Nebraska Statutes 44-6017. Regulatory action level event
(1) Regulatory action level event means any of the following events:
Terms Used In Nebraska Statutes 44-6017
- Action: shall include any proceeding in any court of this state. See Nebraska Statutes 49-801
- Adjusted risk-based capital report: means a risk-based capital report which has been adjusted by the director in accordance with subsection (6) of section Nebraska Statutes 44-6003
- Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
- Authorized control level risk-based capital: means the number determined under the risk-based capital formula in accordance with the risk-based capital instructions. See Nebraska Statutes 44-6011
- Company: shall include any corporation, partnership, limited liability company, joint-stock company, joint venture, or association. See Nebraska Statutes 49-801
- Corrective order: means an order issued by the director specifying corrective actions which the director has determined are required. See Nebraska Statutes 44-6004
- Director: means the Director of Insurance. See Nebraska Statutes 44-6005
- Health organization: means a health maintenance organization, prepaid limited health service organization, prepaid dental service corporation, or other managed care organization. See Nebraska Statutes 44-6007.02
- Insurer: means an insurer as defined in section Nebraska Statutes 44-6008
- Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
- Regulatory action level risk-based capital: means the product of 1. See Nebraska Statutes 44-6011
- Risk-based capital instructions: means the risk-based capital report, including risk-based capital instructions adopted by the National Association of Insurance Commissioners, as such instructions may be amended by the association from time to time in accordance with the procedures adopted by the association. See Nebraska Statutes 44-6010
- Risk-based capital plan: means a comprehensive financial plan containing the elements specified in subsection (2) of section Nebraska Statutes 44-6012
- Risk-based capital report: means the report required in section Nebraska Statutes 44-6013
- Total adjusted capital: means the sum of:
(1) An insurer's or a health organization's statutory capital and surplus as determined in accordance with the statutory accounting applicable to the annual financial statements required to be filed under sections Nebraska Statutes 44-6014
(a) The filing of a risk-based capital 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 risk-based capital but less than its regulatory action level risk-based capital;
(b) The notification by the director to an insurer or a health organization of an adjusted risk-based capital report that indicates the event described in subdivision (1)(a) of this section unless the insurer or health organization challenges the adjusted risk-based capital report under section 44-6020 ;
(c) If, pursuant to section 44-6020, the insurer or health organization challenges an adjusted risk-based capital report that indicates the event described in subdivision (1)(a) of this section, 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;
(d) The failure of the insurer or health organization to file a risk-based capital report by the filing date prescribed in section 44-6015 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;
(e) The failure of the insurer or health organization to submit a risk-based capital plan to the director within the time period set forth in subsection (3) of section 44-6016 ;
(f) Notification by the director to the insurer or health organization that:
(i) The risk-based capital plan or revised risk-based capital plan submitted by the insurer or health organization is, in the judgment of the director, unsatisfactory; and
(ii) Such notification constitutes a regulatory action level event with respect to the insurer or health organization unless the insurer or health organization has challenged the determination under section 44-6020 ;
(g) If, pursuant to section 44-6020, the insurer or health organization challenges a determination by the director under subdivision (1)(f) of this section, the notification by the director to the insurer or health organization that the director has, after a hearing, rejected such challenge;
(h) Notification by the director to the insurer or health organization that the insurer or health organization has failed to adhere to its risk-based capital plan or revised risk-based capital 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 risk-based capital plan or revised risk-based capital plan and the director has so stated in the notification unless the insurer or health organization has challenged the determination under section 44-6020 ; or
(i) If, pursuant to section 44-6020, the insurer or health organization challenges a determination by the director under subdivision (1)(h) of this section, 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:
(a) Require the insurer or health organization to prepare and submit a risk-based capital plan or, if applicable, a revised risk-based capital plan;
(b) 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 risk-based capital plan or revised risk-based capital plan; and
(c) Subsequent to the examination or analysis, issue a corrective order.
(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 risk-based capital instructions. The risk-based capital plan or revised risk-based capital plan shall be submitted:
(a) Within forty-five days after the occurrence of the regulatory action level event;
(b) If the insurer or health organization challenges an adjusted risk-based capital report pursuant to section 44-6020 and the challenge is not frivolous in the judgment of the director, 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
(c) If the insurer or health organization challenges a revised risk-based capital plan pursuant to section 44-6020 and the challenge is not frivolous in the judgment of the director, 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.
(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 risk-based capital plan or revised risk-based capital plan, to examine or analyze the assets, liabilities, and operations, including contractual relationships in the case of a health organization, of the insurer or health organization, and to formulate the corrective order with respect to the insurer or health organization. The fees, costs, and expenses relating to consultants shall be borne by the affected insurer or health organization or such other party as directed by the director.