Section 991.1405 - Standards and Management of an Insurer within an Insurance Holding Company SystemStandards and Management of an Insurer within an Insurance Holding Company System.--
(a)(1) Transactions within an insurance holding company system to which an insurer subject to registration is a party shall be subject to all of the following standards:(i) The terms shall be fair and reasonable.(ii) Charges or fees for services performed shall be reasonable.(iii) Expenses incurred and payment received shall be allocated to the insurer in conformity with customary insurance accounting practices consistently applied and all cost-sharing or expense allocation arrangements must be formalized in writing and authorized by the board of directors of the domestic insurer.(iv) The books, accounts and records of each party to all such transactions shall be so maintained as to clearly and accurately disclose the nature and details of the transactions, including such accounting information as is necessary to support the reasonableness of the charges or fees to the respective parties.(v) The insurer's surplus as regards policyholders after any material transaction with an affiliate and after any dividends or distributions to shareholder affiliates shall be reasonable in relation to the insurer's outstanding liabilities and adequate to its financial needs.(vi)(A) If the commissioner deems an insurer subject to this act to be in hazardous financial condition, as determined by the commissioner under 31 Pa. Code Ch. 160 (relating to standards to define insurers deemed to be in hazardous financial condition) or a condition that would be grounds for supervision, conservation or a delinquency proceeding, the commissioner may require the insurer to secure and maintain a deposit, held by the commissioner, or a bond, as determined by the insurer at the insurer's discretion, for the protection of the insurer for the duration of the contract or agreement, or the existence of the condition for which the commissioner required the deposit or bond. In determining whether a deposit or bond is required, the commissioner may consider whether concerns exist with respect to the affiliated person's ability to fulfill the contract or agreement if the insurer were to be put into liquidation.(B) If the insurer is deemed to be in a hazardous financial condition or a condition that would be grounds for supervision, conservation or a delinquency proceeding, and a deposit or bond is necessary, the commissioner has discretion to determine the amount of the deposit or bond, not to exceed the value of the contract or agreement in any one year, and whether the deposit or bond should be required for a single contract, multiple contracts or a contract only with a specific person.(vii)(A) All records and data of the insurer held by an affiliate are and remain the property of the insurer, are subject to control of the insurer, are identifiable, and are segregated or readily capable of segregation, at no additional cost to the insurer, from all other persons' records and data.(B) Records and data under clause (A) include all records and data that are otherwise the property of the insurer, in whatever form maintained, including claims and claim files, policyholder lists, application files, litigation files, premium records, rate books, underwriting manuals, personnel records, financial records or similar records within the possession, custody or control of the affiliate.(C) At the request of the insurer, the affiliate shall advise that the receiver may obtain a complete set of all records of any type that pertain to the insurer's business, obtain access to the operating systems on which the data is maintained, obtain the software that runs those systems either through assumption of licensing agreements or otherwise and restrict the use of the data by the affiliate if it is not operating the insurer's business.(D) The affiliate shall provide a waiver of any landlord lien or other encumbrance to give the insurer access to all records and data in the event of the affiliate's default under a lease or other agreement.(viii) Premiums or other funds belonging to the insurer that are collected by or held by an affiliate are the exclusive property of the insurer and are subject to the control of the insurer. Any right of offset in the event an insurer is placed into receivership shall be subject to Article V of the act of May 17, 1921 ( P.L. 789, No.285), known as "The Insurance Department Act of 1921."(2) The following transactions involving a domestic insurer and any person in its insurance holding company system , including an amendment or modification of affiliate agreements previously filed under this section that are subject to materiality standards contained in subparagraphs (i), (ii), (iii), (iv) and (v), may not be entered into unless the insurer has notified the department in writing of its intention to enter into such transaction at least thirty (30) days prior thereto or such shorter period as the department may permit and the department has not disapproved it within such period: (i) Sales, purchases, exchanges, loans or extensions of credit, guarantees, investments, pledges of assets or assets to be received by the domestic insurer as contributions to its surplus, provided that, as of the thirty-first day of December next preceding, such transactions are equal to or exceed the lesser of three per centum (3%) of the insurer's admitted assets or twenty-five per centum (25%) of surplus as regards policyholders.(ii) Loans or extensions of credit to any person who is not an affiliate, where the insurer makes such loans or extensions of credit with the agreement or understanding that the proceeds of such transactions, in whole or in substantial part, are to be used to make loans or extensions of credit to, to purchase assets of or to make investments in any affiliate of the insurer making such loans or extensions of credit provided that, as of the thirty-first day of December next preceding, such transactions are equal to or exceed the lesser of three per centum (3%) of the insurer's admitted assets or twenty-five per centum (25%) of surplus as regards policyholders.(iii) Reinsurance agreements or modifications thereto , including:(A) agreements where the reinsurance premium or the projected reinsurance premium in any of the next three twelve-month periods equals or exceeds five per centum (5%) of the insurer's surplus as regards policyholders as of the thirty-first day of December next preceding; (B) agreements where the change in the insurer's liabilities or any transfer of assets required to fund the transaction in any of the next three twelve-month periods equals or exceeds twenty-five per centum (25%) of the insurer's surplus as regards policyholders as of the thirty-first day of December next preceding, including those agreements which may require as consideration the transfer of assets from an insurer to a nonaffiliate, if an agreement or understanding exists between the insurer and nonaffiliate that any portion of such assets will be transferred to one or more affiliates of the insurer. Nothing in this paragraph shall affect or limit the requirements and applicability of section 3 of the act of July 31, 1968 (P.L.941, No.288), entitled "An act providing for reporting to the Insurance Commissioner by domestic insurance companies, associations, or exchanges, of certain conveyances of interests in the assets of such companies, associations, or exchanges " ; or(C) reinsurance pooling agreements.(iv) Any material transactions, specified by regulation, which the department determines may adversely affect the interests of the insurer's policyholders.(v) Management agreements, service contracts, tax allocation agreements, guarantees and cost-sharing arrangements. The notice for amendments or modifications must include the reasons for the change and the financial impact on the domestic insurer. Nothing in this paragraph shall be deemed to authorize or permit any transactions which, in the case of an insurer not a member of the same holding company system, would be otherwise contrary to law.
(2.1) Within thirty (30) days after termination of an agreement previously filed in accordance with paragraph (2), a domestic insurer shall provide notice of the termination to the department.(3) A domestic insurer may not enter into transactions which are part of a plan or series of like transactions with persons within the insurance holding company system if the purpose of those separate transactions is to avoid the statutory threshold amount and thus avoid the review that would occur otherwise. If the department determines that such separate transactions were entered into over any twelve-month period for such purpose, it may exercise its authority under section 1410.(4) The department, in reviewing transactions pursuant to paragraph (2), shall consider whether the transactions comply with the standards set forth in paragraph (1) and whether they may adversely affect the interests of policyholders. The department may retain at the insurer's expense any attorneys, actuaries, accountants and other experts not otherwise a part of the department's staff as may be reasonably necessary to assist the department in reviewing the transaction.(5) The department shall be notified within thirty (30) days of any investment of the domestic insurer in any one corporation if the total investment in such corporation by the insurance holding company system exceeds ten per centum (10%) of such corporations' voting securities.(6) Supervision, seizure, conservatorship or receivership proceedings. The following shall apply: (i) An affiliate that is party to an agreement or contract with a domestic insurer that is subject to section 1405(a)(2)(v) shall be subject to the jurisdiction of any supervision, seizure, conservatorship or receivership proceedings against the insurer and to the authority of any supervisor, conservator, rehabilitator or liquidator for the insurer appointed pursuant to supervision and receivership acts for the purpose of interpreting, enforcing and overseeing the affiliate's obligations under the agreement or contract to perform services for the insurer that: (A) are an integral part of the insurer's operations, including management, administrative, accounting, data processing, marketing, underwriting, claims handling, investment or any other similar functions; or(B) are essential to the insurer's ability to fulfill its obligations under insurance policies.(ii) The commissioner may require that an agreement or contract under subsection (a)(2)(v) for the provision of services under clauses (A) and (B) specify that the affiliate consents to the jurisdiction under this paragraph.(b)(1) No domestic insurer shall pay any extraordinary dividend to its shareholders until: (i) thirty (30) days after the commissioner has received written notice from the insurer of the declaration of the dividend and has not within such period disapproved the payment; or(ii) the commissioner shall have approved the payment within such thirty-day period.(2) For purposes of this subsection, an extraordinary dividend is any dividend or other distribution which, together with other dividends and distributions made within the preceding twelve (12) months, exceeds the greater of: (i) Ten per centum (10%) of such insurer's surplus as regards policyholders as shown on its last annual statement on file with the commissioner; or(ii) The net income of such insurer for the period covered by such statement, but shall not include pro rata distributions of any class of the insurer's own securities.(c)(1) Notwithstanding the control of a domestic insurer by any person, the officers and directors of the insurer shall not thereby be relieved of any obligation or liability to which they would otherwise be subject by law, and the insurer shall be managed so as to assure its separate operating identity consistent with this article.(2) Nothing herein shall preclude a domestic insurer from having or sharing a common management or cooperative or joint use of personnel, property or services with one or more other persons under arrangements meeting the standards of subsection (a)(1).(3)(i) Not less than one-third of the directors of a domestic insurer shall be persons who are not officers or employes of such insurer or of any entity controlling, controlled by or under common control with such insurer and who are not beneficial owners of a controlling interest in the voting stock of such insurer or any such entity. At least one such person must be included in any quorum for the transaction of business at any meeting of the board of directors.(ii) Not less than one-third of the members of each committee of the board of directors of any domestic insurer shall be persons who are not officers or employes of such insurer or of any entity controlling, controlled by or under common control with such insurer. At least one such person must be included in any quorum for the transaction of business at any meeting of each committee.(4) The board of directors of a domestic insurer shall establish a committee comprised solely of directors who are not officers or employes of the insurer or of any entity controlling, controlled by or under common control with the insurer and who are not beneficial owners of a controlling interest in the voting stock of the insurer or any such entity. The committee shall have responsibility for recommending the selection of independent certified public accountants and reviewing the insurer's financial condition, the scope and results of the independent audit and any internal audit. The committee may also have the responsibilities described in paragraph (4.1) if one or more committees described in paragraph (4.1) are not separately established.(4.1) The board of directors of a domestic insurer shall establish one or more committees comprised solely of directors who are not officers or employes of the insurer or of any entity controlling, controlled by or under common control with the insurer. The committee or committees shall have responsibility for recommending candidates to be nominated by the board of directors, in addition to any other nominations by voting shareholders or policyholders, for election as directors by voting shareholders or policyholders, evaluating the performance of officers deemed to be principal officers of the insurer and recommending to the board of directors the selection and compensation of the principal officers.(5) The provisions of paragraphs (3), (4) and (4.1) shall not apply to a domestic insurer if the person controlling such insurer is an insurer , an attorney in fact for a reciprocal exchange, a mutual insurance holding company or a publicly held corporation having a board of directors and committees thereof which already meet the requirements of paragraphs (3), (4) and (4.1).(d) For purposes of this article, in determining whether an insurer's surplus as regards policyholders is reasonable in relation to the insurer's outstanding liabilities and adequate to its financial needs, the following factors, among others, shall be considered: (1) The size of the insurer as measured by its assets, capital and surplus, reserves, premium writings, insurance in force and other appropriate criteria.(2) The extent to which the insurer's business is diversified among the several lines of insurance.(3) The number and size of risks insured in each line of business.(4) The extent of the geographical dispersion of the insurer's insured risks.(5) The nature and extent of the insurer's reinsurance program.(6) The quality, diversification and liquidity of the insurer's investment portfolio.(7) The recent past and projected future trend in the size of the insurer's surplus as regards policyholders.(8) The surplus as regards policyholders maintained by other comparable insurers considering the factors set forth in paragraphs (1) through (7).(9) The adequacy of the insurer's reserves.(10) The quality and liquidity of investments in affiliates. The department may treat any such investment as a disallowed asset for purposes of determining the adequacy of surplus as regards policyholders whenever in its judgment such investment so warrants.(11) The quality of the insurer's earnings and the extent to which the reported earnings include extraordinary items.Amended by P.L. TBD 2022 No. 93, § 4, eff. 9/9/2022.Amended by P.L. 1111 2012 No. 136, § 5, eff. 9/3/2012.1921, May 17, P.L. 682, No. 284, art. XIV, § 1405, added 1992, Dec. 18, P.L. 1519, No. 178, § 19, effective in 120 days. Amended by 1994, Feb. 17, P.L. 92, No. 9, § 14, imd. effective; 2000, Dec. 20, P.L. 967, No. 132, § 6, effective in 60 days; 2008, July 9, P.L. 885, No. 62, § 8, effective in 60 days [Sept. 8, 2008].