reglab/statecodes huggingface dataset:
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 36 - RISK RETENTION GROUPS AND PURCHASING GROUPS › Section 11:2-36.6 - Surplus lines coverage

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Where a purchasing group obtains a group policy from an insurer that is eligible as a surplus lines insurer in this State pursuant to N.J.S.A. 17:22-6.4 0 et seq., and the policy covers members in this State, it shall be deemed that a diligent effort has been made to procure such coverage from among insurers authorized to transact business in this State, provided the producer obtains declination of such coverage based on the group policy issued to the purchasing group. Such declinations may be for the benefit of all members of the purchasing group located in this State that may become members of the purchasing group under the group policy.
(b) For purposes of determining whether coverage obtained by a purchasing group constitutes a "large risk" pursuant to 11:1-34.6(a)16, the amount of premium to be considered shall include premiums paid for the particular coverage for all members under the group policy, rather than the premium for coverage of any individual member of the purchasing group.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 36 - RISK RETENTION GROUPS AND PURCHASING GROUPS › Section 11:2-36.7 - Fines and penalties

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Each risk retention group, whether chartered in this State or otherwise, is subject to the same fines and penalties to which insurers licensed in this State are subject for any violation of this subchapter or any other applicable law.
(b) Failure of a risk retention group or purchasing group doing business in this State to comply with the provisions of this section may, after notice and a hearing in accordance with the Administrative Procedure Act, 52:14B-1 et seq., and the Uniform Administrative Procedure Rules, N.J.A.C. 1:1, result in the revocation or suspension of its registration in this State.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 36 - RISK RETENTION GROUPS AND PURCHASING GROUPS › Section 11:2-36.8 - Purchasing groups rate, rule and form filings

Current through Register Vol. 56, No. 14, July 15, 2024
Effective June 15, 2009, the Office of Solvency Regulation will no longer accept any rate, rule or policy form filings submitted by purchasing groups to the Department other than through SERFF (System for Electronic Rate and Form Filing). Any filing received after June 14, 2009 in any method other than through SERFF will be closed without action and returned to the company without review. This applies to initial registrations, subsequent registrations, or the subsequent addition of insurers. All rate, rule or form filings shall be filed through SERFF. If the filing is related to a purchasing group, then the name of the purchasing group shall be incorporated in the SERFF Filing's General Information, Product Name field.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 36 - RISK RETENTION GROUPS AND PURCHASING GROUPS › Appendix B

Current through Register Vol. 56, No. 14, July 15, 2024
NOTICE OF APPOINTMENT OF ATTORNEY
TO ACCEPT SERVICE
STATE OF .........
DEPARTMENT OF BANKING AND INSURANCE
The ..........................., a Risk Retention Group (called the Group) duly organized under the laws of the State of .........., appoints the Commissioner of Banking and Insurance of the State of New Jersey and his or her successors in office, to be its lawful attorney upon whom all legal process in any action or proceeding against it shall be served and further agrees that any lawful process against it which is served upon this attorney shall have the same legal validity as if served personally upon the Group.
The Group gives the Commissioner and his or her successors, full authority to do every act necessary to be done under this appointment as fully as the Group could do if personally present, and ratifies all that lawfully do under the power granted by this appointment. This authority may be withdrawn only upon a written notice of revocation and in any case shall continue in effect so long as any liability arising out of this appointment remains outstanding in the State. This constitutes full compliance with Section 2(a)(1)(D) of the Liability Risk Retention Act of 1986.
The Group designates [..........] whose address is [..........] as the person to whom process against the Group served upon the Commissioner shall be forwarded.
IN WITNESS OF THIS APPOINTMENT, said Group pursuant to a resolution duly adopted by its Board of Directors, has caused this instrument to be executed in its name by its President and Secretary, and its corporate seal to be affixed at the City of .........., State of .........., this ......... day of .........., ....
Attest:
..................................
..........................................
Secretary
(Name of Risk Retention Group)
By
..........................................
President
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 36 - RISK RETENTION GROUPS AND PURCHASING GROUPS › Appendix D

Current through Register Vol. 56, No. 14, July 15, 2024
NOTICE OF APPOINTMENT OF ATTORNEY
TO ACCEPT SERVICE
STATE OF NEW JERSEY
The ..........................., a Purchasing Group (called the Group) duly organized under the laws of the State of .........., appoints the Commissioner of Banking and Insurance of the State of New Jersey, and his or her successors in office, to be its lawful attorney upon whom all legal process in any action or proceeding against it shall be served and further agrees that any lawful process against it which is served upon this attorney shall have the same legal validity as if served personally upon the Group.
The Group gives the Commissioner and his or her successors full authority to do every act necessary to be done under this appointment as fully as the Group could do if personally present, and ratifies all that lawfully do under the power granted by this appointment. This authority may be withdrawn only upon a written notice of revocation and in any case shall continue in effect so long as any liability arising out of this appointment remains outstanding in the State. This constitutes full compliance with Section 2(a)(1)(D) of the Liability Risk Retention Act of 1986.
The Group designates [..........] whose address is [..........] as the person to whom process against the Group served upon the Commissioner shall be forwarded.
IN WITNESS OF THIS APPOINTMENT, said Group pursuant to a resolution duly adopted by its Board of Directors, has caused this instrument to be executed in its name by its President and Secretary, and its corporate seal to be affixed in the City of .........., State of .........., this ......... day of .........., .....
Attest:
..................................
..........................................
Secretary
(Name of Risk Retention Group)
By .................
President
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 36 - RISK RETENTION GROUPS AND PURCHASING GROUPS › Appendix E

Current through Register Vol. 56, No. 14, July 15, 2024
POLICY FORM CERTIFICATION
I ................................, hereby certify that
(Name)
I am the .................................., an officer
(Title)
of .............................., and am authorized to
(Name of insurer)
execute this certified statement on behalf of the insurer.
I further certify that the policy form(s) and rating system issued to
.......................... has been filed with
(Purchasing Group)
the New Jersey Department of Banking and Insurance, if required by law, and are otherwise in compliance with N.J.S.A. 17:29AA-1 et seq., N.J.A.C. 11:13-1, and N.J.S.A. 17:22-6.4 3.
I further certify that I am aware that the New Jersey Department of Banking and Insurance will rely on this certification in connection with the registration of the above referenced Purchasing Group.
.....................................................................
(Signature)
.....................................................................
(Date)
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 37 - PRODUCER-CONTROLLED INSURERS › Section 11:2-37.1 - Purpose

Current through Register Vol. 56, No. 14, July 15, 2024
The purpose of this subchapter is to implement 17:22D-1 et seq. to enable the Department to regulate transactions involving insurers which are controlled by insurance producers.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 37 - PRODUCER-CONTROLLED INSURERS › Section 11:2-37.2 - Scope

Current through Register Vol. 56, No. 14, July 15, 2024
This subchapter shall apply to all licensed property and casualty insurers domiciled in this State or domiciled in a state that is not an accredited state having in effect a law substantially similar to 17:22D-1 et seq. This subchapter shall not apply to captive insurers.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 37 - PRODUCER-CONTROLLED INSURERS › Section 11:2-37.3 - Definitions

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The following words and terms, when used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise.
"Accredited state" means a state in which the insurance department or other regulatory agency has qualified as meeting the minimum financial regulatory standards promulgated and established from time to time by the NAIC.
"Captive insurer" means an insurance company owned by another organization whose exclusive purpose is to insure risks of the parent organization and affiliated companies or, in the case of groups and associations, insurance organizations owned by the insureds whose exclusive purpose is to insure risks to member organizations or group members and their affiliates.
"Commissioner" means the Commissioner of the New Jersey Department of Banking and Insurance.
"Control" or "controlled" has the same meaning as defined at N.J.S.A. 17:27A-1c.
"Controlled insurer" means a licensed insurer which is controlled, directly or indirectly, by a producer.
"Controlling producer" means a producer who, directly or indirectly, controls an insurer.
"Department" means the New Jersey Department of Banking and Insurance.
"Licensed insurer" or "insurer" means any corporation, association, partnership, reciprocal exchange, interinsurer, Lloyd's insurer, or other person engaged in the business of insurance pursuant to 17:17-1.
"NAIC" means National Association of Insurance Commissioners.
"Producer" means any person engaged in the business of an insurance agent, insurance broker or insurance consultant as defined at 17:22A-28.
"Producer-controlled" means controlled, directly or indirectly, by a producer.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 37 - PRODUCER-CONTROLLED INSURERS › Section 11:2-37.4 - Filing of Producer-Controlled Insurer Information Report

Current through Register Vol. 56, No. 14, July 15, 2024
All licensed property and casualty insurers domiciled in this State or domiciled in another state that is not a NAIC accredited state having in effect a law substantially similar to 17:22D-1 et seq., shall file an annual Producer-Controlled Insurer Information Report on a form (incorporated herein by reference as Appendix A) approved by the Commissioner. The Report shall be completed and filed with the Commissioner on or before April 1 for the calendar year immediately preceding.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 37 - PRODUCER-CONTROLLED INSURERS › Section 11:2-37.5 - Contents of the Producer-Controlled Insurer Information Report

Current through Register Vol. 56, No. 14, July 15, 2024
(a) A Producer-Controlled Insurer Information Report form (Appendix A) shall be completed annually by each licensed property and casualty insurer to whom this subchapter applies and shall include the following information:
1. The name and address of the reporting insurer and any controlling producer. (A separate form should be completed and filed for each controlling producer.);
2. A certification by insurers that are not producer-controlled that they are not issuing any property and casualty insurance coverages that are or may be reportable pursuant to the provisions of 17:22D-1 et seq. or this subchapter;
3. A certification by producer-controlled insurers containing the following information:
i. The amount of the insurer's admitted assets as of September 30 of the preceding calendar year, gross premiums written during the calendar year and the percentage that gross premiums written represent of admitted assets;
ii. The amount of net premiums written during the preceding calendar year, commissions paid to the controlling producer during the calendar year and the percentage that commissions paid to the controlling producer represent of the net premiums written;
iii. Comparable amounts and percentage paid to noncontrolling producers for placement of the same kinds of insurance;
iv. An opinion of an independent casualty actuary reporting loss ratios for each line of business written and attesting to the adequacy of loss reserves established for losses incurred and outstanding as of year-end, including losses incurred but not reported, on business placed by the controlling producer, which loss reserve opinion shall satisfy all requirements established by N.J.A.C. 11:1-21 for loss reserve opinions required to be submitted by licensed property and casualty insurers in this State; and
v. A statement indicating whether or not the insurer's controlling producer or producers have been notified of the requirements of 17:22D-1 et seq. and these rules.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 37 - PRODUCER-CONTROLLED INSURERS › Section 11:2-37.6 - Confidentiality of documents

Current through Register Vol. 56, No. 14, July 15, 2024
All documents submitted to the Commissioner pursuant to this subchapter are confidential and not public documents as defined in the Public Records Act, 47:1A-1 et seq.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 39 - INCREASE IN CAPITAL AND SURPLUS REQUIREMENTS FOR INSURERS › Section 11:2-39.1 - Purpose and scope

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The purpose of this subchapter is to provide a framework for the establishment of uniform risk-based capital and surplus requirements for all insurers authorized, admitted, or eligible to transact business pursuant to Title 17 or Title 17B of the New Jersey Statutes, and to implement the provisions of
17:17-6
et seq., and
17B:18-67
et seq. (enacted August 9, 1993), which provide new minimum capital and surplus requirements and authorize the Commissioner to increase these requirements for individual insurers based upon the insurer's business risks.
(b) This subchapter shall apply to all insurers authorized, admitted, or eligible to transact business pursuant to Title 17 or Title 17B of the New Jersey Statutes. This subchapter shall not apply to mortgage guaranty insurers, financial guaranty insurers, or title insurers.
(c) This subchapter also shall not apply to any domestic property/casualty insurer that writes direct business only in this State; writes direct annual premiums of not more than $2 million; and assumes no reinsurance in excess of five percent of direct premiums written.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 39 - INCREASE IN CAPITAL AND SURPLUS REQUIREMENTS FOR INSURERS › Section 11:2-39.3 - RBC reports

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Every domestic insurer shall, on or before each March 1 (the "filing date"), prepare and submit to the Commissioner an RBC Report as of the preceding December 31. The RBC Report shall be sent or delivered to:
New Jersey Department of Banking and Insurance
Office of Solvency Regulation, RBC Reports
20 West State Street
PO Box 325
Trenton, New Jersey 08625-0325
(b) If at any time the Commissioner believes that the financial condition of an insurer may have materially changed, the Commissioner may request in writing an updated RBC Report from the insurer. In such event, the insurer shall, on or before the 45th day following such request (the "filing date"), prepare and submit to the Commissioner at the address in (a) above an RBC Report as of the last day of the calendar month coincident with or last preceding the date of the request.
(c) Every domestic insurer shall also file its NAIC RBC Report with the NAIC in accordance with the NAIC RBC Instructions. In addition, if the insurer has been notified in writing by the insurance department of any state in which the insurer is authorized to do business, the insurer shall file its NAIC RBC Report with such state by the filing date or, if later, within 15 days from receipt of notice to file.
(d) If an insurer files an RBC Report which in the judgment of the Commissioner is inaccurate, then the Commissioner shall adjust the RBC Report to correct the inaccuracy and shall notify the insurer of the adjustment. The notice shall contain a statement of the reason for the adjustment. An RBC Report so adjusted shall be referred to as an Adjusted RBC Report.
(e) The calculation of an insurer's Required Surplus as set forth in an RBC Report filed and accepted by the Commissioner pursuant to (a) or (b) above, or as adjusted by the Commissioner pursuant to (d) above, shall be deemed to be a redetermination of the insurer's minimum statutory capital and surplus requirement pursuant to
17:17-16
and
17B:18-70
, as applicable.
1. If an insurer disagrees with the minimum capital and surplus as determined above, it may request a hearing as provided at 11:2-39.9.
2. An insurer requesting a hearing shall do so upon filing an RBC Report, or within 20 days of receipt of notice from the Commissioner of an adjustment.
3. Failure to request a hearing shall be deemed to be a waiver of the right to a hearing on the redetermined minimum capital and surplus requirement for the insurer.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 39 - INCREASE IN CAPITAL AND SURPLUS REQUIREMENTS FOR INSURERS › Section 11:2-39.4 - Company action level event

Current through Register Vol. 56, No. 14, July 15, 2024
(a) "Company action level event" means any of the following events:
1. The filing of an RBC Report by an insurer which indicates that:
i. 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;
ii. If a life/health 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 has a negative trend; or
iii. 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;
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 39 - INCREASE IN CAPITAL AND SURPLUS REQUIREMENTS FOR INSURERS › Section 11:2-39.5 - Regulatory action level event

Current through Register Vol. 56, No. 14, July 15, 2024
(a) "Regulatory action level event" means, with respect to any insurer, any of the following events:
1. The filing of an RBC Report by an 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;
2. The notification by the Commissioner to an insurer of an Adjusted RBC Report that indicates the event in (a)1 above, provided the insurer does not challenge the Adjusted RBC Report under 11:2-39.9;
3. If the insurer, under 11:2-39.9, challenges an Adjusted RBC Report that indicates the event in (a)1 above, the notification by the Commissioner to the insurer that the Commissioner has, after a hearing, rejected the insurer's challenge;
4. 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 10 days after the filing date;
5. The failure of the insurer to comply with the filing deadlines set forth at 11:2-39.4(b) and (c);
6. Notification by the Commissioner to the insurer that:
i. An RBC Plan or Revised RBC Plan submitted by the insurer is, in the judgment of the Commissioner, unsatisfactory; and
ii. Such notification constitutes a regulatory action level event with respect to the insurer, provided the insurer has not challenged the determination under 11:2-39.9;
7. If the insurer, under 11:2-39.9, challenges a determination by the Commissioner pursuant to (a)6 above, the notification by the Commissioner to the insurer that the Commissioner has, after a hearing, rejected such challenge;
8. 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 11:2-39.9; or
9. If the insurer, under 11:2-39.9, challenges a determination by the Commissioner pursuant to (a)8 above, the notification by the Commissioner to the insurer that the Commissioner has, after a hearing, rejected the challenge.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 39 - INCREASE IN CAPITAL AND SURPLUS REQUIREMENTS FOR INSURERS › Section 11:2-39.6 - Authorized control level event

Current through Register Vol. 56, No. 14, July 15, 2024
(a) "Authorized control level event" means any of the following events:
1. The filing of an RBC Report by an insurer which indicates that the insurer's total adjusted capital is greater than or equal to its Mandatory Control Level RBC but not less than its Authorized Control Level RBC;
2. The notification by the Commissioner to the insurer of an Adjusted RBC Report that indicates an event in (a)1 above, provided the insurer does not challenge the Adjusted RBC Report under 11:2-39.9;
3. If the insurer, under N.J.A.C. 11:2-39.9, challenges an Adjusted RBC Report that indicates an event in (a)1 above, notification by the Commissioner to the insurer that the Commissioner has, after a hearing, rejected the insurer's challenge;
4. The failure of the insurer to comply with the filing deadline set forth at 11:2-39.5(b)1, unless the insurer has provided an explanation for such failure which is satisfactory to the Commissioner and has cured such failure within 10 days after the deadline;
5. 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 N.J.A.C. 11:2-39.9; or
6. If the insurer has challenged a corrective order under 11:2-39.9 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.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 39 - INCREASE IN CAPITAL AND SURPLUS REQUIREMENTS FOR INSURERS › Section 11:2-39.7 - Mandatory control level event

Current through Register Vol. 56, No. 14, July 15, 2024
(a) "Mandatory control level event" means any of the following events:
1. The filing of an RBC Report which indicates that the insurer's total adjusted capital is less than its Mandatory Control Level RBC;
2. Notification by the Commissioner to the insurer of an Adjusted RBC Report that indicates the event in (a)1 above, provided the insurer does not challenge the Adjusted RBC Report under 11:2-39.9; or
3. If the insurer, under N.J.A.C. 11:2-39.9, challenges an Adjusted RBC Report that indicates the event in (a)1 above, notification by the Commissioner to the insurer that the Commissioner has, after a hearing, rejected the insurer's challenge.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 39 - INCREASE IN CAPITAL AND SURPLUS REQUIREMENTS FOR INSURERS › Section 11:2-39.8 - Filings of RBC Plans

Current through Register Vol. 56, No. 14, July 15, 2024
A filing of an RBC Plan pursuant to 11:2-39.4(b)  or 39.5(b) shall be sent or delivered to:
New Jersey Department of Banking and Insurance
Office of Solvency Regulation
20 West State Street
PO Box 325
Trenton, New Jersey 08625-0325
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 39 - INCREASE IN CAPITAL AND SURPLUS REQUIREMENTS FOR INSURERS › Section 11:2-39.9 - Hearings

Current through Register Vol. 56, No. 14, July 15, 2024
(a) An insurer shall have the right to a departmental hearing, on a record, at which the insurer may challenge any determination or action by the Commissioner.
(b) The insurer shall notify the Commissioner of its request for a hearing within five days upon:
1. Notification to the insurer by the Commissioner of an Adjusted RBC Report;
2. Notification to the insurer by the Commissioner that:
i. The insurer's RBC Plan or Revised RBC Plan is unsatisfactory; and
ii. Such notification constitutes a regulatory action level event with respect to such insurer;
3. Notification to any insurer by the Commissioner that the insurer has failed to adhere to its RBC Plan or Revised RBC Plan and that such failure has a substantial adverse effect on the ability of the insurer to eliminate the company action level event or regulatory action level event with respect to the insurer in accordance with its RBC Plan or Revised RBC Plan;
4. Notification to the insurer by the Commissioner of a corrective order with respect to the insurer; or
5. Increased requirements pursuant to 17:17-16 or 17B:18-70, as applicable.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 39 - INCREASE IN CAPITAL AND SURPLUS REQUIREMENTS FOR INSURERS › Section 11:2-39.11 - Supplemental provisions

Current through Register Vol. 56, No. 14, July 15, 2024
The provisions of this subchapter are supplemental to any other provisions of the laws of this State, and shall not preclude or limit any other powers or duties of the Commissioner under such laws including, but not limited to,
17:51A-1
et seq.,
17B:32-31
et seq., and N.J.A.C. 11:2-27.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 39 - INCREASE IN CAPITAL AND SURPLUS REQUIREMENTS FOR INSURERS › Section 11:2-39.12 - Foreign insurers

Current through Register Vol. 56, No. 14, July 15, 2024
(a) 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 the later of the filing date or within 15 days after the request is received by the foreign insurer.
(b) Any foreign insurer admitted or eligible to transact business pursuant to Title 17 or Title 17B of the New Jersey Statutes shall promptly submit to the Commissioner a copy of any RBC Plan or Revised RBC Plan that is filed with the insurance commissioner of any other state.
(c) In the event of a company action level event, regulatory action level event or authorized control level event with respect to any foreign insurer under the RBC requirements applicable in the state of domicile of the insurer, or if there are no such requirements, under this subchapter, if the insurance commissioner of the state of domicile of the foreign insurer fails to require the foreign insurer to file an RBC Plan in a manner substantially similar to that specified under 11:2-39.4, the Commissioner may require the foreign insurer to file an RBC Plan with the Commissioner. In such event, the failure of the foreign insurer to file an RBC Plan with the Commissioner shall be grounds to order the insurer to cease and desist from writing new business in this State.
(d) In the event of an authorized control level event or a mandatory control level event with respect to any foreign insurer, if no domiciliary receiver has been appointed with respect to the foreign insurer under the rehabilitation and liquidation statute applicable in the state of domicile of the foreign insurer, the Commissioner may make application to the Superior Court pursuant to 17:30C-1 et seq., or 17B:32-31 et seq., as applicable, with respect to the liquidation of property of foreign insurers found in this State, and the occurrence of the authorized control level event or mandatory control level event shall be considered adequate grounds for the application.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 39 - INCREASE IN CAPITAL AND SURPLUS REQUIREMENTS FOR INSURERS › Section 11:2-39.13 - Severability clause

Current through Register Vol. 56, No. 14, July 15, 2024
If any provision of this subchapter, or the application thereof to any person or circumstance, is held invalid, such determination shall not affect the provisions or applications of this subchapter which can be given effect without the invalid provision or application, and to that end the provisions of this subchapter are severable.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 39 - INCREASE IN CAPITAL AND SURPLUS REQUIREMENTS FOR INSURERS › Section 11:2-39.14 - Notices

Current through Register Vol. 56, No. 14, July 15, 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 to the insurer's mailing address as provided pursuant to N.J.A.C. 11:1-25 or, in the case of any other transmission, shall be effective upon the insurer's receipt of such notice.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 39A - INCREASE IN CAPITAL AND SURPLUS REQUIREMENTS FOR HEALTH ORGANIZATIONS › Section 11:2-39A.1 - Purpose and scope

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The purpose of this subchapter is to provide a framework for the establishment of uniform risk-based capital and surplus requirements for all health organizations licensed pursuant to Titles 17 and 26 of the New Jersey Statutes, and to implement sections 11 through 45 of P.L. 2014, c. 81 (enacted December 26, 2014), which authorize the Commissioner to increase capital and surplus requirements for health organizations based upon the organization's business risks.
(b) Except as set forth in (c) below, this subchapter shall apply to all health organizations licensed in this State pursuant to Titles 17 and 26 of the New Jersey Statutes.
(c) This subchapter shall not apply:
1. To a domestic health organization that:
i. Writes direct business only in this State;
ii. Assumes no reinsurance in excess of five percent of direct premium written; and
iii. Writes direct annual premiums for comprehensive medical business of $ 2 million or less; or
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 39A - INCREASE IN CAPITAL AND SURPLUS REQUIREMENTS FOR HEALTH ORGANIZATIONS › Section 11:2-39A.3 - RBC reports

Current through Register Vol. 56, No. 14, July 15, 2024
(a) A domestic health organization shall, on or prior to each March 1 (the "filing date"), prepare and submit to the Commissioner a report of its RBC levels as of the end of the calendar year ended the preceding December 31, in a form and containing such information as is required by the RBC instructions. The RBC report shall be sent or delivered to:
New Jersey Department of Banking and Insurance
Office of Solvency Regulation, Health Organization RBC Reports
20 West State Street
PO Box 325
Trenton, NJ 08625-0325
In addition, a domestic health organization shall file its RBC report:
1. With the NAIC in accordance with the RBC instructions; and
2. 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:
i. Fifteen days from the receipt of notice to file its RBC report with that state; or
ii. The filing date.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 39A - INCREASE IN CAPITAL AND SURPLUS REQUIREMENTS FOR HEALTH ORGANIZATIONS › Section 11:2-39A.4 - Company action level event

Current through Register Vol. 56, No. 14, July 15, 2024
(a) "Company action level event" means any of the following events:
1. The filing of an RBC report by a health organization that indicates that:
i. 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; or
ii. If a health organization 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 triggers the trend test determined in accordance with the trend test calculation included in the health RBC instructions;
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 39A - INCREASE IN CAPITAL AND SURPLUS REQUIREMENTS FOR HEALTH ORGANIZATIONS › Section 11:2-39A.5 - Regulatory action level event

Current through Register Vol. 56, No. 14, July 15, 2024
(a) "Regulatory action level event" means, with respect to a health organization, any of the following events:
1. The filing of an RBC report by the health organization that 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;
2. The notification by the Commissioner to a health organization of an adjusted RBC report that indicates the event in (a)1 above, provided the health organization does not challenge the adjusted RBC report under N.J.A.C. 11:2-39A.9;
3. If the health organization, pursuant to N.J.A.C. 11:2-39A.9, challenges an adjusted RBC report that indicates the event in (a)1 above, the notification by the Commissioner to the health organization that the Commissioner has, after a hearing, rejected the health organization's challenge;
4. The failure of the health organization to file an RBC report by the filing date, unless the health organization has provided an explanation for the failure that is satisfactory to the Commissioner and has cured the failure within 10 days after the filing date;
5. The failure of the health organization to submit an RBC plan to the Commissioner within the time period set forth in N.J.A.C. 11:2-39A.4(b) and (c);
6. The notification by the Commissioner to the health organization that:
i. The RBC plan or revised RBC plan submitted by the health organization is, in the judgment of the Commissioner, unsatisfactory; and
ii. Such notification constitutes a regulatory action level event with respect to the health organization, provided the health organization has not challenged the determination under N.J.A.C. 11:2-39A.9;
7. If the health organization, pursuant to N.J.A.C. 11:2-39A.9, challenges a determination by the Commissioner under (a)6 above, the notification by the Commissioner to the health organization that the Commissioner has, after a hearing, rejected the challenge;
8. 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 the 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 N.J.A.C. 11:2-39A.9; or
9. If the health organization, pursuant to N.J.A.C. 11:2-39A.9, challenges a determination by the Commissioner under (a)8 above, the notification by the Commissioner to the health organization that the Commissioner has, after a hearing, rejected the challenge.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 39A - INCREASE IN CAPITAL AND SURPLUS REQUIREMENTS FOR HEALTH ORGANIZATIONS › Section 11:2-39A.6 - Authorized control level event

Current through Register Vol. 56, No. 14, July 15, 2024
(a) "Authorized control level event" means any of the following events:
1. The filing of an RBC 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 RBC but less than its Authorized Control Level RBC;
2. The notification by the Commissioner to the health organization of an adjusted RBC report that indicates the event in (a)1 above, provided the health organization does not challenge the adjusted RBC report under N.J.A.C. 11:2-39A.9;
3. If the health organization, pursuant to N.J.A.C. 11:2-39A.9, challenges an adjusted RBC report that indicates the event in (a)1 above, notification by the Commissioner to the health organization that the Commissioner has, after a hearing, 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 under N.J.A.C. 11:2-39A.9); or
5. If the health organization has challenged a corrective order under N.J.A.C. 11:2-39A.9 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.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 39A - INCREASE IN CAPITAL AND SURPLUS REQUIREMENTS FOR HEALTH ORGANIZATIONS › Section 11:2-39A.7 - Mandatory control level event

Current through Register Vol. 56, No. 14, July 15, 2024
(a) "Mandatory control level event" means any of the following events:
1. The filing of an RBC report which indicates that the health organization's total adjusted capital is less than its Mandatory Control Level RBC;
2. Notification by the Commissioner to the health organization of an adjusted RBC report that indicates the event in (a)1 above, provided the health organization does not challenge the adjusted RBC report under N.J.A.C. 11:2-39A.9; or
3. If the health organization, pursuant to N.J.A.C. 11:2-39A.9, challenges an adjusted RBC report that indicates the event in (a)1 above, notification by the Commissioner to the health organization that the Commissioner has, after a hearing, rejected the health organization's challenge.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 39A - INCREASE IN CAPITAL AND SURPLUS REQUIREMENTS FOR HEALTH ORGANIZATIONS › Section 11:2-39A.8 - Filings of RBC plans

Current through Register Vol. 56, No. 14, July 15, 2024
A filing of an RBC plan pursuant to N.J.A.C. 11:2-39A.4(b)  or 39A.5(b) shall be sent to or delivered to:
New Jersey Department of Banking and Insurance
Office of Solvency Regulation
20 West State Street
PO Box 325
Trenton, NJ 08625-0325
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 39A - INCREASE IN CAPITAL AND SURPLUS REQUIREMENTS FOR HEALTH ORGANIZATIONS › Section 11:2-39A.9 - Hearings

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Upon the occurrence of any of the following events, the health organization shall have the right to a confidential departmental hearing, on a record, at which the health organization may challenge any determination or action by the Commissioner.
(b) The health organization shall notify the Commissioner of its request for a hearing within five days upon:
1. Notification to a health organization by the Commissioner of an adjusted RBC report;
2. Notification to a health organization by the Commissioner that:
i. The health organization's RBC plan or revised RBC plan is unsatisfactory; and
ii. Such notification constitutes a regulatory action level event with respect to the health organization;
3. Notification to a health organization by the Commissioner that the health organization has failed to adhere to its RBC plan or revised RBC plan and that the failure has a substantial adverse effect on the ability of the health organization to eliminate the company action level event with respect to the health organization in accordance with its RBC plan or revised RBC plan; or
4. Notification to a health organization by the Commissioner of a corrective order with respect to the health organization.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 39A - INCREASE IN CAPITAL AND SURPLUS REQUIREMENTS FOR HEALTH ORGANIZATIONS › Section 11:2-39A.10 - Confidentiality and prohibition on announcements; prohibition on use in ratemaking

Current through Register Vol. 56, No. 14, July 15, 2024
(a) All RBC reports (to the extent the information 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 to this subchapter and any corrective order issued by the Commissioner pursuant to examination or analysis) with respect to a domestic health organization or foreign health organization that are in the possession or control of the Department shall be confidential and privileged, shall not be subject to the Open Public Records Act,
47:1A-1
et seq., 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 the furtherance of any regulatory or legal action brought as a part of the Commissioner's official duties.
(b) 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 (a) above.
(c) In order to assist in the performance of the Commissioner's duties, the Commissioner:
1. May share documents, materials, or other information, including the confidential and privileged documents, materials, or information subject to (a) above, 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;
2. 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, material, or information; and
3. May enter into agreements governing sharing and use of information consistent with this subsection.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 39A - INCREASE IN CAPITAL AND SURPLUS REQUIREMENTS FOR HEALTH ORGANIZATIONS › Section 11:2-39A.11 - Supplemental provisions; rules; exemption

Current through Register Vol. 56, No. 14, July 15, 2024
The provisions of this subchapter are supplemental to any other provisions of the laws of this State, and shall not preclude or limit any other powers or duties of the Commissioner under such laws, including, but not limited to,
17:51A-1
et seq.,
17B:32-31
et seq., and N.J.A.C. 11:2-27.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 39A - INCREASE IN CAPITAL AND SURPLUS REQUIREMENTS FOR HEALTH ORGANIZATIONS › Section 11:2-39A.12 - Foreign health organizations

Current through Register Vol. 56, No. 14, July 15, 2024
(a) A foreign health organization 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 the later of:
1. The date an RBC report would be required to be filed by a domestic health organization under this subchapter; or
2. Fifteen days after the request is received by the foreign health organization.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 39A - INCREASE IN CAPITAL AND SURPLUS REQUIREMENTS FOR HEALTH ORGANIZATIONS › Section 11:2-39A.13 - Severability clause

Current through Register Vol. 56, No. 14, July 15, 2024
If any provision of this subchapter, or its application to any person or circumstance, is held invalid, that determination shall not affect the provisions or applications of this subchapter that can be given effect without the invalid provision or application, and to that end the provisions of this subchapter are severable.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 39A - INCREASE IN CAPITAL AND SURPLUS REQUIREMENTS FOR HEALTH ORGANIZATIONS › Section 11:2-39A.14 - Notices

Current through Register Vol. 56, No. 14, July 15, 2024
All notices by the Commissioner to a health organization that may result in regulatory action under this subchapter 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 notice.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 2 - INSURANCE GROUP › Subchapter 39A - INCREASE IN CAPITAL AND SURPLUS REQUIREMENTS FOR HEALTH ORGANIZATIONS › Section 11:2-39A.15 - Phase-in provision

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Except for HMOs, the following requirements shall apply to the filing of the first RBC reports due on or before March 1, 2015, in lieu of the provisions of N.J.A.C. 11:2-39A.4 through 39A.7:
1. In the event of a company action level event with respect to a domestic health organization, the Commissioner shall take no regulatory action under this subchapter.
2. In the event of a regulatory action level event under N.J.A.C. 11:2-39A.5(a)1, 2, or 3, the Commissioner shall take the actions required under N.J.A.C. 11:2-39A.4.
3. In the event of a regulatory action level event under N.J.A.C. 11:2-39A.5(a)4, 5, 6, 7, 8, or 9 or an authorized control level event, the Commissioner shall take the actions required under N.J.A.C. 11:2-39A.5 with respect to the health organization.
4. In the event of a mandatory control level event with respect to a health organization, the Commissioner shall take the actions required under N.J.A.C. 11:2-39A.6 with respect to the health organization.