211 CMR 90.09 - Reporting Requirements

Current through Register 1466, April 1, 2022

(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:

(a)211 CMR 19.04, 211 CMR 19.08(3), 211 CMR 19.10(1)(g)211 CMR 19.10(7), 211 CMR 19.13 (first paragraph), 211 CMR 19.16, and 211 CMR 19.17 (second paragraph) do not apply.
(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.

Notes

211 CMR 90.09

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