California Code of Regulations › Title 10 - Investment › Chapter 5.7 - Voluntary Alliance Uniting Employers Purchasing Pool (the Health Insurance Plan of California) › Article 2 - Participation Requirements, Application and Enrollment › Section 2699.6123 - Application for Guaranteed Associations

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) To apply for the program a guaranteed
				association shall submit:
(1) The name,
				position, and phone number of a designated contact person who is legally
				authorized to sign and date required declarations on behalf of the guaranteed
				association stating that the information given is true and correct and complete
				to the best of their knowledge.
(2)
				All information, documentation, and declarations necessary to determine program
				qualification as follows:
(A) A list of all
				members of the association including their name, address, beginning date of
				membership, membership category and tax identification number, if
				available.
(B) A list of the member
				employers, member employees and dependents, and individual members and
				dependents who currently have coverage sponsored by the guaranteed association
				or through the guaranteed association's trust through which the guaranteed
				association sponsors coverage.
(C)
				A declaration that the guaranteed association has one or more employers which
				meets the definition of a sole employer.
(D) A declaration that the guaranteed
				association does not condition membership directly or indirectly on the health
				or claims history of any person.
(E) A declaration that the guaranteed
				association uses membership dues solely for and in consideration of the
				membership and membership benefits, except that the amount of the dues shall
				not depend on whether the member applies for or purchases insurance offered by
				the association.
(F) A declaration
				that the guaranteed association is organized and maintained in good faith for
				purposes unrelated to providing insurance to members.
(G) A declaration that the guaranteed
				association has a constitution and bylaws or other analogous governing
				documents that provide for election of the governing board of the association
				by its members.
(H) Written proof
				that the guaranteed association was in active existence on January 1, 1992 and
				for at least five years prior to that date.
(I) Written proof that the guaranteed
				association has been offering health insurance to its members for at least five
				years prior to January 1, 1992.
(J)
				A declaration by the guaranteed association that the guaranteed association
				will notify all association members as well as any other person known to the
				association who, although not an association member, is in a category of
				persons who pursuant to Section
				2699.6109(a)(9)
				will be eligible for coverage through the guaranteed association of the
				guaranteed association's intention to offer coverage through the program and
				provide member employers and individual members with at least a 30 day period
				to respond.
(K) A declaration
				stating when the period for informing member employers and individual members
				of the availability of coverage in the program will be and for how long it will
				be.
(L) A declaration stating that
				the guaranteed association will meet the requirements of Section
				2699.6109(a)(2) and
				(a)(3).
(M) A declaration that the guaranteed
				association will not offer coverage to member employers and their employees or
				to individual members anywhere but in the program.
(N) A declaration disclosing to the program
				the number of persons currently receiving coverage through the guaranteed
				association and when that coverage commenced.
(O) A specification by the guaranteed
				association of which of the members, employees of members, association staff,
				retired members, retired employees of members, and surviving spouses and
				dependents of deceased members the association shall commit to offering
				coverage to in the program.
(3) A description of the guaranteed
				association's plan for offering coverage. This shall include at least the
				following:
(A) The method for providing notice
				of the offering of coverage in the program.
(B) The date the initial offering by the
				guaranteed association will expire.
(C) Whether applications and premiums will be
				submitted through the guaranteed association or directly to the
				program.
(D) If the applications
				and premiums will be submitted through the guaranteed association, whether the
				guaranteed association will be utilizing the services of an agent or broker. If
				the guaranteed association will be utilizing the services of an agent or
				broker, the name, license number, tax identification number, and address of the
				agent or broker.