Iowa Administrative Code › Agency 191 - Insurance Division › Health Benefit Plans › Chapter 77 - Multiple Employer Welfare Arrangements › Rule 191-77.3 - Self-insured Multiple Employer Welfare Arrangements

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Certificate of
				registration.
A person shall not establish or maintain a self-insured
				employee welfare benefit plan that is a self-insured MEWA in this state unless
				the MEWA obtains and maintains a certificate of registration pursuant to this
				rule. Such certificate of registration is required for all MEWAs that elect to
				offer self-insured employee welfare benefit plans to residents of this state
				whether or not the MEWA is domiciled in the state.
(2)
Application for certificate of
				registration.
a. A person wishing to
				obtain a certificate of registration as a self-insured MEWA pursuant to this
				chapter shall submit an application and a plan of operation to the
				commissioner. This application and plan of operation shall include the
				following:
(1) A business plan, including a
				copy of all health coverage contracts or other instruments which the
				self-insured MEWA applicant proposes to make with or sell to its employer
				members or its association's or group's members, a copy of its health coverage
				description and the printed matter to be used in the solicitation of employer
				members or its association's or group's members to purchase the health
				coverage.
(2) Copies of all
				articles, bylaws, agreements, or other documents or instruments describing the
				rights and obligations of employers, employees, and beneficiaries with respect
				to the self-insured MEWA applicant.
(3) A current list of all members of the
				employer group or association sponsoring the self-insured MEWA applicant, a
				description of the relationship among the employers, a description of how the
				relationship serves as the basis for the formation of the association or
				employer group, and a description of how the employer group or association
				complies with paragraphs 77.3(5)
"a"
and
				77.3(5)
"b,"
if applicable.
(4) A description of the activities of the
				association or group of employers on behalf of its employer members or its
				association's or group's members other than the sponsorship of the self-insured
				MEWA applicant, to further demonstrate compliance with paragraph
				77.3(5)
"a,"
if applicable.
(5) Current financial statements of the
				self-insured MEWA applicant that shall include, at a minimum, balance sheets,
				an income statement, a cash flow statement and a detailed listing of
				assets.
(6) An actuarial opinion
				which is prepared, signed, and dated by a person who is a member of the
				American Academy of Actuaries and which states that appropriate loss and loss
				adjustment reserves have been established, that adequate premiums are being
				charged, and that the association is operating in accordance with sound
				actuarial principles and in conformance with this rule.
(7) A statement from an authorized
				representative of the self-insured MEWA applicant that certifies all of the
				following:
1. The self-insured MEWA applicant
				shall be administered by an insurer authorized to do the business of insurance
				in this state or by an authorized third-party administrator that holds a
				current certificate of registration issued by the commissioner pursuant to Iowa
				Code section
				51021..
2. The self-insured MEWA applicant is
				established by a trade, industry, or professional association of employers that
				has a constitution or bylaws, is organized and maintained in good faith, and
				meets all membership requirements set forth in subrule 77.3(5).
3. The association or group of employers
				sponsoring the self-insured MEWA applicant is engaged in substantial activity
				for its members other than sponsorship of an employee welfare benefit
				plan.
4. The association is a
				nonprofit entity organized or authorized to do business under applicable Iowa
				law.
5. No insurance producers or
				benefits consultants established, sponsored, administer, or serve as a trustee
				or on the governing body of the self-insured MEWA applicant.
(8) A certificate from an
				authorized representative of the self-insured MEWA applicant that, to the best
				of the authorized representative's knowledge and belief, the self-insured MEWA
				applicant is in compliance with all applicable provisions of the Employee
				Retirement Income Security Act of 1974 (
				29 U.S.C. Section
				1001 et seq.).
(9) A description of and evidence of a
				mechanism, approved by the commissioner, to ensure that claims shall be paid in
				the event an employer member of the self-insured MEWA applicant is unable to
				comply with the self-insured MEWA applicant's contribution
				requirements.
(10) A copy of the
				most recent Form M-l filed by the self-insured MEWA applicant with the U.S.
				Department of Labor, Pension and Welfare Benefits Administration.
(11) Biographical affidavits from all members
				of the board of directors of the self-insured MEWA applicant. The affidavits
				shall be prepared using the current template for biographical affidavits
				prescribed by the National Association of Insurance Commissioners. This
				requirement shall not apply to any MEWA registered with the state prior to
				January 1, 2018.
(12) Any
				additional information requested by the commissioner.