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As Reported by House Insurance Committee
123rd General Assembly
Regular Session
1999-2000 | Am. H. B. No. 714 |
REPRESENTATIVES EVANS-NETZLEY-GOODMAN-BRITTON-JONES-
SMITH-BENDER-SCHURING-JOLIVETTE-WILLAMOWSKI-CLANCY-
GARDNER-HOLLISTER-WINKLER-TIBERI
A BILL
To amend section 1753.01 and to enact sections 1753.31 to 1753.43
of the Revised Code to apply, with modifications, the National
Association of Insurance Commissioners' Risk-Based Capital for
Insurers Model Act to health insuring corporations.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1. That section 1753.01 be amended and sections 1753.31,
1753.32, 1753.33, 1753.34, 1753.35, 1753.36, 1753.37, 1753.38,
1753.39, 1753.40, 1753.41, 1753.42, and 1753.43 of the Revised
Code be enacted to read as follows:
Sec. 1753.01. As used in this chapter:
(A) "Economic profiling" means a health insuring
corporation's use of economic performance data and economic
information in determining whether to contract with a provider
for the provision of covered health care services to enrollees
as a participating provider.
(B) "Basic health care services," "enrollee," "health care
facility," "health care services," "health insuring corporation," "medical
record," "PERSON," "PRIMARY CARE PROVIDER,"
"provider,"
and "SUBSCRIBER," AND "supplemental health care services"
have the same
meanings as in section 1751.01 of
the Revised Code.
Sec. 1753.31. AS USED IN SECTIONS 1753.31 TO 1753.43 OF THE
REVISED
CODE:
(A) "ADJUSTED RBC REPORT" MEANS AN RBC
REPORT THAT HAS BEEN
ADJUSTED BY THE SUPERINTENDENT OF INSURANCE IN ACCORDANCE WITH DIVISION
(C) OF SECTION 1753.32 OF THE REVISED CODE.
(B) "AUTHORIZED CONTROL LEVEL RBC" MEANS THE NUMBER
DETERMINED
UNDER THE RISK-BASED CAPITAL FORMULA IN ACCORDANCE WITH THE RBC
INSTRUCTIONS.
(C) "COMPANY ACTION LEVEL RBC" MEANS THE PRODUCT OF 2.0 AND A
HEALTH INSURING CORPORATION'S AUTHORIZED CONTROL LEVEL RBC.
(D) "CORRECTIVE ORDER" MEANS AN ORDER ISSUED BY THE
SUPERINTENDENT OF INSURANCE SPECIFYING CORRECTIVE ACTIONS THAT THE SUPERINTENDENT DETERMINES ARE
REQUIRED.
(E) "DOMESTIC HEALTH INSURING CORPORATION" MEANS A HEALTH
INSURING CORPORATION DOMICILED IN THIS STATE.
(F) "FOREIGN HEALTH INSURING CORPORATION" MEANS A HEALTH INSURING
CORPORATION HOLDING A CERTIFICATE OF AUTHORITY UNDER CHAPTER 1751.
OF THE REVISED CODE THAT IS DOMICILED OUTSIDE OF THIS STATE.
(G) "MANDATORY CONTROL LEVEL RBC" MEANS THE PRODUCT OF .70 AND A
HEALTH INSURING CORPORATION'S AUTHORIZED CONTROL LEVEL RBC.
(H) "NAIC" MEANS THE NATIONAL ASSOCIATION OF INSURANCE
COMMISSIONERS.
(I) "NET WORTH" MEANS STATUTORY CAPITAL AND SURPLUS.
(J) "RBC" MEANS RISK-BASED CAPITAL.
(K) "RBC INSTRUCTIONS" MEANS THE RBC
REPORT, INCLUDING RISK-BASED
CAPITAL INSTRUCTIONS, AS ADOPTED BY THE NAIC AND AS AMENDED BY THE
NAIC FROM TIME TO TIME IN ACCORDANCE WITH THE PROCEDURES ADOPTED
BY THE NAIC. "RBC INSTRUCTIONS" ALSO INCLUDES ANY
MODIFICATIONS ADOPTED BY THE SUPERINTENDENT OF INSURANCE, AS THE
SUPERINTENDENT CONSIDERS TO BE
NECESSARY.
(L) "RBC LEVEL" MEANS A HEALTH INSURING CORPORATION'S
ACTION
LEVEL RBC, REGULATORY ACTION LEVEL RBC, AUTHORIZED
CONTROL LEVEL
RBC, OR MANDATORY CONTROL LEVEL RBC.
(M) "RBC PLAN" MEANS A COMPREHENSIVE FINANCIAL PLAN CONTAINING
THE ELEMENTS SPECIFIED IN DIVISION (B) OF SECTION 1753.33 OF THE
REVISED CODE.
(N) "RBC REPORT" MEANS THE REPORT REQUIRED BY SECTION 1753.32 OF
THE REVISED CODE.
(O) "REGULATORY ACTION LEVEL RBC" MEANS THE PRODUCT OF 1.5 AND A
HEALTH INSURING CORPORATION'S AUTHORIZED CONTROL LEVEL RBC.
(P) "REVISED RBC PLAN" MEANS AN RBC PLAN REJECTED BY THE
SUPERINTENDENT OF INSURANCE AND THEN REVISED BY A HEALTH INSURING
CORPORATION WITH OR WITHOUT INCORPORATING THE SUPERINTENDENT'S
RECOMMENDATIONS.
(Q) "TOTAL ADJUSTED CAPITAL" MEANS THE SUM OF BOTH OF THE
FOLLOWING:
(1) A HEALTH INSURING CORPORATION'S NET WORTH AS DETERMINED IN
ACCORDANCE WITH THE STATUTORY ACCOUNTING APPLICABLE TO THE ANNUAL FINANCIAL STATEMENTS REQUIRED TO BE FILED
UNDER SECTION 1751.32 OF THE REVISED CODE;
(2) SUCH OTHER ITEMS, IF ANY, AS THE RBC INSTRUCTIONS MAY
PROVIDE.
Sec. 1753.32. (A) EACH DOMESTIC HEALTH INSURING CORPORATION
SHALL, ON OR PRIOR TO THE FIRST DAY OF MARCH OF EVERY YEAR,
PREPARE AND SUBMIT TO THE SUPERINTENDENT OF INSURANCE A REPORT ON ITS
RBC LEVELS AS OF THE END OF THE CALENDAR YEAR JUST ENDED,
IN A FORM AND CONTAINING SUCH INFORMATION AS IS REQUIRED BY THE
RBC INSTRUCTIONS. IN ADDITION, A DOMESTIC HEALTH
INSURING CORPORATION SHALL FILE ITS RBC REPORT AS FOLLOWS:
(1) WITH THE NAIC, IN ACCORDANCE WITH THE RBC
INSTRUCTIONS;
(2) WITH THE INSURANCE REGULATORY AUTHORITY OF ANY OTHER STATE IN
WHICH THE HEALTH INSURING CORPORATION IS AUTHORIZED TO DO BUSINESS, IF
THE INSURANCE REGULATORY AUTHORITY OF THAT STATE HAS SENT A WRITTEN
REQUEST TO THE HEALTH INSURING CORPORATION FOR THE RBC REPORT.
THE HEALTH INSURING CORPORATION SHALL FILE AN RBC REPORT WITH THE
REQUESTING STATE NO LATER THAN THE LATER OF:
(a) FIFTEEN DAYS AFTER THE HEALTH INSURING CORPORATION'S RECEIPT
OF THE INSURANCE REGULATORY AUTHORITY'S REQUEST FOR THE RBC
REPORT;
(b) PRIOR TO THE FIRST DAY OF MARCH.
(B) A HEALTH INSURING CORPORATION'S RBC LEVELS SHALL BE
DETERMINED IN ACCORDANCE WITH THE FORMULA SET FORTH IN THE RBC
INSTRUCTIONS. THE FORMULA SHALL TAKE THE FOLLOWING RISKS INTO ACCOUNT, AND MAY ADJUST FOR THE
COVARIANCE BETWEEN THESE RISKS, AS DETERMINED IN EACH CASE BY APPLYING THE FACTORS IN THE MANNER
SET FORTH IN THE RBC INSTRUCTIONS:
(1) ASSET RISK;
(2) CREDIT RISK;
(3) UNDERWRITING RISK;
(4) ALL OTHER BUSINESS RISKS AND SUCH OTHER RELEVANT RISKS AS ARE
SET FORTH IN THE RBC INSTRUCTIONS.
(C) IF A DOMESTIC HEALTH INSURING CORPORATION FILES AN
RBC REPORT
THAT IN THE JUDGMENT OF THE SUPERINTENDENT IS INACCURATE, THE
SUPERINTENDENT SHALL ADJUST THE RBC REPORT TO CORRECT THE
INACCURACY AND THEN SHALL PROVIDE A COPY OF THE ADJUSTED RBC
REPORT TO THE HEALTH INSURING CORPORATION. THE SUPERINTENDENT SHALL
ALSO PROVIDE THE HEALTH INSURING CORPORATION WITH
A STATEMENT OF THE REASONS FOR ANY ADJUSTMENT.
(D) IN ENACTING SECTIONS 1753.31 TO 1753.43 OF THE
REVISED CODE,
THE GENERAL ASSEMBLY FINDS ALL OF THE FOLLOWING:
(1) AN EXCESS OF CAPITAL OVER THE AMOUNT PRODUCED BY THE
RISK-BASED CAPITAL REQUIREMENTS OF SECTIONS 1753.31 TO 1753.43 OF THE
REVISED CODE, AND THE FORMULAS, SCHEDULES, AND INSTRUCTIONS
REFERENCED IN SECTIONS 1753.31 TO 1753.43 OF THE REVISED CODE, IS
DESIRABLE IN THE BUSINESS OF INSURANCE.
(2) HEALTH INSURING CORPORATIONS, ACCORDINGLY, SHOULD SEEK TO
MAINTAIN CAPITAL ABOVE THE RBC LEVELS REQUIRED BY SECTIONS 1753.31
TO 1753.43 OF THE REVISED CODE.
(3) ADDITIONAL CAPITAL IS USED AND IS USEFUL IN THE BUSINESS OF
INSURANCE, HELPING TO SECURE A HEALTH INSURING CORPORATION AGAINST
VARIOUS RISKS INHERENT IN, OR AFFECTING, THE BUSINESS OF INSURANCE,
WHICH RISKS ARE NOT ACCOUNTED FOR OR ARE ONLY PARTIALLY MEASURED
BY THE RISK-BASED CAPITAL REQUIREMENTS OF SECTIONS 1753.31 TO
1753.43 OF THE REVISED CODE.
Sec. 1753.33. (A) FOR PURPOSES OF SECTIONS 1753.31 TO 1753.43
OF THE REVISED CODE, A "COMPANY ACTION LEVEL EVENT" IS ANY OF THE
FOLLOWING EVENTS:
(1) A HEALTH INSURING CORPORATION'S FILING OF AN RBC REPORT THAT
INDICATES THAT THE HEALTH INSURING CORPORATION'S TOTAL ADJUSTED
CAPITAL IS GREATER THAN OR EQUAL TO ITS REGULATORY ACTION LEVEL
RBC BUT LESS THAN ITS COMPANY ACTION LEVEL RBC;
(2) THE NOTIFICATION BY THE SUPERINTENDENT OF INSURANCE TO A
HEALTH INSURING CORPORATION OF AN ADJUSTMENT TO THE HEALTH INSURING
CORPORATION'S RBC REPORT, WHICH ADJUSTED RBC REPORT SHOWS THE
HEALTH INSURING CORPORATION'S TOTAL ADJUSTED CAPITAL WITHIN THE RANGE
DESCRIBED IN DIVISION (A)(1) OF THIS SECTION, PROVIDED THAT
THE HEALTH INSURING CORPORATION DOES NOT CHALLENGE THE ADJUSTED
RBC REPORT UNDER SECTION 1753.37 OF THE REVISED
CODE;
(3) THE NOTIFICATION BY THE SUPERINTENDENT TO A HEALTH INSURING
CORPORATION, FOLLOWING THE HEARING REQUIRED UNDER SECTION 1753.37 OF THE
REVISED CODE, THAT THE SUPERINTENDENT HAS REJECTED THE HEALTH
INSURING CORPORATION'S CHALLENGE TO AN ADJUSTED RBC REPORT SHOWING
THE HEALTH INSURING CORPORATION'S TOTAL ADJUSTED CAPITAL WITHIN THE RANGE
DESCRIBED IN DIVISION (A)(1) OF THIS SECTION.
(B) IN THE CASE OF A COMPANY ACTION LEVEL EVENT, THE HEALTH
INSURING CORPORATION SHALL PREPARE AND SUBMIT TO THE SUPERINTENDENT AN
RBC PLAN THAT SHALL DO ALL OF THE FOLLOWING:
(1) IDENTIFY THE CONDITIONS THAT CONTRIBUTED TO THE COMPANY
ACTION LEVEL EVENT;
(2) CONTAIN PROPOSALS OF CORRECTIVE ACTIONS THAT THE HEALTH
INSURING CORPORATION INTENDS TO TAKE TO ELIMINATE THE CONDITIONS
CONTRIBUTING TO THE COMPANY ACTION LEVEL EVENT;
(3) PROVIDE PROJECTIONS OF THE HEALTH INSURING CORPORATION'S
FINANCIAL RESULTS IN THE CURRENT YEAR AND AT LEAST THE TWO SUCCEEDING
YEARS, BOTH IN THE ABSENCE OF THE PROPOSED CORRECTIVE ACTIONS AND
GIVING EFFECT TO THE PROPOSED CORRECTIVE ACTIONS. THE PROJECTIONS SHALL INCLUDE PROJECTIONS OF
STATUTORY BALANCE SHEETS, OPERATING INCOME, NET INCOME, CAPITAL, SURPLUS,
AND RBC LEVELS. PROJECTIONS FOR BOTH NEW AND RENEWAL
BUSINESS MAY INCLUDE SEPARATE PROJECTIONS FOR EACH MAJOR LINE OF
BUSINESS, AND MAY SEPARATELY IDENTIFY EACH SIGNIFICANT
INCOME, EXPENSE, AND BENEFIT COMPONENT OF THE PROJECTION.
(4) IDENTIFY THE KEY ASSUMPTIONS IMPACTING THE HEALTH INSURING
CORPORATION'S PROJECTIONS MADE PURSUANT TO DIVISION (B)(3) OF THIS
SECTION, AND DESCRIBE THE SENSITIVITY OF THE PROJECTIONS TO THE
ASSUMPTIONS;
(5) IDENTIFY THE QUALITY OF, AND PROBLEMS ASSOCIATED WITH, THE
HEALTH INSURING CORPORATION'S BUSINESS, INCLUDING, BUT NOT LIMITED TO,
ITS ASSETS, ANTICIPATED BUSINESS GROWTH AND ASSOCIATED SURPLUS STRAIN,
EXTRAORDINARY EXPOSURE TO RISK, MIX OF BUSINESS, AND THE USE OF
REINSURANCE, IF ANY,IN EACH CASE.
(C) THE RBC PLAN SHALL BE SUBMITTED WITHIN FORTY-FIVE DAYS AFTER
A COMPANY ACTION LEVEL EVENT. HOWEVER, IF A HEALTH INSURING CORPORATION
HAS CHALLENGED AN ADJUSTED RBC REPORT PURSUANT TO SECTION
1753.37 OF THE REVISED CODE, AN RBC PLAN NEED NOT BE SUBMITTED
UNLESS THE SUPERINTENDENT REJECTS THE CHALLENGE FOLLOWING THE HEARING
REQUIRED UNDER SECTION 1753.37 OF THE REVISED CODE. IF THE
SUPERINTENDENT REJECTS THE HEALTH INSURING CORPORATION'S
CHALLENGE, THE RBC PLAN SHALL BE SUBMITTED WITHIN FORTY-FIVE DAYS
AFTER THE SUPERINTENDENT'S NOTIFICATION TO THE HEALTH INSURING CORPORATION OF THE SUPERINTENDENT'S
REJECTION OF THE CHALLENGE.
(D)(1) WITHIN SIXTY DAYS AFTER A HEALTH INSURING CORPORATION
SUBMITS AN RBC PLAN TO THE SUPERINTENDENT, THE SUPERINTENDENT
SHALL EITHER REQUIRE THE HEALTH INSURING CORPORATION TO IMPLEMENT THE
RBC PLAN OR NOTIFY THE HEALTH INSURING CORPORATION
THAT THE RBC PLAN IS UNSATISFACTORY IN THE JUDGMENT OF THE
SUPERINTENDENT. IF THE SUPERINTENDENT HAS DETERMINED THAT THE RBC
PLAN IS UNSATISFACTORY, THE NOTIFICATION TO THE HEALTH INSURING CORPORATION
SHALL SET FORTH THE
REASONS FOR THE DETERMINATION, AND MAY SET FORTH PROPOSED REVISIONS THAT
WILL RENDER THE RBC PLAN SATISFACTORY IN THE JUDGMENT OF
THE SUPERINTENDENT. UPON ITS RECEIPT OF SUCH NOTIFICATION FROM THE
SUPERINTENDENT, THE
HEALTH INSURING CORPORATION SHALL PREPARE AND SUBMIT A REVISED RBC
PLAN, WHICH MAY INCORPORATE BY REFERENCE ANY REVISIONS PROPOSED BY
THE SUPERINTENDENT.
(2) IF A HEALTH INSURING CORPORATION CHALLENGES, UNDER SECTION
1753.37 OF THE REVISED CODE, A NOTIFICATION BY THE SUPERINTENDENT
THAT THE HEALTH INSURING CORPORATION'S RBC PLAN OR A REVISED RBC
PLAN IS UNSATISFACTORY, SUBMISSION OF A REVISED RBC PLAN NEED NOT
BE MADE UNLESS THE SUPERINTENDENT REJECTS THE HEALTH INSURING CORPORATION'S CHALLENGE AND NOTIFIES
THE HEALTH INSURING CORPORATION OF THIS REJECTION. A HEALTH
INSURING CORPORATION SHALL SUBMIT A REVISED RBC PLAN TO THE
SUPERINTENDENT WITHIN FORTY-FIVE DAYS AFTER RECEIVING NOTIFICATION FROM
THE SUPERINTENDENT THAT ITS RBC PLAN IS UNSATISFACTORY, OR
THAT ITS CHALLENGE TO A NOTIFICATION MADE UNDER DIVISION (D)(1) OF
THIS SECTION HAS BEEN REJECTED, AS APPLICABLE.
(E) NOTWITHSTANDING DIVISION (D) OF THIS SECTION, IF THE
SUPERINTENDENT NOTIFIES A HEALTH INSURING CORPORATION THAT ITS RBC
PLAN OR REVISED RBC PLAN IS UNSATISFACTORY, THE SUPERINTENDENT
MAY, AT THE SUPERINTENDENT'S DISCRETION BUT SUBJECT TO THE HEALTH INSURING CORPORATION'S RIGHT TO A
HEARING UNDER SECTION 1753.37 OF THE REVISED CODE, SPECIFY IN THE
NOTIFICATION THAT THE NOTIFICATION CONSTITUTES A REGULATORY ACTION LEVEL
EVENT.
(F) EVERY DOMESTIC HEALTH INSURING CORPORATION THAT SUBMITS AN
RBC PLAN OR REVISED RBC PLAN TO THE SUPERINTENDENT
SHALL FILE A COPY OF THE RBC PLAN OR REVISED RBC PLAN WITH THE
INSURANCE REGULATORY AUTHORITY OF EVERY STATE IN WHICH THE HEALTH INSURING CORPORATION IS AUTHORIZED TO DO BUSINESS UPON RECEIVING
THE INSURANCE REGULATORY AUTHORITY'S WRITTEN REQUEST FOR A COPY OF
THE PLAN, IF THE STATE HAS A CONFIDENTIALITY LAW SUBSTANTIALLY
SIMILAR TO SECTION 1753.38 OF THE REVISED CODE. THE HEALTH
INSURING CORPORATION SHALL FILE THE COPY IN THAT STATE NO LATER THAN THE
LATER OF:
(1) FIFTEEN DAYS AFTER RECEIVING THE REQUEST FOR A COPY OF THE
PLAN;
(2) THE DATE ON WHICH THE RBC PLAN OR REVISED RBC PLAN IS FILED
PURSUANT TO DIVISION (C) OR (D) OF THIS SECTION.
Sec. 1753.34. (A) FOR PURPOSES OF SECTIONS 1753.31 TO 1753.43
OF THE REVISED CODE, A "REGULATORY ACTION LEVEL EVENT" IS ANY OF
THE FOLLOWING EVENTS:
(1) THE FILING OF AN RBC REPORT BY A HEALTH INSURING CORPORATION
THAT INDICATES THAT THE HEALTH INSURING CORPORATION'S TOTAL ADJUSTED CAPITAL IS GREATER THAN OR EQUAL TO ITS AUTHORIZED CONTROL
LEVEL RBC BUT LESS THAN ITS REGULATORY ACTION LEVEL RBC;
(2) THE NOTIFICATION BY THE SUPERINTENDENT OF INSURANCE TO A
HEALTH INSURING CORPORATION OF AN ADJUSTMENT TO THE HEALTH INSURING
CORPORATION'S RBC REPORT, WHICH ADJUSTED RBC REPORT SHOWS THE
HEALTH INSURING CORPORATION'S TOTAL ADJUSTED CAPITAL WITHIN THE
RANGE DESCRIBED IN DIVISION (A)(1) OF THIS SECTION, PROVIDED THAT
THE HEALTH INSURING CORPORATION DOES NOT CHALLENGE THE ADJUSTED
RBC REPORT UNDER SECTION 1753.37 OF THE REVISED
CODE;
(3) THE NOTIFICATION BY THE SUPERINTENDENT TO A HEALTH INSURING
CORPORATION, FOLLOWING THE HEARING REQUIRED UNDER SECTION 1753.37 OF THE
REVISED CODE, THAT THE SUPERINTENDENT HAS REJECTED THE HEALTH
INSURING CORPORATION'S CHALLENGE TO AN ADJUSTED RBC REPORT SHOWING
THE HEALTH INSURING CORPORATION'S TOTAL ADJUSTED CAPITAL WITHIN THE RANGE
DESCRIBED IN DIVISION (A)(1) OF THIS SECTION;
(4) THE FAILURE OF A HEALTH INSURING CORPORATION TO FILE AN RBC
REPORT BY THE FIRST DAY OF MARCH OF EVERY YEAR, UNLESS THE HEALTH
INSURING CORPORATION HAS PROVIDED AN EXPLANATION FOR SUCH FAILURE THAT IS SATISFACTORY TO THE
SUPERINTENDENT AND HAS CURED THE FAILURE WITHIN TEN DAYS AFTER THE FILING
DATE;
(5) THE FAILURE OF A HEALTH INSURING CORPORATION TO SUBMIT AN RBC
PLAN TO THE SUPERINTENDENT WITHIN THE TIME PERIOD SET FORTH IN DIVISION
(C) OF SECTION 1753.33 OF THE REVISED CODE;
(6) THE NOTIFICATION BY THE SUPERINTENDENT TO A HEALTH INSURING
CORPORATION OF BOTH OF THE FOLLOWING:
(a) THE RBC PLAN OR REVISED RBC PLAN SUBMITTED BY THE HEALTH
INSURING CORPORATION IS UNSATISFACTORY IN THE JUDGMENT OF THE
SUPERINTENDENT;
(b) THE NOTIFICATION BY THE SUPERINTENDENT CONSTITUTES A
REGULATORY ACTION LEVEL EVENT WITH RESPECT TO THE HEALTH INSURING CORPORATION,
PROVIDED THAT THE
HEALTH INSURING CORPORATION DOES NOT CHALLENGE THE DETERMINATION
UNDER SECTION 1753.37 OF THE REVISED CODE.
(7) THE NOTIFICATION BY THE SUPERINTENDENT TO A HEALTH INSURING
CORPORATION, FOLLOWING THE HEARING REQUIRED UNDER SECTION 1753.37 OF THE
REVISED CODE, THAT THE SUPERINTENDENT HAS REJECTED THE
HEALTH
INSURING CORPORATION'S CHALLENGE TO THE SUPERINTENDENT'S DETERMINATION
UNDER DIVISION (A)(6) OF THIS SECTION;
(8) THE NOTIFICATION BY THE SUPERINTENDENT TO A HEALTH INSURING
CORPORATION THAT THE SUPERINTENDENT HAS DETERMINED THAT THE HEALTH
INSURING CORPORATION HAS FAILED TO ADHERE TO ITS RBC PLAN OR
REVISED RBC PLAN, AND THIS FAILURE HAS HAD A SUBSTANTIAL ADVERSE
EFFECT ON THE ABILITY OF THE HEALTH INSURING CORPORATION TO ELIMINATE THE CONDITIONS LEADING TO THE
COMPANY ACTION LEVEL EVENT IN ACCORDANCE WITH ITS RBC PLAN OR
REVISED RBC PLAN, PROVIDED THAT THE HEALTH INSURING CORPORATION
DOES NOT CHALLENGE THIS DETERMINATION UNDER SECTION 1753.37 OF THE
REVISED CODE;
(9) THE NOTIFICATION BY THE SUPERINTENDENT TO A HEALTH INSURING
CORPORATION, FOLLOWING THE HEARING REQUIRED UNDER SECTION 1753.37 OF THE
REVISED CODE, THAT THE SUPERINTENDENT HAS REJECTED THE HEALTH
INSURING CORPORATION'S CHALLENGE TO THE SUPERINTENDENT'S DETERMINATION
UNDER DIVISION (A)(8) OF THIS SECTION.
(B) IN THE CASE OF A REGULATORY ACTION LEVEL EVENT, THE
SUPERINTENDENT SHALL DO ALL OF THE FOLLOWING:
(1) REQUIRE THE HEALTH INSURING CORPORATION TO PREPARE AND SUBMIT
AN RBC PLAN OR, IF APPLICABLE, A REVISED RBC PLAN;
(2) PERFORM SUCH EXAMINATIONS AND ANALYSES AS THE SUPERINTENDENT
CONSIDERS NECESSARY OF THE ASSETS, LIABILITIES, AND OPERATIONS OF THE
HEALTH INSURING CORPORATION, INCLUDING A REVIEW OF THE HEALTH INSURING
CORPORATION'S RBC PLAN OR REVISED RBC PLAN AND
THE RESULTS OF ANY
SENSITIVITY TESTS UNDERTAKEN PURSUANT TO THE RBC INSTRUCTIONS;
(3) ISSUE A CORRECTIVE ORDER, BASED UPON THE EXAMINATIONS AND
ANALYSES PERFORMED UNDER DIVISION (B)(2) OF THIS SECTION.
(C)(1) THE RBC PLAN OR REVISED RBC PLAN
REQUIRED BY DIVISION
(B)(1) OF THIS SECTION SHALL BE
SUBMITTED TO THE SUPERINTENDENT WITHIN FORTY-FIVE DAYS AFTER THE
REGULATORY ACTION LEVEL EVENT, EXCEPT BY A HEALTH INSURING
CORPORATION THAT FILES A CHALLENGE TO AN ADJUSTED RBC REPORT OR
REVISED RBC PLAN PURSUANT TO SECTION 1753.37 OF THE REVISED CODE.
IF THE SUPERINTENDENT DETERMINES THE CHALLENGE IS FRIVOLOUS, THE TIME
LIMIT FOR THE SUBMISSION OF THE RBC PLAN OR REVISED RBC
PLAN SHALL NOT BE ALTERED BY THE FILING OF THE CHALLENGE.
(2) IF A HEALTH INSURING CORPORATION FILES A NONFRIVOLOUS
CHALLENGE TO AN ADJUSTED RBC REPORT OR REVISED RBC PLAN, THE RBC
PLAN OR REVISED RBC PLAN REQUIRED BY DIVISION (B)(1) OF THIS
SECTION SHALL ONLY BE SUBMITTED TO THE SUPERINTENDENT IF THE SUPERINTENDENT REJECTS THE CHALLENGE FOLLOWING THE HEARING REQUIRED
UNDER SECTION 1753.37 OF THE REVISED CODE. IF THE SUPERINTENDENT
REJECTS THE HEALTH INSURING CORPORATION'S CHALLENGE, THE RBC PLAN
OR REVISED RBC PLAN SHALL BE SUBMITTED WITHIN FORTY-FIVE DAYS
AFTER THE SUPERINTENDENT'S NOTIFICATION TO THE HEALTH INSURING CORPORATION OF THE SUPERINTENDENT'S
REJECTION OF THE CHALLENGE.
(D) THE SUPERINTENDENT MAY RETAIN ACTUARIES, INVESTMENT EXPERTS,
AND SUCH OTHER CONSULTANTS, AS MAY BE NECESSARY IN THE SUPERINTENDENT'S JUDGMENT, TO REVIEW A HEALTH
INSURING CORPORATION'S RBC PLAN OR REVISED RBC PLAN, TO EXAMINE OR
ANALYZE THE ASSETS, LIABILITIES, AND OPERATION OF THE HEALTH
INSURING CORPORATION, AND TO FORMULATE A CORRECTIVE ORDER FOR THE HEALTH
INSURING CORPORATION. THE FEES, COSTS, AND EXPENSES RELATING TO THESE
CONSULTANTS SHALL BE BORNE BY THE AFFECTED HEALTH INSURING
CORPORATION.
Sec. 1753.35. (A) FOR PURPOSES OF SECTIONS 1753.31 TO 1753.43
OF THE REVISED CODE, AN "AUTHORIZED CONTROL LEVEL EVENT" IS ANY OF
THE FOLLOWING EVENTS:
(1) THE FILING OF AN RBC REPORT BY A HEALTH INSURING CORPORATION
THAT INDICATES THAT THE HEALTH INSURING CORPORATION'S TOTAL ADJUSTED CAPITAL IS GREATER THAN OR EQUAL TO ITS MANDATORY CONTROL
LEVEL RBC BUT LESS THAN ITS AUTHORIZED CONTROL LEVEL RBC;
(2) THE NOTIFICATION BY THE SUPERINTENDENT OF INSURANCE TO A
HEALTH INSURING CORPORATION OF AN ADJUSTMENT TO THE HEALTH INSURING
CORPORATION'S RBC REPORT, WHICH ADJUSTED RBC REPORT SHOWS THE
HEALTH INSURING CORPORATION'S TOTAL ADJUSTED CAPITAL WITHIN THE RANGE
DESCRIBED IN DIVISION (A)(1) OF THIS SECTION, PROVIDED THAT
THE HEALTH INSURING CORPORATION DOES NOT CHALLENGE THE ADJUSTED
RBC REPORT UNDER SECTION 1753.37 OF THE REVISED
CODE;
(3) THE NOTIFICATION BY THE SUPERINTENDENT TO A HEALTH INSURING
CORPORATION, FOLLOWING THE HEARING REQUIRED UNDER SECTION 1753.37 OF THE
REVISED CODE, THAT THE SUPERINTENDENT HAS REJECTED THE HEALTH
INSURING CORPORATION'S CHALLENGE TO AN ADJUSTED RBC REPORT SHOWING
THE HEALTH INSURING CORPORATION'S TOTAL ADJUSTED CAPITAL WITHIN THE RANGE
DESCRIBED IN DIVISION (A)(1) OF THIS SECTION;
(4) THE FAILURE OF A HEALTH INSURING CORPORATION TO RESPOND, IN A
MANNER SATISFACTORY TO THE SUPERINTENDENT, TO A CORRECTIVE ORDER ISSUED
UNDER DIVISION (B)(3) OF SECTION 1753.34 OF THE REVISED
CODE,
PROVIDED THAT THE HEALTH INSURING CORPORATION DOES NOT CHALLENGE
THE
CORRECTIVE ORDER UNDER SECTION 1753.37 OF THE REVISED
CODE;
(5) THE FAILURE OF A HEALTH INSURING CORPORATION TO RESPOND, IN A
MANNER SATISFACTORY TO THE SUPERINTENDENT, TO A CORRECTIVE ORDER ISSUED
UNDER DIVISION (B)(3) OF SECTION 1753.34 OF THE REVISED
CODE
SUBSEQUENT TO THE SUPERINTENDENT'S 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.
(B) IN THE CASE OF AN AUTHORIZED CONTROL LEVEL EVENT, THE
SUPERINTENDENT SHALL DO THE FOLLOWING:
(1) TAKE THE ACTIONS REQUIRED UNDER SECTION 1753.34 OF THE
REVISED
CODE FOR REGULATORY ACTION LEVEL
EVENTS;
(2) IF THE SUPERINTENDENT CONSIDERS IT TO BE IN THE BEST
INTERESTS OF THE SUBSCRIBERS AND CREDITORS OF THE HEALTH INSURING
CORPORATION AND OF THE PUBLIC, TAKE SUCH ACTIONS AS ARE NECESSARY TO
PLACE THE HEALTH INSURING CORPORATION UNDER REGULATORY CONTROL
UNDER SECTIONS 3903.01 TO 3903.59 OF THE REVISED CODE. THE
AUTHORIZED CONTROL LEVEL EVENT SHALL BE DEEMED SUFFICIENT GROUNDS
FOR THE SUPERINTENDENT TO TAKE ACTION UNDER SECTIONS 3903.01 TO 3903.59
OF THE REVISED CODE. NOTHING IN SECTIONS 1753.31 TO
1753.43 OF THE REVISED CODE SHALL IMPAIR OR RESTRICT THE RIGHTS,
POWERS, AND PROTECTIONS AFFORDED TO THE SUPERINTENDENT AND TO HEALTH
INSURING CORPORATIONS UNDER SECTIONS 3903.01 TO 3903.59 OF THE
REVISED CODE.
Sec. 1753.36. (A) FOR PURPOSES OF SECTIONS 1753.31 TO 1753.43
OF THE REVISED CODE, A "MANDATORY CONTROL LEVEL EVENT" IS ANY OF
THE FOLLOWING EVENTS:
(1) THE FILING OF AN RBC REPORT BY A HEALTH INSURING CORPORATION
THAT INDICATES THAT THE HEALTH INSURING CORPORATION'S TOTAL ADJUSTED
CAPITAL IS LESS THAN ITS MANDATORY CONTROL LEVEL RBC;
(2) THE NOTIFICATION BY THE SUPERINTENDENT OF INSURANCE TO A
HEALTH INSURING CORPORATION OF AN ADJUSTMENT TO THE HEALTH INSURING
CORPORATION'S RBC REPORT, WHICH ADJUSTED RBC REPORT SHOWS THE
HEALTH INSURING CORPORATION'S TOTAL ADJUSTED CAPITAL AT LESS THAN ITS
MANDATORY CONTROL LEVEL RBC, PROVIDED THE HEALTH INSURING
CORPORATION DOES NOT CHALLENGE THE ADJUSTED RBC REPORT UNDER
SECTION 1753.37 OF THE REVISED CODE;
(3) THE NOTIFICATION BY THE SUPERINTENDENT TO THE HEALTH INSURING
CORPORATION, FOLLOWING THE HEARING REQUIRED UNDER SECTION 1753.37 OF THE
REVISED CODE, THAT THE SUPERINTENDENT HAS REJECTED THE HEALTH
INSURING CORPORATION'S CHALLENGE TO AN ADJUSTED RBC REPORT.
(B) IN THE CASE OF A MANDATORY CONTROL LEVEL EVENT, THE
SUPERINTENDENT SHALL TAKE SUCH ACTIONS AS ARE NECESSARY TO PLACE THE HEALTH INSURING CORPORATION UNDER
REGULATORY CONTROL UNDER SECTIONS 3903.01 TO 3903.59 OF THE
REVISED CODE. THE MANDATORY
CONTROL LEVEL EVENT SHALL BE DEEMED SUFFICIENT GROUNDS FOR THE SUPERINTENDENT TO TAKE ACTION UNDER
SECTIONS 3903.01 TO 3903.59 OF THE REVISED CODE. NOTHING IN
SECTIONS 1753.31 TO 1753.43 OF THE REVISED CODE SHALL IMPAIR OR
RESTRICT THE RIGHTS, POWERS, AND PROTECTIONS AFFORDED TO THE SUPERINTENDENT AND TO HEALTH INSURING CORPORATIONS UNDER SECTIONS
3903.01 TO 3903.59 OF THE REVISED CODE. HOWEVER, THE
SUPERINTENDENT MAY DEFER ACTION UNDER THIS DIVISION FOR UP TO
NINETY DAYS AFTER THE MANDATORY CONTROL LEVEL EVENT IF THE SUPERINTENDENT FINDS
THAT THERE IS A REASONABLE EXPECTATION THE HEALTH INSURING CORPORATION MAY BE
ABLE TO ELIMINATE THE CONDITIONS LEADING TO THE MANDATORY CONTROL
LEVEL EVENT WITHIN THE NINETY-DAY PERIOD.
Sec. 1753.37. (A) A HEALTH INSURING CORPORATION HAS THE RIGHT
TO A CONFIDENTIAL HEARING UPON RECEIVING ANY OF THE FOLLOWING FROM THE
SUPERINTENDENT OF INSURANCE:
(1) AN ADJUSTED RBC REPORT;
(2) NOTIFICATION THAT THE HEALTH INSURING CORPORATION'S RBC PLAN
OR REVISED RBC PLAN IS UNSATISFACTORY AND A STATEMENT THAT THE
NOTIFICATION CONSTITUTES A REGULATORY ACTION LEVEL EVENT FOR THE HEALTH
INSURING CORPORATION;
(3) NOTIFICATION THAT THE SUPERINTENDENT HAS DETERMINED THAT THE
HEALTH INSURING CORPORATION HAS FAILED TO ADHERE TO ITS RBC PLAN
OR REVISED RBC PLAN, WHICH FAILURE HAS A SUBSTANTIAL ADVERSE
EFFECT ON THE ABILITY OF THE HEALTH INSURING CORPORATION TO ELIMINATE THE
CONDITIONS LEADING TO A
COMPANY ACTION LEVEL EVENT IN ACCORDANCE WITH ITS RBC PLAN OR
REVISED RBC PLAN;
(4) A CORRECTIVE ORDER ISSUED UNDER DIVISION (B)(3) OF SECTION
1753.34 OF THE REVISED CODE.
(B) A HEALTH INSURING CORPORATION SHALL NOTIFY THE SUPERINTENDENT
OF ITS REQUEST FOR A HEARING WITHIN FIVE DAYS AFTER ITS RECEIPT OF ANY
ITEM LISTED IN DIVISION (A) OF THIS SECTION. UPON THE
SUPERINTENDENT'S RECEIPT OF THE HEALTH INSURING CORPORATION'S REQUEST FOR A HEARING, THE
SUPERINTENDENT SHALL SET A DATE FOR THE HEARING, WHICH DATE SHALL
BE NO LESS THAN TEN DAYS AND NO MORE THAN THIRTY DAYS AFTER THE
SUPERINTENDENT'S RECEIPT OF THE HEALTH INSURING CORPORATION'S
REQUEST.
(C) A HEALTH INSURING CORPORATION MAY CHALLENGE ANY DETERMINATION
OR ACTION TAKEN BY THE SUPERINTENDENT UNDER SECTIONS 1753.31 TO 1753.43
OF THE REVISED CODE AT THE HEARING HELD PURSUANT TO THIS
SECTION.
Sec. 1753.38. (A) THE SUPERINTENDENT OF INSURANCE SHALL KEEP
ALL OF THE FOLLOWING CONFIDENTIAL:
(1) AN RBC REPORT, TO THE EXTENT THAT INFORMATION CONTAINED IN
THE REPORT IS NOT REQUIRED TO BE INCLUDED IN AN ANNUAL STATEMENT
AVAILABLE TO THE PUBLIC;
(2) AN RBC PLAN;
(3) THE RESULTS OF, OR REPORTS ON, EXAMINATIONS OR ANALYSES
CONDUCTED PURSUANT TO DIVISION (B)(2) OF SECTION 1753.34 OF THE
REVISED CODE, AND A CORRECTIVE
ORDER ISSUED PURSUANT TO DIVISION (B)(3) OF SECTION 1753.34 OF THE
REVISED CODE.
A DISCLOSURE TO THE SUPERINTENDENT OF THESE PLANS, REPORTS,
INFORMATION, AND ORDERS DOES NOT CONSTITUTE A WAIVER OF ANY APPLICABLE
PRIVILEGE OR CLAIM OF CONFIDENTIALITY IN THE PLANS, REPORTS,
INFORMATION, AND ORDERS.
(B) NOTWITHSTANDING DIVISION (A) OF THIS SECTION:
(1) THE PLANS, REPORTS, INFORMATION, AND ORDERS DESCRIBED IN
DIVISION (A) OF THIS SECTION MAY BE USED BY THE SUPERINTENDENT IN
ACCORDANCE WITH THE INSURANCE LAWS OF THIS STATE.
(2) IN THE PERFORMANCE OF THE SUPERINTENDENT'S DUTIES, THE
SUPERINTENDENT MAY SHARE THE PLANS, REPORTS, INFORMATION, AND ORDERS
WITH STATE, FEDERAL, AND INTERNATIONAL REGULATORY AGENCIES AND LAW
ENFORCEMENT AUTHORITIES, AND WITH THE NAIC AND ITS AFFILIATES AND
SUBSIDIARIES, PROVIDED THAT THE RECIPIENT AGREES TO MAINTAIN THE
CONFIDENTIALITY OF THE PLANS, REPORTS, INFORMATION, AND
ORDERS.
(C)(1) THE PLANS, REPORTS, INFORMATION, AND ORDERS DESCRIBED IN
DIVISION (A) OF THIS SECTION ARE NOT PUBLIC RECORDS FOR PURPOSES
OF SECTION 149.43 OF THE REVISED CODE AND SHALL NOT
BE SUBJECT TO
SUBPOENA. THE PLANS, REPORTS, INFORMATION, AND ORDERS SHALL NOT BE
SUBJECT TO DISCOVERY OR ADMISSIBLE IN EVIDENCE IN ANY PRIVATE CIVIL
ACTION.
(2) NEITHER THE SUPERINTENDENT NOR ANY PERSON WHO RECEIVES THE
PLANS, REPORTS, INFORMATION, AND ORDERS WHILE ACTING UNDER THE AUTHORITY
OF THE SUPERINTENDENT SHALL BE PERMITTED OR REQUIRED TO TESTIFY IN ANY
PRIVATE CIVIL ACTION CONCERNING THESE PLANS, REPORTS, INFORMATION,
AND ORDERS.
(D) A COMPARISON OF A HEALTH INSURING CORPORATION'S TOTAL
ADJUSTED CAPITAL TO ANY OF ITS RBC LEVELS SHALL NOT BE USED TO
RANK HEALTH INSURING CORPORATIONS.
(E) RBC INSTRUCTIONS, RBC REPORTS, ADJUSTED
RBC REPORTS, RBC
PLANS, AND REVISED RBC PLANS SHALL NOT BE USED BY THE
SUPERINTENDENT FOR RATEMAKING, CONSIDERED OR INTRODUCED AS
EVIDENCE IN ANY RATE PROCEEDING, OR USED BY THE SUPERINTENDENT TO
CALCULATE OR DERIVE ANY ELEMENTS OF AN APPROPRIATE PREMIUM LEVEL OR RATE OF
RETURN FOR ANY LINE OF INSURANCE THAT A HEALTH INSURING CORPORATION OR ANY
AFFILIATE IS AUTHORIZED TO WRITE.
(F) EXCEPT AS OTHERWISE REQUIRED UNDER CHAPTER 1751. OR
1753. OF
THE REVISED CODE, IT IS AN UNFAIR AND DECEPTIVE ACT OR
PRACTICE IN
THE BUSINESS OF INSURANCE UNDER SECTIONS 3901.19 TO 3901.26 OF THE
REVISED CODE FOR ANY PERSON TO MAKE, PUBLISH,
DISSEMINATE,
CIRCULATE, OR PLACE BEFORE THE PUBLIC, OR TO CAUSE, DIRECTLY OR INDIRECTLY, TO BE MADE, PUBLISHED, DISSEMINATED, CIRCULATED, OR PLACED BEFORE THE
PUBLIC, IN A NEWSPAPER, MAGAZINE, OR OTHER PUBLICATION, IN THE
FORM OF A NOTICE, CIRCULAR, PAMPHLET, LETTER, OR POSTER, OR OVER
ANY RADIO OR TELEVISION STATION, OR IN ANY OTHER MANNER, AN
ADVERTISEMENT, ANNOUNCEMENT, OR STATEMENT, WRITTEN OR ORAL, THAT
CONTAINS AN ASSERTION, REPRESENTATION, OR STATEMENT, REGARDING THE
RBC LEVELS OF A HEALTH INSURING CORPORATION, OR ANY
COMPONENT DERIVED IN THE CALCULATION OF THE RBC LEVELS.
(G) IF ANY MATERIALLY FALSE STATEMENT IS PUBLISHED COMPARING A
HEALTH INSURING CORPORATION'S TOTAL ADJUSTED CAPITAL TO ITS RBC
LEVELS, OR ANY INAPPROPRIATE COMPARISON OF ANY OTHER AMOUNT TO ANY OF THE HEALTH INSURING
CORPORATION'S RBC LEVELS IS PUBLISHED, AND THE HEALTH INSURING
CORPORATION IS ABLE TO DEMONSTRATE TO THE SUPERINTENDENT WITH
SUBSTANTIAL PROOF THE FALSITY OF THE STATEMENT OR THE INAPPROPRIATENESS OF THE COMPARISON,
THEN THE HEALTH INSURING CORPORATION MAY PUBLISH WITH THE
SUPERINTENDENT'S APPROVAL AN ANNOUNCEMENT IN A WRITTEN
PUBLICATION TO REBUT THE MATERIALLY FALSE STATEMENT OR INAPPROPRIATE
COMPARISON.
Sec. 1753.39. (A) EACH FOREIGN HEALTH INSURING CORPORATION
SHALL SUBMIT TO THE SUPERINTENDENT OF INSURANCE, UPON RECEIVING THE SUPERINTENDENT'S WRITTEN REQUEST,
AN RBC REPORT FOR THE CALENDAR YEAR JUST ENDED. THE HEALTH
INSURING CORPORATION SHALL SUBMIT THE RBC REPORT TO THE
SUPERINTENDENT NO LATER THAN THE LATER OF:
(1) THE DATE A DOMESTIC HEALTH INSURING CORPORATION WOULD BE
REQUIRED TO FILE AN RBC REPORT UNDER SECTION 1753.32 OF THE
REVISED CODE;
(2) FIFTEEN DAYS AFTER THE SUPERINTENDENT'S REQUEST IS RECEIVED
BY THE FOREIGN HEALTH INSURING CORPORATION.
(B) EACH FOREIGN HEALTH INSURING CORPORATION SHALL, UPON
RECEIVING THE SUPERINTENDENT'S WRITTEN REQUEST, PROMPTLY SUBMIT TO THE
SUPERINTENDENT A COPY OF ANY RBC PLAN OR REVISED RBC PLAN
FILED WITH THE INSURANCE REGULATORY AUTHORITY OF ANY OTHER STATE.
(C) THE SUPERINTENDENT MAY REQUIRE A FOREIGN HEALTH INSURING
CORPORATION TO FILE AN RBC PLAN WITH THE SUPERINTENDENT IN THE
CASE OF A COMPANY ACTION LEVEL EVENT, REGULATORY ACTION LEVEL EVENT, OR
AUTHORIZED CONTROL LEVEL EVENT INVOLVING THE FOREIGN HEALTH
INSURING CORPORATION, IF THE INSURANCE REGULATORY AUTHORITY OF THE STATE
OF DOMICILE OF THE FOREIGN HEALTH INSURING CORPORATION FAILS TO REQUIRE
THE FOREIGN HEALTH INSURING CORPORATION TO FILE AN RBC PLAN IN THE
MANNER SPECIFIED UNDER THAT STATE'S RBC LAWS, IF ANY. THE FAILURE
OF A FOREIGN HEALTH INSURING CORPORATION TO FILE AN RBC PLAN OR
REVISED RBC PLAN WITH THE SUPERINTENDENT AS REQUIRED SHALL BE
GROUNDS FOR THE SUPERINTENDENT TO ORDER THE HEALTH INSURING CORPORATION TO CEASE AND DESIST FROM
WRITING NEW BUSINESS IN THIS STATE.
(D) IN THE CASE OF A MANDATORY CONTROL LEVEL EVENT INVOLVING A
FOREIGN HEALTH INSURING CORPORATION, IF NO DOMICILIARY RECEIVER
HAS BEEN APPOINTED FOR THE FOREIGN HEALTH INSURING CORPORATION
UNDER THE REHABILITATION AND LIQUIDATION LAWS APPLICABLE IN THE
STATE OF DOMICILE OF THE FOREIGN HEALTH INSURING CORPORATION, THE
SUPERINTENDENT MAY MAKE APPLICATION TO THE COURT OF COMMON PLEAS
AS PERMITTED IN SECTIONS 3903.50 TO 3903.59 OF THE REVISED CODE
FOR AN ORDER DIRECTING THE SUPERINTENDENT TO LIQUIDATE THE PROPERTY OF THE FOREIGN HEALTH INSURING CORPORATION FOUND IN THIS STATE.
THE OCCURRENCE OF THE MANDATORY CONTROL LEVEL EVENT SHALL BE DEEMED
SUFFICIENT GROUNDS FOR THE SUPERINTENDENT TO MAKE
APPLICATION TO THE COURT.
Sec. 1753.40. THERE SHALL BE NO LIABILITY ON THE PART OF, AND NO
CAUSE OF ACTION SHALL ARISE AGAINST, THE SUPERINTENDENT OF INSURANCE, OR
THE DEPARTMENT OF INSURANCE, ITS EMPLOYEES, OR ITS AGENTS, FOR ANY
ACTION TAKEN IN THEIR PERFORMANCE OF THE POWERS AND DUTIES UNDER SECTIONS
1753.31 TO 1753.43 OF THE REVISED CODE.
Sec. 1753.41. UNLESS OTHERWISE PROVIDED, ALL NOTICES SENT TO A
HEALTH INSURING CORPORATION BY THE SUPERINTENDENT OF INSURANCE THAT MAY
RESULT IN REGULATORY ACTION UNDER SECTIONS 1753.31 TO 1753.43 OF THE
REVISED CODE SHALL BE EFFECTIVE UPON DISPATCH IF
TRANSMITTED BY REGISTERED OR CERTIFIED MAIL. ANY OTHER NOTICE TRANSMITTED SHALL BE EFFECTIVE UPON THE HEALTH INSURING CORPORATION'S RECEIPT OF THE
NOTICE.
Sec. 1753.42. THE SUPERINTENDENT OF INSURANCE MAY EXEMPT ANY
DOMESTIC HEALTH INSURING CORPORATION FROM THE APPLICATION OF SECTIONS
1753.31 TO 1753.43 OF THE REVISED CODE, IF THE HEALTH
INSURING CORPORATION MEETS ALL OF THE FOLLOWING REQUIREMENTS:
(A) THE HEALTH INSURING CORPORATION WRITES DIRECT BUSINESS IN
THIS STATE ONLY.
(B) THE HEALTH INSURING CORPORATION ASSUMES NO REINSURANCE IN
EXCESS OF FIVE PER CENT OF DIRECT PREMIUM WRITTEN.
(C) THE HEALTH INSURING CORPORATION EITHER:
(1) WRITES DIRECT ANNUAL PREMIUMS OF TWO MILLION DOLLARS OR LESS
FOR BASIC HEALTH CARE SERVICES;
(2) COVERS LESS THAN TWO THOUSAND ENROLLEES UNDER POLICIES,
CONTRACTS, CERTIFICATES, OR AGREEMENTS FOR SUPPLEMENTAL HEALTH CARE
SERVICES.
Sec. 1753.43. THE SUPERINTENDENT OF INSURANCE MAY ADOPT RULES IN
ACCORDANCE WITH CHAPTER 119. OF THE REVISED CODE AS ARE REASONABLY
NECESSARY FOR THE IMPLEMENTATION AND OPERATION OF SECTIONS 1753.31 TO
1753.43 OF THE REVISED CODE.
Section 2. That existing section 1753.01 of the Revised Code is
hereby repealed.
Section 3. The authorized control level RBC, as defined by
division (B) of section 1753.31 of the Revised Code, as enacted by
this act, shall be adjusted for use in reports filed for periods
through December 31, 2001. Notwithstanding division (B) of
section 1753.31 of the Revised Code, the authorized control level
RBC shall be the product of 0.90 and the number determined under
the risk-based capital formula in accordance with the RBC
instructions. Thereafter, the authorized control level RBC shall
be determined in accordance with division (B) of section 1753.31
of the Revised Code without this adjustment.
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