N.J. Admin. Code § 11:2-39A.3

Current through Register Vol. 56, No. 24, December 18, 2024

Section 11:2-39A.3 - RBC reports

(a) A domestic health organization shall, on or prior to each March 1 (the "filing date"), prepare and submit to the Commissioner a report of its RBC levels as of the end of the calendar year ended the preceding December 31, in a form and containing such information as is required by the RBC instructions. The RBC report shall be sent or delivered to:

New Jersey Department of Banking and Insurance

Office of Solvency Regulation, Health Organization RBC Reports

20 West State Street

PO Box 325

Trenton, NJ 08625-0325

In addition, a domestic health organization shall file its RBC report:

1. With the NAIC in accordance with the RBC instructions; and

2. 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:

i. Fifteen days from the receipt of notice to file its RBC report with that state; or

ii. The filing date.

(b) 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) determined in each case by applying the factors in the manner set forth in the RBC instructions:

1. Asset risk;

2. Credit risk;

3. Underwriting risk; and

4. All other business risks and such other relevant risks as are set forth in the RBC instructions.

(c) If a domestic health organization files an RBC report that 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."

(d) The calculation of a health organization's required capital and surplus as set forth in the RBC report filed and accepted by the Commissioner pursuant to (a) or (b) above, or as adjusted by the Commissioner pursuant to (c) above, shall be deemed to be a redetermination of a health organization's minimum statutory capital and surplus requirements pursuant to applicable statutes.

1. If a health organization disagrees with the minimum capital and surplus as determined above, it may request a hearing as provided in N.J.A.C. 11:2-39A.9.

2. A health organization requesting a hearing shall do so upon filing an RBC report, or within 20 days of receipt of notice from the Commissioner of an adjustment.

3. Failure to request a hearing shall be deemed to be a waiver of the right to a hearing on the redetermined minimum capital and surplus requirements for the health organization.

N.J. Admin. Code § 11:2-39A.3

Adopted by 48 N.J.R. 2441(a), effective 11/21/2016