Accounting Standards and Principles

PURPOSE: This rule effectuates or aids in the interpretation of sections 354.470, 375.537, 375.539, 375.881, 375.1160, 375.1165, and 375.1175, RSMo, and in the administration of sections 354.080 and 354.355, RSMo. (1) Each insurance company shall make and file statements of its assets, liabilities, capital and surplus, income and expenses, including all schedules and exhibits used in connection with such statements, which statements the director may use to determine any of the following according to the applicable accounting guidance, standards, and principles approved by the National Association of Insurance Commissioners (NAIC), published in the Accounting Practices and Procedures Manual, Annual Statement Instructions, Valuation of Securities, Examiner’s Handbook, and Financial Analysis Handbook, except where the applicable provisions of Chapters 374–385, RSMo or other specific rules expressly provide otherwise: (A) Whether an insurance company is impaired under section 375.537, RSMo; (B) Whether any standards are implicated under section 375.539.2, RSMo; (C) Whether an insurance company is insolvent under section 375.881(1) or 375.1175.1(2), RSMo; (D) Whether an insurance company fails to comply with the requirements for admission under section 375.881(2), RSMo; (E) Whether an insurance company is in such a financial condition that its further transaction of business in this state would be hazardous to policyholders and creditors in this state and to the public under section 375.881(3), RSMo; (F) Whether an insurance company’s condition renders the continuance of its business hazardous to the public or to its insureds under section 375.1160.2(1)(a), RSMo; (G) Whether an insurance company is in such condition that the further transaction of business would be hazardous financially to its policyholders, creditors, or the public under section 375.1165(1), RSMo; and (H) Whether an insurance company is found to be in such condition that the further transaction of business would be hazardous, financially or otherwise, to its policyholders, its creditors or the public under section 375.1175.1(3), RSMo. (2) Each health services corporation shall make and file statements of its assets, liabilities, capital and surplus, income and expenses, including all schedules and exhibits used in connection with such statements, which statements the director may use to determine any of the following according to the applicable accounting guidance, standards, and principles approved by the NAIC, published in the Accounting Practices and Procedures Manual, Annual Statement Instructions, Valuation of Securities, Examiner’s Handbook, and Financial Analysis Handbook, except where the applicable provisions of Chapters 354 and 374-385, RSMo or other specific rules expressly provide otherwise: (A) Whether a health services corporation is maintaining reserves in accordance with section 354.080, RSMo; (B) Whether a health services corporation is in such condition that its further transaction of business will be hazardous to its policyholders or to its creditors or to the public under section 354.355(3), RSMo; (C) Whether a health services corporation is impaired under section 375.537, RSMo; (D) Whether any standards are implicated under section 375.539.2, RSMo; (E) Whether a health services corporation’s condition renders the continuance of its business hazardous to the public or to its insureds under section 375.1160.2(1)(a), RSMo; (F) Whether a health services corporation is in such condition that the further transaction of business would be hazardous financially to its policyholders, creditors, or the public under section 375.1165(1), RSMo; (G) Whether a health services corporation is insolvent under section 375.1175.1(2), RSMo; and (H) Whether a health services corporation is found to be in such condition that the further transaction of business would be hazardous, financially or otherwise, to its policyholders, its creditors, or the public under section 375.1175.1(3), RSMo. (3) Each health maintenance organization shall make and file statements of its assets, liabilities, capital and surplus, income and expenses, including all schedules and exhibits used in connection with such statements, which statements the director may use to determine any of the following according to the applicable accounting guidance, standards, and principles approved by the NAIC, published in the Accounting Practices and Procedures Manual, Annual Statement Instructions, Valuation of Securities, Examiner’s Handbook, and Financial Analysis Handbook, except where the applicable provisions of Chapters 354 and 374-385, RSMo or other specific rules expressly provide otherwise: (A) Whether a health maintenance organization is no longer financially responsible and may reasonably be expected to be unable to meet its obligations to enrollees or prospective enrollees under section 354.470.1(4), RSMo; (B) Whether the continued operation of a health maintenance organization would be hazardous to its enrollees under section 354.470.1(8), RSMo; (C) Whether a health maintenance organization is impaired under section 375.537, RSMo; (D) Whether any standards are implicated under section 375.539.2, RSMo; (E) Whether a health maintenance organization’s condition renders the continuance of its business hazardous to the public or to its insureds under section 375.1160.2(1)(a), RSMo; (F) Whether a health maintenance organization is in such condition that the further transaction of business would be hazardous financially to its policyholders, creditors, or the public under section 375.1165(1), RSMo; (G) Whether a health maintenance organization is insolvent under section 375.1175.1(2), RSMo; and (H) Whether a health maintenance organization is found to be in such condition that the further transaction of business would be hazardous, financially or otherwise, to its policyholders, its creditors, or the public under section 375.1175.1(3), RSMo. AUTHORITY: sections 354.120, 354.485, and 374.045, RSMo 2016.* This rule was previously filed as 4 CSR 190-11.230. Original rule filed Feb. 3, 1989, effective May 1, 1989. Amended: Filed Aug. 25, 1989, effective Jan. 1, 1990. Amended: Filed Dec. 14, 2000, effective July 30, 2001. Amended: Filed Dec. 4, 2001, effective June 30, 2002. Amended: Filed Oct. 30, 2018, effective April 30, 2019. *Original authority: 354.120, RSMo 1973, amended 1983, 1993, 1995; 354.485, RSMo 1983, 2007; and 374.045, RSMo 1967, amended 1993, 1995, 2008.