reglab/statecodes huggingface dataset:
Oregon Administrative Rules › Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS › Division 141 - OREGON HEALTH PLAN › Section 410-141-5085 - ASSET VALUATION AND PERMITTED INVESTMENTS: Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
As used in OAR 410-141-5085  to 410-141-5165:
(1) "Amply secured obligation" means an
			 obligation which is not in default and as to which no default is imminent, and
			 which satisfies the requirements of one or more of the following subsections:
(a) An obligation of a sovereign or political
			 subdivision thereof, if it is issued, assumed or guaranteed by the governmental
			 unit involved and is payable either from:
(b) Taxes levied or which may be levied by
			 such governmental unit; or
(c)
			 Adequate special revenues pledged or otherwise appropriated or required by law
			 to be used for the purpose of such payment, provided the law authorizing the
			 issuance of the obligation requires that adequate rates be fixed, maintained
			 and collected at all times so as to produce sufficient revenue or earnings to
			 pay all operating expenses, maintenance charges, and the principal, interest
			 and dividends on the obligation. An obligation payable solely out of special
			 assessments on real property benefited by local improvements shall not be
			 considered amply secured unless the total amount so payable is less than 50
			 percent of the market value of the real property (including any improvements
			 thereon) and constitutes a lien on such property.
(d) An obligation issued, assumed or
			 guaranteed by a corporation, if the corporation is solvent, has not been in
			 default on any of its obligations during the preceding three years, and if the
			 obligation is secured by the pledge of property the market value of which
			 exceeds the amount of the obligation by 25 percent or more. Obligations which
			 are the subject of OAR 410-141-5105  and OAR 410-141-5110  are not included
			 within the provisions of this subsection.
(e) An obligation otherwise found to be amply
			 secured by the Authority. In making such determinations, the Authority shall
			 give consideration to model laws, model regulations and other statutory
			 accounting guidance pertaining to amply secured obligations issued from time to
			 time by the NAIC, and shall consider the financial condition of the issuing,
			 assuming or guaranteeing corporation as well as the existence or absence of any
			 pledge of property as security.
Oregon Administrative Rules › Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS › Division 141 - OREGON HEALTH PLAN › Section 410-141-5090 - ASSET VALUATION AND PERMITTED INVESTMENTS: Calculation of Value; Books and Records

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Securities
			 held by a CCO, other than bonds or other evidences of debt to which OAR
			 410-141-5095, applies, must be valued in the discretion of the Authority at
			 their market value, at their appraised value or at prices determined by the
			 Authority as representing their fair market value.
(2) Preferred or guaranteed stocks or shares
			 while paying full dividends may be carried at a fixed value instead of market
			 value, at the discretion of the Authority and in accordance with any method of
			 valuation approved by the Authority.
(3) Stock of a subsidiary corporation of a
			 CCO may not be valued at an amount in excess of the net value thereof as based
			 upon the assets only of the subsidiary that would be eligible under OAR
			 410-141-5095  to 410-141-5140  for investment of the funds of the CCO
			 directly.
(4) The Authority may
			 determine the method of calculating values as provided in this section, but the
			 method or valuation may not be inconsistent with any applicable method or
			 valuation used by CCOs in general or any such method of valuation then
			 currently formulated or approved by the NAIC or its successor
			 organization.
(5) Assets may be
			 allowed as deductions from corresponding liabilities, liabilities may be
			 charged as deductions from assets, deductions from assets may be charged as
			 liabilities, and deductions from liabilities may be allowed as assets, in
			 accordance with the form of annual statement prescribed by the Authority, or
			 otherwise in the discretion of the Authority.
(6) A CCO shall keep its books, records,
			 accounts and transaction source data in such manner that the Authority may
			 readily verify its statements of financial condition and ascertain whether the
			 CCO is unimpaired, has given proper treatment to Members and has complied with
			 Applicable Law.
Statutory/Other Authority: ORS
				  413.042,
				  414.615,
				  414.625,
				  414.635 & 414.651
Statutes/Other Implemented: ORS
				  414.610 -
				  414.685
Oregon Administrative Rules › Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS › Division 141 - OREGON HEALTH PLAN › Section 410-141-5095 - ASSET VALUATION AND PERMITTED INVESTMENTS: Assets Other Than Securities; Bonds; Real Property; Mortgages; Compensating Balances

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Each bond or other evidence of debt
			 having a fixed term and rate of interest may be valued as follows, if amply
			 secured and not in default as to principal or interest:
(a) If purchased at par, at the par
			 value.
(b) If purchased above or
			 below par, according to an accepted method of valuation approved by the
			 Authority.
Oregon Administrative Rules › Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS › Division 141 - OREGON HEALTH PLAN › Section 410-141-5100 - ASSET VALUATION AND PERMITTED INVESTMENTS: Investments Used to Provide Compensating Balances

Current through Register Vol. 63, No. 7, July 1, 2024
Investments of a CCO of the kind described in OAR
				410-141-5105(2)  that are made for the purpose of providing compensating
				balances for other persons will not be prohibited by OAR 410-141-5140  while the
				following conditions are met:
(1) The
			 investment is made in the name of and remains the sole property of the
			 CCO;
(2) The investment is not
			 subject to appropriation in any manner by any person, including the person for
			 whom the compensating balance is being provided, the institution in which the
			 deposit is made and other creditors of such persons;
(3) The CCO holds an irrevocable written
			 waiver from the depositary institution, in a form satisfactory to the
			 Authority, waiving all right, title and interest in or to any setoff, banker's
			 or similar lien or other security interest in such investment or any funds
			 represented thereby;
(4) The
			 investment is unrestricted as to right of withdrawal except for such
			 restrictions as may be usual and customary for such investments under OAR
			 410-141-5105(2)  when no compensating balance is involved; and
(5) The CCO receives a reasonable fee, taking
			 into consideration its return on other funds, for providing the compensating
			 balance involved.
Statutory/Other Authority: ORS
				  413.042,
				  414.615,
				  414.625,
				  414.635 & 414.651
Statutes/Other Implemented: ORS
				  414.610 -
				  414.685
Oregon Administrative Rules › Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS › Division 141 - OREGON HEALTH PLAN › Section 410-141-5105 - ASSET VALUATION AND PERMITTED INVESTMENTS: Investment of Required Capitalization

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Funds
			 of a CCO at least equal to its required capitalization shall be invested and
			 kept invested as follows:
(a) In amply secured
			 obligations of the United States, a state or a political subdivision of this
			 state.
(b) In loans secured by
			 first liens upon improved, unencumbered real property (other than leaseholds)
			 in this state where:
(A) The lien does not
			 exceed 50 percent of the appraised value of the property and the loan is for a
			 term of five years or less;
(B) The
			 lien does not exceed 66-2/3 percent of the appraised value of the property
			 provided there is an amortization plan mortgage, deed of trust or other
			 instrument under the terms of which the installment payments are sufficient to
			 repay the loan within a period of not more than 25 years; or
(C) The investment is insured or guaranteed
			 by the Federal Housing Administration, the United States Department of Veterans
			 Affairs, or under Title I of the Housing Act of 1949 (providing for slum
			 clearance and redevelopment projects) enacted by Congress on July 15,
			 1949.
Oregon Administrative Rules › Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS › Division 141 - OREGON HEALTH PLAN › Section 410-141-5110 - ASSET VALUATION AND PERMITTED INVESTMENTS: Investment in Mortgage Loans

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Funds of a CCO
			 may be invested in:
(a) Loans secured by
			 first liens upon improved, unencumbered real property (other than leaseholds)
			 in the manner and subject to the same terms and conditions set forth in OAR
			 410-141-5105, except that the property may be located within the boundaries of
			 any sovereign; for loans described in OAR 410-141-5105 (1)(b)(B), the maximum
			 permitted ratio of the loan to the appraised value shall be 80 rather than
			 66-2/3 percent, and the maximum term of the loan shall be 30 rather than 25
			 years.
(b) Loans secured by first
			 liens upon a leasehold of improved, unencumbered real property located within
			 the boundaries of any sovereign if:
(A) The
			 leasehold has a period of not less than 20 years to run from the date of the
			 loan, inclusive of the term which may be provided by an enforceable option of
			 renewal, the loan does not exceed 70 percent of the fair market value of the
			 leasehold together with any improvements located thereon which are subject to
			 the lien, the terms of the loan provide for amortization payments to be made by
			 the borrower on the principal thereof at least once in each year in amounts
			 sufficient to completely amortize the loan within a period of four-fifths of
			 the term of the leasehold, and the CCO is entitled to be subrogated to all
			 rights of the lessee under the leasehold; or
(B) The investment is insured or guaranteed
			 in the manner provided in OAR 410-141-5105 (1)(b)(C).
Oregon Administrative Rules › Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS › Division 141 - OREGON HEALTH PLAN › Section 410-141-5120 - ASSET VALUATION AND PERMITTED INVESTMENTS: Investment in Corporate Stocks

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Funds of a
			 CCO may be invested in stocks (including trust certificates) of solvent
			 corporations organized and carrying on a business under the laws of a sovereign
			 as follows:
(a) Preferred or guaranteed
			 stocks if the corporation is not in default or arrears as to any preferred or
			 guaranteed dividend and has continuously and regularly paid such dividends
			 during the preceding three years or has paid cash dividends for five years on
			 common stock.
(b) Common stocks as
			 provided in paragraph (c) of this subsection if:
(A) The obligations and preferred stock, if
			 any, of such corporation are eligible for investment under these rules;
			 and
(B) The stock is registered on
			 a national securities exchange regulated under the Securities Exchange Act of
			 1934,
			 15
			 U.S.C. §§
											78a et seq., or if of a
			 type not commonly so registered is regularly traded on a broad national or
			 regional basis.
(C) Notwithstanding
			 OAR 410-141-5165(1), not more than 25 percent of admitted assets may be in
			 common stocks that have not paid a cash dividend during each of the five years
			 preceding the date of acquisition.
Oregon Administrative Rules › Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS › Division 141 - OREGON HEALTH PLAN › Section 410-141-5125 - ASSET VALUATION AND PERMITTED INVESTMENTS: Loans; Security; Limitations

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Funds of
			 a CCO may be invested in loans secured by pledges of obligations and stocks
			 eligible for investment under these rules. As of the date the loan is made, it
			 shall not exceed in amount 80 percent of the market value of the collateral
			 pledged. No such loan shall be made for the purpose of providing funds to
			 purchase or carry stocks registered on a national securities
			 exchange.
(2) Funds of a CCO may be
			 invested in loans secured by personal property or fixtures if such loan is:
(a) In connection with a loan on the security
			 of real property or a leasehold as provided in OAR 410-141-5110;
(b) In an amount not exceeding 20 percent of
			 the amount loaned on the real property or leasehold;
(c) For a term of not more than five
			 years;
(d) Secured by a security
			 interest which constitutes a first lien, except for taxes not then delinquent,
			 on tangible, permanent personal property of the borrower kept and used on the
			 premises, other than stocks of goods held for sale or transfer in the ordinary
			 course of business or items which by normal use will be consumed or depleted
			 during the period of the loan; and
(e) In an amount, the ratio of which to the
			 value of the security does not exceed the ratio of the companion loan to the
			 value of the real property or leasehold.
Oregon Administrative Rules › Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS › Division 141 - OREGON HEALTH PLAN › Section 410-141-5130 - ASSET VALUATION AND PERMITTED INVESTMENTS: Investments; Certain Obligations, Property, Loans and Other Specified Items

Current through Register Vol. 63, No. 7, July 1, 2024
Funds of a CCO may be invested in the following:
(1) Obligations secured by a mortgage or deed
			 of trust payment of which is guaranteed by a policy of mortgage
			 insurance.
(2) Obligations issued,
			 assumed or guaranteed by the International Bank for Reconstruction and
			 Development.
(3) Bank and bankers'
			 acceptances and other bills of exchange of the kind and nature made eligible by
			 law for purchase in the open market by federal reserve banks.
(4) Deposits, certificates of deposits,
			 accounts or savings or certificate shares or accounts of or in banks, trust
			 companies, savings and loan associations or building and loan associations
			 insured with the Federal Deposit Insurance Corporation or qualified to do
			 business under the laws of this state.
(5) Obligations issued by trustees or
			 receivers of a corporation created or existing under the laws of a sovereign
			 which, or the assets of which, are being administered under the direction of a
			 court having jurisdiction if the obligation is adequately secured as to
			 principal and interest.
(6)
			 Transportation equipment used wholly or in part within a sovereign, or
			 adequately secured trust certificates of participation or similar obligations
			 or contracts evidencing an interest in such transportation equipment, where the
			 investor is entitled to receive a determined or determinable portion of rental,
			 purchase or other obligatory payments for use or purchase of the
			 equipment.
(7) Purchase contracts
			 or lease-purchase agreements executed under the Federal Public Buildings
			 Purchase Contract Act of 1954, or the Post Office Department Property Act of
			 1954.
(8) Stock of the Federal Home
			 Loan Bank to the extent of the minimum required by the Federal Home Loan Bank
			 Act. A CCO acquiring such stock may exercise all rights and powers given to
			 members under such Act, including but not by way of limitation the right to
			 obtain advances or borrow money from such bank and to pledge collateral as
			 security therefor.
(9) Obligations
			 issued, assumed or guaranteed by the Inter-American Development Bank.
(10) Obligations issued, assumed or
			 guaranteed by the Asian Development Bank.
(11) Obligations issued, assumed or
			 guaranteed by the African Development Bank.
Statutory/Other Authority: ORS
				  413.042,
				  414.615,
				  414.625,
				  414.635 & 414.651
Statutes/Other Implemented: ORS
				  414.610 -
				  414.685
Oregon Administrative Rules › Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS › Division 141 - OREGON HEALTH PLAN › Section 410-141-5135 - ASSET VALUATION AND PERMITTED INVESTMENTS: Personal Property; Protection of Investment Property; Custom

Current through Register Vol. 63, No. 7, July 1, 2024
(1) A CCO may acquire and retain personal
			 property received as a dividend, gift or devise, or pursuant to a lawful plan
			 of merger, consolidation or reorganization or bona fide agreement of bulk
			 reinsurance, or in satisfaction or liquidation of an obligation, or in exchange
			 or part payment for real or personal property previously owned or to protect or
			 enhance such property.
(2) A CCO
			 may make purchases or loan sums necessary to protect, preserve or enhance
			 investment property, real or personal, which it is otherwise authorized to
			 acquire or hold.
(3) The Authority
			 shall allow as assets in any determination of the financial condition of the
			 CCO only such property or investments acquired or retained under this section
			 as are consistent with the customary operations of a CCO.
Statutory/Other Authority: ORS
				  413.042,
				  414.615,
				  414.625,
				  414.635 & 414.651
Statutes/Other Implemented: ORS
				  414.610 -
				  414.685
Oregon Administrative Rules › Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS › Division 141 - OREGON HEALTH PLAN › Section 410-141-5140 - ASSET VALUATION AND PERMITTED INVESTMENTS: "Prudent Investor" Standard

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Funds of a
			 CCO may be invested in a manner not expressly prohibited under OAR 410-141-5145  and OAR 410-141-5165  provided such investments are made in the exercise of the
			 judgment and care under the circumstances then prevailing which investors of
			 prudence, discretion and intelligence exercise in the management of their own
			 affairs not in regard to speculation but in regard to the permanent disposition
			 of their funds, considering the probable income as well as the probable safety
			 of their capital.
(2) Funds
			 invested under this section shall not exceed the lesser of seven and one-half
			 percent of the CCO's assets or the excess of the CCO's assets over all
			 liabilities and required capitalization.
(3) If the Authority has reason to believe
			 that loans or investments made pursuant to this section are not adequately
			 secured or are not yielding an income the Authority may direct the CCO to
			 report under oath the amount of such loans or investments, the security
			 therefor and its market value.
Statutory/Other Authority: ORS
				  413.042,
				  414.615,
				  414.625,
				  414.635 & 414.651
Statutes/Other Implemented: ORS
				  414.610 -
				  414.685
Oregon Administrative Rules › Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS › Division 141 - OREGON HEALTH PLAN › Section 410-141-5145 - ASSET VALUATION AND PERMITTED INVESTMENTS: Prohibited Conduct by Directors, Trustees, Officers, Agents or Employees

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Except in the case of the issuance or
			 sale of the CCO's securities, as approved by a majority of the disinterested
			 members of the CCO's Board, or failing such majority by the shareholders, a
			 director, trustee, officer, agent or employee, or spouse or relative thereof,
			 shall not receive any fee, commission, compensation or other valuable
			 consideration whatsoever, directly or indirectly, for aiding, promoting or
			 assisting:
(a) The planning, preparing or
			 executing of an activity described in OAR 410-141-5160; or
(b) The planning, preparing or executing of
			 any plan for the issuance, sale or acquisition of shares or other securities of
			 the CCO for any purpose.
Oregon Administrative Rules › Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS › Division 141 - OREGON HEALTH PLAN › Section 410-141-5150 - ASSET VALUATION AND PERMITTED INVESTMENTS: Investment of Funds in Obligations That Are Not Investment Quality; Percentage of Assets

Current through Register Vol. 63, No. 7, July 1, 2024
(1) A CCO may
			 acquire or hold obligations that are not investment grade only as provided in
			 this section.
(2) For purposes of
			 this section, an obligation is not investment grade if the obligation is either
			 of the following:
(a) A "medium grade
			 obligation", which means an obligation that is rated three by the
			 SVO;
(b) A "lower grade
			 obligation", which means an obligation that is rated four, five or six by
			 SVO.
Oregon Administrative Rules › Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS › Division 141 - OREGON HEALTH PLAN › Section 410-141-5155 - ASSET VALUATION AND PERMITTED INVESTMENTS: Approval by Board

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The investment
			 policy shall be approved by the CCO's Board or a committee thereof charged with
			 the duty of investing the funds of the CCO.
(2) Deposits shall be made in banks or
			 banking institutions approved by the CCO's Board.
Statutory/Other Authority: ORS
				  413.042,
				  414.615,
				  414.625,
				  414.635 & 414.651
Statutes/Other Implemented: ORS
				  414.610 -
				  414.685
Oregon Administrative Rules › Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS › Division 141 - OREGON HEALTH PLAN › Section 410-141-5160 - ASSET VALUATION AND PERMITTED INVESTMENTS: Record of Investments

Current through Register Vol. 63, No. 7, July 1, 2024
As to each investment, a CCO shall make a written record in
				permanent form, signed by a person authorized by the CCO's Board or by a
				committee thereof charged with the duty of investing the funds. The record
				shall show the authorization and approval of the investment and in addition
				shall contain:
(1) In the case of
			 mortgage loans:
(a) The name of the
			 borrower;
(b) The location and
			 legal description of the property;
(c) A physical description and the appraised
			 value of the security as determined by a competent and qualified appraiser;
			 and
(d) The amount of the loan,
			 rate of interest and terms of repayment.
Oregon Administrative Rules › Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS › Division 141 - OREGON HEALTH PLAN › Section 410-141-5165 - ASSET VALUATION AND PERMITTED INVESTMENTS: Prohibited Investments

Current through Register Vol. 63, No. 7, July 1, 2024
(1) A CCO shall not
			 make investments:
(a) Which at the time of
			 purchase or acquisition are not interest-bearing or dividend or income-paying,
			 or are in default in any respect; or
(b) From which the CCO is not entitled to
			 receive for its exclusive account and benefit the interest, dividends or
			 income.
Oregon Administrative Rules › Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS › Division 141 - OREGON HEALTH PLAN › Section 410-141-5170 - CAPITALIZATION: Capital and Surplus

Current through Register Vol. 63, No. 7, July 1, 2024
(1) A
			 CCO shall possess and thereafter maintain capital or surplus or any combination
			 thereof equal to no less than $2.5 million.
(2) A CCO applying for its original CCO
			 contract this state shall possess, when so applying, additional capital or
			 surplus, or any combination thereof, of not less than $500,000.
(3) Notwithstanding a CCO's compliance with
			 subsections (1) and (2), a CCO shall at all times also comply with the
			 risk-based capital standards set forth at OAR 410-141-5295  to 5320.
(4) For the protection of the public, the
			 Authority may require a CCO to possess and maintain capital or surplus, or any
			 combination thereof, in excess of the amounts otherwise required under this
			 section owing to the type, volume and nature of business transacted by the CCO.
			 For the purpose of determining the reasonableness and adequacy of a CCO's
			 capital and surplus, the Authority may consider the following factors, as among
			 others:
(a) The size of the CCO, as measured
			 by its assets, capital and surplus, reserves, capitated revenue and other
			 appropriate criteria.
(b) The
			 number of Members covered by the CCO.
(c) The extent of the geographical dispersion
			 of the Members covered by the CCO.
(d) The nature and extent of the reinsurance
			 program of the CCO.
(e) The
			 quality, diversification and liquidity of the investment portfolio of the
			 CCO.
(f) The recent past and
			 projected future trend in the size of the investment portfolio of the
			 CCO.
(g) The combined capital and
			 surplus maintained by comparable CCOs.
(h) The adequacy of the reserves of the
			 CCO.
(i) The quality and liquidity
			 of investments in affiliates. The Authority may treat any such investment as a
			 disallowed asset for purposes of determining the adequacy of combined capital
			 and surplus whenever in the judgment of the Authority the investment so
			 warrants.
(j) The quality of the
			 earnings of the CCO and the extent to which the reported earnings include
			 extraordinary items.
Oregon Administrative Rules › Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS › Division 141 - OREGON HEALTH PLAN › Section 410-141-5175 - CAPITALIZATION: Impaired Capital and Surplus

Current through Register Vol. 63, No. 7, July 1, 2024
(1) If the Authority determines in accordance
			 with OAR 410-141-5195  et seq. that a CCO's reserves, however calculated or
			 estimated, are inadequate, the Authority may require the CCO to maintain
			 reserves in such additional amount as is needed to make them
			 adequate.
(2) Whenever the
			 Authority determines from any showing or statement made to the Authority or
			 from any examination made by the Authority that the assets of a CCO are less
			 than its liabilities plus required capitalization, the Authority may proceed
			 immediately under the provisions of OAR 410-141-5469 and Section 26 of S.B.
			 1041 or the Authority may allow the CCO a period of time, not to exceed 90
			 days, in which to make good the amount of the impairment with cash or
			 authorized investments.
(3) If the
			 amount of any such impairment is not made good within the time prescribed by
			 the Authority under subsection (1) of this section, the Authority shall proceed
			 under the provisions of OAR 410-141-5469 and Section 26 of the S.B.
			 1041.
(4) An order directing a CCO
			 to cure an impairment shall be confidential for such time as the Authority
			 considers proper but not exceeding the time prescribed by the Authority for
			 making the amount of the impairment good. If the Authority determines that the
			 public interest in disclosure outweighs the public interest in protecting the
			 solvency of the CCO, the Authority may make the order available for public
			 inspection.
Statutory/Other Authority: ORS
				  413.042,
				  414.615,
				  414.625,
				  414.635 & 414.651
Statutes/Other Implemented: ORS
				  414.610 -
				  414.685
Oregon Administrative Rules › Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS › Division 141 - OREGON HEALTH PLAN › Section 410-141-5180 - CAPITALIZATION: Dividend and Distribution Restrictions

Current through Register Vol. 63, No. 7, July 1, 2024
Unless prior written approval of the Authority is first
				obtained, a CCO shall not:
(1) Make
			 any distribution of assets by dividend or other distribution to shareholders,
			 equity members, parent companies or any related parties that would cause the
			 CCO's capital and surplus to fall below the prescribed minimum under OAR
			 410-141-5170.
(2) Reduce its total
			 adjusted capital by partial distribution of its assets, by payment in the form
			 of a dividend or otherwise to shareholders, equity members, parent companies or
			 any related parties below an amount equal to 300% of the CCO's authorized
			 control level risk-based capital, as defined in and calculated pursuant to OAR
			 410-141-5215.
(3) Declare or pay
			 dividends to shareholders, equity members, parent companies or any related
			 parties other than from earned surplus. For purposes of this subsection,
			 "earned surplus" does not include surplus arising from unrealized capital gains
			 or revaluation of assets.
(4)
			 Declare or pay an extraordinary dividend or distribution to shareholders,
			 equity members, parent companies or any related parties. A dividend or dividend
			 is "extraordinary" for purposes of this subsection if it exceeds an amount
			 equal to the aggregate of the CCO's net after-tax income for the prior three
			 calendar years, less any dividends or distributions paid during the prior two
			 calendar years and the current year. "Extraordinary dividend or distribution"
			 does not include pro rata distributions of any class of the CCO's own
			 securities.
Statutory/Other Authority:ORS
				  413.042,
				  414.615,
				  414.625,
				  414.635  & 414.651
Statutes/Other Implemented:ORS
				  414.610 -
				  414.685
Oregon Administrative Rules › Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS › Division 141 - OREGON HEALTH PLAN › Section 410-141-5185 - CAPITALIZATION: Restricted Reserve Account

Current through Register Vol. 63, No. 7, July 1, 2024
(1) A CCO shall establish a Restricted
			 Reserve Account and maintain sufficient Restricted Reserve Funds in the
			 Restricted Reserve Account to meet the Authority's Primary Reserve and
			 Secondary Reserve requirements. Restricted Reserve Funds shall be held for the
			 purpose of:
(a) Making payments to providers
			 in the event of the CCO's insolvency; and
(b) Assuring the CCO's performance in the
			 event its contract with the Authority is terminated.
Oregon Administrative Rules › Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS › Division 141 - OREGON HEALTH PLAN › Section 410-141-5186 - CAPITALIZATION: Restricted Reserve Account-Permitted Investments in Obligations with Political Subdivisions; Public Supported Housing

Current through Register Vol. 63, No. 7, July 1, 2024
(1) With prior written approval from the
			 Authority, a CCO may invest up to 25% of its Primary Reserve and Secondary
			 Reserve with one or more public housing authorities created under ORS
			 456.055 to
			 456.235 and governed by a county in the CCO's service area.
(a) The housing authority(ies) must address a
			 documented social determinant of health need for that community;
(b) The CCO shall complete and file with the
			 Authority a Form D as described and required under OAR 410-141-5320  for each
			 housing authority that the CCO contracts with under this section;
(c) The CCO shall complete and file with the
			 Authority the Model Depository Agreement specific to any obligation described
			 in this section that will not be held with a third-party financial
			 institution.
Oregon Administrative Rules › Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS › Division 141 - OREGON HEALTH PLAN › Section 410-141-5190 - CAPITALIZATION: Surplus Notes

Current through Register Vol. 63, No. 7, July 1, 2024
(1) With the
			 prior approval of the Authority, a CCO may issue one or more surplus notes in
			 order to secure funding needed to comply with minimum capital and surplus
			 requirements and/or minimum risk-based capital requirements under these rules,
			 or otherwise to provide additional funding required for the CCO's
			 operations.
(2) Approval by the
			 Authority of the issuance and sale of a surplus note by a CCO, including the
			 form and terms of the surplus note and the purchaser of the surplus note, is
			 required and shall be at the sole discretion of the Authority.
(3) The issuance and sale of a surplus note,
			 and the form and terms of the surplus note, shall comply with the standards for
			 the issuance of surplus notes set forth in the Accounting Practices and
			 Procedures Manual published by the NAIC, as well as the following requirements:
(a) A surplus note shall be sold only in
			 return for cash or marketable securities having readily determinable values and
			 liquidity satisfactory to the Authority.
(b) Commissions, promotion expenses or
			 finders' fees may not be paid in connection with a surplus note sale except for
			 commissions, expenses and fees customarily incurred within the context of
			 public or private placement offerings underwritten by an investment banking or
			 similar entity.
(c) Payment of
			 principal or interest on a surplus note may not be made without the prior
			 written approval of the Authority. The issuer shall provide the Authority with
			 written notice at least thirty days prior to the intended date of the payment
			 of principal or interest on a surplus note or such shorter period as the
			 Authority may permit.
(d) Payment
			 of principal or interest on a surplus note shall be subordinated to payment of
			 all other liabilities of the issuer.
(e) Payment of interest on a surplus note may
			 be made only from the unassigned funds of the issuer.
(f) Surplus notes shall not be assignable or
			 negotiable without the prior written approval of the Authority.
Oregon Administrative Rules › Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS › Division 141 - OREGON HEALTH PLAN › Section 410-141-5195 - CAPITALIZATION: Risk-based Capital (RBC) Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
As used in OAR 410-141-5195  to 410-141-5220:
(1) "Authorized Control Level RBC" means the
			 number determined under the risk-based capital formula in accordance with the
			 RBC Instructions.
(2) "Company
			 Action Level RBC" means, with respect to any CCO, the product of 2.0 (200%) and
			 the CCO's Authorized Control Level RBC.
(3) "Corrective Order" means an order entered
			 by the Authority under OAR 410-141-5310  to OAR 410-141-5320  specifying
			 corrective actions the Authority determines are required of a CCO in respect of
			 its Total Adjusted Capital and its RBC Level.
(4) "Mandatory Control Level RBC" means the
			 product of .70 (70%) and the CCO's authorized control level RBC.
(5) "RBC Instructions" means the RBC Report
			 form and including risk-based capital instructions adopted by the NAIC, as such
			 form and instructions may be amended by the NAIC from time to time.
(6) "RBC Level" means a CCO's Company Action
			 Level RBC, Regulatory Action Level RBC, Authorized Control Level RBC or
			 Mandatory Control Level RBC.
(7)
			 "RBC Plan" means a comprehensive financial plan containing the elements
			 specified in OAR 410-141-5295  to 410-141-5320. If the Authority rejects the RBC
			 Plan and it is revised by the CCO with or without the Authority's
			 recommendation, the plan shall be called the "revised RBC Plan."
(8) "RBC Report" means the report required by
			 OAR 410-141-5300.
(9) "Regulatory
			 Action Level RBC" means the product of 1.5 (150%) and the CCO's Authorized
			 Control Level RBC.
(10) "Total
			 Adjusted Capital" means the sum of:
(a) A
			 CCO's capital and surplus as determined in accordance with the statutory
			 accounting applicable to the annual financial statements required to be filed
			 under OAR 410-141-5015; and
(b)
			 Such other items, if any, as the RBC instructions may provide.
Oregon Administrative Rules › Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS › Division 141 - OREGON HEALTH PLAN › Section 410-141-5200 - CAPITALIZATION: RBC Reports

Current through Register Vol. 63, No. 7, July 1, 2024
(1) On or
			 before April 30 of each year, a CCO shall prepare and submit to the Authority a
			 report of its Total Adjusted Capital and its RBC Levels as of the end of the
			 calendar year just ended, in a form and containing such information as are
			 required by the RBC instructions. In addition, a CCO shall file its RBC Report
			 with the NAIC in accordance with the RBC instructions. The CCO shall report in
			 its annual financial statement its Total Adjusted Capital and its Authorized
			 Control Level RBC as calculated in its RBC Report. A CCO's RBC Report will be
			 considered confidential and shall not be made available to the
			 public.
(2) A CCO's Total Adjusted
			 Capital shall be determined in accordance with the formula set forth in the RBC
			 instructions. The formula shall take the following factors into account (and
			 may adjust for the covariance between such factors) determined in each case by
			 applying the factors in the manner set forth in the RBC instructions:
(a) Asset risk;
(b) Credit risk;
(c) Underwriting risk; and
(d) All other business risks and such other
			 relevant risks as are set forth in the RBC instructions.
Oregon Administrative Rules › Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS › Division 141 - OREGON HEALTH PLAN › Section 410-141-5205 - CAPITALIZATION: Company Action Level Event

Current through Register Vol. 63, No. 7, July 1, 2024
(1) "Company Action Level Event" means any of
			 the following events:
(a) The filing of an
			 RBC Report by a CCO that indicates that the CCO's Total Adjusted Capital is
			 greater than or equal to its Regulatory Action Level RBC but less than its
			 Company Action Level RBC. The CCO shall provide prompt written notice to the
			 Authority, together with an RBC Report, if it learns that the CCO is the
			 subject of a Company Action Level Event.
(b) Notification by the Authority to the CCO
			 of an adjusted RBC Report that indicates an event in subsection (a), if the CCO
			 does not challenge the adjusted RBC Report.
(c) If a CCO challenges an adjusted RBC
			 Report that indicates the event in subsection (a), notification by the
			 Authority to the CCO that the Authority has, after a hearing, rejected the
			 CCO's challenge.
Oregon Administrative Rules › Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS › Division 141 - OREGON HEALTH PLAN › Section 410-141-5210 - CAPITALIZATION: Regulatory Action Level Event

Current through Register Vol. 63, No. 7, July 1, 2024
(1) "Regulatory Action Level Event" means,
			 with respect to a CCO, any of the following events:
(a) The filing of an RBC Report by the CCO
			 that indicates that the CCO's Total Adjusted Capital is greater than or equal
			 to its Authorized Control Level RBC but less than its Regulatory Action Level
			 RBC. The CCO shall provide prompt written notice to the Authority, together
			 with an RBC Report, if it learns that the CCO is the subject of a Regulatory
			 Action Level Event.
(b)
			 Notification by the Authority to a CCO of an adjusted RBC Report that indicates
			 the event in subsection (a), if the CCO does not challenge the adjusted RBC
			 Report.
(c) If the CCO challenges
			 an adjusted RBC Report that indicates the event in subsection (a), the
			 notification by the Authority to the CCO that the Authority has, after a
			 hearing, rejected the CCO's challenge.
(d) The failure of the CCO to file an RBC
			 Report by the filing date, unless the CCO has provided an explanation for the
			 failure that is satisfactory to the Authority and has cured the failure within
			 ten days after the filing date.
(e)
			 The failure of the CCO to submit an RBC Plan to the Authority within the time
			 period set forth in this section.
(f) Notification by the Authority to the CCO
			 that:
(A) The RBC Plan or revised RBC Plan
			 submitted by the CCO under this section is, in the judgment of the Authority,
			 unsatisfactory; and
(B) The CCO has
			 not challenged the determination.
(g) If the CCO challenges a determination by
			 the Authority, the notification by the Authority to the CCO that the Authority
			 has, after a hearing, rejected the challenge;
(h) Notification by the Authority to the CCO
			 that the CCO 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 CCO to
			 eliminate the Company Action Level Event in accordance with its RBC Plan or
			 revised RBC Plan and the Authority has so stated in the notification, if the
			 CCO has not challenged the determination; or
(i) If the CCO challenges a determination by
			 the Authority, the notification by the Authority to the CCO that the Authority
			 has, after a hearing, rejected the challenge.
Oregon Administrative Rules › Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS › Division 141 - OREGON HEALTH PLAN › Section 410-141-5215 - CAPITALIZATION: Authorized Control Level Event

Current through Register Vol. 63, No. 7, July 1, 2024
(1) "Authorized Control Level Event" means
			 any of the following events:
(a) The filing
			 of an RBC Report by the CCO that indicates that the CCO's Total Adjusted
			 Capital is greater than or equal to its Mandatory Control Level RBC but less
			 than its Authorized Control Level RBC. The CCO shall provide prompt written
			 notice to the Authority, together with an RBC Report, if it learns that the CCO
			 is the subject of an Authorized Control Level Event;
(b) The notification by the Authority to the
			 CCO of an adjusted RBC Report that indicates the event in subsection (a), if
			 the CCO does not challenge the adjusted RBC Report;
(c) If the CCO challenges an adjusted RBC
			 Report that indicates the event in subsection (a), notification by the
			 Authority to the CCO that the Authority has, after a hearing, rejected the
			 CCO's challenge;
(d) The failure of
			 the CCO to respond, in a manner satisfactory to the Authority, to a Corrective
			 Order if the CCO has not challenged the Corrective Order;
(e) If the CCO has challenged a Corrective
			 Order and the Authority has, after a hearing, rejected the challenge or
			 modified the Corrective Order, the failure of the CCO to respond, in a manner
			 satisfactory to the Authority, to the Corrective Order subsequent to rejection
			 or modification by the Authority.
Oregon Administrative Rules › Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS › Division 141 - OREGON HEALTH PLAN › Section 410-141-5220 - CAPITALIZATION: Mandatory Control Level Event

Current through Register Vol. 63, No. 7, July 1, 2024
(1) "Mandatory Control Level Event" means any
			 of the following events:
(a) The filing of an
			 RBC Report that indicates that the CCO's Total Adjusted Capital is less than
			 its Mandatory Control Level RBC. The CCO shall provide prompt written notice to
			 the Authority, together with an RBC Report, if it learns that the CCO is the
			 subject of a Mandatory Control Level Event.
(b) Notification by the Authority to the CCO
			 of an adjusted RBC Report that indicates the event in subsection (a), if the
			 CCO does not challenge the adjusted RBC Report.
(c) If the CCO challenges an adjusted RBC
			 Report that indicates the event in subsection (a), notification by the
			 Authority to the CCO that the Authority has, after a hearing, rejected the
			 CCO's challenge.
Oregon Administrative Rules › Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS › Division 141 - OREGON HEALTH PLAN › Section 410-141-5225 - REPORTING AND APPROVAL OF CERTAIN TRANSACTIONS: Extraordinary Dividends and Other Distributions

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Requests
			 for approval of extraordinary dividends or any other extraordinary distribution
			 to shareholders shall include the following:
(a) The amount of the proposed
			 dividend;
(b) The date established
			 for payment of the dividend;
(c) A
			 statement as to whether the dividend is to be in cash or other property and, if
			 in property, a description thereof, its cost, and its fair market value
			 together with an explanation of the basis for valuation;
(d) A copy of the calculations determining
			 that the proposed dividend is extraordinary. The work paper must include the
			 following information:
(A) The amounts, dates
			 and form of payment of all dividends or distributions, including regular
			 dividends but excluding distributions of the CCO's own securities, paid within
			 the period of 12 consecutive months ending on the date fixed for payment of the
			 proposed dividend for which approval is sought and commencing on the day after
			 the same day of the same month in the last preceding year;
(B) Total capital and surplus as of the 31st
			 day of December immediately preceding;
(C) Net income for the 12-month period ending
			 the 31st day of December immediately preceding and the two preceding 12-months
			 periods; and
(D) Dividends paid to
			 stockholders excluding distributions of the CCO's own securities in the
			 preceding two calendar years.
(e) A balance sheet and statement of income
			 for the period intervening from the last annual statement filed with the
			 Authority and the end of the month preceding the month in which the request for
			 dividend approval is submitted; and
(f) A brief statement as to the effect of the
			 proposed dividend upon the CCO's capital and surplus and the reasonableness of
			 combined capital and surplus in relation to the CCO's outstanding liabilities
			 and the adequacy of surplus relative to the CCO's financial needs.
Oregon Administrative Rules › Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS › Division 141 - OREGON HEALTH PLAN › Section 410-141-5230 - REPORTING AND APPROVAL OF CERTAIN TRANSACTIONS: Reports of Material Acquisitions And Dispositions Of Assets, and Changes to Ceded Reinsurance Agreements; Assumption Reinsurance

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Every
			 CCO shall file a report with the Authority disclosing material acquisitions and
			 dispositions of assets or material nonrenewals, cancellations or revisions of
			 ceded reinsurance agreements unless the subject transaction has been submitted
			 to the Authority for review, approval or information under or pursuant to
			 another provision of Applicable Law.
(2) The report required in subsection (1) is
			 due no later than the 15th day following the end of the calendar month in which
			 any of the reportable transaction occurred.
(3) A CCO shall not enter a transaction in
			 which the CCO assumes or transfers obligations or risks on contracts under an
			 Assumption Reinsurance Agreement or any equivalent agreement, unless the
			 Authority first approves the transaction.
Statutory/Other Authority: ORS
				  413.042,
				  414.615,
				  414.625,
				  414.635 & 414.651
Statutes/Other Implemented: ORS
				  414.610 -
				  414.685