(a)
(1) All risk-based provider organizations (RBPOs) shall be responsible for meeting the following solvency standards under this section:
- (A) At the time of initial licensure;
- (B) In the evaluation of their application; and
- (C) Continuously thereafter.
(2) All RBPOs acting as a carrier under Arkansas Code § 20-77-2703(4) shall be subject to this section in addition to any other provision in the Arkansas Insurance Code or rules applicable to its type of organization, unless excluded by:
- (A) This part;
- (B) The Medicaid Provider-Led Organized Care Act, Arkansas Code § 20-77-2701 et seq.; or
- (C) Medicaid preemption.
(b) Solvency standards. All RBPOs participating in the Organized Care Act Program shall:
(1)
- (A) Meet the reserve or capital requirements under Arkansas Code § 20-77-2706(f)(4) and any additional amounts needed to satisfy risk-based capital requirements under Arkansas Code § 23-63-1501 et seq. (hereafter, HMO-RBC).
- (B) The reserve requirements in Arkansas Code § 20-77-2706(f)(4) shall refer to the organization’s capital or capital and surplus under statutory accounting principles (SAP).
- (C) The Insurance Commissioner may adjust the reserve requirements of the RBPO from initial licensure, on a prospective basis, related to the timing of the RBPO assumption levels of partial to full risk in its business operations.
- (D) In addition, the commissioner may consider the extent to which the RBPO has reinsurance or stop loss coverage, or agreements with a licensed insurer or health maintenance organization (HMO), to cede risk, as a circumstance to reduce or modify reserve or capital requirements under this section.
- (E) The commissioner shall review and approve all such risk sharing agreements, including any major modifications thereof;
- (2) Comply with SAP reporting and file quarterly and annual financial statements with the State Insurance Department under SAP in the same manner as is required of a health maintenance organization regulated by the department under Arkansas Code § 23-76-113;
- (3) Comply with HMO-RBC requirements and reporting;
- (4) Comply with Arkansas Code § 23-63-601 et seq., referring to assets and liabilities;
- (5) Comply with Arkansas Code § 23-68-101 et seq., referring to rehabilitation and liquidation;
- (6) Comply with Arkansas Code § 23-69-134, referring to home office and records and the penalty for unlawful removal of records;
- (7) Comply with Arkansas Code § 23-76-122, related to examinations, in the same manner as a health maintenance organization;
- (8) Comply with Arkansas Code §§ 23-60-101 – 23-60-108 and 23-60-110 referring to the scope of the Arkansas Insurance Code;
- (9) Comply with Arkansas Code §§ 23-61-101, 23-61-201, and 23-61-301 referring to the Insurance Commissioner;
- (10) Comply with Arkansas Code §§ 23-63-102 – 23-63-104, § 23-63-201 et seq., general provisions, and Arkansas Code § 23-63-301 et seq., referring to service of process, a registered agent as process agent, serving legal process, and time to plead;
- (11) Comply with the annual independent audit under Arkansas Code § 23-63-216(a)(5) and actuarial requirements under Arkansas Code § 23-63-216(e)(1) and (2);
- (12) Comply with the custody of assets requirements under Arkansas Code § 23-69-134; and
- (13) Comply with the transfer of ownership requirements or acquisition provisions under Arkansas Code § 23-69-142.