Louisiana Revised Statutes 22:637 – Mandatory-control level event
Terms Used In Louisiana Revised Statutes 22:637
- Adjusted risk-based capital report: means a risk-based capital report which has been adjusted by the commissioner in accordance with Louisiana Revised Statutes 22:631
- Commissioner: means the commissioner of insurance. See Louisiana Revised Statutes 22:631
- Health organization: means a health maintenance organization licensed under Subpart I of Part I of this Chapter, a limited health service organization which bears risk, dental or vision plan which bears risk, hospital, medical and dental indemnity or service corporation which bears risk, provider-sponsored organization which bears risk, or other risk-bearing managed care organization licensed under this Title. See Louisiana Revised Statutes 22:631
- Mandatory-control level risk-based capital: means the product of seventy hundredths and the number determined under the risk-based capital formula in accordance with the risk-based capital instructions. See Louisiana Revised Statutes 22:631
- Risk-based capital report: means the report required in Louisiana Revised Statutes 22:631
- Total adjusted capital: means the sum of the following:
(a) 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 Louisiana Revised Statutes 22:631
A. “Mandatory-control level event” means any of the following events:
(1) The filing of a risk-based capital report which indicates that the health organization‘s total adjusted capital is less than its mandatory-control level risk-based capital.
(2) Notification by the commissioner to the health organization of an adjusted risk-based capital report that indicates the event in Paragraph (1) of this Subsection, provided the health organization does not challenge the adjusted risk-based capital report pursuant to La. Rev. Stat. 22:638.
(3) If, pursuant to La. Rev. Stat. 22:638, the health organization challenges an adjusted risk-based capital report that indicates the event in Paragraph (1) of this Subsection, notification by the commissioner to the health organization that the commissioner has rejected the health organization’s challenge.
B. In the event of a mandatory-control level event, the commissioner shall take such actions as are necessary to place the health organization under regulatory control pursuant to La. Rev. Stat. 22:73 and 96, Subpart H of this Part, La. Rev. Stat. 22:731 et seq., and Chapter 9 of this Title, La. Rev. Stat. 22:2001 et seq. In that event, the mandatory-control level event shall be deemed sufficient grounds for the commissioner to take action under, and the commissioner shall have the rights, powers, and duties with respect to the health organization as are set forth in La. Rev. Stat. 22:73 and 96, Subpart H of this Part, and Chapter 9 of this Title. Notwithstanding any of the foregoing, the commissioner may forego action for up to ninety days after the mandatory-control level event if the commissioner finds there is a reasonable expectation that the mandatory-control level event may be eliminated within the ninety-day period.
Acts 2003, No. 1106, §1, eff. Dec. 31, 2003; Redesignated from La. Rev. Stat. 22:2036.7 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009; Acts 2009, No. 317, §1; Acts 2009, No. 503, §1.
NOTE: Former La. Rev. Stat. 22:637 redesignated as La. Rev. Stat. 22:885 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.