reglab/statecodes huggingface dataset:
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 51 - Capital Requirements For Insurers › Subchapter I - Risk Based Capital Requirement for Insurers › Section Ins 51.30 - Authorized control level event

Current through June 24, 2024
If an authorized control level event occurs with respect to
				  an insurer, the commissioner shall:
(1) Take such actions as are required under
				s.
				Ins
				51.20 regarding an insurer with respect to which a
				regulatory action level event has occurred; or
(2) If the commissioner deems it to be in the
				best interests of the policyholders and creditors of the insurer and of the
				public, take such actions as are necessary to cause the insurer to be placed
				under regulatory control under ch. 645, Stats. If the commissioner takes such
				actions, the authorized control level event shall be deemed sufficient grounds
				for the commissioner to take action under ch. 645, Stats., and the commissioner
				shall have the rights, powers and duties with respect to the insurer as are set
				forth in ch. 645, Stats.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 51 - Capital Requirements For Insurers › Subchapter I - Risk Based Capital Requirement for Insurers › Section Ins 51.40 - Mandatory control level

Current through June 24, 2024
If there is a mandatory control level event:
(1) With respect to a life or health insurer,
				the commissioner shall take such actions as are necessary to place the insurer
				under regulatory control under ch. 645, Stats. The mandatory control level
				event shall be deemed sufficient grounds for the commissioner to take action
				under ch. 645, Stats., and the commissioner shall have the rights, powers and
				duties with respect to the insurer as are set forth in ch. 645, Stats.
				Notwithstanding any of the foregoing, the commissioner may forego action for up
				to ninety days after the mandatory control level event if the commissioner
				finds there is a reasonable expectation that the mandatory control level event
				may be eliminated within the 90 day period.
(2) With respect to a property and casualty
				insurer, the commissioner shall take such actions as are necessary to place the
				insurer under regulatory control under ch. 645, Stats., or, in the case of an
				insurer which is writing no business and which is running-off its existing
				business, may allow the insurer to continue its run-off under the supervision
				of the commissioner. In either event, the mandatory control level event shall
				be deemed sufficient grounds for the commissioner to take action under ch. 645,
				Stats., and the commissioner shall have the rights, powers and duties with
				respect to the insurer as are set forth in ch. 645, Stats. Notwithstanding any
				of the foregoing, the commissioner may forego action for up to 90 days after
				the mandatory control level event if the commissioner finds there is a
				reasonable expectation that the mandatory control level event may be eliminated
				within the 90 day period.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 51 - Capital Requirements For Insurers › Subchapter I - Risk Based Capital Requirement for Insurers › Section Ins 51.50 - Hearings

Current through June 24, 2024
(1) An insurer shall have the right to a
				hearing, on a record, at which the insurer may challenge any determination or
				action by the commissioner under this subchapter upon any of the following:
(a) Notification to an insurer by the
				commissioner of an adjusted risk based capital report.
(b) Notification to an insurer by the
				commissioner of all of the following:
1. The
				insurer's risk based capital plan or revised risk based capital plan is
				unsatisfactory.
2. Such
				notification constitutes a regulatory action level event with respect to such
				insurer.
(c)
				Notification to any insurer by the commissioner that the insurer has failed to
				adhere to its risk based capital plan or revised risk based capital plan and
				that such failure has a substantial adverse effect on the ability of the
				insurer to eliminate the company action level event with respect to the insurer
				in accordance with its risk based capital plan or revised risk based capital
				plan.
(d) Notification to an
				insurer by the commissioner of a corrective order with respect to the insurer
				under this subchapter.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 51 - Capital Requirements For Insurers › Subchapter I - Risk Based Capital Requirement for Insurers › Section Ins 51.55 - Confidentiality; prohibition on announcements, prohibition on use in ratemaking

Current through June 24, 2024
(1) Except as permitted under sub. (2) the
				commissioner shall keep all of the following information confidential and it
				may not be subject to subpoena:
(a) Risk
				based capital reports, to the extent the information is not required to be set
				forth in a publicly available annual statement schedule.
(b) Risk based capital plans, including the
				results or report of any examination or analysis of an insurer performed under
				this chapter.
(c) Any corrective
				order issued by the commissioner pursuant to examination or analysis, with
				respect to any domestic insurer or foreign insurer, which is issued under s.
				645.21,
				Stats.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 51 - Capital Requirements For Insurers › Subchapter I - Risk Based Capital Requirement for Insurers › Section Ins 51.60 - Supplemental provisions; exemptions

Current through June 24, 2024
(1) The provisions
				of this subchapter are supplemental to any other provisions of the laws or
				rules of this state, and do not preclude or limit any other powers or duties of
				the commissioner under these laws or rules or procedures for applying those
				laws, including, but not limited to, chs. 620, 623, and 645, Stats., and subch.
				II. An insurer which is in violation of subch. II is in financially hazardous
				condition and may be subject to any of the proceedings provided under ch. 645,
				Stats., regardless of whether the insurer is in compliance with this subchapter
				or a proceeding is requested or pending under this subchapter and regardless of
				the insurer's risk based capital level. Nothing in this subchapter prevents the
				commissioner from taking, or limits the authority of the commissioner to take,
				action under any of those provisions when action is not permitted or required
				under this subchapter.
(2) The
				commissioner may exempt from the application of this subchapter any domestic
				property and casualty insurer which complies with all of the following:
(a) The insurer writes direct business only
				in this state.
(b) The insurer
				writes direct annual premiums of $10,000,000 or less.
(c) The insurer assumes no reinsurance in
				excess of five percent of direct premium written.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 51 - Capital Requirements For Insurers › Subchapter I - Risk Based Capital Requirement for Insurers › Section Ins 51.65 - Foreign insurers

Current through June 24, 2024
(1) Any foreign insurer shall, upon the
				written request of the commissioner, submit to the commissioner a risk based
				capital report as of the end of the calendar year just ended by the later of
				the following:
(a) The date a risk based
				capital report would be required to be filed by a domestic insurer under this
				chapter.
(b) Fifteen days after the
				request is received by the foreign insurer.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 51 - Capital Requirements For Insurers › Subchapter II - Permanent Capital, Compulsory Surplus and Security Surplus › Section Ins 51.75 - Applicability

Current through June 24, 2024
This subchapter applies to insurers on, before and after
				  January 1, 1997 except s.
				  Ins
				  51.80 applies to service insurance corporations
				  organized under ch. 613, Stats., only after December 31, 1996, and first
				  requires filing of reports or plans by a service insurance corporation for year
				  end calendar year 1996 or for after that date.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 51 - Capital Requirements For Insurers › Subchapter II - Permanent Capital, Compulsory Surplus and Security Surplus › Section Ins 51.80 - Capital, compulsory and security surplus

Current through June 24, 2024
(1) PURPOSE. This section implements and interprets ss. 600.03(45), 618.21(1) (a), 623.11 and 623.12, Stats., for the purpose of establishing the amount of capital and compulsory
										surplus an insurer is required to maintain to provide reasonable security against contingencies affecting its
										financial position that are not fully covered by reserves or by reinsurance, and the amount of security
										surplus that an insurer should maintain in order to provide an ample margin of safety and clearly assure a
										sound operation.
(2) SCOPE. This section applies to all lines of
										insurance except title insurance and mortgage guarantee insurance as defined in s. Ins 6.75 (2) (h) and (i),
										and to each insurer subject to ss. 623.11 and 645.41, Stats., except insurers licensed under chs. 612 or 616,
										Stats., insurers subject to s. Ins 9.04 and life insurers domiciled in foreign countries.
(3) COMPULSORY SURPLUS. Except for the adjustments to the circumstances of
										individual insurers provided in s. 623.11(1) (b), Stats., and sub. (6), the amount of compulsory surplus of
										an insurer shall be the greater of:
(a) The sum of:
1. 15% of premiums for individual life and disability insurance, not
										including variable life insurance;
2. 10% of premiums for group
										life and disability insurance, not including variable life insurance;
3. The greater of 2% of reserves or 7½% of premiums for annuities
										and deposit administration funds, not including variable annuity business;
3e. 2% of premiums for variable life and variable annuity
										business;
3m. 30% of premiums for medical professional liability
										insurance;
3s. 7% of premiums for Medicare stand-alone drug
										coverage insurance;
4. 20% of premiums for all other covered
										lines of insurance; or
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 52 - Credit For Reinsurance › Subchapter I - Requirements for Credit for Reinsurance › Section Ins 52.005 - Purpose and intent

Current through June 24, 2024
The purpose of this subchapter is to protect the interest of
				  insureds, claimants, ceding insurers, assuming insurers, and the public
				  generally. The intent is to ensure adequate regulation of insurers and
				  reinsurers, and adequate protection for those to whom they owe obligations. In
				  furtherance of this interest, the commissioner hereby provides that upon the
				  insolvency of a non-United States insurer or reinsurer that provides security
				  to fund its United States obligations in accordance with this subchapter, the
				  assets representing the security shall be maintained in the United States and
				  claims shall be filed with and valued by the state insurance commissioner with
				  regulatory oversight, and the assets shall be distributed, in accordance with
				  the insurance laws of the state in which the trust is domiciled that are
				  applicable to the liquidation of domestic United States insurance companies.
				  This subchapter sets forth rules and procedural requirements that the
				  commissioner deems necessary to carry out the provisions of this subchapter.
				  The actions and information required by this subchapter are declared to be
				  necessary and appropriate in the public interest and for the protections of the
				  ceding insurers in this state. The commissioner further declares that the
				  matters contained in this subchapter are fundamental to the business of
				  insurance in accordance with
				  15 USC 1011
				  to
				  1012.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 52 - Credit For Reinsurance › Subchapter I - Requirements for Credit for Reinsurance › Section Ins 52.01 - Definitions

Current through June 24, 2024
In this subchapter, unless the context otherwise
				  requires:
(1g) "Covered agreement"
				means an agreement entered into pursuant to Dodd-Frank Wall Street Reform and
				Consumer Protection Act,
				31 USC
				313 and
				314, that is
				currently in effect or in a period of provisional application and addresses the
				elimination, under specified conditions, of collateral requirements as a
				condition for entering into any reinsurance agreement with a ceding insurer
				domiciled in this state or for allowing the ceding insurer to recognize credit
				for reinsurance.
(1m) "Policyholder
				surplus" means capital and surplus.
(2) "Qualified United States financial
				institution" means an institution that:
(a)
				Is organized or, in the case of a United States office of a foreign banking
				organization, licensed, under the laws of the United States or any
				state;
(b) Is regulated, supervised
				and examined by United States federal or state authorities having regulatory
				authority over banks and trust companies; and
(c) Has been determined by either the
				commissioner or equivalent official of the ceding insurer's state of domicile,
				or the securities valuation office of the national association of insurance
				commissioners, to meet such standards of financial condition and standing as
				are considered necessary and appropriate to regulate the quality of financial
				institutions whose letters of credit will be acceptable to the commissioner or
				equivalent official.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 52 - Credit For Reinsurance › Subchapter I - Requirements for Credit for Reinsurance › Section Ins 52.02 - Credit allowed a licensed ceding insurer

Current through June 24, 2024
Except as provided by s.
				  Ins
				  52.04 and unless otherwise prohibited by the
				  commissioner with any such prohibition not to be in contravention of an
				  applicable covered agreement, a domestic insurer may take credit for ceded
				  reinsurance as either an asset or a deduction from liability only if the
				  reinsurer at all times complies with one or more of the following:
(1) The reinsurer is licensed as an insurer
				in this state.
(2) The reinsurer is
				accredited in this state by the commissioner at the time credit is claimed or
				taken and the reinsurer:
(a) Files with the
				commissioner evidence of its submission to this state's jurisdiction;
(b) Submits to this state's authority to
				examine its books and records;
(c)
				Files a properly executed Form AR-1 as evidence of its submission to this
				state's jurisdiction and to this state's authority to examine its books and
				records;
Note:
Form AR-1 is published as Chapter
				  Ins
				  52 Appendix A.
(d) Is licensed to transact insurance or
				reinsurance in at least one state, or in the case of a United States branch of
				an alien assuming insurer is entered through and licensed to transact insurance
				or reinsurance in at least one state;
(e) Files with the commissioner a certified
				copy of a letter or a certificate of authority or of compliance as evidence
				that it is licensed to transact insurance or reinsurance, or, in the case of a
				United States branch of an alien assuming insurer, is entered through and
				licensed to transact insurance or reinsurance, as required under par.
				(d);
(f) Files annually with the
				commissioner by March 1, or a later date approved in writing by the
				commissioner, a copy of its annual statement filed with the insurance
				department of its state of domicile or, in the case of an alien assuming
				insurer, with the state through which it is entered and in which it is licensed
				to transact insurance or reinsurance, and a copy of its most recent audited
				financial statement annually by June 1; and
(g) Unless otherwise specifically approved in
				writing by the commissioner, maintains policyholder surplus in an amount which
				is not less than $20,000,000.
(h)
				Demonstrates to the satisfaction of the commissioner that it has adequate
				financial capacity to meet its reinsurance obligations and is otherwise
				qualified to assume reinsurance from domestic insurers. An assuming insurer is
				presumed to meet this requirement as of the time of its application if it
				maintains a surplus as regards policyholders in an amount not less than
				$20,000,000 and its accreditation has not been denied by the commissioner
				within 90 days after submission of its application.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 52 - Credit For Reinsurance › Subchapter I - Requirements for Credit for Reinsurance › Section Ins 52.025 - Revocation of accreditation or certification

Current through June 24, 2024
(1) The
				commissioner may revoke the accreditation or certification of a reinsurer under
				s.
				Ins
				52.02. If the accreditation or certification of a
				reinsurer is revoked, a licensed insurer may not take credit for ceded
				reinsurance to the reinsurer under s.
				Ins
				52.02(2), (3), or (4m), regardless of
				when the reinsurance was ceded or the reinsurance contract executed. If a
				reinsurer does not comply with any provision of s.
				Ins
				52.02(2), (3), (4), (4m), or (5) an
				insurer may not take credit for reinsurance ceded to the reinsurer under s.
				Ins
				52.02(2), (3), (4), (4m), or (5),
				regardless of whether the reinsurer is or remains accredited or certified and
				regardless of when the reinsurance was ceded or the reinsurance contract
				executed.
(2) For the purpose of
				accreditation under s.
				Ins
				52.02(2) it is presumed that a
				reinsurer should not be accredited or take credit if the reinsurer has a
				policyholder surplus of less than $20,000,000.
(3) The commissioner may revoke the
				certification of a reinsurer under s.
				Ins
				52.02(4m) at any time if the
				certified reinsurer fails to meet the requirements of s.
				Ins
				52.02(4m).
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 52 - Credit For Reinsurance › Subchapter I - Requirements for Credit for Reinsurance › Section Ins 52.03 - Insolvency clause and jurisdiction; financial reinsurance disallowed

Current through June 24, 2024
(1)
				Except as permitted by s.
				Ins
				52.02(5), a ceding domestic insurer
				may take credit for reinsurance ceded to a reinsurer which does not comply with
				s.
				Ins
				52.02(1), (2), (3), (4), and (4m)
				only if the reinsurer in a written reinsurance agreement does all of the
				following:
(a) Agrees that if the reinsurer
				fails to perform its obligations under the terms of the reinsurance agreement,
				the reinsurer, at the request of the ceding insurer, shall submit to the
				jurisdiction of any court of competent jurisdiction in any state of the United
				States, will comply with all requirements necessary to give the court
				jurisdiction, and will abide by the final decision of such court or of any
				appellate court in the event of an appeal.
(b) Designates the commissioner or a
				designated attorney upon whom may be served any lawful process in any action,
				suit or proceeding instituted by or on behalf of the ceding insurer.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 52 - Credit For Reinsurance › Subchapter I - Requirements for Credit for Reinsurance › Section Ins 52.04 - Reduction from liability for reinsurance ceded by a licensed insurer to an assuming insurer

Current through June 24, 2024
Unless otherwise ordered by the commissioner, an insurer may
				  take credit for a reduction in liability for reinsurance ceded to a reinsurer
				  even if the credit is not permitted under s.
				  Ins
				  52.02 in an amount not exceeding the lesser of the
				  liabilities carried by the ceding insurer or the amount of funds held by or on
				  behalf of the ceding insurer, but only if the funds are held in the United
				  States and are security for the payment of obligations under the reinsurance
				  contract and if the funds meet one of the following:
(1) Are included under a security arrangement
				and are subject to withdrawal solely by, and are under the exclusive control
				of, the ceding insurer, and the form of the funds and the security agreement
				are approved by the commissioner or the equivalent official of the state of
				domicile or entry of the ceding insurer.
(2) Are unencumbered, are securities listed
				by the securities valuation office of the national association of insurance
				commissioners and qualifying as admitted assets or cash, are withheld by the
				ceding insurer, and are subject to withdrawal solely by, and are under the
				exclusive control of, the ceding insurer;
(3) Are securities listed by the securities
				valuation office of the national association of insurance commissioners,
				including those deemed exempt from filing as defined by the purposes and
				procedures manual of the securities valuation office, and qualifying as
				admitted assets or cash, are held in a trust for the exclusive benefit of the
				ceding insurer and the ceding insurer, reinsurer, reinsurance contract and
				trust comply with s.
				Ins
				52.05; or
(4) Are available under a clean, irrevocable,
				unconditional and evergreen letter of credit which is issued or confirmed by a
				qualified United States institution and are subject to withdrawal solely by,
				and are under the exclusive control of, the ceding insurer and the letter of
				credit is in the possession of the ceding insurer and the ceding insurer,
				reinsurer and letter of credit comply with s.
				Ins 52.06. A
				letter of credit meeting applicable standards of issuer acceptability as of the
				date of issue or confirmation continues to meet those standards for the purpose
				of this subsection if after issuance or confirmation the financial institution
				fails to meet applicable standards of issuer acceptability. The letter of
				credit continues to be acceptable as funds until its expiration, extension,
				renewal, modification or amendment, whichever first occurs.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 52 - Credit For Reinsurance › Subchapter I - Requirements for Credit for Reinsurance › Section Ins 52.05 - Trust agreements qualifying for security

Current through June 24, 2024
(1) In this
				section:
(a) "Beneficiary" means the person
				for whose sole benefit the trust has been established and any successor of the
				beneficiary by operation of law, including, but not limited to, any liquidator,
				rehabilitator, receiver, or conservator.
(b) "Grantor" means the person that has
				established a trust, including, but not limited to, an unlicensed, unaccredited
				assuming insurer that establishes a trust.
(c) "Reinsurance obligations" means:
1. Reinsured losses and allocated loss
				expenses paid by the ceding insurer, but not recovered from the assuming
				insurer;
2. Reserves for reinsured
				losses reported and outstanding;
3.
				Reserves for reinsured losses incurred but not reported; and
4. Reserves for allocated reinsured loss
				expenses and unearned premiums.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 52 - Credit For Reinsurance › Subchapter I - Requirements for Credit for Reinsurance › Section Ins 52.065 - Concentration Risk

Current through June 24, 2024
(1) A ceding insurer shall take steps to
				manage its reinsurance recoverable balances proportionate to its own book of
				business. A domestic ceding insurer shall notify the commissioner within 30
				days after reinsurance recoverable from any single assuming insurer, or group
				of affiliated assuming insurers, exceeds 50% of the domestic ceding insurer's
				last reported surplus to policyholders, or after it determined that reinsurance
				recoverable from any single assuming insurer, or of affiliated assuming
				insurers, is likely to exceed this limit. The notification shall include an
				explanation demonstrating that the exposure is safely managed by the domestic
				ceding insurer.
(2) A ceding
				insurer shall take steps to diversity its reinsurance program. A domestic
				ceding insurer shall notify the commissioner within 30 days after ceding to any
				single assuming insurer, or group of affiliated assuming insurers, more than
				20% of the ceding insurer's gross written premium in the prior calendar year,
				or after it has determined that the reinsurance ceded to any single assuming
				insurer, or group of affiliated assuming insurers, is likely to exceed this
				limit. The notification shall include an explanation demonstrating that the
				exposure is safely managed by the domestic ceding insurer.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 52 - Credit For Reinsurance › Subchapter I - Requirements for Credit for Reinsurance › Section Ins 52.07 - Applicability

Current through June 24, 2024
(1) This subchapter applies to determine
				whether credit may be taken for:
(a) Any
				reinsurance ceded under agreements entered into on or after August 1, 1993;
				or
(b) Any reinsurance ceded if the
				reinsurance agreement is renewed by agreement on or after August 1,
				1993.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 52 - Credit For Reinsurance › Subchapter II - Credit for Reinsurance Involving Term and Universal Life Reserve Financing › Section Ins 52.20 - Purpose, intent, and applicability

Current through June 24, 2024
In addition to provisions contained at s.
				  Ins
				  2.80, the following apply to this subchapter:
(1) PURPOSE AND INTENT. The purpose and
				intent of this subchapter is to establish uniform, national standards governing
				reserve financing arrangements pertaining to life insurance policies containing
				guaranteed nonlevel gross premium, guaranteed nonlevel benefits and universal
				life insurance policies with secondary guarantees; and to ensure that, with
				respect to each such financing arrangement, funds consisting of primary
				security and other security are held by or on behalf of ceding insurers in the
				forms and amounts required. In general, reinsurance that is ceded for reserve
				financing purposes has one or more of the following characteristics: some or
				all of the assets used to secure the reinsurance treaty or to capitalize the
				reinsurer are issued by the ceding insurer or its affiliates; or are not
				unconditionally available to satisfy the general account obligations of the
				ceding insurer; or create a reimbursement, indemnification or other similar
				obligation on the part of the ceding insurer or any if its affiliates, other
				than a payment obligation under a derivative contract acquired in the normal
				course and used to support and hedge liabilities pertaining to the actual risks
				in the policies ceded pursuant to the reinsurance treaty.
(2) APPLICABILITY. This subchapter shall
				apply to reinsurance treaties that cede liabilities pertaining to covered
				policies issued by any life insurance company domiciled in this state.
				Subchapter I and this subchapter shall both apply to such reinsurance treaties;
				provided, that in the event of a direct conflict between the provisions of this
				subchapter and subch. I, the provisions of this subchapter shall apply, but
				only to the extent of the conflict.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 52 - Credit For Reinsurance › Subchapter II - Credit for Reinsurance Involving Term and Universal Life Reserve Financing › Section Ins 52.21 - Exemptions

Current through June 24, 2024
This subchapter does not apply to the situations described
				  below:
(1) Reinsurance of:
(a) Policies that satisfy the criteria for
				exemption set forth in s.
				Ins 2.80(5)
				(k) or (L) that were issued prior to June 1,
				2022.
(b) Portions of policies that
				satisfy the criteria for exemption set forth in s.
				Ins 2.80(5)
				(j), that were issued prior to June 1,
				2022.
(c) Any universal life policy
				that meets the following requirements:
1.
				Secondary guarantee period, if any, is 5 years or less.
2. Specified premium for the secondary
				guarantee period is not less than the net level reserve premium for the
				secondary guarantee period based on the commissioners standard ordinary
				valuation tables and valuation interest rate applicable to the issue year of
				the policy; and
3. The initial
				surrender charge is not less than 100% of the first year annualized specified
				premium for the secondary guarantee period.
(d) Credit life insurance.
(e) Any variable life insurance policy that
				provides for life insurance, the amount or duration of which varies according
				to the investment experience of any separate account or accounts.
(f) Any group life insurance certificate
				unless the certificate provides for a stated or implied schedule of maximum
				gross premiums required in order to continue coverage in force for a period in
				excess of one year.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 52 - Credit For Reinsurance › Subchapter II - Credit for Reinsurance Involving Term and Universal Life Reserve Financing › Section Ins 52.22 - Definitions

Current through June 24, 2024
In this subchapter, unless the context otherwise
				  requires:
(1) "Actuarial method" means
				the methodology used to determine the required level of primary
				security.
(2) "Covered policies"
				means the following: subject to the exemptions described in s. Ins 52.21
				covered policies are those policies, other than grandfathered policies, of the
				following policy types:
(a) Life insurance
				policies with guaranteed nonlevel gross premiums and/or guaranteed nonlevel
				benefits, except for flexible premium universal life insurance policies;
				or,
(b) Flexible premium universal
				life insurance policies with provisions resulting in the ability of a
				policyholder to keep a policy in force over a secondary guarantee
				period.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 52 - Credit For Reinsurance › Subchapter II - Credit for Reinsurance Involving Term and Universal Life Reserve Financing › Section Ins 52.26 - Prohibition against avoidance

Current through June 24, 2024
No insurer that has covered policies as to which this
				  subchapter applies, as set forth in s. Ins 52.20(2), shall take any action or
				  series of actions or enter into any transaction or arrangement or series of
				  transactions or arrangements if the purpose of such action, transaction or
				  arrangement or series thereof is to avoid the requirements of this regulation,
				  or to circumvent its purpose and intent, as set forth in s. Ins
				  52.20(1).
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Appendix A - FORM AR-1

Current through June 24, 2024
CERTIFICATE OF ASSUMING INSURER
I, __________________, ___________________of
			 __________________________, the assuming insurer under (name of officer) (title
			 of officer) (name of assuming insurer) a reinsurance agreement(s) with one or
			 more insurers domiciled in ______________________, hereby certify that (name of
			 state)
_________________________ (Assuming Insurer"):
(name of assuming insurer)
1. Submits to the jurisdiction of any court of competent
			 jurisdiction in ______________________________
(ceding insurer's state of domicile)
for the adjudication of any issues arising out of the reinsurance
			 agreement(s), agrees to comply with all requirements necessary to give such
			 court jurisdiction, and will abide by the final decision of such court or any
			 appellate court in the event of an appeal. Nothing in this paragraph
			 constitutes or should be understood to constitute a waiver of Assuming
			 Insurer's rights to commence an action in any court of competent jurisdiction
			 in the United States, to remove an action to a United States District Court, or
			 to seek a transfer of a case to another court as permitted by the laws of the
			 United States or of any state in the United States. This paragraph is not
			 intended to conflict with or override the obligation of the parties to the
			 reinsurance agreement(s) to arbitrate their disputes if such an obligation is
			 created in the agreement(s).
2. Designates the Insurance Commissioner
			 of____________________________ as its lawful attorney upon
(ceding insurer's state of domicile)
whom may be served any lawful process in any action, suit or
			 proceeding arising out of the reinsurance agreement(s) instituted by or on
			 behalf of the ceding insurer.
3. Submits to the authority of the Insurance Commissioner of
			 _____________________________to examine
(ceding insurer's state of domicile)
its books and records and agrees to bear the expense of any such
			 examination.
4. Submits with this form a current list of insurers domiciled in
			 _____________________________reinsured
(ceding insurer's state of domicile)
by Assuming Insurer and undertakes to submit additions to or
			 deletions from the list to the Insurance Commissioner at least once per
			 calendar quarter.
Dated: ______________________
			 _________________________________
(name of assuming insurer)
BY: __________________________________
(name of officer)
___________________________________
(title of officer)
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Appendix F - FORM CR-S - PART 1 - SECTION 1

Current through June 24, 2024
Reinsurance Assumed Life Insurance, Annuities, Deposit Funds and
			 Other Liabilities Without Life or Disability Contingencies, and Related
			 Benefits Listed by Reinsured Company as of December 31, Current Year
See
			 Image
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 53 - Corporate Governance Annual Disclosures › Section Ins 53.01 - Purpose

Current through June 24, 2024
The purpose of these regulations is to set forth the
				procedures for filing, and the required contents of, the corporate governance
				annual disclosure, deemed necessary by the commissioner to carry out the
				provisions of s.
				610.80,
				Stats.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 53 - Corporate Governance Annual Disclosures › Section Ins 53.02 - Definitions

Current through June 24, 2024
In addition to definitions contained in s.
				610.80(1),
				Stats., the following definitions shall apply in this chapter:
(1) "Commissioner" means the Wisconsin
			 insurance commissioner.
(2)
			 "Insurance group" means those insurers and affiliates included within an
			 insurance holding company system, as defined at s.
			 622.03(2),
			 Stats.
(3) "Senior management"
			 means any corporate officer responsible for reporting information to the board
			 of directors at regular intervals or providing this information to shareholders
			 or regulators and shall include, for example, the chief executive officer
			 (CEO), chief financial officer, chief operating officer, or any other "C" level
			 executives.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 53 - Corporate Governance Annual Disclosures › Section Ins 53.03 - Filing procedures

Current through June 24, 2024
Each year following the initial filing of the corporate
				governance annual disclosure, the insurer or insurance group shall file an
				amended version of the previously filed disclosure indicating where changes
				have been made. If no changes were made in the information or activities
				reported by the insurer or insurance group, the filing should so
				state.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 55 - Life and health reinsurance agreements › Section Ins 55.01 - Scope

Current through June 24, 2024
(1) This chapter applies only to:
(a) Domestic life and accident and health
			 insurers;
(b) Licensed life and
			 accident and health insurers which are not subject to a substantially similar
			 rule or law in their state of domicile; and
(c) Licensed property and casualty insurers
			 which are not subject to a substantially similar rule or law in their state of
			 domicile with respect to their accident and health business.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 55 - Life and health reinsurance agreements › Section Ins 55.03 - Written agreements

Current through June 24, 2024
An insurer may not reduce any liability or establish any asset
				in any financial statement filed with the office of the commissioner of
				insurance, based on a reinsurance agreement or amendment to any agreement
				unless:
(1) The agreement, amendment
			 or a binding letter of intent has been duly executed by all parties no later
			 than the date for which the financial statement is reporting the financial
			 condition of the insurer;
(2) If
			 only a letter of intent has been executed, a reinsurance agreement or an
			 amendment to a reinsurance agreement is to be executed within a reasonable
			 period of time, not exceeding 90 days from the execution date of the letter of
			 intent; and
(3) The reinsurance
			 agreement or amendment provides that:
(a) The
			 agreement or amendment constitutes the entire agreement between the parties
			 with respect to the business being reinsured and that there are no
			 understandings between the parties other than as expressed in the agreement;
			 and
(b) Any change or modification
			 to the agreement or amendment is null and void unless made by amendment and
			 signed by all parties.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 55 - Life and health reinsurance agreements › Section Ins 55.04 - Effect of failure to comply

Current through June 24, 2024
No insurer may reduce any liability or establish or maintain an
				asset for the purpose of determining whether the insurer is in financially
				hazardous condition, establishing or representing the financial condition of
				the insurer, or for the purpose of meeting compulsory surplus or security
				surplus requirements if the insurer may not reduce the liability or establish
				or maintain the asset on its financial statement under this
				chapter.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 55 - Life and health reinsurance agreements › Section Ins 55.05 - Applicability

Current through June 24, 2024
(1) This chapter applies to reinsurance
			 agreements entered into prior to, on or after its effective date.
(2) An insurer shall reduce to zero by
			 December 31, 1994, any reserve credits or assets established with respect to
			 reinsurance agreements entered into prior to August 1, 1993 which, under the
			 provisions of this chapter would not be entitled to recognition of the reserve
			 credits or assets. Section Ins 6.73 and the annual statement instructions in
			 effect prior to August 1, 1993 continue to apply to agreements entered into
			 prior to August 1, 1993 until December 31, 1994.
Note: Ins 6.73 was repealed eff. 8-1-93.
(3) This chapter is in addition to, and does
			 not supersede other requirements, including, but not limited to, the
			 requirements of ch. Ins 52.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 57 - Care management organizations › Section Ins 57.01 - Definitions

Current through June 24, 2024
In addition to the definitions in s.
				648.01, Stats., in
				this chapter:
(1) "Affiliate" of, or
			 person "affiliated" with, a specific person means a person that directly or
			 indirectly through one or more intermediaries, controls or is controlled by, or
			 is under common control with, the person specified.
(2) "Care management organization" or "CMO"
			 means an entity defined at s.
			 648.01(1),
			 Stats.
(3) "Commissioner" means the
			 commissioner of insurance of this state or the commissioner's
			 designee.
(4) "Department" means
			 the department of health services of this state.
(5) "Independent certified public accountant"
			 means an independent certified public accountant, or independent accounting
			 firm, in good standing with the American Institute of Certified Public
			 Accountants in this state, and in the states in which the accountant or firm is
			 licensed, or required to be licensed, to practice.
(6) "Net assets" means assets minus
			 liabilities.
(7) "Restricted
			 reserve" means liquid assets maintained in a segregated account by a care
			 management organization.
(8)
			 "Subsidiary" of a person means a person which is controlled, directly or
			 indirectly through one or more intermediaries, by the first person.
(9) "Ultimate controlling person" means a
			 person who is not controlled by any other person.
(10) "Work papers" means records kept by the
			 independent certified public accountant of the procedures followed, the tests
			 performed, the information obtained, and the conclusions reached pertinent to
			 the independent certified public accountant's examination of the financial
			 statements of a care management organization. "Work papers" includes audit
			 planning documentation, audit guides, work programs, analyses, memoranda,
			 letters of confirmation and representation, abstracts of company documents and
			 schedules or commentaries prepared or obtained by the independent certified
			 public accountant in the course of examination of the financial statements of a
			 care management organization or which support the opinion of the independent
			 certified public accountant regarding the financial statements.
(11) "Working capital" means a measure
			 calculated as current assets minus current liabilities.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 57 - Care management organizations › Section Ins 57.04 - Financial requirements

Current through June 24, 2024
All of the following are the minimum financial requirements for
				compliance with this section unless a different amount is ordered by the
				commissioner, after consultation with the department:
(1) WORKING CAPITAL. Unless otherwise ordered
			 by the commissioner the care management organization shall maintain working
			 capital of not less than 3% of the projected annual capitation made over the
			 effective contract period.
(2)
			 RESTRICTED RESERVE. Unless otherwise ordered by the commissioner the care
			 management organization shall maintain a restricted reserve of not less than
			 the sum of the following:
(a) 8% of the first
			 $5 million of annual budgeted capitation revenue.
(b) 4% of the next $5 million annual budgeted
			 capitation revenue.
(c) 3% of the
			 next $10 million annual budgeted capitation revenue.
(d) 2% of the next $30 million annual
			 budgeted capitation revenue.
(e) 1%
			 of annual budgeted capitation revenue in excess of $50 million.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 57 - Care management organizations › Section Ins 57.05 - Business plan

Current through June 24, 2024
All applications for permits of a care management organization
				shall include a proposed business plan. In addition to the items listed in s.
				648.05(2),
				Stats., the following information shall be contained in the business
				plan:
(1) ORGANIZATIONAL INFORMATION.
			 All care management organization business plans shall include:
(a) A narrative that discusses the business
			 environment, the strategies and tactics that will be employed to manage the
			 business including a plan to utilize mandated care principles and targets
			 associated with that plan, and other areas of focus, stress, change, efficiency
			 or any other information that supports or affects the financial
			 projections.
(b) A description of
			 the general business model to be employed by the care management
			 organization.
(c) A brief
			 organizational history, providing and describing major milestones in the
			 development of the care management organization including organizational
			 strengths and deficits, as they relate to the ongoing delivery of the Family
			 Care program.
(d) A description of
			 the care management organization's governance structure, including organizing
			 documents (e.g., articles, by-laws, mission statement, etc.), and an
			 organizational chart that clearly demonstrates reporting lines and domains of
			 management authority, with names of current incumbents for management
			 positions.
(e) Information for all
			 persons or entities who are in direct control of the care management
			 organization, including the names, addresses and occupations of all controlling
			 persons, directors and principal officers of the care management organization
			 currently and for the preceding 10 years. The care management organization
			 information shall also include the position held and target group
			 representation, if applicable, for each member of the board of
			 directors.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 57 - Care management organizations › Section Ins 57.06 - Changes in the business plan

Current through June 24, 2024
A care management organization shall file a written report of
				any proposed substantial change in its business plan. The care management
				organization shall file the report at least 30 days prior to the effective date
				of the change. The office, after consulting with the department, may disapprove
				the change. The care management organization may not enter into any
				transaction, contract, amendment to a transaction or contract or take action or
				make any omission that is a substantial change in the care management
				organization's business plan prior to the effective date of the change or if
				the change is disapproved. Substantial changes include changes in articles and
				bylaws, organization type, geographical service areas, provider agreements,
				provider availability, plan administration, financial projections and
				guarantees and any other change that might affect the financial solvency of the
				organization. Any transaction or series of transactions that exceed the lesser
				of 5% of the care management organization's assets or 10% of net assets as of
				December 31 of the immediately preceding calendar year shall be deemed
				material. Any changes in the items listed in s.
				Ins
				9.05(3) shall be filed under this
				section.
Wisconsin Administrative Code › Office of the Commissioner of Insurance › Chapter Ins 57 - Care management organizations › Section Ins 57.07 - Copies of provider agreements

Current through June 24, 2024
(1) Notwithstanding
			 any claim of trade secret or proprietary information, all care management
			 organizations shall, upon request, from the commissioner, make available to the
			 commissioner all executed copies of any provider agreements between the care
			 management organization and intermediate entities or individual providers. Any
			 party to a provider agreement may assert that a portion of the contracts
			 contain trade secrets, and the commissioner may withhold that portion to the
			 extent it may be withheld under s.
			 Ins
			 6.13.
(2)
			 All care management organizations shall file with the commissioner a list of
			 providers executing a standard contract and a copy of the form of the contract
			 may be filed instead of copies of the executed contracts.