Establishes Various Standards Of Creditworthiness And Protection Of Persons Incorporated In Institutions Of Social Security, Health Administrators Of Pension Funds And Insurance Company Ias

Original Language Title: ESTABLECE DIVERSAS NORMAS DE SOLVENCIA Y PROTECCION DE PERSONAS INCORPORADAS A INSTITUCIONES DE SALUD PREVISIONAL, ADMINISTRADORAS DE FONDOS DE PENSIONES Y COMPAÑIAS DE SEGUROS

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"(Artículo 1º.-Introdúcense las siguientes modificaciones en la ley Nº 18.933: 1.-Modifíca_se el artículo 2º deel siguiente modo: a) replaced, in the letter g), the conjunction"and"that completes and the comma (,) that precedes it by a point and comma (,)."
((b) replace, in the letter h), the final dot (.) by a semicolon (;).
(((c) Agreganse the following letters i) and j), new, then the letter h): "i) the expression"fee-paying captive", for the purposes of the provisions of article 44 ter and 45 bis, by the fee paying whose will is affected seriously, for reasons of age, sex or by the occurrence of health history, either he or one of the beneficiaries" (, and that it prevents him or restrict, significant or permanently, their ability to contract with another health insurance institution, and j) the expression "health provider" corresponds to any natural or legal person, establishment, or institution that is authorized to grant health care, such as: consultation, clinic, hospital, clinic, Medical Center, therapeutic diagnosis, health reference center , laboratory and others of any nature, including ambulances and other vehicles adapted for outpatient care. "."

2.-amended article 3 as follows: to) Agreganse, then of the number 13 of the first paragraph, the following numbers 14 and 15, new: "14.-develop and disseminate indexes, statistics and studies related to the institutions and the private health system."
15 provide general instructions on the transfer of health and contracts portfolio members and beneficiaries referred to in article 44 ter and give its approval to these operations. "."

(b) Insert, in the second paragraph, between the word "advisers" and letter "o", the expression "external auditors", preceded by a comma (,).
(c) Insert, in the third paragraph, between the word "advisors" and the letter "and" expression "external auditors", preceded by a comma (,).

3. replace the third subparagraph of article 25 by the following third and fourth subparagraphs, new: "also, institutions shall maintain a heritage equal to or greater than 0.3 times its total debts. That relationship will be reviewed monthly by the Superintendency. In any case, the heritage will never be less than five thousand units of building. "."

4 Agreganse, continuation of article 25, the following articles 25 bis and ter, new 25: "article 25 bis.-institutions shall designate independent external auditors, who shall examine the accounting, inventory, balance sheets and other financial statements, and report in writing to the Superintendent, in the manner this determined in general application instructions.
These auditors shall be selected from among those enrolled in the register of Auditors external carrying the Superintendency of securities and insurance and shall apply, in general, the requirements, rights, obligations, roles and other powers established in the Corporations Act and its regulations.
The external auditors will be paid by the supervised institutions.
Without prejudice to the provisions of the first subparagraph, the Superintendent may require, in addition, specific reports or any data or history related to the execution of their duties in the supervised institutions; and to examine, in its own dependencies, such information or background.

Article 25 ter-institutions shall maintain a not less than 0.8 times liquidity indicator the ratio between current assets and current liabilities. For the purposes of this calculation, are not considered as financial instruments referred to in the d), of the fourth subsection, of article 26 of this law when they have issued to support the warranty covered by that article. That relationship will be reviewed monthly by the Superintendency.
Without limiting the foregoing, the Superintendent shall be given general application instructions to establish the conditions of diversification, issuer and depositary of instruments of long-term and easy liquidation, as well as the form in which it can be considered by institutions, to set the indicator referred to in this article. For the purposes of compliance with the provisions of this article, the warranty shall be deemed an integral part of current assets, except for the financial instruments referred to in the preceding subparagraph. "."
5 replace article 26 by the following: ' article 26-institutions remain, in any entity authorized by law to perform the deposit and custody of securities, which in effect determined by the Superintendent, a security equal to the amount of the obligations listed below: 1. in respect of contributors and beneficiaries, the amount of guarantee should consider obligations for benefits payable " , benefits in the process of liquidation, benefits that occurred and not reported, services in litigation, excess of quotes, quotes by regularizing and quotes aware ahead of time.
2. with regard to health care providers, the warranty should be considered the obligations of health benefits provided to contributors and beneficiaries of the institution.
The warranty upgrade may not exceed thirty days, for which the institution must complete it within twenty days, to cover the total amount that corresponds to the related obligations.
When the amount of the above obligations, within the period indicated in the preceding paragraph, is less than the existing warranty, the institution may ask the Superintendent that you grind the whole or part of the excess. The Superintendent will have a period not exceeding ten days to authorize such rebates, which may be extended by resolution founded and once.
Financial instruments to be considered for the Constitution of the warranty are as follows: a. documents issued by the Central Bank of Chile or the General Treasury of the Republic;
b deposits in national currency maturity less than one year issued by banks;
c shares of mutual funds in instruments of short-term debt with duration of less than 90 days, nominated in national currency;
d report cards view warranties issued by banks;
((e covenants repurchase Bank backed instruments indicated in letters a) and b) unprecedented. The contract must be expressly given sale and repurchase of these tools promise;
f agreements of loans in pesos or endorsable building units that are two or more banks, provided that the credit is due in less than a year from your subscription and that the debtor are classified by sorting risk agencies registered in the registry of the Superintendency of securities and insurance, at the very least, in AA risk category;
g term deposits, mortgage credit, bonds and other credit, or debt securities issued by banks;
h shares of mutual funds whose assets are invested in securities or national assets;
i fees mutual funds constituted outside the country;
j shares of mutual funds in the country, whose assets are invested in foreign securities;
k shares of investment funds;
l bonds, promissory notes and other debt or credit, securities issued by enterprises, public or private;
m shares of joint-stock companies with stock market presence, according to the requirements established by the Superintendency of securities and insurance through norm of general and classified as first class actions, in compliance with law No. 18,045;
n debts by concept of health contributions payable by affiliates or their employers, the percentage that the Superintendency;
(n covenants repurchase Bank backed instruments other than those specified in subparagraph e);
or conventions of credits which comply with two or more banks, which do not correspond to those described in (f)), and p-other instruments or assets of easy settlement authorizing the Superintendent of Isapres.

In any case guarantee may be supported in instruments issued or guaranteed by the institution or its related persons as defined by article 100 of law No 18,045, stock market.
The Superintendent shall issue general application instructions to define the conditions of diversification, issuer, classification of risk, stock market presence, market value and liquidity level.
Also, the Superintendent may, following a report of the Ministry of finance, establish maximum for each instrument. However, Isapres must be kept, at least 50% the warranty on the instruments mentioned in the letters to) to f) of the fourth subparagraph of this article.
The Superintendent may, also bring the depository institutions from instruments where it is not possible to apply first the provisions of subsection of this article.
In the case of financial instruments referred to in c), h), i) and j), the institution must hold a mandate with a Bank for the acquisition and management of these financial instruments. The Superintendent may always require the ISAPRE access to information regarding the financial instruments which the Bank maintains account and name of that.
The health insurance institution shall communicate to the Superintendent his intention of that part of the funds under guarantee are destined to the payment of any of the requirements referred to in paragraphs 1 and 2 of subsection first. If after five days, the Superintendent has not voted on this operation, means that it can take effect.
Without limiting the foregoing, pertaining to the guarantee funds and the representative of these obligations documents not may be used to warn any other obligation. Any act in violation of this article shall be void.

The warranty covered by this article shall be unattachable and in no case may be less than the equivalent in national currency, two thousand units of building. "."
6 article 28 replaced by the following: "article 28.-the SVS, in case of cancellation of the registration of an entity, may, by resolution established, make this warranty efective and allocate it, total or partially, to the following purposes: 1.-payment of the obligations of the institution, existing at the date of cancellation of the registration, to contributors, their loads and third-party beneficiaries."
2. the payment of the obligations of the institution, existing at the date of cancellation of the registration, for health care providers with respect to the obligations accrued to that date and which derive from health benefits granted to contributors and beneficiaries of the institution, or that stem from health agreements concluded with this institution for the care of those contributors and beneficiaries.
3. the payment of contributions corresponding to the Isapre or to the national health fund.
4. for the payment of other obligations which, according to the law, should be covered by the warranty. "."
7 Agreganse, continuation of article 44, the following article 44 bis and 44 ter: "article 44 bis.-institutions must notify the Superintendent every fact or relevant information for purposes of supervision and control over themselves and their operations and business.
The Superintendent will provide general application instructions governing cases, form and opportunity that shall comply with this obligation.
Institutions may communicate, as reserved, certain facts or information relating to negotiations still pending that, spread, would be prejudicial to the interest of the entity.
Article 44 ter-health social security institutions may transfer all its contracts of pension health and portfolio of members and beneficiaries, to one or more Isapres operating legally and are not affected to any of the situations provided for in articles 45 bis and 46. Consider two or more Isapres target in this transfer, the distribution of beneficiaries, among these institutions, must not involve discrimination between beneficiaries either by age, sex, agreed quotation or captivity status.
This transfer may not, under any circumstances, affect the rights and obligations arising from the contracts of health transferred, impose other restrictions than that already were in force under the contract that is yielded to members and beneficiaries, or establish a new declaration of health requirement. Institutions receiving must notify this fact to the contributors by registered letter issued within a period of five working days, from the date of the transfer, informing them, moreover, can choose to disaffiliate from the institution and transferred, together with their legal charges, the rule of law Nº 18.469 or another Isapre that agree. The notification means practiced for the third working day following the issuance of the letter. If Members say nothing until the last business day of the month subsequent to the respective notification, be governed in its regard the provisions of article 38, second paragraph. For all legal purposes, the date of the loan agreement will be the same of the original contract.
Transfer of contracts and portfolio referred to in this provision require the authorization of the Superintendent and must agree to general application instructions handed down for the purpose.
Health institution wishing to make use of the mechanism of transfer of all of its health insurance scheme and contracts portfolio of members and beneficiaries, under the terms of this provision, shall publish, prior to the execution of the aforementioned transfer, a notice in three national newspapers, on different days, its intention to transfer their health contracts indicate the institution which aims to transfer and the corporate, financial and economic support of the same conditions. "."
8 Add, then of article 45, the following article 45 bis, new: "article 45 bis.-the institution of health pension that failing to carry to the liquidity indicator defined in article 25 ter, shall be subject to the special regime of supervision and control established in this article." The Superintendent must apply this same regime when heritage or the guarantee decrease below the limits laid down in articles 25 and 26. In any case, once remedied the situation of non-compliance in question, is will boost the measures taken under this regime of supervision and control.
Detected by the Superintendent of any breaches identified above, this will represent the Isapre situation and will give you no less than ten business days to bring forward a Plan of adjustment and contingency, which may relate, inter alia, on increase of capital, transfers of portfolio, change in the composition of assets, payment of liabilities, sale of the institution and in general, about any measure that seeks the solution of existing problems.
The Superintendent shall have a maximum period of ten working days to speak out about the adjustment and Contingency Plan submitted, either approving it or rejecting it.
If the Superintendent approves the adjustment and Contingency Plan presented by the institution, it must run within a period not exceeding 120 days, after which it should be assessed whether this remedied the defaults that sought to regulate its implementation. The Superintendent may, by resolution established, extend the referred period up to sixty days.
Where the Superintendent, founded resolution, rejects the adjustment and Contingency Plan submitted, it will be empowered to appoint a provisional administrator in terms that are later designated either for commenting to the referral Plan. In the latter case, the Superintendent shall grant the Isapre a period of five working days from the notification of the respective resolution, to present a new Plan of adjustment and contingency, which must be approved or rejected within five working days of its presentation.
In the event that the Superintendency rejects the adjustment and Contingency Plan submitted or if, having it approved, this violates or is expected lead time unless the problem reported or detected has passed, the Superintendent shall appoint in the Isapre, founded resolution, an administrator provisional for a period of four months, which may be extended for equal term by only once. Fees of the provisional administrator will be in charge of the health insurance institution, except if he is a civil servant of the Superintendency, case in which will not receive fees for such purpose.
The provisional administrator shall have the powers conferred by the law to the directory, the general manager or Board of Directors of the health insurance institution, as appropriate, with the goal of a settlement with patrimonial effect to overcome the problems detected or reported, and can, among other things, summon extraordinary meeting of shareholders or operative body of the Isapre and negotiate the transfer of the portfolio members and beneficiaries , under the terms of article 44 ter. However, the provisional administrator may not, in any case, sold the institution, unless it has been authorized by the aforementioned Board or Resolutive organ. Solved the problems detected or reported, the provisional administration ceases.
In the event that you fail to solve the problems, the Superintendent will start, founded resolution, the procedure for cancellation of the registration of the Isapre, which will take place in the following manner and will be in charge of the provisional administrator, even with expiry of the term of his appointment: a.-the provisional administrator will proceed to the transfer of all of the affiliated with one or more Isapres portfolio through a public tender which must be no more than one-hundred twenty days from the date of the decision mentioned above.
b for the purposes of the indicated bid, the Superintendent may, at the request of the provisional administrator or nursing, suspend new contracts with the institution and the desafiliaciones of it.
c the bidding rules may provide that, with charge to the guarantee referred to in article 26 of this law, be paid a value the Isapre awarded in case that proceeds to tender the portfolio members and beneficiaries to pay less. This value should be considered, among other variables, the characteristics of risk, the agreed price and the condition of captivity of the contributors of the Isapre whose portfolio is tendered. This value will fall wholly or partly to the guarantee, depending on the preference indicated in article 48.
d not those institutions that are in any of the situations described in the subparagraph first of this article, on the last preceding semester to bid may participate in the tender.

Tendered portfolio or when the tender has been received, the Superintendent shall cancel the registration of the Isapre.
However, if the institution comunicare to the Superintendent any defaults specified in subsection first rather than this detectare it, you will have one period greater than five business days specified in the second paragraph to introduce the Plan of adjustment and contingency, which may be extended by the Superintendency.
Institutions who have received all or part of the members and beneficiaries of the health insurance institution to which it applies the special regime of supervision and control established in this article, shall be ascribed to each of the contributors in any of their current health plans whose price is adjust to the amount of the price agreed at the time of the transfer , without prejudice to the parties, by mutual agreement, to agree a different plan. Institutions may not, under any circumstances, impose other restrictions or exclusions that where found already in force under the contract that kept the institution of previous affiliation to members and beneficiaries, or require a new statement of health. The institutions shall notify contributors by registered letter issued within the period of 15 working days from the date of the transfer, informing them, moreover, can choose to disaffiliate from the institution and transferred, together with their legal charges, the rule of law Nº 18.469 or another Isapre that agree. If Members say nothing until the last business day of the month subsequent to the respective notification, be governed in its regard the provisions of article 38, second paragraph. "."
9 Add, then article 45 bis, the following rule 45 ter, new: "rule 45 ter.-without prejudice to the provisions of article 45 bis, and from that they represent the breaches indicated in subparagraph first of this precept, the Superintendency, founded resolution, you can take custody of investments of the institution, approve transactions" demanding the change of the composition of assets, allocate part of the funds guarantee the payment of any of the requirements referred to in paragraphs 1 and 2 of subsection first article 26, suspend new contracts with the institution and the desafiliaciones of it and restrict the investments with related entities.
Likewise, in the event that occurs any of the circumstances indicated in the letters to) to e) following, the Superintendent may appoint the Interim Manager referred to in article 45 bis, with the same faculties stated there, and you can initiate the cancellation of the registration procedure: a.-when an institution has a heritage equal to or less than 0.2 times its total debts;
b when an institution fails to comply with by more than 25% percent the minimum that must be maintained as a guarantee in accordance with article 26;
c when the institution keep a liquidity indicator equal to or less than 0.6 times the ratio between current assets and current liabilities;
d when it fails to comply with any of the steps referred to in the Plan of adjustment and contingency, and e-where he is declared the bankruptcy of the institution. In this case, the existence of the trustee shall be without prejudice or affect in any way the powers conferred to the provisional administrator to bid portfolio and them having the Superintendent for effects to liquidate the warranty.

However, the Superintendency of Isapres shall apply the provisions of the preceding paragraph when institutions, at any time, present a patrimony exceeding 5,000 units of building or a security below two thousand units of building. "."
10.-amending article 46 in the following way: to) replace the number 1 with the following: "1.-when the portfolio of an Isapre affiliates is acquired by one or more other health institutions social security or when the invitation to tender referred to in article 45 bis has been declared deserted.".
(b) delete the number 3, becoming the numbers 4, 5 and 6 numbers 3, 4 and 5, respectively.
(c) add the following new second subsection: "once issued the resolution which cancels a registration, the institution may not conclude new contracts of pension health and its affiliates may evict existing contracts, even when no expiry of the period provided for in the second paragraph of article 38.".

(11 amending article 48 in the following way: a) Insert, in subparagraph () first, then the number 2, the next number 3, new, passing the current numbers 3 and 4 to be 4 and 5, respectively: "3.-once solved the listed credits, if left a remnant, will proceed to the payment of debts with health care providers, fully or proportionally" , as the case may be; "."

(b) interlayer, then number 4, current, that it became a number 5, the next number 6, new, passing the current number 5 to be number 7: "6.-then, if it is a remnant will know the value that is defined in the tender of portfolio or institution, in accordance with prescribed by the eighth paragraph of article 45 bis;".