(1) “Company action level event” means any of the following events:

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Terms Used In Utah Code 31A-17-603

  • Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
  • Domestic insurer: means an insurer organized under the laws of this state. See Utah Code 31A-1-301
  • Equal: means , with respect to biological sex, of the same value. See Utah Code 68-3-12.5
  • Filed: means that a filing is:
              (69)(a)(i) submitted to the department as required by and in accordance with applicable statute, rule, or filing order;
              (69)(a)(ii) received by the department within the time period provided in applicable statute, rule, or filing order; and
              (69)(a)(iii) accompanied by the appropriate fee in accordance with:
                   (69)(a)(iii)(A) Section 31A-3-103; or
                   (69)(a)(iii)(B) rule. See Utah Code 31A-1-301
  • Filing: when used as a noun, means an item required to be filed with the department including:
         (70)(a) a policy;
         (70)(b) a rate;
         (70)(c) a form;
         (70)(d) a document;
         (70)(e) a plan;
         (70)(f) a manual;
         (70)(g) an application;
         (70)(h) a report;
         (70)(i) a certificate;
         (70)(j) an endorsement;
         (70)(k) an actuarial certification;
         (70)(l) a licensee annual statement;
         (70)(m) a licensee renewal application;
         (70)(n) an advertisement;
         (70)(o) a binder; or
         (70)(p) an outline of coverage. See Utah Code 31A-1-301
  • Health organization: means :
         (3)(b) that is:
              (3)(b)(i) a health maintenance organization;
              (3)(b)(ii) a limited health service organization;
              (3)(b)(iii) a dental or vision plan;
              (3)(b)(iv) a hospital, medical, and dental indemnity or service corporation; or
              (3)(b)(v) other managed care organization. See Utah Code 31A-17-601
  • Insurance: includes :
              (96)(b)(i) a risk distributing arrangement providing for compensation or replacement for damages or loss through the provision of a service or a benefit in kind;
              (96)(b)(ii) a contract of guaranty or suretyship entered into by the guarantor or surety as a business and not as merely incidental to a business transaction; and
              (96)(b)(iii) a plan in which the risk does not rest upon the person who makes an arrangement, but with a class of persons who have agreed to share the risk. See Utah Code 31A-1-301
  • Property: includes both real and personal property. See Utah Code 68-3-12.5
  • Property and casualty insurer: means any insurance company licensed to write lines of insurance other than life but does not include a monoline mortgage guaranty insurer, financial guaranty insurer, or title insurer. See Utah Code 31A-17-601
  • RBC: means risk-based capital. See Utah Code 31A-17-601
  • RBC instructions: means the RBC report including the National Association of Insurance Commissioner's risk-based capital instructions that govern the year for which an RBC report is prepared. See Utah Code 31A-17-601
  • RBC plan: means a comprehensive financial plan containing the elements specified in Subsection 31A-17-603(2). See Utah Code 31A-17-601
  • RBC report: means the report required in Section 31A-17-602. See Utah Code 31A-17-601
  • Reinsurance: means an insurance transaction where an insurer, for consideration, transfers any portion of the risk it has assumed to another insurer. See Utah Code 31A-1-301
  • State: when applied to the different parts of the United States, includes a state, district, or territory of the United States. See Utah Code 68-3-12.5
  • Surplus: means the excess of assets over the sum of paid-in capital and liabilities. See Utah Code 31A-1-301
  • Total adjusted capital: means the sum of an insurer's or health organization's statutory capital and surplus as determined in accordance with:
         (189)(a) the statutory accounting applicable to the annual financial statements required to be filed under Section 31A-4-113; and
         (189)(b) another item provided by the RBC instructions, as RBC instructions is defined in Section 31A-17-601. See Utah Code 31A-1-301
  • Writing: includes :
         (48)(a) printing;
         (48)(b) handwriting; and
         (48)(c) information stored in an electronic or other medium if the information is retrievable in a perceivable format. See Utah Code 68-3-12.5
     (1)(a) the filing of an RBC report by an insurer or health organization that indicates that:

          (1)(a)(i) the insurer’s or health organization’s total adjusted capital is greater than or equal to its regulatory action level RBC but less than its company action level RBC;
          (1)(a)(ii) if a life insurer, accident and health insurer, or health organization, the insurer or health organization:

               (1)(a)(ii)(A) has total adjusted capital that is greater than or equal to its company action level RBC but less than the product of its authorized control level RBC and 3.0; and
               (1)(a)(ii)(B) triggers the trend test determined in accordance with the trend test calculation included in the life, fraternal, or health RBC instructions; or
          (1)(a)(iii) if a property and casualty insurer, the insurer has:

               (1)(a)(iii)(A) total adjusted capital that is greater than or equal to its company action level RBC, but less than the product of its authorized control level RBC and 3.0; and
               (1)(a)(iii)(B) triggers the trend test determined in accordance with the trend test calculation included in the property and casualty RBC instructions;
     (1)(b) the notification by the commissioner to the insurer or health organization of an adjusted RBC report that indicates an event in Subsection (1)(a), provided the insurer or health organization does not challenge the adjusted RBC report under Section 31A-17-607; or
     (1)(c) if, pursuant to Section 31A-17-607, an insurer or health organization challenges an adjusted RBC report that indicates the event in Subsection (1)(a), the notification by the commissioner to the insurer or health organization that after a hearing the commissioner rejects the insurer’s or health organization’s challenge.
(2)

     (2)(a) In the event of a company action level event, the insurer or health organization shall prepare and submit to the commissioner an RBC plan that shall:

          (2)(a)(i) identify the conditions that contribute to the company action level event;
          (2)(a)(ii) contain proposals of corrective actions that the insurer or health organization intends to take and that are expected to result in the elimination of the company action level event;
          (2)(a)(iii) provide projections of the insurer’s or health organization’s financial results in the current year and at least the four succeeding years, both in the absence of proposed corrective actions and giving effect to the proposed corrective actions, including projections of:

               (2)(a)(iii)(A) statutory operating income;
               (2)(a)(iii)(B) net income;
               (2)(a)(iii)(C) capital;
               (2)(a)(iii)(D) surplus; and
               (2)(a)(iii)(E) RBC levels;
          (2)(a)(iv) identify the key assumptions impacting the insurer’s or health organization’s projections and the sensitivity of the projections to the assumptions; and
          (2)(a)(v) identify the quality of, and problems associated with, the insurer’s or health organization’s business, including its assets, anticipated business growth and associated surplus strain, extraordinary exposure to risk, mix of business and use of reinsurance, if any, in each case.
     (2)(b) For purposes of Subsection (2)(a)(iii), the 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.
(3) The RBC plan shall be submitted:

     (3)(a) within 45 days of the company action level event; or
     (3)(b) if the insurer or health organization challenges an adjusted RBC report pursuant to Section 31A-17-607, within 45 days after notification to the insurer or health organization that after a hearing the commissioner rejects the insurer’s or health organization’s challenge.
(4)

     (4)(a) Within 60 days after the submission by an insurer or health organization of an RBC plan to the commissioner, the commissioner shall notify the insurer or health organization whether the RBC plan:

          (4)(a)(i) shall be implemented; or
          (4)(a)(ii) is unsatisfactory.
     (4)(b) If the commissioner determines the RBC plan is unsatisfactory, the notification to the insurer or health organization shall set forth the reasons for the determination, and may propose revisions that will render the RBC plan satisfactory. Upon notification from the commissioner, the insurer or health organization shall:

          (4)(b)(i) prepare a revised RBC plan that incorporates any revision proposed by the commissioner; and
          (4)(b)(ii) submit the revised RBC plan to the commissioner:

               (4)(b)(ii)(A) within 45 days after the notification from the commissioner; or
               (4)(b)(ii)(B) if the insurer challenges the notification from the commissioner under Section 31A-17-607, within 45 days after a notification to the insurer or health organization that after a hearing the commissioner rejects the insurer’s or health organization’s challenge.
(5) In the event of a notification by the commissioner to an insurer or health organization that the insurer’s or health organization’s RBC plan or revised RBC plan is unsatisfactory, the commissioner may specify in the notification that the notification constitutes a regulatory action level event subject to the insurer’s or health organization’s right to a hearing under Section 31A-17-607.
(6) Every domestic insurer or health organization that files an RBC plan or revised RBC plan with the commissioner shall file a copy of the RBC plan or revised RBC plan with the insurance commissioner in any state in which the insurer or health organization is authorized to do business if:

     (6)(a) the state has an RBC provision substantially similar to Subsection 31A-17-608(1); and
     (6)(b) the insurance commissioner of that state notifies the insurer or health organization of its request for the filing in writing, in which case the insurer or health organization shall file a copy of the RBC plan or revised RBC plan in that state no later than the later of:

          (6)(b)(i) 15 days after the receipt of notice to file a copy of its RBC plan or revised RBC plan with that state; or
          (6)(b)(ii) the date on which the RBC plan or revised RBC plan is filed under Subsections (3) and (4).
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