Chapter Ins 51

Ins 51.05(1)(b)2. 2. March 1.

Ins 51.05(1g) (1g) The risk based capital of health maintenance organization insurers and of insurers writing only limited service health organization business shall be determined in accordance with the formula set forth in the risk based capital instructions. The formula shall take into account, and may adjust for the covariance between each of the following:

Ins 51.05(1g)(a) (a) Asset risk.

Ins 51.05(1g)(b) (b) Credit risk.

Ins 51.05(1g)(c) (c) Underwriting risk.

Ins 51.05(1g)(d) (d) All other business risks and such other relevant risks as are set forth in the risk based capital instructions.

Ins 51.05(1r) (1r) The risks identified under sub. (1g) shall be provided for as determined in each case by applying the factors in the manner set forth in the risk based capital instructions.

Ins 51.05(2) (2) A life or health insurer’s risk based capital shall be determined in accordance with the formula set forth in the risk based capital instructions. The formula shall take into account, and may adjust for the covariance between each of the following:

Ins 51.05(2)(a) (a) The risk with respect to the insurer’s assets.

Ins 51.05(2)(b) (b) The risk of adverse insurance experience with respect to the insurer’s liabilities and obligations.

Ins 51.05(2)(c) (c) The interest rate risk with respect to the insurer’s business.

Ins 51.05(2)(d) (d) All other business risks and such other relevant risks as are set forth in the risk based capital instructions.

Ins 51.05(3) (3) The risks identified under sub. (2) shall be provided for as determined in each case by applying the factors in the manner set forth in the risk based capital instructions.

Ins 51.05(4) (4) A property and casualty insurer’s risk based capital shall be determined in accordance with the formula set forth in the risk based capital instructions. The formula shall take into account, and may adjust for the covariance between each of the following:

Ins 51.05(4)(a) (a) Asset risk.

Ins 51.05(4)(b) (b) Credit risk.

Ins 51.05(4)(c) (c) Underwriting risk.

Ins 51.05(4)(d) (d) All other business risks and such other relevant risks as are set forth in the risk based capital instructions.

Ins 51.05(5) (5) The risks identified under sub. (4) shall be provided for as determined in each case by applying the factors in the manner set forth in the risk based capital instructions.

Ins 51.05 Note Note: An excess of capital over the amount produced by the risk based capital requirements in this subchapter and the formulas, schedules and instructions referenced in this subchapter is desirable in the business of insurance. Accordingly, insurers should seek to maintain capital above the risk based capital levels required by this subchapter. Additional capital is used and useful in the insurance business and helps to secure an insurer against various risks inherent in, or affecting, the business of insurance and not accounted for or only partially measured by the risk-based capital requirements contained in this chapter.

Ins 51.05(6) (6) If a domestic insurer files a risk based capital report which in the judgment of the commissioner is inaccurate, then the commissioner shall adjust the risk based capital report to correct the inaccuracy and shall notify the insurer of the adjustment. The notice shall contain a statement of the reason for the adjustment.

Ins 51.05 History History: Cr. Register, December, 1996, No. 492, eff. 1-1-97; cr. (1g) and (1r), Register, May, 1999, No. 521, eff. 6-1-99.

Ins 51.15 Ins 51.15 Company action event.

Ins 51.15(1) (1) If a company action level event occurs, the insurer shall prepare and submit to the commissioner a risk based capital plan which shall include all of the following:

Ins 51.15(1)(a) (a) Identification of the conditions which contribute to the company action level event.

Ins 51.15(1)(b) (b) Proposals of corrective actions which the insurer intends to take and would be expected to result in the elimination of the company action level event.

Ins 51.15(1)(c) (c) Projections of the insurer’s financial results in the current year and at least the four succeeding years, both in the absence of proposed corrective actions and giving effect to the proposed corrective actions, including projections of statutory operating income, net income, capital or surplus or both. The projections for both new and renewal business shall include separate projections for each major line of business and separately identify each significant income, expense and benefit component, if appropriate.

Ins 51.15(1)(d) (d) Identification of the key assumptions impacting the insurer’s projections and the sensitivity of the projections to the assumptions.

Ins 51.15(1)(e) (e) Discussion of the quality of, and problems associated with, the insurer’s business, including but not limited to its assets, anticipated business growth and associated surplus strain, extraordinary exposure to risk, mix of business and use of reinsurance, if any, in each case.

Ins 51.15(1)(f) (f) Such other information as is requested by the commissioner.

Ins 51.15(2) (2) The risk based capital plan required under this section shall be submitted:

Ins 51.15(2)(a) (a) Within 45 days of the company action level event; or

Ins 51.15(2)(b) (b) If the insurer challenges an adjusted risk based capital report under s. Ins 51.50, within 45 days after notification to the insurer that the commissioner has, after a hearing, rejected the insurer’s challenge.

Ins 51.15(3) (3) Within 60 days after the submission by an insurer of a risk based capital plan to the commissioner, the commissioner shall notify the insurer whether the risk based capital plan shall be implemented or is, in the judgment of the commissioner, unsatisfactory. If the commissioner determines the risk based capital plan is unsatisfactory, the notification to the insurer shall set forth the reasons for the determination, and may set forth proposed revisions which will render the risk based capital plan satisfactory, in the judgment of the commissioner. Upon notification from the commissioner, the insurer shall prepare a revised risk based capital plan, which may incorporate by reference any revisions proposed by the commissioner, and shall submit the revised risk based capital plan to the commissioner:

Ins 51.15(3)(a) (a) Within 45 days after the notification from the commissioner; or

Ins 51.15(3)(b) (b) If the insurer challenges the notification from the commissioner under s. Ins 51.50, within 45 days after a notification to the insurer that the commissioner has, after a hearing, rejected the insurer’s challenge.

Ins 51.15(4) (4) If the commissioner notifies an insurer that the insurer’s risk based capital plan or revised risk based capital plan is unsatisfactory, the commissioner may at the commissioner’s discretion, subject to the insurer’s right to a hearing under s. Ins 51.50, specify in the notification that the notification constitutes a regulatory action level event.

Ins 51.15(5) (5) Every domestic insurer that files a risk based capital plan or revised risk based capital plan with the commissioner shall file a copy of the risk based capital plan or revised risk based capital plan with the insurance commissioner in any state in which the insurer is authorized to do business if:

Ins 51.15(5)(a) (a) Such state has a risk based capital provision substantially similar to s. Ins 51.50 (1); and

Ins 51.15(5)(b) (b) The insurance commissioner of that state has notified the insurer of its request for the filing in writing.

Ins 51.15(6) (6) If an insurer is required to file a risk based capital plan or revised risk based capital plan under sub. (5) in a state it shall file a copy of the risk based capital plan or revised risk based capital plan in that state no later than the later of the following:

Ins 51.15(6)(a) (a) Fifteen days after the receipt of notice to file a copy of its risk based capital plan or revised risk based capital plan with the state.

Ins 51.15(6)(b) (b) The date on which the risk based capital plan or revised risk based capital plan is filed under s. Ins 51.15 (2) or (3).

Ins 51.15 History History: Cr. Register, December, 1996, No. 492, eff. 1-1-97.

Ins 51.20 Ins 51.20 Regulatory action level event.

Ins 51.20(1) (1) If a regulatory action level event occurs with respect to an insurer the commissioner shall:

Ins 51.20(1)(a) (a) Require the insurer to prepare and submit a risk based capital plan or, if applicable, a revised risk based capital plan;

Ins 51.20(1)(b) (b) Perform such examination or analysis as the commissioner deems necessary of the assets, liabilities and operations of the insurer including a review of its risk based capital plan or revised risk based capital plan; and

Ins 51.20(1)(c) (c) Subsequent to the examination or analysis, issue an order specifying such corrective actions as the commissioner shall determine are required.

Ins 51.20(2) (2) In determining corrective actions, the commissioner may take into account such factors as are deemed relevant with respect to the insurer based upon the commissioner’s examination or analysis of the assets, liabilities and operations of the insurer, including, but not limited to, the results of any sensitivity tests undertaken pursuant to the risk based capital instructions. The insurer shall submit a risk based capital plan or revised risk based capital plan:

Ins 51.20(2)(a) (a) Within 45 days after the occurrence of the regulatory action level event;

Ins 51.20(2)(b) (b) If the insurer challenges an adjusted risk based capital report under s. Ins 50.50 and the challenge is not frivolous in the judgment of the commissioner, within 45 days after the notification to the insurer that the commissioner has, after a hearing, rejected the insurer’s challenge; or

Ins 51.20(2)(c) (c) If the insurer challenges a revised risk based capital plan pursuant to s. Ins 51.50 and the challenge is not frivolous in the judgment of the commissioner, within 45 days after the notification to the insurer that the commissioner has, after a hearing, rejected the insurer’s challenge.

Ins 51.20(3) (3) The commissioner may retain actuaries and investment experts and other consultants as may be necessary in the judgment of the commissioner to review the insurer’s risk based capital plan or revised risk based capital plan, examine or analyze the assets, liabilities and operations of the insurer and formulate a corrective order with respect to the insurer. The fees, costs and expenses relating to consultants shall be borne by the affected insurer or such other party as directed by the commissioner.

Ins 51.20 History History: Cr. Register, December, 1996, No. 492, eff. 1-1-97.

Ins 51.30 Ins 51.30 Authorized control level event. If an authorized control level event occurs with respect to an insurer, the commissioner shall:

Ins 51.30(1) (1) Take such actions as are required under s. Ins 51.20 regarding an insurer with respect to which a regulatory action level event has occurred; or

Ins 51.30(2) (2) If the commissioner deems it to be in the best interests of the policyholders and creditors of the insurer and of the public, take such actions as are necessary to cause the insurer to be placed under regulatory control under ch. 645, Stats. If the commissioner takes such actions, the authorized control level event shall be deemed sufficient grounds for the commissioner to take action under ch. 645, Stats., and the commissioner shall have the rights, powers and duties with respect to the insurer as are set forth in ch. 645, Stats.

Ins 51.30 History History: Cr. Register, December, 1996, No. 492, eff. 1-1-97.

Ins 51.40 Ins 51.40 Mandatory control level. If there is a mandatory control level event:

Ins 51.40(1) (1) With respect to a life or health insurer, the commissioner shall take such actions as are necessary to place the insurer under regulatory control under ch. 645, Stats. The mandatory control level event shall be deemed sufficient grounds for the commissioner to take action under ch. 645, Stats., and the commissioner shall have the rights, powers and duties with respect to the insurer as are set forth in ch. 645, Stats. Notwithstanding any of the foregoing, the commissioner may forego action for up to ninety days after the mandatory control level event if the commissioner finds there is a reasonable expectation that the mandatory control level event may be eliminated within the 90 day period.

Ins 51.40(2) (2) With respect to a property and casualty insurer, the commissioner shall take such actions as are necessary to place the insurer under regulatory control under ch. 645, Stats., or, in the case of an insurer which is writing no business and which is running-off its existing business, may allow the insurer to continue its run-off under the supervision of the commissioner. In either event, the mandatory control level event shall be deemed sufficient grounds for the commissioner to take action under ch. 645, Stats., and the commissioner shall have the rights, powers and duties with respect to the insurer as are set forth in ch. 645, Stats. Notwithstanding any of the foregoing, the commissioner may forego action for up to 90 days after the mandatory control level event if the commissioner finds there is a reasonable expectation that the mandatory control level event may be eliminated within the 90 day period.

Ins 51.40 History History: Cr. Register, December, 1996, No. 492, eff. 1-1-97.

Ins 51.50 Ins 51.50 Hearings.

Ins 51.50(1) (1) An insurer shall have the right to a hearing, on a record, at which the insurer may challenge any determination or action by the commissioner under this subchapter upon any of the following:

Ins 51.50(1)(a) (a) Notification to an insurer by the commissioner of an adjusted risk based capital report.

Ins 51.50(1)(b) (b) Notification to an insurer by the commissioner of all of the following:

Ins 51.50(1)(b)1. 1. The insurer’s risk based capital plan or revised risk based capital plan is unsatisfactory.

Ins 51.50(1)(b)2. 2. Such notification constitutes a regulatory action level event with respect to such insurer.

Ins 51.50(1)(c) (c) Notification to any insurer by the commissioner that the insurer has failed to adhere to its risk based capital plan or revised risk based capital plan and that such failure has a substantial adverse effect on the ability of the insurer to eliminate the company action level event with respect to the insurer in accordance with its risk based capital plan or revised risk based capital plan.

Ins 51.50(1)(d) (d) Notification to an insurer by the commissioner of a corrective order with respect to the insurer under this subchapter.

Ins 51.50(2) (2) The procedures established under ss. 601.62, 601.63, and 645.21, Stats., apply to an order, determination or hearing under this chapter.

Ins 51.50(3) (3) This section does not apply to an action by the commissioner based on ch. 645, Stats., subch. II or any other provision of the statutes or rules other than this subchapter. An insurer’s right to a hearing, if any, is solely governed by those provisions and not this section.

Ins 51.50 History History: Cr. Register, December, 1996, No. 492, eff. 1-1-97.

Ins 51.55 Ins 51.55 Confidentiality; prohibition on announcements, prohibition on use in ratemaking.

Ins 51.55(1) (1) Except as permitted under sub. (2) the commissioner shall keep all of the following information confidential and it may not be subject to subpoena:

Ins 51.55(1)(a) (a) Risk based capital reports, to the extent the information is not required to be set forth in a publicly available annual statement schedule.

Ins 51.55(1)(b) (b) Risk based capital plans, including the results or report of any examination or analysis of an insurer performed under this chapter.

Ins 51.55(1)(c) (c) Any corrective order issued by the commissioner pursuant to examination or analysis, with respect to any domestic insurer or foreign insurer, which is issued under s. 645.21, Stats.

Ins 51.55(2) (2) The information described under sub. (1) is information that is obtained by the commissioner under ss. 601.465 and 645.24, Stats., and shall be retained as confidential under those statutes. This information is not subject to subpoena. The commissioner may disclose the information only for the purpose of enforcement actions taken by the commissioner under chs. 600 to 655, Stats.

Ins 51.55(3) (3) 

Ins 51.55(3)(a) (a) Except as otherwise required under the provisions of this chapter, no insurer, agent, broker or other person engaged in any manner in the insurance business may make, publish, disseminate, circulate or place before the public, or cause, directly or indirectly to be made, published, disseminated, circulated or placed before the public, in a newspaper, magazine or other publication, or in the form of a notice, circular, pamphlet, letter or poster, or over any radio or television station, or in any other way, an advertisement, announcement or statement containing an assertion, representation or statement with regard to the risk based capital levels of any insurer, or of any component derived in the calculation of risk based capital levels. Any such representation is misleading.

Ins 51.55(3)(b) (b) If any materially false statement with respect to the comparison regarding an insurer’s total adjusted capital to its risk based capital levels or an inappropriate comparison of any other amount to an insurer’s risk based capital levels is published in any written publication and the insurer is able to demonstrate to the commissioner with substantial proof the falsity of such statement, or the inappropriateness, as the case may be, then the insurer may publish an announcement in a written publication if the sole purpose of the announcement is to rebut the materially false statement.

Ins 51.55(4) (4) The commissioner shall principally use risk based capital instructions, risk based capital reports, adjusted risk based capital reports, risk based capital plans and revised risk based capital plans as one method for monitoring the solvency of insurers and to assist in determining the need for corrective action with respect to insurers. The commissioner may not use these instructions, reports or plans for ratemaking nor as evidence in any rate proceeding nor used by the commissioner to calculate or derive any elements of an appropriate premium level or rate of return for any line of insurance which an insurer or any affiliate is authorized to write. The commissioner finds that the comparison of an insurer’s total adjusted capital to any of its risk based capital levels is a regulatory tool which may indicate the need for possible corrective action with respect to the insurer, and is not intended as a means to rank insurers generally.

Ins 51.55 History History: Cr. Register, December, 1996, No. 492, eff. 1-1-97.

Ins 51.60 Ins 51.60 Supplemental provisions; exemptions.

Ins 51.60(1) (1) The provisions of this subchapter are supplemental to any other provisions of the laws or rules of this state, and do not preclude or limit any other powers or duties of the commissioner under these laws or rules or procedures for applying those laws, including, but not limited to, chs. 620, 623, and 645, Stats., and subch. II. An insurer which is in violation of subch. II is in financially hazardous condition and may be subject to any of the proceedings provided under ch. 645, Stats., regardless of whether the insurer is in compliance with this subchapter or a proceeding is requested or pending under this subchapter and regardless of the insurer’s risk based capital level. Nothing in this subchapter prevents the commissioner from taking, or limits the authority of the commissioner to take, action under any of those provisions when action is not permitted or required under this subchapter.

Ins 51.60(2) (2) The commissioner may exempt from the application of this subchapter any domestic property and casualty insurer which complies with all of the following:

Ins 51.60(2)(a) (a) The insurer writes direct business only in this state.