Virginia Code 38.2-5504: Regulatory Action Level Event
A. “Regulatory Action Level Event” means, with respect to any licensee, any of the following events:
Terms Used In Virginia Code 38.2-5504
- adjusted capital: means net worth of a health maintenance organization and, for all other licensees, means surplus to policyholders. See Virginia Code 38.2-5501
- Adjusted RBC Report: means an RBC report which has been adjusted by the Commission in accordance with subsection F of § Virginia Code 38.2-5501
- Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
- Authorized Control Level RBC: means the number determined under the risk-based capital formula in accordance with the RBC Instructions;
4. See Virginia Code 38.2-5501
- Commission: means the State Corporation Commission. See Virginia Code 38.2-100
- Company: means any association, aggregate of individuals, business, corporation, individual, joint-stock company, Lloyds type of organization, organization, partnership, receiver, reciprocal or interinsurance exchange, trustee or society. See Virginia Code 38.2-100
- Corrective Order: means an order issued by the Commission specifying corrective actions which the Commission has determined are required. See Virginia Code 38.2-5501
- Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
- Licensee: means and includes a life and health insurer, a property and casualty insurer, and a health organization. See Virginia Code 38.2-5501
- RBC: means risk-based capital. See Virginia Code 38.2-5501
- RBC Instructions: means the RBC Report including risk-based capital instructions adopted by the NAIC, as such RBC Instructions may be amended by the NAIC from time to time in accordance with the procedures adopted by the NAIC. See Virginia Code 38.2-5501
- RBC Plan: means a comprehensive financial plan containing the elements specified in subsection B of § Virginia Code 38.2-5501
- RBC Report: means the report required in § Virginia Code 38.2-5501
- Regulatory Action Level RBC: means the product of 1. See Virginia Code 38.2-5501
1. The filing of an RBC Report by the licensee which indicates that the licensee’s Total Adjusted Capital is greater than or equal to its Authorized Control Level RBC but less than its Regulatory Action Level RBC;
2. The notification by the Commission to a licensee of an Adjusted RBC Report that indicates the event in subdivision A 1, provided the licensee does not challenge the Adjusted RBC Report under § 38.2-5507;
3. If, pursuant to § 38.2-5507, the licensee challenges an Adjusted RBC Report that indicates the event in subdivision A 1, the notification by the Commission to the licensee that the Commission has, after a hearing, rejected the licensee’s challenge;
4. The failure of the licensee to file an RBC Report by the filing date, unless the licensee has provided an explanation for such failure which is satisfactory to the Commission and has cured the failure within ten days after the filing date;
5. The failure of the licensee to submit an RBC Plan to the Commission within the time period set forth in subsection C of § 38.2-5503;
6. Notification by the Commission to the licensee that:
a. The RBC Plan or Revised RBC Plan submitted by the licensee is, in the judgment of the Commission, unsatisfactory; and
b. Such notification constitutes a Regulatory Action Level Event with respect to the licensee, provided the licensee has not challenged the determination under § 38.2-5507;
7. If, pursuant to § 38.2-5507, the licensee challenges a determination by the Commission under subdivision A 6, the notification by the Commission to the licensee that the Commission has, after a hearing, rejected such challenge;
8. Notification by the Commission to the licensee that the licensee has failed to adhere to its RBC Plan or Revised RBC Plan, but only if such failure has a substantial adverse effect on the ability of the licensee to eliminate the Company Action Level Event in accordance with its RBC Plan or Revised RBC Plan and the Commission has so stated in the notification, provided the licensee has not challenged the determination under § 38.2-5507; or
9. If, pursuant to § 38.2-5507, the licensee challenges a determination by the Commission under subdivision A 8, the notification by the Commission to the licensee that the Commission has, after a hearing, rejected the challenge.
B. In the event of a Regulatory Action Level Event, the Commission shall:
1. Require the licensee to prepare and submit an RBC Plan or, if applicable, a Revised RBC Plan;
2. Perform such examination or analysis as the Commission deems necessary of the assets, liabilities and operations of the licensee including a review of its RBC Plan or Revised RBC Plan; and
3. Subsequent to the examination or analysis, issue a corrective order specifying such corrective actions as the Commission shall determine are required. In determining corrective actions, the Commission may take into account such factors as are deemed relevant with respect to the licensee based upon the Commission’s examination or analysis of the assets, liabilities and operations of the licensee, including, but not limited to, the results of any sensitivity tests undertaken pursuant to the RBC Instructions.
C. The RBC Plan or Revised RBC Plan shall be submitted:
1. Within forty-five days after the occurrence of the Regulatory Action Level Event;
2. If the licensee challenges an Adjusted RBC Report pursuant to § 38.2-5507 and the challenge is not frivolous in the judgment of the Commission, within forty-five days after the notification to the licensee that the Commission has, after a hearing, rejected the licensee’s challenge; or
3. If the licensee challenges a Revised RBC Plan under § 38.2-5507 and the challenge is not frivolous in the judgment of the Commission, within forty-five days after notification to the licensee that the Commission has, after a hearing, rejected the licensee’s challenge.
D. The Commission may retain actuaries and investment experts and other consultants as may be necessary in the judgment of the Commission to review the licensee’s RBC Plan or Revised RBC Plan, examine or analyze the assets, liabilities and operations, including contractual relationships, of the licensee and formulate the corrective order with respect to the licensee. The fees, costs and expenses relating to consultants shall be borne by the affected licensee or such other party as directed by the Commission.