Oklahoma § 36-6938 - Definitions

§ 36-6938. Definitions

As used in the Risk-based Capital (RBC) for Health Maintenance

Organizations Act of 2003:

1. “Adjusted Risk-based Capital (RBC) report” means an RBC

report which has been adjusted by the Insurance Commissioner in

accordance with the provisions of subsection C of Section 39 of this

act;

2. “Corrective order” means an order issued by the Commissioner

specifying corrective actions which the Insurance Commissioner has

determined are required;

3. “Domestic health maintenance organization” means a health

maintenance organization domiciled in this state;

4. “Foreign health maintenance organization” means a health

maintenance organization that is licensed to do business in this

Oklahoma Statutes - Title 36. Insurance

state under the Health Maintenance Organization Act of 2003, but is

not domiciled in this state;

5. “NAIC” means the National Association of Insurance

Commissioners;

6. “Health maintenance organization” means a health maintenance

organization licensed under the Health Maintenance Organization Act

of 2003. This definition does not include an organization that is

licensed as either a life and health insurer or a property and

casualty insurer under Title 36 of the Oklahoma Statutes and that is

otherwise subject to either life or property and casualty RBC

requirements;

7. “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 from time to time in accordance with the

procedures adopted by the NAIC;

8. “RBC level” means a health maintenance 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 maintenance 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, or

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 subsection B of Section 40 of this act.

If the Insurance Commissioner rejects the RBC plan, and it is

revised by the health maintenance organization, with or without the

Insurance Commissioner’s recommendation, the plan shall be called

the “revised RBC plan”;

10. “RBC report” means the report required in Section 39 of

this act; and

11. “Total adjusted capital” means the sum of:

a.

a health maintenance organization’s statutory capital

and surplus, or its net worth, as determined in

accordance with the statutory accounting applicable to

the annual financial statements required to be filed

under Section 9 of this act, and

b.

such other items, if any, as the RBC instructions may

provide.

Added by Laws 2003, c. 197, § 38, eff. Nov. 1, 2003.

Oklahoma Statutes - Title 36. Insurance