Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 33 - CONTINUING CARE PROVIDERS › Subchapter C - APPLICATION BY CONTINUING CARE PROVIDER FOR CERTIFICATE OF AUTHORITY › Section 33.204 - Contents of Application for Certificate of Authority

Current through Reg. 49, No. 28; July 12, 2024
(a) The applicant shall submit an original
				  and two copies of the items listed in paragraphs (1) - (19), as applicable.
(1) CCRC Form #1 (Application for Certificate
				  of Authority To Do Business in the State of Texas under the Act,
				  §246.022);
(2) CCRC Form #3
				  (Officers and Directors page);
(3)
				  CCRC Form #4 (Biographical Data Form) or CCRC Form #4a (Biographical Data Form
				  for Not-for-Profit CCRC Board Members);
(4) basic organizational documents and all
				  amendments thereto, with an original certification or seal from the state of
				  domicile. These documents shall include, but not be limited to, the articles of
				  incorporation, the bylaws, and the resolution by the board of directors
				  certifying corporate approval of the project;
(5) certified copy of assumed name
				  certificate;
(6) letter from
				  Internal Revenue Service recognizing tax-exempt status under Internal Revenue
				  Code with a certification by an officer that it is a true and correct copy of
				  the original;
(7) chart or listing
				  clearly presenting the identities and interrelationship among affiliates
				  showing the percentage of each class of voting securities of each affiliate
				  which is owned or controlled, directly or indirectly, by another affiliate, or
				  indicating the basis of control if other than by ownership or control of voting
				  securities;
(8) agreements
				  establishing the entrance fee and reserve fund accounts or a verified statement
				  explaining why an escrow is not required. The agreements shall be accompanied
				  by the items described in subparagraphs (A) - (C) of this paragraph:
(A) name and address of escrow
				  agent;
(B) certification of the
				  number of persons and the percentage of the number of living units in the
				  facility under reservation agreements with funds on deposit in the entrance fee
				  escrow accounts; and
(C) statement
				  or set of instructions that the provider will send to the escrow agent to
				  request a release of funds to the provider from the entrance fee and
				  reservation fund escrow accounts;
(9) complete disclosure statement on CCRC
				  Form #6 (Form For Disclosure Statement);
(10) service contracts or agreements with
				  affiliates;
(11) management
				  contract if the facility will be managed on a day-to-day basis by a person
				  other than individuals directly employed by the provider;
(12) independent feasibility study;
(13) actuarial review as defined in §
											33.2 of
				  this title (relating to Definitions);
(14) all priority agreements, reservation
				  agreements, or any types of contracts or agreements which the provider is using
				  in soliciting continuing care contracts, contracting, or collection of funds,
				  if not included in the disclosure statement;
(15) financial statements dated no more than
				  90 days prior to the application submission date, if not included in the
				  disclosure statement;
(16)
				  documentation evidencing a commitment to the provider for any permanent
				  mortgage loan or other long-term financing arrangement;
(17) list or description of liens which
				  attach to any part of the facility before, during, or after
				  construction;
(18) legal
				  description of real property on which the facility is or will be located;
				  and
(19) any additional information
				  relating to items required under paragraphs (1) - (18) of this subsection, as
				  the department may request.