                                 CODE OF VIRGINIA

CONDITIONS FOR A BENEFITS CONSORTIUM (§ 59.1-590)

A. This section does not apply to a multiple employer welfare arrangement (MEWA)
that offers or provides health benefit plans that are fully insured by an
insurer authorized to transact the business of health insurance in the
Commonwealth.

B. A trust shall constitute a benefits consortium and shall be authorized to
sell or offer to sell health benefit plans to members of a sponsoring
association in accordance with the provisions of this chapter if all of the
following conditions are satisfied:

   1. The trust shall be subject to (i) ERISA and U.S. Department of Labor
   regulations applicable to multiple employer welfare arrangements and (ii) the
   authority of the U.S. Department of Labor to enforce such law and regulations;

   2. A Form M-1, Report for Multiple Employer Welfare Arrangements (MEWAs), for
   the applicable plan year shall be filed with the U.S. Department of Labor
   identifying the arrangement among the trust, sponsoring association, and
   health benefit plans offered through the trust as a multiple employer welfare
   arrangement;

   3. The trust&#8217;s organizational documents shall:
   				a. Provide that the trust is sponsored by the sponsoring association;
   				b. State that the purpose of the trust is to provide medical, prescription
   drug, dental, and vision benefits to participating employees of the sponsoring
   association or its members, and the dependents of those employees, through
   health benefit plans;
   				c. Provide that the funds of the trust are to be used for the benefit of
   participating employees, and the dependents of those employees, through
   self-funding of claims, the purchase of reinsurance, or a combination thereof,
   as determined by the trustee, and for defraying reasonable expenses of
   administering and operating the trust and any health benefit plan;
   				d. Limit participation in health benefit plans to participating employees
   of the sponsoring association and its members;
   				e. Provide for a board of trustees, composed of no fewer than five
   trustees, that has complete fiscal control over the arrangement and is
   responsible for all operations of the arrangement. The trustees selected for
   the board shall be owners, partners, officers, directors, or employees of one
   or more employers in the arrangement. A trustee or director may not be an
   owner, officer, or employee of the administrator or service company of the
   arrangement. The board shall have the authority to approve applications of
   association members for participation in the arrangement and to contract with
   a licensed administrator or service company to administer the day-to-day
   affairs of the arrangement;
   				f. Provide for the election of trustees to the board of trustees; and
   				g. Require the trustees to discharge their duties with respect to the
   trust in accordance with the fiduciary duties defined in ERISA;

   4. Five or more members shall participate in one or more health benefit plans;

   5. The trust shall establish and maintain reserves determined in accordance
   with sound actuarial principles and in compliance with all financial and
   solvency requirements imposed upon domestic self-funded MEWAs;

   6. The trust shall purchase and maintain policies of specific, aggregate, and
   terminal excess insurance with retention levels determined in accordance with
   sound actuarial principles from insurers licensed to transact the business of
   insurance in the Commonwealth;

   7. The trust shall secure one or more guarantees or standby letters of credit
   that:
   				a. Guarantee the payment of claims under the health benefit plan in an
   aggregate amount not less than the amount of the trust&#8217;s annual
   aggregate excess insurance retention level minus (i) the annual premium
   assessments for the health benefit plans and (ii) the trust&#8217;s net
   assets, which amount shall be the net of the trust&#8217;s reasonable estimate
   of incurred but not reported claims; and
   				b. Have been issued by a qualified United States financial institution, as
   such term is used in subdivision 2 c of &#xA7; 38.2-1316.4;

   8. The trust shall purchase and maintain commercially reasonable fiduciary
   liability insurance;

   9. The trust shall purchase and maintain a bond that satisfies the
   requirements of ERISA;

   10. The trust is audited annually by an independent certified public
   accountant; and

   11. The trust does not include in its name the words &#8220;insurance,&#8221;
   &#8220;insurer,&#8221; &#8220;underwriter,&#8221; &#8220;mutual,&#8221; or any
   other word or term or combination of words or terms that is uniquely
   descriptive of an insurance company or insurance business unless the context
   of the remaining words or terms clearly indicates that the entity is not an
   insurance company and is not transacting the business of insurance.

HISTORY: 2022, cc. 404, 405.