Okla. Admin. Code § 365:40-3-32

Current through Vol. 42, No. 8, January 2, 2025

Section 365:40-3-32 - Standards for determining hazardous financial condition

The following may be considered by the Insurance Commissioner to determine whether the continued operation of any HMO might be deemed to be hazardous to the enrollees, members, subscribers, creditors or the general public. The Commissioner may consider:

(1) financial condition and market conduct examination reports;

(2) the National Association of Insurance Commissioners Insurance Regulatory Information System and its related reports;

(3) the ratios of commission expense, general business expense, group and individual contract benefits and reserve increases as to annual premium and net investment income;

(4) the HMO's assets;

(5) the HMO's reinsurance program;

(6) the HMO's operating results for the last twelve month period or any shorter period of time;

(7) the financial condition of the HMO's affiliates, subsidiaries, or reinsurers;

(8) contingent liabilities, pledges or guaranties;

(9) whether any "controlling person" of an HMO is delinquent in the transmitting to, or payment of, net premiums to such HMO;

(10) the age and collectibility of receivables;

(11) competence and fitness of the management of the HMO, including officers, directors, or any other person who directly or indirectly controls the operation of such HMO;

(12) whether the HMO has failed to respond to the Insurance Commissioner's inquiries relative to the condition of the HMO or has furnished false and misleading information in response to such inquiries;

(13) whether the HMO either has filed any false or misleading sworn financial statements, or has released false or misleading financial statements to lending institutions or to the general public;

(14) whether the HMO lacks adequate financial and administrative capacity to meet its obligations in a timely manner;

(15) whether the HMO has experienced or will experience in the foreseeable future cash flow and/or liquidity problems.

Okla. Admin. Code § 365:40-3-32

Added at 21 Ok Reg 77, eff 11-1-03 (emergency); Added at 21 Ok Reg 1672, eff 7-14-04