As Introduced 1
123rd General Assembly 4
Regular Session H. B. No. 714 5
1999-2000 6
REPRESENTATIVES EVANS-NETZLEY-GOODMAN-BRITTON-JONES- 8
SMITH-BENDER-SCHURING-JOLIVETTE-WILLAMOWSKI-CLANCY- 9
GARDNER-HOLLISTER 10
_________________________________________________________________ 11
A B I L L
To amend section 1753.01 and to enact sections 13
1753.31 to 1753.43 of the Revised Code to apply, 14
with modifications, the National Association of 15
Insurance Commissioners' Risk-Based Capital for
Insurers Model Act to health insuring 16
corporations.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO: 18
Section 1. That section 1753.01 be amended and sections 20
1753.31, 1753.32, 1753.33, 1753.34, 1753.35, 1753.36, 1753.37, 21
1753.38, 1753.39, 1753.40, 1753.41, 1753.42, and 1753.43 of the 22
Revised Code be enacted to read as follows: 23
Sec. 1753.01. As used in this chapter: 32
(A) "Economic profiling" means a health insuring 34
corporation's use of economic performance data and economic 35
information in determining whether to contract with a provider 36
for the provision of covered health care services to enrollees as 38
a participating provider.
(B) "Basic health care services," "enrollee," "health care 40
facility," "health care services," "health insuring corporation," 41
"medical record," "PERSON," "PRIMARY CARE PROVIDER, "provider," 42
and "SUBSCRIBER," AND "supplemental health care services" have 44
the same meanings as in section 1751.01 of the Revised Code. 46
Sec. 1753.31. AS USED IN SECTIONS 1753.31 TO 1753.43 OF 48
THE REVISED CODE: 50
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(A) "ADJUSTED RBC REPORT" MEANS AN RBC REPORT THAT HAS 53
BEEN ADJUSTED BY THE SUPERINTENDENT OF INSURANCE IN ACCORDANCE 54
WITH DIVISION (C) OF SECTION 1753.32 OF THE REVISED CODE. 55
(B) "AUTHORIZED CONTROL LEVEL RBC" MEANS THE NUMBER 57
DETERMINED UNDER THE RISK-BASED CAPITAL FORMULA IN ACCORDANCE 59
WITH THE RBC INSTRUCTIONS. 60
(C) "COMPANY ACTION LEVEL RBC" MEANS THE PRODUCT OF 2.0 62
AND A HEALTH INSURING CORPORATION'S AUTHORIZED CONTROL LEVEL RBC. 63
(D) "CORRECTIVE ORDER" MEANS AN ORDER ISSUED BY THE 65
SUPERINTENDENT OF INSURANCE SPECIFYING CORRECTIVE ACTIONS THAT 66
THE SUPERINTENDENT DETERMINES ARE REQUIRED. 67
(E) "DOMESTIC HEALTH INSURING CORPORATION" MEANS A HEALTH 69
INSURING CORPORATION DOMICILED IN THIS STATE. 70
(F) "FOREIGN HEALTH INSURING CORPORATION" MEANS A HEALTH 72
INSURING CORPORATION HOLDING A CERTIFICATE OF AUTHORITY UNDER 73
CHAPTER 1751. OF THE REVISED CODE THAT IS DOMICILED OUTSIDE OF 74
THIS STATE.
(G) "MANDATORY CONTROL LEVEL RBC" MEANS THE PRODUCT OF .70 76
AND A HEALTH INSURING CORPORATION'S AUTHORIZED CONTROL LEVEL RBC. 77
(H) "NAIC" MEANS THE NATIONAL ASSOCIATION OF INSURANCE 79
COMMISSIONERS. 80
(I) "NET WORTH" MEANS STATUTORY CAPITAL AND SURPLUS. 82
(J) "RBC" MEANS RISK-BASED CAPITAL. 84
(K) "RBC INSTRUCTIONS" MEANS THE RBC REPORT, INCLUDING 87
RISK-BASED CAPITAL INSTRUCTIONS, AS ADOPTED BY THE NAIC AND AS 88
AMENDED BY THE NAIC FROM TIME TO TIME IN ACCORDANCE WITH THE 89
PROCEDURES ADOPTED BY THE NAIC. "RBC INSTRUCTIONS" ALSO INCLUDES 90
ANY MODIFICATIONS ADOPTED BY THE SUPERINTENDENT OF INSURANCE, AS 91
THE SUPERINTENDENT CONSIDERS TO BE NECESSARY. 93
(L) "RBC LEVEL" MEANS A HEALTH INSURING CORPORATION'S 95
ACTION LEVEL RBC, REGULATORY ACTION LEVEL RBC, AUTHORIZED CONTROL 98
LEVEL RBC, OR MANDATORY CONTROL LEVEL RBC. 99
(M) "RBC PLAN" MEANS A COMPREHENSIVE FINANCIAL PLAN 101
CONTAINING THE ELEMENTS SPECIFIED IN DIVISION (B) OF SECTION 102
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1753.33 OF THE REVISED CODE. 103
(N) "RBC REPORT" MEANS THE REPORT REQUIRED BY SECTION 105
1753.32 OF THE REVISED CODE. 106
(O) "REGULATORY ACTION LEVEL RBC" MEANS THE PRODUCT OF 1.5 108
AND A HEALTH INSURING CORPORATION'S AUTHORIZED CONTROL LEVEL RBC. 109
(P) "REVISED RBC PLAN" MEANS AN RBC PLAN REJECTED BY THE 111
SUPERINTENDENT OF INSURANCE AND THEN REVISED BY A HEALTH INSURING 112
CORPORATION WITH OR WITHOUT INCORPORATING THE SUPERINTENDENT'S 113
RECOMMENDATIONS. 114
(Q) "TOTAL ADJUSTED CAPITAL" MEANS THE SUM OF BOTH OF THE 116
FOLLOWING: 117
(1) A HEALTH INSURING CORPORATION'S NET WORTH AS 119
DETERMINED IN ACCORDANCE WITH THE STATUTORY ACCOUNTING APPLICABLE 120
TO THE ANNUAL FINANCIAL STATEMENTS REQUIRED TO BE FILED UNDER 121
SECTION 1751.32 OF THE REVISED CODE;
(2) SUCH OTHER ITEMS, IF ANY, AS THE RBC INSTRUCTIONS MAY 123
PROVIDE. 124
Sec. 1753.32. (A) EACH DOMESTIC HEALTH INSURING 126
CORPORATION SHALL, ON OR PRIOR TO THE FIRST DAY OF MARCH OF EVERY 127
YEAR, PREPARE AND SUBMIT TO THE SUPERINTENDENT OF INSURANCE A 128
REPORT ON ITS RBC LEVELS AS OF THE END OF THE CALENDAR YEAR JUST 129
ENDED, IN A FORM AND CONTAINING SUCH INFORMATION AS IS REQUIRED 130
BY THE RBC INSTRUCTIONS. IN ADDITION, A DOMESTIC HEALTH INSURING 132
CORPORATION SHALL FILE ITS RBC REPORT AS FOLLOWS:
(1) WITH THE NAIC, IN ACCORDANCE WITH THE RBC 135
INSTRUCTIONS;
(2) WITH THE INSURANCE REGULATORY AUTHORITY OF ANY OTHER 137
STATE IN WHICH THE HEALTH INSURING CORPORATION IS AUTHORIZED TO 138
DO BUSINESS, IF THE INSURANCE REGULATORY AUTHORITY OF THAT STATE 139
HAS SENT A WRITTEN REQUEST TO THE HEALTH INSURING CORPORATION FOR 140
THE RBC REPORT. THE HEALTH INSURING CORPORATION SHALL FILE AN 141
RBC REPORT WITH THE REQUESTING STATE NO LATER THAN THE LATER OF: 142
(a) FIFTEEN DAYS AFTER THE HEALTH INSURING CORPORATION'S 144
RECEIPT OF THE INSURANCE REGULATORY AUTHORITY'S REQUEST FOR THE 145
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RBC REPORT; 146
(b) PRIOR TO THE FIRST DAY OF MARCH. 148
(B) A HEALTH INSURING CORPORATION'S RBC LEVELS SHALL BE 150
DETERMINED IN ACCORDANCE WITH THE FORMULA SET FORTH IN THE RBC 151
INSTRUCTIONS. THE FORMULA SHALL TAKE THE FOLLOWING RISKS INTO 152
ACCOUNT, AND MAY ADJUST FOR THE COVARIANCE BETWEEN THESE RISKS, 153
AS DETERMINED IN EACH CASE BY APPLYING THE FACTORS IN THE MANNER
SET FORTH IN THE RBC INSTRUCTIONS: 154
(1) ASSET RISK; 156
(2) CREDIT RISK; 158
(3) UNDERWRITING RISK; 160
(4) ALL OTHER BUSINESS RISKS AND SUCH OTHER RELEVANT RISKS 162
AS ARE SET FORTH IN THE RBC INSTRUCTIONS. 163
(C) IF A DOMESTIC HEALTH INSURING CORPORATION FILES AN RBC 165
REPORT THAT IN THE JUDGMENT OF THE SUPERINTENDENT IS INACCURATE, 166
THE SUPERINTENDENT SHALL ADJUST THE RBC REPORT TO CORRECT THE 167
INACCURACY AND THEN SHALL PROVIDE A COPY OF THE ADJUSTED RBC 168
REPORT TO THE INSURER. THE SUPERINTENDENT SHALL ALSO PROVIDE THE 169
HEALTH INSURING CORPORATION WITH A STATEMENT OF THE REASONS FOR 170
ANY ADJUSTMENT.
(D) IN ENACTING SECTIONS 1753.31 TO 1753.43 OF THE REVISED 172
CODE, THE GENERAL ASSEMBLY FINDS ALL OF THE FOLLOWING: 173
(1) AN EXCESS OF CAPITAL OVER THE AMOUNT PRODUCED BY THE 175
RISK-BASED CAPITAL REQUIREMENTS OF SECTIONS 1753.31 TO 1753.43 OF 176
THE REVISED CODE, AND THE FORMULAS, SCHEDULES, AND INSTRUCTIONS 177
REFERENCED IN SECTIONS 1753.31 TO 1753.43 OF THE REVISED CODE, IS 178
DESIRABLE IN THE BUSINESS OF INSURANCE. 179
(2) HEALTH INSURING CORPORATIONS, ACCORDINGLY, SHOULD SEEK 181
TO MAINTAIN CAPITAL ABOVE THE RBC LEVELS REQUIRED BY SECTIONS 182
1753.31 TO 1753.43 OF THE REVISED CODE. 183
(3) ADDITIONAL CAPITAL IS USED AND IS USEFUL IN THE 185
BUSINESS OF INSURANCE, HELPING TO SECURE A HEALTH INSURING 186
CORPORATION AGAINST VARIOUS RISKS INHERENT IN, OR AFFECTING, THE 187
BUSINESS OF INSURANCE, WHICH RISKS ARE NOT ACCOUNTED FOR OR ARE 188
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ONLY PARTIALLY MEASURED BY THE RISK-BASED CAPITAL REQUIREMENTS OF 189
SECTIONS 1753.31 TO 1753.43 OF THE REVISED CODE. 190
Sec. 1753.33. (A) FOR PURPOSES OF SECTIONS 1753.31 TO 192
1753.43 OF THE REVISED CODE, A "COMPANY ACTION LEVEL EVENT" IS 193
ANY OF THE FOLLOWING EVENTS: 194
(1) A HEALTH INSURING CORPORATION'S FILING OF AN RBC 196
REPORT THAT INDICATES THAT THE HEALTH INSURING CORPORATION'S 197
TOTAL ADJUSTED CAPITAL IS GREATER THAN OR EQUAL TO ITS REGULATORY 198
ACTION LEVEL RBC BUT LESS THAN ITS COMPANY ACTION LEVEL RBC; 199
(2) THE NOTIFICATION BY THE SUPERINTENDENT OF INSURANCE TO 201
A HEALTH INSURING CORPORATION OF AN ADJUSTMENT TO THE HEALTH 202
INSURING CORPORATION'S RBC REPORT, WHICH ADJUSTED RBC REPORT 203
SHOWS THE HEALTH INSURING CORPORATION'S TOTAL ADJUSTED CAPITAL 204
WITHIN THE RANGE DESCRIBED IN DIVISION (A)(1) OF THIS SECTION, 205
PROVIDED THAT THE HEALTH INSURING CORPORATION DOES NOT CHALLENGE 206
THE ADJUSTED RBC REPORT UNDER SECTION 1753.37 OF THE REVISED 208
CODE;
(3) THE NOTIFICATION BY THE SUPERINTENDENT TO A HEALTH 210
INSURING CORPORATION, FOLLOWING THE HEARING REQUIRED UNDER 211
SECTION 1753.37 OF THE REVISED CODE, THAT THE SUPERINTENDENT HAS 212
REJECTED THE HEALTH INSURING CORPORATION'S CHALLENGE TO AN 213
ADJUSTED RBC REPORT SHOWING THE HEALTH INSURING CORPORATION'S 214
TOTAL ADJUSTED CAPITAL WITHIN THE RANGE DESCRIBED IN DIVISION 215
(A)(1) OF THIS SECTION.
(B) IN THE CASE OF A COMPANY ACTION LEVEL EVENT, THE 217
HEALTH INSURING CORPORATION SHALL PREPARE AND SUBMIT TO THE 218
SUPERINTENDENT AN RBC PLAN THAT SHALL DO ALL OF THE FOLLOWING: 219
(1) IDENTIFY THE CONDITIONS THAT CONTRIBUTED TO THE 221
COMPANY ACTION LEVEL EVENT; 222
(2) CONTAIN PROPOSALS OF CORRECTIVE ACTIONS THAT THE 224
HEALTH INSURING CORPORATION INTENDS TO TAKE TO ELIMINATE THE 225
CONDITIONS CONTRIBUTING TO THE COMPANY ACTION LEVEL EVENT; 226
(3) PROVIDE PROJECTIONS OF THE HEALTH INSURING 228
CORPORATION'S FINANCIAL RESULTS IN THE CURRENT YEAR AND AT LEAST 229
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THE TWO SUCCEEDING YEARS, BOTH IN THE ABSENCE OF THE PROPOSED 230
CORRECTIVE ACTIONS AND GIVING EFFECT TO THE PROPOSED CORRECTIVE 231
ACTIONS. THE PROJECTIONS SHALL INCLUDE PROJECTIONS OF STATUTORY 232
BALANCE SHEETS, OPERATING INCOME, NET INCOME, CAPITAL, SURPLUS,
AND RBC LEVELS. PROJECTIONS FOR BOTH NEW AND RENEWAL BUSINESS 234
MAY INCLUDE SEPARATE PROJECTIONS FOR EACH MAJOR LINE OF BUSINESS, 235
AND MAY SEPARATELY IDENTIFY EACH SIGNIFICANT INCOME, EXPENSE, AND 236
BENEFIT COMPONENT OF THE PROJECTION.
(4) IDENTIFY THE KEY ASSUMPTIONS IMPACTING THE HEALTH 238
INSURING CORPORATION'S PROJECTIONS MADE PURSUANT TO DIVISION 239
(B)(3) OF THIS SECTION, AND DESCRIBE THE SENSITIVITY OF THE 240
PROJECTIONS TO THE ASSUMPTIONS; 241
(5) IDENTIFY THE QUALITY OF, AND PROBLEMS ASSOCIATED WITH, 243
THE HEALTH INSURING CORPORATION'S BUSINESS, INCLUDING, BUT NOT 244
LIMITED TO, ITS ASSETS, ANTICIPATED BUSINESS GROWTH AND 245
ASSOCIATED SURPLUS STRAIN, EXTRAORDINARY EXPOSURE TO RISK, MIX OF 246
BUSINESS, AND THE USE OF REINSURANCE, IF ANY, IN EACH CASE. 247
(C) THE RBC PLAN SHALL BE SUBMITTED WITHIN FORTY-FIVE DAYS 249
AFTER A COMPANY ACTION LEVEL EVENT. HOWEVER, IF A HEALTH 250
INSURING CORPORATION HAS CHALLENGED AN ADJUSTED RBC REPORT 251
PURSUANT TO SECTION 1753.37 OF THE REVISED CODE, AN RBC PLAN NEED 252
NOT BE SUBMITTED UNLESS THE SUPERINTENDENT REJECTS THE CHALLENGE 253
FOLLOWING THE HEARING REQUIRED UNDER SECTION 1753.37 OF THE 254
REVISED CODE. IF THE SUPERINTENDENT REJECTS THE HEALTH INSURING 255
CORPORATION'S CHALLENGE, THE RBC PLAN SHALL BE SUBMITTED WITHIN 256
FORTY-FIVE DAYS AFTER THE SUPERINTENDENT'S NOTIFICATION TO THE 257
HEALTH INSURING CORPORATION OF THE SUPERINTENDENT'S REJECTION OF 258
THE CHALLENGE.
(D)(1) WITHIN SIXTY DAYS AFTER A HEALTH INSURING 260
CORPORATION SUBMITS AN RBC PLAN TO THE SUPERINTENDENT, THE 261
SUPERINTENDENT SHALL EITHER REQUIRE THE HEALTH INSURING 262
CORPORATION TO IMPLEMENT THE RBC PLAN OR SHALL NOTIFY THE HEALTH 263
INSURING CORPORATION THAT THE RBC PLAN IS UNSATISFACTORY IN THE 264
JUDGMENT OF THE SUPERINTENDENT. IF THE SUPERINTENDENT HAS 265
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DETERMINED THAT THE RBC PLAN IS UNSATISFACTORY, THE NOTIFICATION 266
TO THE HEALTH INSURING CORPORATION SHALL SET FORTH THE REASONS 267
FOR THE DETERMINATION, AND MAY SET FORTH PROPOSED REVISIONS THAT
WILL RENDER THE RBC PLAN SATISFACTORY IN THE JUDGMENT OF THE 269
SUPERINTENDENT. UPON ITS RECEIPT OF SUCH NOTIFICATION FROM THE
SUPERINTENDENT, THE HEALTH INSURING CORPORATION SHALL PREPARE AND 270
SUBMIT A REVISED RBC PLAN, WHICH MAY INCORPORATE BY REFERENCE ANY 271
REVISIONS PROPOSED BY THE SUPERINTENDENT. 272
(2) IF A HEALTH INSURING CORPORATION CHALLENGES, UNDER 274
SECTION 1753.37 OF THE REVISED CODE, A NOTIFICATION BY THE 275
SUPERINTENDENT THAT THE HEALTH INSURING CORPORATION'S RBC PLAN OR 276
A REVISED RBC PLAN IS UNSATISFACTORY, SUBMISSION OF A REVISED RBC 277
PLAN NEED NOT BE MADE UNLESS THE SUPERINTENDENT REJECTS THE 278
HEALTH INSURING CORPORATION'S CHALLENGE AND NOTIFIES THE HEALTH 279
INSURING CORPORATION OF THIS REJECTION. A HEALTH INSURING 280
CORPORATION SHALL SUBMIT A REVISED RBC PLAN TO THE SUPERINTENDENT 281
WITHIN FORTY-FIVE DAYS AFTER RECEIVING NOTIFICATION FROM THE 282
SUPERINTENDENT THAT ITS RBC PLAN IS UNSATISFACTORY, OR THAT ITS 283
CHALLENGE TO A NOTIFICATION MADE UNDER DIVISION (D)(1) OF THIS 284
SECTION HAS BEEN REJECTED, AS APPLICABLE.
(E) NOTWITHSTANDING DIVISION (D) OF THIS SECTION, IF THE 286
SUPERINTENDENT NOTIFIES A HEALTH INSURING CORPORATION THAT ITS 287
RBC PLAN OR REVISED RBC PLAN IS UNSATISFACTORY, THE 288
SUPERINTENDENT MAY, AT THE SUPERINTENDENT'S DISCRETION BUT 289
SUBJECT TO THE HEALTH INSURING CORPORATION'S RIGHT TO A HEARING 290
UNDER SECTION 1753.37 OF THE REVISED CODE, SPECIFY IN THE
NOTIFICATION THAT THE NOTIFICATION CONSTITUTES A REGULATORY 291
ACTION LEVEL EVENT. 292
(F) EVERY DOMESTIC HEALTH INSURING CORPORATION THAT 294
SUBMITS AN RBC PLAN OR REVISED RBC PLAN TO THE SUPERINTENDENT 295
SHALL FILE A COPY OF THE RBC PLAN OR REVISED RBC PLAN WITH THE 296
INSURANCE REGULATORY AUTHORITY OF EVERY STATE IN WHICH THE HEALTH 297
INSURING CORPORATION IS AUTHORIZED TO DO BUSINESS UPON RECEIVING
THE INSURANCE REGULATORY AUTHORITY'S WRITTEN REQUEST FOR A COPY 298
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OF THE PLAN, IF THE STATE HAS A CONFIDENTIALITY LAW SUBSTANTIALLY 299
SIMILAR TO SECTION 1753.38 OF THE REVISED CODE. THE HEALTH 300
INSURING CORPORATION SHALL FILE THE COPY IN THAT STATE NO LATER 301
THAN THE LATER OF: 302
(1) FIFTEEN DAYS AFTER RECEIVING THE REQUEST FOR A COPY OF 304
THE PLAN; 305
(2) THE DATE ON WHICH THE RBC PLAN OR REVISED RBC PLAN IS 307
FILED PURSUANT TO DIVISION (C) OR (D) OF THIS SECTION. 308
Sec. 1753.34. (A) FOR PURPOSES OF SECTIONS 1753.31 TO 310
1753.43 OF THE REVISED CODE, A "REGULATORY ACTION LEVEL EVENT" IS 311
ANY OF THE FOLLOWING EVENTS: 312
(1) THE FILING OF AN RBC REPORT BY A HEALTH INSURING 314
CORPORATION THAT INDICATES THAT THE HEALTH INSURING CORPORATION'S 315
TOTAL ADJUSTED CAPITAL IS GREATER THAN OR EQUAL TO ITS AUTHORIZED
CONTROL LEVEL RBC BUT LESS THAN ITS REGULATORY ACTION LEVEL RBC; 316
(2) THE NOTIFICATION BY THE SUPERINTENDENT OF INSURANCE TO 318
A HEALTH INSURING CORPORATION OF AN ADJUSTMENT TO THE HEALTH 319
INSURING CORPORATION'S RBC REPORT, WHICH ADJUSTED RBC REPORT 320
SHOWS THE HEALTH INSURING CORPORATION'S TOTAL ADJUSTED CAPITAL 321
WITHIN THE RANGE DESCRIBED IN DIVISION (A)(1) OF THIS SECTION, 322
PROVIDED THAT THE HEALTH INSURING CORPORATION DOES NOT CHALLENGE 323
THE ADJUSTED RBC REPORT UNDER SECTION 1753.37 OF THE REVISED 325
CODE;
(3) THE NOTIFICATION BY THE SUPERINTENDENT TO A HEALTH 327
INSURING CORPORATION, FOLLOWING THE HEARING REQUIRED UNDER 328
SECTION 1753.37 OF THE REVISED CODE, THAT THE SUPERINTENDENT HAS 329
REJECTED THE HEALTH INSURING CORPORATION'S CHALLENGE TO AN 330
ADJUSTED RBC REPORT SHOWING THE HEALTH INSURING CORPORATION'S 331
TOTAL ADJUSTED CAPITAL WITHIN THE RANGE DESCRIBED IN DIVISION 332
(A)(1) OF THIS SECTION;
(4) THE FAILURE OF A HEALTH INSURING CORPORATION TO FILE 334
AN RBC REPORT BY THE FIRST DAY OF MARCH OF EVERY YEAR, UNLESS THE 335
HEALTH INSURING CORPORATION HAS PROVIDED AN EXPLANATION FOR SUCH 336
FAILURE THAT IS SATISFACTORY TO THE SUPERINTENDENT AND HAS CURED 337
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THE FAILURE WITHIN TEN DAYS AFTER THE FILING DATE; 338
(5) THE FAILURE OF A HEALTH INSURING CORPORATION TO SUBMIT 340
AN RBC PLAN TO THE SUPERINTENDENT WITHIN THE TIME PERIOD SET 341
FORTH IN DIVISION (C) OF SECTION 1753.33 OF THE REVISED CODE; 342
(6) THE NOTIFICATION BY THE SUPERINTENDENT TO A HEALTH 344
INSURING CORPORATION OF BOTH OF THE FOLLOWING: 345
(a) THE RBC PLAN OR REVISED RBC PLAN SUBMITTED BY THE 347
HEALTH INSURING CORPORATION IS UNSATISFACTORY IN THE JUDGMENT OF 348
THE SUPERINTENDENT; 349
(b) THE NOTIFICATION BY THE SUPERINTENDENT CONSTITUTES A 351
REGULATORY ACTION LEVEL EVENT WITH RESPECT TO THE HEALTH INSURING 352
CORPORATION, PROVIDED THAT THE HEALTH INSURING CORPORATION HAS 353
NOT CHALLENGED THE DETERMINATION UNDER SECTION 1753.37 OF THE 354
REVISED CODE.
(7) THE NOTIFICATION BY THE SUPERINTENDENT TO A HEALTH 356
INSURING CORPORATION, FOLLOWING THE HEARING REQUIRED UNDER 357
SECTION 1753.37 OF THE REVISED CODE, THAT THE SUPERINTENDENT HAS 358
REJECTED THE HEALTH INSURING CORPORATION'S CHALLENGE TO THE 359
SUPERINTENDENT'S DETERMINATION UNDER DIVISION (A)(6) OF THIS 360
SECTION;
(8) THE NOTIFICATION BY THE SUPERINTENDENT TO A HEALTH 362
INSURING CORPORATION THAT THE SUPERINTENDENT HAS DETERMINED THAT 363
THE HEALTH INSURING CORPORATION HAS FAILED TO ADHERE TO ITS RBC 364
PLAN OR REVISED RBC PLAN, AND THIS FAILURE HAS HAD A SUBSTANTIAL 365
ADVERSE EFFECT ON THE ABILITY OF THE HEALTH INSURING CORPORATION 366
TO ELIMINATE THE CONDITIONS LEADING TO THE COMPANY ACTION LEVEL 367
EVENT IN ACCORDANCE WITH ITS RBC PLAN OR REVISED RBC PLAN, 368
PROVIDED THAT THE HEALTH INSURING CORPORATION DOES NOT CHALLENGE 369
THIS DETERMINATION UNDER SECTION 1753.37 OF THE REVISED CODE; 370
(9) THE NOTIFICATION BY THE SUPERINTENDENT TO A HEALTH 372
INSURING CORPORATION, FOLLOWING THE HEARING REQUIRED UNDER 373
SECTION 1753.37 OF THE REVISED CODE, THAT THE SUPERINTENDENT HAS 374
REJECTED THE HEALTH INSURING CORPORATION'S CHALLENGE TO THE 375
SUPERINTENDENT'S DETERMINATION UNDER DIVISION (A)(8) OF THIS 376
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SECTION.
(B) IN THE CASE OF A REGULATORY ACTION LEVEL EVENT, THE 378
SUPERINTENDENT SHALL DO ALL OF THE FOLLOWING: 379
(1) REQUIRE THE HEALTH INSURING CORPORATION TO PREPARE AND 381
SUBMIT AN RBC PLAN OR, IF APPLICABLE, A REVISED RBC PLAN; 382
(2) PERFORM SUCH EXAMINATIONS AND ANALYSES AS THE 384
SUPERINTENDENT CONSIDERS NECESSARY OF THE ASSETS, LIABILITIES, 385
AND OPERATIONS OF THE HEALTH INSURING CORPORATION, INCLUDING A 386
REVIEW OF THE HEALTH INSURING CORPORATION'S RBC PLAN OR REVISED 387
RBC PLAN AND THE RESULTS OF ANY SENSITIVITY TESTS UNDERTAKEN 389
PURSUANT TO THE RBC INSTRUCTIONS;
(3) ISSUE A CORRECTIVE ORDER, BASED UPON THE EXAMINATIONS 391
AND ANALYSES PERFORMED UNDER DIVISION (B)(2) OF THIS SECTION. 392
(C)(1) THE RBC PLAN OR REVISED RBC PLAN REQUIRED BY 395
DIVISION (B)(1) OF THIS SECTION SHALL BE SUBMITTED TO THE 397
SUPERINTENDENT WITHIN FORTY-FIVE DAYS AFTER THE REGULATORY ACTION 398
LEVEL EVENT, EXCEPT BY A HEALTH INSURING CORPORATION THAT FILES A 399
CHALLENGE TO AN ADJUSTED RBC REPORT OR REVISED RBC PLAN PURSUANT 400
TO SECTION 1753.37 OF THE REVISED CODE. IF THE SUPERINTENDENT 401
DETERMINES THE CHALLENGE IS FRIVOLOUS, THE TIME LIMIT FOR THE 402
SUBMISSION OF THE RBC PLAN OR REVISED RBC PLAN SHALL NOT BE 403
ALTERED BY THE FILING OF THE CHALLENGE.
(2) IF A HEALTH INSURING CORPORATION FILES A NONFRIVOLOUS 405
CHALLENGE TO AN ADJUSTED RBC REPORT OR REVISED RBC PLAN, THE RBC 406
PLAN OR REVISED RBC PLAN REQUIRED BY DIVISION (B)(1) OF THIS 407
SECTION SHALL ONLY BE SUBMITTED TO THE SUPERINTENDENT IF THE 408
SUPERINTENDENT REJECTS THE CHALLENGE FOLLOWING THE HEARING
REQUIRED UNDER SECTION 1753.37 OF THE REVISED CODE. IF THE 409
SUPERINTENDENT REJECTS THE HEALTH INSURING CORPORATION'S 410
CHALLENGE, THE RBC PLAN OR REVISED RBC PLAN SHALL BE SUBMITTED 411
WITHIN FORTY-FIVE DAYS AFTER THE SUPERINTENDENT'S NOTIFICATION TO 412
THE HEALTH INSURING CORPORATION OF THE SUPERINTENDENT'S REJECTION 413
OF THE CHALLENGE.
(D) THE SUPERINTENDENT MAY RETAIN ACTUARIES, INVESTMENT 415
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EXPERTS, AND SUCH OTHER CONSULTANTS, AS MAY BE NECESSARY IN THE 416
SUPERINTENDENT'S JUDGMENT, TO REVIEW A HEALTH INSURING 417
CORPORATION'S RBC PLAN OR REVISED RBC PLAN, TO EXAMINE OR ANALYZE 418
THE ASSETS, LIABILITIES, AND OPERATION OF THE HEALTH INSURING 419
CORPORATION, AND TO FORMULATE A CORRECTIVE ORDER FOR THE HEALTH
INSURING CORPORATION. THE FEES, COSTS, AND EXPENSES RELATING TO 420
THESE CONSULTANTS SHALL BE BORNE BY THE AFFECTED HEALTH INSURING 421
CORPORATION. 422
Sec. 1753.35. (A) FOR PURPOSES OF SECTIONS 1753.31 TO 424
1753.43 OF THE REVISED CODE, AN "AUTHORIZED CONTROL LEVEL EVENT" 425
IS ANY OF THE FOLLOWING EVENTS: 426
(1) THE FILING OF AN RBC REPORT BY A HEALTH INSURING 428
CORPORATION THAT INDICATES THAT THE HEALTH INSURING CORPORATION'S 429
TOTAL ADJUSTED CAPITAL IS GREATER THAN OR EQUAL TO ITS MANDATORY
CONTROL LEVEL RBC BUT LESS THAN ITS AUTHORIZED CONTROL LEVEL RBC; 430
(2) THE NOTIFICATION BY THE SUPERINTENDENT OF INSURANCE TO 432
A HEALTH INSURING CORPORATION OF AN ADJUSTMENT TO THE HEALTH 433
INSURING CORPORATION'S RBC REPORT, WHICH ADJUSTED RBC REPORT 434
SHOWS THE HEALTH INSURING CORPORATION'S TOTAL ADJUSTED CAPITAL 435
WITHIN THE RANGE DESCRIBED IN DIVISION (A)(1) OF THIS SECTION, 436
PROVIDED THAT THE HEALTH INSURING CORPORATION DOES NOT CHALLENGE 437
THE ADJUSTED RBC REPORT UNDER SECTION 1753.37 OF THE REVISED 439
CODE;
(3) THE NOTIFICATION BY THE SUPERINTENDENT TO A HEALTH 441
INSURING CORPORATION, FOLLOWING THE HEARING REQUIRED UNDER 442
SECTION 1753.37 OF THE REVISED CODE, THAT THE SUPERINTENDENT HAS 443
REJECTED THE HEALTH INSURING CORPORATION'S CHALLENGE TO AN 444
ADJUSTED RBC REPORT SHOWING THE HEALTH INSURING CORPORATION'S 445
TOTAL ADJUSTED CAPITAL WITHIN THE RANGE DESCRIBED IN DIVISION 446
(A)(1) OF THIS SECTION;
(4) THE FAILURE OF A HEALTH INSURING CORPORATION TO 448
RESPOND, IN A MANNER SATISFACTORY TO THE SUPERINTENDENT, TO A 449
CORRECTIVE ORDER ISSUED UNDER DIVISION (B)(3) OF SECTION 1753.34 450
OF THE REVISED CODE, PROVIDED THAT THE HEALTH INSURING 451
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CORPORATION HAS NOT CHALLENGED THE CORRECTIVE ORDER UNDER SECTION 452
1753.37 OF THE REVISED CODE;
(5) THE FAILURE OF A HEALTH INSURING CORPORATION TO 454
RESPOND, IN A MANNER SATISFACTORY TO THE SUPERINTENDENT, TO A 455
CORRECTIVE ORDER ISSUED UNDER DIVISION (B)(3) OF SECTION 1753.34 456
OF THE REVISED CODE SUBSEQUENT TO THE SUPERINTENDENT'S 457
MODIFICATION OF AN EARLIER ORDER OR THE SUPERINTENDENT'S
REJECTION OF THE HEALTH INSURING CORPORATION'S CHALLENGE OF THE
ORDER UNDER SECTION 1753.37 OF THE REVISED CODE. 458
(B) IN THE CASE OF AN AUTHORIZED CONTROL LEVEL EVENT, THE 460
SUPERINTENDENT SHALL DO THE FOLLOWING: 461
(1) TAKE THE ACTIONS REQUIRED UNDER SECTION 1753.34 OF THE 463
REVISED CODE FOR REGULATORY ACTION LEVEL EVENTS; 466
(2) IF THE SUPERINTENDENT CONSIDERS IT TO BE IN THE BEST 468
INTERESTS OF THE SUBSCRIBERS AND CREDITORS OF THE HEALTH INSURING 469
CORPORATION AND OF THE PUBLIC, TAKE SUCH ACTIONS AS ARE NECESSARY 470
TO PLACE THE HEALTH INSURING CORPORATION UNDER REGULATORY CONTROL 471
UNDER SECTIONS 3903.01 TO 3903.59 OF THE REVISED CODE. THE 472
AUTHORIZED CONTROL LEVEL EVENT SHALL BE DEEMED SUFFICIENT GROUNDS 473
FOR THE SUPERINTENDENT TO TAKE ACTION UNDER SECTIONS 3903.01 TO 474
3903.59 OF THE REVISED CODE. NOTHING IN SECTIONS 1753.31 TO 475
1753.43 OF THE REVISED CODE SHALL IMPAIR OR RESTRICT THE RIGHTS, 476
POWERS, AND PROTECTIONS AFFORDED TO THE SUPERINTENDENT AND TO 477
HEALTH INSURING CORPORATIONS UNDER SECTIONS 3903.01 TO 3903.59 OF 478
THE REVISED CODE. 479
Sec. 1753.36. (A) FOR PURPOSES OF SECTIONS 1753.31 TO 481
1753.43 OF THE REVISED CODE, A "MANDATORY CONTROL LEVEL EVENT" IS 482
ANY OF THE FOLLOWING EVENTS: 483
(1) THE FILING OF AN RBC REPORT BY A HEALTH INSURING 485
CORPORATION THAT INDICATES THAT THE HEALTH INSURING CORPORATION'S 486
TOTAL ADJUSTED CAPITAL IS LESS THAN ITS MANDATORY CONTROL LEVEL 487
RBC;
(2) THE NOTIFICATION BY THE SUPERINTENDENT OF INSURANCE TO 489
A HEALTH INSURING CORPORATION OF AN ADJUSTMENT TO THE HEALTH 490
13
INSURING CORPORATION'S RBC REPORT, WHICH ADJUSTED RBC REPORT 491
SHOWS THE HEALTH INSURING CORPORATION'S TOTAL ADJUSTED CAPITAL AT 492
LESS THAN ITS MANDATORY CONTROL LEVEL RBC, PROVIDED THE HEALTH 493
INSURING CORPORATION DOES NOT CHALLENGE THE ADJUSTED RBC REPORT 494
UNDER SECTION 1753.37 OF THE REVISED CODE; 495
(3) THE NOTIFICATION BY THE SUPERINTENDENT TO THE HEALTH 497
INSURING CORPORATION, FOLLOWING THE HEARING REQUIRED UNDER 498
SECTION 1753.37 OF THE REVISED CODE, THAT THE SUPERINTENDENT HAS 499
REJECTED THE HEALTH INSURING CORPORATION'S CHALLENGE TO AN 500
ADJUSTED RBC REPORT.
(B) IN THE CASE OF A MANDATORY CONTROL LEVEL EVENT, THE 502
SUPERINTENDENT SHALL TAKE SUCH ACTIONS AS ARE NECESSARY TO PLACE 503
THE HEALTH INSURING CORPORATION UNDER REGULATORY CONTROL UNDER 504
SECTIONS 3903.01 TO 3903.59 OF THE REVISED CODE. THE MANDATORY 505
CONTROL LEVEL EVENT SHALL BE DEEMED SUFFICIENT GROUNDS FOR THE 506
SUPERINTENDENT TO TAKE ACTION UNDER SECTIONS 3903.01 TO 3903.59 507
OF THE REVISED CODE. NOTHING IN SECTIONS 1753.31 TO 1753.43 OF 508
THE REVISED CODE SHALL IMPAIR OR RESTRICT THE RIGHTS, POWERS, AND 509
PROTECTIONS AFFORDED TO THE SUPERINTENDENT AND TO HEALTH INSURING
CORPORATIONS UNDER SECTIONS 3903.01 TO 3903.59 OF THE REVISED 510
CODE. HOWEVER, THE SUPERINTENDENT MAY DEFER ACTION UNDER THIS 511
DIVISION FOR UP TO NINETY DAYS AFTER THE MANDATORY CONTROL LEVEL 512
EVENT IF THE SUPERINTENDENT FINDS THAT THERE IS A REASONABLE 513
EXPECTATION THE HEALTH INSURING CORPORATION MAY BE ABLE TO 514
ELIMINATE THE CONDITIONS LEADING TO THE MANDATORY CONTROL LEVEL 515
EVENT WITHIN THE NINETY-DAY PERIOD.
Sec. 1753.37. (A) A HEALTH INSURING CORPORATION HAS THE 517
RIGHT TO A CONFIDENTIAL HEARING UPON RECEIVING ANY OF THE 518
FOLLOWING FROM THE SUPERINTENDENT OF INSURANCE: 519
(1) AN ADJUSTED RBC REPORT; 521
(2) NOTIFICATION THAT THE HEALTH INSURING CORPORATION'S 523
RBC PLAN OR REVISED RBC PLAN IS UNSATISFACTORY AND A STATEMENT 524
THAT THE NOTIFICATION CONSTITUTES A REGULATORY ACTION LEVEL EVENT 525
FOR THE HEALTH INSURING CORPORATION; 526
14
(3) NOTIFICATION THAT THE SUPERINTENDENT HAS DETERMINED 528
THAT THE HEALTH INSURING CORPORATION HAS FAILED TO ADHERE TO ITS 529
RBC PLAN OR REVISED RBC PLAN, WHICH FAILURE HAS A SUBSTANTIAL 530
ADVERSE EFFECT ON THE ABILITY OF THE HEALTH INSURING CORPORATION 531
TO ELIMINATE THE CONDITIONS LEADING TO A COMPANY ACTION LEVEL 533
EVENT IN ACCORDANCE WITH ITS RBC PLAN OR REVISED RBC PLAN; 534
(4) A CORRECTIVE ORDER ISSUED UNDER DIVISION (B)(3) OF 536
SECTION 1753.34 OF THE REVISED CODE. 537
(B) A HEALTH INSURING CORPORATION SHALL NOTIFY THE 539
SUPERINTENDENT OF ITS REQUEST FOR A HEARING WITHIN FIVE DAYS 540
AFTER ITS RECEIPT OF ANY ITEM LISTED IN DIVISION (A) OF THIS 541
SECTION. UPON THE SUPERINTENDENT'S RECEIPT OF THE HEALTH 542
INSURING CORPORATION'S REQUEST FOR A HEARING, THE SUPERINTENDENT 543
SHALL SET A DATE FOR THE HEARING, WHICH DATE SHALL BE NO LESS 544
THAN TEN DAYS AND NO MORE THAN THIRTY DAYS AFTER THE
SUPERINTENDENT'S RECEIPT OF THE HEALTH INSURING CORPORATION'S 545
REQUEST. 546
(C) A HEALTH INSURING CORPORATION MAY CHALLENGE ANY 548
DETERMINATION OR ACTION TAKEN BY THE SUPERINTENDENT UNDER 549
SECTIONS 1753.31 TO 1753.43 OF THE REVISED CODE AT THE HEARING 550
HELD PURSUANT TO THIS SECTION. 551
Sec. 1753.38. (A) THE SUPERINTENDENT OF INSURANCE SHALL 553
KEEP ALL OF THE FOLLOWING CONFIDENTIAL: 554
(1) AN RBC REPORT, TO THE EXTENT THAT INFORMATION 556
CONTAINED IN THE REPORT IS NOT REQUIRED TO BE INCLUDED IN AN 557
ANNUAL STATEMENT AVAILABLE TO THE PUBLIC; 558
(2) AN RBC PLAN; 560
(3) THE RESULTS OF, OR REPORTS ON, EXAMINATIONS OR 562
ANALYSES CONDUCTED PURSUANT TO DIVISION (B)(2) OF SECTION 1753.34 563
OF THE REVISED CODE, AND A CORRECTIVE ORDER ISSUED PURSUANT TO 565
DIVISION (B)(3) OF SECTION 1753.34 OF THE REVISED CODE. 566
A DISCLOSURE TO THE SUPERINTENDENT OF THESE PLANS, REPORTS, 568
INFORMATION, AND ORDERS DOES NOT CONSTITUTE A WAIVER OF ANY 569
APPLICABLE PRIVILEGE OR CLAIM OF CONFIDENTIALITY IN THE PLANS, 570
15
REPORTS, INFORMATION, AND ORDERS. 571
(B) NOTWITHSTANDING DIVISION (A) OF THIS SECTION: 573
(1) THE PLANS, REPORTS, INFORMATION, AND ORDERS DESCRIBED 575
IN DIVISION (A) OF THIS SECTION MAY BE USED BY THE SUPERINTENDENT 576
IN ACCORDANCE WITH THE INSURANCE LAWS OF THIS STATE. 577
(2) IN THE PERFORMANCE OF THE SUPERINTENDENT'S DUTIES, THE 579
SUPERINTENDENT MAY SHARE THE PLANS, REPORTS, INFORMATION, AND 580
ORDERS WITH STATE, FEDERAL, AND INTERNATIONAL REGULATORY AGENCIES 581
AND LAW ENFORCEMENT AUTHORITIES, AND WITH THE NAIC AND ITS 582
AFFILIATES AND SUBSIDIARIES, PROVIDED THAT THE RECIPIENT AGREES 583
TO MAINTAIN THE CONFIDENTIALITY OF THE PLANS, REPORTS, 584
INFORMATION, AND ORDERS. 585
(C)(1) THE PLANS, REPORTS, INFORMATION, AND ORDERS 587
DESCRIBED IN DIVISION (A) OF THIS SECTION ARE NOT PUBLIC RECORDS 588
FOR PURPOSES OF SECTION 149.43 OF THE REVISED CODE AND SHALL NOT 589
BE SUBJECT TO SUBPOENA. THE PLANS, REPORTS, INFORMATION, AND 591
ORDERS SHALL NOT BE SUBJECT TO DISCOVERY OR ADMISSIBLE IN 592
EVIDENCE IN ANY PRIVATE CIVIL ACTION. 593
(2) NEITHER THE SUPERINTENDENT NOR ANY PERSON WHO RECEIVES 595
THE PLANS, REPORTS, INFORMATION, AND ORDERS WHILE ACTING UNDER 596
THE AUTHORITY OF THE SUPERINTENDENT SHALL BE PERMITTED OR 597
REQUIRED TO TESTIFY IN ANY PRIVATE CIVIL ACTION CONCERNING THESE 598
PLANS, REPORTS, INFORMATION, AND ORDERS. 599
(D) A COMPARISON OF A HEALTH INSURING CORPORATION'S TOTAL 601
ADJUSTED CAPITAL TO ANY OF ITS RBC LEVELS SHALL NOT BE USED TO 602
RANK INSURERS. 603
(E) RBC INSTRUCTIONS, RBC REPORTS, ADJUSTED RBC REPORTS, 606
RBC PLANS, AND REVISED RBC PLANS SHALL NOT BE USED BY THE 607
SUPERINTENDENT FOR RATEMAKING, CONSIDERED OR INTRODUCED AS 608
EVIDENCE IN ANY RATE PROCEEDING, OR USED BY THE SUPERINTENDENT TO 609
CALCULATE OR DERIVE ANY ELEMENTS OF AN APPROPRIATE PREMIUM LEVEL 610
OR RATE OF RETURN FOR ANY LINE OF INSURANCE THAT A HEALTH 611
INSURING CORPORATION OR ANY AFFILIATE IS AUTHORIZED TO WRITE. 612
(F) EXCEPT AS OTHERWISE REQUIRED UNDER CHAPTER 1751. OR 614
16
1753. OF THE REVISED CODE, IT IS AN UNFAIR AND DECEPTIVE ACT OR 616
PRACTICE IN THE BUSINESS OF INSURANCE UNDER SECTIONS 3901.19 TO 618
3901.26 OF THE REVISED CODE FOR ANY PERSON TO MAKE, PUBLISH, 619
DISSEMINATE, CIRCULATE, OR PLACE BEFORE THE PUBLIC, OR TO CAUSE, 621
DIRECTLY OR INDIRECTLY, TO BE MADE, PUBLISHED, DISSEMINATED,
CIRCULATED, OR PLACED BEFORE THE PUBLIC, IN A NEWSPAPER, 622
MAGAZINE, OR OTHER PUBLICATION, IN THE FORM OF A NOTICE, 623
CIRCULAR, PAMPHLET, LETTER, OR POSTER, OR OVER ANY RADIO OR 624
TELEVISION STATION, OR IN ANY OTHER MANNER, AN ADVERTISEMENT, 625
ANNOUNCEMENT, OR STATEMENT, WRITTEN OR ORAL, THAT CONTAINS AN 626
ASSERTION, REPRESENTATION, OR STATEMENT, REGARDING THE RBC LEVELS 627
OF A HEALTH INSURING CORPORATION, OR ANY COMPONENT DERIVED IN THE 628
CALCULATION OF THE RBC LEVELS.
(G) IF ANY MATERIALLY FALSE STATEMENT IS PUBLISHED 630
COMPARING A HEALTH INSURING CORPORATION'S TOTAL ADJUSTED CAPITAL 631
TO ITS RBC LEVELS, OR ANY INAPPROPRIATE COMPARISON OF ANY OTHER 632
AMOUNT TO ANY OF THE HEALTH INSURING CORPORATION'S RBC LEVELS IS 633
PUBLISHED, AND THE HEALTH INSURING CORPORATION IS ABLE TO 634
DEMONSTRATE TO THE SUPERINTENDENT WITH SUBSTANTIAL PROOF THE 635
FALSITY OF THE STATEMENT OR THE INAPPROPRIATENESS OF THE
COMPARISON, THEN THE HEALTH INSURING CORPORATION MAY PUBLISH WITH 636
THE SUPERINTENDENT'S APPROVAL AN ANNOUNCEMENT IN A WRITTEN 637
PUBLICATION TO REBUT THE MATERIALLY FALSE STATEMENT OR 638
INAPPROPRIATE COMPARISON. 639
Sec. 1753.39. (A) EACH FOREIGN HEALTH INSURING 641
CORPORATION SHALL SUBMIT TO THE SUPERINTENDENT OF INSURANCE, UPON 642
RECEIVING THE SUPERINTENDENT'S WRITTEN REQUEST, AN RBC REPORT FOR 643
THE CALENDAR YEAR JUST ENDED. THE HEALTH INSURING CORPORATION 644
SHALL SUBMIT THE RBC REPORT TO THE SUPERINTENDENT NO LATER THAN 645
THE LATER OF:
(1) THE DATE A DOMESTIC HEALTH INSURING CORPORATION WOULD 647
BE REQUIRED TO FILE AN RBC REPORT UNDER SECTION 1753.32 OF THE 649
REVISED CODE;
(2) FIFTEEN DAYS AFTER THE SUPERINTENDENT'S REQUEST IS 651
17
RECEIVED BY THE FOREIGN HEALTH INSURING CORPORATION. 652
(B) EACH FOREIGN HEALTH INSURING CORPORATION SHALL, UPON 654
RECEIVING THE SUPERINTENDENT'S WRITTEN REQUEST, PROMPTLY SUBMIT 655
TO THE SUPERINTENDENT A COPY OF ANY RBC PLAN OR REVISED RBC PLAN 656
FILED WITH THE INSURANCE REGULATORY AUTHORITY OF ANY OTHER STATE. 657
(C) THE SUPERINTENDENT MAY REQUIRE A FOREIGN HEALTH 659
INSURING CORPORATION TO FILE AN RBC PLAN WITH THE SUPERINTENDENT 660
IN THE CASE OF A COMPANY ACTION LEVEL EVENT, REGULATORY ACTION 661
LEVEL EVENT, OR AUTHORIZED CONTROL LEVEL EVENT INVOLVING THE 662
FOREIGN HEALTH INSURING CORPORATION, IF THE INSURANCE REGULATORY 663
AUTHORITY OF THE STATE OF DOMICILE OF THE FOREIGN HEALTH INSURING 664
CORPORATION FAILS TO REQUIRE THE FOREIGN HEALTH INSURING 665
CORPORATION TO FILE AN RBC PLAN IN THE MANNER SPECIFIED UNDER 666
THAT STATE'S RBC LAWS, IF ANY. THE FAILURE OF A FOREIGN HEALTH 667
INSURING CORPORATION TO FILE AN RBC PLAN OR REVISED RBC PLAN WITH 668
THE SUPERINTENDENT AS REQUIRED SHALL BE GROUNDS FOR THE 669
SUPERINTENDENT TO ORDER THE HEALTH INSURING CORPORATION TO CEASE
AND DESIST FROM WRITING NEW BUSINESS IN THIS STATE. 670
(D) IN THE CASE OF A MANDATORY CONTROL LEVEL EVENT 672
INVOLVING A FOREIGN HEALTH INSURING CORPORATION, IF NO 673
DOMICILIARY RECEIVER HAS BEEN APPOINTED FOR THE FOREIGN HEALTH 674
INSURING CORPORATION UNDER THE REHABILITATION AND LIQUIDATION 675
LAWS APPLICABLE IN THE STATE OF DOMICILE OF THE FOREIGN HEALTH 676
INSURING CORPORATION, THE SUPERINTENDENT MAY MAKE APPLICATION TO 677
THE COURT OF COMMON PLEAS AS PERMITTED IN SECTIONS 3903.50 TO 678
3903.59 OF THE REVISED CODE FOR AN ORDER DIRECTING THE 679
SUPERINTENDENT TO LIQUIDATE THE PROPERTY OF THE FOREIGN HEALTH
INSURING CORPORATION FOUND IN THIS STATE. THE OCCURRENCE OF THE 680
MANDATORY CONTROL LEVEL EVENT SHALL BE DEEMED SUFFICIENT GROUNDS 681
FOR THE SUPERINTENDENT TO MAKE APPLICATION TO THE COURT. 682
Sec. 1753.40. THERE SHALL BE NO LIABILITY ON THE PART OF, 684
AND NO CAUSE OF ACTION SHALL ARISE AGAINST, THE SUPERINTENDENT OF 685
INSURANCE, OR THE DEPARTMENT OF INSURANCE, ITS EMPLOYEES, OR ITS 686
AGENTS, FOR ANY ACTION TAKEN IN THEIR PERFORMANCE OF THE POWERS 687
18
AND DUTIES UNDER SECTIONS 1753.31 TO 1753.43 OF THE REVISED CODE. 688
Sec. 1753.41. UNLESS OTHERWISE PROVIDED, ALL NOTICES SENT 690
TO A HEALTH INSURING CORPORATION BY THE SUPERINTENDENT OF 691
INSURANCE THAT MAY RESULT IN REGULATORY ACTION UNDER SECTIONS 692
1753.31 TO 1753.43 OF THE REVISED CODE SHALL BE EFFECTIVE UPON 693
DISPATCH IF TRANSMITTED BY REGISTERED OR CERTIFIED MAIL. ANY 694
OTHER NOTICE TRANSMITTED SHALL BE EFFECTIVE UPON THE HEALTH
INSURING CORPORATION'S RECEIPT OF THE NOTICE. 695
Sec. 1753.42. THE SUPERINTENDENT OF INSURANCE MAY EXEMPT 697
ANY DOMESTIC HEALTH INSURING CORPORATION FROM THE APPLICATION OF 698
SECTIONS 1753.31 TO 1753.43 OF THE REVISED CODE, IF THE HEALTH 699
INSURING CORPORATION MEETS ALL OF THE FOLLOWING REQUIREMENTS: 700
(A) THE HEALTH INSURING CORPORATION WRITES DIRECT BUSINESS 702
IN THIS STATE ONLY. 703
(B) THE HEALTH INSURING CORPORATION ASSUMES NO REINSURANCE 705
IN EXCESS OF FIVE PER CENT OF DIRECT PREMIUM WRITTEN. 706
(C) THE HEALTH INSURING CORPORATION EITHER: 708
(1) WRITES DIRECT ANNUAL PREMIUMS OF TWO MILLION DOLLARS 710
OR LESS FOR BASIC HEALTH CARE SERVICES; 711
(2) COVERS LESS THAN TWO THOUSAND ENROLLEES UNDER 713
POLICIES, CONTRACTS, CERTIFICATES, OR AGREEMENTS FOR SUPPLEMENTAL 714
HEALTH CARE SERVICES. 715
Sec. 1753.43. THE SUPERINTENDENT OF INSURANCE MAY ADOPT 717
RULES IN ACCORDANCE WITH CHAPTER 119. OF THE REVISED CODE AS ARE 718
REASONABLY NECESSARY FOR THE IMPLEMENTATION AND OPERATION OF 719
SECTIONS 1753.31 TO 1753.43 OF THE REVISED CODE. 720
Section 2. That existing section 1753.01 of the Revised 722
Code is hereby repealed. 723
Section 3. The authorized control level RBC, as defined by 725
division (B) of section 1753.31 of the Revised Code, as enacted 726
by this act, shall be adjusted for use in reports filed for 727
periods through December 31, 2001. Notwithstanding division (B) 728
of section 1753.31 of the Revised Code, the authorized control 729
level RBC shall be the product of 0.90 and the number determined 730
19
under the risk-based capital formula in accordance with the RBC 731
instructions. Thereafter, the authorized control level RBC shall 732
be determined in accordance with division (B) of section 1753.31 733
of the Revised Code without this adjustment. 734