(1)  “Authorized control level event” means any of the following events:

Terms Used In Utah Code 31A-17-605

  • Corrective order: means an order issued by the commissioner specifying corrective action that the commissioner determines is required. See Utah Code 31A-17-601
  • Filing: when used as a noun, means an item required to be filed with the department including:
(a) a policy;
(b) a rate;
(c) a form;
(d) a document;
(e) a plan;
(f) a manual;
(g) an application;
(h) a report;
(i) a certificate;
(j) an endorsement;
(k) an actuarial certification;
(l) a licensee annual statement;
(m) a licensee renewal application;
(n) an advertisement;
(o) a binder; or
(p) an outline of coverage. See Utah Code 31A-1-301
  • Health organization: means :
    (a) an entity that is authorized under Chapter 7, Nonprofit Health Service Insurance Corporations, or Chapter 8, Health Maintenance Organizations and Limited Health Plans; and
    (b) that is:
    (i) a health maintenance organization;
    (ii) a limited health service organization;
    (iii) a dental or vision plan;
    (iv) a hospital, medical, and dental indemnity or service corporation; or
    (v) other managed care organization. See Utah Code 31A-17-601
  • Order: means an order of the commissioner. See Utah Code 31A-1-301
  • RBC: means risk-based capital. See Utah Code 31A-17-601
  • RBC report: means the report required in Section 31A-17-602. See Utah Code 31A-17-601
  • Total adjusted capital: means the sum of an insurer's or health organization's statutory capital and surplus as determined in accordance with:
    (a) the statutory accounting applicable to the annual financial statements required to be filed under Section 31A-4-113; and
    (b) another item provided by the RBC instructions, as RBC instructions is defined in Section 31A-17-601. See Utah Code 31A-1-301
    (a)  the filing of an RBC report by the insurer or health organization that indicates that the insurer’s or health organization’s total adjusted capital is greater than or equal to its mandatory control level RBC but less than its authorized control level RBC;

    (b)  the notification by the commissioner to the insurer or health organization of an adjusted RBC report that indicates the event in Subsection (1)(a), provided the insurer or health organization does not challenge the adjusted RBC report under Section 31A-17-607;

    (c)  if, pursuant to Section 31A-17-607, the insurer or health organization challenges an adjusted RBC report that indicates the event in Subsection (1)(a), notification by the commissioner to the insurer or health organization that after a hearing the commissioner rejects the insurer’s or health organization’s challenge;

    (d)  the failure of the insurer or health organization to respond, in a manner satisfactory to the commissioner, to a corrective order, provided the insurer or health organization has not challenged the corrective order under Section 31A-17-607; or

    (e)  if the insurer or health organization has challenged a corrective order under Section 31A-17-607 and the commissioner after a hearing rejects the challenge or modifies the corrective order, the failure of the insurer or health organization to respond, in a manner satisfactory to the commissioner, to the corrective order subsequent to rejection or modification by the commissioner.
  • (2) 

    (a)  In the event of an authorized control level event with respect to an insurer or health organization, the commissioner shall:

    (i)  take any action required under Section 31A-17-604 regarding an insurer or health organization with respect to which a regulatory action level event has occurred; or

    (ii)  take any action as is necessary to cause the insurer or health organization to be placed under regulatory control under 5, if the commissioner considers it to be in the best interests of:

    (A)  the policyholders or members;

    (B)  creditors of the insurer or health organization; and

    (C)  the public.

    (b)  If the commissioner takes an action described in Subsection (2)(a), the authorized control level event is sufficient grounds for the commissioner to take action under 5, and the commissioner shall have the rights, powers, and duties with respect to the insurer or health organization set forth in 5.

    (c)  If the commissioner takes an action under Subsection (2)(a) pursuant to an adjusted RBC report, the insurer or health organization is entitled to the protections afforded to an insurer or health organization under Section 31A-27-504 pertaining to an action by the commissioner.

    Amended by Chapter 309, 2007 General Session