44-6105.

Application; fee.

A domestic mutual insurer may convert to a stock insurer by meeting the requirements of the Insurers Demutualization Act. The mutual insurer shall file an application to convert to a stock insurer with the director. The application shall be accompanied by a nonrefundable application fee of one thousand dollars. The application shall include the following at a minimum:

(1) A plan of conversion containing a description of the structure and form of the proposed consideration to the policyholders, the projected range of the number of shares of capital stock to be issued by the new stock insurer or the holding company of such insurer, whether to policyholders, to be sold or reserved for sale to investors by the new stock insurer or the holding company of such insurer, or to a trust established for the exclusive benefit of policyholders for the purpose of effecting the conversion into which shares of the capital stock of the new stock insurer or the holding company of such insurer are placed pending distribution to the policyholders, and such other proposed conditions and provisions as determined by the mutual insurer not to be inconsistent with the act;

(2) A certification that the plan of conversion has been duly adopted by a vote of not less than two-thirds of the members of the board of directors of the mutual insurer;

(3) A certification adopted by not less than two-thirds of the members of the board of directors of the mutual insurer that the plan of conversion is fair and equitable to the policyholders;

(4) Certified copies of the proposed amendments to the articles of incorporation and bylaws to effectuate the conversion;

(5) A form of the proposed notice to be mailed by the mutual insurer to its policyholders as required in section 44-6109; and

(6) Any other additional information as the director may reasonably request.