3 CCR 702-3
DEPARTMENT OF REGULATORY AGENCIES FINANCIAL ISSUES 3 CCR 702-3 [Editor’s Notes follow the text of the rules at the end of this CCR Document.] _________________________________________________________________________ Regulation 3-1-1 FIDELITY BOND REQUIREMENTS Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Definitions Section 5 Requirement for Fidelity Coverage Section 6 Severability Section 7 Enforcement Section 8 Effective Date Section 9 History Section 1 Authority This regulation is promulgated and adopted by the Commissioner of Insurance under the authority of §§ 10-1-108(7), 10-1-109, 10-6-129, 10-14-505 and 10-16-109, C.R.S. Section 2 Scope and Purpose The purpose of this regulation is to prescribe the minimum amount of fidelity coverage required to be maintained by insurers for money or other property, which may be lost because of theft or dishonest acts of its officers, directors and employees.
Section 3 Applicability This regulation shall apply to all Colorado domestic insurers, as well as to each Colorado domiciled risk retention group captive insurer, fraternal benefit society, health maintenance organization, public entity self-insurance pool, limited service licensed provider network, and non-profit hospital, medical- surgical and health service corporation.
Section 4 Definitions A. “Insurer” means, for the purpose of this regulation, the same as found at § 10-1-102(13), C.R.S.
B. “Fidelity coverage” means, for the purpose of this regulation, a form of business insurance that provides protection against losses - either monetary or physical - caused by its employees' fraudulent or dishonest actions that are not generally covered under normal theft or burglary policies.
Section 5 Requirement for Fidelity Coverage All insurers must obtain fidelity coverage for all officers, directors and employees who have access to, or authorize transactions concerning company funds and investments. The amount of coverage shall be determined in accordance with the following schedule:
Minimum Amounts of Fidelity Insurance Exposure Index Bracket No Amount of Bond $ 1,000 - $ 25,000 1 $ 15,000 - $ 25,000 25,000 - 125,000 2 25,000 - 50,000 125,000 - 250,000 3 50,000 - 75,000 250,000 - 500,000 4 75,000 - 100,000 500,000 - 750,000 5 100,000 - 125,000 750,000 - 1,000,000 6 125,000 - 150,000 1,000,000 - 1,375,000 7 150,000 - 175,000 1,375,000 - 1,750,000 8 175,000 - 200,000 1,750,000 - 2,125,000 9 200,000 - 225,000 2,125,000 - 2,500,000 10 225,000 - 250,000 2,500,000 - 3,325,000 11 250,000 - 300,000 3,325,000 - 4,175,000 12 300,000 - 350,000 4,175,000 - 5,000,000 13 350,000 - 400,000 5,000,000 - 6,075,000 14 400,000 - 450,000 6,075,000 - 7,150,000 15 450,000 - 500,000 7,150,000 - 9,275,000 16 500,000 - 600,000 9,275,000 - 11,425,000 17 600,000 - 700,000 11,425,000 - 15,000,000 18 700,000 - 800,000 15,000,000 - 20,000,000 19 800,000 - 900,000 20,000,000 - 25,000,000 20 900,000 - 1,000,000 25,000,000 - 50,000,000 21 1,000,000 - 1,250,000 50,000,000 - 87,500,000 22 1,250,000 - 1,500,000 87,500,000 - 125,000,000 23 1,500,000 - 1,750,000 125,000,000 - 187,500,000 24 1,750,000 - 2,000,000 187,500,000 - 250,000,000 25 2,000,000 - 2,250,000 250,000,000 - 333,325,000 26 2,250,000 - 2,500,000 333,325,000 - 500,000,000 27 2,500,000 - 3,000,000 500,000,000 - 750,000,000 28 3,000,000 - 3,500,000 750,000,000 - 1,000,000,000 29 3,500,000 - 4,000,000 1,000,000,000 - 1,250,000,000 30 4,000,000 - 4,500,000 1,250,000,000 - 1,500,000,000 31 4,500,000 - 5,000,000 A. Calculation of Exposure Index and Bond Amount
B. Minimum Amount of Bond The minimum amount of bond required is determined by locating the appropriate bracket based upon the calculated Exposure Index as found in Section 5.A.3. above. Bracket # ______ $_________________________ Section 6 Severability If any provision of this regulation or the application of it to any person or circumstance is for any reason held to be invalid, the remainder of this regulation shall not be affected. Section 7 Enforcement Noncompliance with this Regulation may result in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance, or other laws, which include the imposition of civil penalties, issuance of cease and desist orders, and/or suspensions or revocation of license, subject to the requirements of due process.
Section 8 Effective Date This amended regulation shall be effective on April 1, 2016. Section 9 History Originally effective 1974.
Amended effective April 1, 2000.
Amended effective October 2, 2006.
Amended effective April 1, 2016.
Regulation 3-1-2 STATUTORY DEPOSITS QUARTERLY REPORTS ON MARKET VALUE Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Filing of Market Value Reports Section 5 Severability Section 6 Enforcement Section 7 Effective Date Section 8 History Section 1 Authority This regulation is promulgated pursuant to the authority of § 10-1-109 C.R.S. Section 2 Scope and Purpose The purpose of this regulation is to implement the market valuation requirement of § 10-3-235(4) C.R.S., by the establishment of regular reporting method.
Section 3 Applicability This regulation shall apply to any domestic insurance company, and any fraternal benefit society, health maintenance organization, non-profit hospital, medical-surgical and health service corporation, prepaid dental care plan organization, public entity self-insurance pool, and title insurance company, which deposits securities with the Commissioner of Insurance. Section 4 Filing of Market Value Reports Domestic companies, identified in Section 3, which are required to maintain a joint or statutory deposit with the Commissioner of Insurance, shall file quarterly with the Commissioner of Insurance an itemized statement of market value of securities on joint deposit. Companies using a Denver area bank, which makes such quarterly filings with the Commissioner of Insurance on behalf of the companies, need not make a filing under this regulation. The time of filing is to be within thirty days of the end of each calendar quarter. Reports will be due no later than January 30, April 30, July 30, and October 30 of each year. The statement is to be certified by an officer of the company and is to include the following information for each security evaluated:
Section 7 Effective Date This amended regulation shall be effective on August 1, 2012. Section 8 History Originally issued as Regulation 76-3, effective immediately. Re-codified as Regulation 3-1-2.
Regulation amended, effective October 1, 1999.
Amended regulation effective August 1, 2012.
Regulation 3-1-3 CONCERNING ACTUARIAL OPINIONS Section 1 Authority Section 2 Scope And Purpose Section 3 Applicability Section 4 Definitions Section 5 Statement Of Opinion Of Reserves And Other Actuarial Items Section 6 Requirements/Limitations On Domestic Company Opinions Section 7 Exemption Or Extension Section 8 Severability Section 9 Enforcement Section 10 Effective Date Section 11 History Section 1 Authority This regulation is promulgated under the authority of § § 10-1-109, 10-5-117, 10-6-129, 10-16-109, C.R.S.
Section 2 Scope And Purpose The purpose of this regulation is to improve the Colorado Insurance Division's surveillance of the financial condition of companies, for the protection of all policyholders, contractholders and the general public, by requiring an annual opinion of a qualified actuary as to the adequacy of a company's reserves and other actuarial items which ought to be established in the required annual statement filings. Section 3 Applicability This regulation shall apply to all companies defined in Section 4 below, excluding those filing pursuant to Colorado Insurance Regulation 3-1-8 (3CCR 702-3). Domestic mutual protective and pure assessment associations operating under Part 1 of Article 12 of Title 10, C.R.S. are exempted from this filing requirement unless an actuarial opinion is specifically requested by the Commissioner. Section 4 Definitions The following terms used in this regulation shall have the following meanings:
A. “Company” means a licensed insurance company, captive insurance company, non-profit hospital, medical-surgical and health service corporation, health maintenance organization, foreign authorized surplus lines insurance company, Pinnacol Assurance, foreign risk retention group operating in this state, title company, or foreign authorized non-admitted reinsurer.
B. “Qualified actuary” generally means an actuary meeting the qualifications set forth in Colorado Insurance Regulation 1-1-1 (3CCR 702-1). However, for opinions submitted with any financial statement filing required of Property and Casualty insurers, a qualified actuary is a person who is either a member in good standing of the Casualty Actuarial Society or a member in good standing of the American Academy of Actuaries who has been approved as qualified for signing casualty loss reserve opinions by the Casualty Practice Council of the American Academy of Actuaries. Section 5 Statement Of Opinion Of Reserves And Other Actuarial Items Each company shall submit with the annual financial statement filing an opinion of a qualified actuary, in a form acceptable to the Commissioner, which must at a minimum meet the recommended standards contained in the NAIC Annual Statement Instructions as to the adequacy of the company's reserves. A non-domestic company that files an opinion with the NAIC in conformity with the requirements of this section shall be exempted from filing a separate opinion with the Colorado Division of Insurance. The actuary shall consider provisions of Colorado statutes, regulations and generally accepted actuarial standards in forming such opinion. Companies that have not filed the actuarial opinion by the due date of the annual financial statement, or written extension date if granted, shall be assessed a late fee of up to $100.00 per day for each day the opinion is received beyond such date. Such late fee may be assessed in addition to any other fines relating to the annual financial statement filing requirement. Section 6 Requirements/Limitations On Domestic Company Opinions Opinions submitted for Colorado domestic companies must comply with the following:
A. A company's loss and loss adjustment expense reserves reported in any required financial filing to the Commissioner shall reflect the company's best estimate of its insurance obligations, derived from reasonable assumptions, calculated in accordance with appropriate actuarial standards of practice and verified by the opining actuary. A company that establishes an amount less than the actuary's best estimate as indicated in the underlying actuarial report, if applicable, shall submit the underlying actuarial report supporting the actuary's opinion to the Commissioner no later than 30 days following the due date of the opinion. Failure to file the actuarial report within 30 days of a request by the Commissioner may result in a penalty of up to $100.00 per
B. In addition to the items required by any applicable annual statement filing instructions, all company balance sheet amounts that are established through actuarial principles, including loss analysis, mortality, morbidity, discounting or estimation techniques, must be included within the actuarial opinion. These amounts include, but are not limited to: contingent reinsurance commissions, retrospective premium adjustments, premium deficiency reserves, claims-made free tail coverage, and unearned premium reserves which are determined in a manner other than pro-rata.
C. The actuary should be familiar with the material reinsurance arrangements of the insurer when determining the reasonableness of net reserves. The company shall not reflect any credit for reinsurance ceded in any financial statement filed, unless the reinsurance arrangements comply with the provisions of § 10-3-118, C.R.S. and Colorado Insurance Regulations 3-3-3 and 3-3-5. The actuary's opinion shall not reflect any credit taken for reinsurance ceded if the actuary is aware that reinsurance arrangements violate any provision of § 10-3-118, C.R.S. or Colorado Insurance Regulations 3-3-3 and 3-3-5.
D. Unless otherwise specified by statute, reserves for outstanding losses may not be discounted, with the exception of reserves established for losses with fixed and determinable future payments, such as those emanating from workers' compensation tabular indemnity reserves and long-term disability claims. The rate of interest, at each valuation date, used in the calculation of the discount shall not exceed the lesser of (i) the company's rate of return on statutory invested assets, and (ii) the 20 year duration valuation rate determined pursuant to §10-7-309.5, C.R.S.
E. Reserves shall not be reduced for anticipated salvage and subrogation unless such reduction has been evaluated, analyzed and opined upon by the actuary as being reasonable based upon the company's past experience, current and reasonably anticipated activities, and has made due provision for the collection and other expenses associated with the receipt of the salvage and subrogation amounts. The actuary may analyze the reserve data net of salvage and subrogation so long as the actuary is satisfied that such treatment of the data will cause no material distortion.
F. For all health insurers and Health Maintenance Organizations (HMOs), the annual Statement of Actuarial Opinion shall include a statement that the opining actuary has considered the impact of any risk-sharing arrangements with provider groups on health claim liabilities. If the insurer or HMO has entered into any kind of risk-sharing, usually contractual, arrangements with provider groups providing medical services to enrollees, then it is expected that the opining actuary evaluate these arrangements, and the financial position of each contracting entity. In the development and calculation of health claim reserves and other related actuarial items, due regard shall be given to the types and scopes of these arrangements, and the financial position of each contracting entity, including, but not limited to, the following:
G. For all health insurers and HMOs, the annual Statement of Actuarial Opinion should include a statement such as:
H. Any HMO whose sole business is providing health care services to recipients under the “Colorado Medical Assistance Act”, Articles 4 to 6 of Title 25.5, C.R.S., “The Children’s Basic Health Plan”, Article 8 of Title 25.5, C.R.S., or Medicare under Title XVIII of the federal “Social Security Act”, as amended, shall also include the following statement in the annual Statement of Actuarial Opinion, “The company’s surplus level and outstanding claims liability meet the requirements of §10-16- 411 (1.5), C.R.S.”
Section 7 Exemption Or Extension A. The Commissioner may consider a written request for exemption or extension for the filing of the statement of actuarial opinion. Any such request must be made no later than 15 days before the due date of such opinion for which the exemption or extension is sought. Such request must contain a statement which sets forth the basis on which such exemption or extension is sought.
B. Requests for exemptions and extensions will be considered for the following reasons:
C. In all cases, however, an exception or extension will only be granted after the commissioner has determined that the non-submission or delay of the actuarial opinion would result in minimal potential harm to policyholders.
Section 8 Severability If any provision of this regulation or the application thereof to any person or circumstance is for any reason held to be invalid, the remainder of this regulation shall not be affected thereby. Section 9 Enforcement Noncompliance with this Regulation may result, after proper notice and hearing, in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance or other laws which include the imposition of fines, issuance of cease and desist orders and/or suspension or revocation of license. Among others, the penalties provided for in § 10-3-1108, C.R.S. may be applied. Section 10 Effective Date This regulation is hereby amended and restated and shall be effective for any Statement of Actuarial Opinion filed with the Colorado Division of Insurance after October 1, 2007. Section 11 History New Regulation 90-1, effective December 31, 1994.
Amended Regulation, effective August 31, 1998.
Amended Regulation, effective December 1, 2005.
Amended Regulation, effective February 1, 2007.
Amended Regulation, effective October 1, 2007.
Regulation 3-1-4 CONCERNING A COMPANY’S ANNUAL AUDITED FINANCIAL REPORTS, AUDIT COMMITTEE AND INTERNAL CONTROL DEPARTMENT REQUIREMENTS Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Definitions Section 5 General Requirements Related to Filing and Extensions for Filing of Annual Audited Financial Report and Audit Committee Appointment Section 6 Contents of Annual Audited Financial Report Section 7 Designation of Independent Certified Public Accountant Section 8 Qualifications of Independent Certified Public Accountant Section 9 Consolidated or Combined Audits Section 10 Scope of Audit and Report of Independent Certified Public Accountant Section 11 Notification of Adverse Financial Condition Section 12 Communication of Internal Control Related Matters Noted in an Audit Section 13 Accountant’s Letter of Qualifications Section 14 Definition, Availability and Maintenance of Independent Certified Public Accountant Workpapers Section 15 Requirements for Audit Committees Section 16 Internal Audit Function Requirements Section 17 Conduct of Company in Connection with the Preparation of Required Reports and Documents Section 18 Management’s Report of Internal Control over Financial Reporting Section 19 Exemptions and Effective Dates Section 20 Canadian and British Companies Section 21 Severability Provision Section 22 Incorporated Materials Section 23 Enforcement Section 24 Effective Date Section 25 History Section 1 Authority This regulation is promulgated under the authority of §§10-1-108(7), 10-1-109, 10-1-203, 10-3-109, 10-3- 118, 10-3-208, 10-5-117, 10-6-114, 10-6-129, 10-14-505, 10-14-602, 10-16-109, 10-16-111 and 8-45-121 C.R.S.
Section 2 Scope and Purpose The purpose of this regulation is to improve the Division’s surveillance of the financial condition of companies by requiring: (1) an annual audit of financial statements reporting the financial position and the results of operations of companies by independent certified public accountants, (2) Communication of Internal Control Related Matters Noted in an Audit, and (3) Management’s Report of Internal Control over Financial Reporting.
This regulation shall not prohibit, preclude or in any way limit the Commissioner from ordering or conducting or performing examinations of companies under the rules and regulations of the Division and the practices and procedures of the Division.
Section 3 Applicability Every company (as defined in Section 4) shall be subject to this regulation. Companies having direct premiums written in this state of less than $1,000,000 in any calendar year and less than 1,000 policyholders or certificate holders of direct written policies nationwide at the end of the calendar year shall be exempt from this regulation for the year (unless the Commissioner makes a specific finding that compliance is necessary for the Commissioner to carry out statutory responsibilities) except that companies having assumed premiums pursuant to contracts and/or treaties of reinsurance of $1,000,000 or more will not be so exempt.
Foreign or alien insurers filing the audited financial report in another state, pursuant to that state’s requirement for filing of audited financial reports, which has been found by the Commissioner to be substantially similar to the requirements herein, are exempt from Sections 5 through 14 of this regulation if:
A. A copy of the audited financial report, Communication of Internal Control Related Matters Noted in an Audit, and the Accountant’s Letter of Qualifications that are filed with the other state are filed with the Commissioner in accordance with the filing dates specified in Sections 5, 12 and 13, respectively (Canadian insurers may submit accountants’ reports as filed with the Office of the Superintendent of Financial Institutions, Canada).
B. A copy of any Notification of Adverse Financial Condition Report filed with the other state is filed with the Commissioner within the time specified in Section 11. Foreign or alien insurers required to file Management’s Report of Internal Control over Financial Reporting in another state are exempt from filing the Report in this state provided the other state has substantially similar reporting requirements and the Report is filed with the Commissioner of the other state within the time specified.
Section 4 Definitions A. “Accountant” or “independent certified public accountant” means, for the purposes of this regulation, an independent certified public accountant or accounting firm in good standing with the American Institute of Certified Public Accountants (AICPA) and in all states in which he or she is licensed to practice; for Canadian and British companies, it means a Canadian chartered or British-chartered accountant.
B. An “affiliate” of, or person “affiliated” with, a specific person, means, for the purposes of this regulation, a person that directly, or indirectly through one or more intermediaries, controls, or is controlled by, or is under common control with, the person specified.
C. “Audit committee” means, for the purposes of this regulation, a committee (or equivalent body) established by the board of directors of an entity for the purpose of overseeing: the accounting and financial reporting processes of a company or group of insurers; the internal audit function of a company or group of insurers; and the external audits of financial statements of the company or group of insurers. The Audit committee of any entity that controls a group of insurers may be deemed to be the Audit committee for one or more of these controlled companies solely for the purposes of this regulation at the election of the controlling person. Refer to Section 15.E. for exercising this election. If an Audit committee is not designated by the company, the company’s entire board of directors shall constitute the Audit committee.
D. “Audited financial report” means, for the purposes of this regulation, and includes those items specified in Section 6 of this regulation.
E. “Commissioner” means, for the purposes of this regulation, the Commissioner of Insurance for the State of Colorado.
F. “Company” means, for the purposes of this regulation, an insurer, captive insurance company, health maintenance organization or Pinnacol Assurance.
G. “Division” means, for the purposes of this regulation, the Colorado Division of Insurance.
H. “Indemnification” means, for the purposes of this regulation, an agreement of indemnity or a release from liability where the intent or effect is to shift or limit in any manner the potential liability of the person or firm for failure to adhere to applicable auditing or professional standards, whether or not resulting in part from knowing of other misrepresentations made by the company or its representatives.
I. “Insurer” means, for the purposes of this regulation, a licensed insurance company, authorized surplus lines insurance company, authorized non-admitted reinsurer, nonprofit hospital, medical- surgical, and health service corporation or fraternal benefit society.
J. “Group of insurers” means, for the purposes of this regulation, those licensed insurers included in the reporting requirements of §10-3-801 et seq., C.R.S., or a set of insurers as identified by management, for the purpose of assessing the effectiveness of internal control over financial reporting.
K. “Internal audit function” means, for the purposes of this regulation, a person or persons that provide independent, objective and reasonable assurance designed to add value and improve an organization’s operations and accomplish its objectives by bringing a systematic disciplined approach to evaluate and improve the effectiveness of risk management, control and governance processes.
L. “Internal control over financial reporting” means, for the purposes of this regulation, a process effected by an entity’s board of directors, management and other personnel designed to provide reasonable assurance regarding the reliability of the financial statements, i.e., those items specified in Section 6.B. through 6.G. of this regulation and includes those policies and procedures that:
M. “SEC” means, for the purposes of this regulation, the United States Securities and Exchange Commission.
N. “Section 404” means, for the purposes of this regulation, Section 404 of the Sarbanes-Oxley Act of 2002 and the SEC’s rules and regulations promulgated thereunder.
O. “Section 404 Report” means, for the purposes of this regulation, management’s report on “internal control over financial reporting” as defined by the SEC and the related attestation report of the independent certified public accountant as described in Section 4.A.
P. “SOX Compliant Entity” means an entity that either is required to be compliant with, or voluntarily is compliant with, all of the following provisions of the Sarbanes- Oxley Act of 2002: (i) the preapproval requirements of Section 201 (Section 10A(i) of the Securities Exchange Act of 1934);
A. All companies shall have an annual audit by an independent certified public accountant and shall file an audited financial report with the Commissioner on or before June 1 for the year ended December 31 immediately preceding. The Commissioner may require a company to file an audited financial report earlier than June 1 with ninety (90) days advance notice to the company.
B. Extensions of the June 1 filing date may be granted by the Commissioner for thirty day periods upon a showing by the company and its independent certified public accountant of the reasons for requesting an extension and determination by the Commissioner of good cause for an extension. The request for extension must be submitted in writing not less than ten (10) days prior to the due date in sufficient detail to permit the Commissioner to make an informed decision with respect to the requested extension.
C. If an extension is granted in accordance with the provisions in Section 5.B., a similar extension of thirty (30) days is granted to the filing of Management’s Report of Internal Control over Financial Reporting.
D. Every company required to file an annual audited financial report pursuant to this regulation shall designate a group of individuals as constituting its audit committee, as defined in Section 4. The audit committee of an entity that controls a company may be deemed to be the company’s audit committee for purposes of this regulation at the election of the controlling person. Section 6 Contents of Annual Audited Financial Report The annual audited financial report shall report the financial position of the company as of the end of the most recent calendar year and the results of its operations, cash flows and changes in capital and surplus for the year then ended, in conformity with statutory accounting practices prescribed, or otherwise permitted, by the Department of Insurance of the state of domicile. The annual audited financial report shall include the following:
A. Report of independent certified public accountant.
B. Balance sheet reporting admitted assets, liabilities, capital and surplus.
C. Statement of operations.
D. Statement of cash flow.
E. Statement of changes in capital and surplus.
F. Notes to financial statements. These notes shall be those required by the appropriate NAIC Annual Statement Instructions and the NAIC Accounting Practices and Procedures Manual. The notes shall include a reconciliation of differences, if any, between the audited statutory financial statements and the annual statement filed pursuant to §§10-3-109, 10-3-208, 10-5-110, 10-6-114, 10-14-602, 10-16-111 or 8-45-117, C.R.S., with a written description of the nature of these differences.
G. The financial statements included in the audited financial report shall be prepared in a form and using language and groupings substantially the same as the relevant sections of the annual statement of the company filed with the Commissioner, and the financial statement shall be comparative, presenting the amounts as of December 31 of the current year and the amounts as of the immediately preceding December 31. However, in the first year in which a company is required to file an audited financial report, the comparative data may be omitted. Section 7 Designation of Independent Certified Public Accountant A. Each company required by this regulation to file an annual audited financial report must within sixty (60) days after becoming subject to the requirement, register with the Commissioner in writing the name and address of the independent certified public accountant or accounting firm retained to conduct the annual audit set forth in this regulation. Companies not retaining an independent certified public accountant on the effective date of this regulation shall register the name and address of their retained independent certified public accountant not less than six (6) months before the date when the first audited financial report is to be filed.
B. The company shall obtain a letter from the accountant, and file a copy with the Commissioner stating that the accountant is aware of the provisions of the insurance code and the regulations of the insurance department of the state of domicile that relate to accounting and financial matters and affirming that the accountant will express his or her opinion on the financial statements in terms of their conformity to the statutory accounting practices prescribed or otherwise permitted by that insurance department, specifying such exceptions as he or she may believe appropriate.
C. If an accountant who was the accountant for the immediately preceding filed audited financial report is dismissed or resigns, the company shall within five (5) business days notify the Commissioner of this event. The company shall also furnish the Commissioner with a separate letter within ten (10) business days of the above notification stating whether in the twenty-four
Section 8 Qualifications of Independent Certified Public Accountant A. The Commissioner shall not recognize a person or firm as a qualified independent certified public accountant if the person or firm:
B. Except as otherwise provided in this regulation, the Commissioner shall recognize an independent certified public accountant as qualified as long as he or she conforms to the standards of his or her profession as contained in the Code of Professional Ethics of the American Institute of Certified Public Accountants, and the Rules and Regulations and Code of Ethics and Rules of Professional Conduct of the Colorado State Board of Accountancy.
C. A qualified independent certified public accountant may enter into an agreement with a company to have disputes relating to an audit resolved by mediation or arbitration. However, in the event of a delinquency proceeding commenced against the company under §10-3-401, et seq., C.R.S., the mediation or arbitration provisions shall operate at the option of the statutory successor.
D. The lead (or coordinating) audit partner (having primary responsibility for the audit) may not act in that capacity for more than five (5) consecutive years. The person shall be disqualified from acting in that or a similar capacity for the same company or its insurance subsidiaries or affiliates for a period of five (5) consecutive years. A company may make application to the Commissioner for relief from the above rotation requirement on the basis of unusual circumstances. This application should be made at least thirty (30) days before the end of the calendar year. The Commissioner may consider the following factors in determining if the relief should be granted:
E. The insurer shall file, with its annual statement filing, the approval for relief from Subsection D.1. with the states that it is licensed in or doing business in and with the NAIC. If the nondomestic state accepts electronic filing with the NAIC, the insurer shall file the approval in an electronic format acceptable to the NAIC.
F. The Commissioner shall neither recognize as a qualified independent certified public accountant, nor accept an annual audited financial report, prepared in whole or in part by, a natural person who:
G. The Commissioner of insurance may hold a hearing to determine whether an independent certified public accountant is qualified and, considering the evidence presented, may rule that the accountant is not qualified for purposes of expressing his or her opinion on the financial statements in the annual audited financial report made pursuant to this regulation and require the company to replace the accountant with another whose relationship with the company is qualified within the meaning of this regulation.
H. The Commissioner shall not recognize as a qualified independent certified public accountant, nor accept an annual audited financial report, prepared in whole or in part by an accountant who provides to a company, contemporaneously with the audit, the following non-audit services:
I. In general, the principles of independence with respect to services provided by the qualified independent certified public accountant are largely predicated on three basic principles, violations of which would impair the accountant’s independence. The principles are that the accountant cannot function in the role of management, cannot audit his or her own work, and cannot serve in an advocacy role for the company.
J. Companies having direct written and assumed premiums of less than $100,000,000 in any calendar year may request an exemption from Subsection G.1. The company shall file with the Commissioner a written statement discussing the reasons why the company should be exempt from these provisions. If the Commissioner finds, upon review of this statement, that compliance with this regulation would constitute a financial or organizational hardship upon the company, an exemption may be granted.
K. A qualified independent certified public accountant who performs the audit may engage in other non-audit services, including tax services, that are not described in Subsection G.1. or that do not conflict with Subsection G.2.), only if the activity is approved in advance by the Audit committee, in accordance with Subsection J.
L. All auditing services and non-audit services provided to a company by the qualified independent certified public accountant of the company shall be preapproved by the Audit committee. The preapproval requirement is waived with respect to non-audit services if the company is a SOX Compliant Entity or a direct or indirect wholly-owned subsidiary of a SOX Compliant Entity or:
M. The Audit committee may delegate to one or more designated members of the Audit committee the authority to grant the preapprovals required by Subsection J. The decisions of any member to whom his authority is delegated shall be presented to the full Audit committee at each of its scheduled meetings.
N. The Commissioner shall not recognize an independent certified public accountant as qualified for a particular company if a member of the board, president, chief executive officer, controller, chief financial officer, chief accounting officer, or any person serving in an equivalent position for that company, was employed by the independent certified public accountant and participated in the audit of that company during the one-year period preceding the date that the most current statutory opinion is due. This section shall only apply to partners and senior managers involved in the audit. A company may make application to the Commissioner for relief from the above requirement on the basis of unusual circumstances.
O. The company shall file, with its annual statement filing, the approval for relief from Subsection L.1. with the states that it is licensed in or doing business in and the NAIC. If the nondomestic state accepts electronic filing with the NAIC, the company shall file the approval in an electronic format acceptable to the NAIC.
Section 9 Consolidated or Combined Audits A company may make written application to the Commissioner for approval to file audited consolidated or combined financial statements in lieu of separate annual audited financial statements if the insurer is part of a group of insurance companies that utilizes a pooling or one hundred percent (100%) reinsurance agreement that affects the solvency and integrity of the company’s reserves and the company cedes all of its direct and assumed business to the pool. In such cases, a columnar consolidating or combining worksheet shall be filed with the report, as follows:
A. Amounts shown on the consolidated or combined audited financial report shall be shown on the worksheet;
B. Amounts for each company subject to this section shall be stated separately;
C. Noninsurance operations may be shown on the worksheet on a combined or individual basis;
D. Explanations of consolidating and eliminating entries shall be included; and E. A reconciliation shall be included of any differences between the amounts shown in the individual company columns of the worksheet and comparable amounts shown on the annual statements of the companies.
Section 10 Scope of Audit and Report of Independent Certified Public Accountant Financial statements furnished pursuant to Section 6 shall be examined by the independent certified public accountant. The audit of the company’s financial statements shall be conducted in accordance with generally accepted auditing standards. In accordance with AU Section 319 of the Professional Standards of the AICPA, Consideration of Internal Control in a Financial Statement Audit, the independent certified public accountant should obtain an understanding of internal control sufficient to plan the audit. To the extent required by AU 319, for those companies required to file a Management’s Report of Internal Control over Financial Reporting pursuant to Section 18, the independent certified public accountant should consider (as that term is defined in Statement on Auditing Standards (SAS) No. 102, Defining Professional Requirements in Statements on Auditing Standards or its replacement) the most recently available report in planning and performing the audit of the statutory financial statements. Consideration shall be given to the procedures illustrated in the Financial Condition Examiners Handbook promulgated by the National Association of Insurance Commissioners as the independent certified public accountant deems necessary.
Section 11 Notification of Adverse Financial Condition A. The company required to furnish the annual audited financial report shall require the independent certified public accountant to report, in writing, within five (5) business days to the board of directors or its Audit committee any determination by the independent certified public accountant that the company has materially misstated its financial condition as reported to the Commissioner as of the balance sheet date currently under audit or that the company does not meet the minimum capital and surplus requirement of the Colorado insurance code as of that date. A company that has received a report pursuant to this paragraph shall forward a copy of the report to the Commissioner within five (5) business days of receipt of the report and shall provide the independent certified public accountant making the report with evidence of the report being furnished to the Commissioner. If the independent certified public accountant fails to receive the evidence within the required five (5) business day period, the independent certified public accountant shall furnish to the Commissioner a copy of its report within the next five (5) business days.
B. No independent certified public accountant shall be liable in any manner to any person for any statement made in connection with the above paragraph if the statement is made in good faith in compliance with Subsection A.
C. If the accountant, subsequent to the date of the audited financial report filed pursuant to this regulation, becomes aware of facts that might have affected his or her report, the Commissioner notes the obligation of the accountant to take such action as prescribed in Volume 1, AU Section 561 of the Professional Standards of the AICPA.
Section 12 Communication of Internal Control Related Matters Noted in an Audit A. In addition to the annual audited financial report, each company shall furnish the Commissioner with a written communication as to any unremediated material weaknesses in its internal control over financial reporting noted during the audit. Such communication shall be prepared by the accountant within sixty (60) days after the filing of the annual audited financial report, and shall contain a description of any unremediated material weakness as of December 31 immediately preceding (so as to coincide with the audited financial report discussed in Section 5.A.) in the company’s internal control over financial reporting noted by the accountant during the course of their audit of the financial statements. If no unremediated material weaknesses were noted, the communication should so state. The term material weakness is defined by Statement on Auditing Standard 60, Communication of Internal Control Related Matters Noted in an Audit.
B. The company is required to provide a description of remedial actions taken or proposed to correct unremediated material weaknesses, if the actions are not described in the accountant’s communication.
Section 13 Accountant’s Letter of Qualifications The accountant shall furnish the company in connection with, and for inclusion in, the filing of the annual audited financial report, a letter stating:
A. That the accountant is independent with respect to the company and conforms to the standards of his or her profession as contained in the Code of Professional Ethics and pronouncements of the American Institute of Certified Public Accountants, and the Rules of Professional Conduct of the Colorado State Board of Accountancy;
B. The background and experience in general, and the experience in audits of companies of the staff assigned to the engagement and whether each is an independent certified public accountant. Nothing within this regulation shall be construed as prohibiting the accountant from utilizing such staff as he or she deems appropriate where use is consistent with the standards prescribed by generally accepted auditing standards;
C. That the accountant understands the annual audited financial report and his opinion thereon will be filed in compliance with this regulation and that the Commissioner will be relying on this information in the monitoring and regulation of the financial position of companies;
D. That the accountant consents to the requirements of Section 14 of this regulation and that the accountant consents and agrees to make available for review by the Commissioner, or the Commissioner’s designee or appointed agent, the workpapers, as defined in Section 14;
E. A representation that the accountant is properly licensed by an appropriate state licensing authority and is a member in good standing in the AICPA; and F. A representation that the accountant is in compliance with the requirements of Section 8 of this regulation.
Section 14 Definition, Availability and Maintenance of Independent Certified Public Accountants Workpapers A. Workpapers are the records kept by the independent certified public accountant of the procedures followed, the tests performed, the information obtained, and the conclusions reached pertinent to the accountant’s audit of the financial statements of a company. Workpapers, accordingly, may include audit planning documentation, work programs, analyses, memoranda, letters of confirmation and representation, abstracts of company documents and schedules or commentaries prepared or obtained by the independent certified public accountant in the course of his or her audit of the financial statements of a company and which support the accountant’s opinion.
B. Every company required to file an audited financial report pursuant to this regulation, shall require the accountant to make available for review by insurance department examiners, all workpapers prepared in the conduct of the accountant’s audit and any communications related to the audit between the accountant and the company, at the offices of the company, at the insurance department or at any other reasonable place designated by the Commissioner. The company shall require that the accountant retain the audit workpapers and communications until the insurance department has filed a report on examination covering the period of the audit but no longer than seven (7) years from the date of the audit report.
C. In the conduct of the aforementioned periodic review by the Division examiners, it shall be agreed that photocopies of pertinent audit workpapers may be made and retained by the Division. Such reviews by the Division examiners shall be considered investigations and all working papers and communications obtained during the course of such investigations shall be afforded the same confidentiality as other examination workpapers generated by the Division. Section 15 Requirements for Audit Committees This section shall not apply to foreign or alien insurers licensed in this state or a company that is a SOX Compliant Entity or a direct or indirect wholly-owned subsidiary of a SOX Compliant Entity.
A. The Audit committee shall be directly responsible for the appointment, compensation and oversight of the work of any accountant (including resolution of disagreements between management and the accountant regarding financial reporting) for the purpose of preparing or issuing the audited financial report or related work pursuant to this regulation. Each accountant shall report directly to the Audit committee.
B. The Audit committee of a company or group of insurers shall be responsible for overseeing the company’s internal audit function and granting the person or persons performing the function suitable authority and resources to fulfill their responsibilities if required by Section 16 of this regulation.
C. Each member of the Audit committee shall be a member of the board of directors of the company or a member of the board of directors of an entity elected pursuant to Subsection F. and Section 4.C.
D. In order to be considered independent for purposes of this section, a member of the Audit committee may not, other than in his or her capacity as a member of the Audit committee, the board of directors, or any other board committee, accept any consulting, advisory or other compensatory fee from the entity or be an affiliated person of the entity or any subsidiary thereof. However, if law requires board participation by otherwise non-independent members, that law shall prevail and such members may participate in the Audit committee and be designated as independent for Audit committee purposes, unless they are an officer or employee of the company or one of its affiliates.
E. If a member of the Audit committee ceases to be independent for reasons outside the member’s reasonable control, that person, with notice by the responsible entity to the state, may remain an Audit committee member of the responsible entity until the earlier of the next annual meeting of the responsible entity or one year from the occurrence of the event that caused the member to be no longer independent.
F. To exercise the election of the controlling person to designate the Audit committee for purposes of this regulation, the ultimate controlling person shall provide written notice to the Commissioners of the affected companies. Notification shall be made timely prior to the issuance of the statutory audit report and include a description of the basis for the election. The election can be changed through notice to the Commissioner by the company, which shall include a description of the basis for the change. The election shall remain in effect for perpetuity, until rescinded.
G. The Audit committee shall require the accountant that performs for a company any audit required by this regulation to timely report to the Audit committee in accordance with the requirements of SAS No. 61, Communication With Audit Committees, including:
H. If a company is a member of an insurance holding company system, the reports required by Subsection G. may be provided to the Audit committee on an aggregate basis for companies in the holding company system, provided that any substantial differences among companies in the system are identified to the Audit committee.
I. The proportion of independent Audit committee members shall meet or exceed the following criteria:
J. A company with direct written and assumed premium, excluding premiums reinsured with the Federal Crop Insurance Corporation and Federal Flood Program, less than $500,000,000 may make application to the Commissioner for a waiver from the Section 15 requirements based upon hardship. The company shall file, with its annual statement filing, the approval for relief from Section 15 with the states that it is licensed in or doing business in and the NAIC. If the nondomestic state accepts electronic filing with the NAIC, the company shall file the approval in an electronic format acceptable to the NAIC.
Section 16 Internal Audit Function Requirements A. Exemption – A company is exempt from the requirements of this section if:
B. Function – The company or group of insurers shall establish an internal audit function providing independent, objective and reasonable assurance to the Audit committee and company management regarding the company’s governance, risk management and internal controls. This assurance shall be provided by performing general and specific audits, reviews and tests and by employing other techniques deemed necessary to protect assets, evaluate control effectiveness and efficiency, and evaluate compliance with policies and regulations.
C. Independence – In order to ensure that internal auditors remain objective, the internal control function must be organizationally independent. Specifically, the internal control function will not defer ultimate judgement on audit matters to others, and shall appoint an individual to head the internal audit function who will have direct and unrestricted access to the board of directors. Organizational independence does not preclude dual-reporting relationships.
D. Reporting – The head of the internal audit function shall report to the Audit committee regularly, but no less than annually, on the periodic audit plan, factors that may adversely impact the internal audit function’s independence or effectiveness, material findings from completed audits and the appropriateness of corrective actions implemented by management as a result of audit findings.
E. Additional Requirements – If a company is a member of an insurance holding company system or included in a group of insurers, the company may satisfy the internal audit function requirements set forth in this section at the ultimate controlling parent level, an intermediate holding company level or the individual legal entity level.
Section 17 Conduct of Company in Connection with the Preparation of Required Reports and Documents A. No director or officer of a company shall, directly or indirectly:
B. No officer or director of a company, or any other person acting under the direction thereof, shall directly or indirectly take any action to coerce, manipulate, mislead or fraudulently influence any accountant engaged in the performance of an audit pursuant to this regulation if that person knew or should have known that the action, if successful, could result in rendering the company’s financial statements materially misleading.
C. For purposes of Subsection B of this section, actions that, “if successful, could result in rendering the company’s financial statements materially misleading” include, but are not limited to, actions taken at any time with respect to the professional engagement period to coerce, manipulate, mislead or fraudulently influence an accountant:
A. Every company required to file an audited financial report pursuant to this regulation that has annual direct written and assumed premiums, excluding premiums reinsured with the Federal Crop Insurance Corporation and Federal Flood Program, of $500,000,000 or more shall prepare a report of the company’s or group of insurers’ internal control over financial reporting, as these terms are defined in Section 4. The report shall be filed with the Commissioner along with the Communication of Internal Control Related Matters Noted in an Audit described under Section 12. Management’s Report of Internal Control over Financial Reporting shall be as of December 31 immediately preceding.
B. Notwithstanding the premium threshold in Subsection A, the Commissioner may require a company to file Management’s Report of Internal Control over Financial Reporting if the company is in any RBC level event, or meets any one or more of the standards of a company deemed to be in hazardous financial condition as defined in § 10-1-110, C.R.S.
C. A company or a group of insurers may file its or its parent’s Section 404 Report and an addendum in satisfaction of this Section 18 requirement provided that those internal controls of the company or group of insurers having a material impact on the preparation of the company’s or group of insurers’ audited statutory financial statements (those items included in Section 6.B. through 6.G. of this regulation) were included in the scope of the Section 404 Report. The addendum shall be a positive statement by management that there are no material processes with respect to the preparation of the company’s or group of insurers’ audited statutory financial statements (those items included in Section 6.B. through 6.G. of this regulation) excluded from the Section 404 Report. If there are internal controls of the company or group of insurers that have a material impact on the preparation of the company’s or group of insurers’ audited statutory financial statements and those internal controls were not included in the scope of the Section 404 Report, the company or group of insurers may either file (i) a Section 18 report, or (ii) the Section 404 Report and a Section 18 report for those internal controls that have a material impact on the preparation of the company’s or group of insurers’ audited statutory financial statements not covered by the Section 404 Report if the company or group of insurers are:
D. Management’s Report of Internal Control over Financial Reporting shall include:
E. Management shall document and make available upon financial condition examination the basis upon which its assertions, required in Subsection D above, are made. Management may base its assertions, in part, upon its review, monitoring and testing of internal controls undertaken in the normal course of its activities.
A. Upon written application of any company, the Commissioner may grant an exemption from compliance with any and all provisions of this regulation if the Commissioner finds, upon review of the application, that compliance with this regulation would constitute a financial or organizational hardship upon the company. An exemption may be granted at any time and from time to time for a specified period or periods. Within ten (10) days from a denial of a company’s written request for an exemption from this regulation, the company may request in writing a hearing on its application for an exemption.
B. Domestic companies retaining a certified public accountant on the effective date of this regulation who qualifies as independent shall comply with this regulation for the year ending December 31, 2009 and each year thereafter unless the Commissioner permits otherwise.
C. Domestic companies not retaining a certified public accountant on the effective date of this regulation who qualifies as independent may meet the following schedule for compliance unless the Commissioner permits otherwise.
D. Foreign insurers shall comply with this regulation for the year ending December 31, 2010, and each year thereafter, unless the Commissioner permits otherwise.
E. The requirements of Section 8.D. shall be in effect for audits of the year beginning January 1, 2010, and thereafter.
F. The requirements of Section 15 are to be in effect January 1, 2010. A company or group of insurers that is not required to have independent Audit committee members or only a majority of independent Audit committee members (as opposed to a supermajority) because the total written and assumed premium is below the threshold and subsequently becomes subject to one of the independence requirements due to changes in premium shall have one (1) year following the year the threshold is exceeded (but not earlier than January 1, 2010) to comply with the independence requirements. Likewise, a company that becomes subject to one of the independence requirements as a result of a business combination shall have one (1) calendar year following the date of acquisition or combination to comply with the independence requirements.
G. The requirements of Section 18, and Sections 4, 5, 6, 7, 8, 10, 11, 12, 13, 14, 17, and 20, are effective beginning with the reporting period ending December 31, 2010 and each year thereafter. A company or group of insurers that is not required to file a report because the total written premium is below the threshold and subsequently becomes subject to the reporting requirements shall have two (2) years following the year the threshold is exceeded (but not earlier than December 31, 2010) to file a report. Likewise, a company acquired in a business combination shall have two (2) calendar years following the date of acquisition or combination to comply with the reporting requirements.
H. The requirements of Section 16 go into effect on January 1, 2017. If a company or group of insurers that is exempt from the requirements contained in Section 16 no longer qualifies for that exemption, it shall have one year after the year the threshold is exceeded to comply with the requirements of this article.
Section 20 Canadian and British Companies A. In the case of Canadian and British insurers, the annual audited financial report shall be defined as the annual statement of total business on the form filed by such companies with their supervision authority duly audited by an independent chartered accountant.
B. For such insurers, the letter required in Section 7.B. shall state that the accountant is aware of the requirements relating to the annual audited financial report filed with the Commissioner pursuant to Section 5 and shall affirm that the opinion expressed is in conformity with those requirements. Section 21 Severability Provision If any provision of this regulation or the application of it to any person or circumstance is for any reason held to be invalid, the remainder of this regulation shall not be affected. Section 22 Incorporated Materials The Sarbanes-Oxley Act of 2002 (Public Law 107-204, 116 Stat. 745, enacted July 30, 2002), published in United States federal law shall mean Public Law 107-204, 116 Stat. 745, enacted July 30, 2002, as published on the effective date of this regulation and does not include later amendments to or editions of Public Law 107-204, 116 Stat. 745, enacted July 30, 2002. A copy of Public Law 107-204, 116 Stat. 745, enacted July 30, 2002 may be examined during regular business hours at the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, Colorado, 80202. A Certified copy of Public Law 107-204, 116 Stat. 745, enacted July 30, 2002 may be requested from the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, Colorado, 80202. A charge for certification or copies may apply. The AU Section 319, published by Auditing Standards Board of the American Institute of Certified Public Accountants shall mean AU Section 319 as published on the effective date of this regulation and does not include later amendments to or editions of AU Section 319. A copy of the AU Section 319 may be examined during regular business hours at the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, Colorado, 80202. A Certified copy of AU Section 319 may be requested from the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, Colorado, 80202. A charge for certification or copies may apply.
The Statement on Auditing Standards (SAS) No. 102, published by Auditing Standards Board of the American Institute of Certified Public Accountants shall mean SAS No. 102 as published on the effective date of this regulation and does not include later amendments to or editions of SAS No. 102. A copy of the SAS No. 102 may be examined during regular business hours at the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, Colorado, 80202. A Certified copy of SAS No. 102 may be requested from the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, Colorado, 80202. A charge for certification or copies may apply.
The AU Section 561, published by Auditing Standards Board of the American Institute of Certified Public Accountants shall mean AU Section 561 as published on the effective date of this regulation and does not include later amendments to or editions of AU Section 561. A copy of the AU Section 561 may be examined during regular business hours at the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, Colorado, 80202. A Certified copy of AU Section 561 may be requested from the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, Colorado, 80202. A charge for certification or copies may apply.
The Statement on Auditing Standards (SAS) No. 60, published by Auditing Standards Board of the American Institute of Certified Public Accountants shall mean SAS No. 60 as published on the effective date of this regulation and does not include later amendments to or editions of SAS No. 60. A copy of the SAS No. 60 may be examined during regular business hours at the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, Colorado, 80202. A Certified copy of SAS No. 60 may be requested from the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, Colorado, 80202. A charge for certification or copies may apply.
The Statement on Auditing Standards (SAS) No. 61, published by Auditing Standards Board of the American Institute of Certified Public Accountants shall mean SAS No. 61 as published on the effective date of this regulation and does not include later amendments to or editions of SAS No. 61. A copy of the SAS No. 61 may be examined during regular business hours at the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, Colorado, 80202. A Certified copy of SAS No. 61 may be requested from the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, Colorado, 80202. A charge for certification or copies may apply.
Section 23 Enforcement Noncompliance with this regulation may result in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance, or other laws, which include the imposition of civil penalties, issuance of cease and desist orders, and/or suspensions or revocation of license, subject to the requirements of due process.
Section 24 Effective Date This regulation shall become effective January 1, 2017. Section 25 History This regulation was originally effective December 31, 1990. Amended regulation effective January 31, 1994.
Amended regulation effective April 1, 2001.
Repealed and repromulgated January 30, 2007.
Repealed and repromulgated January 1, 2010.
Amended regulation effective January 1, 2017.
Regulation 3-1-5 CONCERNING ENTERPRISE ZONE CREDIT AGAINST PREMIUM TAX Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Filing Requirements Section 5 Severability Section 6 Enforcement Section 7 Effective Date Section 8 History Section 1 Authority This regulation is promulgated under the authority of Sections 10-1-109, and 39-30-108(2), Colorado Revised Statutes Section 2 Scope and Purpose The purpose of this regulation is to assure the orderly implementation of the premium tax credit provisions set forth in the Urban and Rural Enterprise Zone Act. This regulation sets forth the criteria for filing and documenting a claim for credit or refund of premium tax. Section 3 Applicability This regulation shall apply to any taxpayer who is subject to the tax on insurance premiums established by § § 10-3-209, 10-5-111, and 10-6-128, C.R.S. and who is eligible to claim a credit or refund pursuant to Article 30 of Title 39, Colorado Revised Statutes.
Section 4 Filing Requirements Each taxpayer seeking to claim a credit or refund of premium tax must file the tax form prescribed by the commissioner of insurance. Each such filing must be for the calendar year, and such filing must be received on or before March 1. In addition to the prescribed form, when an enterprise zone credit or refund is sought, a supplementary schedule must be attached to the tax form. This schedule shall itemize and describe each claim for credit or refund and include a statutory citation referencing the pertinent section of Article 30 of Title 39, Colorado Revised Statutes that permits each claim or refund. This schedule shall be attested to by an officer of the company and contain, in a prominent location, the full company name, NAIC company number (if any), corporate seal, printed name and title of officer attesting to the correctness of the claim.
The value of the credit sought shall be further supported by an original certificate issued by the enterprise zone administrator. This certification shall set forth both the value and purpose of the related expenditure for which credit or refund is sought.
Section 5 Severability If any provision of this regulation or the application of it to any person or circumstance is for any reason held to be invalid, the remainder of this regulation shall not be affected. Section 6 Enforcement Noncompliance with this regulation may result in the imposition of the sanctions made available in the Colorado statutes pertaining to the business of insurance or other laws, which include the imposition of fines issuance of cease and desist orders, and/or suspensions or revocation of license. Section 7 Effective Date This amended regulation shall become effective on September 1, 2012 Section 8 History Original regulation effective December 31, 1990 Amended regulation effective September 1, 2012 Regulation 3-1-6 Repealed eff. 10/02/2006 Regulation 3-1-7 REGULATION TO DEFINE STANDARDS AND COMMISSIONER’S AUTHORITY FOR COMPANIES DEEMED TO BE IN HAZARDOUS FINANCIAL CONDITION Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Standards Section 5 Commissioner's Authority Section 6 Severability Section 7 Enforcement Section 8 Effective Date Section 9 History Section 1 Authority This regulation is promulgated under the authority of § § 10-1-109, 10-3-201(1)(b), 10-6-129, 10-14-505, and 10-16-109, C.R.S.
Section 2 Scope and Purpose The purpose of this regulation is to set forth the standards which the Commissioner of Insurance may use for identifying insurers found to be in such condition as to render the continuance of their business hazardous to their policyholders, creditors or the general public. This regulation shall not be interpreted to limit the powers granted the Commissioner by any laws or parts of laws of this state, nor shall this regulation be interpreted to supersede any laws or parts of laws of this state. Section 3 Applicability This regulation shall apply to all Colorado licensed insurers as well as to each Colorado licensed group captive insurer, fraternal benefit society, health maintenance organization, prepaid dental care plan organization, and non-profit hospital, medical-surgical and health service corporation. Section 4 Standards The following standards, either singly or a combination of two or more, may be considered by the Commissioner to determine whether the continued operation of any company in this state might be deemed to be hazardous to its policyholders, creditors or the general public. The Commissioner may consider, but is not limited to, the following:
A. Adverse findings reported in financial condition and market conduct examination reports, audit reports, and actuarial opinions, reports or summaries;
B. The National Association of Insurance Commissioners Insurance Regulatory Information System and its other financial solvency tools and reports;
C. Whether the company has made adequate provision, according to presently accepted actuarial standards of practice, for the anticipated cash flows required by the contractual obligations and related expenses of the company, when considered in light of the assets held by the company with respect to such reserves and related actuarial items including, but not limited to, the investment earnings on such assets, and the considerations anticipated to be received and retained under such policies and contracts;
D. The ability of an assuming reinsurer to perform and whether the company's reinsurance program provides sufficient protection for the company's remaining surplus after taking into account the company's cash flow and the classes of business written as well as the financial condition of the assuming reinsurer;
E. The company's operating loss in the last twelve month period or any shorter period of time, including but not limited to net capital gain or loss, or its change in non-admitted assets, and cash dividends paid to shareholders, is greater than 50% of such company's remaining surplus as regards policyholders in excess of the minimum required;
F. Whether the insurer's operating loss in the last twelve-month period or any shorter period of time, excluding net capital gains, is greater than 20% of the insurer's remaining surplus as regards policyholders in excess of the minimum required;
G Whether a reinsurer, obligor or any entity within the company’s holding company system, is insolvent, threatened with insolvency or delinquent in payment of its monetary or other obligations, and which in the opinion of the Commissioner may affect the solvency of the company;
H. Contingent liabilities, pledges or guarantees which, either individually or collectively, involve a total amount which in the opinion of the Commissioner may affect the solvency of the company;
I. Whether any “controlling person” of a company is delinquent in transmitting to, or payment of, net premiums or other amounts to such company;
J. The age and collectability of receivables;
K. Whether the management of a company, including officers, directors, or any other person who directly or indirectly controls the operation of such company, fails to possess and demonstrate the competence, fitness and reputation deemed necessary to serve the company in such position;
L. Whether management of a company has failed to respond to inquiries relative to the condition of the company or has furnished false and misleading information concerning an inquiry; M Whether the company has failed to meet financial and holding company filing requirements in the absence of a reason satisfactory to the Commissioner;
N. Whether management of a company either has filed any false or misleading sworn financial statement, or has released a false or misleading financial statement to lending institutions or to the general public, or has made a false or misleading entry, or has omitted an entry of material amount in the books of the company;
O. Whether the company has grown so rapidly and to such an extent that it lacks adequate financial and administrative capacity to meet its obligations in a timely manner;
P. Whether the company has experienced or will experience in the foreseeable future cash flow and/or liquidity problems;
Q. Whether management has established reserves that do not comply with minimum standards established by state insurance laws, regulations, statutory accounting standards, sound actuarial principles and standards of practice;
R. Whether management persistently engages in material under-reserving that results in adverse development;
S. Whether transactions among affiliates, subsidiaries or controlling persons for which the company receives assets or capital gains, or both, do not provide sufficient value, liquidity or diversity to assure the company's ability to meet its outstanding obligations as they mature;
T. Any other finding determined by the Commissioner to be hazardous to the company’s policyholders, creditors or general public.
Section 5 Commissioner's Authority A. For the purposes of making a determination of a company's financial condition under this regulation, the Commissioner may, among other things:
B. If the Commissioner determines that the continued operation of the company licensed to transact business in this state may be hazardous to the policyholders, creditors or the general public, then the Commissioner may, upon a determination, furnish the company with a written explanation of the concerns, request additional information, if necessary, to conclude the investigation or determination and request the position of the company with regard to such findings. The Commissioner may provide a written list of requirements for the company to abate the situation. Alternatively, the company may offer a plan of abatement for review and approval by the Commissioner. Examples of corrective measures or monitoring that the Commissioner may consider include, but are not limited to requiring the company to:
12 Notwithstanding any other provision of law limiting the frequency or amount of premium rate adjustments, adjust rates for any non-life insurance product written by the company that the Commissioner considers necessary to improve the financial condition of the company.
Section 6 Severability If any provision of this regulation or the application of it to any person or circumstance is for any reason held to be invalid, the remainder of this regulation shall not be affected. Section 7 Enforcement Noncompliance with this regulation may result in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance, or other laws, which include the imposition of civil penalties, issuance of cease and desist orders, and/or suspensions or revocation of license, subject to the requirements of due process.
Section 8 Effective Date This amended regulation shall become effective May 1, 2013. Section 9 History Amended, Effective October 1, 1992 Amended, Effective April 1, 2001 Amended, Effective December 1, 2012 Amended, Effective May 1, 2013 Regulation 3-1-8 CONCERNING ACTUARIAL OPINIONS AND MEMORANDUMS FOR LIFE COMPANIES AND FRATERNAL BENEFIT SOCIETIES Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Definitions Section 5 General Requirements Section 6 Statement of Actuarial Opinion Based On Asset Adequacy Analysis Section 7 Description of Actuarial Memorandum Including an Asset Adequacy Analysis and Regulatory Asset Adequacy Issues Summary Section 8 Severability Section 9 Enforcement Section 10 Effective Date Section 11 History Section 1 Authority This regulation is promulgated and adopted by the Commissioner of Insurance under the authority of §§10-1-108(7), 10-1-109, 10-7-114, and 10-14-505, C.R.S. Section 2 Scope and Purpose The purpose of this regulation is to prescribe:
A. Guidelines and standards for statements of actuarial opinion, which are to be submitted in accordance with §§10-7-114 and 10-14-602, C.R.S. and for memorandums submitted in support thereof;
B. Rules applicable to the appointment of an appointed actuary; and C. Guidance as to the meaning of “adequacy of reserves.” Section 3 Applicability This regulation shall apply to all life insurance companies and fraternal benefit societies doing business in this State and to all life insurance companies and fraternal benefit societies that are authorized to reinsure life insurance, annuities or accident and health insurance business in this State. This regulation shall be applied in a manner that allows the appointed actuary to utilize his or her professional judgment in performing the asset adequacy analysis and developing the actuarial opinion and supporting memoranda, consistent with relevant actuarial standards of practice. However, the Commissioner shall have the authority to specify specific methods of actuarial analysis and actuarial assumptions when, in the Commissioner’s judgment, these specifications are necessary for an acceptable opinion to be rendered relative to the adequacy of reserves and related items; see Section 7.D. of this regulation for requirements specific to companies domiciled in the State of Colorado. This regulation shall be applicable to all annual statements filed with the office of the Commissioner after the effective date of this regulation. A statement of opinion on the adequacy of the reserves and related actuarial items based on an asset adequacy analysis in accordance with Section 6. of this regulation, and a memorandum in support thereof in accordance with Section 7. of this regulation, shall be required each year.
Section 4 Definitions A. “Actuarial Opinion” means, for the purposes of this regulation, the opinion of an appointed actuary regarding the adequacy of the reserves and related actuarial items based on an asset adequacy analysis in accordance with Section 6. of this regulation and with applicable Actuarial Standards of Practice.
B. “Actuarial Standards Board” means, for the purposes of this regulation, the board established by the American Academy of Actuaries to develop and promulgate actuarial standards of practice.
C. “Actuarial Standards of Practice” means, for the purposes of this regulation, the Actuarial Standards of Practice and Compliance Guidelines as promulgated by the Actuarial Standards Board.
D. “Annual statement” means, for the purposes of this regulation, that statement required by §§10-3- 208 and 10-14-602, C.R.S. to be filed annually, by the company, with the Commissioner.
E. “Appointed actuary” means, for the purposes of this regulation, an individual who is appointed or retained in accordance with the requirements set forth in Section 5.B. of this regulation to provide the actuarial opinion and supporting memorandum as required by this regulation and §10-7-114, C.R.S.
F. “Asset adequacy analysis” means an analysis that meets the standards and other requirements referred to in Section 5.C. of this regulation. It may take many forms, including, but not limited to, cash flow testing, sensitivity testing or applications of risk theory.
G. “Commissioner” means, for the purposes of this regulation, the Insurance Commissioner of the State of Colorado.
H. “Company” means, for the purposes of this regulation, a life insurance company, fraternal benefit society or reinsurer subject to the provisions of this regulation.
I. “Qualified actuary” means, for the purposes of this regulation, an individual who meets the requirements set forth in §10-7-114 (1.1), C.R.S.
Section 5 General Requirements A. Submission of Statement of Actuarial Opinion
B. Appointed Actuary. An “appointed actuary” is a qualified actuary who is appointed or retained to prepare the Statement of Actuarial Opinion required by this regulation, either directly by or by the authority of the board of directors through an executive officer of the company other than the qualified actuary. The company shall give the Commissioner timely written notice of the name, title (and, in the case of a consulting actuary, the name of the firm) and manner of appointment or retention of each person appointed or retained by the company as an appointed actuary and shall state in the notice that the person meets the requirements set forth in §10-7-114(1.1), C.R.S. Once notice is furnished, no further notice is required with respect to this person, provided that the company shall give the Commissioner timely written notice in the event the actuary ceases to be appointed or retained as an appointed actuary or to meet the requirements set forth in §10-7- 114(1.1), C.R.S. If any person appointed or retained as an appointed actuary replaces a previously appointed actuary, the notice shall so state and give the reasons for replacement.
C. Standards for Asset Adequacy Analysis. The asset adequacy analysis required by this regulation:
D. Liabilities to be Covered.
Section 6 Statement of Actuarial Opinion Based On Asset Adequacy Analysis A. General Description. The Statement of Actuarial Opinion submitted in accordance with this section shall consist of:
B. Recommended Language. The following paragraphs are to be included in the Statement of Actuarial Opinion in accordance with this section. Language is that which in typical circumstances should be included in a Statement of Actuarial Opinion. The language may be modified as needed to meet the circumstances of a particular case, but the appointed actuary should use language that clearly expresses his or her professional judgment. However, in any event the opinion shall retain all pertinent aspects of the language provided in this section.
A statement of reliance on other experts should be accompanied by a statement by each of the experts in the form prescribed by Section 6.E.
“My examination included such review of the actuarial assumptions and actuarial methods and of the underlying basic asset and liability records and such tests of the actuarial calculations as I considered necessary. I also reconciled the underlying basic asset and liability records to [exhibits and schedules listed as applicable] of the company’s current annual statement.”
The section shall be accompanied by a statement by each person relied upon in the form prescribed by Subsection 6.E. of this regulation.
The reserves and related items, when considered in light of the assets held by the company with respect to such reserves and related actuarial items including, but not limited to, the investment earnings on the assets, and the considerations anticipated to be received and retained under the policies and contracts, make adequate provision, according to presently accepted actuarial standards of practice, for the anticipated cash flows required by the contractual obligations and related expenses of the company.
The actuarial methods, considerations and analyses used in forming my opinion conform to the appropriate Actuarial Standards of Practice as promulgated by the Actuarial Standards Board, which standards form the basis of this statement of opinion.
This opinion is updated annually as required by statute. To the best of my knowledge, there have been no material changes from the applicable date of the annual statement to the date of the rendering of this opinion which should be considered in reviewing this opinion.”
or “The following material change(s) which occurred between the date of the statement for which this opinion is applicable and the date of this opinion should be considered in reviewing this opinion: (Describe the change or changes.)” Note: Choose one of the above two paragraphs, whichever is applicable. “The impact of unanticipated events subsequent to the date of this opinion is beyond the scope of this opinion. The analysis of asset adequacy portion of this opinion should be viewed recognizing that the company’s future experience may not follow all the assumptions used in the analysis.”
_______________________________________ Signature of Appointed Actuary _______________________________________ Address of Appointed Actuary _______________________________________ Telephone Number of Appointed Actuary _______________________________________ Date Note: This table must be included in the actuarial opinion filed. Asset Adequacy Tested Amounts—Reserves and Liabilities (a) (b) Total Formula Additional Analysis Other Amount Reserves Actuarial Method Amount (1)+(2)+(3)
Statement Item (1) Reserves (2) (3) (4)
Exhibit 5 A Life Insurance B Annuities C Supplementary Contracts Involving Life Contingencies D Accidental Death Benefit E Disability – Active F Disability – Disabled G Miscellaneous Total (Exhibit 5, Item 1, Page 3)
Exhibit 6 A Active Life Reserve B Claim Reserve Total (Exhibit 6, Item 2, Page 3)
Exhibit 7 Premium and Other Deposit Funds (Column 5, Line 14)
Guaranteed Interest Contracts (Column 2, Line 14)
Other (Column 6, Line 14)
Supplemental Contracts and Annuities Certain (Column 3, Line 14)
Dividend Accumulations or Refunds (Column 4, Line 14)
Total (Exhibit 7, Column 1, Line 14)
Exhibit 8, Part 1 Life (Page 3, Line 4.1)
Health (Page 3, Line 4.2)
Total (Exhibit 11, Part 1)
Separate Accounts (Page 3 of the Annual Statement, Line 27)
TOTAL RESERVES IMR (General Account, Page 3, Line 9.4)
Separate Accounts, (Page 3, Line 27)
AVR (Page 3, Line 24.1) (c)
Net Deferred and Uncollected Premium, (Page 2, Lines 13.1 and 13.2) Notes:
C. Assumptions for New Issues The adoption for new issues or new claims or other new liabilities of an actuarial assumption that differs from a corresponding assumption used for prior new issues or new claims or other new liabilities is not a change in actuarial assumptions within the meaning of this Section 6.
D. Adverse Opinions If the appointed actuary is unable to form an opinion, then he or she shall refuse to issue a Statement of Actuarial Opinion. If the appointed actuary’s opinion is adverse or qualified, then he or she shall issue an adverse or qualified actuarial opinion explicitly stating the reasons for the opinion. This statement should follow the scope paragraph and precede the opinion paragraph.
E. Reliance on Information Furnished by Other Persons If the appointed actuary relies on the certification of others on matters concerning the accuracy or completeness of any data underlying the actuarial opinion, or the appropriateness of any other information used by the appointed actuary in forming the actuarial opinion, the actuarial opinion should so indicate the persons the actuary is relying upon and a precise identification of the items subject to such reliance. In addition, the persons on whom the appointed actuary relies shall provide a certification that precisely identifies the items on which the person is providing information and a statement as to the accuracy, completeness or reasonableness, as applicable, of the items. This certification shall include the signature, title, company, address and telephone number of the person rendering the certification, as well as the date on which it is signed.
F. Alternate Option
G. Confidentiality. The Statement of Actuarial Opinion is not considered to be a confidential document; however, all related supporting materials and memoranda are confidential pursuant to § 10-7-114, C.R.S. and the Colorado Open Records Act (§ 24-72-201 et seq, C.R.S). Section 7 Description of Actuarial Memorandum Including an Asset Adequacy Analysis and Regulatory Asset Adequacy Issues Summary A. General
B. Details of the Memorandum Section Documenting Asset Adequacy Analysis When an actuarial opinion is provided, the memorandum shall demonstrate that the analysis has been done in accordance with the standards for asset adequacy referred to in Section 5.C. of this regulation and any additional standards under this regulation. It shall specify:
The documentation of the assumptions shall be such that an actuary reviewing the actuarial memorandum could form a conclusion as to the reasonableness of the assumptions;
C. Details of the Regulatory Asset Adequacy Issues Summary
D. Required Interest Scenarios For the purpose of performing the asset adequacy analysis required by this regulation, the qualified actuary is expected to follow all appropriate Actuarial Standards of Practice. In addition, the appointed actuary, for each Colorado domestic insurer, must consider, in any analysis incorporating cash flow testing as the basis for the asset adequacy analysis, the effect of at least the following interest rate scenarios:
E. Conformity to Standards of Practice.
F. Use of Assets Supporting the Interest Maintenance Reserve and the Asset Valuation Reserve. An appropriate allocation of assets in the amount of the interest maintenance reserve (IMR), whether positive or negative, shall be used in any asset adequacy analysis. Analysis of risks regarding asset default may include an appropriate allocation of assets supporting the asset valuation reserve (AVR); these AVR assets may not be applied for any other risks with respect to reserve adequacy. Analysis of these and other risks may include assets supporting other mandatory or voluntary reserves available to the extent not used for risk analysis and reserve support.
G. Documentation.
Section 8 Severability If any provision of this regulation or the application of it to any person or circumstance is for any reason held to be invalid, the remainder of this regulation shall not be affected. Section 9 Enforcement Noncompliance with this regulation may result in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance, or other laws, which include the imposition of civil penalties, issuance of cease and desist orders, and/or suspensions or revocation of license subject to the requirements of due process.
Section 10 Effective Date This regulation shall become effective on November 1, 2017. Section 11 History New regulation effective September 1, 1992.
Amended regulation effective September 1, 1994.
Amended regulation effective January 1, 2004.
Amended regulation effective November 1, 2010.
Amended Regulation effective November 1, 2017.
Regulation 3-1-9 MINIMUM RESERVE STANDARDS FOR INDIVIDUAL AND GROUP HEALTH INSURANCE CONTRACTS Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Definitions Section 5 Adequacy of Reserves Section 6 Categories of Reserves Section 7 Appendices Section 8 Claim Reserves Section 9 Premium Reserves Section 10 Contract Reserves Section 11 Reinsurance Section 12 Severability Section 13 Incorporated Materials Section 14 Enforcement Section 15 Effective Date Section 16 History Appendix A Specific Standards for Morbidity, Interest and Mortality Section 1 Authority This regulation is promulgated and adopted by the Commissioner of Insurance under the authority of §§ 10-1-109, 10-16-109 and 10-16-220, C.R.S.
Section 2 Scope and Purpose The purpose of this regulation is to set forth minimum standards for reserves of insurers providing individual and group health insurance.
Section 3 Applicability These standards apply to all individual and group health sickness and accident insurance coverages except credit insurance regulated under Article 10 of Title 10 of the Colorado Revised Statutes. Section 4 Definitions A. “Annual statement” means that statement required by §§ 10-3-208 and 10-14-602, C.R.S. to be filed annually, by the insurer, with the Commissioner.
B. “Commissioner” means the Insurance Commissioner of the State of Colorado.
C. “Qualified actuary” means an actuary meeting the qualifications set forth in Colorado Insurance Regulation 1-1-1 (3 CCR 702-1).
D. “2012 GLTD termination table” shall mean termination table presented by the Group Long-Term Disability Valuation Standard Report of the American Academy of Actuaries’ Group Long-Term Disability Work Group to the National Association of Insurance Commissioners’ Health Actuarial Task Force on August 10, 2012.
Section 5 Adequacy of Reserves When an insurer determines that adequacy of its health insurance reserves requires reserves in excess of the minimum standards specified herein, such increased reserves must be held and shall be considered the minimum reserves for that insurer.
With respect to any block of contracts, or with respect to an insurer’s health business as a whole, a prospective gross premium valuation is the ultimate test of reserve adequacy as of a given valuation date. Such a gross premium valuation will take into account, for contracts in force, in a claims status, or in a continuation of benefits status on the valuation date, the present value as of the valuation date of; all expected benefits unpaid, all expected expenses unpaid, and all unearned or expected premiums, adjusted for future premium increases reasonably expected to be put into effect. Such a gross premium valuation is to be performed whenever a significant doubt exists as to reserve adequacy with respect to any major block of contracts, or with respect to the insurer’s health business as a whole. In the event inadequacy is found to exist, immediate loss recognition shall be made and the reserves restored to adequacy. Adequate reserves (inclusive of claim, premium and contract reserves, if any) shall be held with respect to all contracts, regardless of whether contract reserves are required for such contracts under these standards.
Whenever minimum reserves, as defined in these standards, exceed reserve requirements as determined by a prospective gross premium valuation, such minimum reserves remain the minimum requirement under these standards.
Section 6 Categories of Reserves The following sections set forth minimum standards for three categories of health insurance reserves: claim reserves, premium reserves and contract reserves. Adequacy of an insurer’s health insurance reserves is to be determined on the basis of all three categories combined. However, these standards emphasize the importance of determining appropriate reserves for each of the three categories separately.
Section 7 Appendices These standards contain two appendices which are an integral part of the standards, and one additional “supplementary” appendix which is not part of the standards as such, but is included for explanatory and illustrative purposes only.
Appendix A. Specific minimum standards with respect to morbidity, mortality and interest, which apply to claim reserves according to year of incurral and to contract reserves according to year of issue. Appendix B. Glossary of Technical Terms used.
Appendix C. (Supplementary) Waiver of Premium Reserves. Section 8 Claim Reserves A. General
B. Minimum Standards for Claim Reserves
Once an insurer elects to calculate reserves for all open claims on a more recent standard then all future valuations must be on that basis.
C. Claim Reserve Methods Generally Any generally accepted or reasonable actuarial method or combination of methods may be used to estimate all claim liabilities. The methods used for estimating liabilities generally may be aggregate methods, or various reserve items may be separately valued. Approximations based on groupings and averages may also be employed. Adequacy of the claim reserves, however, shall be determined in the aggregate.
Section 9 Premium Reserves A. General
B. Minimum Standards for Unearned Premium Reserves
C. Premium Reserve Methods Generally The insurer may employ suitable approximations and estimates; including, but not limited to groupings, averages and aggregate estimation; in computing premium reserves. Such approximations or estimates should be tested periodically to determine their continuing adequacy and reliability.
Section 10 Contract Reserves A. General
B. Basis for Minimum Standards for Contract Reserves
C. Alternative Valuation Methods and Assumptions Generally Provided the contract reserve on all contracts to which an alternative method or basis is applied is not less in the aggregate than the amount determined according to the applicable standards specified above, an insurer may use any reasonable assumptions as to interest rates, termination and/or mortality rates, and rates of morbidity or other contingency. Also, subject to the preceding condition, the insurer may employ methods other than the methods stated above in determining a sound value of its liabilities under such contracts, including, but not limited to the following: the net level premium method; the one-year full preliminary term method; prospective valuation on the basis of actual gross premiums with reasonable allowance for future expenses; the use of approximations such as those involving age groupings, groupings of several years of issue, average amounts of indemnity, grouping of similar contract forms; the computation of the reserve for one contract benefit as a percentage of, or by other relation to, the aggregate contract reserves exclusive of the benefit or benefits so valued; and the use of a composite annual claim cost for all or any combination of the benefits included in the contracts valued.
D. Tests for Adequacy and Reasonableness of Contract Reserves Annually, an appropriate review shall be made of the insurer’s prospective contract liabilities on contracts valued by tabular reserves, to determine the continuing adequacy and reasonableness of the tabular reserves giving consideration to future gross premiums. The insurer shall make appropriate increments to such tabular reserves if such tests indicate that the basis of such reserves is no longer adequate, subject to the minimum standards of Section 10(B). In the event an insurer has a contract or a group of related similar contracts, for which future gross premiums will be restricted by contract, insurance department regulations, or for other reasons, such that the future gross premiums reduced by expenses for administration, commissions, and taxes will be insufficient to cover future claims, the insurer must establish contract reserves for such shortfall in the aggregate.
Section 11 Reinsurance Increases to, or credits against reserves carried, arising because of reinsurance assumed or reinsurance ceded, must be determined in a manner consistent with these minimum reserve standards and with all applicable provisions of the reinsurance contracts which affect the insurer’s liabilities. Section 12 Severability If any provision of this regulation or the application of it to any person or circumstance is for any reason held to be invalid, the remainder of this regulation shall not be affected. Section 13 Incorporated Materials Valuations Manual shall mean the January 1, 2022, Edition as published by the National Association of Insurance Commissioners and does not include later amendments or editions of the Valuations Manual. A copy of the Valuations Manual may be examined during regular business hours at the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, Colorado, 80202. A certified copy of the Valuations Manual may be requested from the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, CO 80202. A charge for certification or copies may apply. A copy may also be obtained online from https://content.naic.org/. A copy may also be obtained from the NAIC Central Office, 1100 Walnut Street, Suite 1500, Kansas City, Missouri 64106.
2012 GLTD termination table shall mean the termination table presented by the Group Long-Term Disability Valuation Standard Report of the American Academy of Actuaries’ Group Long-Term Disability Work Group to the National Association of Insurance Commissioners’ Health Actuarial Task Force on August 10, 2012 and does not include later amendments or editions. A copy of the 2012 GLTD termination table may be examined during regular business hours at the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, Colorado, 80202. A certified copy of the 2012 GLTD termination table may be requested from the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, CO 80202. A charge for certification or copies may apply. A copy may also be obtained online from https://www.actuary.org/homepage and https://www.actuary.org/sites/default/files/files/GLTDWG%20Table%20Report_Final_Version_.pdf. A copy may also be obtained from the American Academy of Actuaries, 1850 M Street NW, Suite 300 Washington, DC 20036.
The Accounting Practices and Procedures Manual, including Actuarial Guideline XLVII, shall mean the 2022 Accounting Practices and Procedures Manual published by the National Association of Insurance Commissioners and does not include later amendments or editions. A copy of the Accounting Practices and Procedures Manual may be examined during regular business hours at the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, Colorado, 80202. A certified copy of the Accounting Practices and Procedures Manual may be requested from the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, CO 80202. A charge for certification or copies may apply. A copy may also be obtained online from https://content.naic.org/publications?name=Accounting+Practices+and+Procedures. A copy shall be available at the state publications depository and distribution center. A copy may also be obtained from the NAIC Central Office, 1100 Walnut Street, Suite 1500, Kansas City, Missouri 64106. A copy of the Accounting Practices and Procedures Manual shall also be available at the state publications depository and distribution center.
The 1964 Commissioners Disability Table shall mean the version published by the Health Insurance Association, copyright 1965, and does not include later amendments or editions. A copy of the 1964 Commissioners Disability Table may be examined during regular business hours at the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, Colorado, 80202. A certified copy of the 1964 Commissioners Disability Table may be requested from the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, CO 80202. A charge for certification or copies may apply. A copy of the 1964 Commissioners Disability Table shall be available at the state publications depository and distribution center.
The 1985 Commissioners Individual Disability Tables A shall mean the version published in the Transactions of the Society of Actuaries, Volume XXXVII, pp.449-601, and does not include later amendments or editions. A copy of the 1985 Commissioners Individual Disability Tables A may be examined during regular business hours at the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, Colorado, 80202. A certified copy of the 1985 Commissioners Individual Disability Tables A may be requested from the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, CO 80202. A charge for certification or copies may apply. A copy may also be obtained online from https://www.soa.org/ and https://www.soa.org/globalassets/assets/library/research/transactions-of- society-of-actuaries/1985/january/tsa85v3713.pdf. A copy may also be obtained from the Society of Actuaries, 475 North Martingale #600, Schaumburg, Illinois 60173. The 1985 Commissioners Individual Disability Tables B shall mean the version published in the Proceedings of the National Association of Insurance Commissioners, Volume 1, 1985, pp. 494-540, and does not include later amendments or editions. A copy of the 1985 Commissioners Individual Disability Tables B may be examined during regular business hours at the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, Colorado, 80202. A certified copy of the 1985 Commissioners Individual Disability Tables B may be requested from the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, CO 80202. A charge for certification or copies may apply. A copy may also be obtained online from https://content.naic.org/ and https://naic.soutronglobal.net/Portal/Public/en- US/DownloadImageFile.ashx?objectId=5252&ownerType=0&ownerId=17562. A copy may also be obtained from the NAIC Central Office, 1100 Walnut Street, Suite 1500, Kansas City, Missouri 64106. DTS Valuation Table exhibits 3a, 3b, 3c, 4, and 5 shall mean the version published by the Transactions of the Society of Actuaries XXXVII, pp. 457-465, and does not include later amendments or editions. A copy of the DTS Valuation Table exhibits 3a, 3b, 3c, 4, and 5 may be examined during regular business hours at the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, Colorado, 80202. A certified copy of the DTS Valuation Table exhibits 3a, 3b, 3c, 4, and 5 may be requested from the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, CO 80202. A charge for certification or copies may apply. A copy may also be obtained online from https://www.soa.org/ and https://www.soa.org/globalassets/assets/library/research/transactions-of-society-of- actuaries/1985/january/tsa85v3713.pdf. A copy may also be obtained from the Society of Actuaries, 475 North Martingale #600, Schaumburg, Illinois 60173.
The 1974 Medical Expense Tables, Table A, shall mean the version published by the Transactions of the Society of Actuaries XXX, pg. 63 – 64, and does not include later amendments or editions. A copy of the 1974 Medical Expense Tables, Table A may be examined during regular business hours at the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, Colorado, 80202. A certified copy of the 1974 Medical Expense Tables, Table A may be requested from the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, CO 80202. A charge for certification or copies may apply. A copy may also be obtained online from https://www.soa.org/ and https://www.soa.org/globalassets/assets/library/research/transactions-of-society-of- actuaries/1978/january/tsa78v303.pdf. A copy may also be obtained from the Society of Actuaries, 475 North Martingale #600, Schaumburg, Illinois 60173.
1985 NAIC Cancer Claim Cost Table shall mean the version published in the Proceedings of the National Association of Insurance Commissioners, Volume 1, 1986, pp. 601-624), and does not include later amendments or editions. A copy of the 1985 NAIC Cancer Claims Cost Table may be examined during regular business hours at the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, Colorado, 80202. A certified copy of the 1985 NAIC Cancer Claims Cost Table may be requested from the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, CO 80202. A charge for certification or copies may apply. A copy may also be obtained online from https://content.naic.org/ and https://naic.soutronglobal.net/Portal/Public/en- US/DownloadImageFile.ashx?objectId=5255&ownerType=0&ownerId=17563 . A copy may also be obtained from the NAIC Central Office, 1100 Walnut Street, Suite 1500, Kansas City, Missouri 6410. 2016 Cancer Claim Cost Valuation Tables shall mean the version published by the Joint American Academy of Actuaries and Society of Actuaries Cancer Claims Cost Tables Work Group and does not include later amendments or editions. A copy of the 2016 Cancer Claim Cost Valuation Tables may be examined during regular business hours at the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, Colorado, 80202. A certified copy of 2016 Cancer Claim Cost Valuation Tables may be requested from the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, CO 80202. A charge for certification or copies may apply. A copy may also be obtained online from https://www.soa.org/ and https://www.soa.org/4a520b/globalassets/assets/files/resources/experience- studies/2022/2016-ccc-valuation-tables.pdf. A copy may also be obtained from the Society of Actuaries, 475 North Martingale #600, Schaumburg, Illinois 60173.
The 1959 Accidental Death Benefits Table shall mean the version published by the Society of Actuaries, copyright 1962, and does not include later amendments or editions. A copy of the 1959 Accidental Death Benefits Table may be examined during regular business hours at the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, Colorado, 80202. A certified copy of the 1959 Accidental Death Benefits Table may be requested from the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, CO 80202. A charge for certification or copies may apply. A copy may also be obtained online from https://www.soa.org/ and https://www.soa.org/globalassets/assets/library/research/transactions-of- society-of-actuaries/1959/january/tsa59v11n3177.pdf. A copy may also be obtained from the Society of Actuaries, 475 North Martingale #600, Schaumburg, Illinois 60173. The 1987 Commissioners Group Disability Income Table shall mean the version published by the Transactions of the Society of Actuaries XXXIX, pp. 393-458, and does not include later amendments or editions. A copy of the 1987 Commissioners Group Disability Income Table (87CGDT) may be examined during regular business hours at the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, Colorado, 80202. A certified copy of the 1987 Commissioners Group Disability Income Table may be requested from the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, CO 80202. A charge for certification or copies may apply. A copy may also be obtained online from https://www.soa.org/ and https://www.soa.org/globalassets/assets/library/research/transactions-of- society-of-actuaries/1987/january/tsa87v3913.pdf. A copy may also be obtained from the Society of Actuaries, 475 North Martingale #600, Schaumburg, Illinois 60173. Section 14 Enforcement Noncompliance with this regulation may result in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance, or other laws, which include the imposition of civil penalties, issuance of cease-and-desist orders, and/or suspensions or revocation of license, subject to the requirements of due process.
Section 15 Effective Date This amended regulation shall become effective on March 2, 2023. Section 16 History Regulation 3-1-9 effective January 31, 1993.
Amended regulation effective January 1, 2013.
Amended regulation effective March 2, 2023.
APPENDIX A. SPECIFIC STANDARDS FOR MORBIDITY, INTEREST AND MORTALITY I. MORBIDITY A. Minimum morbidity standards for valuation of specified individual contract health insurance benefits are as follows:
The 1985 Commissioners Individual Disability Tables A (85CIDA) with claim termination rates multiplied by the following adjustment factors: Adjusted Adjustment Duration Duration Factor Rates* Week 1 0.366 0.04831 2 0.366 0.04172 3 0.366 0.04063 4 0.366 0.04355 5 0.365 0.04088 6 0.365 0.04271 7 0.365 0.04380 8 0.365 0.04344 9 0.370 0.04292 10 0.370 0.04107 11 0.370 0.03848 12 0.370 0.03478 13 0.370 0.03034 Month 4 0.391 0.08758 5 0.371 0.07346 6 0.435 0.07531 7 0.500 0.07245 8 0.564 0.06655 9 0.613 0.05520 10 0.663 0.04705 11 0.712 0.04486 12 0.756 0.04309 13 0.800 0.04080 14 0.844 0.03882 15 0.888 0.03730 16 0.932 0.03448 17 0.976 0.03026 18 1.020 0.02856 19 1.049 0.02518 20 1.078 0.02264 21 1.107 0.02104 22 1.136 0.01932 23 1.165 0.01865 24 1.195 0.01792 Year 3 1.369 0.16839 4 1.204 0.10114 5 1.199 0.07434 6 and later 1.000 ** *The adjusted duration rates derived from the application of the adjustment factors to the DTS Valuation Table duration rates shown in exhibits 3a, 3b, 3c, 4 and 5, Transactions of the Society of Actuaries (TSA) XXXVII, pp. 457-463, are displayed.
**Applicable DTS Valuation Table duration rate from exhibits 3c and 4 (TSA XXXVII, pp. 462-463).
The 85CIDA table so adjusted for the computation of claim reserves shall be known as the 85CIDC (The 1985 Commissioners Individual Disability Table C).
Contracts issued on or after January 1, 1982:
The 1974 Medical Expense Tables, Table A (published in the Transactions of the Society of Actuaries (TSA), Volume XXX, pg. 63. Refer to the paper (in the same volume, pg. 9) to which this table is appended, including its discussions, for methods of adjustment for benefits not directly valued in Table A: “Development of the 1974 Medical Expense Benefits,” Houghton and Wolf).
No specific standard. See Item I.A.5, below.
The 1985 NAIC Cancer Claim Cost Tables (published in the Proceedings of the National Association of Insurance Commissioners, Volume 1, 1986, pp. 601-624).
The 2016 Cancer Claim Cost Valuation Tables (2016 CCCVT); http://www.naic.org/documents/01_naic_2017_cancer_claim_cos t_valuation_table.xlsx (b) For all other benefits:
Assumptions based on company experience, relevant industry experience, and actuarial judgement. Such assumptions should be appropriate for valuation which considers margin for adverse experience.
Contracts issued on or after January 1, 1965:
The 1959 Accidental Death Benefits Table (1959 ADB) (published by the Society of Actuaries, copyright 1962).
Actual amount incurred.
For all other individual contract benefits, morbidity assumptions are to be determined as provided in the reserve standards.
For all benefits other than disability, claim reserves are to be determined as provided in the standards.
B. Minimum morbidity standards for valuation of specified group contract health insurance benefits are as follows:
The 1987 Commissioners Group Disability Income Table (87CGDT) (published in the Transactions of the Society of Actuaries, Volume XXXIX, pp. 393-458).
The 1987 Commissioners Group Disability Income Table (87CGDT) (published in the Transactions of the Society of Actuaries, Volume XXXIX, pp. 393-458);
Use of the 87CGDT is optional.
For all other group contract benefits, morbidity assumptions are to be determined as provided in the reserve standards.
For all benefits other than disability, claim reserves are to be determined as provided in the standards.
II. INTEREST A. For contract reserves the maximum interest rate is the maximum rate permitted by Article 7 of Title 10, C.R.S., for the valuation of whole life insurance issued on the same date as the health insurance contract.
B. For claim reserves, for which interest discounting is expressly permitted:
III. MORTALITY A. Unless Subsection B or C applies, the mortality basis used shall be according to a table (but without use of selection factors) permitted by Article 7 of Title 10, C.R.S. for the valuation of whole life insurance issued on the same date as the health insurance contract.
B. For long-term care individual policies and group certificates issued on or after January 1, 2013, the mortality basis used shall be the 1994 Group Annuity Mortality Static Table with Projection Scale AA (1994 GAR). The 1994 GAR table can be found in Appendix A of Colorado Insurance Regulation 4-1-7.
C. Other mortality tables adopted by the National Association of Insurance Commissioners and promulgated by the Commissioner may be requested to be used in the calculation of the minimum reserves if appropriate for the type of benefits and if approved by the Commissioner. The request for such approval must include the proposed mortality table and the reason that the standard specified in Subsection A is inappropriate.
APPENDIX B. GLOSSARY OF TECHNICAL TERMS USED As used in this valuation standard, the following terms have the following meaning: ANNUAL CLAIM COST. The net annual cost per unit of benefit before the addition of expenses, including claim settlement expenses, and a margin for profit or contingencies. For example, the annual claim cost for a $100 monthly disability benefit, for a maximum disability benefit period of one year, with an elimination period of one week, with respect to a male at age 35, in a certain occupation might be $12, while the gross premium for this benefit might be $18. The additional $6 would cover expenses and profit or contingencies.
CLAIMS ACCRUED. That portion of claims incurred on or prior to the valuation date which result in liability of the insurer for the payment of benefits for medical services which have been rendered on or prior to the valuation date, and for the payment of benefits for days of hospitalization and days of disability which have occurred on or prior to the valuation date, which the insurer has not paid as of the valuation date, but for which it is liable, and will have to pay after the valuation date. This liability is sometimes referred to as a liability for “accrued” benefits. A claim reserve, which represents an estimate of this accrued claim liability, must be established.
CLAIMS REPORTED. When an insurer has been informed that a claim has been incurred, if the date reported is on or prior to the valuation date, the claim is considered as a reported claim for annual statement purposes.
CLAIMS UNACCRUED. That portion of claims incurred on or prior to the valuation date which result in liability of the insurer for the payment of benefits for medical services expected to be rendered after the valuation date, and for benefits expected to be payable for days of hospitalization and days of disability occurring after the valuation date. This liability is sometimes referred to as a liability for unaccrued benefits. A claim reserve, which represents an estimate of the unaccrued claim payments expected to be made, must be established.
CLAIMS UNREPORTED. When an insurer has not been informed, on or before the valuation date, concerning a claim that has been incurred on or prior to the valuation date, the claim is considered as an unreported claim for annual statement purposes.
DATE OF DISABLEMENT. The earliest date the insured is considered as being disabled under the definition of disability in the contract, based on a doctor's evaluation or other evidence. Normally this date will coincide with the start of any elimination period. ELIMINATION PERIOD. A specified number of days, weeks, or months starting at the beginning of each period of loss, during which no benefits are payable.
GROSS PREMIUM. The amount of premium charged by the insurer. It includes the net premium (based on claim cost) for the risk, together with any loading for expenses, profit or contingencies. GROUP INSURANCE. The term group insurance includes blanket insurance and franchise insurance and any other forms of group insurance.
GROUP LONG-TERM DISABILITY INCOME. The term group long-term disability income includes group contracts providing group disability income coverage with a maximum benefit duration longer than two years. Group long-term disability income contracts are based on a group pricing structure. The term group long-term disability does not include group short-term disability (coverage with benefit periods of two years or less in maximum duration). It also does not include voluntary group disability income coverage that is priced on an individual risk structure and generally sold in the workplace. LEVEL PREMIUM. A premium calculated to remain unchanged throughout either the lifetime of the policy, or for some shorter projected period of years. The premium need not be guaranteed; in which case, although it is calculated to remain level, it may be changed if any of the assumptions on which it was based are revised at a later time. Generally, the annual claim costs are expected to increase each year and the insurer, instead of charging premiums that correspondingly increase each year, charges a premium calculated to remain level for a period of years or for the lifetime of the contract. In this case the benefit portion of the premium is more than needed to provide for the cost of benefits during the earlier years of the policy and less than the actual cost in the later years. The building of a prospective contract reserve is a natural result of level premiums.
MODAL PREMIUM. This refers to the gross premium paid on a contract based on a premium term which could be annual, semiannual, quarterly, monthly, or weekly. Thus, if the annual premium is $100 and if, instead, monthly premiums of $9 are paid then the modal premium is $9. NEGATIVE RESERVE. Normally the terminal reserve is a positive value. However, if the values of the benefits are decreasing with advancing age or duration it could be a negative value, called a negative reserve.
PRELIMINARY TERM RESERVE METHOD. Under this method of valuation, the valuation net premium for each year falling within the preliminary term period is exactly sufficient to cover the expected incurred claims of that year, so that the terminal reserves will be zero at the end of the year. As of the end of the preliminary term period, a new constant valuation net premium (or stream of changing valuation premiums) becomes applicable such that the present value of all such premiums is equal to the present value of all claims expected to be incurred following the end of the preliminary term period. PRESENT VALUE OF AMOUNTS NOT YET DUE ON CLAIMS. The reserve for “claims unaccrued” (see definition), which may be discounted at interest.
RATING BLOCK. “Rating block” means a grouping of contracts based on common characteristics, such as a policy form or forms having similar benefit designs. RESERVE. The term “reserve” is used to include all items of benefit liability, whether in the nature of incurred claim liability or in the nature of contract liability relating to future periods of coverage, and whether the liability is accrued or unaccrued.
An insurer under its contracts promises benefits which result in:
a. Claims which have been incurred, that is, for which the insurer has become obligated to make payment, on or prior to the valuation date. On these claims, payments expected to be made after the valuation date for accrued and unaccrued benefits are liabilities of the insurer which should be provided for by establishing claim reserves; or b. Claims which are expected to be incurred after the valuation date. Any present liability of the insurer for these future claims should be provided for by the establishment of contract reserves and unearned premium reserves.
TERMINAL RESERVE. This is the reserve at the end of a contract year, and is defined as the present value of benefits expected to be incurred after that contract year minus the present value of future valuation net premiums.
UNEARNED PREMIUM RESERVE. This reserve values that portion of the premium paid or due to the insurer which is applicable to the period of coverage extending beyond the valuation date. Thus, if an annual premium of $120 was paid on November 1, $20 would be earned as of December 31 and the remaining $100 would be unearned. The unearned premium reserve could be on a gross basis as in this example, or on a valuation net premium basis.
VALUATION NET MODAL PREMIUM. This is the modal fraction of the valuation net annual premium that corresponds to the gross modal premium in effect on any contract to which contract reserves apply. Thus, if the mode of payment in effect is quarterly, the valuation net modal premium is the quarterly equivalent of the valuation net annual premium.
WORKSITE DISABILITY POLICIES. The term worksite disability policy refers to individual short-term disability policies that are sold at the worksite through employer-sponsored enrollment, cover normal pregnancy, and that have benefit periods up to 24 months. Worksite disability policies do not include personal disability policies sold to an individual and not associated with employer-sponsored enrollment. They also do not include business overhead expense, disability buyout, or key person policies, in whatever manner those policies are sold.
APPENDIX C. RESERVES FOR WAIVER OF PREMIUM (Supplementary explanatory material)
Waiver of premium reserves involve several special considerations. First, the disability valuation tables promulgated by the National Association of Insurance Commissioners are based on exposures that include contracts on premium waiver as in-force contracts. Hence, contract reserves based on these tables are NOT reserves on “active lives” but rather reserves on contracts “in force.” This is true for the 1964 CDT and for the 1985CIDA, 1985CIDB and 1985CIDC tables. Accordingly, tabular reserves using any of these tables should value reserves on the following basis: Claim reserves should include reserves for premiums expected to be waived, valuing as a minimum the valuation net premium being waived.
In addition to the annual statements, the NAIC also adopts instruction and procedure manuals for the convention blanks. These manuals include information which contributes to the body of knowledge referred to as statutory accounting practices.
The purpose of this regulation is twofold:
1. To enhance the consistency of the accounting treatment of assets, liabilities, reserves, income and expenses by setting forth the accounting standards, practices and procedures to be followed in completing all of the required annual statements.
2. To set forth the form of the financial statements to be filed for those entities which do not have the form prescribed in statute.
Section 3 Applicability This regulation shall apply to all Colorado domestic insurers as well as to each domestic group captive insurer, fraternal benefit society, health maintenance organization, prepaid dental care plan organization, and non-profit hospital, medical-surgical and health service corporation. Section 4 Rule A. Standards, Practices and Procedures Statutory financial statements must be completed in accordance with statutory accounting principles and practices as prescribed by Colorado insurance laws, regulations, and rulings, including the instructions, footnotes, annual statement accounting practices and procedures developed by the NAIC. These NAIC documents include the appropriate Annual Statement Instructions Manual and the Accounting Practices and Procedures Manual. These manuals provide direction, procedures, and methods of completing the annual statements and include those categories for which a company is required to establish reserves or liabilities. Liabilities and reserves which are to be established shall include, but are not necessarily limited to, life reserves, active life reserves, unearned premium reserves, loss reserves for claims both known and unknown, loss adjustment expenses both allocated and unallocated, unpaid claims, unpaid claims adjustment expenses, and accounts payable.
B. Filing
C. Notwithstanding the foregoing, it should be noted that while the NAIC's Accounting Practices and Procedures Manual identifies and establishes generally accepted statutory accounting principles, such principles and procedures do not supersede any specific statutes, regulations, orders or rulings of the state of Colorado or this office.
Section 5 Severability If any provision of this regulation or the application of it to any person or circumstance is for any reason held to be invalid, the remainder of this regulation shall not be affected. Section 6 Enforcement Noncompliance with this regulation may result in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance, or other laws, which include the imposition of civil penalties, issuance of cease and desist orders, and/or suspensions or revocation of license, subject to the requirements of due process.
Section 7 Effective Date This regulation shall be effective July 1, 2012.
Section 8 History Originally effective November 1, 1992.
Amended effective April 1, 2001.
Amended effective July 1, 2012.
Regulation 3-1-11 RISK BASED CAPITAL (RBC) FOR INSURERS Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Definitions Section 5 RBC Reports Section 6 Company Action Level Event Section 7 Regulatory Action Level Event Section 8 Authorized Control Level Event Section 9 Mandatory Control Level Event Section 10 Hearings Section 11 Confidentiality and Prohibition on Announcements Section 12 Foreign Insurers Section 13 Notices Section 14 Severability Section 15 Enforcement Section 16 Effective Date Section 17 History Section 1 Authority This Regulation is promulgated under the authority of §§ 10-1-109, 10-3-201(1)(b), 10-6-129, and 10-14- 604, C.R.S.
Section 2 Scope and Purpose The purpose of this Regulation is to establish standards for the minimum capital and surplus to be maintained by insurers, captive insurers and fraternal benefit societies as provided by §§ 10-3-201(1)(b), 10-6-116, and 10-14-604, C.R.S. These standards provide for the early detection of a potentially hazardous or otherwise dangerous condition of an insurer in order to protect its insureds and the general public. This Regulation additionally provides for reporting, corrective measures, and enforcement actions available to the Commissioner.
Section 3 Applicability This Regulation shall apply to all insurers as defined in Section 4. below. Section 4 Definitions As used in this Regulation, these terms shall have the following meanings:
A. “Adjusted RBC Report” shall mean, for the purposes of this regulation, an RBC report which has been adjusted by the Commissioner in accordance with Section 5.E.
B. “Corrective Order” shall mean, for the purposes of this regulation, an order issued by the Commissioner pursuant to § 10-3-404, C.R.S., specifying corrective actions which the Commissioner has determined are required.
C. “Domestic insurer” shall mean, for the purposes of this regulation, any insurance company or fraternal benefit society domiciled in this State.
D. “Foreign insurer” shall mean, for the purposes of this regulation, any insurance company or fraternal benefit society that is licensed to do business in this State, but is not domiciled in this State.
E. “Life and/or health insurer” shall mean, for the purposes of this regulation, any insurance company licensed as a life insurer, health insurer, fraternal benefit society, or a licensed property and casualty insurer writing only accident and health insurance.
F. “NAIC” shall mean, for the purposes of this regulation, the National Association of Insurance Commissioners.
G. “Negative trend” shall mean, for the purposes of this regulation, with respect to a life and/or health insurer, a negative trend over a period of time, as determined in accordance with the “Trend Test Calculation” included in the Life RBC Instructions.
H. “Property and casualty insurer” shall mean, for the purposes of this regulation, any licensed property and casualty insurance company, including a group captive insurance company organized pursuant to the provisions of Article 6 of Title 10, C.R.S., but shall not include monoline mortgage guaranty insurers, financial guaranty insurers, title insurers and county mutual protective associations organized on an assessment basis pursuant to § 10-12-101(2), C.R.S.
I. “RBC instructions” shall mean, for the purposes of this regulation, the RBC Report, including risk- based capital instructions and procedures adopted by the NAIC, as part of the required annual filing on the NAIC convention blank.
J. “RBC Level” shall mean, for the purposes of this regulation, an insurer’s Company Action Level RBC, Regulatory Action Level RBC, Authorized Control Level RBC, or Mandatory Control Level RBC, where:
K. “RBC Plan” shall mean, for the purposes of this regulation, a comprehensive financial plan containing the elements specified in Section 6.B. If the Commissioner rejects the RBC Plan, and it is revised by the insurer, with or without the Commissioner’s recommendation, the plan shall be called the “Revised RBC Plan.”
L. “RBC Report” shall mean, for the purposes of this regulation, the report required in Section 5. of this Regulation.
M. “Total Adjusted Capital” shall mean, for the purposes of this regulation, the sum of:
A. A domestic insurer shall, on or prior to each March 1 (the “filing date”), prepare and submit to the Commissioner a report of its RBC Levels as of the end of the calendar year just ended, in a form and containing such information as is required by the RBC Instructions. In addition, a domestic insurer shall file its RBC Report:
B. A life and/or health insurer’s RBC shall be determined in accordance with the formula set forth in the RBC Instructions. The formula shall take the following into account (and may adjust for the covariance between) determined in each case by applying the factors in the manner set forth in the RBC Instructions:
C. A property and casualty insurer’s RBC shall be determined in accordance with the formula set forth in the RBC Instructions. The formula shall take the following into account (and may adjust for the covariance between) determined in each case by applying the factors in the manner set forth in the RBC Instructions:
D. An excess of capital over the amount produced by the risk-based capital requirements contained in this Regulation and the formulas, schedules and instructions referenced in this Regulation is desirable in the business of insurance. Accordingly, insurers should seek to maintain capital above the RBC Levels required by this Regulation. 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 Regulation.
E. If a domestic insurer files an RBC Report which in the judgment of the Commissioner is inaccurate, then the Commissioner shall adjust the RBC 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. An RBC Report as so adjusted is referred to as an “Adjusted RBC Report.” Section 6 Company Action Level Event A. “Company Action Level Event” means any of the following events:
B. In the event of a Company Action Level Event, the insurer shall prepare and submit to the Commissioner an RBC Plan which shall:
C. The RBC Plan shall be submitted:
D. Within sixty (60) days after the submission by an insurer of an RBC Plan to the Commissioner, the Commissioner shall notify the insurer whether the RBC Plan shall be implemented or is, in the judgment of the Commissioner, unsatisfactory. If the Commissioner determines the RBC 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 RBC Plan satisfactory, in the judgment of the Commissioner. Upon notification from the Commissioner, the insurer shall prepare a Revised RBC Plan, which may incorporate by reference any revisions proposed by the Commissioner, and shall submit the Revised RBC Plan to the Commissioner:
E. In the event of a notification by the Commissioner to an insurer that the insurer’s RBC Plan or Revised RBC Plan is unsatisfactory, the Commissioner may at the Commissioner’s discretion, subject to the insurer’s right to a hearing under Section 10., specify in the notification that the notification constitutes a Regulatory Action Level Event.
F. Every domestic insurer that files an RBC Plan or Revised RBC Plan with the Commissioner shall file a copy of the RBC Plan or Revised RBC Plan with the insurance commissioner or other regulatory authority in any state in which the insurer is authorized to do business if:
Section 7 Regulatory Action Level Event A. “Regulatory Action Level Event” means any of the following events:
B. In the event of a Regulatory Action Level Event the Commissioner shall:
C. In determining corrective actions, the Commissioner may take into account factors the Commissioner deems 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 RBC Instructions. The RBC Plan or Revised RBC Plan shall be submitted:
D. 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 RBC Plan or Revised RBC Plan, examine or analyze the assets, liabilities and operations of the insurer and formulate the 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.
Section 8 Authorized Control Level Event A. “Authorized Control Level Event” means any of the following events:
B. In the event of an Authorized Control Level Event with respect to an insurer, the Commissioner shall:
Section 9 Mandatory Control Level Event A. “Mandatory Control Level Event” means any of the following events:
B. In the event of a Mandatory Control Level Event:
Section 10 Hearings Upon the occurrence of any of the following events, the insurer shall have the right to a confidential departmental hearing pursuant to § 24-4-105, C.R.S., on a record, at which the insurer may challenge any determination or action by the Commissioner. The insurer shall notify the Commissioner of its request for a hearing within five (5) days after the notification by the Commissioner under Subsection A., B., C. or D. Upon receipt of the insurer’s request for a hearing, the Commissioner shall set a date for the hearing, which shall be no less than ten (10) nor more than thirty (30) days after the date of the insurer’s request. The events include:
A. Notification to an insurer by the Commissioner of an Adjusted RBC Report; or B. Notification to an insurer by the Commissioner that:
C. Notification to an insurer by the Commissioner that the insurer has failed to adhere to its RBC Plan or Revised RBC 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 RBC Plan or Revised RBC Plan; or D. Notification to an insurer by the Commissioner of a Corrective Order with respect to the insurer. Section 11 Confidentiality and Prohibition on Announcements A. All RBC Reports (to the extent the information therein is not required to be set forth in a publicly available annual statement schedule) and RBC Plans (including the results or report of any examination or analysis of an insurer performed pursuant hereto and any Corrective Order issued by the Commissioner pursuant to examination or analysis) with respect to a domestic insurer or foreign insurer that are in the possession or control of the Commissioner shall be confidential by law and privileged, pursuant to § 24-72-204(3)(a)(IV), C.R.S., and shall not be subject to § 24-72- 201, et. seq. C.R.S., shall not be subject to subpoena, and shall not be subject to discovery or admissible in evidence in any private civil action. However, the Commissioner is authorized to use the documents, materials or other information in the furtherance of any regulatory or legal action brought as a part of the Commissioner’s official duties.
B. Neither the Commissioner nor any person who received documents, materials or other information while acting under the authority of the Commissioner shall be permitted or required to testify in any private civil action concerning any confidential documents, materials or information subject to Subsection A.
C. In order to assist in the performance of the Commissioner’s duties, the Commissioner:
D. No waiver of any applicable privilege or claim of confidentiality in the documents, materials or information shall occur as a result of disclosure to the Commissioner under this section or as a result of sharing as authorized in Section 11.C.
E. The comparison of an insurer’s Total Adjusted Capital to any of its RBC 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. Therefore, except as otherwise required under the provisions of this Regulation, the making, publishing, disseminating, circulating or placing before the public, or causing, 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 RBC Levels of any insurer, or of any component derived in the calculation, by any insurer, agent, broker or other person engaged in any manner in the insurance business would be misleading and a violation of § 10-3-1104, C.R.S., and is therefore prohibited; provided, however, that if any materially false statement with respect to the comparison regarding an insurer’s Total Adjusted Capital to its RBC Levels (or any of them) or an inappropriate comparison of any other amount to the insurers’ RBC 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.
Section 12 Foreign Insurers A. Any foreign insurer shall, upon the written request of the Commissioner, submit to the Commissioner an RBC Report as of the end of the calendar year just ended the later of:
B. Any foreign insurer shall, at the written request of the Commissioner, promptly submit to the Commissioner a copy of any RBC Plan that is filed with the insurance commissioner of any other state.
C. In the event of a Company Action Level Event, Regulatory Action Level Event or Authorized Control Level Event with respect to any foreign insurer as determined under the RBC statute or regulation applicable in the state of domicile of the insurer (or, if no RBC statute or regulation is in force in that state, under the provisions of this Regulation), if the insurance commissioner of the state of domicile of the foreign insurer fails to require the foreign insurer to file an RBC Plan in the manner specified under that state’s RBC statute or regulation (or, if no RBC statute or regulation is in force in that state, under Section 6. hereof), the Commissioner may require the foreign insurer to file an RBC Plan with the Commissioner. In such event, the failure of the foreign insurer to file an RBC Plan with the Commissioner shall be grounds to order the insurer to cease and desist from writing new insurance business in this State.
D. In the event of a Mandatory Control Level Event with respect to a foreign insurer, if no domiciliary receiver has been appointed with respect to the foreign insurer under the rehabilitation and liquidation statute applicable in the state of domicile of the foreign insurer, the Commissioner may make application to the Denver District Court permitted under § 10-3-501 et. seq., C.R.S., with respect to the liquidation of property of foreign insurers found in this State, and the occurrence of the Mandatory Control Level Event shall be considered adequate grounds for the application. Section 13 Notices All notices by the Commissioner to an insurer which may result in regulatory action thereunder shall be effective upon dispatch if transmitted by registered or certified mail, or in the case of any other transmission shall be effective upon the insurer's receipt of such notice. Section 14 Severability If any provision of this regulation or the application of it to any person or circumstance is for any reason held to be invalid, the remainder of this regulation shall not be affected. Section 15 Enforcement Noncompliance with this regulation may result in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance, or other laws, which include the imposition of civil penalties, issuance of cease and desist orders, and/or suspensions or revocation of license, subject to the requirements of due process.
Section 16 Effective Date This Regulation shall become effective on August 1, 2017. Section 17 History Originally effective March 31, 1994.
Amended Regulation, effective August 31, 1997.
Amended Regulation, effective November 1, 1999.
Amended Regulation, effective April 1, 2002.
Repealed and Repromulgated Regulation, effective February 1, 2012 Amended Regulation, effective August 1, 2013 Amended Regulation, effective August 1, 2017 Regulation 3-1-12 RISK BASED CAPITAL (RBC) FOR HEALTH ORGANIZATIONS Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Definitions Section 5 RBC Reports Section 6 Company Action Level Event Section 7 Regulatory Action Level Event Section 8 Authorized Control Level Event Section 9 Mandatory Control Level Event Section 10 Hearings Section 11 Confidentiality and Prohibition on Announcements Section 12 Foreign Health organizations Section 13 Severability Section 14 Notices Section 15 Enforcement Section 16 Effective Date Section 17 History Section 1 Authority This Regulation is promulgated under the authority of § § 10-16-310(3) and 10-16-411(2), C.R.S. Section 2 Scope and Purpose The purpose of this Regulation is to establish standards for the minimum capital and surplus to be maintained by health organizations as provided by § § 10-16-310 and 10-16-411, C.R.S. These standards provide for the early detection of a potentially hazardous or otherwise dangerous condition of a health organization in order to protect its enrollees/members and the general public. This Regulation additionally provides for reporting, corrective measures, and enforcement actions available to the Commissioner. Section 3 Applicability This Regulation shall apply to all health organizations defined in Section 4 below. Section 4 Definitions As used in this Regulation, these terms shall have the following meanings:
A. “Adjusted RBC Report” means an RBC report which has been adjusted by the Commissioner in accordance with Section 5E.
B. “Corrective Order” means an order issued by the Commissioner pursuant to § 10-3-404, C.R.S., specifying corrective actions which the Commissioner has determined are required.
C. “Domestic health organization” means a health organization domiciled in this State.
D. “Foreign health organization” means a health organization that is licensed to do business in this State, but is not domiciled in this State.
E. “Health organization” means a health maintenance organization, nonprofit hospital medical- surgical and health service corporation, or other managed care organization. This definition does not include an organization that is licensed as either a life and health insurer or a property and casualty insurer, and that is otherwise subject to either the life or property and casualty RBC requirements.
F. “NAIC” means the National Association of Insurance Commissioners.
G. “RBC instructions” means the RBC Report, including risk-based capital instructions and procedures adopted by the NAIC, as part of the required annual filing on the NAIC convention blank.
H. “RBC Level” means a health organization’s Company Action Level RBC, Regulatory Action Level RBC, Authorized Control Level RBC, or Mandatory Control Level RBC where:
I. “RBC Plan” means a comprehensive financial plan containing the elements specified in Section 6B. If the Commissioner rejects the RBC Plan, and it is revised by the health organization, with or without the Commissioner’s recommendation, the plan shall be called the “Revised RBC Plan.” J. “RBC Report” means the report required in Section 5 of this Regulation.
K. “Total Adjusted Capital” means the sum of:
A. A domestic health organization shall, on or prior to each March 1 (the “filing date”), prepare and submit to the Commissioner a report of its RBC Levels as of the end of the calendar year just ended, in a form and containing such information as is required by the RBC Instructions. In addition, a domestic health organization shall file its RBC Report:
B. A health organization’s RBC shall be determined in accordance with the formula set forth in the RBC Instructions. The formula shall take the following into account (and may adjust for the covariance between) determined in each case by applying the factors in the manner set forth in the RBC Instructions.
C. An excess of capital (i.e. net worth) over the amount produced by the risk-based capital requirements contained in this Regulation, and the formulas, schedules and instructions referenced in this Regulation is desirable in the business of health insurance. Accordingly, health organizations should seek to maintain capital above the RBC Levels required by this Regulation. Additional capital is used and useful in the insurance business and helps to secure a health organization 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 Regulation.
D. If a domestic health organization files an RBC Report which in the judgment of the Commissioner is inaccurate, then the Commissioner shall adjust the RBC Report to correct the inaccuracy and shall notify the health organization of the adjustment. The notice shall contain a statement of the reason for the adjustment. An RBC Report as so adjusted is referred to as an “Adjusted RBC Report.”
Section 6 Company Action Level Event A. “Company Action Level Event” means any of the following events:
B. In the event of a Company Action Level Event, the health organization shall prepare and submit to the Commissioner an RBC Plan that shall:
C. The RBC Plan shall be submitted:
D. Within sixty (60) days after the submission by a health organization of an RBC Plan to the Commissioner, the Commissioner shall notify the health organization whether the RBC Plan shall be implemented or is, in the judgment of the Commissioner, unsatisfactory. If the Commissioner determines the RBC Plan is unsatisfactory, the notification to the health organization shall set forth the reasons for the determination, and may set forth proposed revisions which will render the RBC Plan satisfactory, in the judgment of the Commissioner. Upon notification from the Commissioner, the health organization shall prepare a Revised RBC Plan, which may incorporate by reference any revisions proposed by the Commissioner, and shall submit the Revised RBC Plan to the Commissioner:
E. In the event of a notification by the Commissioner to a health organization that the health organization’s RBC Plan or Revised RBC Plan is unsatisfactory, the Commissioner may at the Commissioner’s discretion, subject to the health organization’s right to a hearing under Section 10, specify in the notification that the notification constitutes a Regulatory Action Level Event.
F. Every domestic health organization that files an RBC Plan or Revised RBC Plan with the Commissioner shall file a copy of the RBC Plan or Revised RBC Plan with the insurance commissioner in any state in which the health organization is authorized to do business if:
Section 7 Regulatory Action Level Event A. “Regulatory Action Level Event” means any of the following events:
B. In the event of a Regulatory Action Level Event the Commissioner shall:
C. In determining corrective actions, the Commissioner may take into account factors the Commissioner deems relevant with respect to the health organization based upon the Commissioner’s examination or analysis of the assets, liabilities and operations of the health organization, including, but not limited to, the results of any sensitivity tests undertaken pursuant to the RBC Instructions. The RBC Plan or Revised RBC Plan shall be submitted:
D. The Commissioner may retain actuaries and investment experts and other consultants as may be necessary in the judgment of the Commissioner to review the health organization’s RBC Plan or Revised RBC Plan, examine or analyze the assets, liabilities and operations (including contractual relationships) of the health organization and formulate the Corrective Order with respect to the health organization. The fees, costs and expenses relating to consultants shall be borne by the affected health organization or such other party as directed by the Commissioner. Section 8 Authorized Control Level Event A. “Authorized Control Level Event” means any of the following events:
B. In the event of an Authorized Control Level Event with respect to a health organization, the Commissioner shall:
A. “Mandatory Control Level Event” means any of the following events:
B. In the event of a Mandatory Control Level Event, the Commissioner shall take such actions as are necessary to place the health organization under regulatory control under § § 10-16-418 and 10- 3-501 et seq., C.R.S. In that event, the Mandatory Control Level Event shall be deemed sufficient grounds for the Commissioner to take action under § § 10-16-418 and 10-3-501 et seq., C.R.S., and the Commissioner shall have the rights, powers and duties with respect to the health organization as are set forth in § § 10-16-418 and 10-3-501 et seq., C.R.S. If the Commissioner takes actions pursuant to an Adjusted RBC Report, the health organization shall be entitled to the protections of § § 10-16-418 and 10-3-501 et seq., C.R.S., pertaining to summary proceedings. Notwithstanding any of the foregoing, the Commissioner may forego action for up to ninety (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 ninety (90) day period.
Section 10 Hearings Upon the occurrence of any of the following events, the health organization shall have the right to a confidential departmental hearing pursuant to § 24-4-105, C.R.S., on a record, at which the health organization may challenge any determination or action by the Commissioner. The health organization shall notify the Commissioner of its request for a hearing within five (5) days after the notification by the Commissioner under Subsection A, B, C or D. Upon receipt of the health organization’s request for a hearing, the Commissioner shall set a date for the hearing, which shall be no less than ten (10) nor more than thirty (30) days after the date of the health organization’s request. The events include:
A. Notification to a health organization by the Commissioner of an Adjusted RBC Report; or B. Notification to a health organization by the Commissioner that:
C. Notification to a health organization by the Commissioner that the health organization has failed to adhere to its RBC Plan or Revised RBC Plan and that the failure has a substantial adverse effect on the ability of the health organization to eliminate the Company Action Level Event with respect to the health organization in accordance with its RBC Plan or Revised RBC Plan; or D. Notification to a health organization by the Commissioner of a Corrective Order with respect to the health organization.
Section 11 Confidentiality and Prohibition on Announcements A. All RBC Reports (to the extent the information is not required to be set forth in a publicly available annual statement schedule) and RBC Plans (including the results or report of any examination or analysis of a health organization performed pursuant to this statute and any Corrective Order issued by the Commissioner pursuant to examination or analysis) with respect to a domestic or foreign health organization that are in the possession or control of the Commissioner shall be confidential by law and privileged, pursuant to § 24-72-204(3)(a)(IV), C.R.S., and shall not be subject to § 24-72-201, et. seq. C.R.S., shall not be subject to subpoena, and shall not be subject to discovery or admissible in evidence in any private civil action. However, the Commissioner is authorized to use the documents, materials or other information in the furtherance of any regulatory or legal action brought as a part of the Commissioner’s official duties.
B. Neither the Commissioner nor any person who received documents, materials or other information while acting under the authority of the Commissioner shall be permitted or required to testify in any private civil action concerning any confidential documents, materials or information subject to Subsection A.
C. In order to assist in the performance of the Commissioner’s duties, the Commissioner:
D. No waiver of any applicable privilege or claim of confidentiality in the documents, materials or information shall occur as a result of disclosure to the Commissioner under this section or as a result of sharing as authorized in Section 11C.
E. The comparison of a health organization’s Total Adjusted Capital to any of its RBC Levels is a regulatory tool which may indicate the need for corrective action with respect to the health organization, and is not intended as a means to rank health organizations generally. Therefore, except as otherwise required under the provisions of this Regulation, the making, publishing, disseminating, circulating or placing before the public, or causing, 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 a radio or television station, or in any other way, an advertisement, announcement or statement containing an assertion, representation or statement with regard to the RBC Levels of any health organization, or of any component derived in the calculation, by any health organization, agent, broker or other person engaged in any manner in the insurance business would be misleading and is therefore prohibited; provided, however, that if any materially false statement with respect to the comparison regarding a health organization’s Total Adjusted Capital to its RBC Levels (or any of them) or an inappropriate comparison of any other amount to the health organizations’ RBC Levels is published in any written publication and the health organization is able to demonstrate to the Commissioner with substantial proof the falsity of the statement, or the inappropriateness, as the case may be, then the health organization may publish an announcement in a written publication if the sole purpose of the announcement is to rebut the materially false statement.
Section 12 Foreign Health Organizations A. A foreign health organization shall, upon the written request of the Commissioner, submit to the Commissioner an RBC Report as of the end of the calendar year just ended the later of:
B. A foreign health organization shall, at the written request of the Commissioner, promptly submit to the Commissioner a copy of any RBC Plan that is filed with the insurance commissioner of any other state.
C. In the event of a Company Action Level Event, Regulatory Action Level Event or Authorized Control Level Event with respect to a foreign health organization as determined under the RBC statute or regulation applicable in the state of domicile of the health organization (or, if no RBC statute or regulation is in force in that state, under the provisions of this Regulation), if the insurance commissioner of the state of domicile of the foreign health organization fails to require the foreign health organization to file an RBC Plan in the manner specified under that state’s RBC statute or regulation (or, if no RBC statute or regulation is in force in that state, under Section 6 of this Regulation), the Commissioner may require the foreign health organization to file an RBC Plan with the Commissioner. In such event, the failure of the foreign health organization to file an RBC Plan with the Commissioner shall be grounds to order the health organization to cease and desist from writing new insurance business in this state.
D. In the event of a Mandatory Control Level Event with respect to a foreign health organization, if no domiciliary receiver has been appointed with respect to the foreign health organization under the rehabilitation and liquidation statute applicable in the state of domicile of the foreign health organization, the Commissioner may make application to the Denver District Court permitted under § 10-3-501 et. seq., C.R.S., with respect to the liquidation of property of foreign health organizations found in this state, and the occurrence of the Mandatory Control Level Event shall be considered adequate grounds for the application.
Section 13 Severability If any provision of this Regulation or the application of it to any person or circumstance is for any reason held to be invalid, the remainder of this Regulation shall not be affected. Section 14 Notices All notices by the Commissioner to a health organization which may result in regulatory action thereunder shall be effective upon dispatch if transmitted by registered or certified mail, or in the case of any other transmission shall be effective upon the health organization’s receipt of such notice. Section 15 Enforcement Noncompliance with this regulation may result in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance, or other laws, which include the imposition of civil penalties, issuance of cease and desist orders, and/or suspensions or revocation of license, subject to the requirements of due process.
Section 16 Effective Date This Regulation shall become effective on August 1, 2013. Section 17 History New Regulation, effective March 1, 2012.
Amended Regulation, effective August 1, 2013 Regulation 3-1-13 DISCLOSURE OF MATERIAL TRANSACTIONS Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Report Section 5 Acquisitions and Dispositions of Assets Section 6 Nonrenewals, Cancellations or Revisions of Ceded Reinsurance Agreements Section 7 Confidentiality Section 8 Severability Section 9 Enforcement Section 10 Effective Date Section 11 History Section 1 Authority This regulation is promulgated under the authority of § §10-1-109, 10-6-114, 10-6-129, 10-14-505, 10-16- 109 C.R.S.
Section 2 Scope and Purpose The purpose of this regulation is to establish filing requirements for certain domestic insurers for material transactions, which have the potential of creating a hazardous financial condition. It is necessary to monitor the financial condition and operation of an insurer so as to adequately protect its insureds and the public.
Section 3 Applicability This regulation shall apply to Colorado domestic insurers licensed under §10-3-102 C.R.S. as well as each risk retention group captive insurer, fraternal benefit society, health maintenance organization, non- profit hospital, medical-surgical and health service corporation, and prepaid dental care plan. Section 4 Report A. Every insurer domiciled in this state shall file a report with the Commissioner disclosing material acquisitions and dispositions of assets or material nonrenewals, cancellations or revisions of ceded reinsurance agreements or material new ceded reinsurance agreements affecting life insurance business unless the acquisitions and dispositions of assets or material nonrenewals, cancellations or revisions of ceded reinsurance agreements or material new ceded reinsurance agreements affecting in force life insurance business have been submitted to the Commissioner for review, approval or information purposes pursuant to other provisions of the insurance laws, regulations, or other requirements.
B. The report required in Subsection A is due within fifteen (15) days after the end of the calendar month in which any of the foregoing transactions occur.
C. One complete copy of the report, including any exhibits or other attachments, shall be filed with:
A. Materiality.
B. Scope.
C. Information to be reported.
Section 6 Nonrenewals, Cancellations or Revisions of Ceded Reinsurance Agreements Introduction: For purposes of this Section 6, health maintenance organizations, non-profit hospital, medical-surgical and health service corporations, prepaid dental care plans, title companies and group captives shall follow the requirements for property and casualty companies, and fraternal benefit societies shall follow the rules for life insurance companies.
A. Materiality and Scope.
B. Information to be reported.
Section 7 Confidentiality A. All reports obtained by or disclosed to the Commissioner pursuant to this Regulation in the possession or control of the Division of Insurance, shall be considered confidential and privileged pursuant to §24-72-204(3)(a)(IV), C.R.S., and where applicable §10-3-807, C.R.S. Said reports shall not be subject to subpoena, and shall not be subject to discovery or admissible in evidence in any private civil action without the prior written consent of the insurer to which it pertains. However, the Commissioner is authorized to use the documents, materials or other information in the furtherance of any regulatory or legal action brought as a part of the Commissioner’s official duties.
B. After giving the insurer who would be affected notice and an opportunity to be heard, the Commissioner may determine that the interest of policyholders, shareholders or the public will be served by publication of the information subject to Subsection A, in which event the Commissioner may publish all or any part in the manner the Commissioner may deem appropriate.
C. Neither the Commissioner nor any person who received documents, materials or other information while acting under the authority of the Commissioner shall be permitted or required to testify in any private civil action concerning any confidential documents, materials or information subject to Subsection A.
D. In order to assist in the performance of the Commissioner’s duties, the Commissioner:
E. No waiver of any applicable privilege or claim of confidentiality in the documents, materials or information shall occur as a result of disclosure to the Commissioner under this section or as a result of sharing as authorized in Subsection D.
Section 8 Severability If any provision of this regulation or the application thereof to any person or circumstance is for any reason held to be invalid, the remainder of this regulation shall not be affected thereby. Section 9 Enforcement Noncompliance with this Regulation may result, after proper notice and hearing, in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance or other laws which include the imposition of fines, issuance of cease and desist orders, and/or suspensions or revocation of license. Among others, the penalties provided for in §10-3-109(3), C.R.S. may be applied. Section 10 Effective Date This amended regulation shall be effective for all transactions accomplished on or after October 2, 2006. Section 11 History Original effective April 1, 1996.
Amended effective October 2, 2006 Regulation 3-1-14 ALTERNATIVE MECHANISMS FOR CARRIERS ENTERING INTO CONTRACTS WITH RISK BEARING ENTITIES Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Definitions Section 5 Determining and Monitoring the Financial Viability of the Risk Bearing Entity Section 6 Appropriate Management Expertise and Infrastructure Section 7 Reinsurance/Reserves or other Financial Assurance Section 8 Risk Bearing Entity/Provider Communication Section 9 Reports from Carrier to Risk Bearing Entity Section 10 Corrective Action Section 11 Resolution of Conflicts through Binding Arbitration Section 12 Applying for the Alternative Mechanism Section 13 Severability Section 14 Enforcement Section 15 Effective Date Section 16 History Section 1 Authority This regulation is promulgated under the authority of § §10-1-109, 10-16-109 and 10-16-708 C.R.S. Section 2 Scope and Purpose Colorado law permits carriers to enter into contracts with risk bearing entities. Section 10-16-705(5)(a), C.R.S. states that in the event of nonpayment by or insolvency of the risk bearing entity the carrier is responsible for the payment of all participating providers that have provided covered health care services to covered persons of the Carrier. In lieu of this automatic requirement to pay, Section 10-16-705(5)(b) provides a Carrier with the option of applying for use of an alternative mechanism to ensure that all participating providers that have provided covered health care services to covered persons of the Carrier pursuant to one or more contracts with such contractors or subcontractors or their intermediaries receive payment due.
The alternative mechanism is approved and operating to exempt the Carrier from the automatic requirement to pay under Section 10-16-705(5)(a) as long as the carrier complies with the provisions of the alternative mechanism for which it is directly responsible and monitors the execution of the provisions of the alternative mechanism for which the Risk Bearing Entity is responsible. If a carrier knew or should have known the Risk Bearing Entity was unable to meet its contractual obligations and did not take reasonable action, then the carrier is deemed not to be in compliance with the alternative mechanism, and therefore is subject to §10-16-705(5)(a), C.R.S.
The purpose for this regulation is to establish an acceptable alternative mechanism pursuant to §10-16- 705(5)(b), C.R.S. This regulation establishes the terms of an alternative mechanism, which, if complied with, is deemed approved for purposes of §10-16-705(5)(b), C.R.S. Carriers are not limited to this one alternative mechanism. Other alternative mechanism plans can be submitted for consideration to the commissioner.
Section 3 Applicability This regulation applies to all carriers requesting approval from the commissioner for the use of an alternative mechanism to ensure that all participating providers receive payment due. Section 4 Definitions A. “Risk Bearing Entity” is any entity assuming risk from a licensed Carrier to provide covered benefits and services under a managed care plan, which risk the entity would not otherwise have the ability and legal authority to provide.
B. “Start Up Entity” is any Risk Bearing Entity which has less than 24 months operational experience in the Colorado market; or an entity which has experienced a major change in business, including significant market and product expansions; or an entity which has less than 24 months experience in managing its current scope of services.
C. “Established Entity” is a Risk Bearing Entity which has been operating in the Colorado market under its current operational plan for a minimum of 24 months.
D. “Carrier” as referenced herein, is an entity as defined in §10-16-102(8), C.R.S. which enters into a risk bearing arrangement with providers of services to members of the Carrier's managed care plan.
E. “IBNR report” is a report containing sufficient information to assess all of the Risk Bearing Entity's future liabilities under the contract, including all liabilities incurred and reported but not paid and incurred but not reported.
Section 5 Determining and Monitoring the Financial Viability of the Risk Bearing Entity A. For a Start Up Entity, a Carrier must receive, review and accept documentation from the Risk Bearing Entity which evidences sufficient ability to accept the risk transfer.
B. For an Established Entity a Carrier must receive, review and accept documentation evidencing sufficient ability to accept the risk transfer.
A. A Carrier shall ascertain that a Risk Bearing Entity has the management expertise and infrastructure needed to successfully enter into and perform in accordance with the risk contract.
B. The Risk Bearing Entity shall notify the Carrier of 1) all material modifications to its plan of operations; 2) changes in ownership structure and 3) material financial or operational concerns regarding the financial viability of the Risk Bearing Entity or of the Carrier's contract which has been brought to the attention of the Risk Bearing Entity’s board of directors. Section 7 Reinsurance/Reserves or other Financial Assurance A. A Risk Bearing Entity must maintain cash and cash equivalents at least equal to 45 days of claims liability and capitation payments if claims are administered by the Carrier and 90 days of claims liability and capitation payments if claims are administered by the Risk Bearing Entity. The Commissioner may establish alternative requirements in cases where the contract contains the following terms: 1) The carrier pays the provider directly; 2) The providers are only at risk to provide services which they have the ability and the legal authority to provide; and 3) Neither the carrier nor the risk bearing entity may withhold or redirect funds from these providers to pay for other services.
B. A Risk Bearing Entity shall have appropriate aggregate and specific reinsurance contracts. At a minimum, aggregate and specific reinsurance in amounts required for Risk Bearing Entities participating in HCFA Medicare + Choice programs is required, even if the Risk Bearing Entity does not participate in a Medicare + Choice program.
C. Once the Start Up Entity and the Carrier have agreed to a contract, a Start Up Entity shall obtain an actuarial opinion from a mutually agreed upon qualified actuarial firm certifying that the financial arrangements, including initial capitation rates, are actuarially sound. Section 8 Risk Bearing Entity/Provider Communication A. The contract between a Carrier and a Risk Bearing Entity shall include a provision requiring the Risk Bearing Entity to obtain from each provider a statement of understanding at the time the provider enters into a contract with the Risk Bearing Entity and at least annually thereafter. The statement of understanding shall disclose:
B. The contract between a Carrier and a Risk Bearing Entity shall include a provision requiring the Risk Bearing Entity to provide, no less than quarterly, its participating providers with a financial summary including claims performance versus projections for the Risk Bearing Entity as a whole and by Carrier contract; a report of claims paid by the Carrier and by the Risk Bearing Entity; an IBNR report; the amount of actual cash and cash equivalents compared to the minimum amount required to be owned pursuant to Section 6(A) and material changes in major contracts.
C. Excluding privileged, member, client and provider specific proprietary information, all of the reports in their standard format described in this regulation will be made available to any provider contracted with the Risk Bearing Entity, upon request, on line, if possible, but in any event within ten (10) business days from receipt of a written request. Section 9 Reports from Carrier to Risk Bearing Entity A. The Carrier shall provide the Risk Bearing Entity reports at least monthly pertaining to the specific contract which includes:
B. The Carrier shall notify the Risk Bearing Entity of
Section 10 Corrective Action A. If at any time the Carrier identifies deficiencies and determines that the deficiencies would result in imminent nonpayment to participating providers or inability to provide services to a substantial number of members, the Carrier may immediately deem itself insecure and take back administration of the contract including paying providers directly. Such action can only be taken upon written confirmation by a mutually agreed upon third party named within three business days of notice from the Carrier to the Risk Bearing Entity of imminent nonpayment to participating providers or inability to provide services to a substantial number of members. If the parties are unable to make a determination on a third party within the allowed 3 days, they may seek selection by the Commissioner.
B. If the Carrier determines that the Risk Bearing Entity is not meeting significant requirements of the contract, the Carrier must notify the Risk Bearing Entity of the deficiency in writing. The Carrier and the Risk Bearing Entity have 30 days to mutually agree upon a reasonable action plan and begin implementation of the action plan.
C. If the deficiencies continue after the completion of the term of the action plan, and the deficiencies would have a material detrimental financial impact, the Carrier shall deem itself insecure and may take back administration of the contract including paying providers directly.
D. If the Risk Bearing Entity determines that the Carrier is not meeting significant requirements of the contract, the Risk Bearing Entity must notify the Carrier in writing of the deficiency. The Carrier and the Risk Bearing Entity have 30 days to mutually agree upon a reasonable action plan and begin implementation of the action plan.
E. If the deficiencies continue after the completion of the term of the action plan, and the deficiencies would have a material detrimental financial impact, the Risk Bearing Entity shall deem itself insecure and must initiate remedies available under the contract.
F. If 20% or more of providers contracted with the Risk Bearing Entity sign a letter addressed to the Carrier and to the Risk Bearing Entity attesting to the fact that the Risk Bearing Entity or Carrier is not providing payment as required by their contracts or state statute, the Carrier, the Risk Bearing Entity and a representative of these providers have 30 days to mutually agree upon a reasonable action plan to address the providers' issues.
G. If 50% or more of providers contracted with the Risk Bearing Entity sign a letter addressed to the Carrier and to the Risk Bearing Entity indicating that the deficiencies continue after the completion of the term of the action plan, and a third party, mutually agreed upon by the Carrier, the Risk Bearing Entity and the providers, determines that the deficiencies would have a material detrimental financial impact, the Carrier shall deem itself insecure and shall take back administration of, including paying providers directly, or terminate the contract.
H. If 50% or more of providers contracted with the Risk Bearing Entity sign a letter addressed to the Carrier and to the Risk Bearing Entity identifying deficiencies that would result in imminent nonpayment to participating providers or inability to provide services to a substantial number of members, the providers may ask that the Carrier deem itself insecure and take back administration of, including paying providers directly, or terminate the contract.
I. If the above provisions do not result in payment to the providers pursuant to their contracts, the Carrier, the Risk Bearing Entity or a representative of 50% of the providers may seek Alternative Dispute Resolution (ADR).
J. The Carrier shall provide notice of any deficiency identified under this Section 9, alleging a material detrimental financial impact, to the Financial Affairs Section of the Division of Insurance within five business days from the date the Carrier receives notification from or notifies the Risk Bearing Entity.
Section 11 Resolution of Conflicts through Binding Arbitration A. All contracts between or among a Carrier, a Risk Bearing Entity and one or more providers arising under circumstances covered in Section 9, shall contain a provision that conflicts will be resolved through binding arbitration or through any other form of ADR agreed to by all parties.
B. The purpose of ADR is to provide an allocation of responsibility between providers, Carriers and Risk Bearing Entities with respect to compliance with the alternative mechanism.
C. The arbitration panel shall be established as follows. One person may be selected if the parties can agree. Otherwise, a three person panel will be selected with one member selected by the Carrier, and one member selected by the provider representative and one member by the Risk Bearing Entity. If any of the three parties do not suggest a panel member, the third panelist will be selected by the other two panelists.
Section 12 Applying for the Alternative Mechanism A. When a Carrier and a Risk Bearing Entity enter into a contract, both parties will certify their intention to comply with the alternative mechanism described in this Regulation. The Carrier will maintain a copy of the contractual language or certification on file.
B. When a Carrier submits its risk based capital report on March 1 of each year, the report will include an attachment to the report identifying each contract for which this alternative mechanism was invoked, the amount of managed care credit taken by contract and the total managed care credit taken for risk based capital purposes.
C. The Carrier will be responsible to provide the Commissioner with information substantiating compliance with the provisions of the alternative mechanism upon request. Section 13 Severability If any provision of this regulation or the application of it to any person or circumstance is for any reason held to be invalid, the remainder of this regulation shall not be affected. Section 14 Enforcement Noncompliance with this regulation may result in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance, or other laws, which include the imposition of civil penalties, issuance of cease and desist orders, and/or suspensions or revocation of license, subject to the requirements of due process.
Section 15 Effective Date This amended regulation shall become effective on July 1, 2012. Section 16 History New regulation effective on May 1, 2001 Amended regulation effective July 1, 2012 Regulation 3-1-15 PREMIUM DEFICIENCY RESERVE STANDARDS FOR INDIVIDUAL AND GROUP HEALTH BENEFIT PLANS Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Definitions Section 5 Calculations Section 6 Restrictions and Other Guidelines Section 7 Documentation Section 8 Severability Section 9 Enforcement Section 10 Effective Date Section 11 History Section 1 Authority This regulation is promulgated and adopted by the Commissioner of Insurance under the authority of §§ 10-1-108, 10-1-109, 10-3-109, 10-3-208, 10-16-109, and 10-16-220, C.R.S. Section 2 Scope and Purpose The purpose of this regulation is to establish minimum standards for determining when a Premium Deficiency Reserve is necessary, for companies providing individual and group health coverage, and to implement rules for calculating the reserve.
Section 3 Applicability This regulation applies to all licensed companies conducting business in the State of Colorado, as defined in Section 4, who issue any line of health coverage including, but not limited to, major medical, long-term care, and disability insurance. Each company is required to establish a Premium Deficiency Reserve, when necessary, on each financial statement submitted to the Colorado Division of Insurance. The Premium Deficiency Reserve is in addition to claim and contract reserves, rate stabilization reserves, retroactive premium liabilities, provider reserves, provider withhold or bonus pool reserves, and other reserves not held to specifically make future benefit payments. A reserve similar to the Premium Deficiency Reserve may also be necessary for other types of contractual arrangements, such as administrative services agreements, or any other health benefit contracts in which the administrative fees or compensation received are not sufficient to cover the expenses for the remainder of the deficiency period. This reserve should be calculated using the procedures outlined in this regulation. Section 4 Definitions A. “Claims” means, for purposes of this regulation, all amounts payable for losses incurred under the health benefit contract.
B. “Company” means, for purposes of this regulation, a carrier as defined in Section 10-16-102(8), C.R.S., and includes, but is not limited to, licensed property and casualty insurance companies; licensed life and health insurance companies; non-profit hospital, medical-surgical, and health service corporations; health maintenance organizations; prepaid dental companies; and limited service licensed provider networks.
C. “Contract Grouping” means, for purposes of this regulation, a collection of health benefit contracts with similar benefits, such as comprehensive individual major medical plans, Medicaid, or small group health benefit plans. Each grouping should be determined in a manner consistent with how policies are marketed, serviced and measured. Generally, the groupings should reflect how the premium rates are developed. A grouping shall not include multistate ACA business. Instead, the company shall create multiple contract groupings of ACA business for each state in which the company does business, and each line of business with policies that differ significantly from the other lines in how they are marketed, serviced, and measured..
D. “Contract Period” means, for purposes of this regulation, the period of time for which the company is liable for the provision of benefits as provided in the health benefit contract. This period may include multi-year arrangements.
E. “Deficiency Period” means, for purposes of this regulation, the period of time for which future earned premiums and current reserves are not sufficient to cover future incurred claim payments and expenses. This period may be for the remainder of the contract period and may include future contract periods.
F. “Expenses” means, for the purpose of this regulation, a reasonable allocation, by contract grouping, of the company’s expenses (including claims adjustment expenses) reasonably assumed to be incurred in the settlement of the claims to be paid in the deficiency period. Fixed expenses need not be allocated to each contract grouping. These expenses may be allocated as determined by the Company and the calculation of the premium deficiency reserve may be performed using the direct costs only. Expenses for functions performed under a management agreement may not be waived and must be considered as part of the company’s fixed expenses.
G. “Investment Income” means, for purposes of this regulation, any income, dividends, or other earnings that can appropriately be attributable to the contract grouping and the time period for which the calculation is being performed. This income normally can be attributed to earnings from earned premium reserves, reserves for known losses, and reserves for incurred but not reported losses.
H. “Premium” means, for the purpose of this regulation, the amount of compensation received to pay future claims payments and expenses potentially payable during the deficiency period.
I. “Premium Deficiency Reserve” means, for the purpose of this regulation, a reserve established on the valuation date when, it is probable that, future premiums and current reserves are not sufficient to pay future claim payments and expenses for the remainder of the deficiency period. This reserve should be reviewed at least annually and adjusted as necessary. The procedure for calculating this reserve can be found in Section 5 below.
J. “Valuation Date” means, for the purpose of this regulation, the beginning of the time period over which the Premium Deficiency Reserve is calculated.
Section 5 Calculations The Premium Deficiency Reserve must be calculated, according to the following methodology and, if greater than zero, disclosed as a liability on each financial statement filed with the Colorado Division of Insurance, with a corresponding charge to operations. The reserve must be calculated, for each contract grouping, as the sum of the:
A. Accuracy Review - Determinations of the reserve may be done monthly, quarterly, annually, or any time the actuary determines is reasonable, or is necessary for statutory reporting purposes, but no less frequently than annually. As of the date of each successive statutory financial statement, the Premium Deficiency Reserve must be re-evaluated and adjusted to reflect the losses that have been realized since the previous financial statement, and any deficiencies that have arisen.
B. Actuarial Opinions - The Premium Deficiency Reserve amount is expected to be included in each Statement of Actuarial Opinion submitted to the Colorado Division of Insurance.
C. Assumptions - All underlying assumptions should be specified and supported by as much company data as possible and other supporting data deemed necessary. These include, but are not limited to, the following assumptions; lapse, interest rate, claim and expense trend, premium increases and enrollment changes.
D. Contract Grouping – Each contract grouping should be large enough to be material relative to the size of the company as a whole. In some cases, considerations of similarity and materiality may result in all health contracts being treated as a single grouping. Each contract grouping should be reviewed to determine if earned premiums and reserves will be sufficient to cover incurred claims and related expenses for each contract period. Each contract grouping should remain relatively consistent from valuation to valuation. A Premium Deficiency Reserve must be recognized for each contract grouping where a premium deficiency is indicated.
E. Enrollment - The Premium Deficiency Reserve must be calculated using reasonable and supportable enrollment assumptions. Enrollment assumptions should be tied to any anticipated rate increases during the deficiency period. The effect of new business must be considered in the enrollment assumptions.
F. Expenses - The actuary should disclose whether expenses from a start-up situation, where the entity has just begun to write business, were considered in the Premium Deficiency Reserve calculations. The actuary may only exclude relevant start-up expenses in the calculation if they explicitly identify the expenses excluded, and clearly justify their decision and rationale for doing so.
G. Interest Rate - The interest rate used in determining the present values should be reasonable and supportable based upon the type of business and the deficiency period. Guidance may be found in Colorado Insurance Regulation 3-1-9.
H. Investment Income – The calculation may reflect investment income that is appropriately attributable to the contract grouping and the time period for which the calculation is being performed. Investment income should be reflected as a cash inflow in the calculation.
I. Profit Recognition – Under no circumstances may anticipated future profits from contracts in one contract grouping from future renewal periods be used to reduce or mitigate the calculated Premium Deficiency Reserve for prior periods for contracts in a different contract grouping. Within a contract grouping, if rate increases are on file with the Division of Insurance that increase rates for the new contract period, and these increases will be adequate to cover claims and expenses in the new contract period, the anticipated profits may be used to reduce or mitigate the calculated Premium Deficiency Reserve for prior contract periods. Considerable actuarial judgment, including consideration of all pertinent factors, should be incorporated to determine if it is highly probable that these future profits will offset the calculated deficiencies in the valuation period.
Section 7 Documentation The company must maintain adequate documentation as to how the Premium Deficiency Reserve was determined or why a Premium Deficiency Reserve was not necessary. The documentation should be maintained in a report or workpaper containing, at a minimum, the following information:
A. The characteristics of the policies in each contract grouping.
B. A listing of all of the assumptions underlying the calculation of the Premium Deficiency Reserve. Support for the determination of the assumptions should also be maintained. The listing should include, but not be limited to:
C. Documentation as to how the Premium Deficiency Reserve, including all relevant calculations and formulas in spreadsheet format.
All documentation should be made available, upon request, from the Colorado Division of Insurance within 30 days of the date of the request, or within 30 days of the filing date of the financial statements to which the request is directed.
Section 8 Severability If any provision of this regulation or the application of it to any person or circumstance is for any reason held to be invalid, the remainder of this regulation shall not be affected. Section 9 Enforcement Non compliance with this regulation may result in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance or other laws, which include the imposition of fines, issuance of cease and desist orders, and/or suspensions or revocation of license. Section 10 Effective Date This regulation shall become effective on March 15, 2021. Section 11 History New regulation effective March 2, 2002.
Amended regulation effective July 1, 2012.
Amended regulation effective March 15, 2021.
Regulation 3-1-16 CUSTODIAL AGREEMENTS AND THE USE OF CLEARING CORPORATIONS Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Definitions Section 5 Custody Agreement; Requirements Section 6 Severability Section 7 Enforcement Section 8 Effective Date Section 9 History Section 1 Authority This regulation is promulgated and adopted by the Commissioner of Insurance under the authority of §§ 10-1-109, and 10-3-1203(2), 10-6-129, 10-14-505 and 10-16-109, C.R.S. Section 2 Scope and Purpose The purpose of this regulation is to provide current criteria, procedures and clarification concerning the holding of securities or book-entry securities as investments or in meeting the statutory deposits or guaranty fund deposits pursuant to §§ 10-3-210, 10-6-116, 10-16-310, 10-16-412 and 10-16-505, C.R.S. Only custodial agreements complying with this regulation shall be acceptable to the Commissioner of Insurance.
Section 3 Applicability This regulation shall apply to all Colorado domestic insurers as well as each Colorado domestic risk retention group captive insurer, fraternal benefit society, health maintenance organization and non-profit hospital, medical-surgical and health service corporation, prepaid dental care plan and Pinnacol Assurance.
Section 4 Definitions A. “Agent” means, for the purposes of this regulation, a national bank, state bank, trust company or broker/dealer that maintains an account in its name in a clearing corporation or which is a member of the Federal Reserve System and through which a custodian participates in a clearing corporation, including the Treasury/Reserve Automated Debt Entry Securities System (TRADES) or Treasury Direct systems, except that with respect to securities issued by institutions organized or existing under the laws of a foreign country or securities used to meet the deposit requirements pursuant to the laws of a foreign country as a condition of doing business therein, “agent” may include a corporation which is organized or existing under the laws of a foreign country and that is legally qualified under those laws to accept custody of securities.
B. “Clearing corporation” means, for the purposes of this regulation, a corporation as defined in Sections 4-8-102(a)(5) and 10-3-1202(1), C.R.S., that is organized for the purpose of effecting transactions in securities by computerized book-entry, except that with respect to securities issued by institutions organized or existing under the laws of a foreign country or securities used to meet the deposit requirements pursuant to the laws of a foreign country as a condition of doing business therein, “clearing corporation” may include a corporation that is organized or existing under the laws of a foreign country and which is legally qualified under those laws to effect transactions in securities by computerized book-entry. Clearing corporation also includes “Treasury/Reserve Automated Debt Entry Securities System” and “Treasury Direct” book-entry securities systems established pursuant to 31 U.S. Code § 3100 et seq.,12 U.S. Code § 391 and 5 U.S. Code § 301.
C. “Commissioner” means, for the purposes of this regulation, the commissioner of insurance.
D. “Company” means, for the purposes of this regulation, an insurer, captive insurance company, fraternal benefit society, health maintenance organization, nonprofit hospital, medical-surgical and health service corporation, prepaid dental care plan and Pinnacol Assurance.
E. “Custodian” means for the purposes of this regulation:
F. “Custodied securities” means, for the purposes of this regulation, securities held by the custodian or its agent or in a clearing corporation, including the Treasury/Reserve Automated Debt Equity Securities System (TRADES) or Treasury Direct systems.
G. “Tangible net worth” means, for the purposes of this regulation, shareholders equity, less intangible assets, as reported in the broker/dealer's most recent Annual or Transition Report pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934 (S.E.C. Form 10-K) filed with the Securities and Exchange Commission.
H. “Treasury/Reserve Automated Debt Entry Securities System” (“TRADES”) and “Treasury Direct” mean, for the purposes of this regulation, the book entry securities systems established pursuant to 31 U.S. Code § 3100 et seq.,12 U.S. Code § 391 and 5 U.S. Code § 301. The operation of TRADES and Treasury Direct are subject to 31 Code of Federal Regulations § 357 et seq.
I. “Securities” shall have the same meaning as found at § 4-8-102(15), C.R.S.
J. “Securities’ certificate” shall have the same meaning as found at § 4-8-102(16), C.R.S. Section 5 Custody Agreement Requirements A. A company may, by written agreement with a custodian, provide for the custody of its securities with that custodian. The securities that are the subject of the agreement may be held by the custodian or its agent or in a clearing corporation.
B. Any custodial agreement shall be in writing and shall be authorized by a resolution of the board of directors of the company or of an authorized committee of the board. The terms of the agreement shall comply with the following:
Section 6 Severability If any provision of this regulation or the application of it to any person or circumstance is for any reason held to be invalid, the remainder of this regulation shall not be affected. Section 7 Enforcement Noncompliance with this Regulation may result in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance, or other laws, which include the imposition of civil penalties, issuance of cease and desist order, and/or suspensions or revocation of license, subject to the requirements of due process.
Section 8 Effective Date This regulation shall become effective on April 1, 2017. Section 9 History New regulation effective October 2, 2006.
Amended Regulation, Effective April 1, 2017.
COUNTY OF ________________________ )
_______________________________________, being duly sworn deposes and says that he or she is ____________________ of _____________________________________, a corporation organized under and pursuant to the laws of the _________________ with the principal place of business at ____________________________ (hereinafter called the “corporation”): That his or her duties involve supervision of activities as custodian and records relating thereto; That the corporation is custodian for certain securities of _________________________ _________________ having a place of business at _____________________________ _______________________ (hereinafter called the “insurance company”) pursuant to an agreement between the corporation and the insurance company;
That the schedule attached hereto is a true and complete statement of securities (other than those caused to be deposited with The Depository Trust Company or like entity or a Federal Reserve Bank under the TRADES or Treasury Direct systems) which were in the custody of the corporation for the account of the insurance company as of the close of business on ________________________; that, unless otherwise indicated on the schedule, the next maturing and all subsequent coupons were then either attached to coupon bonds or in the process of collection; and that, unless otherwise shown on the schedule, all such securities were in bearer form or in registered form in the name of the insurance company or its nominee or of the corporation or its nominee, or were in the process of being registered in such form;
That the corporation as custodian has the responsibility for the safekeeping of such securities as that responsibility is specifically set forth in the agreement between the corporation as custodian and the insurance company; and That, to the best of his or her knowledge and belief, unless otherwise shown on the schedule, the securities were the property of the insurance company and were free of all liens, claims or encumbrances whatsoever.
Subscribed and sworn to before me this _____day of ______________, 20____ _______________________________(L.S.) Vice President [or other authorized officer] Notary Public___________________________ Residing in: ____________________________ My Commission Expires: _________________ ______________________________________ Street Address of Branch or Office ______________________________________ Name of Organization Employing Notary FORM B CUSTODIAN AFFIDAVIT (For use in instances where a custodian corporation maintains securities on deposit with The Depository Trust Company or like entity.)
STATE OF __________________________ )
COUNTY OF ________________________ )
__________________________________________, being duly sworn deposes and says that he or she is ____________________ of __________________________________________, a corporation organized under and pursuant to the laws of the _______________________ with the principal place of business at __________________________ (hereinafter called the “corporation”): That his or her duties involve supervision of activities of the corporation as custodian and records relating thereto;
That the corporation is custodian for certain securities of ___________________________________________ having a place of business at _______________________________ _________________________ (hereinafter called the “insurance company”) pursuant to an agreement between the corporation and the insurance company; That the corporation has caused certain of such securities to be deposited with _________________________________________ and that the schedule attached hereto is a true and complete statement of the securities of the insurance company of which the corporation was custodian as of the close of business on _______________________________________, and which were so deposited on such date;
That the corporation as custodian has the responsibility for the safekeeping of the securities both in the possession of the corporation or deposited with ____________________________________ as is specifically set forth in the agreement between the corporation as custodian and the insurance company; and That, to the best of his or her knowledge and belief, unless otherwise shown on the schedule, the securities were the property of the insurance company and were free of all liens, claims or encumbrances whatsoever.
Subscribed and sworn to before me this _____day of ______________, 20____ _______________________________(L.S.) Vice President [or other authorized officer] Notary Public___________________________ Residing in: ____________________________ My Commission Expires: _________________ ______________________________________ Street Address of Branch or Office ______________________________________ Name of Organization Employing Notary FORM C CUSTODIAN AFFIDAVIT (For use where ownership is evidenced by book entry at a Federal Reserve Bank.) STATE OF __________________________ )
COUNTY OF ________________________ )
_______________________________________, being duly sworn deposes and says that he or she is ____________________ of __________________________________________, a corporation organized under and pursuant to the laws of the __________________________ with the principal place of business at ________________________________________________ (hereinafter called the “corporation”):
That his or her duties involve supervision of activities of the corporation as custodian and records relating thereto;
That the corporation is custodian for certain securities of ______________________________________ with a place of business at __________________________ (hereinafter called the “insurance company”) pursuant to an agreement between the corporation and the insurance company; That it has caused certain securities to be credited to its book entry account with the Federal Reserve Bank of ________________________________________ under the TRADES or Treasury Direct systems; and that the schedule attached hereto is a true and complete statement of the securities of the insurance company of which the corporation was custodian as of the close of business on ________________, which were in a “general” book entry account maintained in the name of the corporation on the books and records of the Federal Reserve Bank of _______________________ at such date;
That the corporation has the responsibility for the safekeeping of such securities both in the possession of the corporation or in the “general” book entry account as is specifically set forth in the agreement between the corporation as custodian and the insurance company; and That, to the best of his or her knowledge and belief, unless otherwise shown on the schedule, the securities were the property of the insurance company and were free of all liens, claims or encumbrances whatsoever.
Subscribed and sworn to before me this _____day of ______________, 20____ _______________________________ (L.S.) Vice President [or other authorized officer] Notary Public___________________________ Residing in: ____________________________ My Commission Expires: _________________ ______________________________________ Street Address of Branch or Office ______________________________________ Name of Organization Employing Notary Regulation 3-1-17 CONCERNING CORPORATE GOVERNANCE ANNUAL DISCLOSURES Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Definitions Section 5 Filing Procedures Section 6 Contents of Corporate Governance Annual Disclosure Section 7 Severability Section 8 Enforcement Section 9 Effective Date Section 10 History Section 1 Authority This regulation is promulgated and adopted by the Commissioner of Insurance under the authority of §§ 10-1-109(1), 10-3-1603, 10-3-1604(2), 10-3-1608, 10-5-117, 10-6-129 and 10-16-109, C.R.S. Section 2 Scope and Purpose The purpose of these regulations is to set forth the procedures for filing and the required contents of the Corporate Governance Annual Disclosure (CGAD) as required by §§ 10-3-1603 and 10-3-1604, C.R.S. Section 3 Applicability This regulation applies to all insurers and all insurance groups of which an insurer is a member subject to the insurance laws of Colorado.
Section 4 Definitions A. “Corporate governance annual disclosure” or “CGAD” shall have the same meaning as found at § 10-3-1602(1), C.R.S.
B. “Insurance group” shall have the same meaning as found at § 10-3-1602(2), C.R.S.
C. “Insurer” shall have the same meaning as found at § 10-3-1602(3), C.R.S.
D. “ORSA summary report” shall have the same meaning as found in § 10-3-1502(5), C.R.S., and as referenced in § 10-3-1602(5), C.R.S.
E. “Senior Management” means, for the purposes of this regulation, any corporate officer responsible for reporting information to the board of directors at regular intervals or providing this information to shareholders or regulators and shall include but is not limited to the Chief Executive Officer (“CEO”), Chief Financial Officer (“CFO”), Chief Operations Officer (“COO”), Chief Procurement Officer (“CPO”), Chief Legal Officer (“CLO”), Chief Information Officer (“CIO”), Chief Technology Officer (“CTO”), Chief Revenue Officer (“CRO”), Chief Visionary Officer (“CVO”), or any other “C” level executive.
Section 5 Filing Procedures A. An insurer, or the insurance group of which the insurer is a member, subject to Title 10, article 3, part 16, is required to file a Corporate Governance Annual Disclosure (CGAD) pursuant to § 10-3- 1604, C.R.S., no later than June 1 of each calendar year pursuant to § 10-3-1603, C.R.S., and submit to the Commissioner a CGAD that contains the information described in Section 6 of these regulations.
B. Pursuant to § 10-3-1603(2)(a) and (b), C.R.S., the CGAD must include a signature of the insurer’s or insurance group’s chief executive officer or corporate secretary attesting to the best of that individual’s belief and knowledge that the insurer or insurance group has implemented the corporate governance practices and that a copy of the CGAD has been provided to the insurer’s or insurance group’s Board of Directors or the appropriate committee thereof.
C. The insurer or insurance group shall have discretion regarding the appropriate format for providing the information required by these regulations and is permitted to customize the CGAD to provide the most relevant information necessary to permit the Commissioner to gain an understanding of the corporate governance structure, policies and practices utilized by the insurer or insurance group.
D. For purposes of completing the CGAD, the insurer or insurance group may choose to provide information on governance activities that occur at the ultimate controlling parent level, an intermediate holding company level and/or the individual legal entity level, depending upon how the insurer or insurance group has structured its system of corporate governance. The insurer or insurance group is encouraged to make the CGAD disclosures at the level at which the insurer’s or insurance group’s risk appetite is determined, or at which the earnings, capital, liquidity, operations, and reputation of the insurer or insurance group are overseen collectively and at which the supervision of those factors are coordinated and exercised, or the level at which legal liability for failure of general corporate governance duties would be placed. If the insurer or insurance group determines the level of reporting based on these criteria, it shall indicate which of the three criteria was used to determine the level of reporting and explain any subsequent changes in level of reporting.
E. Notwithstanding Section 5.A., and as outlined in § 10-3-1603, C.R.S., if the CGAD is completed at the insurance group level, then it must be filed with the lead state of the group, in accordance with the laws of the lead state, as determined by the procedures outlined in the most recent Financial Analysis Handbook adopted by the NAIC. In these instances, a copy of the CGAD must also be provided to the chief regulatory official of any state in which the insurance group has a domestic insurer, upon request.
F. An insurer or insurance group may comply with this section by referencing other existing documents (e.g., ORSA Summary Report, Holding Company Form B or F Filings, Securities and Exchange Commission (SEC) Proxy Statements, foreign regulatory reporting requirements, etc.) if the documents provide information that is comparable to the information described in Section 6. The insurer or insurance group shall clearly reference the location of the relevant information within the CGAD and attach the referenced document if it is not already filed or available to the Commissioner.
G. Each year following the initial filing of the CGAD, the insurer or insurance group shall file an amended version of the previously filed CGAD indicating where changes have been made. If no changes were made in the information or activities reported by the insurer or insurance group, the filing should so state.
Section 6 Contents of Corporate Governance Annual Disclosure A. The insurer or insurance group shall be as descriptive as possible in completing the CGAD, with inclusion of attachments or example documents that are used in the governance process, since these may provide a means to demonstrate the strengths of their governance framework and practices.
B. The CGAD shall describe the insurer’s or insurance group’s corporate governance framework and structure including consideration of the following:
C. The insurer or insurance group shall describe the policies and practices of the most senior governing entity and significant committees thereof, which shall include the following factors:
D. The insurer or insurance group shall describe the policies and practices for directing Senior Management, which shall include the following factors:
E. The insurer or insurance group shall describe the processes by which the Board, its committees and Senior Management ensure an appropriate amount of oversight to the critical risk areas impacting the insurer’s business activities, and shall include:
Section 7 Severability If any provision of this regulation or the application of it to any person or circumstances is for any reason held to be invalid, the remainder of this regulation shall not be affected. Section 8 Incorporated Materials The Financial Analysis Handbook adopted by the NAIC as published on the effective date of this regulation and does not include later amendments to or editions of the Financial Analysis Handbook adopted by the NAIC. A copy of the Financial Analysis Handbook adopted by the NAIC may be examined during regular business hours at the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, Colorado, 80202, or by visiting the NAIC website at https://www.naic.org/prod_serv/FAH-ZU-16-02.pdf. Certified copies of the Financial Analysis Handbook adopted by the NAIC are available from the Colorado Division of Insurance for a fee.
The Risk Management and Own Risk and Solvency Assessment Model Act, published by the NAIC, as published on the effective date of this regulation and does not include later amendments to or editions of the Risk Management and Own Risk and Solvency Assessment Model Act. A copy of the Risk Management and Own Risk and Solvency Assessment Model Act adopted by the NAIC may be examined during regular business hours at the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, Colorado, 80202, or by visiting the NAIC website at https://www.naic.org/store/free/MDL- 505.pdf. Certified copies of the Risk Management and Own Risk and Solvency Assessment Model Act are available from the Colorado Division of Insurance for a fee. Section 9 Enforcement Noncompliance with this regulation may result in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance, or other laws, which include the imposition of civil penalties, issuance of cease and desist orders, and/or suspensions or revocation of license, subject to the requirements of due process.
Section 9 Effective Date This regulation shall be effective April 15, 2020.
Section 10 History New regulation effective April 15, 2020.
Regulation 3-1-18 CONCERNING THE CLIMATE RISK DISCLOSURE SURVEY Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Definitions Section 5 Rules Section 6 Severability Section 7 Enforcement Section 8 Effective Date Section 9 History Section 1 Authority This regulation is being promulgated and adopted by the Commissioner of Insurance under the authority of §§ 10-1-109(1), and 10-3-244(1), C.R.S.
Section 2 Scope and Purpose The purpose of this regulation is to provide the requirements for insurers to participate in and complete the National Association of Insurance Commissioners (NAIC) Insurer Climate Risk Disclosure Survey. Section 3 Applicability This regulation applies to all insurers issued a certificate of authority to transact business pursuant to §§ 10-3-101 to 10-3-131, C.R.S., that report more than 100 million dollars on their annual NAIC Schedule T Filings as of January 1, 2023.
Section 4 Definitions A. “Group” shall mean, for the purposes of this regulation, those insurers and affiliates that are included within an insurance holding company system, as defined in § 10-3-801(5), C.R.S.
B. “Insurer” shall have the same meaning as found at § 10-3-801(6), C.R.S.
C. “NAIC” shall have the same meaning as found at § 10-3-801(7), C.R.S.
D. “Schedule T Filing” shall mean, for the purpose of this regulation, the NAIC convention blank form, Schedule T “Exhibit of Premiums Written and Allocated by States and Territories”, to be filed by insurers as part of their annual statement with NAIC required by Colorado Insurance Regulation 3-1-10.
Section 5 Rules A. On or before August 31, 2024, and each year thereafter, insurers shall submit a completed “NAIC Climate Risk Disclosure Survey” (“Survey”) to the California Department of Insurance as directed on the Department’s website.
B. Insurers are expected to address the content of the entire Survey to the best of their ability.
C. Insurers subject to this regulation, as defined in Section 3, that are within the same group with similar policies and practices and whose answers would not be materially different from each other may submit uniform group responses. When submitting group responses, insurers must check the premium amounts for each individual company in the group and submit a Survey response for each company issued a certificate of authority to transact business pursuant to Sections 10-3-101 to 10-3-131, C.R.S. with more than 100 million dollars in direct written premium nationwide.
D. Insurers that are required to respond to the Survey by one of the partner states and jurisdictions are only required to submit the Survey once.
Section 6 Severability If any provision of this regulation or the application of it to any person or circumstance is for any reason held to be invalid, the remainder of this regulation shall not be affected. Section 7 Enforcement Noncompliance with this regulation may result in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance, or other laws, which include the imposition of civil penalties, issuance of cease and desist orders, and/or suspensions or revocation of license, subject to the requirements of due process.
Section 8 Effective Date This regulation shall become effective on December 30, 2023. Section 9 History New regulation effective December 30, 2023.
Regulation 3-2-1 PROXIES, CONSENTS AND AUTHORIZATIONS OF DOMESTIC STOCK INSURERS Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Definitions Section 5 Solicitations to Which Regulation Applies Section 6 Information to Be Furnished To Security Holders Section 7 Requirements as To Proxy Section 8 Presentation of Information in Proxy Statement Section 9 Material Required To Be Filed Section 10 Mailing Communications for Security Holder Section 11 Proposals of Security Holders Section 12 False or Misleading Statement Section 13 Prohibition of Certain Solicitations Section 14 Special Provisions Applicable To Election Contest Section 15 Solicitations and Materials Complying with NAIC Model Regulation and Schedules Section 16 Severability Section 17 Enforcement Section 18 Effective Date Section 19 History Schedule A Schedule B Schedule C Section 1 Authority This regulation is promulgated and adopted by the Commissioner of Insurance under the authority of §§ 10-1-109, and 10-3-121(2), C.R.S.
Section 2 Scope and Purpose The purpose of this regulation is to set forth rules and procedural requirements which the Commissioner deems necessary to carry out the provisions of Section 10-3-121, C.R.S., regarding domestic stock insurers that solicit proxies, consents or authorizations in respect to any class of equity securities. Section 3 Applicability A. No domestic stock insurer that has any class of equity securities held of record by 100 or more persons, or any director, officer or employee of that insurer, or any other person, shall solicit, or permit the use of the person’s name to solicit, by mail or otherwise, any proxy, consent or authorization in respect to any class of equity securities in contravention of this regulation and Schedules A and B, hereby made a part of this regulation. However, this regulation shall not apply to any insurer if ninety-five percent (95%) or more of its equity securities is owned or controlled by a parent or an affiliated insurer and the remaining securities are held of record by less than 500 persons. A domestic stock insurer which files with the Securities and Exchange Commission with respect to any class of securities forms of proxies, consents and authorizations complying with the requirements of the Securities Exchange Act of 1934, as amended, and its applicable regulations, shall be exempt from the provisions of this regulation with respect to that class of securities.
B. Unless proxies, consents or authorizations in respect of any class of equity securities of a domestic insurer subject to Section 3A are solicited by or on behalf of the management of the insurer from the holders of record of the securities in accordance with this regulation and its schedules prior to any annual or other meeting of the security holders, the insurer shall file with the Commissioner and transmit to every security holder who is entitled to vote in regard to any matter to be acted upon at the meeting and from whom a proxy is not solicited a written information statement containing the information specified in Schedule C. Section 4 Definitions A. “Affiliate” means an “affiliate” of, or a person affiliated with a specified person, is a person that directly, or indirectly through one or more intermediaries, controls, or is controlled by, or is under common control with, the person specified.
B. “Associate,” used to indicate a relationship with any person, means:
C. “Beneficial owner” means a person who, directly or indirectly, through a contract, arrangement, understanding, relationship, or otherwise, has or shares:
D. “Control” (including the terms “controlling”, “controlled by” and “under common control with”) means the possession, direct or indirect, of the power to direct or cause the direction of the management and policies of a person, whether through the ownership of voting securities, by contract, or otherwise.
E. “Issuer” means the issuer of the securities in respect of which a proxy is solicited.
F. “Last fiscal year” of the issuer means the last fiscal year of the issuer ending prior to the date of the meeting for which proxies are to be solicited.
G. “Officer” means the president, secretary, treasurer, any vice president in charge of a principal business function (such as sales, administration or finance) and any other person who performs similar policymaking functions for the insurer.
H. “Parent” of a specified person is an affiliate controlling the person directly or indirectly through one or more intermediaries.
I “Person” means an individual, a corporation, a partnership, an association, a joint stock company, a trust, an unincorporated organization, or a government or political subdivision thereof. As used in this subsection, the term “trust” shall include only a trust where the interest or interests of the beneficiary or beneficiaries are evidenced by a security.
J. “Proxy statement” means the statement required by Section 6, whether or not contained in a single document.
K. Solicitation:
Section 5 Solicitations to Which Regulation Applies Section 12 of this regulation shall apply to every solicitation that is subject to Section 3. Sections 4 through 11 and Section 13 of this regulation shall apply to every solicitation that is subject to Section 3 except the following:
A. A solicitation made otherwise than on behalf of the issuer where the total number of persons solicited is not more than ten (10).
B. A solicitation by a person in respect of securities carried in his name or in the name of his nominee (otherwise than as voting trustee) or held in his or her custody, if the person:
C. A solicitation by a person in respect of securities of which it is the beneficial owner.
D. A solicitation through the medium of a newspaper advertisement which informs security holders of a source from which they may obtain copies of a proxy statement, form of proxy and any other soliciting material and does no more than:
E. Any solicitation which the Commissioner finds for good cause should be exempted from this regulation or any part thereof.
Section 6 Information to Be Furnished To Security Holders A. No solicitation subject to this regulation shall be made unless each person solicited is concurrently furnished or has previously been furnished with a written proxy statement containing the information specified in Schedule A.
B. If the solicitation is made on behalf of the issuer and relates to an annual meeting of security holders at which directors are to be elected, each proxy statement furnished pursuant to Subsection A shall be accompanied or preceded by an annual report to security holders as follows:
C. Two (2) copies of the report sent to security holders pursuant to this section shall be mailed to the Commissioner, solely for the Commissioner’s information, not later than the date on which the report was first sent or given to security holders or the date on which preliminary copies of solicitation material are filed pursuant to Section 9, whichever date is later.
D. If the issuer knows that securities of any class entitled to vote at a meeting with respect to which the issuer intends to solicit proxies, consents or authorizations are held of record by a broker, dealer, bank or voting trustee, or their nominees, the issuer shall inquire of the record holder at least ten (10) days prior to the record date for the meeting of security holders whether other persons are the beneficial owners of the securities and, if so, the number of copies of the proxy and other soliciting material and, in the case of an annual meeting at which directors are to be elected, the number of copies of the annual report to security holders, necessary to supply these materials to beneficial owners. The issuer shall supply the record holder in a timely manner with additional copies assembled in a form and at a place the record holder may reasonably request, in order to address and send one copy to each beneficial owner of securities so held and shall, upon the request of the record holder, pay its reasonable expenses for mailing the materials to security holders to whom the material is sent.
Section 7 Requirements as To Proxy A. The form of proxy shall:
B. Proxy votes
C. A proxy may confer discretionary authority to vote with respect to any of the following matters:
D. No proxy shall confer authority to vote for the election of any person to any office which a bona fide nominee is not named in the proxy statement, or to vote at any annual meeting other than the next annual meeting (or any adjournment thereof), to be held after the date on which the proxy statement and form of proxy are first sent or given to security holders. A person shall not be deemed to be a bona fide nominee and shall not be named as such unless the person has consented to being named in the proxy statement and to serve if elected.
E. The proxy statement or form of proxy shall provide, subject to reasonable specified conditions, that the securities represented by the proxy will be voted and that where the person solicited specifies by means of ballot provided pursuant to Subsection B a choice with respect to any matter to be acted upon, the securities will be voted in accordance with the specifications so made.
Section 8 Presentation of Information in Proxy Statement A. The information included in the proxy statement shall be clearly presented and the statements made shall be divided into groups according to subject matter and the various groups of statements shall be preceded by appropriate headings.
B. All proxy statements shall disclose, under an appropriate caption, the date by which proposals of security holders intended to be presented at the next annual meeting must be received by the issuer for inclusion in the issuer’s proxy statement and form of proxy relating to that meeting, such date to be calculated in accordance with the provisions of Section 11A. If the date of the next annual meeting is subsequently advanced by more than thirty (30) calendar days or delayed by more than ninety (90) calendar days from the date of the annual meeting to which the proxy statement relates, the issuer shall, in a timely manner, inform security holders of the change, and the date by which proposals of security holders must be received, by any means reasonably calculated to so inform them.
Section 9 Material Required To Be Filed A. Two (2) preliminary copies of the proxy statement and form of proxy and any other soliciting material to be furnished to security holders with the proxy (or the information statement pursuant to Schedule C) shall be filed with the Commissioner at least ten (10) days prior to the date final copies of the material are first sent or given to security holders, or a shorter period prior to that date as the Commissioner may authorize upon a showing of good cause.
B. Two (2) preliminary copies of any additional soliciting material relating to the same meeting or subject matter to be furnished to security holders after the proxy statement shall be filed with the Commissioner at least two (2) days (exclusive of Saturdays, Sundays and holidays) prior to the date copies of the material are first sent or given to security holders, or a shorter period prior to the date as the Commissioner may authorize upon a showing of good cause.
C. Two (2) definitive copies of the proxy statement, form of proxy and all other soliciting material (or the information statement) in the form in which the material is furnished to security holders, shall be filed with, or mailed for filing to, the Commissioner no later than the date the material is first sent or given to any security holder.
D. Copies of replies to inquiries from security holders requesting further information and copies of communications that do no more than request that forms of proxy previously solicited be signed and returned do not need to be filed pursuant to this section.
E. Despite the provisions of Subsections A and B of this section and of Section 14E, copies of soliciting material in the form of speeches, press releases and radio or television scripts may, but need not, be filed with the Commissioner prior to use or publication. Definitive copies, however, shall be filed with or mailed for filing to the Commissioner as required by Subsection C no later than the date the material is used or published. The provisions of Subsections A and B of this section and of Section 14E shall apply, however, to any reprints or reproductions of all or any part of such material.
F. Where any proxy statement, form of proxy or other material filed pursuant to this regulation is amended or revised, one of the copies of the amended or revised material filed pursuant to this regulation shall be marked to indicate clearly and precisely the changes. Section 10 Mailing Communications for Security Holders If the management of the issuer has made or intends to make any solicitation subject to this regulation, the issuer shall perform any of the following acts requested in writing with respect to the same subject matter or meeting by any security holder who is, or security holders who are, entitled to vote at least one percent of the votes entitled to be voted on the matter and who shall defray the reasonable expenses to be incurred by the issuer in the performance of the act or acts requested.
A. The issuer shall mail or otherwise furnish to a security holder, as promptly as practicable after the receipt of the request:
B.
C. In lieu of performing the acts specified above, the issuer may, at its option, furnish promptly to a security holder a reasonably current list of the names and addresses of the record owners and, to the extent known to the issuer, the beneficial owners the security holder shall designate and a schedule of the handling and mailing costs if the schedule has been supplied to the issuer. Section 11 Proposals of Security Holders A If any holder or holders of an issuer’s securities (hereafter referred to as the “proponent”) notifies the issuer in writing not less than ninety (90) days before the issuer’s annual meeting of his intention to present a lawful proposal for action at an upcoming meeting of the issuer’s security holders and at the time of the notice the proponent is entitled to vote at least one percent of the votes entitled to be voted on the proposal, the issuer shall set forth the proposal in its proxy statement and identify it in its form of proxy and provide for the specification of approval or disapproval of the proposal. The proxy statement shall also include the name and address of the proponent.
B. If the issuer opposes any proposal received from a proponent, it shall also, at the request of the proponent, include in its proxy statement a statement of the proponent of not more than two hundred (200) words in support of the proposal.
C. The issuer may omit a proposal and any statement in support thereof from its proxy statement and form of proxy under any of the following circumstances:
D. If the issuer intends to omit any proposal from its proxy statement or forms of proxy or both, it shall notify the proponent in writing of its intention at least ten (10) days before the issuer’s preliminary proxy material is filed pursuant to Section 9A. Section 12 False or Misleading Statement No proxy statement, form of proxy, notice of meeting, information statement, or other communication, written or oral, subject to this regulation, shall contain any statement which at the time and in the light of the circumstances under which it is made, is false or misleading with respect to any material fact, or which omits to state any material fact necessary in order to make the statements therein not false or misleading or necessary to correct any statement in any earlier communication with respect to the same meeting or subject matter which has become false or misleading.
Section 13 Prohibition of Certain Solicitations No person making a solicitation which is subject to this regulation shall solicit any undated or postdated proxy or any proxy which provides that it shall be deemed to be dated as of any date subsequent to the date on which it is signed by the security holder subject to this regulation. Section 14 Special Provisions Applicable To Election Contest A. This section shall apply to any solicitation subject to this regulation by any person or group for the purpose of opposing a solicitation subject to this regulation by any other person or group with respect to the election or removal of directors at any annual or special meeting of security holders.
B. Participant or Participant in a Solicitation.
C. Filing of Information Required by Schedule B.
D. Solicitations Prior to Furnishing Required Written Proxy Statement. Notwithstanding the provisions of Section 6A, a solicitation subject to this section may be made prior to furnishing security holders a written proxy statement containing the information specified in Schedule A with respect to such solicitation, provided that:
E. Solicitations Prior to Furnishing Required Written Proxy Statement Filing Requirements. Two (2) copies of any soliciting material proposed to be sent or given to security holders prior to the furnishing of the written proxy statement required by Section 6A shall be filed with the Commissioner in preliminary form at least five (5) business days prior to the date definitive copies of such material are first sent or given to such persons, or such shorter period as the Commissioner may authorize upon a showing of good cause.
F. Notwithstanding the provisions of Sections 6B, two (2) copies of any portion of the annual report referred to in Section 6B which comments upon or refers to any solicitation subject to this section, or to any participant in any solicitation, other than the solicitation by the management, shall be filed with the Commissioner as proxy material subject to this regulation. This portion of the report shall be filed with the Commissioner, in preliminary form, at least five (5) business days prior to the date copies of the report are first sent or given to security holders. Section 15 Solicitations and Materials Complying With NAIC Model Regulation and Schedules Notwithstanding the foregoing sections, the Commissioner may permit the solicitation of proxies, consents or authorizations, provided that the manner of solicitation and the form of proxy, proxy statement and other documents used in the solicitation comply with the National Association of Insurance Commissioners’ (NAIC) model regulation and schedules.
Section 16 Severability If any provision of this regulation or the application of it to any person or circumstance is for any reason held to be invalid, the remainder of this regulation shall not be affected. Section 17 Enforcement Noncompliance with this regulation may result in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance, or other laws, which include the imposition of civil penalties, issuance of cease and desist orders, and/or suspensions or revocation of license, subject to the requirements of due process.
Section 18 Effective Date This amended regulation shall become effective November 15, 2014. Section 19 History Effective February 1, 1972.
Amended, Effective December 31, 1992.
Amended, Effective November 15, 2014.
SCHEDULE A Item 1. Revocability of Proxy State whether or not the person giving the proxy has the power to revoke it. If the right of revocation before the proxy is exercised is limited, or is subject to compliance with any formal procedure, briefly describe the limitation or procedure.
Item 2. Dissenters’ Rights of Appraisal Outline briefly any rights of appraisal or similar rights of dissenters with respect to any matter to be acted upon and indicate any statutory procedure required to be followed by dissenting security holders in order to perfect their rights. Where these rights may be exercised only within a limited time after the proposal’s date of adoption, the filing of a charter amendment or other similar act, indicate whether the person solicited will be notified of the date.
Item 3. Persons Making the Solicitation A. Solicitations not subject to Section 14
4 State the names of the persons who will bear the cost of solicitation, directly or indirectly.
B. Solicitations subject to Section 14
Item 4. Interest of Certain Persons in Matters to be Acted Upon A. Solicitations not subject to Section 14. Describe briefly any substantial interest, direct or indirect, of each of the following persons in a matter to be acted upon, other than elections to office:
B. Solicitations subject to Section 14. Describe briefly any substantial interest, direct or indirect, of each participant (except the issuer) in any matter to be acted upon at the meeting. Include, with respect to each participant, the information required by Items 2A, 2D, 3, 4B, and 4C of Schedule B.
Item 5. Voting Securities and Principal Holders Thereof A. State for each class of voting securities of the issuer entitled to be voted at the meeting, the number of shares outstanding and the number of votes to which each class is entitled.
B. Give the date that the record of security holders entitled to vote at the meeting will be determined. If the right to vote is not limited to security holders of record on that date, indicate the conditions under which other security holders may be entitled to vote.
C. If action is to be taken with respect to the election of directors and if the persons solicited have cumulative voting rights:
D. Furnish the following information as of the most practicable date, in substantially the tabular form indicated, with respect to:
E. If, to the knowledge of the person on whose behalf the solicitation is made, a change in control of the issuer has occurred since the beginning of its last fiscal year, state:
A. Identification of directors and officers. List the names and ages of all directors and officers of the issuer and all persons nominated or chosen to become directors or officers. Indicate all positions and offices with the issuer held by each person; state the term of office as director or officer or both and any period during which the person served. Briefly describe any arrangement or understanding between the person and any other person or persons (naming the persons) pursuant to which the person was or is to be selected as a director, officer or nominee. The information regarding officers does not need to be furnished in proxy or information statements provided that the information is furnished in a separate item in the issuer’s annual report to stockholders.
B. Family relationships. State the nature of a family relationship not more remote than first cousin between a director, officer or person nominated or chosen by the issuer to become a director or officer. State the nature of any family relationship between any such person and an officer or director of any of the issuer’s parent companies, subsidiaries or other affiliates.
C. Business experience. State the principal occupations and employment during the past five (5) years of each director and each person nominated or chosen to become a director or officer and the name and principal business of any corporation or other organization in which the occupations and employment were carried on.
D. Directorships. Indicate other directorships held by each director or person nominated or chosen to become a director.
E. Involvement in certain legal proceedings. Describe any legal proceedings that have occurred during the past five (5) years or which are pending that are material to an evaluation of the ability or integrity of any director or nominee for director or officer of the issuer.
F. Describe any of the following relationships that exist:
G. State the total number of meetings of the board of directors (including regularly scheduled and special meetings) that were held during the last full fiscal year. Name each incumbent director who, during the last full fiscal year, attended fewer than seventy-five percent (75%) of the aggregate of:
H. If a director has resigned or declined to stand for re-election to the board of directors since the date of the last annual meeting of shareholders because of a disagreement with the issuer on any matter relating to the issuer’s operations, policies or practices, and if the director has furnished the issuer with a letter describing that disagreement and requesting that the matter be disclosed, the issuer shall state the date of resignation or declination to stand for re-election and summarize the director’s description of the disagreement. If the issuer believes that the description provided by the director is incorrect or incomplete, it may include a brief statement presenting its views of the disagreement.
1. Calculate the percentage of shares present at the meeting and voting or withholding authority to vote in the election of directors, referred to in Subsection J(1)(a), by dividing the total shares cast for and withheld from the vote for or, where applicable, voted against, the director for whom the highest aggregate number of shares was cast by the total number of shares outstanding that were eligible to vote as of the record date for the meeting.
2. No information need be given in response to Item 6J unless, with respect to any class of voting stock (or group of classes which voted together), five percent (5%) or more of the total shares cast for and withheld from the votes for or, where applicable, cast against any nominee were withheld from the vote for or cast against the nominee.
3. If an issuer elects less than the entire board of directors annually, disclosure is required for all directors if five percent (5%) or more of the total shares cast for and withheld from, the vote for or, where applicable, cast against an incumbent director were withheld from, or cast against, the vote for the director at the meeting where the person was most recently elected.
4. No information must be given in response to Item 6J if the issuer has previously furnished to its security holders a report of the results of the most recent meeting of security holders where directors were elected which includes:
Item 7. Remuneration of Directors and Officers Furnish the following information if action is to be taken concerning (i) the election of directors; (ii) any bonus, profit sharing or other remuneration plan, contract or arrangement that a director, nominee for election as a director or officer of the issuer will participate; (iii) a pension or retirement plan where a person will participate; or (iv) the granting or extension to a person of any options, warrants or rights to purchase securities, other than warrants or rights issued to security holders on a pro rata bases. If the solicitation is made on behalf of persons other than the issuer, the information required need be furnished only as to nominees of the person making the solicitation and associates of the nominees.
A. Current remuneration. Furnish the information required in the table below, in substantially the tabular form specified, concerning all remuneration of the following persons and groups for services in all capacities to the issuer and its subsidiaries during the issuer’s last fiscal year or, in specified instances, certain prior fiscal years:
COLUMN C COLUMN D Include all cash and cash equivalent forms of remuneration received Include all contingent forms of during the fiscal year and all amounts accrued during the fiscal year remuneration, vesting and which, with reasonable certainty, will be distributed or vested in the measurement of which is subject future. to future events. Report only COLUMN C-1 COLUMN C-2 amounts relating to the latest Salaries, Bonuses, Fees and Securities, Property Insurance fiscal year, not amounts accrued Commissions Benefits or Reimbursements, in previous periods.
1. All cash remuneration Personal Benefits 1. Amount expensed for financial distributed or accrued in the 1. Spread between the reporting purposes representing form of salaries, commissions, acquisition price, if any, and fair non-vested contributions, bonuses and fees for services market price of securities or payments rendered. property acquired under any or accruals under any pension or 2. Compensation earned for contract, plan or arrangement. retirement plans, annuities, services performed in the latest 2. Cost of any life insurance employment contracts deferred fiscal year even if it is deferred premiums, health insurance compensation plans including IRS for future payment. premiums and medical qualified plans, unless the 3. Payments received in the reimbursement plans. Premiums amount for the individual cannot latest fiscal year but earned in for nondiscriminatory plans be separated, in which case a prior years that were deferred generally available to all salaried footnote is required indicating the until the latest year, if the employees are excluded. percentage that contributions to amounts were not shown in an 3. Personal benefits (perquisites) the plan bear to participants’ total earlier proxy statement or not directly related to job remuneration. annual report to stockholders. performance, excluding benefits 2. The amount expensed for provided on a nondiscriminatory financial reporting purposes basis, valued on the basis of cost under any incentive plans (long- to the issuer of providing the term income plans), such as stock benefits. appreciation rights, stock options,
B. Proposed remuneration.
C. Remuneration of directors. Describe any standard or special arrangements, stating amounts, by which directors of the issuer are compensated for services as a director.
D. Options, warrants or rights.
Furnish the information required by the following table for all options to purchase securities from the issuer or its subsidiaries that were granted to or exercised by the persons and groups specified in Item 7A since the beginning of the issuer’s last fiscal year and as to all options held by these persons as of the latest practicable date:
The following tabulation shows as to certain directors and officers and as to all directors and officers as a group:
Title of Name Name Name All directors Securities and officers as a group Granted-20[ ] to date:
Number of shares Average per share $ $ $ $ option price Exercised-20[ ] to date:
Number of shares Aggregate option $ $ $ $ price of options exercised Aggregate market $ $ $ $ value of shares on date options exercised Sales-20[ ] to date:
Number of shares Unexercised at 20[ ]:
Number of shares ** Average per share $ $ $ $ option price In addition, during the period employees were granted options for ____ shares at an average price per share of $____.
A. All figures should be adjusted, where applicable, in accordance with the terms of the options to reflect stock splits and to give effect to share dividends.
B. Other tabular presentations are acceptable if they include the necessary data. Tabular presentation may not be needed if only a very few options have been granted
E. Indebtedness of management.
F. Transactions with management.
Instructions:
In describing any transaction involving the purchase or sale of assets by or to the issuer or any of its subsidiaries, other than in the ordinary course of business, state the cost of the assets to the purchaser and, if acquired by the seller within two (2) years prior to the transaction, the cost to the seller. Indicate the principle followed in determining the issuer’s purchase or sale price and the name of the person making the determination.
Information shall be furnished in answer to this Item with respect to transactions not excluded above which involve remuneration from the issuer or its subsidiaries, directly or indirectly, to any of the specified persons for services in any capacity unless the interest of these persons arises solely from the ownership individually and in the aggregate of less than ten percent (10%) of any class of equity securities of another corporation furnishing the services to the issuer or its subsidiaries.
G. Transactions with pension or similar plans.
Instructions:
Subparagraph 3 to Item 7F shall apply to this Item 7G.
Without limiting the general meaning of the term “transaction” there shall be included in the answer to this item any remuneration received or any loans received or outstanding during the period, or proposed to be received.
Item 8. Matters Related to Accounting If the solicitation is made on behalf of the issuer and relates to an annual meeting of security holders at which directors are to be elected, or financial statements are included, furnish the following information:
A. State if the issuer’s financial statements are not certified by independent public or certified accountants.
B. State if the board of directors has no audit or similar committee.
C. If the issuer’s financial statements are certified by independent public or certified accountants, state that fact and provide the following information:
D. For the fiscal year most recently completed, describe each professional service provided by the principal accountant and state the percentage relationship that the aggregate of the fees for all nonaudit services bear to the audit fees and, except as provided below, state the percentage relationship that the fee for each nonaudit service bears to the audit fees. Indicate whether, before each professional service provided by the principal accountant was rendered, it was approved by, and the possible effect on the independence of the accountant was considered by:
For purposes of this subsection, all fees for services provided in connection with the audit function (e.g. reviews of quarterly reports) may be computed as part of the audit fees. Indicate which services are reflected in the audit fees computation.
If the fee for any non-audit service is less than three percent (3%) of the audit fees, the percentage relationship does not need to be disclosed.
Each service should be specifically described. Broad general categories such as “tax matters” or “management advisory services” are not sufficiently specific. Describe the circumstances and give details of any services provided by the issuer’s independent accountant during the latest fiscal year that were furnished at rates or terms that were not customary. Describe any existing direct or indirect understanding or agreement that places a limit on current or future years’ audit fees, including fee arrangements that provide fixed limits on fees that are not subject to reconsideration if unexpected issues involving accounting or auditing are encountered. Disclosure of fee estimates is not required.
Item 9. Bonus, Profit Sharing and Other Remuneration Plans: Pension and Retirement Plans If action is to be taken with respect to any bonus, profit sharing or other remuneration plan or any pension or retirement plan, furnish the following information:
A. Describe briefly the material features of the plan, identify each class of persons who will participate, indicate the approximate number of persons in each class and state the basis of the participation.
B. Furnish the information, in addition to that required by this item and Item 7, as may be necessary to describe adequately the provisions already made pursuant to all bonus, profit sharing, pension, retirement, stock option, stock purchase, deferred compensation or other remuneration or incentive plans, now in effect or in effect within the past five (5) years, for:
C. If the plan to be acted upon can be amended otherwise than by a vote of stockholders, to increase the cost thereof to the issuer or to alter the allocation of the benefits as between the directors and officers on the one hand and employees on the other, state the nature of the amendments which can be made.
D. With regard to any bonus, profit sharing or other remuneration plan, on which action is to be taken, furnish the following information:
E. With regard to any pension or retirement plan on which action is to be taken, furnish the following information:
Instructions:
A. If action is to be taken with respect to the amendment or modification of an existing plan, the item shall be answered with respect to the plan as proposed to be amended or modified and shall indicate any material differences from the existing plan.
B. The following instruction shall apply to Subsection B:
C. If the plan to be acted upon is set forth in a written document, three (3) copies shall be filed with the Commissioner at the time preliminary copies of the proxy statement and form of proxy are filed.
D. The information called for by Subsection E(1)(c) or E(2)(b) of this Item 9 does not need to be given as to payments made on an actuarial basis pursuant to any group pension plan that provides for fixed benefits in the event of retirement at a specified age or after a specified number of years of service.
Item 10. Options, Warrants or Rights If action is to be taken with respect to the granting or extension of any options to purchase securities of the issuer or any subsidiary, furnish the following information:
A. State:
B. Furnish the information, in addition to that required by this item and Item 7, necessary to describe adequately the provisions already made pursuant to all bonus, profit sharing, pension, retirement, stock option, stock purchase, deferred compensation, or other remuneration or incentive plans, now in effect or in effect within the past five (5) years, for:
A. For the purpose of this Item 10 the term option includes any option, warrant or right.
B. Paragraphs B and C do not apply to warrants or rights to be issued to security holders on a pro rata basis.
C. Instruction 2 to Item 9 shall also apply to Paragraph C of this item.
D. If the options described in answer to this item are issued pursuant to a plan which is set forth in a written document, three (3) copies shall be filed with the Commissioner at the time preliminary copies of the proxy statement and form of proxy are filed. Item 11. Authorization or Issuance of Securities Otherwise than for Exchange If action is to be taken with respect to the authorization or issuance of any securities otherwise than for exchange for outstanding securities of the issuer, furnish the following information:
A. State the title and amount of securities to be authorized or issued.
B. If the securities are other than additional shares of common stock of a class outstanding, furnish a brief summary of the following, if applicable: dividend, voting, liquidation, preemptive and conversion rights, redemption and sinking fund provisions, interest rate and date of maturity.
C. Describe briefly the transaction in which the securities are to be issued, including a statement as to:
D. If the securities are to be issued otherwise than in a general public offering for cash, state the reasons for the proposed authorization or issuance and the general effect upon the rights of existing security holders.
Item 12. Modification or Exchange of Securities If action is to be taken with respect to the modification of any class of securities of the issuer, or the issuance or authorization for issuance of securities of the issuer in exchange for outstanding securities of the issuer, furnish the following information:
A. If outstanding securities are to be modified, state the title and amount thereof. If securities are to be issued in exchange for outstanding securities, state the title and amount of securities to be so issued, the title and amount of outstanding securities to be exchanged therefor and the basis of the exchange.
B. Describe any material differences between the outstanding securities and the modified or new securities.
C. State the reasons for the proposed modification or exchange and the general effect upon the rights of existing security holders.
D. Furnish a brief statement as to arrears in dividends or as to defaults in principal or interest in respect to the outstanding securities which are to be modified or exchanged and other information appropriate in the particular case to disclose adequately the nature and effect of the proposed action.
E. Outline briefly any other material features of the proposed modification or exchange. If the plan of proposed action is set forth in a written document, file copies thereof with the Commissioner at the time the preliminary proxy material is filed.
Item 13. Mergers, Consolidations, Acquisitions and Similar Matters Furnish the following information if action is to be taken with respect to any plan for (i) the merger or consolidation of the issuer into or with another person or of another person into or with the issuer; (ii) the acquisition by the issuer or any of its security holders of securities of another issuer; (iii) the acquisition by the issuer of another going business or of the assets thereof; (iv) the sale or other transfer of all or any substantial part of the assets of the issuer; or (v) the liquidation or dissolution of the issuer:
A. Outline briefly the material features of the plan. State the reasons therefor and the general effect thereof upon the rights of existing security holders. If the plan is set forth in a written document, file three (3) copies thereof with the Commissioner at the time preliminary copies of the proxy statement and form of proxy are filed.
B. Furnish the following information as to the issuer and each person which is to be merged into the issuer or into or with which the issuer is to be merged or consolidated or the business or assets that are to be acquired or which is the issuer of securities to be acquired by the issuer in exchange for all or a substantial part of its assets or to be acquired by security holders of the issuer. What is required is information essential to an investor’s appraisal of the action proposed to be taken.
Subparagraph B of this Item 13 shall not apply if the plan described in answer to Paragraph A involves only the issuer and one or more of its totally-held subsidiaries.
C. As to each class of securities of the issuer, or of any person specified in Paragraph B, which is admitted to dealing on a national securities exchange or with respect to which a market otherwise exists, and that will be materially affected by the plan, state the high and low sale prices (or, in the absence of trading in a particular period, the range of the bid and asked prices) for each quarterly period within two (2) years. This information may be omitted if the plan involves merely the liquidation or dissolution of the issuer.
Item 14. Financial Statements A. If action is to be taken with respect to any matter specified in Items 11, 12, or 13, furnish financial statements of the issuer and its subsidiaries complying with the requirements of Section 4B(1),
B. If action is to be taken with respect to any matter specified in Item 13B, furnish for each person specified, other than the issuer, financial statements complying with the requirements of Section 4B(1), (2) and (3) of the regulation.
C. The Commissioner may, upon the request of the issuer, permit the omission of any of the statements herein required where the statements are not necessary for the exercise of prudent judgment in regard to any matter to be acted upon, or may permit the filing in substitution of appropriate statements of comparable character. The Commissioner may also require the filing of other statements in addition to, or in substitution for, the statements required in any case where the statements are necessary or appropriate for an adequate presentation of the financial condition of any person whose financial statements are required, or whose statements are otherwise material for the exercise of prudent judgment in regard to any matter to be acted upon. In the usual case, financial statements are deemed material to the exercise of prudent judgment where the matter to be acted upon is authorization or issuance of a material amount of senior securities, but are not deemed material where the matter to be acted upon is the authorization or issuance of common stock, otherwise than in an exchange, merger or consolidation, acquisition or similar transaction.
C. The proxy statement may incorporate by reference any financial statements contained in an annual report sent to security holders with respect to the same meeting as that to which the proxy statement relates, provided the financial statements substantially meet the requirements of this item.
Item 15. Acquisition or Disposition of Property If action is to be taken with respect to the acquisition or disposition of any property, furnish the following information:
A. Describe briefly the general character and location of the property.
B. State the nature and amount of consideration to be paid or received by the issuer or any subsidiary. To the extent practicable outline briefly the facts bearing upon the question of the fairness of the consideration.
C. State the name and address of the transferor or transferee, as the case may be, and the nature of any material relationship of the person to the issuer or an affiliate of the issuer.
D. Outline briefly any other material features of the contract or transaction. Item 16. Restatement of Accounts If action is to be taken with respect to the restatement of any asset, capital or surplus account of the issuer, furnish the following information:
A. State the nature of the restatement and the date as of which it is to be effective.
B. Outline briefly the reasons for the restatement and for the selection of the particular effective date.
C. State the name and amount of each account (including any reserve accounts) affected by the restatement and the effect of the restatement thereon. Tabular presentation of the amounts shall be made when appropriate, particularly in the case of recapitalizations.
D. To the extent practicable, state whether and the extent, if any, to which the restatement will, as of the date thereof, alter the amount available for distribution to the holders of equity securities. Item 17. Action with Respect to Reports If action is to be taken with respect to any report of the issuer or of its directors, officers or committees or any minutes of meetings of its stockholders, furnish the following information:
A. State whether or not the action is to constitute approval or disapproval of any of the matters referred to in the reports or minutes.
B. Identify each of the matters which it is intended will be approved or disapproved and furnish the information required by the appropriate item or items of this schedule with respect to each matter. Item 18. Matters Not Required to be Submitted If action is to be taken with respect to any matter which is not required to be submitted to a vote of security holders, state the nature of the matter, the reasons for submitting it to a vote of security holders and what action is intended to be taken by the management in the event of a negative vote on the matter by the security holders.
Item 19. Amendment of Charter, Bylaws or Other Documents If action is to be taken with respect to any amendment of the issuer’s charter, bylaws or other documents as to which information is not required above, state briefly the reasons for and general effect of the amendment.
Note: Where the matter to be acted upon is the classification of directors, state whether vacancies which occur during the year may be filled by the board of directors to serve only until the next annual meeting or may be so filled for the remainder of the full term.
Item 20. Other Proposed Action If action is to be taken with respect to any matter not specifically referred to above describe briefly the substance of each matter in substantially the same degree of detail as is required by Items 5 to 19. Item 21. Vote Required for Approval As to each matter that is to be submitted to a vote of security holders, other than elections to office or the selection or approval of auditors, state the vote required for its approval. SCHEDULE B INFORMATION TO BE INCLUDED IN STATEMENTS FILED BY OR ON BEHALF OF A PARTICIPANT (OTHER THAN THE ISSUER) IN A PROXY SOLICITATION IN AN ELECTION CONTEST Item 1. Issuer State the name and address of the Issuer.
Item 2. Identity and Background A. State the following:
B. State the following:
C. State whether or not you are or have been a participant in any other proxy contest involving this company or other companies within the past ten (10) years. If so, identify the principals, the subject matter and your relationship to the parties and the outcome.
D. State whether or not, during the past ten (10) years, you have been convicted in a criminal proceeding (excluding traffic violations or similar misdemeanors) and, if so, give dates, nature of conviction, name and location of court, and penalty imposed or other disposition of the case. A negative answer to this sub-item does not need to be included in the proxy statement or other proxy soliciting material.
Item 3. Interest in Securities of the Issuer A. State the amount of each class of securities of the issuer that you own beneficially, directly or indirectly.
B. State the amount of each class of securities of the issuer that you own of record but not beneficially.
C. State with respect to all securities of the issuer purchased or sold within the past two (2) years, the dates when they were purchased or sold and the amount purchased or sold on each date.
D. State if any part of the purchase price or market value of any of the securities specified in Subsection C is represented by funds borrowed or otherwise obtained for the purpose of acquiring or holding securities. Indicate the amount of the indebtedness as of the latest practicable date. If funds were borrowed or obtained otherwise than pursuant to a margin account or bank loan in the regular course of business of a bank, broker or dealer, briefly describe the transaction and state the names of the parties.
E. State whether or not you are a party to any contracts, arrangements or understandings with any person with respect to any securities of the issuer including but not limited to joint ventures, loan or option arrangements, puts or calls guarantees against losses or guarantees of profits, division of losses or profits, or the giving or withholding of proxies. If so, name the persons with whom some contracts, arrangements or understandings exist and give the details thereof.
F. State the amount of securities of the issuer owned beneficially, directly or indirectly, by each of your associates and the name and address of each associate.
G. State the amount of each class of securities of any parent, subsidiary or affiliate of the issuer that you own beneficially, directly or indirectly.
Item 4. Further Matters A. Describe the time and circumstances under which you became a participant in the solicitation and state the nature and extent of your activities or proposed activities as a participant.
B. Describe briefly, and where practicable state the approximate amount of any material interest, direct or indirect, of yourself and of each of your associates in any material transactions since the beginning of the company’s last fiscal year, or in any material proposed transactions, to which the company or any of its subsidiaries or affiliates was or is to be a party.
C. State whether or not you or any of your associates have any arrangement or understanding with any person:
Item 2. Statement That Proxies Are Not Solicited The following statement shall be set forth on the first page of the information statement in bold face type: “WE ARE NOT ASKING YOU FOR A PROXY AND YOU ARE REQUESTED NOT TO SEND US A PROXY.”
Item 3. Date, Time and Place of Meeting State the date, time and place of the meeting of security holders, unless the information is otherwise disclosed in material furnished to security holders with the information statement. Item 4. Interest of Certain Persons in or Opposition to Matters to Be Acted Upon A. Describe briefly any substantial interest, direct or indirect, by security holdings or otherwise, of each of the following persons in any matter to be acted upon, other than elections to office:
B. Give the name of any director of the issuer who has informed the management in writing that he intends to oppose any action to be taken by the management at the meeting and indicate the action that he intends to oppose.
Item 5. Proposals by Security Holders If any security holder entitled to vote at the meeting has submitted to the issuer, not less than 90 days before the issuer’s annual meeting, a proposal that is accompanied by notice of the security holder’s intention to present the proposal “for action at the meeting, make a statement to that effect, identify the proposal” and indicate the disposition proposed to be made of the proposal by the management at the meeting.
Regulation 3-2-2 INSIDER TRADING OF EQUITY SECURITIES OF A DOMESTIC STOCK INSURANCE COMPANY Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Definitions Section 5 Transactions Exempted from the Operation of Section 10-3-120, C.R.S. Section 6 Filing of Statements Section 7 Ownership of More than Ten Percent of an Equity Security Section 8 Disclaimer of Beneficial Ownership Section 9 Exemptions from Section 10-3-120(1) and (2), C.R.S. Section 10 Exemption from Section 10-3-120, C.R.S., of Securities Purchased or Sold by Odd-Lot Dealers Section 11 Certain Transactions Subject to Section 10-3-120(1), C.R.S. Section 12 Ownership of Securities Held in Trust Section 13 Exemption for Small Transactions Section 14 Exemption from Section 10-3-120(2), C.R.S., of the Transactions Which Need Not Be Reported Under Section 10-3-120(1), C.R.S.
Section 15 Exemption from Section 10-3-120(2), C.R.S., of Certain Transactions Effected in Connection with Distribution Section 16 Exemption from Section 10-3-120(2), C.R.S., of Acquisitions of Shares of Stock and Stock Options Exemption from Section 10-3-120(2), C.R.S., of Acquisitions of Shares of Stock and Stock Options under Certain Bonus, Stock Option or Similar Plans Section 17 Exemption from Section 10-3-120(2), C.R.S., of Certain Transactions in Which Securities Are Received By Redeeming Other Securities Section 18 Exemption of Long Term Profits Incident to Sales within Six Months of the Exercise of an Option Section 19 Exemption from Section 10-3-120(2), C.R.S., of Certain Acquisitions and Dispositions of Securities Pursuant to Merger or Consolidations Section 20 Exemption from Section 10-3-120(2), C.R.S., of Transactions Involving the Deposit or Withdrawal of Equity Securities under a Voting Trust or Deposit Agreement Section 21 Exemption from Section 10-3-120(2), C.R.S., of Certain Transactions Involving the Conversion of Equity Securities Section 22 Exemption from Section 10-3-120(2), C.R.S., of Certain Transactions Involving the Sale of Subscription Rights Section 23 Exemption of Certain Securities from Section 10-3-120(3), C.R.S. Section 24 Exemption from Section 10-3-120(3), C.R.S., of Certain Transactions Effected in Connection with a Distribution Section 25 Exemption from Section 10-3-120(3), C.R.S., of Sales of Securities to be Acquired Section 26 Arbitrage Transactions under Section 10-3-120(5), C.R.S. Section 27 Severability Section 28 Enforcement Section 29 Effective Date Section 30 History Form 3 Initial Statement of Beneficial Ownership of Securities Form 3 Instructions Form 4 Statement of Changes in Beneficial Ownership of Securities Form 4 Instructions Section 1 Authority This regulation is promulgated pursuant to the authority of Section 10-1-109, C.R.S. Section 2 Scope and Purpose The purpose of this regulation is to set forth rules and procedural requirements which the Commissioner deems necessary to carry out the provisions of Section 10-3-120, C.R.S., regarding the acquisition or disposition of equity securities of a domestic stock insurance company by a beneficial owner, director or officer.
Section 3 Applicability This regulation is applicable to each domestic stock insurance company which has any class of equity security held of record by one hundred or more persons; provided, however, that this regulation shall not apply to any insurer which is registered or required to be registered, pursuant to the Securities Exchange Act of 1934, as amended.
Section 4 Definitions A. “Insurer” means any domestic stock insurance company with an equity security subject to the provisions of Section 10-3-120, C.R.S., and not exempt thereunder.
B. “Officer” means a president, vice president, treasurer, actuary, secretary, controller and any other person who performs for the insurer functions corresponding to those performed by the foregoing officers.
C. “Equity security” means any stock or similar security; or any voting trust certificate or certificate of deposit for such a security; or any security convertible, with or without consideration, into such a security, or carrying any warrant or right to subscribe to or purchase such a security; or any such warrant or right.
D. Securities “held of record”
E. “Class” means all securities of an insurer which are of substantially similar character and the holders of which enjoy substantially similar rights and privileges. Section 5 Transactions Exempted from the Operation of Section 10-3-120, C.R.S. Any acquisition or disposition of any equity security by a director or officer of an insurer within six months prior to the date on which Section 10-3-120, C.R.S. first became applicable with respect to the equity securities of such insurer shall not be subject to the operation of Section 10-3-120(2), C.R.S. Section 6 Filing of Statements Initial statements of beneficial ownership of equity securities required by Section 10-3-120(1) shall be filed on Form 3 attached hereto. Statements of changes in such beneficial ownership required by Section 10- 3-120(1) shall be filed on Form 4 attached hereto. All such statements shall be prepared and filed in accordance with the requirements of the applicable form. Reproduction of the attached forms is advised as the Division of Insurance will not maintain a supply thereof. Section 7 Ownership of More than Ten Percent of an Equity Security A In determining, for the purpose of Section 10-3-120(1) whether a person is the beneficial owner, directly or indirectly, of more than ten percent of any class of any equity security, such class shall be deemed to consist of the total amount of such class outstanding, exclusive of any securities of such class held by or for the account of the insurer or a subsidiary of the insurer; except that for the purpose of determining percentage ownership of voting trust certificates or certificates of deposit for equity securities, the class of voting trust certificates or certificates of deposit shall be deemed to consist of the amount of voting trust certificates or certificates of deposit issuable with respect to the total amount of outstanding equity securities of the class which may be deposited under the voting trust agreement or deposit agreement in question, whether or not all of such outstanding securities have been so deposited. For the purpose of this section, a person acting in good faith may rely on the information contained in the latest Annual Statement filed with the Commissioner with respect to the amount of securities of a class outstanding or in the case of voting trust certificates or certificates of deposit the amount thereof issuable.
B. In determining for the purpose of Section 10-3-120(1), C.R.S., whether a person is the beneficial owner, directly or indirectly, of more than ten percent of any class of equity securities, such person shall be deemed to be the beneficial owner of securities of such class which such person has the right to acquire through the exercise of presently exercisable options, warrants or rights or through the conversion of presently convertible securities. The securities subject to such options, warrants, right of conversion privileges held by a person shall be deemed to be outstanding for the purpose of computing, in accordance with Subsection A, the percentage of outstanding securities of the class owned by that person, but shall not be deemed outstanding for the purpose of computing the percentage of the class owned by another person. This subsection shall not be construed to relieve any person of any duty to comply with Section 10-3-120(1), C.R.S., with respect to any equity securities consisting of options, warrants, rights or convertible securities which are otherwise subject as a class to Section 10-3-120(1), C.R.S. Section 8 Disclaimer of Beneficial Ownership Any person filing a statement may expressly declare therein that the filing of such statement shall not be construed as an admission that such person is, for the purpose of Section 10-3-120, C.R.S., the beneficial owner of any equity securities covered by the statement. Section 9 Exemptions from Section 10-3-120(1) and (2), C.R.S.
A. During the period of 12 months following their appointment and qualification, securities held by the following persons shall be exempt from Section 10-3-120(1) and (2), C.R.S.
B. After the 12-month period following their appointment or qualification the foregoing persons shall be required to file reports with respect to the securities held by the estates which they administer under Section 10-3-120(1), C.R.S., and shall be liable for profits realized from trading in such securities pursuant to Section 10-3-120(2), C.R.S., only when the estate being administered is a beneficial owner of more than 10 percent of any class of equity security of an insurer subject to Section 10-3-120, C.R.S.
C. Securities reacquired by or for the account of an insurer and held by it for its account shall be exempt from Section 10-3-120(1) and (2), C.R.S. during the time they are held by the insurer. Section 10 Exemption from Section 10-3-120, C.R.S., of Securities Purchased or Sold by Odd- Lot Dealers Securities purchased or sold by an odd-lot dealer in odd lots so far as reasonably necessary to carry on odd-lot transactions or in round lots to offset odd-lot transactions previously or simultaneously executed or reasonably anticipated in the usual course of business, shall be exempt from the provisions of Section 10-3-120, C.R.S., with respect to participation by such odd-lot dealer in such transactions. Section 11 Certain Transactions Subject to Section 10-3-120(1), C.R.S. The acquisition or disposition of any transferable option, put, call, spread or straddle shall be deemed such a change in the beneficial ownership of the security to which such privilege relates so as to require the filing of a statement reflecting the acquisition or disposition of such privilege. Nothing in this section, however, shall exempt any person from filing the statements required upon the exercise of such option, put, call, spread or straddle.
Section 12 Ownership of Securities Held in Trust A. Beneficial ownership of a security for the purpose of Section 10-3-120(1), C.R.S., shall include:
B. In the event that ten percent of any class of any equity security of an insurer is held in a trust, that trust and the trustees thereof as such shall be deemed a person required to file the reports specified in Section 10-3-120(1), C.R.S.
C. No more than one report need be filed to report any holdings or with respect to any transaction in securities held by a trust, regardless of the number of officers, directors or ten percent stockholders who are either trustees, settlors, or beneficiaries of a trust, provided that the report filed shall disclose the names of all trustees, settlors and beneficiaries who are officers, directors or ten percent stockholders. A person having an interest only as a beneficiary of a trust shall not be required to file any such report so long as he relies in good faith upon an understanding that the trustee of such trust will file whatever reports might otherwise be required of such beneficiary.
D. As used in this section the “immediate family” of a trustee means:
For the purpose of determining whether any of the foregoing relations exists, a legally adopted child of a person shall be considered a child of such person by blood.
E. In determining, for the purposes of Section 10-3-120(1), C.R.S., whether a person is the beneficial owner, directly or indirectly, of more than ten percent of any class of any equity security, the interest of such person in the remainder of a trust shall be excluded from the competition.
F. No report shall be required by any person, whether or not otherwise subject to the requirement of filing reports under Section 10-3-120(1), C.R.S., with respect to his indirect interest in portfolio securities held by:
G. Nothing in this section shall be deemed to impose any duties or liabilities with respect to reporting any transaction or holding prior to its effective date. Section 13 Exemption for Small Transactions A. Any acquisition of securities shall be exempt from Section 10-3-120, C.R.S., where:
B. Any acquisition or disposition of securities by way of gift, where the total amount of such gifts does not exceed $3,000 in market value for any six months' period, shall be exempt from Section 10-3-120(1), C.R.S., and may be excluded from the computations prescribed in Subsection A(2).
C. Any person exempted by Subsection A or B shall include in the first report filed by him/her after a transaction within the exemption a statement showing his acquisitions and dispositions for each six months' period or portion thereof which has elapsed since his last filing. Section 14 Exemption from Section 10-3-120(2), C.R.S., of Transactions Which Need Not Be Reported Under Section 10-3-120(1), C.R.S.
Any transaction which has been or shall be exempted from the requirements of Section 10-3-120(1), C.R.S., shall, insofar as it is otherwise subject to the provisions of Section 10-3-120(2), C.R.S., be likewise exempted from Section 10-3-120(2), C.R.S.
Section 15 Exemption from Section 10-3-120(2), C.R.S., of Certain Transactions Effected in Connection with a Distribution A. Any transaction of purchase and sale, or sale and purchase, of a security which is effected in connection with the distribution of a substantial block of securities shall be exempt from the provisions of Section 10-3-120(2), C.R.S., to the extent specified in this section as not comprehended within the purpose of said Section 10-3-120(2), C.R.S., upon the following conditions:
B. The exemption of a transaction pursuant to this section with respect to the participation therein of one party thereto shall not render such transaction exempt with respect to participation of any other party therein unless such other party also meets the conditions of this section. Section 16 Exemption from Section 10-3-120(2), C.R.S., of Acquisitions of Shares of Stock and Stock Options under Certain Bonus, Stock Option or Similar Plans Any acquisition of shares of stock (other than stock acquired upon the exercise of an option, warrant or right) pursuant to a stock bonus, profit sharing, retirement, incentive, thrift, savings or similar plan, or any acquisition of a qualified or a restricted stock option pursuant to an employee stock purchase plan, by a director or officer of an insurer issuing such stock or stock option shall be exempt from the operation of Section 10-3-120(2), C.R.S., if the plan meets the following conditions:
A. The plan has been approved, directly or indirectly, (1) by the affirmative votes of the holders of a majority of the securities of such insurer present, or represented, and entitled to vote at a meeting duly held in accordance with the applicable laws of the State of Colorado, or (2) by the written consent of the holders of a majority of the securities of such insurer entitled to vote: provided however, that if such vote or written consent was not solicited substantially in accordance with the proxy rules and regulations prescribed by the National Association of Insurance Commissioners, if any, in effect at the time of such vote or written consent, the insurer shall furnish in writing to the holders of record of the securities entitled to vote for the plan substantially the same information concerning the plan which would be required by any such rules and regulations so prescribed and in effect at the time such information is furnished, if proxies to be voted with respect to the approval or disapproval of the plan were then being solicited, on or prior to the date of the first annual meeting of security holders held subsequent to the later of the date Section 10-3-120, C.R.S., first applies to such insurer, or the acquisition of an equity security for which exemption is claimed. Such written information may be furnished by mail to the last known address of the security holders of record within 30 days prior to the date of mailing. Four copies of such written information shall be filed with, or mailed for filing to the Commissioner not later than the date on which it is first sent or given to security holders of the insurer. For the purposes of this subsection, the term “insurer” includes a predecessor corporation if the plan or obligations to participate thereunder were assumed by the insurer in connection with the succession.
B. If the selection of any director or officer of the insurer to whom stock may be allocated or to whom qualified, restricted or employee stock purchase plan stock options may be granted pursuant to the plan, or the determination of the number or maximum number of shares of stock which may be allocated to any such director or officer or which may be covered by qualified, restricted or employee stock purchase plan stock options granted to any such director or officer, is subject to the discretion of any person, then such discretion shall be exercised only as follows:
For the purpose of this subsection, a director or committee member shall be deemed to be a disinterested person only if such person is not at the time such discretion is exercised eligible and has not at any time within one year prior thereto been eligible for selection as a person to whom stock may be allocated or to whom qualified, restricted or employee stock purchase plan stock options may be granted pursuant to the plan or any other plan of the insurer or any of its affiliates entitling the participants therein to acquire stock or qualified, restricted or employee stock purchase plan stock options of the insurer or any of its affiliates.
C. As to each participant or as to all participants the plan effectively limits the aggregate dollar amount or the aggregate number of shares of stock which may be allocated, or which may be subject to qualified, restricted, or employee stock purchase plan stock options granted, pursuant to the plan. The limitations may be established on an annual basis, or for the duration of the plan, whether or not the plan has a fixed termination date; and may be determined either by fixed or maximum dollar amounts or fixed or maximum numbers of shares or by formulas based upon earnings of the insurer, dividends paid, compensation received by participants, option prices, market value of shares, outstanding shares or percentages thereof outstanding from time to time, or similar factors which will result in an effective and determinable limitation. Such limitations may be subject to any provisions for adjustment of the plan or of stock allocable or options outstanding thereunder to prevent dilution or enlargement of rights.
D. Unless the context otherwise requires, all terms used in this section shall have the same meaning as in Section 10-3-120, C.R.S., and Section 4 of this regulation. In addition, the following definitions apply:
Section 17 Exemption from Section 10-3-120(2), C.R.S., of Certain Transactions in Which Securities Are Received By Redeeming Other Securities Any acquisition of an equity security (other than a convertible security or right to purchase a security) by a director or officer of the insurer issuing such security shall be exempt from the operation of Section 10-3- 120(2), C.R.S., upon condition that:
A. The equity security is acquired by way of redemption of another security of an insurer substantially all of whose assets other than cash (or Government bonds) consist of securities of the insurer issuing the equity security so acquired, and which
B. No security of the same class as the security redeemed was acquired by the director or officer within six months prior to such redemption or is acquired within six months after such redemption;
C. The insurer issuing the equity security acquired has recognized the applicability of Subsection A of this section by appropriate corporate action.
Section 18 Exemption of Long Term Profits Incident to Sales within Six Months of the Exercise of an Option A. To the extent specified in Subsection B of this section, the Commissioner hereby exempts as not comprehended within the purposes of Section 10-3-120(2), C.R.S., any transaction or transactions involving the purchase and sale, or sale and purchase, of any equity security where such purchase is pursuant to the exercise of an option or similar right either (1) acquired more than six months before its exercise, or (2) acquired pursuant to the terms of an employment contract entered into more than six months before its exercise.
B. In respect of transactions specified in Subsection A of this section, the profits inuring to the insurer shall not exceed the difference between the proceeds of sale and the lowest market price of any security of the same class within six months before or after the date of sale. Nothing in this section shall be deemed to enlarge the amount of profit which would inure to such insurer in the absence of this section.
C. The Commissioner also hereby exempts, as not comprehended within the purposes of Section 10-3-120(2), C.R.S., the disposition of security, purchased in a transaction specified in Subsection A of this section pursuant to a plan or agreement or merger or consolidation, or reclassification of the insurer's securities, or for the exchange of its securities for the securities of another person which has acquired its assets, or which is in control, as defined in Section 368 (c) of the Internal Revenue Code of 1954, of a person which has acquired its assets, where the terms of such plan or agreement are binding upon all stockholders of the insurer except to the extent that dissenting stockholders may be entitled, under statutory provisions or provisions contained in the certificate of incorporation, to receive the appraised or fair value of their holdings.
D. The exemptions provided by this section shall not apply to any transaction made unlawfully by Section 10-3-120(3), C.R.S., or by any rules and regulations thereunder.
E. The burden of establishing market price of a security for the purpose of this section shall rest upon the person claiming the exemption.
Section 19 Exemption from Section 10-3-120(2), C.R.S., of Certain Acquisitions and Dispositions of Securities Pursuant to Merger or Consolidations A. The following transactions shall be exempt from the provisions of Section 10-3-120(2), C.R.S., as not comprehended within the purpose of Section 10-3-120(2), C.R.S.:
B. A merger within the meaning of this section shall include the sale or purchase of substantially all the assets of one insurer by another in exchange for stock which is then distributed to the security holders of the insurer which sold its assets.
C. Notwithstanding the foregoing, if an officer, director or stockholder shall make any purchase (other than a purchase exempted by this Section) of a security in any company involved in the merger or consolidation and any sale (other than a sale exempted by this Section) of a security in any other company involved in the merger or consolidation within any period of less than six months during which the merger or consolidation took place, the exemption provided by this Section shall be unavailable to such officer, director, or stockholder to the extent of such purchase and sale.
Section 20 Exemption from Section 10-3-120(2), C.R.S., of Transactions Involving the Deposit or Withdrawal of Equity Securities under a Voting Trust or Deposit Agreement Any acquisition or disposition of any equity security involved in the deposit of such security under, or the withdrawal of such security from, a voting trust or deposit agreement, and the acquisition or disposition in connection therewith of the certificate representing such security, shall be exempt from the operation of Section 10-3-120(2), C.R.S., if substantially all of the assets held under the voting trust or deposit agreement immediately after the deposit or immediately prior to the withdrawal, as the case may be, consisted of equity securities of the same class as the security deposited or withdrawn: provided, however, that this section shall not apply to the extent that there shall have been either (a) a purchase of an equity security of the class deposited and a sale of any certificate representing an equity security of such class, or (b) a sale of an equity security of the class deposited and purchase of any certificate representing an equity security of such class (otherwise than in a transaction involved in such deposit or withdrawal or in a transaction exempted by any other provision of the regulations under Section 10-3- 120(2), C.R.S.), within a period of less than six months which includes the date of the deposit or withdrawal.
Section 21 Exemption from Section 10-3-120(2), C.R.S., of Certain Transactions Involving the Conversion of Equity Securities A. Any acquisition or disposition of an equity security involved in the conversion of an equity security which, by its terms or pursuant to the terms of the insurer's charter or other governing instruments, is convertible immediately or after a stated period of time into another equity security of the same insurer, shall be exempt from the operation of Section 10-3-120(2), C.R.S.: provided, however, that this section shall not apply to the extent that there shall have been either (1) a purchase of any equity security of the class convertible (including any acquisition of or change in a conversion privilege) and a sale of any equity security of the class issuable upon conversion, or
B. For the purpose of this section, an equity security shall not be deemed to be acquired or disposed of upon conversion of an equity security if the terms of the equity security converted require the payment or entail the receipt, in connection with such conversion, of cash or other property in connection with such conversion, of cash or other property (other than equity securities involved in the conversion) equal in value at the time of conversion to more than 15 percent of the value of the equity security issued upon conversion.
C. For the purpose of this section, an equity security shall be deemed convertible if it is convertible at the option of the holder or of some other person or by operation of the terms of the security or the governing instruments.
Section 22 Exemption from Section 10-3-120(2), C.R.S., of Certain Transactions Involving the Sale of Subscription Rights A. Any sale of a subscription right to acquire any subject security of the same insurer shall be exempt from the provision of Section 10-3-120(2), C.R.S. to the extent prescribed in this section, as not comprehended within the purpose of Section 10-3-120(2), C.R.S., if:
B. When used within this section the following terms shall have the meaning indicated:
C. Notwithstanding anything contained herein to the contrary, if a person purchases subscription rights for cash or other consideration, then a sale by such person of subscription rights otherwise exempted by this section will not be so exempted to the extent of such purchases within the six month period preceding or following such sale.
Section 23 Exemption of Certain Securities from Section 10-3-120(3), C.R.S. Any security shall be exempt from the operation of Section 10-3-120(3), C.R.S., to the extent necessary to render lawful thereunder the execution by a broker of an order for an account in which he has no direct or indirect interest.
Section 24 Exemption from Section 10-3-120(3), C.R.S., of Certain Transactions Effected in Connection with a Distribution Any security shall be exempt from the operation of Section 10-3-120(3), C.R.S., to the extent necessary to render lawful thereunder any sale made by or on behalf of a dealer in connection with a distribution of a substantial block of securities, upon the following conditions:
A. The sale is represented by an over-allotment in which the dealer is participating as a member of an underwriting group, or the dealer or a person acting on his behalf intends in good faith to offset such sale with a security to be acquired by or on behalf of the dealer as a participant in an underwriting, selling or soliciting dealer group of which the dealer is a member at the time of the sale, whether or not the security to be so acquired is subject to a prior offering to existing security holders or some other class of persons; and B. Other persons not within the purview of Section 10-3-120(3), C.R.S., are participating in the distribution of such block of securities on terms at least as favorable as those under which such dealer is participating and to an extent at least equal to the aggregate participation of persons exempted from the provisions of Section 10-3-120(3), C.R.S., by this section. However, the performance of the functions of the manager of a distributing group and the receipt of a bona fide payment for performing such functions shall not preclude an exemption which would otherwise be available under this section.
Section 25 Exemption from Section 10-3-120(3), C.R.S., of Sales of Securities to be Acquired A. Whenever any person is entitled, as an incident to his ownership of an issued security and without the payment of consideration, to receive another security “when issued” or “when distributed,” the security to be acquired shall be exempt from the operation of Section 10-3- 120(3), C.R.S., provided that:
B. This section shall not be construed as exempting transactions involving both a sale of a security “when issued” or “when distributed” and a sale of the security by virtue of which the seller expects to receive the “when issued” or “when distributed” security, if the two transactions combined result in a sale of more units than the aggregate of those owned by the seller plus those to be received by him pursuant to this right of acquisition.
Section 26 Arbitrage Transactions under Section 10-3-120(5), C.R.S. It shall be unlawful for any director or officer of an insurer to effect any foreign or domestic arbitrage transaction in any equity security of such insurer, unless he shall include such transaction in the statements required by Section 10-3-120(1), C.R.S., and shall account to such insurer for the profits arising from such transaction, as provided in Section 10-3-120(2), C.R.S. The provisions of Section 10-3- 120(3), C.R.S., shall not apply to such arbitrage transactions. The provisions of Section 10-3-120, C.R.S., shall not apply to any bona fide foreign or domestic arbitrage transaction insofar as it is affected by any person other than such director or officer of the insurer. Section 27 Severability If any provision of this regulation or the application of it to any person or circumstance is for any reason held to be invalid, the remainder of this regulation shall not be affected. Section 28 Enforcement Noncompliance with this regulation may result in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance, or other laws, which include the imposition of civil penalties, issuance of cease and desist orders, and/or suspensions or revocation of license, subject to the requirements of due process.
Section 29 Effective Date This amended regulation shall become effective November 15, 2014. Section 30 History New regulation, effective on February 1, 1972 Amended effective December 31, 1992 Amended, effective November 15, 2014.
INSIDER TRADING REPORTING FORMS AND INSTRUCTIONS FORM 3 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES STATE OF COLORADO Commissioner of Insurance FORM 3 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed Pursuant to Section 10-3-120, C.R.S.
(See instruction 5)
Date of event which requires the filing of this state.
(See instruction 6)
REMARKS: (See instruction 10)
FORM 3 INSTRUCTIONS 1. PERSONS REQUIRED TO FILE STATEMENTS A statement on this form is required to be filed by every person who is directly or indirectly the beneficial owner of more than 10 percent of any class of any equity security of a Colorado domestic stock insurance company, or who is a director or an officer of such a company.
2. WHEN STATEMENTS ARE TO BE FILED A. Persons who hold any of the relationships specified in Instruction 1 are required to file a statement within 10 days after assuming such relationship.
B. Statements are not deemed to have been filed with the Commissioner until they have actually been received by the Commissioner.
3. WHERE STATEMENTS ARE TO BE FILED One signed copy of each statement shall be filed with the Commissioner of Insurance, 1560 Broadway, Suite 850, Denver, Colorado 80202.
4. SEPARATE STATEMENT FOR EACH COMPANY A separate statement shall be filed with respect to the securities of each company.
5. RELATIONSHIP OF REPORTING PERSON TO COMPANY Indicate clearly the relationship of the reporting person to the company; for example, “Director,” ''Director and Vice President,” “Beneficial owner of more than 10 percent of the company's common stock,” etc.
6. DATE AS OF WHICH BENEFICIAL OWNERSHIP IS TO BE GIVEN The information as to beneficial ownership of securities shall be given as of [insert month, day, year], or, in the case of persons who subsequently assume any of the relationships specified in Instruction 1, as of the date that relationship was assumed.
7. TITLE OF SECURITY The statement of the title of a security shall be such as clearly to identify the security even though there may be only one class; for example, “Class A Common Stock,” “$6 Convertible Preferred Stock,” “5% Debentures Due 1965,” etc.
8. NATURE OF OWNERSHIP Under “nature of ownership,” state whether ownership of the securities is “direct” or ''indirect'' If the ownership is indirect, i.e., through a partnership, corporation, trust or other entity, indicate in a footnote or other appropriate manner the name or identity of the medium through which the securities are indirectly owned. The fact that securities are held in the name of a broker or other nominee does not, of itself, constitute indirect ownership. Securities owned indirectly shall be reported on separate lines from those owned directly and also from those owned through a different type of indirect ownership.
9. STATEMENT OF AMOUNT OWNED In stating the amount of securities beneficially owned, give the face amount of debt securities or the number of shares or other units of other securities. In the case of securities owned indirectly, the entire amount of securities owned by the partnership, corporation, trust or other entity shall be stated. The person whose ownership is reported may, if he or she so desires, also indicate in a footnote or other appropriate manner the extent of his interest in the partnership, corporation, trust or other entity.
10. INCLUSION OF ADDITIONAL INFORMATION A statement may include any additional information or explanation deemed relevant by the person filing the statement.
11. SIGNATURE.
If the statement is filed for a corporation, partnership, trust, etc., the name of the organization shall appear over the signature of the officer or other person authorized to sign the statement. If the statement is filed for an individual, it shall be signed by him or specifically on his behalf by a person authorized to sign for him.
FORM 4 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES STATE OF COLORADO Commissioner of Insurance FORM 4 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed Pursuant to Section 10-3-120, C.R.S.
(See instruction 5)
REMARKS: (See instruction 11)
FORM 4 INSTRUCTIONS 1. PERSONS REQUIRED TO FILE STATEMENTS Statements on this form are required to be filed by every person who at any time during any calendar month was directly or indirectly the beneficial owner of more than 10 percent of any class of equity security of a domestic stock insurance company, or a director or officer of the company which is the issuer of such securities, and who during such month had any change in his beneficial ownership of any class of equity security of such company.
2. WHEN STATEMENTS ARE TO BE FILED Statements are required to be filed on or before the 10th day after the end of each month in which any change in beneficial ownership has occurred. Statements are not deemed to have been filed with the Commissioner until they have actually been received by him.
3. WHERE STATEMENTS ARE TO BE FILED One signed copy of each statement shall be filed with the Commissioner of Insurance, 1560 Broadway, Suite 850, Denver, Colorado 80202.
4. SEPARATE STATEMENT FOR EACH COMPANY A separate statement shall be filed with respect to the securities of each company.
5. RELATIONSHIP OF REPORTING PERSON TO COMPANY Indicate clearly the relationship of the reporting person to the company; for example, “Director,” “Director and Vice President,” “Beneficial owner of more than 10 percent of the company's common stock,” etc.
6. TRANSACTIONS AND HOLDINGS TO BE REPORTED Every transaction shall be reported even though purchases and sales during the month are equal or the change involves only the nature of ownership; for example, from direct to indirect ownership. Beneficial ownership at the end of the month of all classes of securities required to be reported shall be shown even though there has been no change during the month in the ownership of securities of one or more classes.
7. TITLE OF SECURITY The statement of the title of the security shall be such as clearly to identify the security even though there may be only one class; for example, “Class A Common Stock,” “$6 Convertible Preferred Stock,” “5% Debentures Due 1965,” etc.
8. DATE OF TRANSACTION The exact date (month, day and year) of each transaction shall be stated opposite the amount involved in the transaction.
9. STATEMENT OF AMOUNTS OF SECURITIES In stating the amount of the securities acquired, disposed of, or beneficially owned, give the face amount of debt securities or the number of shares or other units of other securities. In the case of securities owned indirectly, i.e., through a partnership, corporation, trust or other entity, the entire amount of securities involved in the transaction or owned by the partnership, corporation, trust or other entity shall be stated. The person whose ownership is reported may, if he so desires, also indicate in a footnote or other appropriate manner the extent of his interest in the transaction or holdings of the partnership, corporation, trust or other entity.
10. NATURE OF OWNERSHIP Under “Nature of ownership,” state whether ownership of the securities is “direct” or “indirect” If the ownership is indirect, i.e., through a partnership, corporation, trust or other entity, indicate in a footnote, or other appropriate manner, the name or identity of the medium through which the securities are indirectly owned. The fact that securities are held in the name of a broker or other nominee does not, of itself, constitute indirect ownership. Securities owned indirectly shall be reported on separate lines from those owned directly and from those owned through a different type of indirect ownership.
11. CHARACTER OF TRANSACTION If the transaction was with the issuer of the securities, so state. If it involved the purchase of securities through the exercise of options, so state and give the exercise price per share. If any other purchase or sale was affected otherwise than in the open market, that fact shall be indicated. If the transaction was not a purchase or sale, indicate its character; for example, gift, 5% stock dividend, etc., as the case may be. The foregoing information may be appropriately set forth in the table or under “Remarks” at the end of the table.
12. INCLUSION OF ADDITIONAL INFORMATION A statement may include any additional information or explanation deemed relevant by the person filing the statement.
13. SIGNATURE If the statement is filed for a corporation, partnership, trust, etc., the name of the organization shall appear over the signature of the officer or other person authorized to sign the statement. If the statement is filed for an individual, it shall be signed by him or specifically on his behalf by a person authorized to sign for him.
Regulation 3-2-4 PARTICIPATION LOANS Section 1 Authority This regulation is promulgated under the authority of § § 10-1-109, 10-6-129, 10-14-505 and 10-16-109, C.R.S.
Section 2 Scope and Purpose The purpose of this regulation is to implement the provisions of § 10-3-216(1)(f), C.R.S., in regard to participation loans authorized pursuant to statute.
Section 3 Applicability This regulation shall apply to all Colorado domestic insurers as well as each risk retention group captive insurer, fraternal benefit society, health maintenance organization and non-profit hospital, medical- surgical and health service corporation.
Section 4 Participants A. Participation in loans secured by a first lien on real property under § 10-3-216(1)(f), C.R.S. is limited to loans with the following participants:
A. Note evidencing the obligation.
B. Mortgage or Deed of Trust, properly executed and recorded.
C. Participation Certificate.
D. Recorded partial assignment (if recognized under state law).
E. Any other security taken in connection with the loan.
F. Appraisal report prepared as a basis for underwriting in the course of committing to make the loan.
G. Survey of premises (or other satisfactory evidence) identifying the property by address and legal description.
H. Participation (loan sharing) Agreement.
I. Title insurance policy or attorney's title opinion.
J. Hazard insurance policies or certificates.
K. Statement showing unpaid principal balance on mortgage, amount of periodic installments, and date to which interest is paid.
Section 6 Severability If any provision of this regulation of the application thereof to any person or circumstance is for any reason held to be invalid, the remainder of this regulation shall not be affected. Section 7 Enforcement Noncompliance with this Regulation may result, after proper notice and hearing, in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance or other laws which include the imposition of fines, issuance of cease and desist orders, and/or suspensions or revocation of license.
Section 8 Effective Date This regulation is effective on October 2, 2006.
Section 9 History This regulation was originally effective in 1975.
Amended, effective December 31, 1992.
Amended, effective April 1, 2001.
Amended, effective October 1, 2001.
Amended, effective October 2, 2006 Regulation 3-2-6 Repealed Effective 08/01/2012.
Regulation 3-2-7 Repealed Effective 12/01/2012.
Regulation 3-2-8 INTERNAL CONTROLS RELATED TO DERIVATIVES Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Definitions Section 5 Guidelines and Internal Control Procedures Section 6 Commissioner Approval Section 7 Documentation Requirements Section 8 Trading Requirements Section 9 Severability Section 10 Enforcement Section 11 Effective Date Section 12 History Section 1 Authority This regulation is promulgated and adopted by the Commissioner of Insurance under the authority of §§ 10-1-109(1), and 10-3-243(3), C.R.S.
Section 2 Scope and Purpose The purpose of this regulation is to set forth rules and procedural requirements which the Commissioner deems necessary to carry out the provisions of Section 10-3-243, C.R.S., regarding domestic insurers that enter into derivative transactions.
Section 3 Applicability Any domestic insurer that enters into derivative transactions. Section 4 Definitions A. “Business Entity” includes a sole partnership, corporation, limited liability company, association, partnership, joint stock company, joint venture, mutual fund, trust, joint tenancy or similar form of business organization, whether for-profit or not-for-profit.
B. “Qualified clearinghouse” means a clearinghouse for, and subject to the rules of a qualified exchange or a qualified foreign exchange, which clearinghouse provides clearing services, including acting as a counterparty to each of the parties to a transaction such that the parties no longer have credit risk as to each other.
C. “Qualified exchange” means:
D. “Qualified foreign exchange” means a foreign exchange, board of trade or contract market located outside the United States, its territories or possessions:
A. Before engaging in a derivative transaction, an insurance company shall establish written guidelines, approved by the Commissioner which shall be used for effecting and maintaining derivative transactions. The guidelines shall:
B. An insurer shall have a written methodology for determining whether a derivative instrument used for hedging has been effective.
C. An insurer shall have written policies and procedures describing the credit risk management process and a credit risk management system for over-the-counter derivative transactions that measures credit risk exposure using the counterparty exposure amount.
D. An insurer’s board of directors shall:
Section 6 Commissioner Approval Written documentation explaining the insurer’s internal guidelines and controls governing derivative transactions shall be submitted for approval to the Commissioner. The Commissioner shall have the authority to disapprove the guidelines and controls proposed by the insurer if the insurer cannot demonstrate that the proposed internal guidelines and controls would be adequate to manage the risks associated with the derivative transactions the insurer intends to engage in. Section 7 Documentation Requirements An insurance company shall maintain documentation and records relating to each derivative transaction, such as:
A. The purpose or purposes of the transaction;
B. The assets or liabilities to which the transaction relates;
C. The specific derivative instrument used in the transaction;
D. For over-the-counter derivative instrument transactions, the name of the counterparty and the market value; and For exchange traded derivative instruments, the name of the exchange and the name of the firm that handled the trade and the market value.
Section 8 Trading Requirements Each derivative instrument shall be:
A. Traded on a qualified exchange;
B. Entered into with, or guaranteed by, a business entity;
C. Issued or written with the issuer of the underlying interest on which the derivative instrument is based; or D. Entered into with a qualified foreign exchange.
Section 9 Severability If any provision of this regulation or the application of it to any person or circumstance is for any reason held to be invalid, the remainder of this regulation shall not be affected. Section 10 Enforcement Noncompliance with this regulation may result in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance, or other laws, which include the imposition of civil penalties, issuance of cease and desist orders, and/or suspensions or revocation of license, subject to the requirements of due process.
Section 11 Effective Date This regulation shall become effective on January 1, 2015. Section 12 History New Regulation, effective January 1, 2015 Regulation 3-3-1 ASSUMPTION REINSURANCE AGREEMENTS Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Definitions Section 5 Notice Requirements Section 6 Policyholder Rights Section 7 Effect of Consent Section 8 Commissioner’s Discretion Section 9 Severability Section 10 Enforcement Section 11 Effective Date Section 12 History Appendix A Notice of Transfer Section 1 Authority This regulation is promulgated and adopted by the Commissioner of Insurance under the authority of §§ 10-1-108(7) and 10-1-109, C.R.S.
Section 2 Scope and Purpose The purpose of this regulation is to clarify the filing and other requirements regarding insurers gaining approval to reinsure risks through the transfer and novation of contracts of notice and disclosure insurance by way of assumption reinsurance. It defines assumption reinsurance and establishes notice and disclosure requirements which protect and define the rights and obligations of policyholders, regulators and the parties to assumption reinsurance agreements. Section 3 Applicability A. This regulation applies to any insurer authorized in this state pursuant to § 10-3-105, C.R.S. which either assumes or transfers the obligations and/or risks on contracts of insurance pursuant to an assumption reinsurance agreement.
B. This regulation does not apply to:
A. “Assuming insurer” means, for the purpose of this regulation, the insurer that acquires an insurance obligation or risk, or both, from the transferring insurer pursuant to an assumption reinsurance agreement.
B. “Assumption reinsurance agreement” means, for the purpose of this regulation, any contract that:
C. “Contract of insurance” means, for the purpose of this regulation, any written agreement between an insurer and policyholder pursuant to which the insurer, in exchange for premium or other consideration, agrees to assume an obligation or risk, or both, of the policyholder or to make payments on behalf of, or to, the policyholder or its beneficiaries; it shall include all property, casualty, life, health, accident, surety, title and annuity business authorized to be written pursuant to the insurance laws of this state.
D. “Home service business” means, for the purpose of this regulation, insurance business on which premiums are collected on a weekly or monthly basis by an agent of the insurer.
E. “Notice of transfer” means, for the purpose of this regulation, the written notice to policyholders required by Section 5.A. of this regulation.
F. “Policyholder” means, for the purpose of this regulation, any individual or entity which has the right to terminate or otherwise alter the terms of a contract of insurance. It includes any certificate holder whose certificate is in force on the proposed effective date of the assumption, if the certificate holder has the right to keep the certificate in force without change in benefit following termination of the group policy. The right to keep the certificate in force referred to in this section shall not include the right to elect individual coverage under the Consolidated Omnibus Budget Reconciliation Act, (“COBRA”) Section 601, et seq., of the Employee Retirement Income Security Act of 1974, as amended (29 U.S.C. 1161 et seq.
G. “Transferring insurer” means, for the purpose of this regulation, the insurer which transfers an insurance obligation or risk, or both, to an assuming insurer pursuant to an assumption reinsurance agreement.
Section 5 Notice Requirements A. Notice to Policyholders, Agents and Brokers
B. Regulatory Filing and Approval Requirements
Section 6 Policyholder Rights A. Policyholders shall have the right to reject the transfer and novation of their contracts of insurance. Policyholders electing to reject the assumption transaction shall return to the transferring insurer the pre-addressed, postage-paid response card or other written notice and indicate thereon that the assumption is rejected (collectively referred to as the “Response Card”).
B. Payment of any premium to the assuming company during the twenty-four-month period after notice is received shall be deemed to indicate the policyholder’s acceptance of the transfer to the assuming insurer and a novation shall be deemed to have been effected, provided that the premium notice clearly states that payment of the premium to the assuming insurer shall constitute acceptance of the transfer. However, the premium notice shall also provide a method for the policyholder to pay the premium while reserving the right to reject the transfer. With respect to any home service business or any other business not using premium notices, the disclosures and procedural requirements of this subsection are to be set forth in the Notice of Transfer and in the assumption certificate.
C. After no fewer that twenty-four (24) months from the mailing of the initial Notice of Transfer, if positive consent to, or rejection of, the transfer and assumption has not been received or consent has not been deemed to have occurred under Section 6.B. of this regulation, the transferring company shall send to the policyholder a second and final Notice of Transfer. If the policyholder does not accept or reject the transfer during the one month period immediately following the date on which the transferring insurer mails the second and final notice of transfer, the policyholder’s consent will be deemed to have occurred and novation of the contract will be effected. With respect to the home service business, or any other business not using premium notices, the twenty-four and one month periods shall be measured from the date of delivery of the Notice of Transfer.
D. The transferring insurer will be deemed to have received the Response Card on the date it is postmarked. A policyholder may also send its Response Card by facsimile or other electronic transmission or by registered mail, express delivery or courier service, in which case the Response Card shall be deemed to have been received by the assuming insurer on the date of actual receipt by the transferring insurer.
Section 7 Effect of Consent If a policyholder consents to the transfer pursuant to Section 6. of this regulation, or if the transfer is effected under Section 8. of this regulation, there shall be a novation of the contract of insurance subject to the assumption reinsurance agreement with the result that the transferring insurer shall thereby be relieved of all insurance obligations or risks, or both, transferred under the assumption reinsurance agreement and the assuming insurer shall become directly and solely liable to the policyholder for those insurance obligations or risks, or both.
Section 8 Commissioner’s Discretion If an insurer domiciled in this state or in a jurisdiction having a substantially similar law is deemed by the domiciliary Commissioner to be in a hazardous financial condition or an administrative proceeding has been instituted against it for the purpose of reorganizing or conserving the insurer, and the transfer of the contracts of insurance is in the best interest of the policyholders, as determined by the domiciliary Commissioner, a transfer and novation may be effected notwithstanding the provisions of this regulation. This may include a form of implied consent and adequate notification to the policyholder of the circumstances requiring the transfer as approved by the Commissioner. Section 9 Severability If any provision of this regulation or the application of it to any person or circumstance is for any reason held to be invalid, the remainder of this regulation shall not be affected. Section 10 Enforcement Noncompliance with the regulation may result in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance, or other laws, which include the imposition of civil penalties, issuance of cease and desist orders, and/or suspensions or revocation of license, subject to the requirements of due process.
Section 11 Effective Date This regulation shall become effective on April 1, 2016. Section 12 History Original Regulation effective August 1, 1990 Amended Regulation effective August 31, 1994 Repealed and Repromulgated Regulation effective May 1, 2012 Amended Regulation effective April 1, 2016 APPENDIX A NOTICE OF TRANSFER IMPORTANT: THIS NOTICE AFFECTS YOUR CONTRACT RIGHTS. PLEASE READ IT CAREFULLY. Transfer of Policy The [ABC Insurance Company] has agreed to replace us as your insurer under [insert policy/certificate name and number] effective [insert date]. The [ABC Insurance Company's] principal place of business is [insert address] and certain financial information concerning both companies is attached, including (1) ratings for the last five years, if available, or for such lesser period as is available from two nationally recognized insurance rating services; (2) balance sheets, for the previous three years if available, or for such lesser period as is available; and as of the date of the most recent quarterly statement; (3) a copy of the Management's Discussion and Analysis that was filed as a supplement to the previous year's annual statement; and (4) an explanation of the reason for the transfer. You may obtain additional information concerning [ABC Insurance Company] from reference materials in your local library or by contacting your Insurance Commissioner at [insert address and phone number]. The [ABC Insurance Company] is licensed to write this coverage in your state. The Commissioner of Insurance in your state has reviewed the potential effect of the proposed transaction, and has approved the transaction.
Your Rights You may choose to consent to or reject the transfer of your policy to [ABC Insurance Company]. If you want your policy transferred, you may notify us in writing by signing and returning the enclosed pre- addressed, postage-paid card or by writing to us at:
[Insert name, address and facsimile number of contact person.] Payment of your premium to the assuming company will also constitute acceptance of the transaction. However, a method will be provided to allow you to pay the premium while reserving the right to reject the transfer.
If you reject the transfer, you may keep your policy with us or exercise any option under your policy. If we do not receive a written rejection you will, as a matter of law, have consented to the transfer. However, before this consent is final you will be provided a second notice of the transfer twenty-four months from now. After the second notice is provided, you will have one month to reply. If you have paid your premium to the [ABC Insurance Company], without reserving your right to reject the transfer, you will not receive a second notice.
Effect of Transfer If you accept this transfer, [ABC Insurance Company] will be your insurer. It will have direct responsibility to you for the payment of all claims, benefits and for all other policy obligations. We will no longer have any obligations to you.
If you accept this transfer, you should make all premium payments and claims submissions to [ABC Insurance Company] and direct all questions to [ABC Insurance Company]. If you have any further questions about this agreement, you may contact [XYZ Insurance] or [ABC Insurance].
Name:
Street Address:
City, State, Zip:
Regulation 3-3-2 – CEDING REINSURANCE AGREEMENTS – REPEALED [Repealed eff. 1/1/2007. Replaced by Regs. 3-3-3, 3-3-4, and 3-3-5] Regulation 3-3-3 CREDIT FOR REINSURANCE Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Credit for Reinsurance—Reinsurer Licensed in this State Section 5 Credit for Reinsurance—Accredited Reinsurers Section 6 Credit for Reinsurance—Reinsurer Domiciled in Another State Section 7 Credit for Reinsurance—Reinsurers Maintaining Trust Funds Section 8 Credit for Reinsurance––Certified Reinsurers Section 9 Credit for Reinsurance—Reciprocal Jurisdictions Section 10 Credit for Reinsurance Required by Law Section 11 Asset or Reduction from Liability for Reinsurance Ceded to Unauthorized Assuming Insurer Not Meeting the Requirements of Sections 4 Through 10 Section 12 Trust Agreements Qualified Under Section 11 Section 13 Letters of Credit Qualified Under Section 11 Section 14 Other Security Section 15 Reinsurance Contract Section 16 Contracts Affected Section 17 Severability Section 18 Enforcement Section 19 Effective Date Section 20 History Form AR-1 Certificate of Assuming Insurer Form CR-1 Certificate of Certified Reinsurer Form RJ-1 Certificate of Reinsurer Domiciled in Reciprocal Jurisdiction Form CR-F Form CR-S Section 1 Authority This regulation is promulgated pursuant to the authority granted by Sections 10-1-109(1), 10-3-529(4), 10-3-705, 10-6-129, 10-14-505 and 10-16-109, and provides standards regarding reinsurance agreements under Sections 10-3-701 et. seq., 10-6-122, 10-11-113, 10-14-304, 8-44-204, 8-44-205, 8- 45-117, 24-10-115.5, and 29-13-102, C.R.S.
Section 2 Scope and Purpose The purpose of this regulation is to set forth rules and procedural requirements that the Commissioner deems necessary to carry out the provisions of the Section 10-3-701 et. seq., C.R.S., regarding the conditions and circumstances under which a domestic insurer may reduce their liabilities, or establish an asset associated with risks reinsured. The actions and information required by this regulation are declared to be necessary and appropriate in the public interest and for the protection of the ceding insurers in this state. This regulation addresses credit for reinsurance associated with a valid reinsurance contract. The criteria as to what constitutes a valid reinsurance agreement, limitations on the amount of credit that can be claimed and other requirements as regards financial reporting are addressed in Colorado Insurance Regulations 3-3-4 and 3-3-5.
Section 3 Applicability This regulation shall apply to all licensed insurers, as well as to each domestic group captive insurer, fraternal benefit society, health maintenance organization, licensed self-insurance pool, prepaid dental care plan organization, non-profit hospital, medical-surgical and health service corporation, Pinnacol Assurance, interinsurance exchange/reciprocal exchange and title insurance company. Section 4 Credit for Reinsurance—Reinsurer Licensed in this State Pursuant to Section 10-3-702(2), C.R.S., the Commissioner shall allow credit for reinsurance ceded by a domestic insurer to an assuming insurer that was licensed in this state as of any date on which statutory financial statement credit for reinsurance is claimed.
Section 5 Credit for Reinsurance—Accredited Reinsurers A. Pursuant to Section 10-3-702(3), C.R.S., the Commissioner shall allow credit for reinsurance ceded by a domestic insurer to an assuming insurer that is accredited as a reinsurer in this state as of the date on which statutory financial statement credit for reinsurance is claimed. An accredited reinsurer must:
B. If the Commissioner determines that the assuming insurer has failed to meet or maintain any of these qualifications, the Commissioner may upon written notice and opportunity for hearing, suspend or revoke the accreditation. Credit shall not be allowed a domestic ceding insurer under this section if the assuming insurer’s accreditation has been revoked by the Commissioner, or if the reinsurance was ceded while the assuming insurer’s accreditation was under suspension by the Commissioner.
Section 6 Credit for Reinsurance—Reinsurer Domiciled in Another State A. Pursuant to Section 10-3-702(4), C.R.S., the Commissioner shall allow credit for reinsurance ceded by a domestic insurer to an assuming insurer that as of any date on which statutory financial statement credit for reinsurance is claimed:
B. The provisions of this section relating to surplus as regards policyholders shall not apply to reinsurance ceded and assumed pursuant to pooling arrangements among insurers in the same holding company system. As used in this section, “substantially similar” standards means credit for reinsurance standards that the Commissioner determines equal or exceed the standards of Section 10-3-701, et. seq., and this regulation.
Section 7 Credit for Reinsurance—Reinsurers Maintaining Trust Funds A. Pursuant to Section 10-3-702(5), C.R.S., the Commissioner shall allow credit for reinsurance ceded by a domestic insurer to an assuming insurer which, as of any date on which statutory financial statement credit for reinsurance is claimed, and thereafter for so long as credit for reinsurance is claimed, maintains a trust fund in an amount prescribed below in a qualified U.S. financial institution as defined in Section 10-3-704(2), C.R.S., for the payment of the valid claims of its U.S. domiciled ceding insurers, their assigns and successors in interest. The assuming insurer shall report annually to the Commissioner substantially the same information as that required to be reported on the National Association of Insurance Commissioners (NAIC) annual statement form by licensed insurers, to enable the Commissioner to determine the sufficiency of the trust fund.
B. The following requirements apply to the following categories of assuming insurer.
C. Credit for reinsurance shall not be granted unless the form of the trust and any amendments to the trust have been approved by either the Commissioner of the state where the trust is domiciled or the commissioner of another state who, pursuant to the terms of the trust instrument, has accepted responsibility for regulatory oversight of the trust. The form of the trust and any trust amendments also shall be filed with the commissioner of every state in which the ceding insurer beneficiaries of the trust are domiciled.
D. For purposes of this section, the term “liabilities” shall mean the assuming insurer's gross liabilities attributable to reinsurance ceded by U.S. domiciled insurers excluding liabilities that are otherwise secured by acceptable means, and, shall include:
E. Assets deposited in trusts established pursuant to Section 10-3-702, C.R.S., and this section shall be valued according to their current fair market value and shall consist only of cash in U.S. dollars, certificates of deposit issued by a U.S. financial institution as defined in Section 10-3- 704(1), C.R.S., clean, irrevocable, unconditional and “evergreen” letters of credit issued or confirmed by a qualified U.S. financial institution, as defined in Section 10-3-704(1), C.R.S., and investments of the type specified in this subsection, but investments in or issued by an entity controlling, controlled by or under common control with either the grantor or beneficiary of the trust shall not exceed five percent (5%) of total investments. No more than twenty percent (20%) of the total of the investments in the trust may be foreign investments authorized under Paragraphs (1)(e), (3), (6)(b) or (7) of this subsection, and no more than ten percent (10%) of the total of the investments in the trust may be securities denominated in foreign currencies. For purposes of applying the preceding sentence, a depository receipt denominated in U.S. dollars and representing rights conferred by a foreign security shall be classified as a foreign investment denominated in a foreign currency. The assets of a trust established to satisfy the requirements of Section 10-3-702, C.R.S. shall be invested only as follows:
F. A specific security provided to a ceding insurer by an assuming insurer pursuant to Section 11 of this regulation shall be applied, until exhausted, to the payment of liabilities of the assuming insurer to the ceding insurer holding the specific security prior to, and as a condition precedent for, presentation of a claim by the ceding insurer for payment by a trustee of a trust established by the assuming insurer pursuant to this section.
Section 8 Credit for Reinsurance-Certified Reinsurers A. Pursuant to Section 10-3-702(6), C.R.S., the Commissioner shall allow credit for reinsurance ceded by a domestic insurer to an assuming insurer that has been certified as a reinsurer in this state at all times for which statutory financial statement credit for reinsurance is claimed under this section. The credit allowed shall be based upon the security held by or on behalf of the ceding insurer in accordance with a rating assigned to the certified reinsurer by the Commissioner. The security shall be in a form consistent with the provisions of Section 10-3- 702(6), C.R.S., and Section 10-3-703, et. seq., and Sections 12, 13, or 14 of this regulation. The amount of security required in order for full credit to be allowed shall correspond with the following requirements:
B. Certification Procedure.
C. Qualified Jurisdictions.
D. Recognition of Certification Issued by an NAIC Accredited Jurisdiction.
E. Mandatory Funding Clause. In addition to the clauses required under Section 15, reinsurance contracts entered into or renewed under this section shall include a proper funding clause, which requires the certified reinsurer to provide and maintain security in an amount sufficient to avoid the imposition of any financial statement penalty on the ceding insurer under this section for reinsurance ceded to the certified reinsurer.
F. The Commissioner shall comply with all reporting and notification requirements that may be established by the NAIC with respect to certified reinsurers and qualified jurisdictions. Section 9 Credit for Reinsurance––Reciprocal Jurisdictions A. Pursuant to Section 10-3-702(6.5), C.R.S., the Commissioner shall allow credit for reinsurance ceded by a domestic insurer to an assuming insurer that is licensed to write reinsurance by, and has its head office or is domiciled in, a Reciprocal Jurisdiction, and which meets the other requirements of this regulation.
B. A “Reciprocal Jurisdiction” is a jurisdiction, as designated by the Commissioner pursuant to Subsection D, that meets one of the following:
C. Credit shall be allowed when the reinsurance is ceded from an insurer domiciled in this state to an assuming insurer meeting each of the conditions set forth below.
D. The Commissioner shall timely create and publish a list of Reciprocal Jurisdictions.
E. The Commissioner shall timely create and publish a list of assuming insurers that have satisfied the conditions set forth in this section and to which cessions shall be granted credit in accordance with this section.
F. If the Commissioner determines that an assuming insurer no longer meets one or more of the requirements under this section, the Commissioner may revoke or suspend the eligibility of the assuming insurer for recognition under this section.
G. Before denying statement credit or imposing a requirement to post security with respect to Section 9F of this regulation or adopting any similar requirement that will have substantially the same regulatory impact as security, the Commissioner shall:
H. If subject to a legal process of rehabilitation, liquidation or conservation, as applicable, the ceding insurer, or its representative, may seek and, if determined appropriate by the court in which the proceedings are pending, may obtain an order requiring that the assuming insurer post security for all outstanding liabilities.
Section 10 Credit for Reinsurance Required by Law Pursuant to Section 10-3-702(7), C.R.S., the Commissioner shall allow credit for reinsurance ceded by a domestic insurer to an assuming insurer not meeting the requirements of Section 10-3-702(2,3,4,5,6, or 6.5), C.R.S., but only as to the insurance of risks located in jurisdictions where the reinsurance is required by the applicable law or regulation of that jurisdiction. As used in this section, “jurisdiction” means state, district or territory of the United States and any lawful national government. Section 11 Asset or Reduction from Liability for Reinsurance Ceded to an Unauthorized Assuming Insurer not Meeting the Requirements of Sections 4 through 10 A Pursuant to Section 10-3-703, C.R.S., the Commissioner shall allow a reduction from liability for reinsurance ceded by a domestic insurer to an assuming insurer not meeting the requirements of Section 10-3-702, et. seq., C.R.S. in an amount not exceeding the liabilities carried by the ceding insurer. The reduction shall be in the amount of funds held by or on behalf of the ceding insurer, including funds held in trust for the exclusive benefit of the ceding insurer, under a reinsurance contract with such assuming insurer as security for the payment of obligations under the reinsurance contract. The security shall be held in the United States subject to withdrawal solely by, and under the exclusive control of, the ceding insurer or, in the case of a trust, held in a qualified United States financial institution as defined in Section 10-3-704(2), C.R.S. This security may be in the form of any of the following:
B. An admitted asset or a reduction from liability for reinsurance ceded to an unauthorized assuming insurer pursuant to this section shall be allowed only when the requirements of Section -15 and the applicable portions of Sections 12, 13 or 14 of this regulation have been satisfied. Section 12 Trust Agreements Qualified under Section 11 A. As used in this section:
B. Required conditions.
C. Permitted conditions.
D. Additional conditions applicable to reinsurance agreements:
E. Financial reporting. A trust agreement may be used to reduce any liability for reinsurance ceded to an unauthorized assuming insurer in financial statements required to be filed with this department in compliance with the provisions of this regulation when established on or before the date of filing of the financial statement of the ceding insurer. Further, the reduction for the existence of an acceptable trust account may be up to the current fair market value of acceptable assets available to be withdrawn from the trust account at that time, but such reduction shall be no greater than the specific obligations under the reinsurance agreement that the trust account was established to secure.
F. Existing agreements. Notwithstanding the effective date of this regulation, any trust agreement or underlying reinsurance agreement in existence prior to January 1, 2015 will continue to be acceptable until January 1, 2016, at which time the agreements will have to fully comply with this regulation for the trust agreement to be acceptable.
G. The failure of any trust agreement to specifically identify the beneficiary as defined in Subsection A of this section shall not be construed to affect any actions or rights that the Commissioner may take or possess pursuant to the provisions of the laws of this state. Section 13 Letters of Credit Qualified under Section 11 A. The letter of credit must be clean, irrevocable, unconditional and issued or confirmed by a qualified United States financial institution as defined in Section 10-3-704(1), C.R.S. The letter of credit shall contain an issue date and expiration date and shall stipulate that the beneficiary need only draw a sight draft under the letter of credit and present it to obtain funds and that no other document need be presented. The letter of credit also shall indicate that it is not subject to any condition or qualifications outside of the letter of credit. In addition, the letter of credit itself shall not contain reference to any other agreements, documents or entities, except as provided in Subsection H(1) of this section. As used in this section, “beneficiary” means the domestic insurer for whose benefit the letter of credit has been established and any successor of the beneficiary by operation of law. If a court of law appoints a successor in interest to the named beneficiary, then the named beneficiary includes and is limited to the court appointed domiciliary receiver (including conservator, rehabilitator or liquidator).
B. The heading of the letter of credit may include a boxed section containing the name of the applicant and other appropriate notations to provide a reference for the letter of credit. The boxed section shall be clearly marked to indicate that such information is for internal identification purposes only.
C. The letter of credit shall contain a statement to the effect that the obligation of the qualified United States financial institution under the letter of credit is in no way contingent upon reimbursement with respect thereto.
D. The term of the letter of credit shall be for at least one year and shall contain an “evergreen clause” that prevents the expiration of the letter of credit without due notice from the issuer. The “evergreen clause” shall provide for a period of no less than thirty (30) days notice prior to expiration date or nonrenewal.
E. The letter of credit shall state whether it is subject to and governed by the laws of this state or the Uniform Customs and Practice for Documentary Credits of the International Chamber of Commerce Publication 600 (UCP 600) or International Standby Practices of the International Chamber of Commerce Publication 590 (ISP98), or any successor publication, and all drafts drawn thereunder shall be presentable at an office in the United States of a qualified United States financial institution.
F. If the letter of credit is made subject to the Uniform Customs and Practice for Documentary Credits of the International Chamber of Commerce Publication 600 (UCP 600) or International Standby Practices of the International Chamber of Commerce Publication 590 (ISP98), or any successor publication, then the letter of credit shall specifically address and provide for an extension of time to draw against the letter of credit in the event that one or more of the occurrences specified in Article 36 of Publication 600 or any other successor publication, occur.
G. If the letter of credit is issued by a financial institution authorized to issue letters of credit, other than a qualified United States financial institution as described in Subsection A of this section, then the following additional requirements shall be met:
H. Reinsurance agreement provisions.
Section 14 Other Security A ceding insurer may take credit for unencumbered funds withheld by the ceding insurer in the United States subject to withdrawal solely by the ceding insurer and under its exclusive control. Section 15 Reinsurance Contract Credit will not be granted, nor an asset or reduction from liability allowed, to a ceding insurer for reinsurance effected with assuming insurers meeting the requirements of Sections 4, 5, 6, 7, 8, 9 or 11 of this regulation or otherwise in compliance with Section 10-3-702, et. seq. after the adoption of this regulation unless the reinsurance agreement:
A. Includes a proper insolvency clause, which stipulates that reinsurance is payable directly to the liquidator or successor without diminution regardless of the status of the ceding company, pursuant to Section 10-3-531, C.R.S.;
B. Includes a provision pursuant to Section 10-3-702, et. seq., whereby the assuming insurer, if an unauthorized assuming insurer, has submitted to the jurisdiction of an alternative dispute resolution panel or court of competent jurisdiction within the United States, has agreed to comply with all requirements necessary to give the court or panel jurisdiction, has designated an agent upon whom service of process may be effected, and has agreed to abide by the final decision of the court or panel; and C. Includes a proper reinsurance intermediary clause, if applicable, which stipulates that the credit risk for the intermediary is carried by the assuming insurer. Section 16 Contracts Affected All new and renewal reinsurance transactions entered into after January 1, 2015, shall conform to the requirements of Sections 10-3-701 through 10-3-706, C.R.S., and this regulation if credit is to be given to the ceding insurer for such reinsurance.
Section 17 Severability If any provision of this regulation or the application of it to any person or circumstance is for any reason held to be invalid, the remainder of this regulation shall not be affected. Section 18 Enforcement Noncompliance with this regulation may result in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance, or other laws, which include the imposition of civil penalties, issuance of cease and desist orders, and/or suspensions or revocation of license, subject to the requirements of due process.
Section 19 Effective Date This regulation shall become effective on January 1, 2022. Section 20 History Regulation effective January 1, 2007.
Repealed and repromulgated regulation effective January 1, 2015. Amended regulation effective January 1, 2022.
FORM AR-1 CERTIFICATE OF ASSUMING INSURER I·_______________________________________ ______________________________________ (name of officer) (title of officer)
of ______________________________________________________, the assuming insurer (name of assuming insurer)
under a reinsurance agreement with one or more insurers domiciled in _____________________________________________________________, hereby certify that (name of state)
_____________________________________________________________ (“Assuming Insurer') (name of assuming insurer)
1. Submits to the jurisdiction of any court of competent jurisdiction in _____________________ (ceding insurer’s state of domicile)
for the adjudication of any issues arising out of the reinsurance agreement, agrees to comply with all requirements necessary to give such court jurisdiction, and will abide by the final decision of such court or any appellate court in the event of an appeal. Nothing in this paragraph constitutes or should be understood to constitute a waiver of Assuming Insurer's rights to commence an action in any court of competent jurisdiction in the United States, to remove an action to a United States District Court, or to seek a transfer of a case to another court as permitted by the laws of the United States or of any state in the United States. This paragraph is not intended to conflict with or override the obligation of the parties to the reinsurance agreement to arbitrate their disputes if such an obligation is created in the agreement.
2. Designates the Insurance Commissioner of _______________________________________________ (ceding insurer's state of domicile)
as its lawful attorney upon whom may be served any lawful process in any action, suit or proceeding arising out of the reinsurance agreement instituted by or on behalf of the ceding insurer.
3. Submits to the authority of the Insurance Commissioner of ________________________________ to (ceding insurer's state of domicile)
examine its books and records and agrees to bear the expense of any such examination.
4. Submits with this form a current list of insurers domiciled in ______________________________ (ceding insurer's state of domicile)
reinsured by Assuming Insurer and undertakes to submit additions to or deletions from the list to the Insurance Commissioner at least once per calendar quarter. Dated:_________________________________ _____________________________________________ (name of assuming insurer)
FORM CR-1 CERTIFICATE OF CERTIFIED REINSURER I·_________________________________________, _____________________________ (name of officer) (title of officer)
of ____________________________________________________________, the assuming insurer (name of assuming insurer)
under a reinsurance agreement with one or more insurers domiciled in__________________________ (name of state)
in order to be considered for approval in this state, hereby certify that ____________________________________________________________,(“Assuming insurer”): (name of assuming insurer)
1. Submits to the jurisdiction of any court of competent jurisdiction in _________________________ (ceding insurer’s state of domicile)
for the adjudication of any issues arising out of the reinsurance agreement, agrees to comply with all requirements necessary to give such court jurisdiction, and will abide by the final decision of such court or any appellate court in the event of an appeal. Nothing in this paragraph constitutes or should be understood to constitute a waiver of Assuming Insurer's rights to commence an action in any court of competent jurisdiction in the United States, to remove an action to a United States District Court, or to seek a transfer of a case to another court as permitted by the laws of the United States or of any state in the United States. This paragraph is not intended to conflict with or override the obligation of the parties to the reinsurance agreement to arbitrate their disputes if such an obligation is created in the agreement.
2. Designates the Insurance Commissioner of ____________________________________________ (ceding insurer’s state of domicile)
as its lawful attorney upon whom may be served any lawful process in any action, suit or proceeding arising out of the reinsurance agreement instituted by or on behalf of the ceding insurer.
3. Agrees to provide security in an amount equal to 100% of liabilities attributable to U.S. ceding insurers if it resists enforcement of a final U.S. judgment or properly enforceable arbitration award.
4. Agrees to provide notification within 10 days of any regulatory actions taken against it, any change in the provisions of its domiciliary license or any change in its rating by an approved rating agency, including a statement describing such changes and the reasons therefore.
5. Agrees to annually file information comparable to relevant provisions of the NAIC financial statement for use by insurance markets in accordance with Section 10-3-701, et. seq.
6. Agrees to annually file the report of the independent auditor on the financial statements of the insurance enterprise.
7. Agrees to annually file audited financial statements, regulatory filings, and actuarial opinion in accordance with Colorado Insurance Regulation 3-3-3(Section 8(B)(7)(d)).
8. Agrees to annually file an updated list of all disputed and overdue reinsurance claims regarding reinsurance assumed from U.S. domestic ceding insurers.
9. Is in good standing as an insurer or reinsurer with the supervisor of its domiciliary jurisdiction. Dated: _______________________________ ____________________________________ (name of assuming insurer)
FORM RJ-1 CERTIFICATE OF REINSURER DOMICILED IN RECIPROCAL JURISDICTION I, _, (name of officer) (title of officer)
of _, the assuming insurer (name of assuming insurer)
under a reinsurance agreement with one or more insurers domiciled in _, in order to (name of state)
be considered for approval in this state, hereby certify that (“Assuming Insurer”): (name of assuming insurer)
1. Submits to the jurisdiction of any court of competent jurisdiction in Colorado for the adjudication of any issues arising out of the reinsurance agreement, agrees to comply with all requirements necessary to give such court jurisdiction, and will abide by the final decision of such court or any appellate court in the event of an appeal. The assuming insurer agrees that it will include such consent in each reinsurance agreement, if requested by the Commissioner. Nothing in this paragraph constitutes or should be understood to constitute a waiver of assuming insurer’s rights to commence an action in any court of competent jurisdiction in the United States, to remove an action to a United States District Court, or to seek a transfer of a case to another court as permitted by the laws of the United States or of any state in the United States. This paragraph is not intended to conflict with or override the obligation of the parties to the reinsurance agreement to arbitrate their disputes if such an obligation is created in the agreement, except to the extent such agreements are unenforceable under applicable insolvency or delinquency laws.
2. Designates the Insurance Commissioner of Colorado as its lawful attorney in and for the Colorado upon whom may be served any lawful process in any action, suit or proceeding in this state arising out of the reinsurance agreement instituted by or on behalf of the ceding insurer.
3. Agrees to pay all final judgments, wherever enforcement is sought, obtained by a ceding insurer, that have been declared enforceable in the territory where the judgment was obtained.
4. Agrees to provide prompt written notice and explanation if it falls below the minimum capital and surplus or capital or surplus ratio, or if any regulatory action is taken against it for serious noncompliance with applicable law.
5. Confirms that it is not presently participating in any solvent scheme of arrangement, which involves insurers domiciled in Colorado. If the assuming insurer enters into such an arrangement, the assuming insurer agrees to notify the ceding insurer and the Commissioner, and to provide 100% security to the ceding insurer consistent with the terms of the scheme.
6. Agrees that in each reinsurance agreement it will provide security in an amount equal to 100% of the assuming insurer’s liabilities attributable to reinsurance ceded pursuant to that agreement if the assuming insurer resists enforcement of a final U.S. judgment, that is enforceable under the law of the territory in which it was obtained, or a properly enforceable arbitration award whether obtained by the ceding insurer or by its resolution estate, if applicable.
7. Agrees to provide the documentation in accordance with Colorado Insurance Regulation 3-3- 3(Section 9(C)(5)), if requested by the Commissioner.
Dated:
Form CR-F – PART 1 Assumed Reinsurance as of December 31, Current Year (000 Omitted) 1 2 3 4 5 Reinsurance 9 10 11 12 13 14 15 On 6 7 8 Funds Am As o s u e n t t s o f Held By or Pledged or Amount Compan Paid Losses Deposited Compensatin of Assets y Code and Loss Contingent Assumed With Letter g Balances to Pledged N o u r m I b D e r o N f ame D y omiciliar A d ssume A E d x ju p s e t n m s e e n s t K C n a o s w e n Cols. 6 + 7 C s o m Pa m y i a s b s l io e n P R r e e c m ei i v u a m b s l U d nearne R C e o i m ns p u a r n e i d e Credi s t P of o sted L S et e te cu rs r e o f Coll o a r t eral Reinsure Jurisdictio Premiu Losses and e Premiu s Credit Held in d n m LAE m Trust .............. ................... ........................................ ......................... ........................... ...................... ....................... ..................... ........................... ..................... ..................... ...................... 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9999999 Totals Form CR-F – PART 2 Ceded Reinsurance as of December 31, Current Year (000 Omitted) 1 2 3 4 5 6 Reinsurance Recoverable On Reinsurance Payable 18 19 Reinsuran 7 8 9 10 11 12 13 14 15 16 17 ce Net Funds Contracts Amount Held by Compa Ceding Other Recovera Company ny Nam 75% or Reinsuran Known Known IBNR IBN Cols. Ceded Amounts ble From Under C N o u d m ID e b o e r r Rei e n s o u f rer D Ju o r m o i r s y n i d c i i c li t a i P M r W D e o m r ir r it e e i t u e c o m t n f s Pr C e e m c d e iu e m d s L P e o a s s id s P L E d a A i R C L e e o a s s s s e s e r v R C L e e a A s s s e E e r v R L e e o s s s e s r v Res L R e E A r ves U Pr n m e e e m d s a r iu n C C o o m nt n m in s g i s e s n io t 7 t h T h o ro ta u 1 ls g 4 B P a a e l y e a s a n b c l R D e u in r e s s u to re s R [ 1 C e 6 i o n + – l s s u . 1 r 1 7 e 5 ] r R T e r i e n c a s e t u ie ra s n ............. ......... ................... ................... ...................... ................... ............... ............ ............... ............... ................ ............... ................ ..................... ............. ................ ................. ..................... .................. .. ... .. . . . ..
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9999999 Totals Form CR-S – PART 1 – SECTION 1 Reinsurance Assumed Life Insurance, Annuities, Deposit Funds and Other Liabilities Without Life or Disability Contingencies, and Related Benefits Listed by Reinsured Company as of December 31, Current Year 1 2 3 4 5 6 7 8 9 10 11 12 Reinsuranc Compan e Payable Funds y Code Nam Type of Amount on Paid and Modified Withheld or ID Effectiv e of Reinsuranc of In Unpaid Coinsuranc Under Number e Date Reinsured Location e Assumed Force at Reserve Premiums Losses e Reserve Coinsuranc End of e Year ..................... ................. ................... ........................................................... ............................................................... ............................ ............................ ........................ ........................ ............................ ............................ ............................ ..................... . ................... 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Totals Form CR-S – PART 1 – SECTION 2 Reinsurance Assumed Accident and Health Insurance Listed by Reinsured Company as of December 31, Current Year 1 2 3 4 5 6 7 8 9 10 11 12 Reserve Liability Compan Type Other Reinsuranc Funds y Code Nam of Than For e Payable Modified Withheld or ID Effectiv e of Domiciliary Reinsuranc Unearne Unearned on Paid and Coinsuranc Under Number e Date Reinsured Jurisdiction e Assumed Premiums d Premiums Unpaid e Reserve Coinsuranc Premium Losses e s ...................... ................ ..................... .......................................................... ................................................... .............................. ............................. .............................. ............................. ............................. ........................... ............................. ...................... . ..................... . .. .............................. . .............................. . . . 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Totals Form CR-S – PART 2 Reinsurance Recoverable on Paid and Unpaid Losses Listed by Reinsuring Company as of December 31, Current Year 1 2 3 4 5 6 7 Company Name Code or Effective of Paid Unpaid ID Number Date Company Location Losses Losses ................... ............... ................... .......................................................................... .......................................................... .................................................. .................................................. . ........
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Totals—Life, Annuity and Accident and Health Form CR-S – PART 3 – SECTION 1 Reinsurance Ceded Life Insurance, Annuities, Deposit Funds and Other Liabilities Without Life or Disability Contingencies, and Related Benefits Listed by Reinsuring Company as of December 31, Current Year 1 2 3 4 5 6 7 10 13 14 Reserve Outstanding Surplus Relief Compan Credit Funds y Code Nam Type of Amount Taken Modified Withheld N o u r m I b D e r E e f f D e a ct t i e v Com e p o a f ny Location R e e i C ns e u d r e a d n c a in t E F n o d rc o e f Cu 8 rr en P 9 ri o Premiums Cu 1 r 1 re n P 1 r 2 io C e o R in e s s u e r r a v n e c Co U in n s d u e ra r nc Year t Year r t Year r e Yea Yea r r ..................... ................. .................. .......................................................... ......................................... .......................... ........................ ................ ................... .................. ................... ................ ......................... ......................... . .. .. . .
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Totals Form CR-S – PART 3 – SECTION 2 Reinsurance Ceded Accident and Health Insurance Listed by Reinsuring Company as of December 31, Current Year 1 2 3 4 5 6 7 8 9 12 13 Reserve Outstanding Surplus Relief Company Credit Funds 10 11 Code or Nam Unearned Taken Modified Withheld ID Effective e of Premiums Other than Current Prior Coinsurance Under Number Date Company Location Type Premiums (Estimated) for Year Year Reserve Coinsurance Unearned Premiums ................... ................ ................... .......................................................... ............................................... ............ ....................... ........................ ......................... .......................... ........................ ............................ ................................... ......... .. ...
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Totals Regulation 3-3-4 LIFE AND HEALTH REINSURANCE AGREEMENTS Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Definitions Section 5 Accounting Requirements Section 6 Written Agreements Section 7 Filings Section 8 Exemptions Section 9 Severability Section 10 Enforcement Section 11 Effective Date Section 12 History Section 1 Authority This regulation is promulgated and adopted by the Commissioner of Insurance under the authority of §§ 10-1-108(7), 10-1-109(1), 10-3-529(4), 10-3-705, 10-3-1110, 10-6-129, 10-14-505 and 10-16-109, C.R.S. Section 2 Scope and Purpose A. The Colorado Division of Insurance recognizes that licensed insurers routinely enter into reinsurance agreements for many legitimate purposes. These purposes can include relief to the ceding insurer from strain to surplus.
B. It is improper for a licensed insurer, in the capacity of ceding insurer, to enter into reinsurance agreements for the principal purpose of producing significant surplus aid for the ceding insurer, typically on a temporary basis, while not transferring all of the significant risks inherent in the business being reinsured. If, in substance or effect, the expected potential liability to the ceding insurer remains basically unchanged by the reinsurance transaction, notwithstanding certain risk elements in the reinsurance agreement, such as catastrophic mortality or extraordinary survival, the agreements violate:
C. The purpose of this regulation is to establish requirements for acceptable reinsurance agreements to ensure that ceding insurers operate in a sound financial manner; correctly report their financial condition on required financial statements; and properly reduce liabilities or establish assets for reinsurance ceded. These requirements are necessary to protect the ceding insurers’ policy and contract holders and the people of the state of Colorado. Section 3 Applicability This regulation shall apply to all domestic life, fraternal and health insurers and to all other licensed life, fraternal and health insurers that are not subject to a substantially similar regulation in their domiciliary state. This regulation shall also similarly apply to licensed property and casualty insurers with respect to their accident and health insurance business. This regulation shall not apply to assumption reinsurance; yearly renewable term reinsurance; or certain nonproportional reinsurance such as stop loss or catastrophe reinsurance.
Section 4 Definitions A. “Annual Statement” means, for the purpose of this regulation, the NAIC convention blank life, fraternal or health financial annual statement.
B. “Credit for reinsurance” means, for the purpose of this regulation, any reduction of liability, establishment of asset or contra-liability, or any combination thereof.
C. “Credit quality risk” means, for the purpose of this regulation, the risk that invested assets supporting the reinsured business will decrease in value. The main hazards are that assets will default or that there will be a decrease in earning power. It excludes market value declines due to changes in interest rates. It is commonly referred to as the “C1” risk.
D. “Division” means, for the purpose of this regulation, the Colorado Division of Insurance.
E. “Disintermediation risk” means, for the purpose of this regulation, the risk that interest rates rise and policy loans and surrenders increase, or that maturing contracts do not renew at anticipated rates of renewal. If asset durations are greater than the liability durations the mismatch will increase. Policyholders will move their funds into new products offering higher rates. The company may have to sell assets at a loss to provide for these withdrawals. It is commonly included in the “C3” risk.
F. “Financial statement” means, for the purpose of this regulation, any monthly, quarterly or Annual Statement that is submitted to the Division.
G. “Lapse risk” means, for the purpose of this regulation, the risk that the policy will voluntarily terminate prior to the recoupment of a statutory surplus strain experienced at issue of the policy.
H. “LTC” means, for the purpose of this regulation, Long-Term Care Insurance.
I. “LTD” means, for the purpose of this regulation, Long-Term Disability Insurance.
J. “Reinvestment risk” means, for the purpose of this regulation, the risk that interest rates will fall and funds reinvested (coupon payments or monies received upon asset maturity or call) will therefore earn less than expected. If asset durations are less than liability durations, the mismatch will increase. It is commonly included in the “C3” risk. Section 5 Accounting Requirements All ceding insurers are responsible for establishing appropriate statutory gross reserves and reflecting appropriate credit for reinsurance, if any, for their reinsured business. A reinsurance agreement that does not comply with this regulation will be considered as a valid contract, unless terminated or voided by the parties to the agreement, where all terms and obligations are in effect, but no credit for reinsurance is permitted to be taken by the ceding insurer. The ceding insurer shall comply with the applicable provisions of law and this regulation before taking any credit for reinsurance in any financial statement for any reinsurance agreement.
A. No insurer subject to this regulation shall, for reinsurance ceded, reduce any liability or establish any asset in any financial statement filed with the Division if, by the terms of the reinsurance agreement, in substance or effect, any of the following conditions exist:
Risk categories:
R ISK CATEGORY a b c d e f Health Insurance - other than LTC /LTD + 0 + 0 0 0 Health Insurance – LTC/LTD + 0 + + + 0 Immediate Annuities 0 + 0 + + 0 Single Premium Deferred Annuities 0 0 + + + + Flexible Premium Deferred Annuities 0 0 + + + + Guaranteed Interest Contracts 0 0 0 + + + Other Annuity Deposit Business 0 0 + + + + Single Premium Whole Life 0 + + + + + Traditional Non-Par Permanent 0 + + + + + Traditional Non-Par Term 0 + + 0 0 0 Traditional Par Permanent 0 + + + + + Traditional Par Term 0 + + 0 0 0 Adjustable Premium Permanent 0 + + + + + Indeterminate Premium Permanent 0 + + + + + Universal Life Flexible Premium 0 + + + + + Universal Life Fixed Premium 0 + + + + + U niversal Life Fixed Premium (dump-in premiums allowed) 0 + + + + + Key: + Significant 0 Insignificant 7. Credit quality, reinvestment, or disintermediation risk.
B. The following situations require the establishment of additional liabilities or limitations to credits taken by the ceding insurer:
C. Notwithstanding Subsection 5.A., an insurer subject to this regulation may, with the prior approval of the commissioner, take such credit for reinsurance or establish such asset as the commissioner may deem consistent with §10-3-702, C.R.S, Colorado Insurance Regulation 3-3- 3, or other actuarial interpretations or standards adopted by the Division.
D. Retroactive reinsurance.
A. No reinsurance agreement or amendment to any agreement may be used to take any credit for reinsurance in any financial statement filed with the Division, unless the agreement, amendment or a binding letter of intent has been duly executed by both parties no later than the “as of date” of the financial statement.
B. In the case of a letter of intent, a reinsurance agreement or an amendment to a reinsurance agreement must be executed within a reasonable period of time, not exceeding ninety (90) days from the execution date of the letter of intent, in order for credit to be granted for the reinsurance ceded.
C. The reinsurance agreement shall contain provisions that provide that:
Section 7 Filings Complete copies of all reinsurance contracts and agreements and other information requested shall be filed with the commissioner at the commissioner’s request. Any information requested by the commissioner must be submitted no later than twenty (20) days after receipt of the request. Insurers who fail to submit the requested information may be assessed a penalty up to $100 per day for each day after the date the information is due.
Section 8 Exceptions A. A reinsurance agreement is not required to transfer all contract benefits contained in the underlying business reinsured. Transfer of less than all contract benefits is permitted if the reinsurance agreement is otherwise in compliance with this regulation and the benefits being reinsured:
B. A ceding insurer, with the prior written approval of the Commissioner, may have alternative terms or conditions in a reinsurance agreement that are not otherwise in compliance with this regulation, if such alternatives are reasonably necessary for the protection of the public and the insured policyholders, and the terms or conditions substantially comply with the intent and provisions of this regulation.
Section 9 Severability If any provision of this regulation or the application of it to any person or circumstance is for any reason held to be invalid, the remainder of this regulation shall not be affected Section 10 Enforcement Noncompliance with the regulation may result in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance, or other laws, which include the imposition of civil penalties, issuance of cease and desist orders, and/or suspensions or revocation of license, subject to the requirements of due process.
Section 11 Effective Date This regulation is effective April 1, 2016.
Section 12 History New regulation effective January 1, 2007.
Amended regulation effective April 1, 2016.
Regulation 3-3-5 PROPERTY AND CASUALTY REINSURANCE AGREEMENTS Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Definitions Section 5 Accounting Requirements Section 6 Written Agreements Section 7 Filings Section 8 Other Requirements Section 9 Exceptions Section 10 Severability Section 11 Enforcement Section 12 Effective Date Section 13 History Section 1 Authority This regulation is promulgated and adopted by the Commissioner of Insurance under the authority of §§ 10-1-108(7), 10-1-109(1), 10-3-529(4), 10-3-705, 10-6-129, 8-44-205(9), C.R.S. Section 2 Scope and Purpose A. The Colorado Division of Insurance recognizes that licensed insurers routinely enter into reinsurance agreements for many legitimate purposes. These purposes can include relief to the ceding insurer from strain to surplus, and may legitimately limit the amount of risk transferred from the ceding company to the assuming company.
B. It is improper for a licensed insurer to consider any contract as a reinsurance agreement if the principal purpose is not true risk transfer. If, in substance or effect, the expected potential liability of the ceding insurer remains basically unchanged by the reinsurance transaction, notwithstanding certain risk elements in the reinsurance agreement, such as catastrophic loss, the contracts violate:
C. The purpose of this regulation is to establish requirements for acceptable reinsurance agreements to ensure that ceding insurers operate in a sound financial manner, correctly report their financial condition on required financial statements, and properly reduce liabilities or establish assets for reinsurance ceded. These requirements are necessary to protect the ceding insurers’ policy and contract holders and the people of the State of Colorado. Section 3 Applicability This regulation shall apply to all domestic property and casualty insurers; title insurers; captive insurers; Pinnacol Assurance; and public entity self-insurance pools. However, any accident and health business issued by these insurers is specifically excluded from this regulation, and is, instead, subject to the requirements of Colorado Insurance Regulation 3-3-4.
Section 4 Definitions A. “Annual Statement” means, for the purpose of this regulation, the NAIC convention blank property and casualty financial annual statement.
B. “Credit for reinsurance” means, for the purpose of this regulation, any reduction of liability, establishment or asset or contra-liability, or any combination thereof.
C. “Division” means, for the purpose of this regulation, the Colorado Division of Insurance.
D. “Financial statement” means, for the purpose of this regulation, any monthly, quarterly or Annual Statement that is submitted to the Division.
Section 5 Accounting Requirements All ceding insurers are responsible for establishing appropriate statutory gross reserves and reflecting appropriate credit, if any, for reinsurance ceded. A reinsurance agreement that does not comply with this regulation will be considered as a valid contract, unless terminated or voided by the parties to the contract, where all terms and obligations are in effect, but no credit for reinsurance is permitted to be taken by the ceding insurer. The ceding insurer shall comply with the applicable provisions of law and this regulation before taking any credit for reinsurance in any statutory financial statement for any particular reinsurance agreement.
A. The essential element of a reinsurance agreement is the transfer of risk. Unless the agreement contains this essential element of risk transfer, no credit shall be recorded. Therefore, no insurer subject to this regulation shall, for reinsurance ceded, establish any credit for reinsurance in any financial statement filed with the Division if, by the terms of the reinsurance agreement, in substance or effect, any of the following conditions exist:
B. The following situations require the establishment of additional liabilities or limitations to the credit for reinsurance taken by the ceding insurer:
C. Notwithstanding Subsection 5.A., an insurer subject to this regulation may, with the prior written approval of the commissioner, take such credit for reinsurance as the commissioner may deem consistent with § 10-3-702, C.R.S., Colorado Insurance Regulation 3-3-3, or other actuarial interpretations or standards adopted by the Division.
Section 6 Written Agreements The reinsurance agreement shall contain provisions that provide that:
A. The agreement shall constitute the entire contract and agreement between the parties with respect to the business being reinsured thereunder and that there are no understandings between the parties other than as expressed in the agreement; and B. Any change or modification to the agreement shall be null and void unless made by amendment to the agreement and signed by both parties.
C. The dual signature requirement of this section does not apply to facultative reinsurance agreements signed by the reinsurer.
Section 7 Filings Complete copies of all reinsurance contracts and agreements and other information requested shall be filed with the commissioner at the commissioner’s request. Any information requested by the commissioner must be submitted no later than twenty (20) days after receipt of the request. Insurers who fail to submit the requested information may be assessed a penalty up to $100 per day for each day after the date the information is due.
Section 8 Other requirements All companies subject to this regulation shall provide immediate notification to the commissioner upon the exhausting, or impending exhaustion, of any reinsurance coverage which is necessary for the ceding insurer to comply with the provisions of §§ 10-3-102(3) or 10-11-112, C.R.S. Section 9 Exceptions A. A reinsurance agreement is not required to transfer all contract benefits contained in the underlying business reinsured. Transfer of less than all contract benefits is permitted if the reinsurance contract is otherwise in compliance with this regulation and the benefits being reinsured:
B. A ceding insurer, with the prior written approval of the Commissioner, may have alternative terms or conditions in a reinsurance agreement that are not otherwise in compliance with this regulation, if such alternatives are reasonably necessary for the protection of the public and the insured policyholders, and the terms or conditions substantially comply with the intent and provisions of this regulation.
Section 10 Severability If any provision of this regulation or the application of it to any person or circumstance is for any reason held to be invalid, the remainder of this regulation shall not be affected Section 11 Enforcement Noncompliance with this Regulation may result in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance, or other laws, which include the imposition of civil penalties, issuance of cease and desist orders, and/or suspensions or revocation of license, subject to the requirements of due process.
Section 12 Effective Date This regulation is effective April 1, 2016 Section 13 History New regulation effective January 1, 2007 Amended regulation effective April 1, 2016 Regulation 3-4-1 HOLDING COMPANY SYSTEM REGULATION WITH REPORTING FORMS AND INSTRUCTIONS Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Definitions Section 5 Forms - General Requirements Section 6 Forms - Incorporation by Reference, Summaries and Omissions Section 7 Forms - Information Unknown or Unavailable and Extension of Time to Furnish Section 8 Forms - Additional Information and Exhibits Section 9 Subsidiaries of Domestic Insurers Section 10 Acquisition of Control - Statement Filing (Form A) Section 11 Amendments to Form A Section 12 Acquisition of Section 3A(4) Insurers Section 13 Pre-Acquisition Notification (Form E)
Section 14 Annual Registration of Insurers -Statement Filing (Form B) Section 15 Summary of Changes to Registration - Statement Filing (Form C) Section 16 Amendments to Form B Section 17 Alternative and Consolidated Registration Section 18 Disclaimers and Termination of Registration Section 19 Transactions Subject to Prior Notice - Notice Filing (Form D) Section 20 Enterprise Risk Report (Form F)
Section 21 Group Capital Calculation Section 22 Extraordinary Dividends and Other Distributions Section 23 Adequacy of Surplus Section 24 Severability Section 25 Incorporation by Reference Section 26 Enforcement Section 27 Effective Date Section 28 History Appendix A Form A - Statement Regarding the Acquisition of Control of or Merger with a Domestic Insurer Appendix B Form B - Insurance Holding Company System Annual Registration Statement Appendix C Form C - Summary of Changes to Registration Statement Appendix D Form D - Prior Notice of a Transaction Appendix E Form E - Pre-Acquisition Notification Form Appendix F Form F - Enterprise Risk Report Section 1 Authority This regulation is promulgated and adopted by the Commissioner of Insurance under the authority of §§ 10-1-109(1) and 10-3-809, C.R.S.
Section 2 Scope and Purpose The purpose of this regulation is to set forth rules and procedural requirements which the Commissioner deems necessary to carry out the provisions of the Insurance Holding Company Systems Act, Part 8 of Article 3 of Title 10 of the Colorado Revised Statutes. The information called for by this regulation is hereby declared to be necessary and appropriate in the public interest and for the protection of the policyholders in this State.
Section 3 Applicability This regulation shall apply to all Colorado domestic insurers as well as to each domestic group captive insurer, fraternal benefit society, health maintenance organization, prepaid dental care plan organization, non-profit hospital, medical-surgical and health service corporation, and title insurance company. Section 4 Definitions A. "Executive officer" means chief executive officer, chief operating officer, chief financial officer, treasurer, secretary, controller, and any other individual performing functions corresponding to those performed by the foregoing officers under whatever title.
B. "Ultimate controlling person" means that person which is not controlled by any other person.
C. Unless the context otherwise requires, other terms found in this regulation and in § 10-3-801, C.R.S. are used as defined in the said section. Other nomenclature or terminology is according to the Insurance Code, or industry usage if not defined by the Code. Section 5 Forms - General Requirements A. Forms A, B, C, D, E and F are intended to be guides in the preparation of the statements required by §§ 10-3-803, 10-3-803.5, 10-3-804, and 10-3-805, C.R.S. They are not intended to be blank forms which are to be filled in. The statements filed shall contain the numbers and captions of all items, but the text of the items may be omitted provided the answers thereto are prepared in such a manner as to indicate clearly the scope and coverage of the items. All instructions, whether appearing under the items of the form or elsewhere therein, are to be omitted. Unless expressly provided otherwise, if any item is inapplicable or the answer thereto is in the negative, an appropriate statement to that effect shall be made.
B. One complete digital copy of each statement including exhibits and all other papers and documents filed as a part thereof, shall be filed with the Commissioner. It shall be signed in the manner prescribed on the form. If the signature of any person is affixed pursuant to a power of attorney or other similar authority, a copy of the power of attorney or other authority shall also be filed with the statement. The Commissioner may require paper copies of each statement including exhibits and all other papers and documents upon written request.
C. If an applicant requests a hearing on a consolidated basis under 10-3-803(8)(e), C.R.S., in addition to filing the Form A with the commissioner, the applicant shall file a copy of Form A with the National Association of Insurance Commissioners in electronic form.
D. Statements should be prepared electronically. Statements shall be easily readable and suitable for review and reproduction. Debits in credit categories and credits in debit categories shall be designated so as to be clearly distinguishable as such on photocopies. Statements shall be in the English language and monetary values shall be stated in United States currency. If any exhibit or other paper or document filed with the statement is in a foreign language, it shall be accompanied by a translation into the English language and any monetary value shown in a foreign currency normally shall be converted into United States currency. Section 6 Forms - Incorporation by Reference, Summaries and Omissions A. Information required by any item of Form A, Form B, Form D, Form E or Form F may be incorporated by reference in answer or partial answer to any other item. Information contained in any financial statement, annual report, proxy statement, statement filed with a governmental authority, or any other document may be incorporated by reference in answer or partial answer to any item of Form A, Form B, Form D, Form E or Form F provided the document is filed as an exhibit to the statement. Excerpts of documents may be filed as exhibits if the documents are extensive. Documents currently on file with the Commissioner which were filed within three years need not be attached as exhibits. References to information contained in exhibits or in documents already on file shall clearly identify the material and shall specifically indicate that such material is to be incorporated by reference in answer to the item. Matter shall not be incorporated by reference in any case where the incorporation would render the statement incomplete, unclear or confusing.
B. Where an item requires a summary or outline of the provisions of any document, only a brief statement shall be made as to the pertinent provisions of the document. In addition to the statement, the summary or outline may incorporate by reference particular parts of any exhibit or document currently on file with the Commissioner which was filed within three years and may be qualified in its entirety by such reference. In any case where two or more documents required to be filed as exhibits are substantially identical in all material respects except as to the parties thereto, the dates of execution, or other details, a copy of only one of the documents need be filed with a schedule identifying the omitted documents and setting forth the material details in which the documents differ from the documents, a copy of which is filed. Section 7 Forms-Information Unknown or Unavailable and Extension of Time to Furnish If it is impractical to furnish any required information, document or report at the time it is required to be filed, there shall be filed with the Commissioner a separate document:
A. Identifying the information, document or report in question;
B. Stating why the filing thereof at the time required is impractical; and C. Requesting an extension of time for filing the information, document or report to a specified date. The request for extension shall be deemed granted unless the Commissioner within 60 days after receipt thereof enters an order denying the request.
Section 8 Forms - Additional Information and Exhibits In addition to the information expressly required to be included in Form A, Form B, Form C, Form D, Form E and Form F, the Commissioner may request such further material information, if any, as may be necessary to make the information contained therein not misleading. The person filing may also file such exhibits as it may desire in addition to those expressly required by the statement. The exhibits shall be so marked as to indicate clearly the subject matters to which they refer. Changes to Forms A, B, C, D, E or F shall include on the top of the cover page the phrase: "Change No. (insert number) to" and shall indicate the date of the change and not the date of the original filing. Section 9 Subsidiaries of Domestic Insurers The authority to invest in subsidiaries under 10-3-802(2), C.R.S. is in addition to any authority to invest in subsidiaries which may be contained in any other provision of the Insurance Code. Section 10 Acquisition of Control - Statement Filing A person required to file a statement pursuant to § 10-3-803, C.R.S. shall furnish the required information on Form A, hereby made a part of this regulation. Such person shall also furnish the required information on Form E, hereby made a part of this regulation and described in Section 13 of this regulation. Section 11 Amendments to Form A The applicant shall promptly advise the Commissioner of any changes in the information furnished on Form A arising subsequent to the date upon which the information was furnished but prior to the Commissioner's disposition of the application.
Section 12 Acquisition of Section 10-3-803(1)(c), C.R.S. Insurers A. If the person being acquired is deemed to be a “domestic insurer” solely because of the provisions of § 10-3-803(1)(c), C.R.S., the name of the domestic insurer on the cover page should be indicated as follows:
B. Where a § 10-3-803(1)(c), C.R.S. insurer is being acquired, references to “the insurer” contained in Form A shall refer to both the domestic subsidiary insurer and the person being acquired. Section 13 Pre-Acquisition Notification If a domestic insurer, including any person controlling a domestic insurer, is proposing a merger or acquisition pursuant to § 10-3-803(1), C.R.S., that person shall file a pre-acquisition notification form, Form E, which was developed pursuant to § 10-3-803.5(3)(b), C.R.S. Additionally, if a non-domiciliary insurer licensed to do business in this state is proposing a merger or acquisition pursuant to § 10-3-803.5, C.R.S., that person shall file a pre-acquisition notification form, Form E. No pre-acquisition notification form need be filed if the acquisition is beyond the scope of § 10-3-803.5, C.R.S., as set forth in § 10-3-803.5(2)(b), C.R.S.
In addition to the information required by Form E, the Commissioner may wish to require an expert opinion as to the competitive impact of the proposed acquisition. Section 14 Annual Registration of Insurers - Statement Filing An insurer required to file an annual registration statement pursuant to § 10-3-804, C.R.S., shall furnish the required information on Form B, hereby made a part of this regulation. Section 15 Summary of Registration - Statement Filing An insurer required to file an annual registration statement pursuant to § 10-3-804, C.R.S., is also required to furnish information required on Form C, hereby made a part of this regulation. Section 16 Amendments to Form B A. An amendment to Form B shall be filed within fifteen days after the end of any month in which there is a material change to the information provided in the annual registration statement.
B. Amendments shall be filed in the Form B format with only those items which are being amended reported. Each amendment shall include at the top of the cover page “Amendment No. (insert number) to Form B for (insert year)” and shall indicate the date of the change and not the date of the original filings.
Section 17 Alternative and Consolidated Registrations A. Any authorized insurer may file a registration statement on behalf of any affiliated insurer or insurers which are required to register under § 10-3-804, C.R.S. A registration statement may include information not required by § 10-3-804, C.R.S. regarding any insurer in the insurance holding company system even if the insurer is not authorized to do business in this State. In lieu of filing a registration statement on Form B, the authorized insurer may file a copy of the registration statement or similar report which it is required to file in its state of domicile, provided:
B. The question of whether the filing insurer is the principal insurance company in the insurance holding company system is a question of fact and an insurer filing a registration statement or report in lieu of Form B on behalf of an affiliated insurer, shall set forth a brief statement of facts which will substantiate the filing insurer's claim that it, in fact, is the principal insurer in the insurance holding company system.
C. With the prior approval of the Commissioner, an unauthorized insurer may follow any of the procedures which could be done by an authorized insurer under Subsection A above.
D. Any insurer may take advantage of the provisions of §§ 10-3-804(8) and 10-3-804(9), C.R.S. without obtaining the prior approval of the Commissioner. The Commissioner, however, reserves the right to require individual filings if he or she deems such filings necessary in the interest of clarity, ease of administration or the public good.
Section 18 Disclaimers and Termination of Registration A. A disclaimer of affiliation or a request for termination of registration claiming that a person does not, or will not upon the taking of some proposed action, control another person (hereinafter referred to as the “subject”) shall contain the following information:
B. A request for termination of registration shall be deemed to have been granted unless the Commissioner, within 30 days after receipt of the request, notifies the registrant otherwise. Section 19 Transactions Subject to Prior Notice - Notice Filing A. An insurer required to give notice of a proposed transaction pursuant to § 10-3-805, C.R.S. shall furnish the required information on Form D, hereby made a part of this regulation.
B. Agreements for cost sharing services and management services shall at a minimum and as applicable:
Section 20 Enterprise Risk Report The ultimate controlling person of an insurer required to file an enterprise risk report pursuant to § 10-3- 804(12), C.R.S. shall furnish the required information on Form F, hereby made a part of this regulation. Section 21 Group Capital Calculation A. Where an insurance holding company system has previously filed the annual group capital calculation at least once, the lead state commissioner has the discretion to exempt the ultimate controlling person from filing the annual group capital calculation if the lead state commissioner makes a determination based upon that filing that the insurance holding company system meets all of the following criteria:
B. Where an insurance holding company system has previously filed the annual group capital calculation at least once, the lead state commissioner has the discretion to accept in lieu of the group capital calculation a limited group capital filing if: The insurance holding company system has annual direct written and unaffiliated assumed premium (including international direct and assumed premium), but excluding premiums reinsured with the Federal Crop Insurance Corporation and Federal Flood Program, of less than $1,000,000,000; and all of the following additional criteria are met:
C. For an insurance holding company that has previously met an exemption with respect to the group capital calculation pursuant Section 21A or 21B of this regulation, the lead state commissioner may require at any time the ultimate controlling person to file an annual group capital calculation, completed in accordance with the NAIC Group Capital Calculation Instructions, if any of the following criteria are met:
D. A non-U.S. jurisdiction is considered to “recognize and accept” the group capital calculation if it satisfies the following criteria:
E. A list of non-U.S. jurisdictions that “recognize and accept” the group capital calculation will be published through the NAIC Committee Process:
Section 22 Extraordinary Dividends and Other Distributions A. Requests for approval of extraordinary dividends or any other extraordinary distribution to shareholders shall include the following:
B. Subject to § 10-3-805(2), C.R.S., each registered insurer shall report to the Commissioner all dividends and other distributions to shareholders within fifteen business days following the declaration thereof, including the same information required by Subsection A(4). Section 23 Adequacy of Surplus The factors set forth in § 10-3-805(3), C.R.S. are not intended to be an exhaustive list. In determining the adequacy and reasonableness of an insurer's surplus, no single factor is necessarily controlling. The Commissioner instead will consider the net effect of all of these factors plus other factors bearing on the financial condition of the insurer. In comparing the surplus maintained by other insurers, the Commissioner will consider the extent to which each of these factors varies from company to company and in determining the quality and liquidity of investments in subsidiaries, the Commissioner will consider the individual subsidiary and may discount or disallow its valuation to the extent that the individual investments so warrant.
Section 24 Severability If any provision of this regulation or the application of it to any person or circumstance is for any reason held to be invalid, the remainder of this regulation shall not be affected. Section 25 Incorporation by Reference The list of non-U.S. jurisdictions that “recognize and accept” the group capital calculation published by the National Association of Insurance Commissioners Committee Processes on the effective date of this regulation and does not include later amendments or editions of the List. A copy of the List may be examined during regular business hours at the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, Colorado, 80202. A certified copy of the List may be requested from the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, CO 80202. A charge for certification or copies may apply. A copy may also be obtained online from https://content.naic.org/. A copy may also be obtained from the NAIC Central Office, 1100 Walnut Street, Suite 1500, Kansas City, Missouri 64106. Personal Financial Statements Guide as published by the American Institute of Certified Public Accountants means the May 1, 2000 version of the Guide and does not include later amendments or editions of the Guide. A copy of the Guide may be examined during regular business hours at the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, Colorado, 80202. A certified copy of the Guide may be requested from the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, CO 80202. A charge for certification or copies may apply. A copy may also be obtained online from: https://egrove.olemiss.edu/aicpa_indev/554/. A copy may also be obtained from the American Institute of Certified Public Accountants New York Office located at 1345 Avenue of the Americas, 27th Floor, New York, NY 10105.
NAIC Accounting Practices and Procedures Manual published by the National Association of Insurance Commissioners on the effective date of this regulation and does not include later amendments or editions of the NAIC Accounting Practices and Procedures Manual. A copy of the NAIC Accounting Practices and Procedures Manual may be examined during regular business hours at the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, Colorado, 80202. A certified copy of the NAIC Accounting Practices and Procedures Manual may be requested from the Colorado Division of Insurance, 1560 Broadway, Suite 850, Denver, CO 80202. A charge for certification or copies may apply. A copy may also be obtained online from https://content.naic.org/publications A copy may also be obtained from the NAIC Central Office, 1100 Walnut Street, Suite 1500, Kansas City, Missouri 64106. Section 26 Enforcement Noncompliance with this regulation may result in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance, or other laws, which include the imposition of civil penalties, issuance of cease and desist orders, and/or suspensions or revocation of license, subject to the requirements of due process.
Section 27 Effective Date This regulation shall become effective on January 1, 2025. Section 28 History Amended, effective April 30, 1995.
Amended, effective April 1, 2001.
Amended effective July 1, 2012.
Amended regulation effective January 1, 2015 Amended regulation effective January 1, 2025 APPENDIX A FORM A STATEMENT REGARDING THE ACQUISITION OF CONTROL OF OR MERGER WITH A DOMESTIC INSURER _________________________________________________ Name of Domestic Insurer BY _________________________________________________ Name of Acquiring Person (Applicant)
Filed with the Insurance Department of ___________________________________________________ (State of domicile of insurer being acquired)
Dated:______________________, 20___.
Name, Title, address and telephone number of Individual to Whom Notices and Correspondence Concerning this Statement Should be Addressed:
____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ITEM 1. METHOD OF ACQUISITION State the name and address of the domestic insurer to which this application relates and a brief description of how control is to be acquired.
ITEM 2. IDENTITY AND BACKGROUND OF THE APPLICANT State the name and address of the applicant seeking to acquire control over the insurer. If the applicant is not an individual, state the nature of its business operations for the past five years or for such lesser period as such person and any predecessors thereof shall have been in existence. Briefly describe the business intended to be done by the applicant and the applicant's subsidiaries. Furnish a chart or listing clearly presenting the identities of the interrelationships among the applicant and all affiliates of the applicant. Indicate in such chart or listing the percentage of voting securities of each such person which is owned or controlled by the applicant or by any other such person. If control of any person is maintained other than by the ownership or control of voting securities, indicate the basis of such control. As to each person specified in such chart or listing indicate the type of organization (e.g. corporation, trust, partnership) and the state or other jurisdiction of domicile. If court proceedings involving a reorganization or liquidation are pending with respect to any such person, indicate which person, and set forth the title of the court, nature of proceedings and the date when commenced. ITEM 3. IDENTITY AND BACKGROUND OF INDIVIDUALS ASSOCIATED WITH THE APPLICANT On the biographical affidavit, include a third party background check, and state the following with respect to (1) the applicant if (s)he is an individual, or (2) all persons who are directors, executive officers or owners of 10% or more of the voting securities of the applicant if the applicant is not an individual. Name and business address.
ITEM 5. FUTURE PLANS OF INSURER Describe any plans or proposals which the applicant may have to declare an extraordinary dividend, to liquidate the insurer, to sell its assets to or merge it with any person or persons or to make any other material change in its business operations or corporate structure or management. ITEM 6. VOTING SECURITIES TO BE ACQUIRED State the number of shares of the insurer's voting securities which the applicant, its affiliates and any person listed in Item 3 plan to acquire, and the terms of the offer, request, invitation, agreement or acquisition, and a statement as to the method by which the fairness of the proposal was arrived at. ITEM 7. OWNERSHIP OF VOTING SECURITIES State the amount of each class of any voting security of the insurer which is beneficially owned or concerning which there is a right to acquire beneficial ownership by the applicant, its affiliates or any person listed in Item 3.
ITEM 8. CONTRACTS, ARRANGEMENTS, OR UNDERSTANDINGS WITH RESPECT TO VOTING SECURITIES OF THE INSURER Give a full description of any contracts, arrangements or understandings with respect to any voting security of the insurer in which the applicant, its affiliates or any person listed in Item 3 is involved, including but not limited to transfer of any of the securities, joint ventures, loan or option arrangements, puts or calls, guarantees of loans, guarantees against loss or guarantees of profits, division of losses or profits, or the giving or withholding of proxies. Such description shall identify the persons with whom the contracts, arrangements or understandings have been entered into. ITEM 9. RECENT PURCHASES OF VOTING SECURITIES Describe any purchases of any voting securities of the insurer by the applicant, its affiliates or any person listed in Item 3 during the twelve calendar months preceding the filing of this statement. Include in the description the dates of purchase, the names of the purchasers, and the consideration paid or agreed to be paid therefor. State whether any shares so purchased are hypothecated. ITEM 10. RECENT RECOMMENDATIONS TO PURCHASE Describe any recommendations to purchase any voting security of the insurer made by the applicant, its affiliates or any person listed in Item 3, or by anyone based upon interviews or at the suggestion of the applicant, its affiliates or any person listed in Item 3 during the twelve calendar months preceding the filing of this statement.
ITEM 11. AGREEMENTS WITH BROKER-DEALERS Describe the terms of any agreement, contract or understanding made with any broker-dealer as to solicitation of voting securities of the insurer for tender and the amount of any fees, commissions or other compensation to be paid to broker-dealers with regard thereto. ITEM 12. FINANCIAL STATEMENTS AND EXHIBITS Financial statements, exhibits, and three year financial projections of the insurer(s) shall be attached to this statement as an appendix, but list under this item the financial statements and exhibits so attached. The financial statements shall include the annual financial statements of the persons identified in Item 2(c) for the preceding five fiscal years (or for such lesser period as such applicant and its affiliates and any predecessors thereof shall have been in existence), and similar information covering the period from the end of such person's last fiscal year, if the information is available. The statements may be prepared on either an individual basis, or, unless the Commissioner otherwise requires, on a consolidated basis if consolidated statements are prepared in the usual course of business. The annual financial statements of the applicant shall be accompanied by the certificate of an independent public accountant to the effect that such statements present fairly the financial position of the applicant and the results of its operations for the year then ended, in conformity with generally accepted accounting principles or with requirements of insurance or other accounting principles prescribed or permitted under law. If the applicant is an insurer which is actively engaged in the business of insurance, the financial statements need not be certified, provided they are based on the Annual Statement of the person filed with the insurance department of the person's domiciliary state and are in accordance with the requirements of insurance or other accounting principles prescribed or permitted under the law and regulations of the state.
File as exhibits copies of all tender offers for, requests or invitations for, tenders of, exchange offers for, and agreements to acquire or exchange any voting securities of the insurer and (if distributed) of additional soliciting material relating thereto, any proposed employment, consultation, advisory or management contracts concerning the insurer, annual reports to the stockholders of the insurer and the applicant for the last two fiscal years, and any additional documents or papers required by Form A or Regulation 3-4-1(Sections 5 and 7).
ITEM 13. AGREEMENT REQUIREMENTS FOR ENTERPRISE RISK MANAGEMENT Applicant agrees to provide, to the best of its knowledge and belief, the information required by Form F within fifteen days after the end of the month in which the acquisition of control occurs. ITEM 14. SIGNATURE AND CERTIFICATION Signature and certification required as follows:
SIGNATURE Pursuant to the requirements of Section 10-3-804, C.R.S. has caused this application to be duly signed on its behalf in the City of ___________________ and State of ________________on the _______________ day of ________________, 20___.
Attest:
_________________________________ (Signature of Officer)
_________________________________ (Title)
CERTIFICATION The undersigned deposes and says that (s)he has duly executed the attached application date _____________, 20___, for and on behalf of _________________________(Name of Applicant); that (s)he is the (Title of Officer) of such company and that (s)he is authorized to execute and file such instrument. Deponent further says that (s)he is familiar with the instrument and the contents thereof, and that the facts therein set forth are true to the best of his/her knowledge, information and belief.
____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ITEM 1. IDENTITY AND CONTROL OF REGISTRANT Furnish the exact name of each insurer registering or being registered (hereinafter called “the Registrant”), the home office address and principal executive offices of each; the date on which each registrant became part of the insurance holding company system; and the method(s) by which control of each registrant was acquired and is maintained.
ITEM 2. ORGANIZATIONAL CHART Furnish a chart or listing clearly presenting the identities of and interrelationships among all affiliated persons within the insurance holding company system. The chart or listing should show the percentage of each class of voting securities of each affiliate which is owned, directly or indirectly, by another affiliate. If control of any person within the system is maintained other than by the ownership or control of voting securities, indicate the basis of control. As to each person specified in the chart or listing indicate the type of organization (e.g., corporation, trust, partnership) and the state or other jurisdiction of domicile. ITEM 3. THE ULTIMATE CONTROLLING PERSON As to the ultimate controlling person in the insurance holding company system furnish the following information:
The name and address of any person who holds or owns 10% or more of any class of voting security, the class of such security, the number of shares held of record or known to be beneficially owned, and the percentage of class so held or owned; and If court proceedings involving a reorganization or liquidation are pending, indicate the title and location of the court, the nature of proceedings and the date when commenced. ITEM 4. BIOGRAPHICAL INFORMATION If the ultimate controlling person is a corporation, an organization, a limited liability company, or other legal entity, furnish the following information for the directors and executive officers of the ultimate controlling person: the individual's name and address, his or her principal occupation and all offices and positions held during the past five years, and any conviction of crimes other than minor traffic violations. If the ultimate controlling person is an individual, furnish the individual's name and address, his or her principal occupation and all offices and positions held during the past five years, and any conviction of crimes other than minor traffic violations.
ITEM 5. TRANSACTIONS AND AGREEMENTS Briefly describe the following agreements in force, and transactions currently outstanding or which have occurred during the last calendar year between the registrant and its affiliates: Loans, other investments, or purchases, sales or exchanges of securities of the affiliates by the Registrant or of the Registrant by its affiliates;
Dividends and other distributions to shareholders;
Consolidated tax allocation agreements; and Any pledge of the registrant's stock and/or of the stock of any subsidiary or controlling affiliate, for a loan made to any member of the insurance holding company system. No information need be disclosed if such information is not material for purposes of Section 10-3- 804, C.R.S.
Sales, purchases, exchanges, loans or extensions of credit, investments or guarantees involving one-half of 1% or less of the registrant's admitted assets as of the 31st day of December next preceding shall not be deemed material.
The description shall be in a manner as to permit the proper evaluation thereof by the Commissioner, and shall include at least the following: the nature and purpose of the transaction, the nature and amounts of any payments or transfers of assets between the parties, the identity of all parties to the transaction, and relationship of the affiliated parties to the registrant. ITEM 6. LITIGATION OR ADMINISTRATIVE PROCEEDINGS A brief description of any litigation or administrative proceedings of the following types, either then pending or concluded within the preceding fiscal year, to which the ultimate controlling person or any of its directors or executive officers was a party or of which the property of any such person is or was the subject; give the names of the parties and the court or agency in which the litigation or proceeding is or was pending:
ITEM 7. STATEMENT REGARDING PLAN OR SERIES OF TRANSACTIONS The insurer shall furnish a statement that transactions entered into since the filing of the prior year's annual registration statement are not part of a plan or series of like transactions, the purpose of which is to avoid statutory threshold amounts and the review that might otherwise occur. ITEM 8. FINANCIAL STATEMENTS AND EXHIBITS Financial statements and exhibits should be attached to this statement as an appendix, but list under this item the financial statements and exhibits so attached. If the ultimate controlling person is a corporation, an organization, a limited liability company, or other legal entity, the financial statements shall include the annual financial statements of the ultimate controlling person in the insurance holding company system as of the end of the person's latest fiscal year.
SIGNATURE Pursuant to the requirements of Section 10-3-804, C.R.S. has caused this annual registration statement to be duly signed on its behalf in the City of _________________________and State of ______________ on the ______________day of_____________, 20_________. (SEAL)____________________________ Name of Applicant BY_______________________________
Attest:
_______________________________________ (Signature of Officer)
_______________________________________ (Title)
CERTIFICATION The undersigned deposes and says that (s)he has duly executed the attached application dated _____________________, 20___, for and on behalf of _________________________(Name of Applicant); that (s)he is the _______________________ (Title of Officer) of such company and that (s)he is authorized to execute and file such instrument. Deponent further says that (s)he is familiar with the instrument and the contents thereof, and that the facts therein set forth are true to the best of his/her knowledge, information and belief. (Signature)_______________________________ (Type or print name beneath)_______________________________ APPENDIX C FORM C SUMMARY OF CHANGES TO REGISTRATION STATEMENT Filed with the Insurance Department of the State of_____________________________ By _______________________________________ Name of Registrant On Behalf of Following Insurance Companies Name Address ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ Date:________________, 20____ Name, Title, Address and telephone number of Individual to Whom Notices and Correspondence Concerning This Statement Should Be Addressed:
____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ Furnish a brief description of all items in the current annual registration statement which represent changes from the prior year's annual registration statement. The description shall be in a manner as to permit the proper evaluation thereof by the Commissioner, and shall include specific references to Item numbers in the annual registration statement and to the terms contained therein.
Attest:
_______________________________________ (Signature of Officer)
_______________________________________ (Title)
CERTIFICATION The undersigned deposes and says that (s)he has duly executed the attached application dated ______________, 20___, for and on behalf of (Name of Applicant); that (s)he is the (Title of Officer) of such company and that (s)he is authorized to execute and file such instrument. Deponent further says that (s)he is familiar with the instrument and the contents thereof, and that the facts therein set forth are true to the best of his/her knowledge, information and belief. (Signature)____________________________ (Type or print name beneath)___________________________ APPENDIX D FORM D PRIOR NOTICE OF A TRANSACTION Filed with the Insurance Department of the State of ______________________ By _________________________________ Name of Registrant On Behalf of Following Insurance Companies Name Address ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ Date:___________________, 20_____ Name, Title, Address and telephone number of Individual to Whom Notices and Correspondence Concerning This Statement Should Be Addressed:
____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ITEM 1. IDENTITY OF PARTIES TO TRANSACTION Furnish the following information for each of the parties to the transaction: Name;
ITEM 3. SALES, PURCHASES, EXCHANGES, LOANS, EXTENSIONS OF CREDIT, GUARANTEES OR INVESTMENTS Furnish a brief description of the amount and source of funds, securities, property or other consideration for the sale, purchase, exchange, loan, extension of credit, guarantee, or investment, whether any provision exists for purchase by the insurer filing notice, by any party to the transaction, or by any affiliate of the insurer filing notice, a description of the terms of any securities being received, if any, and a description of any other agreements relating to the transaction such as contracts or agreements for services, consulting agreements and the like. If the transaction involves other than cash, furnish a description of the consideration, its cost and its fair market value, together with an explanation of the basis for evaluation.
If the transaction involves a loan, extension of credit or a guarantee, furnish a description of the maximum amount which the insurer will be obligated to make available under such loan, extension of credit or guarantee, the date on which the credit or guarantee will terminate, and any provisions for the accrual of or deferral of interest.
If the transaction involves an investment, guarantee or other arrangement, state the time period during which the investment, guarantee or other arrangement will remain in effect, together with any provisions for extensions or renewals of such investments, guarantees or arrangements. Furnish a brief statement as to the effect of the transaction upon the insurer's surplus. No notice need be given if the maximum amount which can at any time be outstanding or for which the insurer can be legally obligated under the loan, extension of credit or guarantee is less than (a) in the case of non-life insurers, the lesser of 3% of the insurer's admitted assets or 25% of surplus as regards policyholders, or (b) in the case of life insurers, 3% of the insurer's admitted assets, each as of the 31st day of December next preceding.
ITEM 4. LOANS OR EXTENSIONS OF CREDIT TO A NON-AFFILIATE If the transaction involves a loan or extension of credit to any person who is not an affiliate, furnish a brief description of the agreement or understanding whereby the proceeds of the proposed transaction, in whole or in substantial part, are to be used to make loans or extensions of credit to, to purchase the assets of, or to make investments in, any affiliate of the insurer making such loans or extensions of credit, and specify in what manner the proceeds are to be used to loan to, extend credit to, purchase assets of or make investments in any affiliate. Describe the amount and source of funds, securities, property or other consideration for the loan or extension of credit and, if the transaction is one involving consideration other than cash, a description of its cost and its fair market value together with an explanation of the basis for evaluation. Furnish a brief statement as to the effect of the transaction upon the insurer's surplus. No notice need be given if the loan or extension of credit is one which equals less than, in the case of non-life insurers, the lesser of 3% of the insurer's admitted assets or 25% of surplus as regards policyholders or, with respect to life insurers, 3% of the insurer's admitted assets, each as of the 31st day of December next preceding.
ITEM 5. REINSURANCE If the transaction is a reinsurance agreement or modification thereto, as described by Section 10-3- 805(1)(b)(III)(B), C.R.S., or a reinsurance pooling agreement or modification thereto as described by Section 10-3-805(1)(b)(III)(A), C.R.S., furnish a description of the known and/or estimated amount of liability to be ceded and/or assumed in each calendar year, the period of time during which the agreement will be in effect, and a statement whether an agreement or understanding exists between the insurer and non-affiliate to the effect that any portion of the assets constituting the consideration for the agreement will be transferred to one or more of the insurer's affiliates. Furnish a brief description of the consideration involved in the transaction, and a brief statement as to the effect of the transaction upon the insurer's surplus.
No notice need be given for reinsurance agreements or modifications thereto if the reinsurance premium or a change in the insurer's liabilities, or the projected reinsurance premium or change in the insurer's liabilities in any of the next three years, in connection with the reinsurance agreement or modification thereto is less than 5% of the insurer's surplus as regards policyholders, as of the 31st day of December next preceding. Notice shall be given for all reinsurance pooling agreements including modifications thereto.
ITEM 6. MANAGEMENT AGREEMENTS, SERVICE AGREEMENTS AND COST- SHARING ARRANGEMENTS.
For management and service agreements, furnish:
A brief statement as to the effect of the transaction upon the insurer's policyholder surplus; A statement regarding the cost allocation methods that specifies whether proposed charges are based on “cost or market.” If market based, rationale for using market instead of cost, including justification for the company's determination that amounts are fair and reasonable; and A statement regarding compliance with the National Association of Insurance Commissioners Accounting Practices and Procedure Manual regarding expense allocation. ITEM 7. SIGNATURE AND CERTIFICATION Signature and certification required as follows:
SIGNATURE Pursuant to the requirements of Section 10-3-805, C.R.S. has caused this application to be duly signed on its behalf in the City of ______________________and State of _________________ on the _______________day of,____________20_____.
Attest:
_________________________________ (Signature of Officer)
_________________________________ (Title)
CERTIFICATION The undersigned deposes and says that (s)he has duly executed the attached application dated ________________, 20_______, for and on behalf of ___________________(Name of Applicant); that (s)he is the _________________(Title of Officer) of such company and that (s)he is authorized to execute and file such instrument. Deponent further says that (s)he is familiar with the instrument and the contents thereof, and that the facts therein set forth are true to the best of his/her knowledge, information and belief.
ITEM 2. NAME AND ADDRESSES OF AFFILIATED COMPANIES State the names and addresses of the persons affiliated with those listed in Item 1. Describe their affiliations.
ITEM 3. NATURE AND PURPOSE OF THE PROPOSED MERGER OR ACQUISITION State the nature and purpose of the proposed merger or acquisition. ITEM 4. NATURE OF BUSINESS State the nature of the business performed by each of the persons identified in response to Item 1and Item 2.
ITEM 5. MARKET AND MARKET SHARE State specifically what market and market share in each relevant insurance market the persons identified in Item 1 and Item 2 currently enjoy in this state. Provide historical market and market share data for each person identified in Item 1 and Item 2 for the past five years and identify the source of such data. Provide a determination as to whether the proposed acquisition or merger, if consummated, would violate the competitive standards of the state as stated in Section 10-3-803.5(4), C.R.S. If the proposed acquisition or merger would violate competitive standards, provide justification of why the acquisition or merger would not substantially lessen competition or create a monopoly in the state. For purposes of this question, “market” means direct written insurance premium in this state for a line of business as contained in the Annual Statement required to be filed by insurers licensed to do business in this state.
APPENDIX F FORM F ENTERPRISE RISK REPORT Filed with the Insurance Department of the State of. ____________________________ By ___________________________ Name of Applicant On Behalf of/Related to Following Insurance Companies Name Address ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ Date: _____________, 20__ Name, Title, address and telephone number of individual to whom notices and correspondence concerning this statement should be addressed:
____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ITEM 1. ENTERPRISE RISK The Registrant/Applicant, to the best of its knowledge and belief, shall provide information regarding the following areas that could produce enterprise risk as defined in Section 10-3-801(4), C.R.S., provided such information is not disclosed in the Insurance Holding Company System Annual Registration Statement filed on behalf of itself or another insurer for which it is the ultimate controlling person: Any material developments regarding strategy, internal audit findings, compliance or risk management affecting the insurance holding company system;
Acquisition or disposal of insurance entities and reallocating of existing financial or insurance entities within the insurance holding company system;
Any changes of shareholders of the insurance holding company system exceeding 10% or more of voting securities;
Developments in various investigations, regulatory activities litigation that may have a significant bearing or impact on the insurance holding company system;
Business plan of the insurance holding company system and summarized strategies for next twelve months;
Identification of material concerns of the insurance holding company system raised by supervisory college, if any, in last year;
Identification of insurance holding company system capital resources and material distribution patterns; Identification of any negative movement, or discussions with rating agencies which may have caused, or may cause, potential negative movement in the credit ratings and individual insurer financial strength ratings assessment of the insurance holding company system (including both the rating score and outlook);
Information on corporate or parental guarantees throughout the holding company and the expected source of liquidity should such guarantees be called upon; and Identification of any material activity or development of the insurance holding company system that, in the opinion of senior management, could adversely affect the insurance holding company system. The Registrant/Applicant may attach the appropriate form most recently filed with the U.S. Securities and Exchange Commission, provided the Registrant/Applicant includes specific references to those areas listed in Item 1 for which the form provides responsive information. If the Registrant/Applicant is not domiciled in the U.S., it may attach its most recent public audited financial statement filed in its country of domicile, provided the Registrant/Applicant includes specific references to those areas listed in Item 1 for which the financial statement provides responsive information. ITEM 2: OBLIGATION TO REPORT.
If the Registrant/Applicant has not disclosed any information pursuant to Item 1, the Registrant/Applicant shall include a statement affirming that, to the best of its knowledge and belief, it has not identified enterprise risk subject to disclosure pursuant to Item 1 Regulation 3-5-1 TITLE INSURANCE [Repealed eff. 03/15/2017] Regulation 3-5-2 TITLE INSURER ASSESSMENT Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Definitions Section 5 Rules Section 6 Severability Section 7 Enforcement Section 8 Effective Date Section 9 History Section 1 Authority This regulation is promulgated and adopted by the Commissioner of Insurance under the authority of § § 10-1-109 and 10-3-207, C.R.S.
Section 2 Scope and Purpose The purpose of this regulation is to establish the standard to determine the amount each title insurer shall be assessed in accordance with § 10-3-207, C.R.S.
Section 3 Applicability and Scope This regulation shall apply to all title insurers authorized to conduct business in Colorado on December 31, 2007 and on December 31 of each subsequent year.
Section 4 Definitions A. “Two full-time equivalents” for the purpose of this regulation means two full-time employees of the Division of Insurance.
B. “Assessment” for the purpose of this regulation means the amount invoiced by the Division of Insurance.
C. “Business of title insurance” has the same meaning as set forth in § 10-11-102(3), C.R.S. Section 5 Rules A. Commencing on or before March 1, 2008 and every March 1 thereafter, each insurer authorized to transact the business of title insurance in Colorado as of December 31 of the previous year, shall pay an assessment.
B. Each title insurer authorized to transact the business of title insurance shall be assessed an annual fee sufficient to support two full-time equivalents within the Division of Insurance. Such fee shall be:
C. The Division of Insurance shall determine the assessment amount and issue invoices to each title insurer no later than February 1 of the year such assessment is due and payable. Section 6 Severability If any provision of this regulation or the application of it to any person or circumstance is for any reason held to be invalid, the remainder of this regulation shall not be affected. Section 7 Enforcement Noncompliance with this Regulation may result, after proper notice and hearing, in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance or other laws which include the imposition of fines, issuance of cease and desist orders and/or suspension or revocation of license. Among others, the penalties provided for in § 10-3-1108, C.R.S. may be applied. Section 8 Effective Date This regulation shall become effective on January 1, 2008. Section 9 History New regulation effective January 1, 2008.
Regulation 3-5-3 CONCERNING CERTIFICATE OF TAXES DUE – ALTERNATIVE DOCUMENTATION PERMITTED Section 1 Authority Section 2 Scope and Purpose Section 3 Applicability Section 4 Definitions Section 5 Rules Section 6 Severability Section 7 Enforcement Section 8 Effective Date Section 9 History Section 1 Authority This regulation is promulgated and adopted by the Commissioner of Insurance under the authority of § § 10-1-109, and 10-11-122, C.R.S.
Section 2 Scope and Purpose The purpose of this regulation is to establish the requirements of alternative documentation a title entity may use and rely upon during the annual period when county treasurers are certifying the tax rolls and cannot issue a certificate of taxes due.
Section 3 Applicability This regulation shall apply to all title insurance entities licensed to transact the business of title insurance in the state of Colorado.
Section 4 Definitions A. “Title insurance agent” shall have the same meaning as defined in § 10-11-102, C.R.S.
B. “Title insurance company” shall have the same meaning as defined in § 10-11-102, C.R.S.
C. “Title Entity” means title insurance agents, title insurance agencies, and title insurance companies.
Section 5 Rules A. Alternative Documentation
B. Each title entity shall maintain adequate documentation and records sufficient to show compliance with this regulation for a period of not less than seven (7) years. Section 6 Severability If any provision of this regulation or the application of it to any person or circumstance is for any reason held to be invalid, the remainder of this regulation shall not be affected. Section 7 Enforcement Noncompliance with this regulation may result in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance, or other laws, which include the imposition of civil penalties, issuance of cease and desist orders, and/or suspensions or revocation of license, subject to the requirements of due process.
Section 8 Effective Date This regulation shall become effective on October 1, 2013. Section 9 History New regulation effective October 1, 2013.
_________________________________________________________________________ Editor’s Notes History Regulation 3-1-3 eff. 10/01/2007.
Regulation 3-5-2 eff. 01/01/2008.
Regulation 3-1-4 eff. 01/01/2010.
Regulation 3-5-1 eff. 05/01/2010.
Regulation 3-1-8 eff. 11/01/2010.
Regulation 3-1-11 eff. 02/01/2012.
Regulation 3-1-12 eff. 03/01/2012.
Regulation 3-1-15 eff. 06/01/2012.
Regulation 3-3-1 eff. 06/01/2012.
Regulations 3-1-10, 3-1-14, 3-4-1 eff. 07/01/2012.
Regulation 3-1-2 eff. 08/01/2012. Regulation 3-2-6 repealed eff. 08/01/2012. Regulation 3-1-5 eff. 09/01/2012.
Regulation 3-1-7 eff. 12/01/2012. Regulation 3-2-7 repealed eff. 12/01/2012. Regulation 3-1-9 eff. 01/01/2013.
Regulation 3-1-7 eff. 05/01/2013.
Regulations 3-1-11, 3-1-12 eff. 08/01/2013.
Regulation 3-5-3 eff. 10/01/2013.
Regulations 3-2-1, 3-2-2 eff. 11/15/2014.
Regulations 3-2-8, 3-3-3, 3-4-1 eff. 01/01/2015.
Regulation 3-5-1 eff. 10/01/2015.
Regulations 3-1-1, 3-3-1, 3-3-4, 3-3-5 eff. 04/01/2016. Regulation 3-5-1 eff. 08/15/2016.
Regulation 3-1-4 eff. 01/01/2017.
Regulation 3-5-1 repealed eff. 03/15/2017.
Regulation 3-1-16 eff. 04/01/2017.
Regulation 3-1-11 eff. 08/01/2017.
Regulation 3-1-8 eff. 11/01/2017.
Regulation 3-1-17 eff. 04/15/2020.
Regulation 3-1-15 eff. 03/15/2021.
Regulation 3-3-3 eff. 01/01/2022.
Regulation 3-1-9 eff. 03/02/2023.
Regulation 3-1-18 eff. 12/30/2023.
Regulation 3-4-1 eff. 01/01/2025.