Part Definitions

Checkout our iOS App for a better way to browser and research.

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

  1. “Adjusted RBC report” means an RBC report which has been adjusted by the commissioner in accordance with § 56-46-202(d);
  2. “Corrective order” means an order issued by the commissioner specifying corrective actions which the commissioner has determined are required;
  3. “Domestic health organization” means a health organization domiciled in this state;
  4. “Foreign health organization” means a health organization that is licensed to do business in this state under chapters 27, 28, 30, 31, 32 and 51 of this title but is not domiciled in this state;
    1. “Health organization” means a health maintenance organization, limited health service organization, dental or vision plan, hospital, medical and dental indemnity or service corporation, or other managed care organization licensed pursuant to chapters 27, 28, 30, 31, 32 and 51 of this title;
    2. “Health organization” does not include an organization that is licensed as either a life and health insurer or a property and casualty insurer under this title and that is otherwise subject to either the life or property and casualty RBC requirements;
  5. “NAIC” means the National Association of Insurance Commissioners;
  6. “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;
  7. “RBC level” means a health organization's Company Action Level RBC, Regulatory Action Level RBC, Authorized Control Level RBC, or Mandatory Control Level RBC where:
    1. “Company Action Level RBC” means, with respect to any health organization, the product of 2.0 and its Authorized Control Level RBC;
    2. “Regulatory Action Level RBC” means the product of 1.5 and its Authorized Control Level RBC;
    3. “Authorized Control Level RBC” means the number determined under the risk-based capital formula in accordance with the RBC Instructions; and
    4. “Mandatory Control Level RBC” means the product of 0.70 and the Authorized Control Level RBC;
    1. “RBC plan” means a comprehensive financial plan containing the elements specified in § 56-46-203(b);
    2. If the commissioner rejects the RBC plan, and it is revised by the health organization, with or without the commissioner's recommendation, the plan shall be called the “revised RBC plan”;
  8. “RBC report” means the report required in § 56-46-202;
  9. “Total adjusted capital” means the sum of:
    1. A health organization's statutory capital and surplus, also known as net worth, as determined in accordance with the statutory accounting applicable to the annual financial statements required to be filed under § 56-27-117 for medical service plans, § 56-28-111 for hospital service corporations, § 56-30-117 for dental service plans, § 56-31-116 for vision service plans, § 56-32-108 for health maintenance organizations, and § 56-51-134 for prepaid limited health services organizations; and
    2. Such other items, if any, as the RBC instructions may provide.


Download our app to see the most-to-date content.