PURPOSE: This rule sets forth the requirements which an application for self-insurer status must meet. (1) Motor carriers operating in intrastate commerce 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 For Self-Insurer Status Form 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 For Self-Insurer Status Form 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) of this rule, each motor carrier who has been 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.

2. (3) Any carrier whose self-insurance plan has been approved by the Federal Motor Carrier Safety Administration (FMCSA) shall file with this division—

   1. (A) The FMCSA order approving its selfinsurance plan; and
   2. (B) Immediate notice of any proceeding or action by the FMCSA which could result in the suspension, revocation, or termination of its self-insurance plan.
3. (4) Failure of a carrier to comply with the provisions of section (2) or (3) of this rule AUTHORITY: section 622.027, RSMo 2000.* This rule originally filed as 4 CSR 265- 2.068. 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. Moved to 7 CSR 265-10.035 and amended: Filed May 2, 2013, effective Dec. 30, 2013.

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