reglab/statecodes huggingface dataset:
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 20.00 - Risk-based Capital (rbc) For Insurers › Section 20.03 - Company Action Level Event

Current through Register 1525, July 5, 2024
(1)
Company Action Level Event
. Means any of the following
			 events:
(a) The filing of an RBC Report by an
			 insurer which indicates that:
1. The
			 insurer's total adjusted capital is greater than or equal to its Regulatory
			 Action Level RBC but less than its Company Action Level RBC; or
2. If a life and/or health insurer or a
			 Fraternal Benefit Society, the insurer or society has total adjusted capital
			 which 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 has a negative
			 trend.
3. If a property and
			 casualty insurer, the insurer has total adjusted capital which 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 triggers the trend test determined in
			 accordance with the trend test calculation included in the Property and
			 Casualty RBC instructions.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 20.00 - Risk-based Capital (rbc) For Insurers › Section 20.04 - Regulatory Action Level Event

Current through Register 1525, July 5, 2024
(1)
Regulatory Action Level Event
. Means, with respect to
			 any insurer, any of the following events:
(a)
			 The filing of an RBC Report by the insurer which indicates that the insurer's
			 total adjusted capital is greater than or equal to its Authorized Control Level
			 RBC but less than its Regulatory Action Level RBC;
(b) The notification by the Commissioner to
			 an insurer of an Adjusted RBC Report that indicates the event in 211 CMR
			 20.04(1)(a), provided the insurer does not challenge the Adjusted RBC Report
			 under
			 211 CMR 20.07;
(c) If, pursuant to
			 211 CMR 20.07, the
			 insurer challenges an Adjusted RBC Report that indicates the event in 211 CMR
			 20.04(1)(a), the notification by the Commissioner to the insurer that the
			 Commissioner has, after a hearing, rejected the insurer's challenge;
(d) The failure of the insurer to file an RBC
			 Report by the Filing Date, unless the insurer has provided an explanation for
			 such failure which is satisfactory to the Commissioner and has cured the
			 failure within ten days after the Filing Date;
(e) The failure of the insurer to submit an
			 RBC Plan to the Commissioner within the time period set forth in
			 211 CMR
			 20.03(3);
(f) Notification by the Commissioner to the
			 insurer that
1. The RBC Plan or Revised RBC
			 Plan submitted by the insurer is, in the judgment of the Commissioner,
			 unsatisfactory; and
2. Such
			 notification constitutes a Regulatory Action Level Event with respect to the
			 insurer, provided the insurer has not challenged the determination under
			 211 CMR 20.07;
(g) If, pursuant to
			 211 CMR 20.07, the
			 insurer challenges a determination by the Commissioner under 211 CMR
			 20.04(1)(f), the notification by the Commissioner to the insurer that the
			 Commissioner has, after a hearing, rejected such challenge;
(h) Notification by the Commissioner to the
			 insurer that the insurer 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 insurer to eliminate the Company Action Level Event in accordance with
			 its RBC Plan or Revised RBC Plan and the Commissioner has so stated in the
			 notification, provided the insurer has not challenged the determination under
			 211 CMR 20.07; or
(i) If, pursuant to
			 211 CMR 20.07, the
			 insurer challenges a determination by the Commissioner under 211 CMR
			 20.04(1)(h), the notification by the Commissioner to the insurer that the
			 Commissioner has, after a hearing, rejected the challenge.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 20.00 - Risk-based Capital (rbc) For Insurers › Section 20.05 - Authorized Control Level Event

Current through Register 1525, July 5, 2024
(1)
Authorized Control Level Event
. Means any of the
			 following events:
(a) The filing of an RBC
			 Report by the insurer which indicates that the insurer's total adjusted capital
			 is greater than or equal to its Mandatory Control Level RBC but less than its
			 Authorized Control Level RBC;
(b)
			 The notification by the Commissioner to the insurer of an Adjusted RBC Report
			 that indicates the event in 211 CMR 20.05(1)(a), provided the insurer does not
			 challenge the Adjusted RBC Report under
			 211 CMR 20.07;
(c) If, pursuant to
			 211 CMR 20.07, the
			 insurer challenges an Adjusted RBC Report that indicates the event in 211 CMR
			 20.05(1)(a), notification by the Commissioner to the insurer that the
			 Commissioner has, after a hearing, rejected the insurer's challenge;
(d) The failure of the insurer to respond, in
			 a manner satisfactory to the Commissioner, to a corrective order (provided the
			 insurer has not challenged the corrective order under
			 211 CMR 20.07 );
			 or
(e) If the insurer has
			 challenged a corrective order under
			 211 CMR 20.07, and the
			 Commissioner has, after a hearing, rejected the challenge or modified the
			 corrective order, the failure of the insurer to respond, in a manner
			 satisfactory to the Commissioner, to the corrective order subsequent to
			 rejection or modification by the Commissioner.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 20.00 - Risk-based Capital (rbc) For Insurers › Section 20.06 - Mandatory Control Level Event

Current through Register 1525, July 5, 2024
(1)
Mandatory Control Level Event
. Means any of the
			 following events:
(a) The filing of an RBC
			 Report which indicates that the insurer's total adjusted capital is less than
			 its Mandatory Control Level RBC;
(b) Notification by the Commissioner to the
			 insurer of an Adjusted RBC Report that indicates the event in 211 CMR
			 20.06(1)(a), provided the insurer does not challenge the Adjusted RBC Report
			 under
			 211 CMR 20.07;
			 or
(c) If, pursuant to
			 211 CMR 20.07, the
			 insurer challenges an Adjusted RBC Report that indicates the event in 211 CMR
			 20.06(1)(a), notification by the Commissioner to the insurer that the
			 Commissioner has, after a hearing, rejected the insurer's challenge.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 20.00 - Risk-based Capital (rbc) For Insurers › Section 20.07 - Hearings

Current through Register 1525, July 5, 2024
Upon any of the following the insurer shall have the right to a
				confidential hearing, on a record, at which the insurer may challenge any
				determination or action by the Commissioner. The insurer shall notify the
				Commissioner of its request for a hearing within five days after the
				notification by the Commissioner under 211 CMR 20.07(1) through (4). Upon
				receipt of the insurer's request for a hearing, the Commissioner shall set a
				date for the hearing, which date shall be no less than ten nor more than 30
				days after the date of the insurer's request.
(1) Notification to an insurer by the
			 Commissioner of an Adjusted RBC Report; or
(2) Notification to an insurer by the
			 Commissioner that:
(a) The insurer's RBC Plan
			 or Revised RBC Plan is unsatisfactory; and
(b) Such notification constitutes a
			 Regulatory Action Level Event with respect to such insurer; or
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 20.00 - Risk-based Capital (rbc) For Insurers › Section 20.08 - Confidentiality; Prohibition on Announcements, Prohibition on Use in Ratemaking

Current through Register 1525, July 5, 2024
(1) All RBC Reports (to the extent the
			 information therein is not required to be set forth in a publicly available
			 annual statement schedule) and RBC Plans (including the results or report of
			 any examination or analysis of an insurer performed pursuant hereto and any
			 corrective order issued by the Commissioner pursuant to examination or
			 analysis) with respect to any domestic insurer or foreign insurer that are in
			 the possession or control of the Commissioner shall be confidential by law and
			 privileged, shall not be subject to M.G.L. c. 66 or the 26th clause of M.G.L.
			 c. 4, § 7, shall not be subject to subpoena, and shall not be subject to
			 discovery or admissible in evidence in any private civil action. However, the
			 Commissioner is authorized to use the documents, materials or other information
			 in furtherance of any regulatory or legal action brought as part of the
			 Commissioner's official duties.
(2)
			 Neither the Commissioner nor any person who received documents, materials or
			 other information while acting under the authority of the Commissioner shall be
			 permitted or required to testify in any private civil action concerning any
			 confidential documents, materials or information subject to 211 CMR
			 20.08(1).
(3) In order to assist in
			 the performance of the Commissioner's duties, the Commissioner:
(a) May share documents, materials or other
			 information, including the confidential and privileged documents, materials or
			 information subject to 211 CMR 20.08(1), with other state, federal and
			 international regulatory agencies, with the NAIC and its affiliates and
			 subsidiaries, and with state, federal and international law enforcement
			 authorities, provided that the recipient agrees to maintain the confidentiality
			 and privileged status of the document, material or other information;
(b) May receive documents, materials or
			 information, including otherwise confidential and privileged documents,
			 materials or information from the NAIC and its affiliates and subsidiaries, and
			 from regulatory and law enforcement officials of other foreign or domestic
			 jurisdictions, and shall maintain as confidential or privileged any document,
			 material or information received with notice or the understanding that it is
			 confidential or privileged under the laws of the jurisdiction that is the
			 source of the document, materials or information; and
(c) May enter into agreements governing
			 sharing and use of information consistent with 211 CMR 20.08(3).
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 20.00 - Risk-based Capital (rbc) For Insurers › Section 20.09 - Supplemental Provisions; Exemption

Current through Register 1525, July 5, 2024
(1) The
			 provisions of
			 211 CMR 20.00 are
			 supplemental to any other provisions of the laws of Massachusetts, and shall
			 not preclude or limit any other powers or duties of the Commissioner under such
			 laws, including, but not limited to M.G.L. c. 175, §§ 180A through
			 180LV2 and c. 176, § 33.
(2)
			 The Commissioner may exempt from the application of
			 211 CMR 20.00, any domestic
			 property and casualty insurer which;
(a)
			 Writes direct business only in this state;
(b) Writes direct annual premiums of
			 $2,000,000 or less; and
(c) Assumes
			 no reinsurance in excess of 5% of direct premium written.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 20.00 - Risk-based Capital (rbc) For Insurers › Section 20.10 - Foreign Insurers

Current through Register 1525, July 5, 2024
(1) Any foreign
			 insurer shall, upon the written request of the Commissioner, submit to the
			 Commissioner an RBC Report as of the end of the calendar year just ended not
			 later than the later of:
(a) The date an RBC
			 Report would be required to be filed by a domestic insurer under
			 211 CMR 20.00; or
(b) 15 days after the request is received by
			 the foreign insurer.
Any foreign insurer shall, at the written request of the
				Commissioner, promptly submit to the Commissioner a copy of any RBC Plan that
				is filed with the insurance Commissioner of any other state.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 20.00 - Risk-based Capital (rbc) For Insurers › Section 20.11 - Immunity

Current through Register 1525, July 5, 2024
There shall be no liability on the part of, and no cause of
				action shall arise against, the Commissioner or the insurance division or its
				employees or agents for any action taken by them in the performance of their
				powers and duties under
				211 CMR
				20.00.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 20.00 - Risk-based Capital (rbc) For Insurers › Section 20.12 - Severability Clause

Current through Register 1525, July 5, 2024
If any provision of
				211 CMR 20.00, or the
				application thereof to any person or circumstance, is held invalid, such
				determination shall not affect the provisions or applications of
				211 CMR 20.00 which can be
				given effect without the invalid provision or application, and to that end the
				provisions of
				211 CMR 20.00 are
				severable.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 20.00 - Risk-based Capital (rbc) For Insurers › Section 20.13 - Notices

Current through Register 1525, July 5, 2024
All notices by the Commissioner to an insurer which may result
				in regulatory action hereunder shall be effective upon dispatch if transmitted
				by registered or certified mail, or in the case of any other transmission shall
				be effective upon the insurer's receipt of such notice.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 24.00 - Limited Liability Companies And Limited Liability Partnerships; Minimum Amount Of Liability Insurance › Section 24.01 - Authority

Current through Register 1525, July 5, 2024
211 CMR 24.00 is issued
				pursuant to authority granted to the Commissioner of Insurance by M.G.L. c.
				108A, § 45(8) and M.G.L. c. 156C, § 65.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 24.00 - Limited Liability Companies And Limited Liability Partnerships; Minimum Amount Of Liability Insurance › Section 24.02 - Scope and Purpose

Current through Register 1525, July 5, 2024
The purpose of
				211 CMR 24.00 is to designate
				and establish a minimum amount of required professional liability insurance to
				be maintained by limited liability partnerships and their partners and limited
				liability companies and their members.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 24.00 - Limited Liability Companies And Limited Liability Partnerships; Minimum Amount Of Liability Insurance › Section 24.03 - Definitions

Current through Register 1525, July 5, 2024
As used in
				211 CMR 24.00, the following
				words will have the meanings indicated:
LLP
refers to any "registered limited
				liability partnership" or "foreign registered limited liability partnership,"
				as defined in M.G.L. c. 108A, § 1, licensed by the Division of
				Insurance.
LLC
refers to any "registered limited
				liability company" or "foreign registered limited liability company" as defined
				in M.G.L. c. 156C, § 2, licensed by the Division.
Division
refers to the Division of
				Insurance within the Department of Banking and Insurance.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 24.00 - Limited Liability Companies And Limited Liability Partnerships; Minimum Amount Of Liability Insurance › Section 24.04 - Required Insurance and Capital Program

Current through Register 1525, July 5, 2024
(1) An LLP or LLC must maintain in good
			 standing professional liability insurance which meets the following minimum
			 standards:
(a) The insurance shall cover
			 negligence, wrongful acts, errors and omissions and insure the LLP, LLC and
			 their respective partners and members (M.G.L. c. 108A, § 45(8)(a), M.G.L.
			 c. 156C, § 65).
(b) The
			 insurance shall be in an amount for each claim of at least $100,000 multiplied
			 by the number of individual licensees who are employed by, or partners of, the
			 LLP, or members of the LLC, and in an aggregate amount of at least $250,000
			 multiplied by the number of individual licensees who are employed by, or
			 partners, of the LLP or members of the LLC;
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 24.00 - Limited Liability Companies And Limited Liability Partnerships; Minimum Amount Of Liability Insurance › Section 24.05 - Exemptions from Coverage

Current through Register 1525, July 5, 2024
The insurance required by
				211 CMR
				24.04 may provide that it does not apply to
				any dishonest, fraudulent, criminal, or malicious act or omission of the
				insured LLP or LLC, or any partner, member or employee thereof; or the conduct
				of any business enterprise not involving the business of insurance in which the
				insured LLP or LLC may hold an ownership interest or in which the insured LLP
				or LLC may be a partner or which may be controlled, operated, or managed by the
				insured LLP or LLC, in its own or in a fiduciary capacity including the
				ownership, maintenance, or use of any property in connection therewith; and
				bodily injury to, or sickness, disease, or death of, any person, or to injury
				to or destruction of any tangible property, including the loss of use thereof.
				The policy may contain reasonable provisions with respect to policy periods,
				territory, claims, conditions, and other usual matters.
The insurance required by
				211 CMR
				24.04 is not required if the LLP or LLC
				maintains designated and segregated capital equal to the amount of insurance
				required in
				211 CMR
				24.04.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 24.00 - Limited Liability Companies And Limited Liability Partnerships; Minimum Amount Of Liability Insurance › Section 24.06 - Alternative Means of Compliance

Current through Register 1525, July 5, 2024
An LLP or LLC shall be in compliance with
				211 CMR
				24.04 if the LLP or LLC provides an amount of
				funds equal to the amount of insurance required in
				211 CMR
				24.04 which funds must be specifically
				designated and segregated for the satisfaction of judgments against the LLP,
				LLC, or their respective partners or members based on negligence, wrongful
				acts, errors and omission, by:
(a)
			 deposit in trust or in bank escrow of cash, bank certificates of deposit, or
			 United States Treasury obligations; or
(b) a bank letter of credit or insurance
			 company bond.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 24.00 - Limited Liability Companies And Limited Liability Partnerships; Minimum Amount Of Liability Insurance › Section 24.07 - Cancellation and Interruption of Coverage

Current through Register 1525, July 5, 2024
(1)
			 Cancellation or any other interruption in required insurance coverage, or
			 failure to maintain required designated and segregated capital, shall require
			 the LLP or LLC to immediately cease the business of insurance until such time
			 as the LLP or LLC is in compliance with
			 211 CMR 24.00.
(2) An LLP or LLC must notify the Division in
			 writing, within five business days, if the LLP's or LLC's insurance coverage is
			 canceled or otherwise interrupted or if the LLP's or LLC's designated and
			 segregated capital falls below the amount required in
			 211 CMR
			 24.04. Failure to provide required notice to
			 the Division will subject the LLP or LLC and their respective partners or
			 members who are licensed by the Division to disciplinary action, pursuant to
			 M.G.L.c.175, § 163.
(3) An LLP
			 or LLC may be required to provide verification of compliance with
			 211 CMR 24.00, satisfactory
			 to the Division, on initial application, renewal, and at any other time, at the
			 request of the Division.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 25.00 - Risk-based Capital (rbc) For Health Organizations › Section 25.02 - RBC Reports

Current through Register 1525, July 5, 2024
(1) Every Domestic
			 Health Organization shall, on or prior to each March 1st, prepare and submit to
			 the Commissioner a report of its RBC Levels as of the end of the most recent
			 calendar year, in a form and containing such information as is required by the
			 RBC Instructions. In addition, every Domestic Health Organization shall file
			 its RBC Report:
(a) With the NAIC in
			 accordance with the RBC Instructions; and
(b) With the insurance commissioner in any
			 state in which the Health Organization is authorized to do business, if the
			 insurance commissioner has notified the Health Organization of its request in
			 writing, in which case the Health Organization shall file its RBC Report not
			 later than the later of:
1. 15 days from the
			 receipt of notice to file its RBC Report with that state; or
2. The Filing Date.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 25.00 - Risk-based Capital (rbc) For Health Organizations › Section 25.03 - Company Action Level Event

Current through Register 1525, July 5, 2024
(1)
Company Action Level Event
. Means any of the following
			 events:
(a) The filing of an RBC Report by a
			 Health Organization which indicates that the 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.
If a Health Organization has a total adjusted capital which 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 triggers the trend test
				determined in accordance with the trend test calculation included in the Health
				RBC Instructions;
(b) The
			 notification by the Commissioner to the Health Organization of an Adjusted RBC
			 Report that indicates an event in 211 CMR 25.03(1)(a), provided the Health
			 Organization does not challenge the Adjusted RBC Report under
			 211 CMR 25.07;
			 or
(c) If, pursuant to
			 211 CMR 25.07, a Health
			 Organization challenges an Adjusted RBC Report that indicates the event in 211
			 CMR 25.03(1)(a), the notification by the Commissioner to the Health
			 Organization that the Commissioner has, after a hearing, rejected the Health
			 Organization's challenge.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 25.00 - Risk-based Capital (rbc) For Health Organizations › Section 25.04 - Regulatory Action Level Event

Current through Register 1525, July 5, 2024
(1)
Regulatory Action Level Event
. Means, with respect to
			 any Health Organization, any of the following events:
(a) The filing of an RBC Report by the Health
			 Organization which indicates that the Health Organization's total adjusted
			 capital is greater than or equal to its Authorized Control Level RBC but less
			 than its Regulatory Action Level RBC;
(b) The notification by the Commissioner to a
			 Health Organization of an Adjusted RBC Report that indicates the event in 211
			 CMR 25.04(1)(a), provided the Health Organization does not challenge the
			 Adjusted RBC Report under
			 211 CMR 25.07;
(c) If, pursuant to
			 211 CMR 25.07, the
			 Health Organization challenges an Adjusted RBC Report that indicates the event
			 in 211 CMR 25.04(1)(a), the notification by the Commissioner to the Health
			 Organization that the Commissioner has, after a hearing, rejected the Health
			 Organization's challenge;
(d) The
			 failure of the Health Organization to file an RBC Report by the filing date,
			 unless the Health Organization has provided an explanation for such failure
			 which is satisfactory to the Commissioner and has cured the failure within ten
			 days after the Filing Date;
(e) The
			 failure of the Health Organization to submit an RBC Plan to the Commissioner
			 within the time period set forth in
			 211 CMR
			 25.03(3);
(f) Notification by the Commissioner to the
			 Health Organization that:
1. The RBC Plan or
			 Revised RBC Plan submitted by the Health Organization is, in the judgment of
			 the Commissioner, unsatisfactory; and
2. Such notification constitutes a Regulatory
			 Action Level Event with respect to the Health Organization, provided the Health
			 Organization has not challenged the determination under
			 211 CMR 25.07;
(g) If, pursuant to
			 211 CMR 25.07, the
			 Health Organization challenges a determination by the Commissioner under 211
			 CMR 25.04(1)(f), the notification by the Commissioner to the Health
			 Organization that the Commissioner has, after a hearing, rejected such
			 challenge;
(h) Notification by the
			 Commissioner to the Health Organization that the Health Organization 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 Health Organization to
			 eliminate the Company Action Level Event in accordance with its RBC Plan or
			 Revised RBC Plan and the Commissioner has so stated in the notification,
			 provided the Health Organization has not challenged the determination under
			 211 CMR 25.07;
			 or
(i) If, pursuant to
			 211 CMR 25.07, the
			 Health Organization challenges a determination by the Commissioner under 211
			 CMR 25.04(1)(h), the notification by the Commissioner to the Health
			 Organization that the Commissioner has, after a hearing, rejected the
			 challenge.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 25.00 - Risk-based Capital (rbc) For Health Organizations › Section 25.05 - Authorized Control Level Event

Current through Register 1525, July 5, 2024
(1)
Authorized Control Level Event
. Means any of the
			 following events:
(a) The filing of an RBC
			 Report by the Health Organization which indicates that the Health
			 Organization's total adjusted capital is greater than or equal to its Mandatory
			 Control Level RBC but less than its Authorized Control Level RBC;
(b) The notification by the Commissioner to
			 the Health Organization of an Adjusted RBC Report that indicates the event in
			 211 CMR 25.05(1)(a), provided the Health Organization does not challenge the
			 Adjusted RBC Report under
			 211 CMR 25.07;
(c) If, pursuant to
			 211 CMR 25.07, the
			 Health Organization challenges an Adjusted RBC Report that indicates the event
			 in 211 CMR 25.05(1)(a), notification by the Commissioner to the Health
			 Organization that the Commissioner has, after a hearing, rejected the Health
			 Organization's challenge;
(d) 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 under
			 211 CMR 25.07 );
			 or
(e) If the Health Organization
			 has challenged a Corrective Order under
			 211 CMR 25.07, and the
			 Commissioner has, after a hearing, 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.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 25.00 - Risk-based Capital (rbc) For Health Organizations › Section 25.06 - Mandatory Control Level Event

Current through Register 1525, July 5, 2024
(1)
Mandatory Control Level Event
. Means any of the
			 following events:
(a) The filing of an RBC
			 Report which indicates that the Health Organization's total adjusted capital is
			 less than its Mandatory Control Level RBC;
(b) Notification by the Commissioner to the
			 Health Organization of an Adjusted RBC Report that indicates the event in 211
			 CMR 25.06(1)(a), provided the Health Organization does not challenge the
			 Adjusted RBC Report under
			 211 CMR 25.07;
			 or
(c) If, pursuant to
			 211 CMR 25.07, the
			 Health Organization challenges an Adjusted RBC Report that indicates the event
			 in 211 CMR 25.06(1)(a), notification by the Commissioner to the Health
			 Organization that the Commissioner has, after a hearing, rejected the Health
			 Organization's challenge.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 25.00 - Risk-based Capital (rbc) For Health Organizations › Section 25.07 - Hearings

Current through Register 1525, July 5, 2024
Upon any of the following events the Health Organization shall
				have the right to a confidential hearing, on a record, at which the Health
				Organization may challenge any determination or action by the Commissioner. The
				Health Organization shall notify the Commissioner of its request for a hearing
				within five days after the notification by the Commissioner under 211 CMR
				25.07(1) through (4). Upon receipt of the Health Organization's request for a
				hearing, the Commissioner shall set a date for the hearing, which date shall be
				no less than ten nor more than 30 days after the date of the Health
				Organization's request.
(1)
			 Notification to a Health Organization by the Commissioner of an Adjusted RBC
			 Report; or
(2) Notification to a
			 Health Organization by the Commissioner that:
(a) The Health Organization's RBC Plan or
			 Revised RBC Plan is unsatisfactory; and
(b) Such notification constitutes a
			 Regulatory Action Level Event with respect to such Health
			 Organization;
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 25.00 - Risk-based Capital (rbc) For Health Organizations › Section 25.08 - Confidentiality; Prohibition on Announcements, Prohibition on Use in Ratemaking

Current through Register 1525, July 5, 2024
(1) All RBC Reports (to the extent the
			 information therein is not required to be set forth in a publicly available
			 annual statement schedule) and RBC Plans (including the results or report of
			 any examination or analysis of a Health Organization performed pursuant hereto
			 and any Corrective Order issued by the Commissioner pursuant to examination or
			 analysis) with respect to any Domestic Health Organization or Foreign Health
			 Organization that are in the possession or control of the Commissioner shall be
			 confidential by law and privileged, shall not be subject to M.G.L. c. 66 or the
			 26th clause of M.G.L. c. 4, § 7, shall not be subject to subpoena, and
			 shall not be subject to discovery or admissible in evidence in any private
			 civil action. However, the Commissioner is authorized to use the documents,
			 materials or other information in furtherance of any regulatory or legal action
			 brought as a part of the Commissioner's official duties.
(2) Neither the Commissioner nor any person
			 who received documents, materials or other information while acting under the
			 authority of the Commissioner shall be permitted or required to testify in any
			 private civil action concerning any confidential documents, materials or
			 information subject to 211 CMR 25.08(1).
(3) In order to assist in the performance of
			 the Commissioner's duties, the Commissioner:
(a) May share documents, materials or other
			 information, including the confidential and privileged documents, materials or
			 information subject to 211 CMR 25.08(1), with other state, federal and
			 international regulatory agencies, with the NAIC and its affiliates and
			 subsidiaries, and with state, federal and international law enforcement
			 authorities, provided that the recipient agrees to maintain the confidentiality
			 and privileged status of the document, material or other information;
(b) May receive documents, materials or
			 information, including otherwise confidential and privileged documents,
			 materials or information from the NAIC and its affiliates and subsidiaries, and
			 from regulatory and law enforcement officials of other foreign or domestic
			 jurisdictions, and shall maintain as confidential or privileged any document,
			 material or information received with notice or the understanding that it is
			 confidential or privileged under the laws of the jurisdiction that is the
			 source of the document, materials or information; and
(c) May enter into agreements governing
			 sharing and use of information consistent with 211 CMR 25.08(3).
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 25.00 - Risk-based Capital (rbc) For Health Organizations › Section 25.09 - Supplemental Provisions; Exemption

Current through Register 1525, July 5, 2024
(1) The
			 provisions of
			 211 CMR 25.00 are
			 supplemental to any other provisions of the laws of Massachusetts, and shall
			 not preclude or limit any other powers or duties of the Commissioner under such
			 laws, including, but not limited to M.G.L.c. 176A, §§23,33; c.
			 176B,§§ 13,17,21; c. 176E, §§ 13, 16; c. 176F, § 13;
			 and c. 176G, §§ 20 and 20A.
(2) The Commissioner may exempt from the
			 application of
			 211 CMR 25.00, any Domestic
			 Health Organization which;
(a) Writes direct
			 business only in the Commonwealth;
(b) Assumes no reinsurance in excess of 5% of
			 direct premium written; and
(c)
			 Writes direct annual premiums for comprehensive medical business of $2,000,000
			 or less; and
(d) Is a limited
			 health service organization that covers less than 10,000 lives.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 25.00 - Risk-based Capital (rbc) For Health Organizations › Section 25.10 - Foreign Health Organizations

Current through Register 1525, July 5, 2024
(1) Any Foreign
			 Health Organization shall, upon the written request of the Commissioner, submit
			 to the Commissioner an RBC Report as of the end of the most recent calendar
			 year not later than the later of:
(a) The
			 date an RBC Report would be required to be filed by a Domestic Health
			 Organization under
			 211 CMR 25.00; or
(b) 15 days after the request is received by
			 the Foreign Health Organization.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 25.00 - Risk-based Capital (rbc) For Health Organizations › Section 25.11 - Immunity

Current through Register 1525, July 5, 2024
There shall be no liability on the part of, and no cause of
				action shall arise against, the Commissioner or the Division of Insurance or
				its employees or agents for any action taken by them in the performance of
				their powers and duties under
				211 CMR
				25.00.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 25.00 - Risk-based Capital (rbc) For Health Organizations › Section 25.12 - Severability Clause

Current through Register 1525, July 5, 2024
If any provision of
				211 CMR 25.00, or the
				application thereof to any person or circumstance, is held invalid, such
				determination shall not affect the provisions or applications of
				211 CMR 25.00 which can be
				given effect without the invalid provision or application, and to that end the
				provisions of
				211 CMR 25.00 are
				severable.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 25.00 - Risk-based Capital (rbc) For Health Organizations › Section 25.13 - Notices

Current through Register 1525, July 5, 2024
All notices by the Commissioner to a Health Organization which
				may result in regulatory action hereunder shall be effective upon dispatch if
				transmitted by registered or certified mail, or in the case of any other
				transmission shall be effective upon the Health Organization's receipt of such
				notice.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 26.00 - Annual Financial Reporting For Years Ending 2010 And After › Section 26.01 - Authority

Current through Register 1525, July 5, 2024
211 CMR 26.00 is promulgated
				by the Commissioner of Insurance pursuant to M.G.L. c. 175, §§ 4 and
				25 and M.G.L. c. 176G, § 10.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 26.00 - Annual Financial Reporting For Years Ending 2010 And After › Section 26.02 - Purpose

Current through Register 1525, July 5, 2024
The purpose of
				211 CMR 26.00 is to enhance
				the Division's surveillance of the financial condition of insurers by
				requiring:
(a) an annual audit of
			 financial statements reporting the financial position and the results of
			 operations of insurers by independent certified public accountants
			 (CPA);
(b) Communication of
			 Internal Control Related Matters Noted in an Audit; and
(c) Management's Report of Internal Control
			 over Financial Reporting.
			 211 CMR 26.00 will assure
			 that CPA audits are conducted which will enhance the protection of
			 Massachusetts policyholders.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 26.00 - Annual Financial Reporting For Years Ending 2010 And After › Section 26.03 - Applicability

Current through Register 1525, July 5, 2024
(1) Every insurer (as defined in
			 211 CMR 26.04 ) shall
			 be subject to
			 211 CMR 26.00, except as
			 otherwise provided in
			 211 CMR 26.04 and
			 211 CMR
			 26.20.
(2) Exemption based on volume (for other
			 exemptions
see
211 CMR
			 26.20 ):
Insurers having both direct premiums written in Massachusetts
				of less than $1,000,000 in any calendar year and less than 1,000 policyholders
				or certificate holders of direct written policies nationwide at the end of such
				calendar year shall be exempt from
				211 CMR 26.00 for such year,
				(unless the Commissioner makes a specific finding that compliance is necessary
				for the Commissioner to carry out statutory responsibilities); except that
				insurers having assumed premiums pursuant to contracts and/or treaties of
				reinsurance of $1,000,000 or more shall not be so exempt.
(3) Foreign or alien insurers filing the
			 Audited financial reports in another state, pursuant to that other state's
			 requirement for filing of Audited financial reports, which has been found by
			 the Commissioner to be substantially similar to the requirements herein, are
			 exempt from
			 211
			 CMR 26.05 through
			 26.14
			 if:
(a) A copy of the Audited financial
			 report, Communication of Internal Control Related Matters Noted in an Audit,
			 and the Accountant's Letter of Qualifications that are filed with the other
			 state are filed with the Commissioner in accordance with the filing dates
			 specified in
			 211
			 CMR 26.05,
			 26.12
			 and
			 26.13,
			 respectively (Canadian insurers may submit accountants' reports as filed with
			 the Office of the Superintendent of Financial Institutions, Canada);
			 and
(b) A copy of any Notification
			 of Adverse Financial Condition Report filed with the other state is filed with
			 the Commissioner within the time specified in
			 211 CMR
			 26.11.
Foreign or alien insurers required to file Management's Report
				of Internal Control over Financial Reporting in another state are exempt from
				filing the Report in Massachusetts provided the other state has substantially
				similar reporting requirements and the Report is filed with the insurance
				commissioner of the other state within the time specified.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 26.00 - Annual Financial Reporting For Years Ending 2010 And After › Section 26.05 - General Requirements Related to Filing and Extensions for Filing of Annual Audited Financial Reports and Audit Committee Appointment

Current through Register 1525, July 5, 2024
(1)
Filing
. All
			 insurers shall have an annual audit by an independent certified public
			 accountant and shall file an Audited financial report with the Commissioner on
			 or before June 1st for the year ended December
			 31st immediately preceding. The Commissioner may
			 require an insurer to file an Audited financial report earlier than June
			 1st with 90 days advance notice to the insurer.
The annual Audited financial report shall be considered part of
				the insurer's annual statement filing, except as to the due dates provided in
				211 CMR 26.00, as provided by
				M.G.L. c. 175, § 25 and shall be subject to the penalties provided by
				M.G.L. c. 175, § 26.
(2)
Extensions
.
			 Extensions of the June 1st filing date may be
			 granted by the Commissioner for 30-day periods upon a showing by the insurer
			 and its independent certified public accountant of the reasons for requesting
			 such extension and determination by the Commissioner of good cause for an
			 extension. The request for any extension must be submitted in writing not less
			 than ten days prior to the due date of the Audited financial report in
			 sufficient detail to permit the Commissioner to make an informed decision with
			 respect to the requested extension.
If an extension is granted, a similar extension of 30 days
				shall be allowed for the filing of the Management's Report of Internal Control
				over Financial Reporting.
Every insurer required to file an annual Audited financial
				report pursuant to this regulation shall designate a group of individuals as
				its Audit committee, as defined in
				211 CMR 26.04. The
				Audit committee of an entity that controls an insurer may be deemed to be the
				insurer's Audit committee for purposes of
				211 CMR 26.00 at the election
				of the controlling person.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 26.00 - Annual Financial Reporting For Years Ending 2010 And After › Section 26.06 - Contents of Annual Audited Financial Report

Current through Register 1525, July 5, 2024
The annual Audited financial report shall report the financial
				position of the insurer as of the end of the most recent calendar year and the
				results of its operations, cash flows and changes in capital and surplus for
				the year then ended in conformity with statutory accounting practices
				prescribed, or otherwise permitted, by the Division.
The annual Audited financial report shall include the
				following:
(1) Report of independent
			 certified public accountant.
(2)
			 Balance sheet reporting admitted assets, liabilities, capital and
			 surplus.
(3) Statement of
			 operations.
(4) Statement of cash
			 flows.
(5) Statement of changes in
			 capital and surplus.
(6)
Notes to Financial Statements
. These notes shall be
			 those required by the appropriate NAIC Annual Statement Instructions and the
			 NAIC Accounting Practices and Procedures Manual. The notes shall include a
			 reconciliation of differences, if any, between the audited statutory financial
			 statements and the Annual Statement filed pursuant to M.G.L. c. 175, § 25
			 with a written description of the nature of these differences.
(7) The financial statements included in the
			 Audited financial report shall be prepared in a form and using language and
			 groupings substantially the same as the relevant sections of the Annual
			 Statement of the insurer filed with the Commissioner, and the financial
			 statement shall be comparative, presenting the amounts as of December
			 31st of the current year and the amounts as of the
			 immediately preceding December 31st. (However, in
			 the first year in which an insurer is required to file an Audited financial
			 report, the comparative data may be omitted).
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 26.00 - Annual Financial Reporting For Years Ending 2010 And After › Section 26.08 - Qualifications of Independent Certified Public Accountant

Current through Register 1525, July 5, 2024
(1) The Commissioner shall not recognize any
			 person or firm as a qualified independent certified public accountant if the
			 person or firm:
(a) Is not duly licensed to
			 practice in Massachusetts or in a state with similar licensing requirements and
			 is not in good standing with the AICPA and in all states in which the
			 accountant is licensed to practice or, for a Canadian or British company, that
			 is not a chartered accountant; and
(b) Has either directly or indirectly entered
			 into an agreement of indemnity or release from liability (collectively referred
			 to as indemnification) with respect to the audit of the insurer.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 26.00 - Annual Financial Reporting For Years Ending 2010 And After › Section 26.09 - Consolidated or Combined Audits

Current through Register 1525, July 5, 2024
An insurer may make written application to the Commissioner for
				approval to file audited consolidated or combined financial statements in
lieu
of separate annual audited financial statements if the
				insurer is part of a group of insurance companies that utilizes a pooling or
				100% reinsurance agreement that affects the solvency and integrity of the
				insurer's reserves and the insurer cedes all of its direct and assumed business
				to the pool. In such cases, a columnar consolidating or combining worksheet
				shall be filed with the report, as follows:
(1) Amounts shown on the consolidated or
			 combined Audited financial report shall be shown on the worksheet;
(2) Amounts for each insurer subject to 211
			 CMR 26.09 shall be stated separately;
(3) Noninsurance operations may be shown on
			 the worksheet on a combined or individual basis;
(4) Explanations of consolidating and
			 eliminating entries shall be included; and
(5) A reconciliation shall be included of any
			 differences between the amounts shown in the individual insurer columns of the
			 worksheet and comparable amounts shown on the annual statements of the
			 insurers.
Code of Massachusetts Regulations › 211 CMR - DIVISION OF INSURANCE › Title 211 CMR 26.00 - Annual Financial Reporting For Years Ending 2010 And After › Section 26.10 - Scope of Audit and Report of Independent Certified Public Accountant

Current through Register 1525, July 5, 2024
Financial statements furnished pursuant to
				211 CMR
				26.06 shall be examined by the independent
				certified public accountant. The audit of the insurer's financial statements
				shall be conducted in accordance with generally accepted auditing standards. In
				accordance with AU § 319 of the Professional Standards of the AICPA,
Consideration of Internal Control in a Financial Statement
				Audit,
the independent certified public accountant should obtain an
				understanding of internal control sufficient to plan the audit. To the extent
				required by AU § 319, for those insurers required to file a Management's
				Report of Internal Control over Financial Reporting pursuant to
				211 CMR
				26.19, the independent certified public
				accountant should consider (as that term is defined in Statement on Auditing
				Standards (SAS) No. 102,
Defining Professional Requirements in
				Statements on Auditing Standards
or its replacement) the most recently
				available report in planning and performing the audit of the statutory
				financial statements. Consideration shall be given to the procedures
				illustrated in the
Financial Condition Examiner's Handbook
promulgated by the NAIC as the independent certified public accountant deems
				necessary.