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054.00.117-7. Solvency Standards

AR ADC 054.00.117-7Arkansas Administrative CodeEffective: September 25, 2017

West's Arkansas Administrative Code
Title 054. Insurance Department
Division 00.
Rule 117. Provider-Led Organization Licensure Standards
Effective: September 25, 2017
Ark. Admin. Code 054.00.117-7
054.00.117-7. Solvency Standards
Currentness
All RBPOs shall be responsible for meeting the following solvency standards under this Section at the time of initial licensure, in the evaluation of their application, and continuously thereafter. All RBPOs acting as a carrier under Ark. Code Ann. § 20-77-2703(4) shall be subject to this Section in addition to any other provision in the Arkansas Insurance Code or Rules applicable to its type of organization, unless excluded by this Rule or the Organized Care Act or by Medicaid pre-emption.
A. Solvency Standards
All RBPOs participating in the Organized Care Act program shall:
(1) meet the reserve or capital requirements under Ark. Code Ann. § 20-77-2706(f)(4) and any additional amounts needed to satisfy Risk-Based Capital Requirements under Ark. Code Ann. § 23-63-1501 et seq. (hereafter, “HMO-RBC”). The reserve requirements in Ark. Code Ann. § 20-77-2706(f)(4) shall refer to the organization's capital or capital and surplus under Statutory Accounting Principles (SAP). The Commissioner may adjust the reserve requirements of the RBPO from initial licensure, on a prospective basis, related to the timing of the RBPO assumption levels of partial to full risk in its business operations. In addition, the Commissioner may consider the extent to which the RBPO has reinsurance or stop loss coverage, or agreements with a licensed insurer or HMO, to cede risk, as a circumstance to reduce or modify reserve or capital requirements under this Section. The Commissioner shall review and approve all such risk sharing agreements including any major modifications thereof.
(2) comply with SAP reporting and file quarterly and annual financial statements with the Department under SAP in the same manner as is required of a health maintenance organization regulated by the Department under Ark. Code Ann. § 23-76-113;
(3) comply with HMO-RBC requirements and reporting;
(4) comply with Ark. Code Ann. § 23-63-601 et seq., referring to assets and liabilities;
(5) comply with Ark. Code Ann. § 23-68-101 et seq., referring to rehabilitation and liquidation;
(6) comply with Ark. Code Ann. § 23-69-134, referring to home office and records and the penalty for unlawful removal of records;
(7) comply with Ark. Code Ann. § 23-76-122 related to examinations, in the same manner as a health maintenance organization;
(8) comply with Sections Ark. Code Ann. §§ 23-60-101 through 23-60-108 and 23-60-110 referring to the scope of the Arkansas Insurance Code;
(9) comply with Sections Ark. Code Ann. §§ 23-61-101, 23-61-201, 23-61-301 referring to the Insurance Commissioner;
(10) comply with Section Ark. Code Ann. §§ 23-63-102 through 23-63-104, 23-63-201, et seq., general provisions, and 23-63-301 et seq., referring to service of process, a registered agent as process agent, serving legal process, and time to plead;
(11) comply with the annual independent audit under Ark. Code Ann. § 23-63-216(a)(5) and actuarial requirements under Ark. Code Ann. § 23-63-216(e)(1) and (e)(2);
(12) comply with the custody of assets requirements under Ark. Code Ann. § 23-69-134; and
(13) comply with the transfer of ownership requirements or acquisition provisions under Ark. Code Ann. § 23-69-142.

Credits

Adopted emergency effective May 22, 2017. Amended Sept. 25, 2017.
Current with amendments received through February 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 054.00.117-7, AR ADC 054.00.117-7
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