2006 Louisiana Laws - RS 22:2036.1 — Definitions

PART XII-B.  RISK-BASED CAPITAL REQUIREMENTS

FOR HEALTH MAINTENANCE ORGANIZATIONS

§2036.1.  Definitions

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

(1)  "Adjusted risk-based capital report" means a risk-based capital report which has been adjusted by the commissioner in accordance with R.S. 22:2036.2(C).

(2)  "Commissioner" means the commissioner of insurance.

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

(4)  "Health organization" means a health maintenance organization licensed under Part XII of Chapter 2 of this Title.

(5)  "Risk-based capital instructions" means the risk-based capital report including risk-based capital instructions adopted by the National Association of Insurance Commissioners, as these risk-based capital 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.

(6)  "Risk-based capital level" means a health organization's company action level risk-based capital, regulatory action level risk-based capital, authorized control level risk-based capital, or mandatory control level risk-based capital where:

(a)  Effective December 31, 2003:

(i)  "Company action level risk-based capital" means the product of 1.5 and the number determined  under the risk-based capital formula in accordance with the risk-based capital instructions.

(ii)  "Regulatory action level risk-based capital" means the product of 1.25 and the number determined  under the risk-based capital formula in accordance with the risk-based capital instructions.

(iii)  "Authorized control level risk-based capital" means the product of 1.1 and the number determined  under the risk-based capital formula in accordance with the risk-based capital instructions.

(iv)  "Mandatory control level risk-based capital" means the product of .95 and the number determined  under the risk-based capital formula in accordance with the risk-based capital instructions.

(b)  Effective December 31, 2004:

(i)  "Company action level risk-based capital" means the product of 2.0 and the number determined  under the risk-based capital formula in accordance with the risk-based capital instructions.

(ii)  "Regulatory action level risk-based capital" means the product of 1.5 and the number determined  under the risk-based capital formula in accordance with the risk-based capital instructions.

(iii)  "Authorized control level risk-based capital" means the product of 1.25 and the number determined  under the risk-based capital formula in accordance with the risk-based capital instructions.

(iv)  "Mandatory control level risk-based capital" means the product of .95 and the number determined under the risk-based capital formula in accordance with the risk-based capital instructions.

(7)  "Risk-based capital plan" means a comprehensive financial plan containing the elements specified in R.S. 22:2036.4(B). If the commissioner rejects the risk-based capital plan and it is revised by the health organization, with or without the commissioner's recommendation, the plan shall be called the "revised risk-based capital plan".

(8)  "Risk-based capital report" means the report required in R.S. 22:2036.2.

(9)  "Total adjusted capital" means the sum of the following:

(a)  A health organization's statutory capital and surplus as determined in accordance with the statutory accounting applicable to the annual financial statements required to be filed under R.S. 22:2008.

(b)  Such other items, if any, as the risk-based capital instructions may provide.

Acts 2003, No. 1106, §1, eff. Dec. 31, 2003.