Section 2699.6123 - Application for Guaranteed Associations(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.Cal. Code Regs. Tit. 10, § 2699.6123
1. Renumbering and amendment of former section 2699.623.5 to section 2699.6123 filed 5-27-94; operative 5-27-94 (Register 94, No. 21).
2. Amendment of subsection (a)(2)(O) filed 4-25-96; operative 5-25-96 (Register 96, No. 17).
3. Amendment of subsection (a)(3)(D) filed 7-3-98 as an emergency; operative 7-3-98 (Register 98, No. 27). A Certificate of Compliance must be transmitted to OAL by 11-2-98 or emergency language will be repealed by operation of law on the following day.
4. Certificate of Compliance as to 7-3-98 order transmitted to OAL 10-2-98 and filed 11-16-98 (Register 98, No. 47). Note: Authority cited: Section 10731, Insurance Code. Reference: Section 10731, Insurance Code.
1. Renumbering and amendment of former section 2699.623.5 to section 2699.6123 filed 5-27-94; operative 5-27-94 (Register 94, No. 21).
2. Amendment of subsection (a)(2)(O) filed 4-25-96; operative 5-25-96 (Register 96, No. 17).
3. Amendment of subsection (a)(3)(D) filed 7-3-98 as an emergency; operative 7-3-98 (Register 98, No. 27). A Certificate of Compliance must be transmitted to OAL by 11-2-98 or emergency language will be repealed by operation of law on the following day.
4. Certificate of Compliance as to 7-3-98 order transmitted to OAL 10-2-98 and filed 11-16-98 (Register 98, No. 47).