Certification of Compliance with Prohibition against Political Contributions

_______________________________ Bulletin 320 Certification of Compliance with Prohibition against Political Contributions Public Law Chapter 424 enacted in 2003, effective September 13, 2003, amended Title 39-A §403 by prohibiting those self-insured employers and groups that maintain trust funds to secure their workers’ compensation obligations from using any of the trust funds for the purpose of making political contributions. Further, those self-insured employers and groups maintaining trust funds are subject to an additional annual renewal reporting requirement. They must provide a certification that no political contributions have been made from the trust funds during the preceding year. Self-insurers are reminded that pursuant to the Maine Election Code, 21-A M.R.S.A. §§1012(2) and 1052(3), the term “contribution” is defined to include both cash and in-kind contributions, such as campaign advertising. The attached form shall be completed and submitted with each annual renewal submission of self- insured employers and groups. The form must be executed by an officer of the employer or by a Board member of the group. Any self-insurer that has made a contribution before the effective date of the Act which would have been prohibited under the Act shall modify its initial certification form appropriately. August 11, 2003 _________________________________ Alessandro A. Iuppa Superintendent of Insurance NOTE: This bulletin is intended solely for informational purposes. It is not intended to set forth legal rights, duties or privileges nor is it intended to provide legal advice. Readers are encouraged to consult applicable statutes and regulations and to contact the Bureau of Insurance if additional information is needed. TITLE 39-A, §403(6E) USE OF TRUST FUNDS FOR POLITICAL CONTRIBUTIONS I, ______________________________, _________________________________, certify that (Name in Print) (Title) __________________________________________________ has not withdrawn any funds or (Name of Employer or Group) assets from the trust fund established to secure its self-insured workers’ compensation obligations at any time during the immediately preceding 12-month period for the purpose of making a political contribution to a political candidate or political action committee required to file a report under Title 21-A, Chapter 13, Subchapter 2 or 4. (Signature) __________________ (Date) This certification must be executed by an officer of the employer for self-insured employers or by a Board member for self-insured groups. This certification must be executed annually and submitted with the self-insurance renewal application.