Sec 20-488. Definitions

In this article, unless the context otherwise requires:

1. "Adjusted RBC report" means a report that has been adjusted by the director in accordance with section 20-488.01.

2. "Authorized control level event" means any of the following events:

(a) The filing of an RBC report by the insurer indicating that the insurer's total adjusted capital is more than or equal to its mandatory control level RBC but less than its authorized control level RBC.

(b) The notification by the director to the insurer of an adjusted RBC report that indicates the event under subdivision (a) of this paragraph, unless the insurer challenges the adjusted RBC report under section 20-488.06.

(c) If the insurer challenges an adjusted RBC report that indicates the event under subdivision (a) of this paragraph, the notification by the director to the insurer that the director, after a hearing, has rejected the insurer's challenge.

(d) The failure of the insurer to satisfactorily respond to a corrective order, unless the insurer has challenged the corrective order under section 20-488.06.

(e) If the insurer challenges a corrective order and, after a hearing, the director rejects the challenge or modifies the corrective order, the failure of the insurer to satisfactorily respond to the corrective order after its modification or the rejection of the challenge by the director.

3. "Authorized control level RBC" means the number determined under the risk-based capital formula in accordance with the RBC instructions.

4. "Company action level event" means any of the following:

(a) The filing of an RBC report by an insurer indicating either that:

(i) The insurer's total adjusted capital is more than or equal to its regulatory action level RBC but less than its company action level RBC.

(ii) The insurer's total adjusted capital is more than or equal to its company action level RBC but less than the product of its authorized control level RBC and 3.0 and has a negative trend.

(b) The notification by the director to the insurer of an adjusted RBC report that indicates any of the events under subdivision (a) of this paragraph, unless the insurer challenges the adjusted RBC report under section 20-488.06.

(c) If the insurer challenges an adjusted RBC report that indicates either of the events under subdivision (a) of this paragraph, the notification by the director to the insurer that the director, after a hearing, has rejected the insurer's challenge.

5. "Company action level RBC" means, with respect to any insurer, the product of 2.0 and its authorized control level RBC.

6. "Corrective order" means an order that is issued by the director and that specifies corrective actions that the director has determined are required.

7. "Domestic insurer" means a life or health insurer, or both, a property or casualty insurer, or both, or a health organization that is authorized to transact insurance business in this state and that is organized in this state.

8. "Foreign insurer" means a life or health insurer, or both, a property or casualty insurer, or both, or a health organization that is authorized to transact insurance business in this state but that is not domiciled in this state.

9. "Health organization" means a hospital service corporation, medical service corporation, dental service corporation or optometric service corporation or a hospital, medical, dental and optometric service corporation that has a certificate of authority pursuant to chapter 4, article 3 of this title, a prepaid dental plan organization that has a certificate of authority pursuant to chapter 4, article 7 of this title or a health care services organization that has a certificate of authority pursuant to chapter 4, article 9 of this title.

10. "Life or health insurer" means an insurer authorized to transact life insurance, annuities or accident and health insurance in this state, a fraternal benefit society or an authorized property or casualty insurer writing only accident and health insurance, but does not include a health organization.

11. "Mandatory control level event" means any of the following:

(a) The filing of an RBC report by the insurer indicating that the insurer's total adjusted capital is less than its mandatory control level RBC.

(b) The notification by the director to the insurer of an adjusted RBC report that indicates the event under subdivision (a) of this paragraph, unless the insurer challenges the adjusted RBC report under section 20-488.06.

(c) If the insurer challenges an adjusted RBC report that indicates the event under subdivision (a) of this paragraph, the notification by the director to the insurer that the director, after a hearing, has rejected the insurer's challenge.

12. "Mandatory control level RBC" means the product of .70 and the authorized control level RBC.

13. "Negative trend" means, with respect to an insurer, a negative trend over a period of time as determined in accordance with the trend test calculation included in the RBC instructions.

14. "Property or casualty insurer" means an insurer licensed to transact insurance as described in section 20-256 or 20-252, respectively, but does not include monoline mortgage guaranty insurers, financial guaranty insurers and title insurers.

15. "RBC" means risk-based capital.

16. "RBC instructions" means the RBC report, including risk-based capital instructions adopted by the national association of insurance commissioners.

17. "RBC level" means an insurer's company action level RBC, regulatory action level RBC, authorized control level RBC or mandatory control level RBC.

18. "RBC plan" means a comprehensive financial plan containing the elements specified in section 20-488.02, subsection A. If the director rejects the RBC plan and the insurer revises the plan, regardless of the director's recommendation, the plan shall be called the revised RBC plan.

19. "RBC report" means the report required under section 20-488.01.

20. "Regulatory action level event" means, with respect to any insurer, any of the following events:

(a) The filing of an RBC report by the insurer indicating that the insurer's total adjusted capital is more than or equal to its authorized control level RBC but less than its regulatory action level RBC.

(b) The notification by the director to the insurer of an adjusted RBC report that indicates the event under subdivision (a) of this paragraph, unless the insurer challenges the adjusted RBC report under section 20-488.06.

(c) If the insurer challenges an adjusted RBC report that indicates the event under subdivision (a) of this paragraph, the notification by the director to the insurer that the director, after a hearing, has rejected the insurer's challenge.

(d) The failure by the insurer to file an RBC report by the filing date, unless the insurer provides the director with a satisfactory explanation for the failure and cures the failure within ten days after the filing date.

(e) The failure by the insurer to submit an RBC plan to the director within the time period prescribed in section 20-488.02, subsection B.

(f) Notification by the director to the insurer that both:

(i) The RBC plan or revised RBC plan that the insurer submitted is, in the judgment of the director, unsatisfactory.

(ii) If the insurer has not challenged a determination pursuant to section 20-488.06, the notification constitutes a regulatory action level event.

(g) If the insurer challenges pursuant to section 20-488.06 a determination made by the director pursuant to subdivision (f) of this paragraph, the notification by the director to the insurer that the director, after a hearing, has rejected the insurer's challenge.

(h) If the insurer has not challenged the determination pursuant to section 20-488.06, the notification by the director to the insurer that the insurer has failed to adhere to the insurer's RBC plan or revised RBC plan and that states that failure has a substantial adverse effect on the insurer's ability to eliminate the regulatory action level event in accordance with its RBC plan or revised RBC plan.

(i) If the insurer challenges pursuant to section 20-488.06 a determination made by the director pursuant to subdivision (h) of this paragraph, the notification by the director to the insurer that the director, after a hearing, has rejected the insurer's challenge, unless the insurer's failure to adhere to its RBC plan or revised RBC plan does not have a substantial adverse effect on the insurer's ability to eliminate the regulatory action level event.

21. "Regulatory action level RBC" means the product of 1.5 and an insurer's authorized control level RBC.

22. "Total adjusted capital" means the sum of:

(a) An insurer's statutory capital and surplus.

(b) Any other items that the RBC instructions may provide.