Oklahoma Administrative Code › Title 810 - Oklahoma Workers' Compensation Commission › Chapter 25 - Workers' Compensation Insurance and Self Insurance › Subchapter 11 - Group Self-insurance Association Permit › Section 810:25-11-12 - Renewal applications

Current through Vol. 41, No. 20, July 1, 2024
(a) An
				application for renewal of a group self-insurance association permit shall be
				submitted at least sixty (60) days before the expiration date of the existing
				permit, along with all of the following:
(1) A
				One Thousand Dollar ($1,000.00) nonrefundable application fee, made payable to
				the Commission;
(2) A sample of the
				members' indemnity agreement and power of attorney, as required by
				810:25-11-15,
				binding the association and each member thereof, jointly and severally, to
				comply with the provisions of the AWCA;
(3) A copy of the association's current
				audited financial statements, unaudited midyear statements, and all current
				actuarial reports;
(4) An
				attestation from the administrator and chair of the board that:
(A) The collective net worth of the members
				of the association exceeds Two Million Dollars ($2,000,000.00);
(B) The association is and has been in full
				compliance with the rules of the Commission during the current fiscal year;
				and
(C) All appropriate proof of
				coverage filings have been made with the NCCI during the current
				year;
(5) A list of the
				association's members which includes the following information for each member:
(A) A report of the premiums paid and losses
				incurred by each member of the association during the current fiscal year;
				and
(B) The estimated standard and
				discounted premium each association member will pay during the next fiscal year
				of the association;
(6)
				Underwriting guidelines that are used by the association, along with a listing
				of the type, amount and eligibility requirements of discounts available for the
				association members, including scheduled discounts;
(7) Projected expenses for the association
				for the next fiscal year, in dollar amount and a percentage of the standard
				premium to be generated;
(8)
				Specific and aggregate excess insurance binders for the next fiscal year, and
				copies of the policies for the current year;
(9) A copy of the association's bylaws and
				any other governing instrument;
(10) A designation of the members'
				supervisory board and of the administrator of the association;
(11) A copy of the contract(s) between the
				association and all TPAs, including a cover page for each contract which
				indicates the nature of services provided by the TPA (i.e., claims management,
				safety, marketing, underwriting or accounting services);
(12) A copy of all fidelity bonds and errors
				and omissions policies secured by the association, its administrator, and
				organizations providing services to the association, with the exception of any
				TPAs;
(13) Copies of all marketing
				materials utilized by the association;
(14) A list of workers' compensation rates to
				be charged to its members, broken down by classification code. The rates should
				be calculated in accordance with
				810:25-11-8;
(15) Copies of the minutes of all board
				meetings held during the current year; and
(16) A listing of investments currently held
				by the association.