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Ins 51.01(4) (4) "Company action level event" means any of the following events:
Ins 51.01(4)(a) (a) The filing of a risk based capital report by an insurer which indicates one of the following:
Ins 51.01(4)(a)1. 1. The insurer's total adjusted capital is greater than or equal to its regulatory action level risk based capital but less than its company action level risk based capital.
Ins 51.01(4)(a)2. 2. If a life or health insurer that completes the life annual statement for the reporting year, the insurer has total adjusted capital which is greater than or equal to its company action level risk based capital but less than the product of its authorized control level risk based capital and 3.0 and has a negative trend.
Ins 51.01(4)(a)3. 3. If a health insurer that completes the health annual statement for the reporting year, the insurer has total adjusted capital which is greater than or equal to its company action level risk based capital but less than the product of its authorized control level risk based capital and 3.0 and has a negative trend.
Ins 51.01(4)(a)4. 4. If a property and casualty insurer, the insurer has total adjusted capital which is greater than or equal to its company action level risk based capital but less than the product of its authorized control level risk based capital and 3.0 and has a negative trend.
Ins 51.01(4)(b) (b) The notification by the commissioner to the insurer of an adjusted risk based capital report that indicates an event in par. (a), if the insurer does not challenge the adjusted risk based capital report under s. Ins 51.50.
Ins 51.01(4)(c) (c) If, under s. Ins 51.50, an insurer challenges an adjusted risk based capital report that indicates the event in par. (a), the notification by the commissioner to the insurer that the commissioner has, after a hearing, rejected the insurer's challenge.
Ins 51.01(5) (5) "Company action level risk based capital" means, with respect to any insurer, the product of 2.0 and its authorized control level risk based capital.
Ins 51.01(6) (6) "Corrective order" means an order issued by the commissioner specifying corrective actions which the commissioner has determined are required.
Ins 51.01(7) (7) "Domestic insurer" means an insurer organized under the laws of this state.
Ins 51.01(8) (8) "Foreign insurer" means any insurer which is licensed to do business in this state that is not a domestic insurer.
Ins 51.01(8m) (8m) "Health maintenance organization insurer" has the meaning given in s. 600.03 (23c), Stats.
Ins 51.01(9) (9) "Insurer" means:
Ins 51.01(9)(a) (a) An insurer as defined under s. 600.03 (27), Stats., except, unless otherwise required by the commissioner under par. (b), it does not include any of the following:
Ins 51.01(9)(a)1. 1. A town mutual insurer organized under ch. 612, Stats.
Ins 51.01(9)(a)2. 2. An insurer governed by ch. 616, Stats.
Ins 51.01(9)(a)3. 3. A service insurance corporation as defined under s. 600.03 (41m), Stats., but only until the date on which the commissioner makes a determination that risk based capital reporting forms and instructions for service insurance corporations have been developed and adopted by the NAIC.
Ins 51.01(9)(a)4. 4. An insurance plan administered by the office or a board attached to the office or a plan established under ch. 619, Stats.
Ins 51.01(9)(a)5. 5. Monoline mortgage guaranty insurers, financial guaranty insurers and title insurers.
Ins 51.01(9)(b) (b) One or more persons otherwise excepted from the definition of insurer under par. (a) if the commissioner finds that compliance with this subchapter will improve the efficiency and effectiveness of the office's solvency monitoring and the commissioner requires the person to comply as an insurer under this subchapter.
Ins 51.01(10) (10) "Life or health insurer" means any insurer licensed to write life, annuity or health insurance or 2 or more of those lines. A "life or health insurer" includes a fraternal insurer but does not include a health maintenance organization insurer as defined in s. 600.03 (23c), Stats., or an insurer writing only limited service health organization business as defined in s. 609.01 (3), Stats.
Ins 51.01(11) (11) "Mandatory control level event" means any of the following events:
Ins 51.01(11)(a) (a) The filing of a risk based capital report which indicates that the insurer's total adjusted capital is less than its mandatory control level risk based capital.
Ins 51.01(11)(b) (b) Notification by the commissioner to the insurer of an adjusted risk based capital report that indicates the event in par. (a), if the insurer does not challenge the adjusted risk based capital report under s. Ins 51.50.
Ins 51.01(11)(c) (c) If, pursuant to s. Ins 51.50, the insurer challenges an adjusted risk based capital report that indicates the event in par. (a), notification by the commissioner to the insurer that the commissioner has, after a hearing, rejected the insurer's challenge.
Ins 51.01(12) (12) "Mandatory control level risk based capital" means the product of .70 and the authorized control level risk based capital.
Ins 51.01(13) (13) "NAIC" means the national association of insurance commissioners.
Ins 51.01(14) (14) "Negative trend" means an adverse trend test result, as determined in accordance with the trend test calculation included in the risk based capital instructions.
Ins 51.01(15) (15) "Property and casualty insurer" means any insurer licensed to sell property or casualty insurance.
Ins 51.01(16) (16) "Regulatory action level event" means any of the following events:
Ins 51.01(16)(a) (a) The filing of a risk based capital report by an insurer which indicates that the insurer's total adjusted capital is greater than or equal to its authorized control level risk based capital but less than its regulatory action level risk based capital.
Ins 51.01(16)(b) (b) The notification by the commissioner to an insurer of an adjusted risk based capital report that indicates the event in par. (a), if the insurer does not challenge the adjusted risk based capital report under s. Ins 51.50.
Ins 51.01(16)(c) (c) If, pursuant to s. Ins 51.50, the insurer challenges an adjusted risk based capital report that indicates the event in par. (a), the notification by the commissioner to the insurer that the commissioner has, after a hearing, rejected the insurer's challenge.
Ins 51.01(16)(d) (d) The failure of the insurer to file a risk based capital report by the March 1, unless the insurer has provided an explanation for such failure which is satisfactory to the commissioner and has cured the failure within ten days after March 1.
Ins 51.01(16)(e) (e) The failure of the insurer to submit a risk based capital plan to the commissioner within the time period set forth in s. Ins 51.15 (2).
Ins 51.01(16)(f) (f) Notification by the commissioner to the insurer of all of the following:
Ins 51.01(16)(f)1. 1. The risk based capital plan or revised risk based capital plan submitted by the insurer is, in the judgment of the commissioner, unsatisfactory.
Ins 51.01(16)(f)2. 2. Such notification constitutes a regulatory action level event with respect to the insurer, provided the insurer has not challenged the determination under s. Ins 51.50.
Ins 51.01(16)(g) (g) If, under s. Ins 51.50, the insurer challenges a determination by the commissioner under par. (f), the notification by the commissioner to the insurer that the commissioner has, after a hearing, rejected such challenge.
Ins 51.01(16)(h) (h) Notification by the commissioner to the insurer that the insurer has failed to adhere to its risk based capital plan or revised risk based capital plan, but only if such failure has a substantial adverse effect on the ability of the insurer to eliminate the company action level event in accordance with its risk based capital plan or revised risk based capital plan and the commissioner has so stated in the notification, provided the insurer has not challenged the determination under s. Ins 51.50.
Ins 51.01(16)(i) (i) If, under s. Ins 51.50, the insurer challenges a determination by the commissioner under par. (h), the notification by the commissioner to the insurer that the commissioner has, after a hearing, rejected the challenge.
Ins 51.01(17) (17) "Regulatory action level risk based capital" means, with respect to any insurer, the product of 1.5 and its authorized control level risk based capital.
Ins 51.01(18) (18) "Revised risk based capital plan" means a risk based capital plan prepared by an insurer with or without the commissioner's recommendation after the original plan is rejected by the commissioner.
Ins 51.01(19) (19) "Risk based capital instructions" means the risk based capital report including risk based capital instructions adopted by the NAIC, as of September 1, 1996, and, if approved in writing by the commissioner, the risk based capital report and instructions as amended by the NAIC from time to time in accordance with the procedures adopted by the NAIC.
Ins 51.01(20) (20) "Risk based capital level" means an insurer's company action level risk based capital, regulatory action level risk based capital, authorized control level risk based capital, or mandatory control level risk based capital.
Ins 51.01(21) (21) "Risk based capital plan" means a comprehensive financial plan containing the elements specified in s. Ins 50.15 (1).
Ins 51.01(22) (22) "Risk based capital report" means the report required under s. Ins 51.05.
Ins 51.01(23) (23) "Total adjusted capital" means the sum of all of the following:
Ins 51.01(23)(a) (a) An insurer's statutory capital and surplus.
Ins 51.01(23)(b) (b) Such other items, if any, as the risk based capital instructions may provide.
Ins 51.01 History History: Cr. Register, December, 1996, No. 492, eff. 1-1-97; cr. (8m), r. (9) (a) 1., 2., renum. (9) (a) 3. to 8. to be (9) (a) 1. to 6., am. (10), Register, May, 1999, No. 521, eff. 6-1-99; CR 10-077: am. (4) (a) 2., (10), and (14); cr. (4) (a) 3. and 4., r. (9) (a) 3., renum. (9) (a) 4., 5., and 6. to be (9) (a) 3., 4., and 5. Register December 2010 No. 660, eff. 1-1-11; CR 13-059: am. (4) (a) 2. Register June 2014 No. 702, eff. 7-1-14; correction in (9) (a) 2. made under s. 13.92 (4) (b) 7, Stats., Register June 2014 No. 702.
Ins 51.05 Ins 51.05 Risk based capital reports.
Ins 51.05(1) (1) Every domestic insurer shall, on or prior to each March 1, prepare and submit a report of its risk based capital levels as of the end of the calendar year just ended, in a form and containing such information as is required by the risk based capital instructions. For the purpose of this section filing of a risk based capital report with the NAIC constitutes filing with the commissioner. A domestic insurer shall file its risk based capital report with all of the following:
Ins 51.05(1)(a) (a) The NAIC in accordance with the risk based capital instructions.
Ins 51.05(1)(b) (b) The insurance commissioner in any state in which the insurer is authorized to do business, if the insurance commissioner has notified the insurer of its request in writing, in which case the insurer shall file its risk based capital report not later than the later of:
Ins 51.05(1)(b)1. 1. Fifteen days from the receipt of notice to file its risk based capital report with that state.
Ins 51.05(1)(b)2. 2. March 1.
Ins 51.05(1g) (1g) The risk based capital of health maintenance organization insurers and of insurers writing only limited service health organization business shall be determined in accordance with the formula set forth in the risk based capital instructions. The formula shall take into account, and may adjust for the covariance between each of the following:
Ins 51.05(1g)(a) (a) Asset risk.
Ins 51.05(1g)(b) (b) Credit risk.
Ins 51.05(1g)(c) (c) Underwriting risk.
Ins 51.05(1g)(d) (d) All other business risks and such other relevant risks as are set forth in the risk based capital instructions.
Ins 51.05(1r) (1r) The risks identified under sub. (1g) shall be provided for as determined in each case by applying the factors in the manner set forth in the risk based capital instructions.
Ins 51.05(2) (2) A life or health insurer's risk based capital shall be determined in accordance with the formula set forth in the risk based capital instructions. The formula shall take into account, and may adjust for the covariance between each of the following:
Ins 51.05(2)(a) (a) The risk with respect to the insurer's assets.
Ins 51.05(2)(b) (b) The risk of adverse insurance experience with respect to the insurer's liabilities and obligations.
Ins 51.05(2)(c) (c) The interest rate risk with respect to the insurer's business.
Ins 51.05(2)(d) (d) All other business risks and such other relevant risks as are set forth in the risk based capital instructions.
Ins 51.05(3) (3) The risks identified under sub. (2) shall be provided for as determined in each case by applying the factors in the manner set forth in the risk based capital instructions.
Ins 51.05(4) (4) A property and casualty insurer's risk based capital shall be determined in accordance with the formula set forth in the risk based capital instructions. The formula shall take into account, and may adjust for the covariance between each of the following:
Ins 51.05(4)(a) (a) Asset risk.
Ins 51.05(4)(b) (b) Credit risk.
Ins 51.05(4)(c) (c) Underwriting risk.
Ins 51.05(4)(d) (d) All other business risks and such other relevant risks as are set forth in the risk based capital instructions.
Ins 51.05(5) (5) The risks identified under sub. (4) shall be provided for as determined in each case by applying the factors in the manner set forth in the risk based capital instructions.
Ins 51.05 Note Note: An excess of capital over the amount produced by the risk based capital requirements in this subchapter and the formulas, schedules and instructions referenced in this subchapter is desirable in the business of insurance. Accordingly, insurers should seek to maintain capital above the risk based capital levels required by this subchapter. Additional capital is used and useful in the insurance business and helps to secure an insurer 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 this chapter.
Ins 51.05(6) (6) If a domestic insurer files a risk based capital report which in the judgment of the commissioner is inaccurate, then the commissioner shall adjust the risk based capital report to correct the inaccuracy and shall notify the insurer of the adjustment. The notice shall contain a statement of the reason for the adjustment.
Ins 51.05 History History: Cr. Register, December, 1996, No. 492, eff. 1-1-97; cr. (1g) and (1r), Register, May, 1999, No. 521, eff. 6-1-99.
Ins 51.15 Ins 51.15 Company action event.
Ins 51.15(1) (1) If a company action level event occurs, the insurer shall prepare and submit to the commissioner a risk based capital plan which shall include all of the following:
Ins 51.15(1)(a) (a) Identification of the conditions which contribute to the company action level event.
Ins 51.15(1)(b) (b) Proposals of corrective actions which the insurer intends to take and would be expected to result in the elimination of the company action level event.
Ins 51.15(1)(c) (c) Projections of the insurer's financial results in the current year and at least the four succeeding years, both in the absence of proposed corrective actions and giving effect to the proposed corrective actions, including projections of statutory operating income, net income, capital or surplus or both. The projections for both new and renewal business shall include separate projections for each major line of business and separately identify each significant income, expense and benefit component, if appropriate.
Ins 51.15(1)(d) (d) Identification of the key assumptions impacting the insurer's projections and the sensitivity of the projections to the assumptions.
Ins 51.15(1)(e) (e) Discussion of the quality of, and problems associated with, the insurer's business, including but not limited to its assets, anticipated business growth and associated surplus strain, extraordinary exposure to risk, mix of business and use of reinsurance, if any, in each case.
Ins 51.15(1)(f) (f) Such other information as is requested by the commissioner.
Ins 51.15(2) (2) The risk based capital plan required under this section shall be submitted:
Ins 51.15(2)(a) (a) Within 45 days of the company action level event; or
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