Code of Maine Rules
02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
031 - BUREAU OF INSURANCE
Chapter 730 - STANDARDS FOR ACCEPTANCE OF REINSURANCE OF WORKERS' COMPENSATION SELF-INSURANCE
Section 031-730-6 - Application
Current through 2024-38, September 18, 2024
Every applicant must make an initial filing to the Superintendent of Insurance, which shall include:
A. A written application, on forms to be supplied by the Superintendent, signed under oath by the chief executive officer of the company. Applicants are exempt from providing information hereunder to the extent that such information has been provided as part of a filing to obtain or maintain a certificate of authority in the State of Maine. The application shall contain among other things:
B. If the applicant is a corporation, a copy of its Charter and by-laws.
C. If the applicant is a foreign or alien insurer, a certificate of the public insurance supervisory official of its state or country of domicile, showing that it is authorized or qualified in that jurisdiction or insure or reinsure workers' compensation risks.
D. If the applicant is an alien insurer, a certificate of deposit and a copy of the trust deed pertaining to the deposit, certified by the trustee.
E. If the applicant is a domesticated alien insurer, a copy of the appointment and authority of its U.S. manager having custody of its records.
F. If the applicant is a reciprocal insurer or reinsurer, Certificates of Compliance and Deposit from the domiciliary state and copy of the power of attorney of its attorney-in-fact.
G. A certified copy of the most recent three annual statements filed as required with the supervisory official in the applicant's state or country of domicile, including all applicable supporting addenda. If the applicant has operated for less than three years, such annual statements as are available.
H. A copy of audited financial statements for the most recent three years accompanied by the independent certified public or chartered accountant's audit opinion. The financial statements shall be prepared on the basis of statutory insurance accounting principles, or, for an alien insurer, shall be accompanied by a reconciliation to statutory insurance accounting principles, or, with the permission of the Superintendent, a reconciliation to United States GAAP. Also to be included are copies of any comment letters or management letters issued by the certified public or chartered accountant or a statement from the certified public or chartered accountant that states no recommendations have been rendered to management. If the insurer has not operated for three years, it shall provide such audited financial statements as are available.
I. A copy of the current report of examination certified by the supervisory official in the applicant's state or country of domicile. For purposes of this requirement, a report of examination shall be considered current only if its date of account is within three years of filing of the application, except that the Superintendent may, in his/her discretion, accept a report of examination within a period reasonably proximate to three years from its date of account which is filed by the applicant promptly upon its receipt when issuance of the report by the supervisory official has been delayed by reasons beyond the control of the applicant and which are unrelated to the applicant's financial condition or compliance with applicable laws, pursuant to Title 24-A M.R.S.A. §413.
J. A listing of reinsurers to whom the applicant retrocedes risks.
K. Any pertinent prospectus, tender offer materials, or details of any mergers, reorganizations or consolidations for the three year time period preceding the date of application.
L. An organizational chart of its holding company system, if applicable.
M. A statement of ownership of applicant, including a listing of the names and addresses of any shareholder(s) who own 5 percent or more of the outstanding shares of the applicant. If the applicant is a wholly owned subsidiary, this requirement shall apply to the parent company.
N. The most recent Form 10-K (and Forms 10-Q since the date of the 10-K) and proxy statement, if the applicant is registered with the Securities and Exchange Commission.
O. A copy of any management agreements by which effective power to manage or influence this class or any other major class of the applicant's business is transferred to others.
P. Biographical information for all officers and directors. The form prescribed by the National Association of Insurance Commissioners may be substituted for the Maine form. NOTE: Any such data submitted as part of a holding company registration shall be held as confidential information pursuant to Title 24-A M.R.S.A. §222(13-A).
Q. An acknowledged statement signed by the chief executive officer of the applicant attesting that the applicant's license is not under suspension or revocation in any jurisdiction except as may therein be disclosed. If such an action has been taken or is being taken, or if a license has been refused or surrendered, an explanation should be provided along with a copy of any order or finding.
R. Such other information as the Superintendent may consider necessary and appropriate.
