§ 26-48-204 — Regulatory action level event

Wyoming § 26-48-204

• Jurisdiction: Wyoming
• Title 26: Insurance Code
• Ch. 48: RISK-BASED CAPITAL

Text

(a) "Regulatory action level event" means, with respect to
a health organization, any of the following events:
(i) The filing of an RBC 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 RBC but less than its regulatory action level RBC;
(ii) Notification by the commissioner to a health
organization of an adjusted RBC report that indicates the event
in paragraph (i) of this subsection, provided the health
organization does not challenge the adjusted RBC report under
W.S. 26-48-207;
(iii) If the health organization challenges an
adjusted RBC report that indicates the event in paragraph (i) of
this subsection under W.S. 26-48-207, the notification by the
commissioner to the health organization that the commissioner
has, after a hearing, rejected the health organization's
challenge;
(iv) The failure of the health organization to file
an RBC report annually by March 1, unless the health
organization has provided an explanation for the failure that is
satisfactory to the commissioner and has cured the failure
within ten (10) days after the filing date;
(v) The failure of the health organization to submit
an RBC plan to the commissioner within the time period set forth
in W.S. 26-48-203(c);
(vi) Notification by the commissioner to the health
organization that:
(A) The RBC plan or revised RBC plan submitted
by the health organization is, in the judgment of the
commissioner, unsatisfactory; and
(B) Such notification constitutes a regulatory
action level event with respect to the health organization,
provided the health organization has not challenged the
determination under W.S. 26-48-207.
(vii) If the health organization challenges a
determination by the commissioner under paragraph (vi) of this
subsection under W.S. 26-48-207, the notification by the
commissioner to the health organization that the commissioner
has, after a hearing, rejected the challenge;
(viii) Notification by the commissioner to the health
organization that the health organization has failed to adhere
to its RBC plan or revised RBC plan, but only if the failure has
a substantial adverse effect on the ability of the health
organization to eliminate the company action level event in
accordance with its RBC plan or revised RBC plan and the
commissioner has so stated in the notification, provided the
health organization has not challenged the determination under
W.S. 26-48-207; or
(ix) If the health organization challenges a
determination by the commissioner under paragraph (viii) of this
subsection under W.S. 26-48-207, the notification by the
commissioner to the health organization that the commissioner
has, after a hearing, rejected the challenge.
(b) In the event of a regulatory action level event the
commissioner shall:
(i) Require the health organization to prepare and
submit an RBC plan or, if applicable, a revised RBC plan;
(ii) Perform an examination or analysis as he deems
necessary of the assets, liabilities and operations of the
health organization including a review of its RBC plan or
revised RBC plan; and
(iii) Subsequent to the examination or analysis,
issue an order specifying such corrective actions as he shall
determine are required.
(c) In determining corrective actions, the commissioner
may take into account factors he deems relevant with respect to
the health organization based upon his 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 RBC instructions.
The RBC plan or revised RBC plan shall be submitted:
(i) Within forty-five (45) days after the occurrence
of the regulatory action level event;
(ii) If the health organization challenges an
adjusted RBC report under W.S. 26-48-207 and the challenge is
not frivolous in the judgment of the commissioner, within forty-
five (45) days after the notification to the health organization
that the commissioner has, after a hearing, rejected the health
organization's challenge; or
(iii) If the health organization challenges a revised
RBC plan under W.S. 26-48-207 and the challenge is not frivolous
in the judgment of the commissioner, within forty-five (45) days
after the notification to the health organization that the
commissioner has, after a hearing, rejected the health
organization's challenge.
(d) The commissioner may retain actuaries and investment
experts and other consultants necessary in the judgment of the
commissioner to review the health organization's RBC plan or
revised RBC plan, examine or analyze the assets, liabilities and
operations of the health organization and formulate the
corrective order with respect to the health organization. The
fees, costs and expenses relating to consultants shall be borne
by the affected health organization or other party as directed
by the commissioner.