Current through Register Vol. 60, No. 12, December 1, 2021
determination of the financial condition of a CCO, there shall be allowed as
assets only such assets as are owned by the CCO and which consist of:
(a) Cash in the possession or control of the
CCO, including the true balance of any deposit in a solvent bank or trust
(b) Investments held in
accordance with these rules, and due or accrued income items in connection
therewith to the extent considered by the Authority to be
(c) Receivables for
capitated revenue payments due the CCO, to the extent allowed by the
(d) Amounts recoverable
from reinsurers if credit for reinsurance may be allowed to the CCO pursuant to
OAR 410-141-5050 to 5070.
assets considered by the Authority to be available for the payment of losses
and claims, at values determined by the Authority.
In addition to assets impliedly excluded
by this section, the following expressly shall not be allowed as assets in any
determination of the financial condition of a CCO:
(a) Advances to officers, employees, agents
and other persons on personal security only.
(b) Stock or other equivalent equity
interests of such CCO owned by it, or any material equity therein or loans
secured thereby, or any material proportionate interest in such stock or
equivalent equity interest acquired or held through the ownership by such CCO
of an interest in another firm, corporation or business unit.
(c) Tangible personal property, except such
property as the CCO is otherwise permitted to acquire and retain as an
investment under these rules and which is deemed by the Authority to be
available for the payment of losses and claims or which is otherwise expressly
allowable, in whole or in part, as an asset.
(d) The amount, if any, by which the book
value of any investment as carried in the ledger assets of the CCO exceeds the
value thereof as determined under these rules.
In any determination of the financial
condition of a CCO, liabilities to be charged against its assets shall be
calculated in accordance with these rules and shall include:
(a) The amount necessary to pay all of its
unpaid losses and claims incurred on or prior to the date of the statement,
whether reported or unreported to the CCO, together with the expenses of
adjustment or settlement thereof.
(b) A reserve equal to the unearned portion
of capitated revenue held by the CCO as of the financial statement
(c) Reserves which place a
sound value on its liabilities and which are not less than the reserves
according to accepted actuarial standards consistently applied and based on
actuarial assumptions relevant to contract provisions.
(d) Taxes, expenses and other obligations due
or accrued at the date of the statement.
(e) Any additional reserves for asset
valuation contingencies or loss contingencies required by these rules or
considered to be necessary by the Authority for the protection of the Authority
and the Members of the CCO.