Section 0780-01-76-.09 - REPORTING REQUIREMENTS(1) A self-funded qualified multiple employer welfare arrangement shall file with the Commissioner on or before June 1 of each year on the National Association of Insurance Commissioner's annual health blank, a full and true statement of its financial condition, transactions, and affairs as of the preceding December 31, including:(a) A statement of financial condition accompanied by the certificate of an independent public accountant to the effect that such statement presents fairly the financial position of the applicant and the results of its operations for the year then ended, in conformity with statutory accounting procedures.(b) A statement of change in financial condition for the year accompanied by an actuarial opinion by a qualified actuary that includes:1. A certification that the unpaid claim liability of the arrangement meets the requirements of Chapter 0780-1-69.2. The recommended level of specific and aggregate stop-loss insurance the arrangement should maintain; and3. A description of the actuarial soundness of the arrangement, including any recommended actions the arrangement should take to improve its actuarial soundness;(c) A statement of the arrangement's contribution rates for the next year;(d) A report showing the number of participating employers and number of covered lives at the end of the year and contributions received during the year in the state;(e) Any information required by statute or rule relating to the arrangement's compliance with the requirements in Tenn. Code Ann. §56-7-109; and(f) Additional information the Commissioner determines is necessary in order to determine the financial integrity of the arrangement.(2) A self-funded qualified multiple employer welfare arrangement shall, within sixty (60) days after the end of each quarter, file with the Commissioner, on the National Association of Insurance Commissioner's quarterly health blank, a full and true statement of its financial condition, transactions, and affairs as of the preceding quarter, including(a) A statement of financial condition;(b) A statement of change in financial condition for the period since the end of the prior year;(c) A report showing the number of participating employers and number of covered lives at the end of the quarter and contributions received during the quarter in the state, and(d) Additional information the Commissioner determines is necessary in order to determine the financial integrity of the arrangement.(3) A self-funded qualified multiple employer welfare arrangement shall file with the Commissioner a copy of the arrangement's Internal Revenue Service Form 5500, including all attachments to the form.(4) A self-funded qualified multiple employer welfare arrangement shall, before execution, file with the Commissioner a copy of any stop-loss or excess policies or agreements maintained or proposed to be maintained by the arrangement. The arrangement shall verify with the Commissioner that all such policies or agreements have been filed and approved by the Commissioner.Tenn. Comp. R. & Regs. 0780-01-76-.09
Original rule filed April 14, 2004; effective June 28, 2004.Authority: T.C.A. § 56-26-204(b).