AI-assisted research summary: The Department of Insurance may examine the fund, require corrective action, issue cease-and-desist orders, suspend or revoke authority, and levy fines; the fund cannot operate until it gets a certificate of authority.
§4351.5. Authority of Department of Insurance A. The fund shall not become operative until issued a certificate of authority by the department. Except for the certificate of authority, the department shall keep confidential all documents and records associated with the provisions of this Section. B. The certificate of authority shall be continuous until revoked or suspended by the department, or until it is voluntarily surrendered by the fund. C.(1) The department shall have the authority to examine the affairs, books, transactions, workpapers, files, accounts, records, assets, and liabilities of the fund to determine compliance with this Part and with any rules and regulations promulgated by the department or orders and directives issued by the department. In addition, to the extent necessary and material to the examination of the fund, the department shall have the authority to examine the affairs, books, transactions, workpapers, files, accounts, and records of the fund's administrator, service company, certified public accountant, or actuary generated in the course of transacting business on behalf of the group self-insurance fund being examined. All examinations shall be conducted in accordance with the provisions of this Part. The reasonable expenses of the examinations shall be paid by the fund. (2) Upon the request of the department, the group self-insurance fund established pursuant to this Part shall cause a rate review to be conducted by a national independent actuarial firm, provided that the department shall not make more than two requests in any calendar year for a rate review under the provisions of this Subsection. The firm shall report its findings to the department. (3) All work papers, recorded information, documents, information, and copies thereof produced by, obtained by, or disclosed to the department or any other person, pursuant to the authority of the department under this Part, shall be given confidential treatment and shall not be subject to subpoena, except in the following circumstances: (a) Information sought has been provided pursuant to R.S. 3:4351.10(C) or 4351.11(I). (b) Documents sought are audited financial statements which have been filed with the department. D. The department shall have authority to issue cease and desist orders and suspend or revoke the certificate of authority of the fund which the department determines is not in compliance with this Part or with any rule promulgated by the department pursuant to the Administrative Procedure Act or order or directive issued by the department. Without limiting the generality of the provisions of this Subsection, a cease and desist order may include a prohibition on writing or incurring any new or renewal business by the fund. E. Upon the determination by the department that the fund or any trustee, member, officer, director, or employee of the fund failed to comply with the provisions of this Part, any applicable laws relating to the fund, or any rule promulgated by the department or order or directive issued by the department, the department may levy a fine not to exceed two thousand dollars for each violation. If the conduct for which a previous fine was levied by the department is committed again, the department may levy a fine not to exceed four thousand dollars. The enforcement of any fine and any appeal from a fine shall be conducted in accordance with the Administrative Procedure Act. F. The division of administrative law shall conduct a hearing in accordance with R.S. 22:2191. G. Nothing in this Section shall prohibit the legislative auditor from reviewing records and conducting an audit in accordance with R.S. 24:513. H.(1) The department is authorized to order the group self-insurance fund to submit a corrective action plan to the department for its approval to remediate any noncompliance or financial issues affecting the fund. This authority is in addition to any other authority the department holds. (2) The corrective action plan shall be submitted by the fund to the department for its approval and include standards, time frames, and other parameters acceptable to the department. Any corrective action plan that is submitted to the department by the fund shall be kept confidential by the department. (3) Without limiting the discretion of the department, the corrective action plan may include any of the following: (a) Mandatory training. (b) On-site or off-site monitoring and supervision of the activities of the fund for a specified period of time to determine progress regarding correction of deficiencies. (c) The submission of written progress reports. (d) The institution of measures to conserve or generate additional funding for the fund. (e) The imposition of fines and penalties for any misconduct which contributed to the need for the imposition of the corrective action plan. (4) Failure by the group self-insurance fund to comply with a corrective action plan approved by the department may result in any of the following: (a) The imposition of fines and penalties. (b) Revocation of the fund's certificate of authority. (c) Placement of the fund into administrative supervision pursuant to R.S. 22:731 et seq. (d) Placement of the fund into receivership pursuant to R.S. 22:2001 et seq. Acts 2022, No. 586, §1, eff. June 17, 2022; Acts 2022, No. 598, §1, eff. June 18, 2022.