40 Pa. Stat. § 221.5-B

Current through Pa Acts 2024-53, 2024-56 through 2024-92
Section 221.5-B - Company action level event
(a) In the event of a company action level event, a health organization shall submit an RBC plan to the department to include, at a minimum, all of the following:
(1) Identification of the conditions that contributed to the company action level event.
(2) Proposed corrective actions to eliminate the company action level event.
(3) Projections of the health organization's financial results for the current year and at least the four succeeding years, with and without the proposed corrective actions, to include projections of statutory balance sheets, operating income, net income, capital, surplus and RBC levels. Projections for both new and renewal business may include separate projections for each major line of business and separately identify each significant income, expense and benefit component.
(4) The key assumptions impacting the projections under paragraph (3) and the sensitivity of the projections to the assumptions.
(5) The quality of and problems associated with the health organization's business, including assets, anticipated business growth and associated surplus strain, extraordinary exposure to risk, mix of business and use of reinsurance.
(b) An RBC plan under subsection (a) shall be submitted within forty-five days after the occurrence of the company action level event.
(c) Within sixty days of the submission of an RBC plan under subsection (a), the department shall notify the health organization whether the RBC plan should be implemented or that the plan is unsatisfactory. The notification shall set forth the specific reasons for a determination that the plan is unsatisfactory and may include revisions that will make the RBC plan satisfactory to the department.
(d) Upon notification under subsection (c) that the RBC plan is unsatisfactory, the health organization shall prepare a revised RBC plan which may include revisions proposed by the department. Except as provided in subsection (e), the revised RBC plan shall be submitted within forty-five days after notification that the plan is unsatisfactory.
(e) The department may specify that the notification under subsection (c) constitutes a regulatory action level event. In the alternative, the department may take any other action necessary to place the health organization under regulatory control pursuant to Article V.
(f) Every domestic health organization that files an RBC plan or revised RBC plan under this section shall file a copy with the chief insurance regulatory official of any jurisdiction in which the health organization is authorized to do business if:
(1) The jurisdiction has an RBC provision substantially similar to section 511-B(a) and (b) .
(2) The chief insurance regulatory official of the jurisdiction has provided a written request to the health organization for a copy of the RBC plan or revised RBC plan. Upon receipt of the written request, the health organization shall file a copy of the RBC plan or revised RBC plan within fifteen days of the receipt of notice or by the date the RBC plan or revised RBC plan is filed under this section, whichever is later.

40 P.S. § 221.5-B

1921, May 17, P.L. 789, No. 285, § 221.5-B, added 2000, June 22, P.L. 457, No. 62, § 1, imd. effective.