044-71 Wyo. Code R. §§ 71-5 - Licensing Requirements

A MEWA intending to offer a fully insured health benefit plan or a self-insured health benefit plan in this state shall be licensed by the Department prior to engaging in the business of insurance.

(a) All MEWA applications for license shall be on a form prescribed by the Department and shall include:

(i) A complete copy of the MEWA's most recently filed U.S. Department of Labor, Form M-1;

(ii) Mailing address, Employer Identification Number (EIN), contact person's name, email address, and telephone number at which communications are to be received;

(iii) Names and addresses of the employer members;

(iv) Total number of covered lives by employer;

(v) Eligibility requirements for employer membership in the MEWA;

(vi) Fees, if any, charged for membership;

(vii) A copy of the MEWA's by-laws, trust documents, articles of incorporation or other organizational documents;

(viii) All policies, certificates, and contracts of insurance for prior approval before use in accordance with W. S. § 26-15-110 et. seq.

(ix) Proof of registration for all names registered with the Wyoming Secretary of State or written confirmation from the Secretary of State that no registration is required;

(x) The name and contact information for the Wyoming registered agent;

(xi) A copy of all current contracts between the MEWA and insurers or third party administrators to provide coverage for health care benefits and services to be offered in Wyoming; and

(xii) A $500 annual fee as required in W.S. § 26-4-101.

(b) A MEWA offering a self-insured health benefit plan shall provide the following with an application for license, in addition to the required items in subsection (a) of this section:

(i) For MEWAs that have been in business three (3) years or less, a feasibility study, including, but not limited to, the methodology for establishing the contributions of its members. Such contributions shall be based on reasonable assumptions and certified by an actuary;

(ii) For MEWAs that have been in business for more than three (3) years, a written narrative that explains how member contributions are calculated and how loss reserves are established. Include details of who reviews these calculations (e. g. a qualified actuary, the stop-loss carrier, etc);

(iii) Evidence of stop-loss insurance coverage issued by an insurance company that is licensed in Wyoming;

(iv) A dissolution plan containing general provisions on how the MEWA will be wound down, including how any remaining funds would be handled if the MEWA is dissolved and who would make up any shortfall if the MEWA becomes insolvent;

(v) Most recent annual audited financial statement as defined in Section 6(b)(i) of this Chapter, showing that the MEWA is financially solvent; and

(vi) An Actuarial Opinion from a qualified actuary stating that the reserves for the MEWA are adequate and in compliance with actuarial standards. If the MEWA does not contract with a qualified actuary and does not receive an actuarial opinion in the ordinary course of business, provide supporting documentation showing that the MEWA's stop-loss carrier has reviewed and approved the MEWA's contribution levels and the MEWA's reported loss reserve.

(c) If the MEWA is domiciled outside of Wyoming, in addition to the requirements set forth in Sections 5(a) and (b), the MEWA shall provide copies of all materials used by the MEWA to secure approval in the domiciliary state, including evidence of approval by that domiciliary state.

Notes

044-71 Wyo. Code R. §§ 71-5

Adopted, Eff. 1/6/2020. Amended, Eff. 2/9/2022.