| (a) With the initial captive insurance company application,
and within 30 days of employment, contract, or other association with
the captive insurance company, or attorney in fact, the following
individuals must complete a biographical affidavit and submit it to
the department:
(1) with the exception of functions provided by a captive
management company, individuals, including individual representatives
of the attorney in fact, who oversee the management of the captive
insurance company, including the following functions, must complete
a biographical affidavit addressing:
(A) risk management;
(B) financial reporting;
(C) underwriting;
(D) claims; and
(E) investments;
(2) members of the governing body; and
(3) corporate officers.
(b) Biographical affidavits required of individuals
under subsection (a) of this section must include the following information
and disclosures:
(1) the affiant's current name and any names the individual
may have used in the past, social security number, date of birth,
and current mailing addresses, phone numbers, email addresses;
(2) the name and address of the captive insurance company;
(3) the affiant's position or title at the captive
insurance company;
(4) information regarding the affiant's education,
memberships in professional organizations, and any professional, occupational,
or vocational licenses held;
(5) the affiant's employment history for the previous
10 years; and
(6) the affiant's fidelity bond coverage history, criminal
history, and ownership or control of entities involved in the business
of insurance.
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