HB 1968 Modifies regulatory examination of health maintenance organizations and subjects health organizations to risk-based capital analysis

     Handler: Wasson

Current Bill Summary

- Prepared by Senate Research -


SCS/HB 1968 - This act modifies the examination period for health maintenance organizations from at a minimum every three years to at a minimum of every five years under Section 354.465. This act also adds definitions for a health organization, a domestic health organization, and a foreign health organization under Section 375.1250. This act adds health organizations to the entities subject to risk-based capital ("RBC") examination, analysis, and regulation found in Sections 375.1250 to 375.1275. This act creates an RBC analysis formula for health organizations to include: 1) asset risk; 2) credit risk; 3) underwriting risk; and 4) other business and RBC instruction risks. This act also requires foreign health organizations to comply with the same regulatory requirements foreign insurers are currently subject to under Section 375.1270.

This act adds a confidentiality provision for the director of the Department of Insurance ("director") relating to confidential and privileged documents filed as part of an RBC analysis. The director may share these documents with other listed regulatory bodies, and the documents would maintain their confidential and privileged status. This act also gives the director discretion to exempt certain health organizations from RBC examination requirements if they meet certain conditions. This act provides for special regulatory response from the director with respect to RBC reports filed by health organizations for 2014.

This act is substantially similar to SB 874 (2014).

MICHELA BIRK


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