Title 27
Insurance

Chapter 4.7
Risk-Based Capital (RBC) for Health Organizations Act

§ 27-4.7-2. Definitions.

As used in this chapter:

(1) “Adjusted RBC report” means an RBC report that has been adjusted by the commissioner in accordance with § 27-4.7-3;

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

(3) “Commissioner” means the director of the department of business regulation;

(4) “Domestic health organization” means a health organization domiciled in this state;

(5) “Foreign health organization” means a health organization that is licensed or authorized to do business in this state pursuant to this title but is not domiciled in this state;

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

(7) “Health organization” means a health maintenance organization, limited health service organization, dental or vision plan, hospital, medical, and dental indemnity or service corporation or other managed care organization or any other entity providing a plan of health insurance, health benefits, or health services subject to this title. This definition does not include an organization that is licensed as either a life and health insurer or a property and casualty insurer pursuant to chapter 1 or chapter 2 of this title and that is subject to either the life or property and casualty RBC requirements;

(8) “RBC” means risk-based capital;

(9) “RBC instructions” means the RBC report, including risk-based capital instructions adopted by the NAIC, as these RBC instructions may be amended by the NAIC in accordance with the procedures adopted by the NAIC;

(10) “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:

(i) “Company action level RBC” means, with respect to any health organization, the product of two (2.0) and its authorized control level RBC;

(ii) “Regulatory action level RBC” means the product of one and one-half (1.5) and its authorized control level RBC;

(iii) “Authorized control level RBC” means the number determined under the risk-based capital formula in accordance with the RBC instructions;

(iv) “Mandatory control level RBC” means the product of seven tenths (.70) and the authorized control level RBC.

(11) “RBC plan” means a comprehensive financial plan containing the elements specified in § 27-4.7-4(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”;

(12) “RBC report” means the report required in § 27-4.7-3;

(13) “Total adjusted capital” means the sum of:

(i) A health organization’s statutory capital and surplus (i.e., net worth) as determined in accordance with the statutory accounting applicable to the annual and quarterly financial statements required to be filed by health organizations pursuant to applicable sections of this title; and

(ii) Any other items, if any, that the RBC instructions may provide.