I. The application for a purchasing alliance shall include a business plan containing the following information:
- (a) A detailed, written plan of operations explaining how the applicant intends to fulfill the purposes and requirements of this chapter;
- (b) The specific steps that the alliance will use to increase affordability, efficiency, and fairness of health insurance coverage;
- (c) The specific steps that the alliance will use to allow employers and their employees to obtain better value in purchasing health insurance;
- (d) The scope of services to be offered and the resources and expertise to be used to implement and administer those services;
- (e) A provision requiring that any coverage procured by the alliance shall require that the members of the alliance be notified directly by the insurer of cancellation due to nonpayment of premium;
- (f) The personal biographical information and descriptions of the officers of the alliance;
- (g) A written statement demonstrating that those involved in the operation of the alliance have the expertise and experience to effectively and professionally represent employers and their eligible employees; and
- (h) An affirmative demonstration that financial controls are in place as a condition of licensure.
II. In addition to the business plan, each applicant shall file with the commissioner the following information or documents:
- (a) A plan that affirmatively demonstrates that the alliance has the technical expertise and capacity to serve a significant group of employers and their eligible employees;
- (b) A plan that demonstrates that the alliance has the technical capacity to provide service quality;
- (c) The applicant's articles of incorporation, bylaws, or other formation and business operation documents;
- (d) A list of officers and directors of the applicant and the contract administrator, if one is employed, and personal biographical information or firm descriptions for each;
- (e) Evidence of security and prudence in the accounting, deposit, collection, handling, and transfer of moneys; and
- (f) A description of the service area in which the alliance will be marketing and offering services.
- III. Material changes in the operations or the business plan shall not take effect without approval from the commissioner.
- IV. The commissioner shall conduct financial and performance audits or examinations of an alliance on a regular basis. The commissioner shall require audited financial statements from an alliance. The costs of examinations or audits shall be paid by the alliance.
V. A purchasing alliance shall submit an annual report no later than April 1 of each year that includes quarterly financial statements that show:
- (a) The alliance is operating in a sound financial fashion;
- (b) The alliance is not a risk-bearing entity; and
- (c) The alliance is utilizing sound financial controls and money management.
Source. 2010, 346:1, eff. July 20, 2010.