1. (a) A multiple-employer welfare arrangement shall file an application on the prescribed form and furnish such information as may be required by the Insurance Commissioner.

2. (b) The application shall include only those items described in subdivisions (b)(1) – (4) of this section, as follows:

   1. (1) The names and addresses of:

      1. (A) The association or group of employers sponsoring the multiple-employer welfare arrangement;
      2. (B) The members of the board of trustees or directors, as applicable, of the multiple-employer welfare arrangement; and
      3. (C) At least two (2) employers, if the arrangement is not an association, which information shall be retained by the commissioner as confidential;
   2. (2) Evidence that the fidelity bond requirements have been met;
   3. (3) Copies of all plan documents and agreements with service providers, which shall be retained by the commissioner as confidential; and

   4. (4) A funding report containing:

      1. (A) A statement certified by the board of trustees or directors, as applicable, and an actuarial opinion that is satisfactory to the Finance Division of the State Insurance Department;
      2. (B) An actuarial opinion that sets forth a description of the extent to which contributions or premium rates:

3. (i) Are not excessive;

   1. (ii) Are not unfairly discriminatory; and

      1. (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;
      2. (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 ninety (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 twelve-month period and that reflects that the MEWA has maintained adequate cash reserves; and
      3. (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.

Codification Notes: “MEWA” means multiple-employer welfare arrangement.