§ 23-63-1501 - Definitions.

23-63-1501. Definitions.

As used in this subchapter, these terms shall have the following meanings:

(1) "Adjusted RBC report" means an RBC report which has been adjusted by the Insurance Commissioner in accordance with 23-63-1502(d);

(2) "Corrective order" means an order issued by the commissioner specifying corrective actions which the commissioner has determined are required;

(3) "Domestic health organization" means a health maintenance organization domiciled in this state, as established under 23-76-107, or a hospital and medical service corporation as defined in 23-75-101;

(4) "Foreign health organization" means a health organization that is licensed to do business in this state but is not domiciled in this state;

(5) "Health organization" means a health maintenance organization, hospital and medical service corporation, limited health service organization, dental or vision plan, hospital, or a medical and dental indemnity or service corporation. This definition does not include an organization that is licensed as either a life and health insurer or a property and casualty insurer and that is otherwise subject to either the life or property and casualty RBC requirements;

(6) "NAIC" means the National Association of Insurance Commissioners;

(7) "RBC instructions" means the RBC report including risk-based capital instructions adopted by the National Association of Insurance Commissioners, as these RBC instructions may be amended by the National Association of Insurance Commissioners from time to time in accordance with the procedures adopted by the National Association of Insurance Commissioners;

(8) "RBC level" means a health organization'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, with respect to any health organization, the product of 2.0 and its authorized control level RBC;

(B) "Regulatory action level RBC" means the product of 1.5 and its 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; and

(D) "Mandatory control level RBC" means the product of .70 and the authorized control level RBC;

(9) "RBC plan" means a comprehensive financial plan containing the elements specified in 23-63-1503(b). If the commissioner rejects the RBC plan and it is revised by the health organization with or without the commissioner's recommendation, the plan shall be called the "revised RBC plan";

(10) "RBC report" means the report required in 23-63-1502; and

(11) "Total adjusted capital" means the sum of:

(A) A health organization's statutory capital and surplus, i.e., net worth, as determined in accordance with the statutory accounting applicable to the annual financial statements required to be filed; and

(B) Such other items, if any, as the RBC instructions may provide.