§ 521F.5 — Regulatory-action-level event

Iowa § 521F.5

• Jurisdiction: Iowa
• Title XIII: COMMERCE
• Ch. 521F: RISK-BASED CAPITAL REQUIREMENTS FOR HEALTH ORGANIZATIONS

Text

1. “Regulatory-action-level event” means any of the following:
a. The filing of a risk-based capital report by the health organization that indicates
that the health organization’s total adjusted capital is greater than or equal to its
authorized-control-level risk-based capital but less than its regulatory-action-level risk-based
capital.
b. Notification by the commissioner to a health organization of an adjusted risk-based
capitalreportthatindicatestheeventinparagraph“a”, providedthehealthorganizationdoes
not challenge the adjusted risk-based capital report and request a hearing pursuant to section
521F.8.
c. After a hearing pursuant to section 521F.8, notification by the commissioner to the
health organization that the commissioner has rejected the health organization’s challenge
of the adjusted risk-based capital report indicating the event in paragraph “a”.
d. Failure of the health organization to file a risk-based capital report by the filing
date, unless the health organization has provided an explanation for the failure which is
satisfactory to the commissioner and has cured the failure within ten days after the filing
date.
e. Failure of the health organization to submit a risk-based capital plan to the
commissioner within the time period set forth in section 521F.4, subsection 3.
f. Notification by the commissioner to the health organization of both of the following:
(1) The risk-based capital plan or revised risk-based capital plan filed by the health
organization, in the judgment of the commissioner, is unsatisfactory.
(2) Notificationpursuanttothisparagraphconstitutesaregulatory-action-leveleventwith
respect to the health organization, provided the health organization has not challenged the
determination pursuant to section 521F.8.
g. After a hearing pursuant to section 521F.8, notification by the commissioner to the
health organization that the commissioner has rejected the health organization’s challenge
of the determination made by the commissioner pursuant to paragraph “f”.
h. Notificationbythecommissionertothehealthorganizationthatthehealthorganization
has failed to adhere to its risk-based capital plan or revised risk-based capital plan, but only if
thefailurehasasubstantialadverseeffectontheabilityofthehealthorganizationtoeliminate
the company-action-level event pursuant to the health organization’s risk-based capital plan
or revised risk-based capital plan and the commissioner has so stated in the notification.
However, notification by the commissioner pursuant to this paragraph does not constitute a
company-action-level event if the health organization has challenged the determination of
the commissioner pursuant to section 521F.8.
i. After a hearing pursuant to section 521F.8, notification by the commissioner to the
health organization that the commissioner rejected the health organization’s challenge of
the commissioner’s determination pursuant to paragraph “h”.
2. Upon the occurrence of a regulatory-action-level event, the commissioner shall do all
of the following:
a. Require the health organization to prepare and submit a risk-based capital plan or
revised risk-based capital plan, as applicable.
5 RISK-BASED CAPITAL REQUIREMENTS FOR HEALTH ORGANIZATIONS, §521F.6
b. Performanexaminationoranalysisoftheassets,liabilities,andoperationsofthehealth
organization, including a review of its risk-based capital plan or revised risk-based capital
plan.
c. Subsequenttotheexaminationoranalysispursuanttoparagraph“b”, issueacorrective
order.
3. The commissioner, in determining the corrective actions to be ordered, may take into
account factors the commissioner deems relevant with respect to the health organization
based upon the commissioner’s examination or analysis of the assets, liabilities, and
operations of the health organization, including, but not limited to, the results of any
sensitivity tests undertaken pursuant to the risk-based capital instructions. The risk-based
capital plan or revised risk-based capital plan shall be submitted within forty-five days after
the occurrence of the regulatory-action-level event, except as follows:
a. If the health organization challenges a risk-based capital report pursuant to section
521F.8, and in the judgment of the commissioner the challenge is not frivolous, within
forty-five days after the notification to the health organization that the commissioner, after a
hearing pursuant to section 521F.8, has rejected the health organization’s challenge.
b. If the health organization challenges a revised risk-based capital plan pursuant to
section 521F.8, and in the judgment of the commissioner the challenge is not frivolous,
within forty-five days after the notification to the health organization that the commissioner,
after a hearing pursuant to section 521F.8, has rejected the health organization’s challenge.
4. The commissioner may retain actuaries, investment experts, and other consultants
as deemed necessary by the commissioner to review the health organization’s risk-based
capital plan or revised risk-based capital plan; examine or analyze the assets, liabilities, and
operations of the health organization; and assist in the formulation of the corrective order
with respect to the health organization. Fees of the actuaries, investment experts, or other
consultants retained by the commissioner shall be paid by the health organization subject
to the review or examination.