Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 25.00 - Risk-based Capital (rbc) For Health Organizations › Section 25.01 - Definitions

Current through Register 1525, July 5, 2024
The following words as used in
				211 CMR 25.00 shall, unless
				the context requires otherwise, have the following meanings:
Adjusted RBC Report
. An RBC Report
				which has been adjusted by the Commissioner in accordance with
				211 CMR 25.02.
Commissioner
. The Commissioner of
				Insurance, appointed pursuant to M.G.L. c. 26, § 6 or his or her
				designee.
Corrective Order
. An order issued by
				the Commissioner pursuant to
				211 CMR
				25.04(2)(c), specifying
				corrective actions which the Commissioner has determined are required.
Domestic Health Organization
. A Health
				Organization organized under the laws of the Commonwealth and qualified to do
				business in the Commonwealth.
Filing Date
. March
				1st.
Foreign Health Organization
. A Health
				Organization formed by authority of any state or government other than the
				Commonwealth and qualified to conduct business in the Commonwealth.
Health Organization
. A nonprofit
				hospital service corporation authorized under M.G.L. c. 176A, a nonprofit
				medical service corporation authorized under M.G.L. c. 176B, a dental service
				corporation authorized under M.G.L. c. 176E, an optometric service corporation
				authorized under M.G.L. c. 176F, or a health maintenance organization
				authorized under M.G.L. c. 176G.
Health Organization
does not include an organization that is licensed as a life and/or health
				insurer under M.G.L. c. 175 or a property and casualty insurer under M.G.L. c.
				175 and that is otherwise subject to
				211 CMR 20.00:
Risk-based Capital (RBC) for Insurers.
NAIC
. The National Association of
				Insurance Commissioners
RBC Instructions
. 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.
RBC Level
. A Health Organization's
				Company Action Level RBC, Regulatory Action Level RBC, Authorized Control Level
				RBC, or Mandatory Control Level RBC where:
Company Action Level RBC
. With respect
				to any Health Organization, the product of 2.0 and its Authorized Control Level
				RBC;
Authorized Control Level RBC
. The
				number determined under the risk based capital formula in accordance with the
				RBC Instructions;
Regulatory Action Level RBC
. The
				product of 1.5 and its Authorized Control Level RBC;
Mandatory
				Control Level RBC
. the product of .70 and the Authorized Control
				Level RBC.
RBC Plan
. A comprehensive financial
				plan containing the elements specified in
				211 CMR
				25.03(2). If the
				Commissioner rejects the RBC Plan, and it is revised by the Health
				Organization, with or without the Commissioner's recommendation, the plan shall
				be called the
Revised RBC Plan
.
RBC Report
. The report required in
				211 CMR 25.02.
Total Adjusted Capital
. The sum
				of:
(a) A Health Organization's statutory capital and surplus
(i.e.
net worth) as determined in accordance with the
				statutory accounting applicable to the annual financial statements required to
				be filed under M.G.L. c. 176A, §§ 3, 18, 24; c. 176B, §§ 8,
				9, 10; c. 176E, §§ 8, 9, 10; c. 176F, §§ 8, 9, 10; and c.
				176G, §§ 10, 25; and
(b) Such other items, if any, as the RBC Instructions may
				provide.