§488-3 Certificate of authority; authority issued or denied; plan termination. (a) Before conducting business in this State, a plan shall submit for approval with the commissioner an application for a certificate of authority, shall file documentation with the commissioner, and shall pay to the commissioner a fee as provided under section 431:7-101.
(b) The documentation required by subsection (a) shall contain in writing the following:
(1) A brief statement of the plan's financial structure, including a statement of the amount of prepayment, other charges or dues to be paid by plan members, and the manner in which the amounts are to be paid;
(2) A statement of the amount of benefits, legal services, or reimbursement for legal services to be furnished each member of a plan, and the period during which they will be furnished; and, if there are exceptions, reductions, exclusions, limitations, or restrictions of benefits, legal services, or reimbursements, a detailed statement of the exceptions, reductions, exclusions, limitations, or restrictions;
(3) A statement of the terms and conditions upon which the plan may be canceled or otherwise terminated by the group, the plan administrator, the persons furnishing legal services, or the member; provided that for any cancellation or termination other than by a member, there shall be provision made for the disposition of funds accumulated under the plan;
(4) A statement describing the applicability or nonapplicability of the benefits of the plan to the family dependents of the member;
(5) A statement of the period of grace that will be allowed the member or the member's group for making any payment due under the plan;
(6) A statement describing a procedure for settling disputes between or among the group, the plan administrator, the persons furnishing legal services, and the member;
(7) A statement that the plan includes the endorsements thereon and attached papers, if any, and contains the entire contract or contracts to be used among all parties to a plan, including the executed written agreement between the plan and any person providing legal services to the plan; and
(8) A listing of the owners, operators, officers, and plan administrator of the plan, including the current business address, home address, mailing address, business phone number, business fax number, business electronic mail address, business website address, and home phone number.
Any amendments or changes to the documents filed under paragraphs (1) to (8) shall be filed with the commissioner for approval at least sixty days before they take effect. All documents filed under this section shall be public documents.
(c) If the commissioner finds that a plan has met the requirements of this section, the commissioner shall issue to it a proper certificate of authority.
(d) If the commissioner finds that a plan has not met the requirements of this section, the commissioner shall deny the plan a certificate of authority within a reasonable length of time following filing of the application by the plan.
(e) If the plan is canceled or otherwise terminated by the group, the plan administrator, or the persons furnishing legal services, the plan shall notify the commissioner in writing at least sixty days prior to the termination of the plan of the fact of plan termination and the provisions made for the disposition of funds accumulated under the plan. [L 1976, c 156, pt of §1; gen ch 1985; am L 2010, c 47, §1(3); am L 2011, c 186, §5]