Okla. Stat. tit. 36 § 6938

Current through Laws 2024, c. 453.

Section 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 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.

Okla. Stat. tit. 36, § 6938

Added by Laws 2003 , SB 635, c. 197, §38, eff. 11/1/2003.