§ 5820 — Definitions

Delaware § 5820

• Jurisdiction: Delaware
• Title: 18
• Part: Insurance
• Ch. 58: RISK-BASED CAPITAL (RBC)
• Subch.: Risk-Based Capital (RBC) for Health Organizations

Text

As used in this chapter, the following terms shall have the respective meanings hereinafter set forth, unless the context shall otherwise require:

(1)“Adjusted RBC report.” —The term “adjusted RBC report” means an RBC report which has been adjusted by the Commissioner in accordance with § 5821(d) of this title.

(2)“Corrective order.” —The term “corrective order” means an order issued by the Commissioner specifying corrective actions which the Commissioner has determined are required.

(3)“Domestic health organization.” —The term “domestic health organization” means a health organization domiciled in this State.

(4)“Foreign health organization.” —The term “foreign health organization” means a health organization that is licensed to do business in this State under this title but is not domiciled in this State.

(5)“Health organization.” —The term “health organization” means a health maintenance organization, limited health service organization, health service corporation, dental or vision plan, hospital, medical and dental indemnity or service corporation or other managed care organization licensed under this title. This definition does not include an organization that is licensed as either a life and/or health insurer or a property and casualty insurer under § 516 of this title and that is otherwise subject to either the life and/or health or property and casualty RBC requirements.

(6)“NAIC.” —The term “NAIC” means the National Association of Insurance Commissioners.

(7)“RBC instructions.” —The term “RBC instructions” means the RBC report including risk-based capital instructions adopted by the NAIC, as these RBC instructions may be amended by the NAIC from time to time in accordance with the procedures adopted by the NAIC.

(8)“RBC level.” —The term “RBC level” means a health organization’s company action level RBC, regulatory action level RBC, authorized control level RBC, or mandatory control level RBC where:

a. “Authorized control level RBC” means the number determined under the risk based capital formula in accordance with the RBC instructions;

b. “Company action level RBC” means, with respect to any health organization, the product of 2.0 and its authorized control level RBC;

c. “Mandatory control level RBC” means the product of .70 and the authorized control level RBC;

d. “Regulatory action level RBC” means the product of 1.5 and its authorized control level RBC.

(9)“RBC plan.” —The term “RBC plan” means a comprehensive financial plan containing the elements specified in § 5822(b) of this title. If the Commissioner rejects the RBC plan, and it is revised by the health organization, with or without the Commissioner’s recommendation, the plan shall be called the “revised RBC plan.”

(10)“RBC report.” —The term “RBC report” means the report required in § 5821 of this title.

(11)“Total adjusted capital.” —The term “total adjusted capital” means the sum of:

a. A health organization’s statutory capital and surplus (i.e., net worth) as determined in accordance with the statutory accounting applicable to the annual financial statements required to be filed under this title; and

b. Such other items, if any, as the RBC instructions may provide.

Legislative History

79 Del. Laws, c. 425, § 3