An association sponsoring aMEWA shall file with the Commissioner an application for a license on a formprescribed by the Commissioner and signed under oath by officers of theassociation. The application shall include or have attached the following:
(l) A copy of thearticles of incorporation, constitution, and bylaws of the association;
(2) A list of the names,addresses, and official capacities with the MEWA of the individuals who will beresponsible for the management and conduct of the affairs of the MEWA,including all trustees, officers, and directors. Such individuals shall fullydisclose the extent and nature of any contracts or arrangements between themand the MEWA, including possible conflicts of interest.
(3) A copy of thearticles of incorporation, bylaws, or trust agreement that governs theoperation of the MEWA.
(4) A copy of thepolicy, contract, certificate, summary plan description, or other evidence ofthe benefits and coverages provided to covered employees, including a table ofthe rates charged or proposed to be charged for each form of such contract. Anactuary who is a member of the American Academy of Actuaries or the Society ofActuaries and has experience in establishing rates for a self‑insuredtrust and health services being provided, shall certify that:
a. The rates areneither inadequate, nor excessive, nor unfairly discriminatory.
b. The rates areappropriate for the classes of risks for which they have been computed.
c. An adequate descriptionof the rating methodology has been filed with the Commissioner and suchmethodology follows consistent and equitable actuarial principles.
(5) A copy of a fidelitybond, in an amount determined by rules adopted by the Commissioner, issued inthe name of the MEWA and covering any individuals managing or handling thefunds or assets of the MEWA. In no case may the bond be less than fiftythousand dollars ($50,000) or more than five hundred thousand dollars($500,000).
(6) A copy of the MEWA'sexcess insurance agreement.
(7) A feasibility study,made by an independent qualified actuary and an independent certified publicaccountant with an opinion acceptable to the Commissioner, that addressesmarket potential, market penetration, market competition, operating expenses,gross revenues, net income, total assets and liabilities, cash flow, and otheritems as the Commissioner requires. The study shall be for the greater ofthree years or until the MEWA has been projected to be profitable for 12consecutive months. The study must show that the MEWA would not, at any monthend of the projection period, have less than the reserves as required by G.S.58‑49‑40(d).
(8) A copy of an auditedfinancial statement of the MEWA reflecting the minimum statutory reserve asrequired by G.S. 58‑49‑40(d).
(9) Evidencesatisfactory to the Commissioner showing that the MEWA will be operated inaccordance with sound actuarial principles. The Commissioner shall not approvethe MEWA unless it is determined that the MEWA is designed to providesufficient revenues to pay current and future liabilities, as determined inaccordance with sound actuarial principles.
(10) A copy of everycontract between the MEWA and any administrator or service company.
(11) Such additionalinformation as the Commissioner may require. (1991, c. 611, s. 1.)
An association sponsoring aMEWA shall file with the Commissioner an application for a license on a formprescribed by the Commissioner and signed under oath by officers of theassociation. The application shall include or have attached the following:
(l) A copy of thearticles of incorporation, constitution, and bylaws of the association;
(2) A list of the names,addresses, and official capacities with the MEWA of the individuals who will beresponsible for the management and conduct of the affairs of the MEWA,including all trustees, officers, and directors. Such individuals shall fullydisclose the extent and nature of any contracts or arrangements between themand the MEWA, including possible conflicts of interest.
(3) A copy of thearticles of incorporation, bylaws, or trust agreement that governs theoperation of the MEWA.
(4) A copy of thepolicy, contract, certificate, summary plan description, or other evidence ofthe benefits and coverages provided to covered employees, including a table ofthe rates charged or proposed to be charged for each form of such contract. Anactuary who is a member of the American Academy of Actuaries or the Society ofActuaries and has experience in establishing rates for a self‑insuredtrust and health services being provided, shall certify that:
a. The rates areneither inadequate, nor excessive, nor unfairly discriminatory.
b. The rates areappropriate for the classes of risks for which they have been computed.
c. An adequate descriptionof the rating methodology has been filed with the Commissioner and suchmethodology follows consistent and equitable actuarial principles.
(5) A copy of a fidelitybond, in an amount determined by rules adopted by the Commissioner, issued inthe name of the MEWA and covering any individuals managing or handling thefunds or assets of the MEWA. In no case may the bond be less than fiftythousand dollars ($50,000) or more than five hundred thousand dollars($500,000).
(6) A copy of the MEWA'sexcess insurance agreement.
(7) A feasibility study,made by an independent qualified actuary and an independent certified publicaccountant with an opinion acceptable to the Commissioner, that addressesmarket potential, market penetration, market competition, operating expenses,gross revenues, net income, total assets and liabilities, cash flow, and otheritems as the Commissioner requires. The study shall be for the greater ofthree years or until the MEWA has been projected to be profitable for 12consecutive months. The study must show that the MEWA would not, at any monthend of the projection period, have less than the reserves as required by G.S.58‑49‑40(d).
(8) A copy of an auditedfinancial statement of the MEWA reflecting the minimum statutory reserve asrequired by G.S. 58‑49‑40(d).
(9) Evidencesatisfactory to the Commissioner showing that the MEWA will be operated inaccordance with sound actuarial principles. The Commissioner shall not approvethe MEWA unless it is determined that the MEWA is designed to providesufficient revenues to pay current and future liabilities, as determined inaccordance with sound actuarial principles.
(10) A copy of everycontract between the MEWA and any administrator or service company.
(11) Such additionalinformation as the Commissioner may require. (1991, c. 611, s. 1.)
An association sponsoring aMEWA shall file with the Commissioner an application for a license on a formprescribed by the Commissioner and signed under oath by officers of theassociation. The application shall include or have attached the following:
(l) A copy of thearticles of incorporation, constitution, and bylaws of the association;
(2) A list of the names,addresses, and official capacities with the MEWA of the individuals who will beresponsible for the management and conduct of the affairs of the MEWA,including all trustees, officers, and directors. Such individuals shall fullydisclose the extent and nature of any contracts or arrangements between themand the MEWA, including possible conflicts of interest.
(3) A copy of thearticles of incorporation, bylaws, or trust agreement that governs theoperation of the MEWA.
(4) A copy of thepolicy, contract, certificate, summary plan description, or other evidence ofthe benefits and coverages provided to covered employees, including a table ofthe rates charged or proposed to be charged for each form of such contract. Anactuary who is a member of the American Academy of Actuaries or the Society ofActuaries and has experience in establishing rates for a self‑insuredtrust and health services being provided, shall certify that:
a. The rates areneither inadequate, nor excessive, nor unfairly discriminatory.
b. The rates areappropriate for the classes of risks for which they have been computed.
c. An adequate descriptionof the rating methodology has been filed with the Commissioner and suchmethodology follows consistent and equitable actuarial principles.
(5) A copy of a fidelitybond, in an amount determined by rules adopted by the Commissioner, issued inthe name of the MEWA and covering any individuals managing or handling thefunds or assets of the MEWA. In no case may the bond be less than fiftythousand dollars ($50,000) or more than five hundred thousand dollars($500,000).
(6) A copy of the MEWA'sexcess insurance agreement.
(7) A feasibility study,made by an independent qualified actuary and an independent certified publicaccountant with an opinion acceptable to the Commissioner, that addressesmarket potential, market penetration, market competition, operating expenses,gross revenues, net income, total assets and liabilities, cash flow, and otheritems as the Commissioner requires. The study shall be for the greater ofthree years or until the MEWA has been projected to be profitable for 12consecutive months. The study must show that the MEWA would not, at any monthend of the projection period, have less than the reserves as required by G.S.58‑49‑40(d).
(8) A copy of an auditedfinancial statement of the MEWA reflecting the minimum statutory reserve asrequired by G.S. 58‑49‑40(d).
(9) Evidencesatisfactory to the Commissioner showing that the MEWA will be operated inaccordance with sound actuarial principles. The Commissioner shall not approvethe MEWA unless it is determined that the MEWA is designed to providesufficient revenues to pay current and future liabilities, as determined inaccordance with sound actuarial principles.
(10) A copy of everycontract between the MEWA and any administrator or service company.
(11) Such additionalinformation as the Commissioner may require. (1991, c. 611, s. 1.)
