Okla. Admin. Code § 365:40-3-33

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

Section 365:40-3-33 - Commissioner's authority

(a) For the purposes of making a determination of an HMO's financial condition under the Act, the Insurance Commissioner may, if consistent with the facts and existing law:

(1) Disregard any credit or amount receivable resulting from transactions with a reinsurer which is insolvent, impaired or otherwise subject to a delinquency proceedings;

(2) Make appropriate adjustments to asset values attributable to investments in or transactions with parents, subsidiaries, or affiliates;

(3) Refuse to recognize the stated value of accounts receivable if the ability to collect receivables is highly speculative in view of the age of the account or the financial condition of the debtor;

(4) Increase the HMO's liability in an amount equal to any contingent liability, pledge, or guarantee not otherwise included if there is a substantial likelihood that the HMO will be called upon to meet the obligation undertaken within the next 12-month period.

(b) If the Insurance Commissioner determines that the continued operation of the HMO licensed to transact business in this state may be hazardous to the enrollees, members, subscribers or the general public, then the Insurance Commissioner may, upon his determination, issue an order making such finding and including a list of requirements necessary to abate such finding. Such list may include, among other things:

(1) reduce the total amount of present and potential liability for group and individual contract benefits by reinsurance;

(2) reduce, suspend or limit the volume of business being accepted or renewed;

(3) reduce general and commission expenses by specified methods;

(4) increase the HMO's capital and surplus;

(5) suspend or limit the declaration and payment of dividend by an HMO to its stockholders or to its enrollees, members or subscribers;

(6) file reports in a form acceptable to the Insurance Commissioner concerning the market value of an HMO's assets;

(7) limit or withdraw from certain investments or discontinue certain investment practices to the extent the Insurance Commissioner deems necessary;

(8) document the adequacy of premium rates in relation to the risks;

(9) file, in addition to regular annual and quarterly financial statements, interim financial reports on the form adopted by the National Association of Insurance Commissioners or on such format as directed by the Insurance Commissioner.

Okla. Admin. Code § 365:40-3-33

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