PURPOSE: This rule sets forth the requirements which an application for self-insurer status must meet. Editor’s Note: The following material is incorporated into this rule by reference: 1) Missouri Division of Transportation, Single State Registration System (SSRS) Procedures Manual (Jefferson City, MO: Department of Economic Development, Revised July 1, 1994). In accordance with section 536.031(4), RSMo, the full text of material incorporated by reference will be made available to any interested person at the Office of the Secretary of State and the headquarters of the adopting state agency. (1) Motor carriers operating in intrastate commerce or interstate commerce exempt from Interstate Commerce Commission (ICC) jurisdiction filing an application for authority to become a self-insurer shall file the original and one (1) copy of the application with the director of the division. Every application shall include a completed Application Form MO 419-1797 and, whenever applicable, shall include completed Exhibits A, B, C, D and E, as described in the application form. The application may include additional supporting information, which shall not repeat or duplicate the information required in Application Form MO 419-1797 or Exhibits A, B, C, D and E. Photocopies of the form and exhibits are acceptable, if they are clearly legible.

1. (2) Except as provided in section (3) or (4) of this rule, each motor carrier who has been 4 CSR 265-2

granted authority by this division to be a selfinsurer shall file, within sixty (60) days after the close of the previous calendar year, a balance sheet, income statement and a statement listing any claims filed against the motor carrier which arose out of any accidents the motor carrier was involved in during its operations in the previous calendar year, and any unresolved claims which arose out of accidents during previous years. For each claim listed, the applicant shall state the amount, nature and status of the claim including whether it is disputed or undisputed and how much of it remains unpaid. (3) Any carrier whose self-insurance plan has been approved by the Interstate Commerce Commission (ICC) shall file with this division—

1. (A) The ICC order approving its self-insurance plan; and
2. (B) Immediate notice of any proceeding or action by the ICC which could result in the suspension, revocation or termination of its self-insurance plan.

1. (4) Applications for self-insurance of interstate motor carrier operations authorized by a certificate or permit issued by the ICC shall be made as required by the Single State Registration System (SSRS) Procedures Manual, which is adopted by the division. Except as otherwise specifically provided in this chapter or 4 CSR 265-10 with reference to operations under ICC authority, the SSRS Procedures Manual shall govern the registration, licensing, proof of insurance coverage and designation of process agents of all vehicles operated in Missouri under ICC authority.
2. (5) Failure of a carrier to comply with the provisions of section (2) or (3) of this rule shall result in revocation of this division’s approval of the carrier’s self-insurance plan.

AUTHORITY: section 622.027, RSMo 1994.* Emergency rule filed Aug. 1, 1986, effective Aug. 13, 1986, expired Oct. 23, 1986. Original rule filed July 31, 1986, effective Oct. 27, 1986. Emergency rescission filed Oct. 3, 1986, effective Oct. 23, 1986, expired Dec. 11, 1986. Amended: Filed May 2, 1991, effective Nov. 30, 1991. Emergency amendment filed Dec. 1, 1995, effective Dec. 11, 1995, expired Dec. 19, 1995. Emergency amendment filed Dec. 20, 1994, effective Jan. 1, 1995, expired April 30, 1995. Emergency amendment filed April 20, 1995, effective May 1, 1995, expired Aug. 28, 1995. Emergency amendment filed Aug. 18, 1995, effective Aug. 29, 1995, expired Feb. 24, 1995. Amended: Filed Aug. 3, 1995, effective Feb. 25, 1996.

*Original authority: 622.027, RSMo 1985, 1993, 1995.