1. (a) An application for renewal of a group self-insurance association permit shall be submitted at least sixty (60) days before the expiration date of the existing permit, along with all of the following:

   1. (1) A One Thousand Dollar ($1,000.00) nonrefundable application fee, made payable to the Commission;
   2. (2) A sample of the members' indemnity agreement and power of attorney, as required by 810:25-11-15, binding the association and each member thereof, jointly and severally, to comply with the provisions of the AWCA;
   3. (3) A copy of the association's current audited financial statements, unaudited midyear statements, and all current actuarial reports;

   4. (4) An attestation from the administrator and chair of the board that:

      1. (A) The collective net worth of the members of the association exceeds Two Million Dollars ($2,000,000.00);
      2. (B) The association is and has been in full compliance with the rules of the Commission during the current fiscal year; and
      3. (C) All appropriate proof of coverage filings have been made with the NCCI during the current year;

   5. (5) A list of the association's members which includes the following information for each member:

      1. (A) A report of the premiums paid and losses incurred by each member of the association during the current fiscal year; and
      2. (B) The estimated standard and discounted premium each association member will pay during the next fiscal year of the association;
   6. (6) Underwriting guidelines that are used by the association, along with a listing of the type, amount and eligibility requirements of discounts available for the association members, including scheduled discounts;
   7. (7) Projected expenses for the association for the next fiscal year, in dollar amount and a percentage of the standard premium to be generated;
   8. (8) Specific and aggregate excess insurance binders for the next fiscal year, and copies of the policies for the current year;
   9. (9) A copy of the association's bylaws and any other governing instrument;
   10. (10) A designation of the members' supervisory board and of the administrator of the association;
   11. (11) A copy of the contract(s) between the association and all TPAs, including a cover page for each contract which indicates the nature of services provided by the TPA (i.e., claims management, safety, marketing, underwriting or accounting services);
   12. (12) A copy of all fidelity bonds and errors and omissions policies secured by the association, its administrator, and organizations providing services to the association, with the exception of any TPAs;
   13. (13) Copies of all marketing materials utilized by the association;
   14. (14) A list of workers' compensation rates to be charged to its members, broken down by classification code. The rates should be calculated in accordance with 810:25-11-8;
   15. (15) Copies of the minutes of all board meetings held during the current year; and
   16. (16) A listing of investments currently held by the association.
2. (b) The renewal application shall be reviewed and processed by the Commission in the same manner as the original application.

Added at 31 Ok Reg 497, eff 2-4-14 (emergency)

Added at 32 Ok Reg 1493, eff 8-27-15

Amended at 35 Ok Reg 2312, eff 9-14-18