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48.44.037 - Minimum net worth -- Requirement to maintain -- Determination of amount.

Minimum net worth — Requirement to maintain — Determination of amount.

(1) Except as provided in subsection (2) of this section, every health care service contractor must have and maintain a minimum net worth equal to the greater of:

     (a) Three million dollars; or

     (b) Two percent of the annual premium earned, as reported on the most recent annual financial statement filed with the commissioner, on the first one hundred fifty million dollars of premium and one percent of the annual premium on the premium in excess of one hundred fifty million dollars.

     (2) A health care service contractor registered before July 27, 1997, that, on July 27, 1997, has a minimum net worth equal to or greater than that required by subsection (1) of this section must continue to have and maintain the minimum net worth required by subsection (1) of this section. A health care service contractor registered before July 27, 1997, that, on July 27, 1997, does not have the minimum net worth required by subsection (1) of this section must have and maintain a minimum net worth of:

     (a) The amount required immediately prior to July 27, 1997, until December 31, 1997;

     (b) Fifty percent of the amount required by subsection (1) of this section by December 31, 1997;

     (c) Seventy-five percent of the amount required by subsection (1) of this section by December 31, 1998; and

     (d) One hundred percent of the amount required by subsection (1) of this section by December 31, 1999.

     (3)(a) In determining net worth, no debt shall be considered fully subordinated unless the subordination is in a form acceptable to the commissioner. An interest obligation relating to the repayment of a subordinated debt must be similarly subordinated.

     (b) The interest expenses relating to the repayment of a fully subordinated debt shall not be considered uncovered expenditures.

     (c) A subordinated debt incurred by a note meeting the requirement of this section, and otherwise acceptable to the commissioner, shall not be considered a liability and shall be recorded as equity.

     (4) Every health care service contractor shall, when determining liabilities, include an amount estimated in the aggregate to provide for any unearned premium and for the payment of all claims for health care expenditures which have been incurred, whether reported or unreported, which are unpaid and for which the organization is or may be liable, and to provide for the expense of adjustment or settlement of the claims.

     Liabilities shall be computed in accordance with regulations adopted by the commissioner upon reasonable consideration of the ascertained experience and character of the health care service contractor.

     (5) All income from reserves on deposit with the commissioner shall belong to the depositing health care service contractor and shall be paid to it as it becomes available.

     (6) Any funded reserve required by this chapter shall be considered an asset of the health care service contractor in determining the organization's net worth.

     (7) A health care service contractor that has made a securities deposit with the commissioner may, at its option, withdraw the securities deposit or any part thereof after first having deposited or provided in lieu thereof an approved surety bond, a deposit of cash or securities, or any combination of these or other deposits of equal amount and value to that withdrawn. Any securities and surety bond shall be subject to approval by the commissioner before being substituted.

[1997 c 212 § 2; 1990 c 120 § 4.]

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