justicedao/ipfs_state_laws huggingface dataset:
836-029-0085 Acquisition of Control of or Merger with Domestic Captive insurer The acquisition of control of, or merger of, a domestic captive insurer shall be regulated in accordance with section 9, chapter 84, Oregon Laws 2012. However, the Director of the Department of Consumer and Business Services may waive or modify the requirements for public notice and hearing when the director concludes the public hearing is not necessary due to limited public interest in the change of control. Statutory/Other Authority: ORS 731.244, 2012 OL Ch. 84 & Sec. 4 (Enrolled SB 1547) Statutes/Other Implemented: 2012 OL Ch. 84 & Sec. 2-22 (Enrolled SB 1547) History: ID 17-2012, f. & cert. ef. 11-7-12 ID 11-2012(Temp), f. 6-15-12, cert. ef. 7-1-12 thru 12-27-12
836-029-0090 Suspension or Revocation (1) The Director of the Department of Consumer and Business Services may by order suspend or revoke the license of a captive insurer or place the captive insurer on probation on the following grounds: (a) The captive insurer has not commenced business according to its plan of operation within two years of being authorized; (b) The captive insurer has ceased to carry on insurance business in or from within Oregon; (c) At the request of the captive insurer; (d) The captive insurer uses methods that render the operation of the captive insurer detrimental to the public or the policyholders of the captive insurer according to standards set forth in OAR 836-029-0095 or (e) Any reason provided in section 16, chapter 84, Oregon Laws 2012. (2) Before the director takes any action set forth under section 16, chapter 84, Oregon Laws 2012 the director shall give the captive insurer notice in writing of the grounds on which the director proposes to act, and shall provide an opportunity for hearing on the proposed action in accordance with the provision applicable to a contested case proceeding in ORS 183.310 to 183.490. Statutory/Other Authority: ORS 731.244, 2012 OL Ch. 84 & Sec. 4 (Enrolled SB 1547) Statutes/Other Implemented: 2012 OL Ch. 84 & Sec. 2-22 (Enrolled SB 1547) History: ID 17-2012, f. & cert. ef. 11-7-12 ID 11-2012(Temp), f. 6-15-12, cert. ef. 7-1-12 thru 12-27-12
836-029-0100 Director's Authority (1) For the purposes of making a determination of the financial condition of a captive insurer under OAR 836-029-0090 to 836-029-0100, the director may do one or more of the following: (a) Disregard any credit or amount receivable resulting from transactions with a reinsurer that is insolvent, impaired or otherwise subject to a delinquency proceeding; (b) Make appropriate adjustments to asset values attributable to investments in or transactions with parents, subsidiaries or affiliates; (c) Refuse to recognize the stated value of accounts receivable if the ability to collect receivables is highly speculative in view of the age of the account or the financial condition of the debtor; or (d) Increase the captive insurer's liability in an amount equal to any contingent liability, pledge, or guarantee not otherwise included if there is a substantial risk that the captive insurer will be called upon to meet the obligation undertaken within the next 12-month period. (2) An order of the director under ORS 731.385 regarding a foreign captive insurer may be limited to the extent provided by statute. (3) In addition to the requirements the director may impose under ORS 731.385, if the director determines that the continued operation of the captive insurer licensed to transact business in this state may be hazardous to the policyholders or the general public, the director may require the captive insurer to: (a) File reports in a form acceptable to the director concerning the market value of the captive insurer’s assets; (b) Document the adequacy of premium rates in relation to the risks insured; (c) In addition to regular annual statements, file interim financial reports on the form specified by the director; (d) Correct corporate governance practice deficiencies, and adopt and utilize the governance practices acceptable to the director; or (e) Provide a business plan to the director in order to continue to transact business in this state. (4) Notwithstanding any other provision of law limiting the frequency or amount of premium rate adjustments, the director may include as a requirement under section (3) of this rule, any rate adjustment for any non-life insurance product written by the captive insurer that the director considers necessary to improve the financial condition of the captive insurer. Statutory/Other Authority: ORS 731.244, 2012 OL Ch. 84 & Sec. 4 (Enrolled SB 1547) Statutes/Other Implemented: 2012 OL Ch. 84 & Sec. 2-22 (Enrolled SB 1547) History: ID 17-2012, f. & cert. ef. 11-7-12 ID 11-2012(Temp), f. 6-15-12, cert. ef. 7-1-12 thru 12-27-12
836-029-0105 Change of Information in Initial Application (1) Any material change in a captive insurer's business plan that is filed with the Director of the Department of Consumer and Business Services at the time of initial application and any subsequent amendment of the plan requires prior approval of the director. (2) Any change in any other information filed with the initial application must be filed with the director within sixty days after the change, but does not require prior approval. (3) The captive insurer shall immediately notify the director upon making changes in board members or officers of the captive insurer. Statutory/Other Authority: ORS 731.244, 2012 OL Ch. 84 & Sec. 4 (Enrolled SB 1547) Statutes/Other Implemented: 2012 OL Ch. 84 & Sec. 2-22 (Enrolled SB 1547) History: ID 17-2012, f. & cert. ef. 11-7-12 ID 11-2012(Temp), f. 6-15-12, cert. ef. 7-1-12 thru 12-27-12
836-029-0110 Application (1) In order to form a domestic captive insurer a person shall apply to the director of the Department of Consumer and Business Services for a permit to organize using the form, “Application for Permit to Organize Captive Insurer With or Without Capital Stock” as set forth on the Division of Financial Regulation website of the Department of Consumer and Business Services at dfr.oregon.gov. The written application for permit to organize, including all required attachments and information, must be submitted to the department in accordance with instructions provided with the application. (2) In order to be authorized to transact insurance as a captive insurer a person shall apply to the director for authority to conduct a captive insurance using the form, "Application to Form a Captive insurer" as set forth on the Division of Financial Regulation website of the Department of Consumer and Business Services at dfr.oregon.gov. The application materials must: (a) Include one complete copy of the application including forms, attachments, exhibits and all other papers and documents filed as a part thereof, accompanied by the appropriate filing fee filed in writing or online with the director. The written application, including all required attachments and information, must be submitted to the department in accordance with instructions provided with the application. (b) Be signed in the manner prescribed in the application. 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 must also be filed with the application. (c) Include with the application a business plan with supporting data and all other information required by the application. (d) Include a feasibility study demonstrating the feasibility of the business plan of the captive insurer. The department may test the feasibility of the study by examining the captive insurer's corporate records, if any, including but not limited to the insurer’s charter, bylaws and minute books, verification of capital and surplus, verification of principal place of business, determination of assets and liabilities, and any other factor the director considers necessary. Statutory/Other Authority: ORS 731.244, Sec. 4 (Enrolled SB 1547) & Or Laws 2012, ch 84 Statutes/Other Implemented: Or Laws 2012, ch 84 & Sec. 2-22 (Enrolled SB 1547) History: ID 10-2023, minor correction filed 05/19/2023, effective 05/19/2023 ID 17-2012, f. & cert. ef. 11-7-12 ID 11-2012(Temp), f. 6-15-12, cert. ef. 7-1-12 thru 12-27-12
836-029-0115 Fees (1) At the time an applicant submits an application under OAR 836-029-0110 for a permit to organize a captive insurer or for a certificate of authority to operate as a captive insurer the applicant shall pay to the Director of the Department of Consumer and Business Services a nonrefundable fee as set forth in 836-009-0007 for processing the initial application for a permit to organize or for a certificate of authority. (2) In addition, each captive insurer that is authorized by the director shall pay prior to April 1 an annual continuation fee, without proration, for the year following the year during which the certificate of authority was originally issued and each year thereafter in the amount established in OAR 836-009-0007. Statutory/Other Authority: ORS 731.244, 2012 OL Ch. 84 & Sec. 4 (Enrolled SB 1547) Statutes/Other Implemented: 2012 OL Ch. 84 & Sec. 2-22 (Enrolled SB 1547) History: ID 17-2012, f. & cert. ef. 11-7-12 ID 11-2012(Temp), f. 6-15-12, cert. ef. 7-1-12 thru 12-27-12
836-029-0120 Authorized Forms (1) The following forms must be used for any applicant applying for a certificate of authority as a new captive insurer: (a) "Application for Permit to Organize Captive Insurer With or Without Capital Stock;” (b) “Application to Form a Captive insurer;" (c) "Biographical Affidavit for Captive insurer;" (d) "Oregon Division of Financial Regulation Captive Insurer Reinsurance Exhibit;" (e) "Oregon Approved Irrevocable Letter of Credit" if applicable; (f) "Statement of Economic Benefit to the State of Oregon;" and (g) "Appointment of a Registered Resident Agent as Attorney to Accept Service of Process." (2) Except for a captive insurance producer applying to be licensed as a producer pursuant to ORS 744.052 to 744.089, the following forms must be used when applying to become an approved captive insurer service provider: (a) "Application for Placement on Approved Captive Insurer Management Firm List;" (b) "Application to Certify Loss and Expense for Captive insurers Captive Actuary Application;" (c) "Application for Authorization as an Independent Certified Public Accountant for Captive insurers;" and (d) “Application for Authorization as Producer for Captive insurers.” (3) All captive insurers must use the "Captive Insurer Annual Statement Form." (4) The forms required in sections (1) to (3) of this section are set forth on the Division of Financial Regulation website of the Department of Consumer and Business Services at dfr.oregon.gov. Statutory/Other Authority: ORS 731.244, Sec. 4 (Enrolled SB 1547) & Or Laws 2012, ch 84 Statutes/Other Implemented: Or Laws 2012, ch 84 & Sec. 2-22 (Enrolled SB 1547) History: ID 29-2024, minor correction filed 08/16/2024, effective 08/16/2024 ID 4-2023, minor correction filed 05/19/2023, effective 05/19/2023 ID 17-2012, f. & cert. ef. 11-7-12 ID 11-2012(Temp), f. 6-15-12, cert. ef. 7-1-12 thru 12-27-12
836-031-0200 Scope, Authority; Statutes Implemented; Application (1) OAR 836-031-0200 to 836-031-0300 apply to all individual and group health insurance coverages except credit insurance and establish minimum standards for the following three categories of health insurance reserves: (a) Claim reserves, under OAR 836-031-0230; (b) Premium reserves, under OAR 836-031-0240; and (c) Contract reserves, under OAR 836-031-0250. (2) OAR 836-031-0200 to 836-031-0300 are adopted pursuant to the authority of ORS 731.244 and 733.080 for the purpose of implementing 733.080. (3) Reserving requirements under OAR 836-031-0200 to 836-031-0300 must be incorporated in the annual statement of an insurer for the year ending December 31, 1995, and for each year thereafter. Statutory/Other Authority: ORS 731.244 & 733.080 Statutes/Other Implemented: ORS 733.080 History: ID 7-1995, f. & cert. ef. 11-15-95
836-031-0220 Principles Governing Reserves (1) When an insurer determines that health insurance reserves meeting the minimum standards specified in OAR 836-031-0200 to 836-031-0300 are inadequate, increased reserves shall be held and shall be considered the minimum reserves for that insurer. (2) With respect to any block of contracts, or with respect to an insurer’s health insurance 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 must take into account, for all contracts in force, including those in a claims status or in a continuation of benefits status on the valuation date, the present value as of the valuation date of the following: (a) All expected benefits unpaid; (b) All expected expenses unpaid; and (c) All unearned or expected premiums, adjusted for future premium increases reasonably expected to be put into effect. (3) A gross premium valuation described in section (2) of this rule 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 insurance 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) by this standard shall be held with respect to all contracts, regardless of whether contract reserves are required for such contracts under OAR 836-031-0200 to 836-031-0300. (4) Whenever minimum reserves as defined in OAR 836-031-0200 to 836-031-0300 exceed reserve requirements as determined by a prospective gross premium valuation, such minimum reserves remain the minimum requirement under OAR 836-031-0200 to 836-031-0300. (5) Adequacy of an insurer’s health insurance reserves is determined on the basis of all three categories of reserves, including claim reserves, premium reserves and contract reserves, combined. Statutory/Other Authority: ORS 731.244 & 733.080 Statutes/Other Implemented: ORS 733.080 History: ID 7-1995, f. & cert. ef. 11-15-95
836-031-0230 Claim Reserves (1) The following provisions apply to claim reserves generally: (a) An insurer must maintain claim reserves for all incurred but unpaid claims on all health insurance policies; (b) An insurer must maintain appropriate claim expense reserves with respect to the estimated expense of settlement of all incurred but unpaid claims; and (c) An insurer must test all such reserves for prior valuation years for adequacy and reasonableness using claim runoff schedules in accordance with the statutory financial statement, including consideration of any residual unpaid liability. (2) The following minimum standards apply to claim reserves for disability income insurance: (a) Interest. The maximum interest rate for claim reserves is specified in OAR 836-031-0280; (b) Morbidity. Minimum standards with respect to morbidity are those specified in OAR 836-031-0270 except that at the option of the insurer: (A) For claims with a duration from date of disablement of less than two years, reserves may be based on the experience of the insurer, if such experience is considered credible, or upon other assumptions that to place a sound value on the liabilities; and (B) For group disability income claims with a duration from date of disablement of more than two years but less than five years, reserves may, with the approval of the Director, be based on the experience of the insurer. The request for such approval of a plan of modification to the reserve basis must include: (i) An analysis of the credibility of the experience; (ii) A description of how the experience of the insurer is proposed to be used in setting reserves; (iii) A description and quantification of the margins to be included; (iv) A summary of the financial impact that the proposed plan of modification would have had on the last filed annual statement of the insurer; (v) A copy of the approval of the proposed plan of modification by the commissioner of the state of domicile; and (vi) Any other information requested by the Director; and (c) Duration of disablement. For contracts with an elimination period, the duration of disablement must be measured as dating from the time that benefits would have begun to accrue had there been no elimination period. (3) The following minimum standards apply to claim reserves for all other benefits: (a) Interest. The maximum interest rate for claim reserves is specified in OAR 836-031-0280; (b) Morbidity or other contingency. The reserve must be based on the experience of the insurer, if such experience is considered credible, or upon other assumptions that place a sound value on the liabilities. (4) 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. Statutory/Other Authority: ORS 731.244 & 733.080 Statutes/Other Implemented: ORS 733.080 History: ID 7-1995, f. & cert. ef. 11-15-95
836-031-0240 Premium Reserves (1) The following provisions apply to premium reserves generally: (a) An insurer must maintain unearned premium reserves for all contracts with respect to the period of coverage beyond the date of valuation for which premiums, other than premiums paid in advance, have been paid; (b) If premiums due and unpaid are carried as an asset, an insurer must treat such premiums as premiums in force, subject to unearned premium reserve determination for which premiums, other than premiums paid in advance, have been paid. An insurer must carry the value of unpaid commissions, premium taxes and the cost of collection associated with due and unpaid premiums as an offsetting liability; (c) The gross premiums paid in advance for a period of coverage commencing after the next premium due date that follows the date of valuation may be appropriately discounted to the valuation date and shall be held either as a separate liability or as an addition to the unearned premium reserve that would otherwise be required as a minimum. (2) The following are minimum standards for unearned premium reserves: (a) The minimum unearned premium reserve with respect to any contract is the pro rata unearned modal premium that applies to the premium period beyond the valuation date. Such premium must be determined on the basis of: (A) The valuation net modal premium on the contract reserve basis applying to the contract; or (B) The gross modal premium for the contract if no contract reserve applies. (b) Notwithstanding subsection (a) of this section, the sum of the unearned premium and contract reserves for all contracts of the insurer subject to contract reserve requirements shall not be less than the gross modal unearned premium reserve on all such contracts as of the date of valuation. Such sum shall never be less than the expected claims for the period beyond the valuation date represented by such unearned premium reserve, to the extent not provided for elsewhere. (3) An 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 must be tested periodically to determine their continuing adequacy and reliability. Statutory/Other Authority: ORS 731.244 & 733.080 Statutes/Other Implemented: ORS 733.080 History: ID 7-1995, f. & cert. ef. 11-15-95
836-031-0260 Reinsurance Increases to or credits against reserves held that arise because of reinsurance assumed or reinsurance ceded must be determined in a manner consistent with OAR 836-031-0200 to 836-031-0300 and also with all applicable provisions of the reinsurance contracts that affect the liabilities of the insurer. Statutory/Other Authority: ORS 731.244 & 733.080 Statutes/Other Implemented: ORS 733.080 History: ID 7-1995, f. & cert. ef. 11-15-95
836-031-0280 Specific Standards for Interest (1) For contract reserves, the maximum interest rate is the maximum rate permitted by law in the valuation of whole life insurance issued on the same date as the health insurance contract. (2) For claim reserves on policies that require contract reserves, the maximum interest rate is the maximum rate permitted by law in the valuation of whole life insurance issued on the same date as the claim incurral date. (3) For claim reserves on policies not requiring contract reserves, the maximum interest rate is the maximum rate permitted by law in the valuation of single premium immediate annuities issued on the same date as the claim incurral date, reduced by one hundred basis points. Statutory/Other Authority: ORS 731.244 & 733.080 Statutes/Other Implemented: ORS 733.080 History: ID 7-1995, f. & cert. ef. 11-15-95
836-031-0290 Specific Standards for Mortality (1) Except as provided in section (2) of this rule, the mortality basis used shall be according to any table (but without use of selection factors) permitted by law for the valuation of whole life insurance issued on the same date as the health insurance contract. (2) Other mortality tables adopted by the NAIC and also adopted by the Director may be used in the calculation of the minimum reserves if appropriate for the type of benefits and if approved by the Director. The request for such approval must include the proposed mortality table and the reason that the standard specified in section (1) of this rule is inappropriate. Statutory/Other Authority: ORS 731.244 & 733.080 Statutes/Other Implemented: ORS 733.080 History: ID 7-1995, f. & cert. ef. 11-15-95
836-031-0300 Reserves for Waiver of Premium (1) Waiver of premium reserves involves several special considerations. First, the disability valuation tables promulgated by the NAIC 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 are reserves on contracts in force. This is true for the 1964 CDT and for both the 1985 CIDA and CIDB tables. (2) Reserves using any of the tables described in section (1) of this rule shall value reserves on the following basis: (a) Claim reserves must include reserves for premiums expected to be waived, valuing as a minimum the valuation net premium being waived; (b) Premium reserves must include contracts on premium waiver as in-force contracts, valuing as a minimum the unearned modal valuation net premium being waived; and (c) Contract reserves must include recognition of the waiver of premium benefit in addition to other contract benefits provided for, valuing as a minimum the valuation net premium to be waived. Statutory/Other Authority: ORS 731.244 & 733.080 Statutes/Other Implemented: ORS 733.080 History: ID 7-1995, f. & cert. ef. 11-15-95
836-031-0400 Allowed Assets For the purpose of applying investment limitations and prohibitions in ORS Chapter 733 that are based upon percentages, the allowed assets of an insurer shall be those allowed assets described in 733.010 that are shown in the financial statement filed by the insurer for the period immediately preceding the period for which the most recent financial statement was filed. Statutory/Other Authority: ORS 731.244, 733.010 & 733.695 Statutes/Other Implemented: ORS 733.010 & 733.510 - 733.780 History: ID 5-1992, f. & cert. ef. 3-26-92