The sponsoring association shall file with the office an application for a certificate of authority upon a form to be adopted by the commission and furnished by the office, signed under oath by officers of the trust, which shall include or have attached the following:(1) A copy of the articles of incorporation, constitution, and bylaws of the association, if any.
(2) A list of the names, addresses, and official capacities within the arrangement of the individuals who are to be responsible for the management of and the conduct of the affairs of the arrangement, including all trustees, officers, and directors. Such individuals shall fully disclose to the office the extent and nature of any contracts or arrangements between themselves and the arrangement, including any possible conflicts of interest.
(3) A copy of the articles of incorporation, bylaws, or trust agreement which governs the operation of the arrangement.
(4) A copy of the policy, contract, certificate, summary plan description, or other evidence of the benefits and coverages provided to covered employees, which shall be in accordance with s. 627.651(4), and which shall include a table of the rates charged, or proposed to be charged, for each form of such contract. A qualified actuary shall certify that:(a) The rates are not inadequate.
(b) The rates are appropriate for the class of risks for which they have been computed.
(c) An adequate description of the rating methodology has been filed with the office and such methodology follows consistent and equitable actuarial principles.
(5) A copy of the fidelity bond in an amount equal to not less than 10 percent of the funds handled annually and issued in the name of the arrangement covering its trustees, directors, officers, employees, administrator, or other individuals managing or handling the funds or assets of the arrangement. In no case may such bond be less than $50,000 or more than $500,000, except that the office, after due notice to all interested parties and opportunity for hearing, and after consideration of the record, may prescribe an amount in excess of $500,000, subject to the 10-percent limitation of the preceding sentence.
(6)(a) A copy of the arrangement’s excess insurance agreement, which shall provide that the net retention level for any one risk shall not exceed $50,000, and which shall otherwise be in accordance with sound actuarial principles.
(b) The office may waive or modify the maximum net retention requirement if:1. The excess insurance is not available for a reasonable cost; or
2. The arrangement:a. Has 150 percent of the statutory reserve requirement as specified in s. 624.441; b. Has a fund balance in excess of that required by statute; and
c. Has a ratio of current assets to current liabilities of at least 2.0 to 1.0.
(7)(a) A feasibility study, done by an independent qualified actuary and an independent certified public accountant, determined by the office to satisfactorily address market potential, market penetration, market competition, operating expenses, gross revenues, net income, total assets and liabilities, cash flow, and such other items as the office or commission reasonably requires. The study shall be for the greater of 3 years or until the arrangement has been projected to be profitable for 12 consecutive months. The study must show that the arrangement would not, at any month-end of the projection period, have less than the minimum statutory deposit as required by s. 624.441 or have a fund balance less than the amount required by s. 624.4392. (b) The feasibility study shall reflect and support that initial gross premiums for the first year of operation will be at least $100,000.
(8) Evidence satisfactory to the office showing that the arrangement will be operated in accordance with sound actuarial principles. The office shall not approve the arrangement unless the office determines that the plan is designed to provide sufficient revenues to pay current and future liabilities, as determined in accordance with sound actuarial principles.
(9) Confirmation of insolvency protection as required by s. 624.441. (10) A copy of each contract between the arrangement and any administrator or service company which may be made available for review rather than filed or attached.
(11) Such additional information as the office or commission reasonably requires.
