Skip to Top Main Navigation Skip to Left Navigation Skip to Content Area Skip to Footer
Texas Department of Insurance
Topics:   A B C D E F G H I J K L M N O P Q R S T U V W X Y Z All
Topics A to Z

Multiple Employer Welfare Arrangements

Financial - Company Licensing and Registration Forms Listing

For more information regarding any of the topics below, go to the Company Licensing and Registration home page.

  • During the 88th Legislature, HB 290 was enacted to authorize MEWAs to provide comprehensive health benefit plans and structure those plans like a PPO/EPO, provided the MEWA complies with additional Insurance Code provisions.
  • For current MEWAs electing to comply with Insurance Code Section 846.0035, FIN706 - Multiple Employer Welfare Arrangement (MEWA) Election Form is available as a resource for the application.
  • TDI MEWA forms are available as a resource for compliance and are recommended but not required. Here are instructions for a certificate of authority for Multiple Employer Welfare Arrangement (MEWA).

 

If the form is a fillable PDF, learn how to enable all fillable form features.

TDI form number Description Format Language
FIN300 Company Name Reservation Application
Application to reserve a company name 		PDF English
FIN321 Company Licensing Fee Transmittal Form
 PDF English
FIN373 Instructions for Certificate of Authority for Multiple Employer Welfare Arrangement
Filing instructions for preparing the application to become licensed as a Multiple Employer Welfare Arrangement (MEWA) 		PDF English
FIN374 MEWA Application to Do Business
Application form to do business as a Multiple Employer Welfare Arrangement (MEWA) 		PDF English
FIN375 Application for Initial Certificate of Authority (MEWA)
Multiple Employer Welfare Arrangement (MEWA) application for a temporary, or initial certificate of authority 		PDF English
FIN376 MEWA Officers, Directors, and Trustees Page
Listing of all officers, directors, and trustees associated with the Multiple Employer Welfare Arrangement (MEWA) 		PDF English
FIN377 Service of Process (MEWA)
Multiple Employer Welfare Arrangement (MEWA) Service of Process form 		PDF English
FIN378 MEWA Annual Filing Checklist
Instructions for submitting annual filing for a Multiple Employer Welfare Arrangement (MEWA) 		PDF English
FIN407 Statutory Deposit Transaction Form
Statutory Deposit Transaction Form is submitted when a securities is deposited or withdrawn. 		PDF English
FIN453 Declaration of Trust
Form to be executed for securities held on deposit. 		PDF English
FIN590 Financial Analysis Fee Transmittal Form
For MEWAs and CCRCs 		PDF English
FIN706 Multiple Employer Welfare Arrangement (MEWA)
For MEWAs electing to comply with Insurance Code Section 846.0035. 		PDF English

For more information, contact: CompanyLicense@tdi.texas.gov