1. "Company action level event" means any of the following events:
a. The filing of a risk-based capital report by a health organization which indicates
that:
(1)The health organization's total adjusted capital is greater than or equal to its
regulatory action level risk-based capital but less than its company action
level risk-based capital; or
(2)If a health organization has total adjusted capital that is greater than or
equal to its company action level risk-based capital but less than the product
of its authorized control level risk-based capital and three and triggers the
trend test determined in accordance with the trend test calculation included
in the health risk-based capital instructions;
b. Notification by the commissioner to the health organization of an adjusted
risk-based c
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1. "Company action level event" means any of the following events:
a. The filing of a risk-based capital report by a health organization which indicates
that:
(1) The health organization's total adjusted capital is greater than or equal to its
regulatory action level risk-based capital but less than its company action
level risk-based capital; or
(2) If a health organization has total adjusted capital that is greater than or
equal to its company action level risk-based capital but less than the product
of its authorized control level risk-based capital and three and triggers the
trend test determined in accordance with the trend test calculation included
in the health risk-based capital instructions;
b. Notification by the commissioner to the health organization of an adjusted
risk-based capital report that indicates an event in subdivision a, provided the
health organization does not challenge the adjusted risk-based capital report
under section 26.1-03.2-07; or
c. If, pursuant to section 26.1-03.2-07, a health organization challenges an adjusted
risk-based capital report that indicates the event in subdivision a, the notification
by the commissioner to the health organization that the commissioner, after a
hearing, has rejected the health organization's challenge.
2. In the event of a company action level event, the health organization shall prepare and
submit to the commissioner a risk-based capital plan that:
a. Identifies the conditions that contribute to the company action level event;
b. Contains proposals of corrective actions which the health organization intends to
take and which would be expected to result in the elimination of the company
action level event;
c. Provides projections of the health organization's financial results in the current
year and at least the two succeeding years, both in the absence of proposed
corrective actions and giving effect to the proposed corrective actions, including
projections of statutory balance sheets, operating income, net income, capital and
surplus, and risk-based capital levels. The projections for both new and renewal
business may include separate projections for each major line of business and
separately identify each significant income, expense, and benefit component;
d. Identifies the key assumptions impacting the health organization's projections and
the sensitivity of the projections to the assumptions; and
e. Identifies the quality of, and problems associated with, the health organization's
business, including its assets, anticipated business growth and associated
surplus strain, extraordinary exposure to risk, mix of business, and use of
reinsurance, if any, in each case.
3. The risk-based capital plan must be submitted:
a. Within forty-five days of the company action level event; or
b. If the health organization challenges an adjusted risk-based capital report
pursuant to section 26.1-03.2-07, within forty-five days after notification to the
health organization that the commissioner, after a hearing, has rejected the health
organization's challenge.
4. Within sixty days after the submission by a health organization of a risk-based capital
plan to the commissioner, the commissioner shall notify the health organization
whether the risk-based capital plan shall be implemented or is, in the judgment of the
commissioner, unsatisfactory. If the commissioner determines the risk-based capital
plan is unsatisfactory, the notification to the health organization must set forth the
reasons for the determination and may set forth proposed revisions that will render the
risk-based capital plan satisfactory in the judgment of the commissioner. Upon
notification from the commissioner, the health organization shall prepare a revised
risk-based capital plan, which may incorporate by reference any revisions proposed by
the commissioner, and shall submit the revised risk-based capital plan to the
commissioner:
a. Within forty-five days after the notification from the commissioner; or
b. If the health organization challenges the notification from the commissioner under
section 26.1-03.2-07, within forty-five days after a notification to the health
organization that the commissioner has, after a hearing, rejected the health
organization's challenge.
5. In the event of a notification by the commissioner to a health organization that the
health organization's risk-based capital plan or revised risk-based capital plan is
unsatisfactory, the commissioner, subject to the health organization's right to a hearing
under section 26.1-03.2-07, may specify in the notification that the notification
constitutes a regulatory action level event.
6. Every domestic health organization that files a risk-based capital plan or revised
risk-based capital plan with the commissioner shall file a copy of the risk-based capital
plan or revised risk-based capital plan with the insurance commissioner in any state in
which the health organization is authorized to do business if:
a. The state has a risk-based capital provision substantially similar to subsection 1
of section 26.1-03.2-08; and
b. The insurance commissioner of that state has notified the health organization of
its request for the filing in writing, in which case the health organization shall file a
copy of the risk-based capital plan or revised risk-based capital plan in that state
no later than the later of:
(1) Fifteen days after the receipt of notice to file a copy of its risk-based capital
plan or revised risk-based capital plan with the state; or
(2) The date on which the risk-based capital plan or revised risk-based capital
plan is filed under subsections 3 and 4.