Section 1792.10 Of Article 6. Reporting And Reserve Requirements From California Health And Safety Code >> Division 2. >> Chapter 10. >> Article 6.
1792.10
. (a) Each provider that has entered into Type A contracts
shall submit to the department, at least once every five years, an
actuary's opinion as to the provider's actuarial financial condition.
The actuary's opinion shall be based on an actuarial study completed
by the opining actuary in a manner that meets the requirements
described in Section 1792.8. The actuary's opinion, and supporting
actuarial study, shall examine, refer to, and opine on the provider's
actuarial financial condition as of a specified date that is within
four months of the date the opinion is provided to the department.
(b) Each provider required to file an actuary's opinion under
subdivision (a) that held a certificate of authority on December 31,
2003, shall file its actuary's opinion before the expiration of five
years following the date it last filed an actuarial study or opinion
with the department. Thereafter, the provider shall file its required
actuary's opinion before the expiration of five years following the
date it last filed an actuary's opinion with the department.
(c) Each provider required to file an actuary's opinion under
subdivision (a) that did not hold a certificate of authority on
December 31, 2003, shall file its first actuary's opinion within 45
days following the due date for the provider's annual report for the
fiscal year in which the provider obtained its certificate of
authority. Thereafter, the provider shall file its required actuary's
opinion before the expiration of five years following the date it
last filed an actuary's opinion with the department.
(d) The actuary's opinion required by subdivision (a) shall comply
with generally accepted actuarial principles and the standards of
practice adopted by the Actuarial Standards Board. The actuary's
opinion shall also include statements that the data and assumptions
used in the underlying actuarial study are appropriate and that the
methods employed in the actuarial study are consistent with sound
actuarial principles and practices. The actuary's opinion must state
whether the provider has adequate resources to meet all its actuarial
liabilities and related statement items, including an appropriate
surplus, and whether the provider's financial condition is
actuarially sound.