Initial Application | 6
20. Attach a copy of each of the following documents:
a. Any policy or contract describing the benefits offered by the
Association or MEWA.
b. The organizational documents of the Association or MEWA,
including but not limited to:
i. Articles of incorporation;
ii. By-laws; or
iii. Trust instrument;
c. The Association or MEWA's certificate of good standing from the
state in which association or MEWA is registered as a business;
d. Any document executed by an employer to become a member of the
Association, including application for membership in the
e. The biographical affidavits for all trustees, officers, directors, and
other members of the Association or MEWA's governing body who
are responsible for the operation of the Association or MEWA;
f. All current policies or contracts of insurance issued to the
Association or MEWA that provide coverage for health care
benefits and services to be offered in Delaware.;
g. All current contracts between the Association or MEWA and
insurers to provide coverage for health care benefits and services to
be offered in Delaware;
h. All current advertising and marketing materials used by the
association or MEWA;
i. A completed UCAA Form 12 (registered agent for service of
j. The most recent audited financial statement as defined in 18 DE.
Admin. Code § 1405-12.0.
k. The most recent M-1 form as filed with United States Department of
l. Documentation reflecting a minimum surplus that is not less than
$500,000, regardless of whether the insurer directly bills certificate
holders for premiums on behalf of the Association or MEWA or if
the Association or MEWA bills its members for premiums and
remits the premiums to the insurer.
m. A certified copy of a surety bond sufficient to cover 20% of the
Association’s or MEWA’s annual premium for Delaware members
that is in a form to be approved by the Commissioner and has been
issued by an insurer or surety licensed to transact such business in
Delaware, or by a surplus lines insurer on Delaware's approved list.