Louisiana Administrative Code › Title 37 - INSURANCE › Part XIII - Regulations › Chapter 11 - Regulation Number 42-Group Self-Insurance Funds › Section XIII-1103 - Application to Create a Group Self-Insurance Fund

Current through Register Vol. 50, No. 6, June 20, 2024
A. All applications to create a group
				self-insurance fund shall meet the requirements of Louisiana Revised Statutes
				Title 23, §1195 et seq., any
				other applicable laws of the state of Louisiana, and this regulation.
B. Applications shall be made in writing on a
				form provided by the department.
C.
				Applications shall be submitted to the department at least 90 days prior to the
				effective date for establishment of a fund. Any application submitted with less
				than 90 days remaining before the desired effective date, or which does not
				contain answers to all questions, or which is not sworn to and subscribed
				before a notary public, or which does not contain all required documents,
				statements, reports, and required information, may be returned without review
				by the department.
D. All
				applications shall be accompanied by:
1. a
				properly completed indemnity agreement in a form acceptable to the department,
				pursuant to
				§1111 of this regulation;
2. security as required by Louisiana Revised
				Statutes Title 23,
				§1195 et seq. and this
				regulation;
3. copies of acceptable
				excess insurance or reinsurance policies, pursuant to Louisiana Revised
				Statutes Title 23,
				§1195 et seq. and this
				regulation;
4. a bond covering each
				third party administrator, pursuant to Louisiana Revised Statutes Title 23,
				§1195 et seq.;
5. a certification from a designated
				depository attesting to the amount of monies on hand;
6. copies of the fund bylaws and trust
				agreement or other governance documents;
7. individual application of each member of
				the fund applying for membership in the fund on the effective date of the fund,
				and copies of their executed indemnity agreements;
8. evidence of financial strength and
				liquidity of the members dated as of the date of the filing of the application
				to satisfy the financial strength and liquidity requirements of Louisiana
				Revised Statutes Title 23,
				§1195 et seq. and this
				regulation;
9. proof that the fund
				shall have the minimum annual earned normal premium as specified in Louisiana
				Revised Statutes Title 23,
				§1195 et seq.;
10. the current annual report or financial
				statement of any casualty insurance company providing excess or reinsurance
				coverage for the fund, which meets the requirements of Louisiana Revised
				Statutes Title 23,
				§1195 et seq. if such statement is not
				already on file with the department;
11. the name, address, and telephone number
				of the attorney representing the fund, of the qualified actuary for the fund,
				and of the certified public accountant who will be auditing the annual
				financial statements of the fund, as well as evidence of appointment of each by
				the fund;
12. the domicile address
				in this state where the books and records of the fund will be maintained, and
				the state from which the fund will be administered;
13. proof of advance payment to the fund by
				each initial member of the fund of not less than 25 percent of that member's
				first year estimated annual earned normal premium;
14. a feasibility study, or other analysis,
				prepared by a qualified actuary utilizing actual loss history of the initial
				members of the fund;
15. pro forma
				financial statements projecting the first three years of operations of the fund
				based upon a feasibility study or other analysis prepared by a qualified
				actuary, pursuant to Louisiana Revised Statutes Title 23,
				§1195 et seq. and
				§5(A) hereof. Such pro
				forma financial statements shall include a pro forma balance sheet, income
				statement, and statement of cash flow. Each shall be prepared in accordance
				with generally accepted accounting principles;
16. a copy of the fund's premium billing
				policy indicating whether the premium payments to the fund will be paid by
				members annually, monthly, quarterly, or any combination thereof.