Or. Admin. R. 410-141-5170 - CAPITALIZATION: Capital and Surplus

Current through Register Vol. 60, No. 12, December 1, 2021

(1) A CCO shall possess and thereafter maintain capital or surplus or any combination thereof equal to no less than $2.5 million.
(2) A CCO applying for its original CCO contract this state shall possess, when so applying, additional capital or surplus, or any combination thereof, of not less than $500,000.
(3) Notwithstanding a CCO's compliance with subsections (1) and (2), a CCO shall at all times also comply with the risk-based capital standards set forth at OAR 410-141-5295 to 5320.
(4) For the protection of the public, the Authority may require a CCO to possess and maintain capital or surplus, or any combination thereof, in excess of the amounts otherwise required under this section owing to the type, volume and nature of business transacted by the CCO. For the purpose of determining the reasonableness and adequacy of a CCO's capital and surplus, the Authority may consider the following factors, as among others:
(a) The size of the CCO, as measured by its assets, capital and surplus, reserves, capitated revenue and other appropriate criteria.
(b) The number of Members covered by the CCO.
(c) The extent of the geographical dispersion of the Members covered by the CCO.
(d) The nature and extent of the reinsurance program of the CCO.
(e) The quality, diversification and liquidity of the investment portfolio of the CCO.
(f) The recent past and projected future trend in the size of the investment portfolio of the CCO.
(g) The combined capital and surplus maintained by comparable CCOs.
(h) The adequacy of the reserves of the CCO.
(i) The quality and liquidity of investments in affiliates. The Authority may treat any such investment as a disallowed asset for purposes of determining the adequacy of combined capital and surplus whenever in the judgment of the Authority the investment so warrants.
(j) The quality of the earnings of the CCO and the extent to which the reported earnings include extraordinary items.
(5) The factors set forth in this rule for the purpose of determining the reasonableness and adequacy of the CCO's capital and surplus are not intended to be an exhaustive list. In determining the adequacy and reasonableness of 's capital and surplus, no single factor is necessarily controlling. Instead, the Authority shall consider the net effect of all of such factors and also other factors bearing on the financial condition of the CCO. In comparing the capital and surplus maintained by other CCOs, the Authority shall consider the extent to which each of such factors varies from CCO to CCO. In determining the quality and liquidity of investments in subsidiaries, the Authority shall consider the individual subsidiary and may discount or disallow its valuation to the extent that the individual investments so warrant.

Notes

Or. Admin. R. 410-141-5170
DMAP 59-2019, adopt filed 12/18/2019, effective 1/1/2020

Statutory/Other Authority: ORS 413.042, ORS 414.615, 414.625, 414.635 & 414.651

Statutes/Other Implemented: ORS 414.610 - 414.685

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