Louisiana Revised Statutes 22:636 – Authorized-control level event
Terms Used In Louisiana Revised Statutes 22:636
- 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
- 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 Louisiana Revised Statutes 22:631
- Commissioner: means the commissioner of insurance. See Louisiana Revised Statutes 22:631
- Corrective order: means an order issued by the commissioner specifying corrective actions which the commissioner has determined are required. 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. “Authorized-control level event” means any of the following events:
(1) The filing of a risk-based capital report by the health organization that indicates that the health organization’s total adjusted capital is greater than or equal to its mandatory-control level risk-based capital but less than its authorized-control level risk-based capital.
(2) The 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.
(4) The failure of the health organization to respond, in a manner satisfactory to the commissioner, to a corrective order, provided the health organization has not challenged the corrective order pursuant to La. Rev. Stat. 22:638.
(5) If the health organization has challenged a corrective order pursuant to La. Rev. Stat. 22:638 and the commissioner has rejected the challenge or modified the corrective order, the failure of the health organization to respond, in a manner satisfactory to the commissioner, to the corrective order subsequent to rejection or modification by the commissioner.
B. In the event of an authorized-control level event with respect to a health organization, the commissioner shall do either of the following:
(1) Take such actions as are required under La. Rev. Stat. 22:635 regarding a health organization with respect to which a regulatory-action level event has occurred.
(2) If the commissioner deems it to be in the best interests of the policyholders and creditors of the health organization and of the public, take such actions as are necessary to cause the health organization to be placed 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 the event the commissioner takes such actions, the authorized-control level event shall be deemed sufficient grounds for the commissioner to take action pursuant to La. Rev. Stat. 22:73 and 96, Subpart H of this Part, and Chapter 9 of this Title 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.
Acts 2003, No. 1106, §1, eff. Dec. 31, 2003; Redesignated from La. Rev. Stat. 22:2036.6 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. 22:636 redesignated as La. Rev. Stat. 22:887 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.