2009 Iowa Code
Title 13 - Commerce
Subtitle 1 - Insurance and Related Regulation
CHAPTER 521F - RISK=BASED CAPITAL REQUIREMENTS FOR HEALTH ORGANIZATIONS
521F.4 - COMPANY-ACTION-LEVEL EVENT.

        521F.4  COMPANY-ACTION-LEVEL EVENT.
         1.  "Company-action-level event" means any of the following:
         a.  The filing of a risk-based capital report by a health
      organization which indicates that the health organization's total
      adjusted capital is greater than or equal to its
      regulatory-action-level risk-based capital but less than its
      company-action-level risk-based capital.
         b.  Notification by the commissioner to a health organization
      of an adjusted risk-based capital report that indicates an event in
      paragraph "a", provided the health organization does not
      challenge the adjusted risk-based capital report and request a
      hearing pursuant to section 521F.8.
         c.  If a hearing is requested pursuant to section 521F.8,
      notification by the commissioner to the health organization after the
      hearing that the commissioner has rejected the health organization's
      challenge of the adjusted risk-based capital report indicating the
      event in paragraph "a".
         2.  Upon the occurrence of a company-action-level event, the
      health organization shall prepare and submit to the commissioner a
      risk-based capital plan that includes all of the following:
         a.  Identification of the conditions which contributed to the
      company-action-level event.
         b.  Proposed corrective actions which the health organization
      intends to implement and which are expected to result in the
      elimination of the company-action-level event.
         c.  Projections of the health organization's financial results
      for the current year and at least the two succeeding years, including
      projections of statutory balance sheets, operating income, net
      income, capital and surplus, and risk-based capital levels.
      Projections shall be provided assuming the absence of the proposed
      corrective actions and assuming the implementation of the proposed
      corrective actions.  Projections shall be provided for each major
      line of business and separately identify each significant income,
      expense, and benefit component.
         d.  Identification of the primary assumptions impacting the
      health organization's projections and the sensitivity of the
      projections to the assumptions.
         e.  Identification of the quality of, and problems associated
      with, the health organization's business, including but not limited
      to its assets, anticipated business growth and associated surplus
      strain, extraordinary exposure to risk, mix of business, and use of
      reinsurance, if any, in each case.
         3.  The risk-based capital plan shall be filed within forty-five
      days of the company-action-level event, or, if the health
      organization requests a hearing pursuant to section 521F.8 for the
      purpose of challenging the adjusted risk-based capital report, within
      forty-five days after notification to the health organization that
      the commissioner, after hearing, has rejected the health
      organization's challenge.
         4.  Within sixty days after the submission by a health
      organization of a risk-based capital plan to the commissioner, the
      commissioner shall notify the health organization whether the
      risk-based capital plan shall be implemented or, in the judgment of
      the commissioner, is unsatisfactory.  If the commissioner determines
      the risk-based capital plan is unsatisfactory, the notification to
      the health organization shall set forth the reasons for the
      determination, and may set forth proposed revisions which in the
      judgment of the commissioner will render the risk-based capital plan
      satisfactory.  Upon the receipt of the notification from the
      commissioner, the health organization shall prepare a revised
      risk-based capital plan, which may incorporate by reference any
      revisions proposed by the commissioner, and file the revised
      risk-based capital plan with the commissioner.
         5.  The revised risk-based capital plan shall be filed within
      forty-five days of the receipt of notification from the commissioner
      of the commissioner's determination that the risk-based capital plan
      is unsatisfactory, or, if the health organization requests a hearing
      pursuant to section 521F.8 for the purpose of challenging the
      commissioner's determination, within forty-five days after
      notification to the health organization that the commissioner, after
      hearing, has rejected the health organization's challenge.
         6.  After notification of the health organization by the
      commissioner that the health organization's risk-based capital plan
      or revised risk-based capital plan is unsatisfactory, the
      commissioner, pursuant to section 521F.8, may specify in the
      notification that the notification constitutes a
      regulatory-action-level event.
         7. a.  A domestic health organization that files a risk-based
      capital plan or revised risk-based capital plan with the commissioner
      shall file a copy of the risk-based capital plan or revised
      risk-based capital plan with the insurance commissioner in a state in
      which the health organization is authorized to do business if both of
      the following apply:
         (1)  The other state has a risk-based capital provision
      substantially similar to section 521F.9, with respect to the
      confidentiality and availability of such plans.
         (2)  The insurance commissioner of that state has notified the
      health organization in writing of its request to receive a copy of
      the risk-based capital plan or revised risk-based capital plan.
         b.  Upon receipt of the written request under paragraph
      "a", subparagraph (2), the health organization shall file a copy
      of the risk-based capital plan or revised risk-based capital plan
      with the requesting commissioner by no later than the later of the
      following:
         (1)  Fifteen days after the receipt of the written request.
         (2)  The date on which the risk-based capital plan or revised
      risk-based capital plan is filed under subsection 3 or 5, as
      applicable.  

         2000 Acts, ch 1050, §4; 2000 Acts, ch 1232, §80
         Referred to in § 521F.2, 521F.5