(1)
Quarterly Reports. Until such time as the Commissioner
notifies an insurer or membership plan sponsor otherwise, each insurer and
membership plan sponsor shall file a quarterly report with the Commissioner
within 45 calendar days of the close of its fiscal quarter. The report shall
contain a balance sheet, a statement of income and expense, and a statement of
changes in financial position. The financial statements shall be based on legal
services plan operations only. The financial statements shall be comparable and
their form and content shall be governed by those procedures and practices
prescribed by generally accepted accounting principles. The first four
quarterly reports shall compare actual operations against the related
projections appearing in the plan of operation.
The quarterly report shall also include the total number of
subscribers, the number of new subscribers, the number of subscriber
terminations, and the number of covered legal services provided.
(2)
Annual Grievance
Reports. Every insurer and membership plan sponsor shall file with
the Commissioner, within 90 calendar days of the close of its first and second
fiscal years, a statistical summary by quarter of grievances about
participating attorneys, the administration of the plan, and other matters. The
report shall be prepared on a form prescribed by the Commissioner.
(3)
Annual Audited Financial
Reports. Every insurer and membership plan sponsor shall annually
file an audited financial report with the Commissioner no later than 120
calendar days after the close of its fiscal year. The filing date may be
extended prior to the due date by the Commissioner if an insurer or membership
plan sponsor can demonstrate to the Commissioner's satisfaction that an
extension is justified. The audited financial report shall be based on legal
services plan operations only.
The audited financial report of insurers shall be prepared in
accordance with 211 CMR 19.00, with the following modifications:
(b) Calendar year references shall be changed
to the analogous fiscal year references.
(c) "The opinions on the financial statements
filed pursuant to 19.05(2) shall conform with generally accepted accounting
principles." shall be substituted for the third paragraph in 211 CMR
19.09.
The audited financial report of membership plan sponsors shall
be prepared in accordance with 211 CMR 19.00, with the following
modifications:
(d)
"Membership plan sponsor" shall be substituted for "insurer."
(e)211 CMR
19.04, 211 CMR
19.08, 211 CMR
19.10 (1 )(9), 19.10(2), 19.10(3), 19.10(5), 19.10(6)(a), 19.10(7), 211 CMR
19.13, 211 CMR
19.16, 211 CMR
19.17 do not apply.
(f) Calendar year references shall be changed
to the analogous fiscal year references.
(g) References to the annual statement shall
be ignored.
(h) "Statement of
income and expense" shall be substituted for 211 CMR
19.05(2)(b).
(i) "Statement of changes in surplus" shall
be substituted for 211 CMR
19.05(2)(d).
(j) "The opinions of the financial statements
filed pursuant to 211 CMR
19.05(2) shall conform with generally accepted
accounting principles." shall be substituted for the third paragraph in 211 CMR
19.09.
(4)
Reporting on Changed Circumstances.
Each insurer and membership plan sponsor shall inform the
Commissioner within five calendar days of any extraordinary loss or claim which
has the potential to render it unable to meet its obligations, any impairment
of its capital or surplus, or any change in its control. "Control" exists if a
person, group of persons, or entity possesses the power to direct or cause the
direction of the management and policies of an insurer or membership plan
sponsor, whether through ownership of voting stock, by contract, or otherwise.
"Control" shall be presumed to exist if any person or entity owns, controls,
holds with the power to vote, or holds proxies representing
10% of the voting stock of an insurer.
(5)
Additional
Reports.
An insurer or membership plan sponsor shall submit reports in
addition to those required under 211 CMR 90.09(1) through 90.09(4) if requested
to do so by the Commissioner.
