Section 151.09 - Review of Application to be Certified Group Purchasing Cooperative(1) The Commissioner shall review complete applications to be a certified Group Purchasing Cooperative only if fewer than six Group Purchasing Cooperatives are then so certified and if there are fewer than 85,000 Insureds participating in such certified Group Purchasing Cooperatives. If fewer than six Group Purchasing Cooperatives are so certified and if there are fewer than 85,000 Insureds participating in such certified Group Purchasing Cooperatives, then the Commissioner shall provide notice that applications to be a certified Group Purchasing Cooperative will be reviewed, if such applications are submitted to the Division during the time period established by the Commissioner.(2) If, at any time, the number of applicants to be a certified Group Purchasing Cooperative exceeds the six Group Purchasing Cooperatives permitted by M.G.L. c. 176J, § 12(b), the Commissioner will consider which of the applicants better satisfies the criteria set forth in 211 CMR 151.00 and provides access to Group Purchasing Cooperative Health Benefit Plans in a geographic area or to a type of small business or to a type of Association not currently served by other certified Group Purchasing Cooperatives.(3) Upon receipt of a complete application to be a certified Group Purchasing Cooperative, the Commissioner shall review the submitted materials to determine whether the applicant meets the following requirements: (a) The applicant has a corporate and organizational structure capable of supporting the Covered Benefits to be offered;(b) The applicant has a business plan to administer the Group Purchasing Cooperative and its Wellness Program(s) such that the Group Purchasing Cooperative's Health Benefit Plans and Wellness Programs are available and accessible to Insureds and ensure at all times that at least 33% of covered members are enrolled in Wellness Programs;(c) The applicant has enrollment systems that: 1. Ensure that no Qualified Associations, Eligible Association Members, Eligible Small Businesses, Eligible Employees or Eligible Dependents are denied or non-renewed coverage due to health condition, age, race or sex, and ensure that Health Benefit Plans are not made available to other than Eligible Association Members, Eligible Small Businesses, Eligible Employees and Eligible Dependents;2. Ensure that those Eligible Small Businesses that purchase Health Benefit Plans through the Group Purchasing Cooperative do not have more than 50 Eligible Employees and ensure that those Eligible Small Businesses will be disenrolled at the end of the current plan year if the number of Eligible Employees increases beyond 50 in total;3. Ensure that the Group Purchasing Cooperative will offer Health Benefit Plans to Qualified Associations that are new to the Group Purchasing Cooperative only on Health Benefit Plan anniversary dates;4. Ensure that Qualified Associations and Qualified Association Members forfeit annual membership fees if they choose, on dates other than Health Benefit Plan anniversary dates, to cease being offered a Health Benefit Plan(s) through the Group Purchasing Cooperative;5. Ensure that the Group Purchasing Cooperative will not offer Health Benefit Plans to any Qualified Association or Qualified Association Member that has, within the past three years, chosen to cease being offered a Health Benefit Plan(s) through a Group Purchasing Cooperative; and6. Ensure consistent application of open enrollment rules and periods according to documented procedures for Qualified Association Members to enter and exit Group Purchasing Cooperatives for the purchase of Health Benefit Plans;(d) The applicant has marketing systems that present Group Purchasing Cooperative Health Benefit Plans to Eligible Association Members and Qualified Association Members' Eligible Employees and Eligible Dependents, which may include marketing through duly licensed insurance producers;(e) The applicant has billing systems that ensure that no Eligible Small Business in a Group Purchasing Cooperative is charged a rate higher than what the Carrier would charge to a similarly situated Eligible Small Business that is not a participant in a Group Purchasing Cooperative;(f) The applicant has Wellness Programs administered by the Group Purchasing Cooperative or its designees that, at a minimum: 1. Are actuarially similar to Wellness Programs that may be offered through the Commonwealth Health Insurance Connector Authority and meet the standards of 211 CMR 151.15;2. Will received an enrollment commitment from at least 33% of all Eligible Association Members and Eligible Employees that will be covered under Health Benefit Plans offered through the Group Purchasing Cooperative; and3. Have reasonable systems, which shall comply with any applicable sections of the Americans with Disability Act and any other federal requirements, under which Wellness Program participants may record their participation in, and the Group Purchasing Cooperative may monitor Wellness Program participants' participation in available health management programs;(g) The applicant has informational systems, including but not limited to data redundancy and privacy controls, that ensure the appropriate and efficient use of Covered Benefits;(h) The applicant has operations financially capable of coordinating the Group Purchasing Cooperative's Wellness Program with Eligible Association Members or Eligible Small Businesses;(i) The applicant has a written Group Purchasing Cooperative marketing plan for attracting Eligible Association Members and Eligible Small Businesses to obtain coverage from the Group Purchasing Cooperative;(j) The applicant has adequate Wellness Programs to guarantee that all wellness services contracted for will be accessible to Eligible Association Members, Eligible Employees and Eligible Dependents without inappropriate delays; and(k) The applicant has sufficient financial reserves or other resources to meet financial obligations.(4) The Commissioner shall notify an applicant to become a certified Group Purchasing Cooperative in writing if the reviewed application is denied, and the Commissioner shall state the reasons for the denial of the reviewed application.