reglab/statecodes huggingface dataset:
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 8 - CREDIT FOR REINSURANCE › Section 13.2.8.20 - PERMITTED CONDITIONS FOR TRUST AGREEMENTS QUALIFIED UNDER SECTION 18 OF 13.2.8 NMAC

Current through Register Vol. 35, No. 13, July 16, 2024
A. The trust
				agreement may provide that the trustee may resign upon delivery of a written
				notice of resignation, effective not less than 90 days after the beneficiary
				and grantor receive the notice and that the trustee may be removed by the
				grantor by delivery to the trustee and the beneficiary of a written notice of
				removal, effective not less than 90 days after the trustee and the beneficiary
				receive the notice, provided that no such resignation or removal shall be
				effective until a successor trustee has been duly appointed and approved by the
				beneficiary and the grantor and all assets in the trust have been duly
				transferred to the new trustee.
B.
				The grantor may have the full and unqualified right to vote any shares of stock
				in the trust account and to receive from time-to-time payments of any dividends
				or interest upon any shares of stock or obligations included in the trust
				account. Any interest or dividends shall be either forwarded promptly upon
				receipt to the grantor or deposited in a separate account established in the
				grantor's name.
C. The trustee may
				be given authority to invest, and accept substitutions of, any funds in the
				account, provided that no investment or substitution shall be made without
				prior approval of the beneficiary, unless the trust agreement specifies
				categories of investments acceptable to the beneficiary and authorizes the
				trustee to invest funds and to accept substitutions that the trustee determines
				are at least equal in current fair market value to the assets withdrawn and
				that are consistent with the restrictions in Paragraph (2) of Subsection A of
				13.2.8.21
				NMAC.
D. The trust agreement may
				provide that the beneficiary may at any time designate a party to which all or
				part of the trust assets are to be transferred. Transfer may be conditioned
				upon the trustee receiving, prior to or simultaneously, other specified
				assets.
E. The trust agreement may
				provide that, upon termination of the trust account, all assets not previously
				withdrawn by the beneficiary shall, with written approval by the beneficiary,
				be delivered over to the grantor.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 8 - CREDIT FOR REINSURANCE › Section 13.2.8.21 - ADDITIONAL CONDITIONS APPLICABLE TO REINSURANCE AGREEMENTS FOR TRUST AGREEMENTS QUALIFIED UNDER SECTION 18 OF 13.2.8 NMAC

Current through Register Vol. 35, No. 13, July 16, 2024
A. A reinsurance agreement may contain
				provisions that:
(1) require the assuming
				insurer to enter into a trust agreement and to establish a trust account for
				the benefit of the ceding insurer, and specifying what the agreement is to
				cover;
(2) require the assuming
				insurer, prior to depositing assets with the trustee, to execute assignments or
				endorsements in blank, or to transfer legal title to the trustee of all shares,
				obligations or any other assets requiring assignments, in order that the ceding
				insurer, or the trustee upon the direction of the ceding insurer, may whenever
				necessary negotiate these assets without consent or signature from the assuming
				insurer or any other entity;
(3)
				require that all settlements of account between the ceding insurer and the
				assuming insurer be made in cash or its equivalent; and
(4) stipulate that the assuming insurer and
				the ceding insurer agree that the assets in the trust account, established
				pursuant to the provisions of the reinsurance agreement, may be withdrawn by
				the ceding insurer at any time, notwithstanding any other provisions in the
				reinsurance agreement, and shall be utilized and applied by the ceding insurer
				or its successors in interest by operation of law, including without limitation
				any liquidator, rehabilitator, receiver or conservator of such company, without
				diminution because of insolvency on the part of the ceding insurer or the
				assuming insurer, only for the following purposes:
(a) to pay or reimburse the ceding insurer
				for:
(i) the assuming insurer's share under
				the specific reinsurance agreement of premiums returned, but not yet recovered
				from the assuming insurer, to the owners of policies reinsured under the
				reinsurance agreement because of cancellations of such policies;
(ii) the assuming insurer's share of
				surrenders and benefits or losses paid by the ceding insurer pursuant to the
				provisions of the policies reinsured under the reinsurance agreement;
				and
(iii) any other amounts
				necessary to secure the credit or reduction from liability for reinsurance
				taken by the ceding insurer;
(b) to make payment to the assuming insurer
				of amounts held in the trust account in excess of the amount necessary to
				secure the credit or reduction from liability for reinsurance taken by the
				ceding insurer.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 8 - CREDIT FOR REINSURANCE › Section 13.2.8.22 - FINANCIAL REPORTING APPLICABLE TO REINSURANCE AGREEMENTS FOR TRUST AGREEMENTS QUALIFIED UNDER SECTION 18 OF 13.28.8 NMAC

Current through Register Vol. 35, No. 13, July 16, 2024
A trust agreement may be used to reduce any liability for
				  reinsurance ceded to an unauthorized assuming insurer in financial statements
				  required to be filed with this department in compliance with the provisions of
				  this rule when established on or before the date of filing of the financial
				  statement of the ceding insurer. Further, the reduction for the existence of an
				  acceptable trust account may be up to the current fair market value of
				  acceptable assets available to be withdrawn from the trust account at that
				  time, but such reduction shall be no greater than the specific obligations
				  under the reinsurance agreement that the trust account was established to
				  secure.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 8 - CREDIT FOR REINSURANCE › Section 13.2.8.23 - FAILURE TO IDENTIFY BENEFICIARY APPLICABLE TO REINSURANCE AGREEMENTS FOR TRUST AGREEMENTS QUALIFIED UNDER SECTION 18 OF 13.2.8 NMAC

Current through Register Vol. 35, No. 13, July 16, 2024
The failure of any trust agreement to specifically identify
				  the beneficiary as defined in Paragraph B of
				  13.2.8.7
				  NMAC shall not be construed to affect any actions or rights that the
				  superintendent may take or possess pursuant to the provisions of the laws of
				  this state.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 8 - CREDIT FOR REINSURANCE › Section 13.2.8.25 - REINSURANCE AGREEMENT PROVISIONS FOR LETTERS OF CREDIT QUALIFIED UNDER SECTION 18 OF 13.2.8 NMAC

Current through Register Vol. 35, No. 13, July 16, 2024
A. The
				reinsurance agreement in conjunction with which the letter of credit is
				obtained may contain provisions that:
(1)
				require the assuming insurer to provide letters of credit to the ceding insurer
				and specify what they are to cover;
(2) stipulate that the assuming insurer and
				ceding insurer agree that the letter of credit provided by the assuming insurer
				pursuant to the provisions of the reinsurance agreement may be drawn upon at
				any time, notwithstanding any other provisions in the agreement, and shall be
				utilized by the ceding insurer or its successors in interest only for one or
				more of the following reasons:
(a) to pay or
				reimburse the ceding insurer for:
(i) the
				assuming insurer's share under the specific reinsurance agreement of premiums
				returned, but not yet recovered from the assuming insurers, to the owners of
				policies reinsured under the reinsurance agreement on account of cancellations
				of such policies;
(ii) the assuming
				insurer's share, under the specific reinsurance agreement, of surrenders and
				benefits or losses paid by the ceding insurer, but not yet recovered from the
				assuming insurers, under the terms and provisions of the policies reinsured
				under the reinsurance agreement; and
(b) any other amounts necessary to secure the
				credit or reduction from liability for reinsurance taken by the ceding
				insurer.
(3) All of the
				provisions of this subsection shall be applied without diminution because of
				insolvency on the part of the ceding insurer or assuming
				insurer.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 8 - CREDIT FOR REINSURANCE › Section 13.2.8.26 - OTHER SECURITY

Current through Register Vol. 35, No. 13, July 16, 2024
A ceding insurer may take credit for unencumbered funds
				  withheld by the ceding insurer in the U.S. subject to withdrawal solely by the
				  ceding insurer and under its exclusive control.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 8 - CREDIT FOR REINSURANCE › Section 13.2.8.27 - REINSURANCE CONTRACT

Current through Register Vol. 35, No. 13, July 16, 2024
Credit will not be granted, nor an asset or reduction from
				  liability allowed, to a ceding insurer for reinsurance effected with assuming
				  insurers meeting the requirements of Sections (8) through (16), or Section (18)
				  of this rule or otherwise in compliance with Sections 59A-12E-3 through
				  59A-12E-15 NMSA 1978 after the adoption of this rule unless the reinsurance
				  agreement:
A. includes a proper
				insolvency clause, which stipulates that reinsurance is payable directly to the
				liquidator or successor without diminution regardless of the status of the
				ceding company, pursuant to Chapter 59A, Article 41 of the Insurance
				Code.
B. includes a provision
				pursuant to Sections 59A-12E-3 through 59A-12E-15 NMSA 1978 whereby the
				assuming insurer, if an unauthorized assuming insurer, has submitted to the
				jurisdiction of an alternative dispute resolution panel or court of competent
				jurisdiction within the U.S., has agreed to comply with all requirements
				necessary to give the court or panel jurisdiction, has designated an agent upon
				whom service of process may be effected, and has agreed to abide by the final
				decision of the court or panel; and
C. Includes a proper reinsurance intermediary
				clause, if applicable, which stipulates that the credit risk for the
				intermediary is carried by the assuming insurer.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 8 - CREDIT FOR REINSURANCE › Section 13.2.8.28 - SEVERABILITY

Current through Register Vol. 35, No. 13, July 16, 2024
If any provision of this rule, or the application of the
				  provision to any person or circumstance, is held invalid, the remainder of the
				  rule, and the application of the provision to persons or circumstances other
				  than those to which it is held invalid, shall not be
				  affected.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 9 - PROPERTY AND CASUALTY ACTUARIAL OPINIONS › Section 13.2.9.3 - STATUTORY AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
Sections 59A-2-9 and 59A-5-29 NMSA 1978.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 9 - PROPERTY AND CASUALTY ACTUARIAL OPINIONS › Section 13.2.9.5 - EFFECTIVE DATE

Current through Register Vol. 35, No. 13, July 16, 2024
July 30, 2010 unless a later date is cited at the end of a
				  section.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 9 - PROPERTY AND CASUALTY ACTUARIAL OPINIONS › Section 13.2.9.6 - OBJECTIVE

Current through Register Vol. 35, No. 13, July 16, 2024
The purpose of this rule is to require the annual filing of a
				  statement of actuarial opinion by the appointed actuary of each property and
				  casualty insurance company doing business in New Mexico, and the annual filing
				  of an actuarial opinion summary by the appointed actuary of each property and
				  casualty insurance company domiciled in New Mexico.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 9 - PROPERTY AND CASUALTY ACTUARIAL OPINIONS › Section 13.2.9.7 - DEFINITIONS

Current through Register Vol. 35, No. 13, July 16, 2024
For the purpose of this rule:
A.
"actuarial board for counseling and
				discipline"
means the board established by the American academy of
				actuaries and related U.S. actuarial organizations to strengthen their members'
				adherence to recognized standards of ethical and professional
				conduct;
B.
"actuarial
				opinion"
means the opinion of an appointed actuary regarding the
				adequacy of the reserves in accordance with applicable actuarial standards of
				practice;
C.
"actuarial
				report"
means a document or other presentation, prepared as a formal
				means of conveying the actuary's professional conclusions and recommendations,
				of recording and communicating the methods and procedures, of assuring that the
				parties addressed are aware of the significance of the actuary's opinion or
				findings and that documents the analysis underlying the opinion;
D.
"annual statement"
means that
				statement required by Section
				59A-5-29 NMSA
				1978 to be filed by the company with the office of the superintendent
				annually;
E.
"appointed
				actuary"
means a qualified actuary who was appointed by the company's
				board of directors, or its equivalent, or by a committee of the board, by
				December 31 of the calendar year for which the opinion is rendered;
F.
"company"
means an insurer
				authorized to write property or casualty insurance under the laws of any state
				and who files on the property and casualty blank;
G.
"qualified actuary"
means a
				person who meets the basic education, experience and continuing education
				requirements of the Specific Qualification Standards promulgated by the
				American academy of actuaries, has obtained and maintains an accepted actuarial
				designation specified by the National Association of Insurance Commissioners
				Annual Statement Instructions, and is a member of a professional actuarial
				association that requires adherence to the same Code of Professional Conduct
				and U.S. Qualification Standards promulgated by the American academy of
				actuaries, and participates in the actuarial board for counseling and
				discipline when its association members are practicing in the U.S.; or a member
				in good standing of the American academy of actuaries who has been approved as
				qualified for signing casualty loss reserve opinions by the casualty practice
				council of the American academy of actuaries.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 9 - PROPERTY AND CASUALTY ACTUARIAL OPINIONS › Section 13.2.9.8 - ACTUARIAL OPINION OF RESERVES AND SUPPORTING DOCUMENTATION

Current through Register Vol. 35, No. 13, July 16, 2024
A.
Statement
				of actuarial opinion.
Every property and casualty insurance company
				doing business in New Mexico, unless otherwise exempted by the superintendent,
				shall annually submit the opinion of an appointed actuary entitled "statement
				of actuarial opinion." This opinion shall be filed in accordance with the
				appropriate national association of insurance commissioners property and
				casualty annual statement instructions. The request for exemption from this
				requirement must be made in writing to the New Mexico superintendent before
				December 31st of each calendar year.
B.
Actuarial opinion summary.
(1) Every property and casualty insurance
				company domiciled in New Mexico that is required to submit a statement of
				actuarial opinion shall annually submit an actuarial opinion summary, written
				by the company's appointed actuary. This actuarial opinion summary shall be
				filed in accordance with the appropriate national association of insurance
				commissioners property and casualty annual statement instructions and shall be
				considered as a document supporting the actuarial opinion required in
				Subsection A of this section.
(2) A
				company licensed but not domiciled in New Mexico shall provide the actuarial
				opinion summary upon request.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 9 - PROPERTY AND CASUALTY ACTUARIAL OPINIONS › Section 13.2.9.9 - CONFIDENTIALITY

Current through Register Vol. 35, No. 13, July 16, 2024
A. The statement of
				actuarial opinion shall be provided with the annual statement in accordance
				with the appropriate national association of insurance commissioners property
				and casualty annual statement instructions and shall be treated as a public
				document.
B.
Documents,
				materials and other information.
(1)
				Documents, materials or other information in the possession or control of the
				insurance division that are considered an actuarial report, workpapers or
				actuarial opinion summary provided in support of the opinion, and any other
				material provided by the company to the superintendent in connection with the
				actuarial report, workpapers or actuarial opinion summary, shall be
				confidential by law and privileged, shall not be a public record, shall not be
				subject to inspection, shall not be subject to subpoena, and shall not be
				subject to discovery or admissible in evidence in any private civil
				action.
(2) This provision shall
				not be construed to limit the superintendent's authority to release the
				documents to the American academy of actuaries' actuarial board for counseling
				and discipline so long as the material is required for the purpose of
				professional disciplinary proceedings and that the actuarial board for
				counseling and discipline establishes procedures satisfactory to the
				superintendent for preserving the confidentiality of the documents, nor shall
				this section be construed to limit the superintendent's authority to use the
				documents, materials or other information in furtherance of any regulatory or
				legal action brought as part of the superintendent's official duties.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 10 - CORPORATE GOVERNANCE ANNUAL DISCLOSURE › Section 13.2.10.3 - STATUTORY AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
Sections
				  59A-1-18 and
				  59A-2-9,
				  NMSA 1978, Chapter 59A Article 4, NMSA 1978, and Chapter 59A Article 37, NMSA
				  1978 ("the Insurance Holding Company Law").
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 10 - CORPORATE GOVERNANCE ANNUAL DISCLOSURE › Section 13.2.10.5 - EFFECTIVE DATE

Current through Register Vol. 35, No. 13, July 16, 2024
November 1, 2020 unless a later date is cited at the end of a
				  section.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 10 - CORPORATE GOVERNANCE ANNUAL DISCLOSURE › Section 13.2.10.6 - OBJECTIVE

Current through Register Vol. 35, No. 13, July 16, 2024
The purpose of this rule is: to require an insurer or
				  insurance group subject to the requirements of this rule to provide the
				  superintendent with a summary of its corporate governance structure, policies
				  and practices; to outline the requirements for completing and submitting a
				  corporate governance annual disclosure; and to provide for the confidential
				  treatment of the corporate governance annual discloure and related
				  information.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 10 - CORPORATE GOVERNANCE ANNUAL DISCLOSURE › Section 13.2.10.7 - DEFINITIONS

Current through Register Vol. 35, No. 13, July 16, 2024
The following terms have the meaning given, unless the
				  context otherwise requires. Other terms used in this rule have the meanings
				  given in the New Mexico Insurance Code, the Insurance Holding Company Law, or
				  other OSI rules.
A.
"Corporate
				Governance Annual Disclosure ("CGAD")
means a confidential report
				submitted by an insurer or insurance group made in accordance with the
				requirements of this rule.
B.
"Insurance group"
means, for purposes of this rule, those insurers
				and affiliates included within an insurance holding company system as defined
				in the Insurance Holding Company Law.
C.
"Insurer"
has the same
				meaning given in the Insurance Holding Company Law.
D.
"Lead State"
means the state
				where the parent company is domiciled or, if there is no insurance parent, the
				state where the largest (by direct written premium volume as shown by the last
				filed annual statement) insurance subsidiary is domiciled.
E.
"ORSA Summary Report"
means a
				report filed in accordance with the National Association of Insurance
				Commissioners Risk Management and Own Risk and Solvency Assessment Model Act
				("ORSA").
F.
"Senior
				Management"
means any corporate officer responsible for reporting
				information to the board of directors at regular intervals or providing
				information to shareholders or regulators and shall include, for example and
				without limitation, the chief executive officer ("CEO"), chief financial
				officer ("CFO"), chief operations officer ("COO"), or any other chief
				executive.
G.
"Superintendent
" means the New Mexico superintendent of
				insurance.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 10 - CORPORATE GOVERNANCE ANNUAL DISCLOSURE › Section 13.2.10.9 - CONTENTS OF CORPORATE GOVERNANCE ANNUAL DISCLOSURE

Current through Register Vol. 35, No. 13, July 16, 2024
A. The insurer or insurance group shall be as
				descriptive as possible in completing the CGAD, with inclusion of attachments
				or example documents that are used in the governance process, since these may
				provide a means to demonstrate the strengths of their governance framework and
				practices.
B. The CGAD shall
				describe the insurer's or insurance group's corporate governance framework and
				structure including consideration of the following;
(1) The board and various committees thereof
				ultimately responsible for overseeing the insurer or insurance group and the
				level(s) at which that oversight occurs (e.g., ultimate control level,
				intermediate holding company, legal entity, etc.). The insurer or insurance
				group shall describe and discuss the rationale for the current board size and
				structure; and
(2) The duties of
				the board and each of its significant committees and how they are governed
				(e.g., bylaws, charters, informal mandates, etc.), as well as how the board's
				leadership is structured, including a discussion of the roles of CEO and
				chairman of the board within the organization.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 10 - CORPORATE GOVERNANCE ANNUAL DISCLOSURE › Section 13.2.10.10 - CONFIDENTIALITY

Current through Register Vol. 35, No. 13, July 16, 2024
A. Documents,
				materials and other information, including the CGAD, that are in the possession
				or control of OSI and that were submitted to OSI pursuant to this rule are
				confidential as provided by Chapter 59A Article 4, NMSA 1978.
B. To assist in the performance of the
				superintendent's regulatory duties, the superintendent:
(1) May, upon request, share documents,
				materials or other CGAD-related information including otherwise confidential,
				privileged, proprietary and trade secret documents and materials, with other
				state, federal and international financial regulatory agencies, including
				members of any supervisory college as defined in the Insurance Holding Company
				System rule, 13.2.2 NMAC, with the NAIC, and with third party consultants
				pursuant to 13.2.10.11 NMAC, provided that the recipient agrees in writing to
				maintain the confidentiality and privileged status of the CGAD-related
				documents, material or other information and has verified in writing the legal
				authority to maintain confidentiality; and
(2) May receive documents, materials or other
				CGAD-related information, including otherwise confidential, privileged,
				proprietary and trade secret documents and materials, from regulatory officials
				of other state, federal and international financial regulatory agencies,
				including members of any supervisory college as defined in the Insurance
				Holding Company System rule, 13.2.2 NMAC, and from the NAIC, and shall maintain
				as confidential or privileged any documents, materials 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.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 10 - CORPORATE GOVERNANCE ANNUAL DISCLOSURE › Section 13.2.10.12 - SANCTIONS

Current through Register Vol. 35, No. 13, July 16, 2024
Any insurer or insurance group failing to timely file the
				  CGAD may be subject to the penalty provisions of Section
				  59A-1-18, NMSA
				  1978 and other enforcement actions provided by law.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 11 - RISK MANAGEMENT AND OWN RISK AND SOLVENCY ASSESSMENT › Section 13.2.11.1 - ISSUING AGENCY

Current through Register Vol. 35, No. 13, July 16, 2024
New Mexico Office of Superintendent of
				  Insurance.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 11 - RISK MANAGEMENT AND OWN RISK AND SOLVENCY ASSESSMENT › Section 13.2.11.2 - SCOPE

Current through Register Vol. 35, No. 13, July 16, 2024
This rule applies to all insurers domiciled in New Mexico
				  unless exempt pursuant to Subsection 11 of this rule.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 11 - RISK MANAGEMENT AND OWN RISK AND SOLVENCY ASSESSMENT › Section 13.2.11.3 - STATUTORY AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
Authority for this rule derives from the superintendent's
				  powers under Section
				  59A-1-18 NMSA
				  1978, Section
				  59A-2-9
				  NMSA 1978, Section
				  59A-2-12
				  NMSA 1978, Chapter 59A Article 4 NMSA 1978, "Examinations, Hearings and
				  Appeals," Chapter 59A Article 5A NMSA 1978, the "Risk Based Capital Act," and
				  Chapter 57 Article 3A NMSA 1978, the "Uniform Trade Secrets
				  Act."
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 11 - RISK MANAGEMENT AND OWN RISK AND SOLVENCY ASSESSMENT › Section 13.2.11.5 - EFFECTIVE DATE

Current through Register Vol. 35, No. 13, July 16, 2024
August 1, 2021, unless a later date is cited at the end of a
				  section.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 11 - RISK MANAGEMENT AND OWN RISK AND SOLVENCY ASSESSMENT › Section 13.2.11.6 - OBJECTIVE

Current through Register Vol. 35, No. 13, July 16, 2024
The purpose of this rule is to provide the requirements for
				  maintaining a risk management framework and completing an own risk and solvency
				  assessment and to provide guidance and instruction for filing an own risk and
				  solvency assessment with the superintendent.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 11 - RISK MANAGEMENT AND OWN RISK AND SOLVENCY ASSESSMENT › Section 13.2.11.7 - DEFINITIONS

Current through Register Vol. 35, No. 13, July 16, 2024
The following terms have the meaning given, unless the
				  context otherwise requires. Other terms used in this rule have the meanings
				  given in Chapter 59A Article 4 NMSA 1978.
A.
"Guidance manual"
means the
				current version of the own risk and solvency assessment guidance manual
				developed and adopted by the NAIC and as amended from time to time; provided
				that a change in the guidance manual shall be effective on the January 1
				following the calendar year in which the changes have been adopted by the
				NAIC;
B.
"insurance group"
means those insurers and affiliates included within an insurance holding
				company system as defined in Subpargraph F of Section 59A-37-2N MSA
				1978;
C.
"insurer"
has
				the same meaning as set forth in Subparagraph G of Section
				59A-37-2 NMSA
				1978;
D.
"NAIC"
means
				the national association of insurance commissioners;
E.
"own risk and solvency
				assessment"
means a confidential internal assessment, appropriate to the
				nature, scale and complexity of an insurer or insurance group, conducted by
				that insurer or insurance group of the material and relevant risks associated
				with the insurer's or insurance group's current business plan and the
				sufficiency of capital resources to support those risks;
F.
"summary report"
means a
				confidential high-level summary of an insurer's or insurance group's own risk
				and solvency assessment; and
G.
"superintendent"
means the superintendent of the New Mexico office
				of superintendent of insurance.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 11 - RISK MANAGEMENT AND OWN RISK AND SOLVENCY ASSESSMENT › Section 13.2.11.8 - RISK MANAGEMENT FRAMEWORK

Current through Register Vol. 35, No. 13, July 16, 2024
An insurer shall maintain a risk management framework to
				  assist the insurer with identifying, assessing, monitoring, managing and
				  reporting on its material and relevant risks. This requirement may be satisfied
				  if the insurance group of which an insurer is a member maintains a risk
				  management framework applicable to the operations of the
				  insurer.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 11 - RISK MANAGEMENT AND OWN RISK AND SOLVENCY ASSESSMENT › Section 13.2.11.9 - REQUIREMENT FOR OWN RISK AND SOLVENCY ASSESSMENT

Current through Register Vol. 35, No. 13, July 16, 2024
Except as provided pursuant to Section 11 of this rule, an
				  insurer, or the insurance group of which the insurer is a member, shall
				  regularly conduct an own risk and solvency assessment consistent with a process
				  comparable to the guidance manual. The own risk and solvency assessment shall
				  be conducted no less than annually but also at any time when there are
				  significant changes to the risk profile of the insurer or the insurance group
				  of which the insurer is a member.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 11 - RISK MANAGEMENT AND OWN RISK AND SOLVENCY ASSESSMENT › Section 13.2.11.10 - OWN RISK AND SOLVENCY ASSESSMENT SUMMARY REPORT

Current through Register Vol. 35, No. 13, July 16, 2024
A. Upon the superintendent's request, an
				insurer shall submit to the superintendent an own risk and solvency assessment
				summary report or any combination of reports that together contain the
				information described in the guidance manual applicable to the insurer and the
				insurance group, if any, of which it is a member. The summary report, if
				requested, shall be due thirty days after the completion of the insurer's most
				recent own risk and solvency assessment that has been performed in accordance
				with the insurer's or the insurance group's internal strategic planning
				process. Upon the superintendent's request, the insurer shall advise the
				superintendent of the date, annual or otherwise, that the insurer or the
				insurance group conducts its internal strategic planning process. If the
				insurer is a member of an insurance group, the insurer shall submit the summary
				report or summary reports required by this subsection if the superintendent is
				the lead state commissioner of the insurance group as determined by the
				procedures within the financial analysis handbook adopted by the
				NAIC.
B. Each summary report shall
				include a signature of the insurer's or insurance group's chief risk officer or
				other executive having responsibility for the oversight of the insurer's
				enterprise risk management process attesting, to the best of the signatory's
				belief and knowledge, that the insurer applies the enterprise risk management
				process described in the summary report and that a copy of the summary report
				has been provided to the insurer's board of directors or the appropriate
				committee thereof.
C. An insurer
				may comply with the provisions of Subsection A of this section by providing the
				most recent and substantially similar summary report or summary reports
				provided by the insurer or another member of the insurance group of which the
				insurer is a member to the commissioner of another state or to a supervisor or
				regulator of a foreign jurisdiction, if that report provides information that
				is comparable to the information described in the guidance manual. Any such
				report in a language other than English shall be accompanied by a translation
				of that report into the English language.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 11 - RISK MANAGEMENT AND OWN RISK AND SOLVENCY ASSESSMENT › Section 13.2.11.11 - EXEMPTION

Current through Register Vol. 35, No. 13, July 16, 2024
A. An insurer shall
				be exempt from the provisions of this rule if:
(1) the insurer has an annual direct written
				and unaffiliated assumed premium, including international direct and assumed
				premiums but excluding premiums reinsured with the federal crop insurance
				corporation and federal flood program, of less than five hundred million
				dollars ($500,000,000); and
(2) the
				insurance group of which the insurer is a member has an annual direct written
				and unaffiliated assumed premium, including international direct and assumed
				premiums but excluding premiums reinsured with the federal crop insurance
				corporation and federal flood program, of less than one billion dollars
				($1,000,000,000).
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 11 - RISK MANAGEMENT AND OWN RISK AND SOLVENCY ASSESSMENT › Section 13.2.11.12 - CONTENTS OF OWN RISK AND SOLVENCY ASSESSMENT SUMMARY REPORTS

Current through Register Vol. 35, No. 13, July 16, 2024
A. A summary report
				shall be prepared consistent with the guidance manual, subject to the
				requirements of Subsection B of this section. Documentation and supporting
				information shall be maintained and made available upon examination or upon
				request of the superintendent.
B.
				The review of the summary report, and any additional requests for information,
				shall be made using similar procedures currently used in the analysis and
				examination of multistate or global insurers and insurance groups.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 11 - RISK MANAGEMENT AND OWN RISK AND SOLVENCY ASSESSMENT › Section 13.2.11.14 - SANCTIONS

Current through Register Vol. 35, No. 13, July 16, 2024
Any insurer failing, without just cause, to timely file the
				  summary report as required in this rule shall be required, after notice and
				  hearing, to pay a penalty of one thousand dollars ($1,000) for each day's delay
				  to be recovered by the superintendent, and the penalty so recovered shall be
				  paid into the general fund of the state of New Mexico. The maximum penalty
				  under this section is one hundred thousand dollars ($100,000). The
				  superintendent may reduce the penalty if the insurer demonstrates to the
				  superintendent that the imposition of the penalty would constitute a financial
				  hardship to the insurer.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 12 - HEALTH CARE CONSOLIDATION OVERSIGHT › Section 13.2.12.2 - SCOPE

Current through Register Vol. 35, No. 13, July 16, 2024
This rule applies to any proposed transactions that involve a
				  New Mexico hospital as regulated by the Health Care Consolidation Oversight
				  Act, Chapter 59A, Article 63 NMSA 1978.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 12 - HEALTH CARE CONSOLIDATION OVERSIGHT › Section 13.2.12.3 - STATUTORY AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
Authority for this rule derives from the superintendent's
				  powers under Sections 59A-2-9 and from 59A-63-1
et seq
., the
				  Health Care Consolidation Oversight Act.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 12 - HEALTH CARE CONSOLIDATION OVERSIGHT › Section 13.2.12.4 - DURATION

Current through Register Vol. 35, No. 13, July 16, 2024
This emergency rule expires 180 days from the effective date
				  unless a permanent rule is adopted before that time.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 12 - HEALTH CARE CONSOLIDATION OVERSIGHT › Section 13.2.12.5 - EFFECTIVE DATE

Current through Register Vol. 35, No. 13, July 16, 2024
May 15, 2024 unless a later date is cited at the end of a
				  section.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 12 - HEALTH CARE CONSOLIDATION OVERSIGHT › Section 13.2.12.6 - OBJECTIVE

Current through Register Vol. 35, No. 13, July 16, 2024
The purpose of this rule is to establish the standards for
				  meeting the requirements of the health care consolidation oversight act and to
				  provide details related to the superintendent's oversight of proposed
				  transactions.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 12 - HEALTH CARE CONSOLIDATION OVERSIGHT › Section 13.2.12.7 - DEFINITIONS

Current through Register Vol. 35, No. 13, July 16, 2024
For the purpose of this rule, the following terms have the
				  following meanings:
A.
"acquisition"
has the same meaning as defined in Subsection A of
				Section 59A-63-2 NMSA 1978;
B.
"act"
means the health care consolidation oversight act, Chapter
				59A, Article 63 NMSA 1978;
C.
"affiliation"
has the same meaning as defined in Subsection B of
				Section 59A-63-2 NMSA 1978;
D.
"authority"
has the same meaning as defined in Subsection C of
				Section 59A-63-2 NMSA 1978;
E.
"control"
has the same meaning as defined in Subsection D of
				Section 59A-63-2 NMSA 1978;
F.
"essential services"
has the same meaning as defined in Subsection
				E of Section 59A-63-2 NMSA 1978;
G.
"health care provider"
has the same meaning as defined in
				Subsection F of Section 59A-63-2 NMSA 1978;
H.
"health insurer"
has the same
				meaning as defined in Subsection G of Section 59A-63-2 NMSA 1978;
I.
"hospital"
has the same
				meaning as defined in Subsection H of Section 59A-63-2 NMSA 1978;
J.
"insurance holding company
				law"
means Chapter 59A, Article 37 NMSA 1078;
K.
"management services
				organization"
has the same meaning as defined in Subsection I of Section
				59A-63-2 NMSA 1978;
L.
"notice"
means a notification to the superintendent of a proposed
				transaction on a form provided by the superintendent, and when completed
				provides all the information required by Subsection E of 59A-63-2 NMSA
				1978;
M.
"office"
or
"OSI"
has the same meaning as defined in Subsection J of Section
				59A-63-2 NMSA 1978;
N.
"office of general counsel"
means the office of general counsel of
				the office of superintendent of insurance;
O.
"party"
or
"parties"
has the same meaning as defined in Subsection K of
				Section 59A-63-2 NMSA 1978;
P.
"person"
has the same meaning as defined in Subsection L of
				Section 59A-63-2 NMSA 1978;
Q.
"proposed transaction"
means a transaction as defined in
				Subsection N of Section 59A-63-2 NMSA 1978, that is subject to the review of
				the superintendent under the act;
R.
"significantly modified"
means a material change, alteration, or amendment to the scope of the proposed
				transaction from that outlined in the initial notice, that is significant
				enough to affect the outcome of the superintendent's determination;
S.
"superintendent"
has the same
				meaning as defined in Subsection M of Section 59A-63-2 NMSA 1978;
T.
"toll"
or
"tolled"
means a suspension of the 120-day time period that begins
				when the notice of proposed transaction is deemed complete by the
				superintendent or designee; and
U.
"transaction"
has the same meaning as defined in Subsection N of
				Section 59A-63-2 NMSA 1978.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 12 - HEALTH CARE CONSOLIDATION OVERSIGHT › Section 13.2.12.8 - APPLICABILITY, OVERSIGHT PROVISIONS AND PRESUMPTION OF CONTROL

Current through Register Vol. 35, No. 13, July 16, 2024
A. The oversight
				power of the office pursuant to the act applies to proposed transactions that
				involve a New Mexico hospital.
B.
				Being subject to the act does not preclude or negate any person regulated
				pursuant to the insurance hold company law.
C. Control is presumed to exist if a person,
				directly or indirectly, owns, controls, or holds fifteen percent or more of the
				power to vote or holds proxies representing fifteen percent or more of the
				voting securities of any other person.
D. The presumption may be rebutted by a
				showing in the manner provided by Section 59A-37-19 NMSA 1978 that control does
				not in fact exist.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 12 - HEALTH CARE CONSOLIDATION OVERSIGHT › Section 13.2.12.9 - NOTICE OF PROPOSED TRANSACTION

Current through Register Vol. 35, No. 13, July 16, 2024
A.
				Parties to a proposed transaction may submit a written request to the office of
				general counsel via the email provided on the office's website, for a
				pre-notice conference to determine if they are required to file a notice or to
				discuss the potential extent of the review with the superintendent or
				designee.
B. At least one person
				that is a party to a proposed transaction shall submit to the office via the
				email provided on the office's website, a written notice of the proposed
				transaction on the notice of proposed transaction form provided by the
				superintendent.
C. The notice of
				the proposed transaction shall include:
(1) a
				list of the parties, the terms of the proposed transaction and copies of all
				transaction agreements between any of the parties;
(2) a statement describing the goals of the
				proposed transaction and whether and how the proposed transaction affects
				health care services in New Mexico;
(3) the geographic service area of any
				hospital affected by the proposed transaction;
(4) a description of the groups or
				individuals likely to be affected by the transaction; and
(5) a summary of the health care services
				currently provided by any of the parties and any health care services that will
				be added, reduced or eliminated, including an explanation of why any services
				will be reduced or eliminated in the service area in which they are currently
				provided.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 12 - HEALTH CARE CONSOLIDATION OVERSIGHT › Section 13.2.12.10 - PAYMENT OF COSTS, REQUIREMENTS FOR CONSULTATION AND EXPERTS

Current through Register Vol. 35, No. 13, July 16, 2024
A. The office shall
				consult with the authority about the potential effect of the proposed
				transaction and incorporate the authority's recommendations into the office's
				final determination.
B. The office
				may retain actuaries, accountants, attorneys, or other professionals who are
				qualified and have expertise in the type of transaction under review as
				necessary to assist the office in conducting its review of the proposed
				transaction.
C. The office shall
				notify parties before any costs are incurred when a transaction review requires
				the use of outside experts, including the estimated cost of the outside
				expert's services.
D. The parties
				shall pay the reasonable costs and expenses incurred by the office in the
				performance of the office's or authority's duties pursuant to the act for costs
				associated with the office's contracts with experts, unless determined
				otherwise by the superintendent.
E.
				The parties shall not effectuate a transaction without the written approval of
				the superintendent. The submitting party shall notify the office of general
				counsel in writing via the email address located on the office's website, when
				the transaction has been effectuated.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 12 - HEALTH CARE CONSOLIDATION OVERSIGHT › Section 13.2.12.11 - REVIEW OF NOTICE AND TOLLING

Current through Register Vol. 35, No. 13, July 16, 2024
A.
				Upon receipt of a complete notice of a proposed transaction:
(1) the office shall determine if the
				transaction is urgently necessary to maintain the solvency of a hospital or if
				there is an emergency that threatens the continued provision of immediate
				health care services;
(2) in such
				circumstances, the office may agree to an immediate approval of a transaction
				with or without conditions;
(3) the
				office shall inform the authority of the filing of the notice of proposed
				transaction.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 12 - HEALTH CARE CONSOLIDATION OVERSIGHT › Section 13.2.12.12 - REVIEW OF PROPOSED TRANSACTION BY THE OFFICE

Current through Register Vol. 35, No. 13, July 16, 2024
A. Within 120-days of receiving a completed
				notice of a proposed transaction, the office shall complete a review, confer
				with the authority and either:
(1) approve
				the proposed transaction;
(2)
				approve the proposed transaction with conditions; or
(3) disapprove the proposed
				transaction.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 2 - INSURANCE COMPANY LICENSING AND OPERATION › Part 12 - HEALTH CARE CONSOLIDATION OVERSIGHT › Section 12.2.13.13 - NOTIFICATION OF DETERMINATION

Current through Register Vol. 35, No. 13, July 16, 2024
A. The superintendent shall notify the
				submitting party in writing of the office's determination and the reasons for
				the determination.
B. The office
				shall approve the proposed transaction after the comprehensive review if the
				office determines:
(1) the parties to the
				proposed transaction have demonstrated that the transaction will benefit the
				public by:
(a) reducing the growth in patient
				costs, including premiums and out-of-pocket costs; or
(b) maintaining or increasing access to
				services, especially in medically underserved areas;