§ 27-4.7-4. Company action level event.
(a) "Company action level event� means any of the following events:
(1) The filing of an RBC report by a health organization that indicates that the health
organization's total adjusted capital is greater than or equal to its regulatory action
level RBC but less than its company action level RBC;
(i) If a health organization has total adjusted capital which is greater than or equal
to its company action level RBC but less than the product of its authorized control
level RBC and 3.0 and triggers the trend test determined in accordance with the trend
test calculation included in the health RBC instructions;
(2) Notification by the commissioner to the health organization of an adjusted RBC report
that indicates an event in subsection (a)(1) of this section, provided the health
organization does not challenge the adjusted RBC report under § 27-4.7-8; or
(3) If, pursuant to § 27-4.7-8, a health organization challenges an adjusted RBC report that indicates the event
in subsection (a)(1) of this section, the notification by the commissioner to the
health organization that the commissioner has, after a hearing, rejected the health
organization's challenge.
(b) In the event of a company action level event, the health organization shall prepare
and submit to the commissioner an RBC plan that shall:
(1) Identify the conditions that contribute to the company action level event;
(2) Contain proposals of corrective actions that the health organization intends to take
and that would be expected to result in the elimination of the company action level
event;
(3) Provide projections of the health organization's financial results in the current
year and at least the two (2) 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
RBC levels. The projections for both new and renewal business might include separate
projections for each major line of business and separately identify each significant
income, expense, and benefit component;
(4) Identify the key assumptions impacting the health organization's projections and the
sensitivity of the projections to the assumptions; and
(5) Identify the quality of, and problems associated with, the health organization's business,
including, but not limited to, 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.
(c) The RBC plan shall be submitted:
(1) Within forty-five (45) days of the company action level event; or
(2) If the health organization challenges an adjusted RBC report pursuant to § 27-4.7-8, within forty-five (45) days after notification to the health organization that the
commissioner has, after a hearing, rejected the health organization's challenge.
(d) Within sixty (60) days after the submission by a health organization of an RBC plan
to the commissioner, the commissioner shall notify the health organization whether
the RBC plan shall be implemented or is, in the judgment of the commissioner, unsatisfactory.
If the commissioner determines the RBC plan is unsatisfactory, the notification to
the health organization shall set forth the reasons for the determination, and may
set forth proposed revisions which will render the RBC plan satisfactory in the judgment
of the commissioner. Upon notification from the commissioner, the health organization
shall prepare a revised RBC plan, which may incorporate by reference any revisions
proposed by the commissioner, and shall submit the revised RBC plan to the commissioner:
(1) Within forty-five (45) days after the notification from the commissioner; or
(2) If the health organization challenges the notification from the commissioner under
§ 27-4.7-8, within forty-five (45) days after a notification to the health organization that
the commissioner has, after a hearing, rejected the health organization's challenge.
(e) In the event of a notification by the commissioner to a health organization that the
health organization's RBC plan or revised RBC plan is unsatisfactory, the commissioner
may, at the commissioner's discretion, subject to the health organization's right
to a hearing under § 27-4.7-8, specify in the notification that the notification constitutes a regulatory action
level event.
(f) Every domestic health organization that files an RBC plan or revised RBC plan with
the commissioner shall file a copy of the RBC plan or revised RBC plan with the insurance
commissioner in any state in which the health organization is authorized to do business
if:
(1) The state has an RBC provision substantially similar to § 27-4.7-9(a); and
(2) 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 RBC plan or revised RBC plan in that state no later than the later of:
(i) Fifteen (15) days after the receipt of notice to file a copy of its RBC plan or revised
RBC plan with the state; or
(ii) The date on which the RBC plan or revised RBC plan is filed under subsections (c)
and (d) of this section.