Association/Trust Filing Issues by State Update Date: 05/28/15

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1 Association/Trust Filing Issues by Update Date: 05/28/15 The following summary reflects experience and information to consider when filing using an or trust. The information is based on past filing experience and state objections as well as state filing requirements located in SERFF. The references are mainly based on health filings. Any blocks out specific information have no definitive history. Alabama Silent Alaska Per objection in 9/8/2011 Associations must meet the requirements of AS (2). The division requested a copy of the bylaws and the constitution of the to ensure compliance. DOI has also requested: application for membership, minutes of board meetings, number of years in active existence, how dues are billed, written guidelines, policies and procedures used to review the by the insurance company, whether the member may join out buying insurance. Bulletin B provides that when a policy is issued to an the insurer must perform a review of the and determine that the was established and continues to be maintained in good faith for purposes other than that of obtaining insurance. The insurer must submit information showing that the complies this requirement, either as supporting documents a new form filing when the is known before the filing, or as an informational filing when the insurer plans to issue an contract using previously approved forms. Filing is required of policies, certificates, or other forms evidencing insurance coverage, including limited benefit health insurance plans (LHBPs). Order R13-01 exempts out-of-state single employer group plans from the filing requirements of until further notice. This does not apply to insurance issued to or through an out-of-state trust,, or other group. If an filing is being made and there are no current s the following wording should be included in the filing letter: Currently, there are no s to which we are marketing or issuing. When we do, we will submit the necessary documents to your department for approval prior to marketing or issuing. This is based on previous filing experience. Check the DOI website for an checklist and filing guidance. Arkansas Since the DOI requires approval of discretionary groups for accident & health, they have a list of questions required information. This includes documents. See for purposes other than obtaining insurance. Yes for accident & health per objection history ( ) (2)(A) requires that the Insurance Commissioner must find that the group is organized

2 Association/Trust Filing Issues by Update Date: 05/28/15 M:\Compliance Manuals\Association Research\s\Arkansas\AR Discretionary Group Questions.doc Arizona silent California Multiple trusts can be combined in one filing per FIED HIP project. Trust and joinder agreements were required in FIED HIP filing. Colorado The Colorado DOI has advised that the following must be provided for groups: identity of the ; detailed explanation which outlines how the group meets the definition of a valid group; copies of the signed documents; and the s By-Laws and Articles of Incorporation. Also, insurers must comply the general requirements as set forth in CRS (2) for multi-state s and CRS (5.5) for bona fide s.. Use Colorado Bona Fide Association Checklist for review but does not require submission. The DOI has provided instructions that trust documents should be submitted to the Department as a separate filing from the form filing. The group submission should be filed under the TOI/Sub TOI H as a form filing. The Department will then make the determination as to whether it can be considered valid in Colorado. (No citation) 4 EL Business Traveler 12/30/13. The above information was clarified by JN on 1/8/14 Shirley Taylor of the CO DOI. All non bona-fide groups (/trusts/discretionary groups) must be submitted for approval and approved prior to the forms and rates submission. Connecticut Delaware CT may inquire about the nature of the and how individuals enroll. May also request documents. Per Bulletin HC-88: Form filings for health insurance issued to s of individuals that are submitted to the Insurance Department on or after November 1, 2011 will be subject to the statutory and regulatory requirements for individual health insurance policies. The carrier can continue to issue a group master policy to such and certificates to members as long as the contracts meet the minimum requirements for individual policies. Form filings for health insurance issued to s of small employers that are submitted to the Insurance Department on or after November 1, 2011 will be subject to the statutory and regulatory requirements for small employer group health insurance. Association and discretionary groups not specifically recognized. An out of state group policy issued to an meeting the definition of a bona fide (18

3 Association/Trust Filing Issues by Update Date: 05/28/15 District of Columbia Florida Georgia The must meet certain criteria. It must have a constitution and bylaws, must consist of 25 or more individual members, and must have been organized and maintained for a period of 1 year for purposes other than obtaining insurance Florida s out of state checklist requests: Copy of master policy and certificate filed for information purposes. Certification by an officer of the company that the policy and certificate have been filed and approved in the state where the master policy is issued. Yes -per recent objection history 3506) does not require a form filing. However, a filing for the group must be made so the Commissioner can determine if it is a bona fide. No defined eligible groups - and discretionary groups not specifically recognized. Copy of situs state approval has been sent some filings both life & health. Hawaii Please provide situs state approval and acceptance of group master policy. Idaho Illinois Indiana May inquire about nature of and how individuals enroll. May also request or trust documents. May inquire about the nature of the and how individuals enroll. May also request documents. A checklist comes up as an out of state requirement...\..\filing Manual\ Expert Manual\Indiana\IN EHIBIT G -Group Out of Checklist 2010.doc Yes per past objections Based on past filing experience, the state has not asked or warned that if a discretionary group was involved that a filing for approval of the group would be necessary. 10/15/14 Received Obj. : The should not be bracketed. Each group will need to submit a filing to be allowed in Idaho. No citation provided Grp CI obj- state DID accept we ll submit Association information when we actually have an Association to market to language in the cover letters If a group insurance policy is to be issued to an located outside the state of Illinois, no filing is required. However, if the group did not meet the requirements of a true, Illinois does have the authority to approve discretionary groups for group health insurance. In order to do so, an informational filing to include the group master policy is required. Trust documents were not sent for FIED HIP filing. Indiana filing research reveals the requirement that group policies delivered in another state require the delivery state has approved the group policy. Iowa Association_ Trust_Products_Checklist.pdf Kansas recently came back on a Short Term Medical product and would only approved the filing on a one case basis, meaning Iowa only recognizes certain s as defined in the statute as eligible groups. There is no generic

4 Association/Trust Filing Issues by Update Date: 05/28/15 Kansas the Association that was named in the filing is the only one the carrier can use for the approval. recognized in the statues. Kentucky Louisiana Maine Maryland Massachusetts Past filing experience has shown that the Louisiana Department of Insurance required that the s constitution and bylaws be submitted to the DOI even for out-of-state blanket filing. In addition to the s constitution and by-laws, the product filing must also include the membership application, membership agreement and brochure of membership benefits other than insurance products offered. For trust must provide trust agreement, articles of incorporation and membership agreement. The group certificate to be delivered or issued for delivery in Maine shall be filed the Superintendent, at least 60 days prior to any solicitation, along sufficient information concerning the nature of the group, including any trust agreements or bylaws. (24-A s 2412) All out-of-state groups, forms and rates must be submitted to Maryland for their review and approval. (Ins and COMAR ) Has requested and trust documents in past objections. May require Per call DOI in September 2011, they cannot accept an filing out the s constitution, by-laws, membership applications etc. Therefore, before final signing of an, the necessary documentation would need to be filed for approval. They are looking to make sure that it is a qualified that meets all of their requirements. They will not review the forms for approval on a general basis first. Trust and joinder agreements were required in FIED HIP filing. 3/21/13 Objection on a life submission which did not give specific details read: We no longer approve forms that will be issued to s. If you do not have an approved acknowledged by the Bureau I suggest you draw this filing and resubmit the correct market group. Per general checklist info: All Association, Trust, and other Discretionary groups must file the appropriate Constitution and Bylaws; Trust Agreement and Joinder/Participation Agreements; and/or Articles of Incorporation 24-A M.R.S.A. 2805, 2805-A, 2806, 2807, 2807A, 2808 Effective July 1, 2012, insurers will be required to receive prior approval of premium rates for certificates issued, delivered, or renewed in Maryland under health benefit plan contracts issued in a jurisdiction other than Maryland. Insurers that have contracts issued to an out of state must submit premium rate filings for approval for certificates that renew on and after October 1, 2012 no later than July 1, 2012 to continue doing business in Maryland. (Bulletin 12-09) Bulletin stipulates that the Department does not require the following coverage types to be filed if

5 Association/Trust Filing Issues by Update Date: 05/28/15 Michigan offered through an employer or : group accident, group disability income, group specified disease, group hospital indemnity or group long-term care insurance Effective March 19, 2015 (estimated effective date - 90 days after adjournment), a group life insurance policy may be issued to an, or to a trust or trustee of a fund established or maintained for the benefit of members of one or more s, provided that the meet certain criteria. Such insurance could not be offered unless the Department finds all of the following: the issuance of the group policy is not contrary to the best interest of the public, the issuance of the group policy would result in economies of acquisition and administration, and the benefits of the group policy are reasonable in relation to the premiums charged. In addition, the Department would have to determine that substantially similar requirements had been met before a group policy offered by an insurer issued in another state could be issued in Michigan. ( ; 500:4420; 500:4424) Grp Term Life product The General Information section states the Group Life Policy and Certificate will be marketed to Employer, Association and (Other) Union Groups. Minnesota Must meet definition of in MN statutes. May inquire about the nature of the and how individuals enroll. Association documents are required. It is important that I inform you that this Group Policy and Certificate filing is a limited filing and can only be marketed to Employer and Employee Groups. If American Heritage wants market the Group Policy and Certificate to an Association or Union Group, then American Heritage must submit a new and separate filing for each Association or Union Group. Each separate filing for the Association Group or Union Group can have the same forms and content. However, the Policyholder section must identify the specific name of the Association Group or the Union Group. Please note the specific name of the Association Group or the Union Group can t be bracketed as variable. Each Association or Union Group filing s submission must be in compliance the Association statute, Minn. Stat. 60A.02 subdivision 1a. (

6 Association/Trust Filing Issues by Update Date: 05/28/15 The filing must include the requirements cited in the Association statute (below), Minn. Stat. 60A.02 subdivision 1a, clause (a). Multiple trusts can be combined in one filing per FIED HIP project. SERFF instructions state as follows: For Association filings you must submit a copy of the s constitution or by-laws demonstrating that the requirements of Minn. Stat. 60A.02, subd. 1a have been met. These documents should be attached to the SERFF filing on the Supporting Documents tab. Mississippi No defined eligible groups - and discretionary groups not specifically recognized. Missouri Montana Nebraska Requires affidavit of if master policy is not delivered in MO. Has requested copy of master policy if or trust is not sitused in MO. Currently has a detailed questionnaire requirements for s. See M:\Compliance Manuals\Association Research\s\Montana\MT Association Questions 2010.doc Per objection has requested detailed information on trust and trustee. An insurer requesting approval of a policy for group insurance to be issued and delivered to an shall submit to the division: May require Per objection of 8/22/11 DOI requested the information listed on the questionnaire. a copy of each insurance policy, certificate, rider, endorsement and application used for the a statement illustrating that the benefits payable are reasonable in relation to the premiums charged Nevada the name and address of the administrator if an administrator is to pay the claims or collect the premiums the name and address of the trustee of the and the name of the trust copies of all agreements or contracts for the administration of claims and collection of premiums as well as any information relating to utilization reviews, quality assurance programs and the marketing of the insurance policy, including copies of any advertising or brochures to be used

7 Association/Trust Filing Issues by Update Date: 05/28/15 All trusts must be filed. Each trust shall identify and file all products marketed under the trust. New Hampshire New Jersey May inquire about the nature of the and how individuals enroll. May also request documents. SERFF requirements show a Checklist for qualified Association Trust Groups. M:\Filing Manual\ Expert Manual\New Hampshire\NH- EHIBIT D-Qualified Association Trust Checklist.doc. No defined eligible groups - and discretionary groups not specifically recognized. (Although, RSA 415:18 I.(d) makes reference to groups.) Association groups must satisfy participation requirements: not less than 50 members, covering all the members of such ; not less than 75% of any class or classes of members if contributory coverage New Mexico New York North Carolina Required to file trust agreements that are the basis of group benefits the forms filing. 11 NYCRR Association group questionnaire must be completed. It requests copies of by-laws and articles of incorporation as well as other documents. M:\Filing Manual\ Filing Info\North Carolina\NC AssociationGroupQuestionnaire[1].pdf. If no is identified at the time of form submission, the filer must acknowledge that the Association Questionnaire will be completed and submitted to the Life & Health Division prior to marketing any group product in North Carolina in cover letter. The Department requires a sticker to be attached to the face page of each Certificate of Insurance. This sticker must state that the group master policy and trust or is located in another state and governed by another state s laws. The Department provides the following proposed language for the sticker, This Certificate of Insurance provides all of the benefits mandated by the North Carolina Insurance Code, but it is issued under a group master policy located in another state and may be governed by that state s law. (Per 4EL Obj) Trust and joinder agreements were required in FIED HIP filing. If more than one trust group each must have its own filing. North Dakota Multiple trusts can be combined in one filing per FIED HIP project. Ohio

8 Association/Trust Filing Issues by Update Date: 05/28/15 Oklahoma Per an objection the DOI requested the articles of pursuant to Title 36 O.S as well as a copy of the policy. No trust documents were sent for FIED HIP filing. Effective November 1, 2012, the Small Employer Health Insurance Reform Act does not apply to a health benefit plan issued to a small employer group through a bona fide health plan. (36 s 6519) Oregon Pennsylvania Oregon is very particular about which s it will approve and strictly adheres to filing requirements. Associations will require the following; Copies of by-laws and constitution must be included. The must be in existence for at least one year. It must be organized and maintained primarily for the purposes other than obtaining insurance. The is the policyholder. Trust filings require the following: A copy of the trust document included the filing. A tust formed by an includes only membership in the. The policyholder is the trust. The trust is not under control of the insurer. If 2 or more employers are in the trust they must be in the same industry. (ORS (1) (c). Yes based on checklist form A and past objection history Checklist updated 11/11/11..\Association Research\s\Oregon\ a[ ]- Association -Trust Questionaire.pdf OUT-OF-STATE GROUPS: Group accident and health insurance coverage provided in this Commonwealth under a policy issued in another and except as provided in clause 40 P.S (2) of subsection (e) and subsection (f), all group policies, certificates, amendments, endorsements and enrollment forms shall be filed the Commissioner for approval. Evidence of approval of rates and forms, in the where the group policy is issued, must be filed the Commissioner. Rhode Island South Carolina Association and discretionary groups not specifically recognized. Policies may only be issued to a trust or to insure two or more persons who are associated in a common group for purposes other than the obtaining of insurance Multiple trusts can be combined in one filing per FIED HIP project.

9 Association/Trust Filing Issues by Update Date: 05/28/15 South Dakota Tennessee South Dakota has heightened sensitivity to coverage provided through and trust groups. Objection history indicates they require articles of incorporation and by-laws for s and trust agreement and specific trust information.. In response to a blanket product submitted on an informational basis the DOI requested: Proof of jurisdiction as described in T.C.A. Section Please provide: a) A copy of the statutory section of the situs states regulatory authority and filing requirements for this type of form, and b) A copy of the approved cover letter or the submittal letter. If the situs state has a submittal form, please include a copy of the submittal letter also, and c) Written verification from the regulatory state that they assert their jurisdiction of certificates issued to non-residents. This should include verification that if a Tennessee resident has a complaint, the situs state will handle the complaint. d) Verification from your company that the Tennessee resident receives the exact same certificate a resident of the situs state receives the same form number.if the situs state does not require review and approval of these forms or does not require approval of forms for non-residents, you are not permitted to file them for informational purposes. Association and Trust documents are requested on the transmittal form and in SERFF requirements.m:\filing Manual\ Expert Manual\Texas\T EHIBIT A Transmittal Checklist.doc Yes see Bulletin Master Application and Policy required to be submitted See also Association Governance/Administration When filing using multiple trusts it was acceptable to combine all trusts into one filing even though there were different group s i. e. MET, union, and. Texas Utah Vermont Directions from T (2013) When policy was approved under ABC basis, and now you are submitting on a "named " bylaws, you need to submit the policy alternate face page, for this named and not the certificate, unless it had the ABC info on it also. The filing should also be submitted requesting review and approval for this type of filing. Group Questionnaire will require details on type of group. M:\Filing Manual\ Expert Manual\Utah\UT EHIBIT D -Utah A&H Group Questionnaire.doc Yes all lines per LHCA info Yes - per LHCA info Obj would not accept we ll submit Association information when we actually have an Association to market to language in the cover letters Refer to Bulletin 61 which recognizes out of state arrangements, provided the meets VT's statutory group rqmts for an. Also consult Vermont Opinion 4-81 for ET issues. A 2012 objection brought up the following issue on

10 Association/Trust Filing Issues by Update Date: 05/28/15 Virginia Washington Out-of- Groups [WAC ]. 1. Must file as a new submission. You may not request to re-open a previously approved form orate filing to modify its contents for new groups. 2. Must file all certificates [in single case format], providing coverage in the state of Washington. A complete submission includes: applications, riders, or endorsements for approval on the FormSchedule tab. i. Single case format means group specific language no bracketing or variability. 3. Trust or Association submissions must file the original trust documents or articles of incorporation and include revised, amended or restated documents on the Supporting Documentation tab. 4. Must file disclosure statement for approval on the Form Schedule tab [WAC ] when Producer solicitation is allowed. 5. Must disclose in the Filing Description field this is an Out-Of- Group Filing and follow the prescribed Product Name convention in the Submission Requirements. group size: Although the insurer identifies the target market for this product as large groups only, please note that (a) groups like this one are categorized by Vermont insurance statute as de facto small groups [8 VSA 4080a] and (b) this type of product is not exempted from Vermont s 8 VSA 4080a. We note that the insurer is neither a registered small group carrier nor does it have any products approved for use in Vermont s small group market [8 VSA 4080a, Regulation H-91-4B]. Per Objection DOI requested proof of approval of the forms in situs state. Virginia also requires a out of state discretionary group compliance certification in addition to the standard compliance certification. This is not provided by the DOI as a fillable form. Please see the state expert manual for a sample. Washington state extends extraterritorial jurisdiction when a policy is issued in another state (for example Home Depot, their headquarters are in Atlanta but certificates may be delivered to Washington residents) The master policy does not require filing however; certificates traveling into the state are required to be filed and the certificate must meet and include state mandates. Both versions of amending the form are acceptable i.e., a state specific certificate or an endorsement to amend the certificate. However; the amount of revisions if excessive can lead to a required statespecific certificate so that it does not impair the readability of the form. The department no longer allows documents and forms to be filed and approved for business that has in some cases involved companies making filings over a number of years. This appears to be an issue of in-house experience. When it comes to business the department requires that it be filed as stand-alone business. When filing a group form intended for issue to an the department requires Association Bylaws and Articles of Incorporation to be included in the filing. It is not acceptable that a form is filed to accommodate future business.

11 Association/Trust Filing Issues by Update Date: 05/28/15 An must exist and the department will determine if it is a valid. Please see the following info on the FTP site Compliance Manual\..\Association Research\s\Washington\ Washington - Variability Issues.mht As of 12/11/13 the DOI provided updated general instructions very specific guidelines as to the submission of filings. Up to date information can be found in the state expert manual. West Virginia Wisconsin Wyoming Per objection on Med Sup Advertising, the Trust Agreement, By- Laws, and Articles of Incorporation of the Association were requested. No citation was given and this was not a consistent objection. W.S (ii) states that Group disability insurance coverage shall not be offered in this state by an insurer under a policy issued in another state unless the following documents are filed this department: A. A copy of the group master contract B. A copy of the statute of the state where the group policy is issued that authorizes the issuance of the group policy C. Evidence of approval of the group policy in the state where the group policy is issued; and DOI requested copy of Bylaws and Articles of Corporation no cite ( ). For an - Please provide documentation on the number of current members of the to ensure this meets statutory requirements set forth in WV Code ( ) If an filing is being made and there are no current s the following wording should be included in the filing letter: Currently, there are no s to which we are marketing or issuing. When we do, we will submit the necessary documents to your department for approval prior to marketing or issuing. This is based on previous filing experience. Associations meeting the requirements outlined in their statute are eligible groups and do not require a filing. D. Copies of all supportive material used by the insurer to secure

12 Association/Trust Filing Issues by Update Date: 05/28/15 approval of the group in the state where the group policy is issued. On life filings has requested copies of the trust agreement in prior objections.