§4351.10. Examination

            A. The department shall make an examination, at least once every five years, of the group self-insurance fund established pursuant to this Part doing business in this state, and at any other time when in the opinion of the department it is necessary for such an examination to be made.

            B. Upon determining that an examination should be conducted, the department shall appoint one or more examiners to perform the examination and instruct them as to the scope of the examination. In conducting the examination, the examiner or examiners shall observe those guidelines and procedures that the department deems appropriate.

            C. Nothing contained in this Part shall be construed to limit the department's authority to use any final or preliminary examination report, any examiner or fund work papers or other documents, or any other information discovered or developed during the course of any examination in the furtherance of any legal or regulatory action which the department may, in its sole discretion, consider appropriate.

            D. Nothing contained in this Part shall be construed to limit the authority of the department to terminate or suspend any examination in order to pursue other legal or regulatory action pursuant to the applicable laws of this state. Findings of fact and conclusions made pursuant to any examination shall be prima facie evidence in any legal or regulatory action.

            E. In conducting the examination pursuant to this Section, the department shall examine the affairs, transactions, accounts, records, documents, and assets of the authorized group self-insurance fund. For the purpose of ascertaining its condition or compliance with this Part, the department may, as often as it deems advisable, examine the accounts, records, documents, and transactions of all of the following:

            (1) Any insurance agent, solicitor, or broker, but only insofar as the accounts, records, documents, and transactions relate to group self-insurance funds.

            (2) Any person having a contract under which he enjoys, in fact, the exclusive or dominant right to manage or control the group self-insurance fund.

            F. The group self-insurance fund being examined, and its officers, trustees, employees, administrators, and representatives, shall produce and make freely accessible to the department the accounts, records, documents, and files in its possession or control relating to the subject of the examination and shall otherwise facilitate the examination.

            G. The department may take depositions, subpoena witnesses or documentary evidence, administer oaths, and examine under oath any individual relative to the affairs of the group self-insurance fund being examined. Any person who testifies falsely or makes any false affidavit during the course of such an examination shall be guilty of perjury.

            H. Whenever the department makes an examination or investigation pursuant to this Part, all expenses incurred by the department in conducting the examination or investigation, including the expenses and fees of examiners, auditors, accountants, actuaries, attorneys, or clerical or other assistants who are employed by the department to make the examination, shall be paid by the group self-insurance fund.

            I. The department may recover all expenses incurred from the examination or investigation of any person or entity acting as an administrator or third-party administrator in this state for the group self-insurance fund.

            J. The department shall employ the examiners, auditors, accountants, actuaries, attorneys, and clerical or other assistants as are necessary to conduct the examination and to compile and prepare a report thereon, and the compensation for such examination shall be fixed according to the time actually devoted to the work, including conducting the examination and compiling the report thereon, as required by law. The compensation shall be reasonable and commensurate with the value of the services performed.

            K. Upon completion of the examination of the group self-insurance fund or at stated periods during an examination, the department shall forward to the group self-insurance fund a statement showing the amount of expenses incurred in the examination to the date of the statement. Upon receipt, the group self-insurance fund shall pay the amount of expenses to the department.

            L. If the group self-insurance fund considers the amount of expenses billed to it unreasonable or contrary to the provisions of this Part, it may within fifteen days after the receipt of the billing file a rule to show cause in a court of competent jurisdiction upon the department as to the reasonableness and legality under this Part of the amount of expenses billed to it by the department, and the rule shall be tried by preference, and upon appeal, shall be given preference in the appellate court, as provided by the laws of this state for other state cases.

            M. If the group self-insurance fund fails or refuses to pay the expenses of examination as billed by the department after fifteen days from the receipt of the billing or after final judgment of the court where a rule has been filed as provided in this Part, then the department may suspend or revoke the certificate of authority of such group self-insurance fund to do business in this state until the full amount of the bill is paid.

            Acts 2022, No. 586, §1, eff. June 17, 2022; Acts 2022, No. 598, §1, eff. June 18, 2022.