met;

(3) copies of all plan documents and agreements with service providers, which shall be retained by the commissioner as confidential. (Indicate on what pages the specific benefits are listed); and

(4) a funding report containing:

(A) a statement certified by the board of trustees or directors, as applicable, and an actuarial opinion that all applicable requirements of the Insurance Code, Article 3.95-8, have been met;

(B) an actuarial opinion which sets forth a description of the extent to which contributions or premium rates:

(i) are not excessive;

(ii) are not unfairly discriminatory; and

(iii) are adequate to provide for the payment of all obligations and the maintenance of required cash reserves and surplus of the multiple-employer welfare arrangement;

(C) a certified statement of the current value of the assets and liabilities accumulated by the multiple-employer welfare arrangement (unless the application for final certificate of authority is filed 90 days or later following the close of the fiscal year for the multiple-employer welfare arrangement, in which case the financial statement shall be an audited statement), and a projection of the assets, liabilities, income, and expenses of the multiple-employer welfare arrangement for the next 12-month period and that reflects that the MEWA has maintained adequate cash reserves; and

(D) a statement of the costs of coverage to be charged, including an itemization of amounts for administration, reserves, and other expenses associated with operation of the multiple-employer welfare arrangement.

(b) After examination, investigation, and determination that all the requirements of the Insurance Code, Chapter 3, Subchapter I, and these sections have been met, the commissioner shall issue a final certificate of authority to the multiple-employer welfare arrangement.

Source Note: The provisions of this §7.1906 adopted to be effective May 27, 1994, 19 TexReg 3686.