14 Va. Admin. Code § 5-385-100
A. Every member of a group self-insurance pool shall execute a member agreement, which shall set forth the rights, privileges and obligations of the member, and the terms, coverages, limits, and deductible of the pool plan. The member agreement shall be subject to the approval of the commission and shall provide for, in substance, the following:
6. A requirement that the pool, at the request of a member, provide without unreasonable delay, to any person designated by the member, proof of the coverages provided by the pool, including insurance or reinsurance, applicable deductible levels, and the maximum liability that the pool will retain.
Such member agreement may also contain such other provisions not inconsistent with law or this chapter.
B. The first page of the member agreement shall include a summary that shall disclose:
1. In regard to coverage:
2. In regard to the contribution:
3. In regard to excess coverage of the pool:
C. The member agreement shall include a prominent disclosure notice that must be signed by the member or a duly authorized officer or representative of the member. The disclosure notice shall use the following or substantially similar language:
A group self-insurance pool for operators of facilities is not protected by any Virginia insurance guaranty association against default due to insolvency. In the event of insolvency, members and persons filing claims against members may be unable to collect any amount owed to them by the pool regardless of the terms of the member agreement. In the event the pool is unable to pay, a member may be liable for any and all unpaid claims against such member.
§§ 12.1-13, 38.2-223, and 62.1-44.34:12 of the Code of Virginia.
Derived from Virginia Register Volume 19, Issue 2, eff. October 1, 2002.