justicedao/ipfs_state_laws huggingface dataset:
836-042-0225 Criteria for Grouping; Criteria for Substantially Similar Occupations Within Organization; Open Enrollment Required An insurer may combine for rating purposes the experience of a group of employers which it covers for workers’ compensation insurance only if: (1) All employers in the group are members with full rights and privileges of the organization; (2) The group satisfies all requirements of ORS 737.316. Statutory/Other Authority: ORS 731.244 & 737.316 Statutes/Other Implemented: ORS 737.316 History: ID 3-1991, f. & cert. ef. 4-18-91 Reverted to IC 2-1984, f. 1-18-84, ef. 2-1-84 ID 15-1990(Temp), f. & cert. ef. 7-3-90 IC 2-1984, f. 1-18-84, ef. 2-1-84
836-042-0300 Statutory Authority; Purpose; Applicability; Effective Date (1) OAR 836-42-300 to 836-042-0322 are adopted under the specific authority of the Insurance Commissioner in ORS 737.600, to make rules needed to allow mass marketing plans in personal lines casualty and property insurance. (2) The purpose of these rules is to prevent abuses in connection with the sale of personal lines property-casualty insurance in this state under mass marketing plans, while preserving for consumers the potential benefits of this form of marketing. The rules also are to provide for an orderly procedure to carry out the provisions of ORS 737.600. (3) OAR 836-042-0300 to 836-042-0322 apply only to insurance policies issued or renewed in this state after October 14, 1983, and is in addition to, and not instead of, other applicable requirements of the Insurance Code and Division rules. The requirements of OAR 836-042-0300 to 836-042-0322 do not apply to methods of marketing other than mass marketing plans. (4) OAR 836-042-0300 to 836-042-0322 becomes effective October 14, 1983. [Publications: Publications referenced are available from the agency.] Statutory/Other Authority: ORS 731.244 & 737.600 Statutes/Other Implemented: ORS 737.600 History: ID 15-1996, f. & cert. ef. 11-12-96 IC 8-1983, f. & ef. 11-10-83
836-042-0302 Definitions As used in OAR 836-042-0300 to 836-042-0322 unless the context requires otherwise: (1) “Mass marketing plan” means a method of selling property-casualty personal lines insurance to members of a particular association which has agreed to or otherwise endorsed the sale of the insurance to its members. (2) “Personal lines” means property and casualty insurance policies for personal, family or household purposes, and not for commercial or business purposes. (3) “Property-casualty insurance” means insurance to which ORS 731.158 and 731.182 apply. Statutory/Other Authority: ORS 731.244 & 737.600 Statutes/Other Implemented: ORS 737.600 History: ID 15-1996, f. & cert. ef. 11-12-96 IC 8-1983, f. & ef. 11-10-83
836-042-0304 Fictitious Arrangement Prohibited (1) No insurer shall sell insurance under a mass marketing plan to members of any association without the approval of the Commissioner. (2) The Commissioner will not approve any mass marketing plan unless it meets the requirements of ORS 737.600(3)(d). Statutory/Other Authority: ORS 731 Statutes/Other Implemented: ORS 737.600(3)(d) History: IC 8-1983, f. & ef. 11-10-83
836-042-0306 Premium Rates Premium rates under a mass marketing plan shall comply with the standards in the Insurance Code and shall not be excessive, inadequate, or unfairly discriminatory. Rates will not be deemed unfairly discriminatory when premiums differ between policy holders with like loss exposures but different expense factors, or like expense factors but different loss exposures, so long as the rates reflect the differences with reasonable accuracy. Rates will not be deemed unfairly discriminatory if they are averaged broadly among persons insured under a mass marketing plan. [Publications: Publications referenced are available from the agency.] Statutory/Other Authority: ORS 731 Statutes/Other Implemented: ORS 737.600(3)(d) History: IC 8-1983, f. & ef. 11-10-83
836-042-0308 Statistics An insurer selling insurance under mass marketing plans shall maintain separate relevant statistics as to loss and expense experience. Statutory/Other Authority: ORS 731 Statutes/Other Implemented: ORS 737.600(3)(d) History: IC 8-1983, f. & ef. 11-10-83
836-042-0310 Producers A person shall not act as an insurance producer in connection with a mass marketing plan for any kind of insurance unless such person is licensed as an insurance producer to transact casualty insurance. Statutory/Other Authority: ORS 731 & 744 Statutes/Other Implemented: ORS 737.600(3)(d) History: ID 8-2005, f. 5-18-05, cert. ef. 8-1-05 ID 3-1990, f. & cert. ef. 1-19-90 IC 8-1983, f. & ef. 11-10-83
836-042-0312 Compulsory Participation Prohibited No insurer shall sell insurance under a mass marketing plan if purchase under the plan is a condition of employment or of membership in any association, or if any employee or member would be subject to any penalty for non-participation. Statutory/Other Authority: ORS 731 Statutes/Other Implemented: ORS 737.600(3)(d) History: IC 8-1983, f. & ef. 11-10-83
836-042-0314 Tie-In Sales Prohibited No insurer shall sell insurance under a mass marketing plan if: (1) The purchase of insurance under the plan is contingent upon the purchase of any other insurance, product, or service; or (2) The purchase or price of any other insurance, product, or service is contingent upon the purchase of insurance available under the plan. This provision does not prohibit the reasonable requirement of safety devices, such as heat detectors, lightning rods, theft prevention equipment and the like. Statutory/Other Authority: ORS 731 Statutes/Other Implemented: ORS 737.600(3)(d) History: IC 8-1983, f. & ef. 11-10-83
836-042-0316 Disclosure Required Every insurer or insurance producer selling insurance under a mass marketing plan shall make full and fair disclosure to prospective insureds prior to sale of all features of the plan, whether favorable or unfavorable, including but not limited to premium rates, benefits, duration of coverage, policyholder services, conversion privileges available, and the financial interests in the plan, if any, of the association. Statutory/Other Authority: ORS 731 Statutes/Other Implemented: ORS 737.600(3)(d) History: ID 8-2005, f. 5-18-05, cert. ef. 8-1-05 IC 8-1983, f. & ef. 11-10-83
836-042-0318 Underwriting Standards No insurer shall use substantially more restrictive underwriting standards for individual risk selection in a mass marketing plan than the standards used by the insurer for individual risk selection in the sale in this state of the same kind of insurance under other plans. If the insurer does not sell the same kind of insurance in this state under other plans, its underwriting standards for individual risk selection in mass marketing plans shall not be substantially more restrictive than those standards used by its principal affiliate, if any. Statutory/Other Authority: ORS 731 Statutes/Other Implemented: ORS 737.600(3)(d) History: IC 8-1983, f. & ef. 11-10-83
836-042-0320 Cancellation and Non-Renewal (1) For purposes of Sections 742.562 and 742.566 of the Insurance Code, limiting the cancellation and non-renewal of insurance policies, the failure of an association, to remit premiums when due for any reason (including but not limited to interruption or termination of employment or membership) shall not be regarded as “non-payment of premium” by any insured under a plan providing for remittance of premium by such association, unless the insured has been given written notice of the failure to remit and has not paid the premium by ten days after such notice, or the due date of the premium remittance under the mass marketing plan, whichever is later. (2) Every mass marketing plan shall provide that an insured may maintain the policy in force in the same amount, for 60 days after termination of employment or membership or discontinuance of the plan. The member would pay the premium applicable to the class of risk to which the member would belong as an individual. The option to maintain the insurance in force must be exercised within 30 days following the date of termination. Any notice of cancellation or non-renewal of a policy under a mass marketing plan shall include a notice to the insured member that the insurer will allow the association, a reasonable opportunity to consult with the insurer and to present facts in opposition to cancellation or non-renewal. [Publications: Publications referenced are available from the agency.] Statutory/Other Authority: ORS 731 Statutes/Other Implemented: ORS 737.600(3)(d) History: IC 8-1983, f. & ef. 11-10-83
836-042-0322 Compulsory Facilities An insurer or insurance producer selling insurance under a mass marketing plan shall help any members who apply for but are denied insurance under the plan to obtain insurance through some other appropriate insurance plan, such as the assigned risk plan or the FAIR Plan. Statutory/Other Authority: ORS 731 Statutes/Other Implemented: ORS 737.600(3)(d) History: ID 8-2005, f. 5-18-05, cert. ef. 8-1-05 IC 8-1983, f. & ef. 11-10-83
836-042-0400 Statutory Authority; Purpose; Applicability; Effective Date (1) OAR 836-042-0400 to 836-042-0430 are adopted under the authority of ORS 737.600. (2) OAR 836-042-0430 is adopted to enable the Department to: (a) Regulate the sale of casualty insurance in this state on commercial risks under group policies as authorized under ORS 737.600(3)(f); and (b) Regulate the sale of all forms of insurance subject to ORS 737.035 to day care facilities under group policies as authorized under 737.600(3)(g). (3) OAR 836-042-0400 to 836-042-0430 become effective on adoption. Statutory/Other Authority: ORS 731 & 737 Statutes/Other Implemented: ORS 737.600 History: ID 19-2006, f. & cert. ef. 9-26-06 ID 7-1987, f. & ef. 12-11-87
836-042-0405 Definitions As used in OAR 836-042-0400 to 836-042-0430: (1) “Casualty Insurance” as defined in ORS 731.158 and as used in 836-042-0400 to 836-042-0430 means liability or casualty insurance as used in 737.600(3)(f). (2) “Rating System” means a collection of rating plans to be used by an insurer, rules for determining which rating plans are applicable to an insured, a classification system and other rules used by an insurer for determining contractual consideration for an insured. Statutory/Other Authority: ORS 731 & 737 Statutes/Other Implemented: ORS 737.600(3)(f)–(g) History: ID 7-1987, f. & ef. 12-11-87
836-042-0410 Commercial Risks; Prohibition; Requirements; Filing (1) An insurer may not sell casualty insurance on commercial risks under a group policy to members of a group unless: (a) The insurer has satisfied the filing requirements of this rule with respect to that policy; and (b) The Director has approved the policy as meeting the requirements of ORS 737.600(3)(f). (2) An insurer shall file the following with the Director with respect to each group policy of casualty insurance that the insurer proposes to sell: (a) The name of the group and the common element among its members; (b) The name of each member; (c) A copy or a specific explanation of the risk management plan for the group; (d) A specific explanation of the means by which the policy provides for reduced or returned premiums for members of the group; (e) A specific description of the rating system to be used for rating group members. Statutory/Other Authority: ORS 731 & 737 Statutes/Other Implemented: ORS 737.600(3)(f) History: ID 7-1987, f. & ef. 12-11-87
836-042-0415 Day Care Facilities; Prohibition; Requirements; Filing (1) An insurer may not sell insurance under a group policy to members of a group of day care facilities unless: (a) The insurer has satisfied the filing requirements of this rule with respect to that policy; and (b) The Director has approved the policy as meeting the requirements of OAR 836-042-0400 to 836-042-0430. (2) An insurer shall file the following with the Director with respect to each group policy for day care facilities that the insurer proposes to sell: (a) The name of the group; (b) The name of each day care facility in the group; (c) A description of the kind or class of insurance provided to the group; (d) A copy or a specific explanation of the risk management plan for the group; (e) A specific explanation of the means by which the policy provides for reduced or returned premiums for members of the group; (f) A specific description of the rating system to be used for rating group members. Statutory/Other Authority: ORS 731 & 737 Statutes/Other Implemented: ORS 737.600(3)(g) History: ID 7-1987, f. & ef. 12-11-87
836-042-0420 Anniversary Filings Not later than the 45th day before each anniversary of the effective date of each policy of insurance issued to a group under OAR 836-042-0400 to 836-042-0430, the insurer must file with the Director a statement whether premiums have been reduced or returned to the members in the group policy during the prior year. Statutory/Other Authority: ORS 731 & 737 Statutes/Other Implemented: ORS 737.600(3)(f) History: ID 7-1987, f. & ef. 12-11-87
836-042-0425 Statistics (1) An insurer selling casualty insurance on commercial risks to groups shall maintain separate relevant statistics as to loss and expense experiences of the groups insured. (2) An insurer selling insurance under group policies to members of groups of day care facilities certified under ORS 418.805 to 418.885 shall maintain separate relevant statistics as to loss and expense experiences of the groups insured. If the insurer also sells insurance under group policies to members of groups of days are facilities not required to be certified under 418.805 to 418.885, the insurer shall maintain similar statistics for the groups of such day care facilities but shall maintain those statistics separate from the statistics for groups of certified day care facilities. Statutory/Other Authority: ORS 731 & 737 Statutes/Other Implemented: ORS 737.600(3)(f)–(g) History: ID 7-1987, f. & ef. 12-11-87
836-042-0430 Disclosure Required for Day Care Facilities Every insurer selling insurance under a group policy for day care facilities shall make full and fair disclosure to prospective insureds, prior to sale, of all features of the plan, whether favorable or unfavorable, including but not limited to pricing and policyholder services. Statutory/Other Authority: ORS 731 & 737 Statutes/Other Implemented: ORS 737.600(3)(g) History: ID 7-1987, f. & ef. 12-11-87
836-042-0501 Statutory Authority; Purpose; Applicability; Effective Date (1) OAR 836-042-0501 to 836-042-0520 are adopted pursuant to: (a) The general rulemaking authority of the Director in ORS 731.244 as an aid to the effectuation of 737.320(6) which enables the Director to require that filed rates, rating plans and rating systems be submitted to the Director for review prior to becoming effective; and (b) The specific authority of the Director under ORS 737.207 to specify the markets of commercial liability insurance in which insurers and rating organizations must submit rate filings before they become effective if the average annual rate level increase or decrease for each market exceeds 15 percent. (2) The purpose of OAR 836-042-0501 to 836-042-0520 is to moderate the sharp cyclical swings in the availability and affordability of commercial liability insurance. Such moderation is accomplished by requiring that insurers and rating organizations submit to the Director their filings of rates, rating plans and rating systems for a specified commercial liability insurance market for review before such filings become effective, if the average annual rate level increase or decrease for that market exceeds 15 percent. (3) OAR 836-042-0501 to 836-042-0520 apply to all commercial liability insurance filings. Statutory/Other Authority: ORS 731.244 Statutes/Other Implemented: ORS 737.207 & 737.320 History: ID 15-1996, f. & cert. ef. 11-12-96 ID 14-1988, f. & cert. ef. 8-24-88 ID 4-1988(Temp), f. & cert. ef. 2-26-88 IC 7-1986, f. 11-7-86, ef. 11-10-86 IC 4-1986(Temp), f. & ef. 4-21-86
836-042-0505 Definitions As used in OAR 836-042-0501 to 836-042-0520, unless the context requires otherwise: (1) “Anniversary Rating Date” means the month and day that rates, rating plans and rating systems are initially applied to a policy in effect and each annual anniversary thereafter. (2) “Annual Rate” means the total limits base rate per unit exposure. (3) “Classification” means a grouping of insurance risks according to a classification system used by an insurer. (4) “Classification System” means a schedule of classifications and a rule or set of rules used by an insurer for determining the classification applicable to an insured. (5) “Commercial Liability Insurance” has the meaning set forth in ORS 731.074. (6) “Premium” means the contracted consideration charged to an insured for insurance for a specific period of time regardless of the timing of actual charges. (7) “Rating Plan” means a rule or set if rules used by an insurer to calculate premium for an insured, and the parameter values used in such calculation, after application of total limits base rates to units of exposure. (8) “Rating System” means a collection of rating plans to be used by an insurer, rules for determining which rating plans are applicable to an insured, a classification system and other rules used by an insurer for determining contractual consideration for insured. (9) “Total Limits Base Rate” means a monetary amount applied to the units of exposure basis assigned to a classification and used by an insurer to determine the total limits premium for an insured, prior to any adjustment or adjustments resulting from the application of any rating plan. Statutory/Other Authority: ORS 731 & 737 Statutes/Other Implemented: ORS 737.207(2) & 737.320(6) History: ID 14-1988, f. & cert. ef. 8-24-88 ID 4-1988(Temp), f. & cert. ef. 2-26-88 IC 7-1986, f. 11-7-86, ef. 11-10-86 IC 4-1986(Temp), f. & ef. 4-21-86
836-042-0510 Rates, Rating Plans System — Prior Review (1) An insurer or rating organization shall submit to the Director its filing of rates, rating plans and rating systems for a commercial liability insurance market specified in OAR 836-042-0512 prior to the effective date of the rates, rating plans and rating system if the average annual total limits rate level increase or decrease for such market exceeds 15 percent because of changes in any: (a) Total limits base rates; (b) Rating basis; (c) Rating plans; (d) Manual rules; (e) Territorial definitions; or (f) Combination of such rating system components, described in this section, or the compounding series of such changes applied at a date other than the anniversary rating date of a policy. (2) Nothing in this rule applies to annual rate increases or decreases from: (a) Change in hazard of the insured’s operation; (b) Change in magnitude of the exposure basis for the insured, (such as changes in payroll or sales, or other matters); or (c) Application in parameter values provided for in a rating plan approved by the Director, including those approved prior to August 24, 1988. Statutory/Other Authority: ORS 731 & 737 Statutes/Other Implemented: ORS 737.207(2) & 737.320(6) History: ID 14-1988, f. & cert. ef. 8-24-88 ID 4-1988(Temp), f. & cert. ef. 2-26-88 IC 7-1986, f. 11-7-86, ef. 11-10-86 IC 4-1986(Temp), f. & ef. 4-21-86
836-042-0512 Specified Commercial Liability Markets The conditions for a prior review in OAR 836-042-0510 apply to: (1) Average annual rate level increases greater than 15 percent for the following commercial liability markets: (a) Products liability; (b) Medical professional liability; (c) Professional liability other than medical professional liability; (d) Liquor law liability; (e) Child care liability; (f) Directors and officers liability; (g) Recreational liability; (h) Non-profit philanthropic and civic activity liability; (i) Commercial automobile long haul trucking liability; (j) Municipal liability; (k) Public official liability. (2) Average annual rate level decreases greater than 15 percent for all commercial liability markets except for commercial automobile policies and package insurance policies (such as commercial multi-peril and business owners policies). Statutory/Other Authority: ORS 731 & 737 Statutes/Other Implemented: ORS 737.207(1) - 737.207(2) & 737.320(6) History: ID 14-1988, f. & cert. ef. 8-24-88 ID 4-1988(Temp), f. & cert. ef. 2-26-88
836-042-0515 Commercial Liability Filings — Procedural Rules for Insurers and Rating Organizations (1) Each filing of a commercial casualty insurance premium rate, rating plan or rating system that is certified by a member of the American Academy of Actuaries or by an executive officer of the entity making the filing as not being subject to OAR 836-042-0510(1) shall become effective on the date specified in the filing but not earlier than the date the filing is received by the Director. (2) Each filing of commercial liability insurance rate, rating plan or rating system that does not satisfy the condition of section (1) of this rule and the requirements of OAR 836-042-0520 and each filing subject to 836-042-0510(1) must be submitted to the Director for review prior to becoming effective. Statutory/Other Authority: ORS 731 & 737 Statutes/Other Implemented: ORS 737.207(3) & 737.320(6) History: ID 14-1988, f. & cert. ef. 8-24-88 ID 4-1988(Temp), f. & cert. ef. 2-26-88 IC 1-1986, f. & ef. 1-21-87 IC 7-1986, f. 11-7-86, ef. 11-10-86 IC 4-1986(Temp), f. & ef. 4-21-86
836-042-0520 Supporting Data Supporting actuarial data shall accompany every filing of a commercial liability insurance rate, rating plan and rating system. The data shall be in sufficient detail to: (1) Demonstrate compliance with ORS 737.207; and (2) Demonstrate the statistical significance of differences or correlations relevant to rating plan definitions and rate differentials. Statutory/Other Authority: ORS 731 & 737 Statutes/Other Implemented: ORS 737.207(4) & 737.320(6) History: ID 14-1988, f. & cert. ef. 8-24-88 ID 4-1988(Temp), f. & cert. ef. 2-26-88 IC 7-1986, f. 11-7-86, ef. 11-10-86 IC 4-1986(Temp), f. & ef. 4-21-86
836-043-0001 Statutory Authority; Purpose; (1) OAR 836-043-0001 to 836-043-0091 are adopted by the Insurance Commissioner pursuant to the authority and requirements of ORS 656.427, 656.730 and 731.244 for the purpose of implementing ORS 656.427, 656.730, and 737.265, and may be cited as the Oregon Workers’ Compensation Insurance Plan (the “Plan” or “WCIP”). (2) The Oregon Workers’ Compensation Insurance Plan provides for the equitable apportionment among workers’ compensation insurers of employers who are in good faith entitled to workers’ compensation insurance, but who are unable to procure such insurance in a regular manner. (3) The Plan applies to all authorized workers’ compensation insurers and the State Accident Insurance Fund Corporation, their agents and the Plan Administrator. Statutory/Other Authority: ORS 656.427, 656.730 & 731.244 Statutes/Other Implemented: ORS 656.427, 656.730 & 737.265 History: ID 10-1996, f. 6-27-96, cert. ef. 7-1-96 ID 4-1994, f. & cert. ef. 4-19-94 ID 13-1992, f. & cert. ef. 8-12-92 ID 1-1991, f. & cert. ef. 2-19-91 Reverted to ID 7-1990, f. 4-30-90, cert. ef. 5-1-90 ID 18-1990(Temp), f. & cert. ef. 8-6-90 ID 7-1990, f. 4-30-90, cert. ef. 5-1-90 ID 10-1989(Temp), f. & cert. ef. 11-3-89 IC 1-1982, f. 1-15-82, ef. 7-1-82 IC 1-1980, f. & ef. 1-15-80 IC 1-1979(Temp), f. & ef. 10-12-79