Code of Massachusetts Regulations
211 CMR - DIVISION OF INSURANCE
Title 211 CMR 25.00 - Risk-based Capital (rbc) For Health Organizations
Section 25.01 - Definitions

The following words as used in 211 CMR 25.00 shall, unless the context requires otherwise, have the following meanings:

Adjusted RBC Report. An RBC Report which has been adjusted by the Commissioner in accordance with 211 CMR 25.02.

Commissioner. The Commissioner of Insurance, appointed pursuant to M.G.L. c. 26, § 6 or his or her designee.

Corrective Order. An order issued by the Commissioner pursuant to 211 CMR 25.04(2)(c), specifying corrective actions which the Commissioner has determined are required.

Domestic Health Organization. A Health Organization organized under the laws of the Commonwealth and qualified to do business in the Commonwealth.

Filing Date. March 1st.

Foreign Health Organization. A Health Organization formed by authority of any state or government other than the Commonwealth and qualified to conduct business in the Commonwealth.

Health Organization. A nonprofit hospital service corporation authorized under M.G.L. c. 176A, a nonprofit medical service corporation authorized under M.G.L. c. 176B, a dental service corporation authorized under M.G.L. c. 176E, an optometric service corporation authorized under M.G.L. c. 176F, or a health maintenance organization authorized under M.G.L. c. 176G. Health Organization does not include an organization that is licensed as a life and/or health insurer under M.G.L. c. 175 or a property and casualty insurer under M.G.L. c. 175 and that is otherwise subject to 211 CMR 20.00: Risk-based Capital (RBC) for Insurers.

NAIC. The National Association of Insurance Commissioners

RBC Instructions. The RBC Report including risk based capital instructions adopted by the NAIC, as such RBC Instructions may be amended by the NAIC from time to time in accordance with the procedures adopted by the NAIC.

RBC Level. A Health Organization's Company Action Level RBC, Regulatory Action Level RBC, Authorized Control Level RBC, or Mandatory Control Level RBC where:

Company Action Level RBC. With respect to any Health Organization, the product of 2.0 and its Authorized Control Level RBC;

Authorized Control Level RBC. The number determined under the risk based capital formula in accordance with the RBC Instructions;

Regulatory Action Level RBC. The product of 1.5 and its Authorized Control Level RBC; Mandatory Control Level RBC. the product of .70 and the Authorized Control Level RBC.

RBC Plan. A comprehensive financial plan containing the elements specified in 211 CMR 25.03(2). If the Commissioner rejects the RBC Plan, and it is revised by the Health Organization, with or without the Commissioner's recommendation, the plan shall be called the Revised RBC Plan.

RBC Report. The report required in 211 CMR 25.02.

Total Adjusted Capital. The sum of:

(a) A Health Organization's statutory capital and surplus (i.e. net worth) as determined in accordance with the statutory accounting applicable to the annual financial statements required to be filed under M.G.L. c. 176A, §§ 3, 18, 24; c. 176B, §§ 8, 9, 10; c. 176E, §§ 8, 9, 10; c. 176F, §§ 8, 9, 10; and c. 176G, §§ 10, 25; and

(b) Such other items, if any, as the RBC Instructions may provide.