Code of Massachusetts Regulations
211 CMR - DIVISION OF INSURANCE
Title 211 CMR 25.00 - Risk-based Capital (rbc) For Health Organizations
Section 25.02 - RBC Reports

Universal Citation: 211 MA Code of Regs 211.25

Current through Register 1531, September 27, 2024

(1) Every Domestic Health Organization shall, on or prior to each March 1st, prepare and submit to the Commissioner a report of its RBC Levels as of the end of the most recent calendar year, in a form and containing such information as is required by the RBC Instructions. In addition, every Domestic Health Organization shall file its RBC Report:

(a) With the NAIC in accordance with the RBC Instructions; and

(b) With the insurance commissioner in any state in which the Health Organization is authorized to do business, if the insurance commissioner has notified the Health Organization of its request in writing, in which case the Health Organization shall file its RBC Report not later than the later of:
1. 15 days from the receipt of notice to file its RBC Report with that state; or

2. The Filing Date.

(2) A Health Organization's RBC shall be determined in accordance with the formula set forth in the RBC Instructions. The formula shall take the following into account (and may adjust for the covariance between) by applying the factors in each case 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.

(3) An excess of capital (i.e. net worth) over the amount produced by the risk-based capital requirements contained in 211 CMR 25.00 and the formulas, schedules and instructions referenced in 211 CMR 25.00 is desirable in the business of health insurance. Accordingly, Health Organizations should seek to maintain capital above the RBC Levels required by 211 CMR 25.00. Additional capital is used and useful in the insurance business and helps to secure a Health Organization against various risks inherent in, or affecting, the business of insurance and not accounted for or only partially measured by the risk-based capital requirements contained in 211 CMR 25.00.

(4) If a Domestic Health Organization files an RBC Report which in the judgment of the Commissioner is inaccurate, then the Commissioner shall adjust the RBC Report to correct the inaccuracy and shall notify the Health Organization of the adjustment. The notice shall contain a statement of the reason for the adjustment. An RBC Report as so adjusted is referred to as an "Adjusted RBC Report."

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