Section 1322. Risk-based capital for life and accident and health insurance companies  


Latest version.
  • (a) Definitions. In this section:    (1) "Adjusted RBC report" means a RBC report which has  been  adjusted
      by  the  superintendent in accordance with paragraph three of subsection
      (c) of this section.
        (2) "Corrective order" means an order  issued  by  the  superintendent
      specifying  corrective  actions  which the superintendent has determined
      are required.
        (3) "Domestic insurer" means any authorized life insurance company  or
      accident  and  health  insurance company incorporated or organized under
      any law of this state.
        (4) "Foreign insurer" means any authorized life insurance  company  or
      accident  and  health  insurance company incorporated or organized under
      the laws of any state, other than this state.
        (5) "Negative trend" means a negative trend over a period of time,  as
      determined  in  accordance with the "trend test calculation" included in
      the RBC instructions defined in paragraph seven of this subsection.
        (6) "RBC" means risk-based capital.
        (7) "RBC instructions"  means  the  RBC  report  including  risk-based
      capital instructions, which in addition to any other matter which may be
      required  to  be  stated therein, either by law or by the superintendent
      pursuant to law, shall conform substantially to the form of  the  report
      and  instructions  adopted  from time to time for such purpose by, or by
      the authority of, the National Association of  Insurance  Commissioners,
      together  with  such  additions,  omissions  or modifications, similarly
      adopted from time to time, as may be approved by the superintendent.
        (8)  "RBC  level"  means  an  insurer's  company  action  level   RBC,
      regulatory  action level RBC, authorized control level RBC, or mandatory
      control level RBC where:
        (A) "Company action level RBC"  means  the  product  of  2.0  and  the
      insurer's authorized control level RBC;
        (B)  "Regulatory  action  level  RBC" means the product of 1.5 and the
      insurer's authorized control level RBC;
        (C) "Authorized control level RBC" means the number  determined  under
      the risk-based capital formula in accordance with the RBC instructions;
        (D)  "Mandatory  control  level  RBC" means the product of .70 and the
      insurer's authorized control level RBC.
        (9) "RBC plan" means a comprehensive  financial  plan  containing  the
      elements  specified  in paragraph two of subsection (d) of this section.
      If the superintendent rejects the RBC plan, and it  is  revised  by  the
      insurer,  with  or without the superintendent's recommendation, the plan
      shall be called the "Revised RBC plan."
        (10) "RBC report" means the report required in subsection (c) of  this
      section.
        (11) "Total adjusted capital" means the sum of:
        (A) An insurer's statutory capital and surplus; and
        (B) Such other items, if any, as the RBC instructions may provide.
        (b)  Applicability.  This section shall apply to every authorized life
      insurance company and accident and health insurance company.
        (c) RBC reports. (1) Every domestic insurer shall, on or prior to each
      March  fifteenth  (the  "filing  date"),  prepare  and  submit  to   the
      superintendent  a report of 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, the insurer shall file
      the RBC report:
        (A) With  the  National  Association  of  Insurance  Commissioners  in
      accordance with the RBC instructions; and
    
        (B)  With the insurance commissioner in any state in which the insurer
      is authorized to do business, upon the written request of the  insurance
      commissioner. The insurer shall file the RBC report by the later of:
        (i) The filing date; or
        (ii) Fifteen days after the date of the request.
        (2)  An  insurer's  RBC  shall  be  determined  in accordance with the
      formula set  forth  in  the  RBC  instructions.  The  formula  shall  be
      determined  in each case by applying the factors in the manner set forth
      in the RBC instructions, and shall take into account (and may adjust for
      the covariance between):
        (A) The risk with respect to the insurer's assets;
        (B) The risk of adverse  insurance  experience  with  respect  to  the
      insurer's liabilities and obligations;
        (C) The interest rate risk with respect to the insurer's business; and
        (D)  All other business risks and such other relevent risks as are set
      forth in the RBC instructions.
        (3) If a domestic insurer files a RBC report which the  superintendent
      determines  is  inaccurate, then the superintendent shall adjust the RBC
      report to correct the inaccuracy and shall notify  the  insurer  of  the
      adjustment.  The  notice shall contain a statement of the reason for the
      adjustment. A RBC report as so adjusted is referred to as  an  "Adjusted
      RBC report."
        (d)  Company  action  level  event.  (1)  "Company action level event"
      means, with respect to a domestic insurer:
        (A) The filing by the insurer of a RBC report indicating that: (i) The
      insurer's total adjusted  capital  is  greater  than  or  equal  to  its
      regulatory  action level RBC but less than its company action level RBC;
      or
        (ii) (I) The insurer has total adjusted capital which is greater  than
      or  equal  to  its company action level RBC but less than the product of
      2.5 and its authorized control level RBC; and
        (II) there is a negative trend;
        (B) The notification by  the  superintendent  to  the  insurer  of  an
      adjusted  RBC report that indicates the occurrence of an event described
      in item (i) or (ii) of subparagraph (A) of this paragraph, provided  the
      insurer  does not challenge the adjusted RBC report under subsection (h)
      of this section; or
        (C) If, under subsection (h) of this section, the  insurer  challenges
      an  adjusted  RBC  report  that  indicates  the  occurrence  of an event
      described in item (i) or (ii) of subparagraph (A) of this paragraph, the
      notification  by  the   superintendent   to   the   insurer   that   the
      superintendent has, after a hearing, rejected the insurer's challenge.
        (2)  If  there  is  a company action level event, the domestic insurer
      shall prepare and submit to the superintendent a RBC plan which:
        (A) Identifies the conditions in the insurer which contribute  to  the
      company action level event;
        (B) Contains proposals of corrective actions which the insurer intends
      to  take  and  would  be  expected  to  result in the elimination of the
      company action level event;
        (C) Provides projections of the insurer's  financial  results  in  the
      current year and at least the four succeeding years, both in the absence
      of  proposed  corrective  actions  and  giving  effect  to  the proposed
      corrective actions, including projections of statutory operating income,
      net income, and capital and surplus. The projections for  both  new  and
      renewal business may include separate projections for each major line of
      business  and  separately  identify each significant income, expense and
      benefit component;
    
        (D) Identifies the key assumptions impacting the insurer's projections
      and the sensitivity of the projections to the assumptions; and
        (E)  Identifies  the  quality  of,  and  problems associated with, the
      insurer's business, including its assets,  anticipated  business  growth
      and  associated  surplus  strain, extraordinary exposure to risk, mix of
      business and use of reinsurance.
        (3) The RBC plan shall be submitted within forty-five days  after  the
      occurrence of the company action level event.
        (4)  (A) Within sixty days after the submission by an insurer of a RBC
      plan to the superintendent, the superintendent shall notify the  insurer
      whether the RBC plan is satisfactory, unsatisfactory, or unacceptable.
        (B) If the RBC plan is satisfactory, the insurer shall implement it.
        (C) If the RBC plan is unsatisfactory, the notification to the insurer
      shall  set  forth  the  reasons for the determination, and may set forth
      proposed revisions which will render the RBC plan  satisfactory  to  the
      superintendent.  Upon  notification from the superintendent, the insurer
      shall prepare a revised RBC plan, which may incorporate by reference any
      revisions proposed by the superintendent, and shall submit  the  revised
      RBC plan to the superintendent:
        (i)   Within   forty-five   days   after  the  notification  from  the
      superintendent; or
        (ii) If, under subsection (h) of this section, the insurer  challenges
      the notification from the superintendent, within forty-five days after a
      notification  to  the  insurer  that  the  superintendent  has,  after a
      hearing, rejected the insurer's challenge.
        (D) If the RBC plan is unacceptable because  it  does  not  adequately
      address  all  of  the  elements  specified  in  paragraph  two  of  this
      subsection, the notification to the insurer shall set forth the  reasons
      for  the determination and shall state that the notification constitutes
      a regulatory action level event.
        (5) (A) Every domestic insurer that files a RBC plan  or  revised  RBC
      plan  with  the  superintendent  shall  file  a  copy with the insurance
      commissioner of any state in which  the  insurer  is  authorized  to  do
      business, upon the written request of the insurance commissioner, if the
      state  has  a  RBC  provision  substantially similar to paragraph one of
      subsection (i) of this section.
        (B) The insurer shall file a copy of the RBC plan or revised RBC  plan
      in that state by the later of:
        (i)  The date on which the RBC plan or revised RBC plan is filed under
      paragraph three or four of this subsection; or
        (ii) Fifteen days after the date of the request.
        (e) Regulatory action level event. (1) "Regulatory action level event"
      means, with respect to a domestic insurer:
        (A) The filing by the insurer of a  RBC  report  indicating  that  the
      insurer's  total  adjusted  capital  is  greater  than  or  equal to its
      authorized control level RBC but less than its regulatory  action  level
      RBC;
        (B)  The  notification  by  the  superintendent  to  the insurer of an
      adjusted RBC report that indicates the occurrence of an event  described
      in  subparagraph  (A)  of  this paragraph, provided the insurer does not
      challenge the adjusted RBC report under subsection (h) of this section;
        (C) If, under subsection (h) of this section, the  insurer  challenges
      an  adjusted  RBC  report  that  indicates  the  occurrence  of an event
      described in subparagraph (A) of this paragraph, the notification by the
      superintendent to the insurer  that  the  superintendent  has,  after  a
      hearing, rejected the insurer's challenge;
    
        (D) The failure of the insurer to timely file a RBC report, unless the
      insurer  provides the superintendent with a satisfactory explanation for
      the failure and cures the failure within ten days after the filing date;
        (E)  The  failure  of  the  insurer  to  timely submit a RBC plan or a
      revised RBC plan to the superintendent;
        (F)  Notification  by  the  superintendent  that  the  RBC   plan   is
      unacceptable  or  the  revised  RBC plan is unsatisfactory, provided the
      insurer does not challenge the determination  under  subsection  (h)  of
      this section;
        (G) If, under subsection (h) of this section, the insurer challenges a
      determination  by  the  superintendent  under  subparagraph  (F) of this
      paragraph, the notification by the superintendent to  the  insurer  that
      the superintendent has, after a hearing, rejected the challenge;
        (H) Notification by the superintendent to the insurer that the insurer
      has  failed  to adhere to its RBC plan or revised RBC plan, and that the
      failure has a substantial adverse effect on  the  insurer's  ability  to
      eliminate  the company action level event, provided the insurer does not
      challenge the determination under subsection (h) of this section; or
        (I) If, under subsection (h) of this section, the insurer challenges a
      determination by the  superintendent  under  subparagraph  (H)  of  this
      paragraph,  the  notification  by the superintendent to the insurer that
      the superintendent has, after a hearing, rejected the challenge.
        (2) If there is a regulatory action level  event,  the  superintendent
      shall:
        (A)  Require  the  insurer  to  prepare  and  submit a RBC plan or, if
      applicable, a revised RBC plan, unless the RBC plan is unacceptable  (in
      which  case  the  superintendent  may require a revised RBC plan) or the
      revised RBC plan has already been submitted;
        (B) Perform such examination or analysis as the  superintendent  deems
      necessary  of  the  assets,  liabilities  and operations of the insurer,
      including a review of the RBC plan or revised RBC plan; and
        (C) Subsequent to the examination  or  analysis,  issue  a  corrective
      order.
        (3)  In  determining  corrective  actions, the superintendent may take
      into account such  factors  as  are  deemed  relevant,  based  upon  the
      superintendent's  examination or analysis of the assets, liabilities and
      operations of the insurer, including  the  results  of  any  sensitivity
      tests undertaken pursuant to the RBC instructions.
        (4) The RBC plan or revised RBC plan shall be submitted:
        (A)  Within  forty-five  days  after  the occurrence of the regulatory
      action level event; or
        (B) If, under subsection (h) of this section, the  insurer  challenges
      the  superintendent's  determination  that a RBC plan is unsatisfactory,
      within forty-five days  after  notification  to  the  insurer  that  the
      superintendent has, after a hearing, rejected the insurer's challenge.
        (5)  The  superintendent  may retain actuaries, investment experts and
      other consultants as the superintendent deems necessary  to  review  the
      insurer's  RBC  plan or revised RBC plan, examine or analyze the assets,
      liabilities and operations of the insurer, and formulate the  corrective
      order.  The  fees,  costs  and expenses relating to consultants shall be
      borne by the affected insurer as directed by the superintendent.
        (f) Authorized control level  event.  (1)  "Authorized  control  level
      event" means, with respect to a domestic insurer:
        (A)  The  filing  by  the  insurer of a RBC report indicating that the
      insurer's total adjusted  capital  is  greater  than  or  equal  to  its
      mandatory  control  level RBC but less than its authorized control level
      RBC;
    
        (B) The notification by  the  superintendent  to  the  insurer  of  an
      adjusted  RBC report that indicates the occurrence of an event described
      in subparagraph (A) of this paragraph, provided  the  insurer  does  not
      challenge the adjusted RBC report under subsection (h) of this section;
        (C)  If,  under subsection (h) of this section, the insurer challenges
      an adjusted RBC  report  that  indicates  the  occurrence  of  an  event
      described  in  subparagraph  (A)  of this paragraph, notification by the
      superintendent to the insurer  that  the  superintendent  has,  after  a
      hearing, rejected the insurer's challenge;
        (D) The failure of the insurer to respond, in a manner satisfactory to
      the  superintendent, to a corrective order, provided the insurer has not
      challenged the corrective order under subsection (h) of this section; or
        (E) If, under subsection (h) of this section, the insurer challenges a
      corrective order and the superintendent, after a  hearing,  rejects  the
      challenge  or  modifies the corrective order, the failure of the insurer
      to respond, in a manner  satisfactory  to  the  superintendent,  to  the
      corrective   order  subsequent  to  rejection  or  modification  by  the
      superintendent.
        (2) If there is an authorized control level event, the  superintendent
      shall take such actions as are:
        (A) Required under subsection (e) of this section regarding an insurer
      with respect to which a regulatory action level event has occurred; or
        (B)  Necessary  to cause the insurer to be placed under rehabilitation
      or liquidation under article seventy-four of this chapter.
        (g) Mandatory control level event. (1) "Mandatory control level event"
      means, with respect to a domestic insurer:
        (A) The filing by the insurer of a RBC  report,  indicating  that  the
      insurer's  total  adjusted  capital  is  less than its mandatory control
      level RBC;
        (B) Notification by the superintendent to the insurer of  an  adjusted
      RBC  report  that  indicates  the  occurrence  of  an event described in
      subparagraph (A) of  this  paragraph,  provided  the  insurer  does  not
      challenge  the adjusted RBC report under subsection (h) of this section;
      or
        (C) If, under subsection (h) of this section, the  insurer  challenges
      an  adjusted  RBC  report  that  indicates  the  occurrence  of an event
      described in subparagraph (A) of this  paragraph,  notification  by  the
      superintendent  to  the  insurer  that  the  superintendent has, after a
      hearing, rejected the insurer's challenge.
        (2) If there is a mandatory control level  event,  the  superintendent
      shall  take  such  actions  as  are necessary to cause the insurer to be
      placed under rehabilitation or liquidation under article seventy-four of
      this chapter. However, the superintendent may forgo  action  for  up  to
      ninety  days  after the occurrence of a mandatory control level event if
      the superintendent determines that there  is  a  reasonable  expectation
      that  the  mandatory  control  level  event may be eliminated within the
      period.
        (h) Hearings. (1) A domestic insurer shall have the right to a hearing
      upon notification to the insurer by the superintendent;
        (A) Of an adjusted RBC report;
        (B) That the insurer's RBC plan is unsatisfactory or  unacceptable  or
      the revised RBC plan is unsatisfactory;
        (C)  That  the insurer has failed to adhere to its RBC plan or revised
      RBC plan and that the failure has a substantial adverse  effect  on  the
      ability of the insurer to eliminate the company action level event; or
        (D) Of a corrective order.
        (2)   If   a   hearing   is  requested  within  five  days  after  the
      superintendent gives a notification specified in paragraph one  of  this
    
      subsection,  the  superintendent  shall  give  notice  and  a hearing in
      accordance with the provisions of article three of this chapter.
        (3)  The  superintendent  shall set a date for the hearing, which date
      shall be no less than ten nor more than thirty days after  the  date  of
      the insurer's hearing request.
        (i)  Confidentiality  and  prohibition  on  announcements. (1) All RBC
      reports and adjusted RBC reports (to the extent the information  therein
      is not required to be set forth in a publicly available annual statement
      schedule),  RBC  plans,  revised  RBC  plans,  results  or report of any
      examination or analysis of an insurer  performed  pursuant  hereto,  and
      corrective  orders  filed  with  or issued by the superintendent contain
      information that may be damaging to the insurer if made available to its
      competitors, and shall be confidential and not made public or subject to
      subpoena, except to the  extent  the  superintendent  finds  release  of
      information necessary to protect the public.
        (2)(A) The comparison of an insurer's total adjusted capital to any of
      its  RBC  levels  is  a  regulatory tool which may indicate the need for
      possible corrective action with respect  to  the  insurer,  and  is  not
      intended  as  a  means  to  rank  insurers generally, and the use of the
      information to rank insurers may be misleading to the general public.
        (B) Except as otherwise required under the provisions of this section,
      no authorized insurer,  licensed  insurance  agent,  licensed  insurance
      broker,  or any person on behalf of the insurer, agent or broker, or any
      other person licensed pursuant to this  chapter  shall,  make,  publish,
      disseminate, circulate or place before the public, or cause, directly or
      indirectly,  to  be  made, published, disseminated, circulated or placed
      before the public, in a newspaper, magazine or other publication, or  in
      the  form of a notice, circular, pamphlet, letter or poster, or over any
      radio or television station, or in  any  other  way,  an  advertisement,
      announcement  or  statement  containing  an assertion, representation or
      statement with regard to the RBC  Levels  of  any  insurer,  or  of  any
      component derived in the calculation.
        (C)   Notwithstanding   subparagraph  (B)  of  this  paragraph,  if  a
      materially false or  inappropriate  statement,  comparing  an  insurer's
      total adjusted capital or other amount to one or more of its RBC levels,
      is  published  in  a  written  publication,  and  the insurer is able to
      demonstrate to the superintendent the falsity  or  inappropriateness  of
      the statement, then the insurer may publish an announcement in a written
      publication to rebut the statement.
        (j)  Foreign  insurers.  (1) A foreign insurer shall, upon the written
      request of the superintendent, submit to the superintendent a RBC report
      as of the end of the calendar year just ended by the later of:
        (A) The date a RBC report would be required to be filed by a  domestic
      insurer under this section; or
        (B) Fifteen days after the date of the request.
        (2)  A  foreign  insurer  shall,  upon  the  written  request  of  the
      superintendent, within five days, submit to the superintendent a copy of
      its RBC plan or revised RBC  plan  that  is  filed  with  the  insurance
      commissioner of any other state.
        (3)  (A)  If  there is a company action level event, regulatory action
      level event, or  authorized  control  level  event,  and  the  insurance
      commissioner  of  the  state  of  incorporation  or  organization of the
      insurer  does  not  require  the  insurer  to  file  a  RBC  plan,   the
      superintendent  may  require  the  insurer  to file an RBC plan with the
      superintendent  within   forty-five   days   of   the   superintendent's
      notification.
        (B)  If  the  RBC  plan  is  unsatisfactory or if the insurer fails to
      timely file the RBC plan with the superintendent, the superintendent may
    
      order the insurer not to issue any new insurance policies  or  contracts
      in this state.
        (4)  If  there  is a mandatory control level event, the superintendent
      may make application under article seventy-four of this chapter.
        (k) Notices. Unless a later date  is  specified,  any  notice  by  the
      superintendent  to  an  insurer  under  this section which may result in
      regulatory action hereunder shall be  effective  upon  delivery,  except
      that, if the notice is mailed, it shall be effective three days after it
      is mailed.
        (l)  Phase-in  provision.  For  RBC  reports  required  to be filed in
      nineteen hundred ninety-four with  respect  to  calendar  year  nineteen
      hundred  ninety-three,  the  following  requirements  shall apply to the
      provisions of subsections (d), (e), (f) and (g) of this section:
        (1) In the event of a company action level event  with  respect  to  a
      domestic  insurer,  the  superintendent  shall take no regulatory action
      hereunder.
        (2)  In  the  event  of  an  regulatory  action  level   event   under
      subparagraph  (A), (B) or (C) of paragraph one of subsection (e) of this
      section  the  superintendent  shall  take  the  actions  required  under
      subsection (d) of this section.
        (3)   In   the  event  of  an  regulatory  action  level  event  under
      subparagraph (D), (E),  (F),  (G),  (H)  or  (I)  of  paragraph  one  of
      subsection (e) of this section or an authorized control level event, the
      superintendent  shall  take the actions required under subsection (e) of
      this section with respect to the insurer.
        (4) In the event of a mandatory control level event with respect to an
      insurer, the  superintendent  shall  take  the  actions  required  under
      subsection (f) of this section with respect to the insurer.