Missouri § 375.1257 - Regulatory action level event, occurrence of, when — director's duties, corrective actions — plan to be submitted by insurer — or health organization.

§ 375.1257. Regulatory action level event, occurrence of, when — director's duties, corrective actions — plan to be submitted by insurer — or health organization.

1.  "Regulatory action level event" means, with respect to any insurer or health organization, any of the following events:

(1)  The filing of an RBC report by the insurer or health organization which indicates that the insurer's or health organization's total adjusted capital is greater than or equal to its authorized control level RBC but less than its regulatory action level RBC;

(2)  The notification by the director to an insurer or health organization of an adjusted RBC report that indicates the event in subdivision (1) of this subsection, if the insurer or health organization does not challenge the adjusted RBC report under section 375.1265;

(3)  If, pursuant to section 375.1265, the insurer or health organization challenges an adjusted RBC report that indicates the event in subdivision (1) of this subsection, the notification by the director to the insurer or health organization that the director has, after a hearing, rejected the insurer's or health organization's challenge;

(4)  The failure of the insurer or health organization to file an RBC report by the filing date, unless the insurer or health organization has provided an explanation for such failure which is satisfactory to the director and has cured the failure within ten days after the filing date;

(5)  The failure of the insurer or health organization to submit an RBC plan to the director within the time period set forth in subsection 3 of section 375.1255;

(6)  Notification by the director to the insurer or health organization that:

(a)  The RBC plan or revised RBC plan submitted by the insurer or health organization is, in the judgment of the director, unsatisfactory; and

(b)  Such notification constitutes a regulatory action level event with respect to the insurer or health organization, where the insurer or health organization has not challenged the determination under section 375.1265;

(7)  If, pursuant to section 375.1265, the insurer or health organization challenges a determination by the director under subdivision (6) of this subsection, the notification by the director to the insurer or health organization that the director has, after a hearing, rejected such challenge;

(8)  Notification by the director to the insurer or health organization that the insurer or health organization has failed to adhere to its RBC plan or revised RBC plan, but only if such failure has a substantial adverse effect on the ability of the insurer or health organization to eliminate the company action level event in accordance with its RBC plan or revised RBC plan and the director has so stated in the notification provided the insurer or health organization has not challenged the determination under section 375.1265; or

(9)  If, pursuant to section 375.1265, the insurer or health organization challenges a determination by the director under subdivision (8) of this subsection the notification by the director to the insurer or health organization that the director has, after a hearing, rejected the challenge.

2.  In the event of a regulatory action level event the director shall:

(1)  Require the insurer or health organization to prepare and submit an RBC plan or, if applicable, a revised RBC plan;

(2)  Perform such examination or analysis as the director deems necessary of the assets, liabilities and operations of the insurer or health organization, including a review of its RBC plan or revised RBC plan; and

(3)  Subsequent to the examination or analysis, issue an order specifying such corrective actions as the director shall determine are required.

3.  In determining corrective actions, the director may take into account such factors as are deemed relevant with respect to the insurer or health organization based upon the director's examination or analysis of the assets, liabilities and operations of the insurer or health organization, including, but not limited to, the results of any sensitivity tests undertaken pursuant to the RBC instructions.  The RBC plan or revised RBC plan shall be submitted:

(1)  Within forty-five days after the occurrence of the regulatory action level event;

(2)  If the insurer or health organization challenges an adjusted RBC report pursuant to section 375.1265, within forty-five days after the notification to the insurer or health organization that the director has, after a hearing, rejected the insurer's or health organization's challenge; or

(3)  If the insurer or health organization challenges a revised RBC plan under section 375.1265, within forty-five days after notification to the insurer or health organization that the director has, after a hearing, rejected the challenge.

4.  The director may retain actuaries and investment experts and other consultants as may be necessary in the judgment of the director to review the insurer's or health organization's RBC plan or revised RBC plan, examine or analyze the assets, liabilities and operations of the insurer or health organization and formulate the corrective order with respect to the insurer or health organization.  The fees, costs and expenses relating to the consultants shall be borne by the affected insurer or health organization.

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(L. 1993 H.B. 709 § 4, A.L. 1996 S.B. 759, A.L. 2014 H.B. 1968)

---- end of effective  28 Aug 2014 ----

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