Indiana M400 PDF Form

What is the purpose of the Indiana M400 form?

The Indiana M400 form is used for the renewal application of registration for Multiple Employer Welfare Arrangements (MEWAs). MEWAs are entities, other than licensed insurers, that provide accident and sickness or death benefits through employee benefit plans to the employees of at least two different employers, including those who are self-employed and their dependents.

What does "Multiple Employer Welfare Arrangement" (MEWA) mean?

A Multiple Employer Welfare Arrangement refers to an organization, not being a licensed insurance provider, that establishes an employee benefit plan. Its purpose is to offer or provide accident, sickness, or death benefits to the employees and dependents of at least two different employers, including self-employed individuals.

Who needs to complete the Indiana M400 form?

The M400 form must be completed by MEWAs that are seeking to renew their registration in the state of Indiana. This includes entities that manage employee benefit plans for multiple employers, offering accident, sickness, or death benefits.

How do I declare changes to the MEWA's application information or documentation?

If there have been any changes to the previously submitted application information or documentation, they must be declared in the M400 form. The applicant is required to check the corresponding box indicating that there have been changes and attach the revised documentation to the renewal application.

Can a MEWA be a non-for-profit organization?

Yes, a MEWA can be a non-for-profit organization. Applicants are required to indicate on the M400 form whether the MEWA operates as a non-profit entity.

What information is required about the MEWA’s relationship with a third-party administrator?

The form requires MEWAs to disclose whether they have contracts with third-party administrators. If the answer is yes, the MEWA must list or attach the name(s) of the third-party administrator(s). Additionally, any trustees who are owners, officers, or employees of the administrator must be disclosed.

How do I indicate if the MEWA’s fiscal year has changed?

If the MEWA's fiscal year has changed, this must be indicated on the M400 form. The form includes a specific question where applicants can state whether there has been a change in the fiscal year of the MEWA.

What information needs to be provided about the employers in the MEWA?

Applicants must provide information on whether the employers in the MEWA are members of an association or a group of businesses within the same trade or industry. Additionally, it must be indicated whether the association is substantially involved in activities for its members beyond just sponsorship.

What does the fund balance section in the M400 form refer to?

The fund balance section requires MEWAs to state their current fund balance. This information helps assess the financial stability and health of the MEWA, ensuring it has adequate resources to provide the promised benefits to its members.

Filling out the Indiana M400 form, which is the Renewal Application for Registration of Multiple Employer Welfare Arrangement (MEWA), can be a complex process. Mistakes in this process can lead to delays or even rejection of the application. Here are five common mistakes to avoid for a smooth renewal application process.

1. Not Updating Information. One key error is failing to accurately report any changes to the application information and documentation submitted in the previous year. It's crucial that applicants closely review their previously submitted information and update it as necessary. This includes revising the documentation attached to the form if there have been any changes.
2. Incorrect Addresses. The form requires both the statutory home address and the mailing address of the MEWA. Applicants often mistakenly provide incorrect or outdated addresses, or they might use the same address for both when they are, in fact, different. It's essential to double-check the addresses to ensure they are current and accurate.
3. Misidentifying the Contact Person. Providing the wrong contact person and their details can significantly hinder the application process. This individual is the primary point of communication between the MEWA and the state. It's important to provide the correct name, title, and telephone number of the person authorized to speak on behalf of the MEWA.
4. Overlooking MEWA’s Association or Group Membership. The form queries about whether the employers in the MEWA are members of an association or a group of businesses in the same trade or industry. A common mistake is to inaccurately respond to this question or neglect to list the trade or industry if the answer is yes. Accurately identifying the association or group is vital for the state to understand the structure and function of the MEWA.
5. Failure to Disclose Third Party Administrators. If the MEWA has a contract with a third-party administrator, this must be disclosed along with a list or attachment naming the third-party administrator(s). An oversight in providing this information can raise questions about the MEWA’s operations and compliance. Furthermore, if any trustees are owners, officers, or employees of the administrator, this relationship must be clearly explained.

Avoiding these mistakes not only smoothens the application process but also reflects well on the professional operation of the MEWA. Ensuring all information is up-to-date, accurate, and comprehensively provided is crucial. Paying close attention to the details, especially regarding addresses, contact information, and third-party relationships, can make a significant difference. Careful preparation and thorough review before submitting the Indiana M400 form can help avoid unnecessary complications and ensure that the MEWA's renewal application is processed efficiently and successfully.

When managing or renewing the registration of a Multiple Employer Welfare Arrangement (MEWA) in Indiana through the M400 form, several other forms and documents can play a crucial role in ensuring compliance and thorough documentation. These documents are pivotal for providing additional information, clarifying the MEWA's operations, and maintaining transparency with regulatory bodies. Understanding each document's purpose can help streamline the renewal process and avoid potential delays or complications.

• Articles of Incorporation or Organization: This document officially establishes the entity's existence under state law, detailing its structure, purpose, and regulatory compliance intentions.
• Bylaws or Operating Agreement: These documents outline the internal governance rules of the MEWA, including procedures for decision-making, the roles of officers and directors, and membership regulations.
• Financial Statements: Recent financial statements, audited by a certified public accountant, provide a snapshot of the MEWA's financial health and ensure that it has the resources necessary to cover its commitments.
• Third-Party Administrator (TPA) Agreement: If a MEWA contracts with a third-party administrator, the agreement should detail the roles, responsibilities, and scope of authority of the TPA in managing the MEWA.
• Proof of Fidelity Bond: MEWAs are often required to maintain fidelity bonds as a safeguard against fraudulent or dishonest acts by those handling its funds, illustrating the organization's financial integrity.
• Summary Plan Description (SPD): The SPD provides participants and beneficiaries with detailed information about the plan, including benefits, claims review procedures, and participants' rights, ensuring transparency and compliance with federal requirements.
• List of Employers Participating: An updated list of the employers participating in the MEWA is necessary to verify that the arrangement continues to meet eligibility requirements and that all employers are in good standing.

Together, these documents complement the Indiana M400 form by painting a full picture of the MEWA's operations, financial status, governance, and compliance with relevant laws and regulations. Each document serves a specific purpose in substantiating the MEWA's adherence to state and federal requirements, thus facilitating a smoother renewal process.

The Indiana M400 form is similar to the 5500 Series forms required by the U.S. Department of Labor for employee benefit plans. Both forms are designed to ensure compliance with federal and state regulations regarding the management and operation of employee benefit schemes. Specifically, the 5500 Series, like the M400, collects detailed information about the plan's operations, funding, eligibility, and coverage. Both sets of forms serve as a key resource for monitoring and ensuring the welfare and rights of the participants and beneficiaries of these plans. Additionally, they aid in the enforcement of laws that govern these plans and in the collection of statistical information about their financial condition and operations.

Another document similar to the Indiana M400 form is the Form 990 filed by nonprofit organizations with the IRS. This is pertinent to MEWAs that operate as non-for-profit entities, as indicated in section (9) of the M400. While Form 990 focuses broadly on the financial health, governance, and operational practices of nonprofit organizations, both documents are critical for demonstrating compliance with specific regulatory requirements. The M400 and Form 990 help ensure that entities are transparent about their financial status, governance, and program operations. This transparency is crucial for maintaining the trust and confidence of stakeholders, regulators, and the general public.

When filling out the Indiana M400 form, there are important guidelines to follow to ensure your submission is accurate and compliant. Here are some key dos and don'ts:

• Review the entire form before starting to ensure you understand all the requirements and questions.
• Check that there have been no changes to your application information and documentation since the last year, or if there have, ensure you attach the revised documentation accordingly.
• Provide the full statutory home address and mailing address of the MEWA, ensuring no detail is left out.
• Include a contact person with their title and contact number for any follow-up or clarification.
• Clarify if the employers in the MEWA are part of an association or a group of businesses in the same trade or industry, and specify the trade or industry if applicable.
• Sign and date the form to certify that the statements made are true and accurate.

• Leave any section incomplete unless it is not applicable to your MEWA. If a question does not apply, clearly state this rather than leaving it blank.
• Forget to check whether the MEWA’s fiscal year has changed, as this affects your reporting and filing requirements.
• Overlook the need to disclose if the MEWA is a non-for-profit organization or if there’s a contractual relationship with a third-party administrator.
• Fail to list the names of any trustees who are also owners, officers, or employees of the third-party administrator, if applicable.
• Ignore the question about the MEWA’s fund balance. This financial information is crucial for the state’s assessment of your MEWA’s viability.
• Submit the form without ensuring that all attached documents are current and accurately reflect your MEWA’s situation.

• It's only for health benefits – Misconception: The form is solely for the renewal of health benefits. Truth: While it does involve employee benefit plans, these can also include death benefits, not just accident and sickness coverage. This distinction underscores the form's broad application in managing various employee benefits.
• No changes, no need to notify – Misconception: If there are no changes to the MEWA, there's no need to complete the form. Truth: Whether there are changes or not, the renewal application requires certification from the applicant. This ensures that the information on record is up to date and accurate, regardless of changes or lack thereof.
• MEWA's location doesn't matter – Misconception: The physical location of the MEWA is irrelevant. Truth: The form requires both the statutory and mailing addresses, indicating the importance of the location for legal and communication purposes. This detail affects regulatory jurisdiction and administrative handling.
• Any business can join – Misconception: All businesses, regardless of industry, can participate in a MEWA. Truth: Membership in the MEWA requires the employers to be part of an association or a group within the same trade or industry. This ensures that the arrangement serves a cohesive group with common interests and needs.
• Profit status is irrelevant – Misconception: Whether a MEWA is for-profit or non-profit doesn't matter. Truth: The form explicitly asks about the non-profit status, indicating its significance. The tax and regulatory obligations of MEWAs can vary significantly based on their profit status, influencing their operations and member benefits.
• Relationships with administrators aren't important – Misconception: The identities and roles of administrators and trustees don't need to be disclosed. Truth: Disclosure of any relationships between trustees and administrators is required. This transparency helps prevent conflicts of interest and ensures that administrators act in the best interests of members.
• MEWA's financial status is private– Misconception: The financial health of the MEWA is a private matter and not required on the form. Truth: The fund balance must be disclosed, highlighting the regulatory interest in the financial stability of these arrangements. This information is crucial for assessing the MEWA's ability to meet its obligations to members.
• Signature is a formality – Misconception: The requirement for a signature is just a formality. Truth: The signature certifies that the provided information is true and accurate, holding the signer legally accountable. It's a critical component of the application, ensuring integrity and reliability in the information submitted.

Filling out and using the Indiana M400 form is essential for renewing the registration of a Multiple Employer Welfare Arrangement (MEWA). Below are seven key takeaways to consider during this process:

• Understand what a MEWA is: It is an arrangement other than a duly admitted insurer that provides accident, sickness, or death benefits to the employees of at least two employers, including self-employed individuals and their dependents.
• Complete the Applicant's Certification accurately: Indicate whether there have been changes to the application information and documentation submitted in the previous year. If there have been changes, attach the revised documentation.
• Provide comprehensive details of the MEWA: Include the full name, statutory home address, and mailing address of the MEWA, ensuring that all information is current and correct.
• List the contact details for the MEWA: Identify the contact person, including their title and telephone number, to ensure there is a clear point of communication.
• Clarify the association or group membership: Indicate whether the employers in the MEWA are part of an association or a group of businesses in the same trade or industry, and if the association is substantially involved in activities other than sponsorship for its members.
• Disclose organizational changes and third-party relationships: Report any changes to the MEWA's fiscal year, whether it is a non-for-profit organization, and if there is a contract with a third party administrator, listing their names if applicable.
• Ensure transparency about trustees: If any of the trustees are an owner, officer, or employee of the administrator, this should be disclosed and explained in the application.

Following these guidelines will help ensure that the renewal process for the MEWA registration is completed effectively and in compliance with the Indiana Code.