reglab/statecodes huggingface dataset:
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0060 - Conditions for Division of Payroll of Individual Employees

Current through Register Vol. 63, No. 7, July 1, 2024
(1) When there is
			 an interchange of labor, the payroll of an individual employee shall be divided
			 and allocated among the classification or classifications that may be properly
			 assigned to the employer, provided verifiable payroll records maintained by the
			 employer disclose a specific allocation for each such individual employee, in
			 accordance with the standards for rebilling set forth in OAR 836-043-0190 and
			 this rule.
(2)This rule does not
			 apply to a single employee whose duties vary within exposure areas normally
			 anticipated by the scope of a single classification or who spends only a
			 limited amount of time, on an infrequent or irregular basis, in a
			 classification exposure that is not a normal job function for that employee. As
			 used in this section, "infrequent or irregular" means that the time spent in
			 the classification exposure is limited, is not anticipated in the normal duties
			 of the employee and occurs only randomly.
(3) When verifiable payroll records are
			 required with respect to a single employee and the employer does not maintain
			 them as required in this rule, the entire payroll of the employee shall be
			 assigned to the highest rated classification exposure in accordance with the
			 standards for rebilling set forth in OAR 836-043-0190.
(4) For purposes of this rule, payroll
			 records of an employee are verifiable if they have the following
			 characteristics:
(a) The records must
			 establish a time basis, and the time basis must be hourly or a part thereof,
			 daily or part thereof, weekly or part thereof, monthly or part thereof or
			 yearly or part thereof;
(b) For
			 each salaried employee, the records must also include time records in which the
			 salary is converted to an hourly, daily, weekly, monthly or yearly rate and
			 then multiplied by the time spent by the employee in each classification
			 exposure;
(c) The records must
			 include a description of duties performed by the employee, to enable the
			 insurer to determine correct classification assignment. Records requiring
			 additional explanation or interpretation are not considered to be verifiable;
			 and
(d) The records must be
			 supported by original entries from other records, including but not limited to
			 time cards, calendars, planners or daily logs prepared by the employee or the
			 employee's direct supervisor or manager. Estimated ratios or percentages do not
			 comply with the requirement of this subsection and are not acceptable for
			 verification. Verifiable records must be summarized in the insured employer's
			 accounting records.
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0070 - Statutory Authority and Purpose

Current through Register Vol. 63, No. 7, July 1, 2024
OAR 836-042-0070  to 836-042-0090  are adopted pursuant to the
				general rulemaking authority of the Director of the Department of Consumer and
				Business Services in ORS
				731.244 to specify for insurers
				offering large deductible provisions of workers' compensation insurance
				policies requirements for rates, rating plans, and rating systems which may be
				approved according to ORS Chapter 737.
Stat. Auth.: ORS
				  731.244
Stats. Implemented: ORS 737, ORS
				  737.310 & ORS
				  741.001 - ORS
				  742.007
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0075 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
As used in OAR 836-042-0070  to 836-042-0090:
(1) "Insurer" means any insurer authorized to
			 write workers' compensation insurance and includes the State Accident Insurance
			 Fund Corporation.
(2) "Director"
			 means the Director of the Department of Consumer and Business
			 Services.
(3) "Large Deductible"
			 means a provision in a workers' compensation policy, or added by endorsement
			 thereto, which allows a policy holder to be financially responsible for claims
			 incurred under the policy up to a percentage of premium, a stated amount per
			 claim, or other limit specified in the provision in exchange for a prospective
			 premium reduction.
(4) "Workers'
			 Compensation Insurance" means insurance providing coverage for the obligations
			 of an employer arising from illness or injury to workers whether such
			 obligation is imposed by ORS Chapters 654 and 656, similar laws of the United
			 States, or agreements between states.
Stat. Auth.: ORS
				  731.244
Stats. Implemented: ORS 737, ORS
				  737.310 & ORS
				  741.001 - ORS
				  742.007
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0080 - Rate Filing Requirements and Standards

Current through Register Vol. 63, No. 7, July 1, 2024
An insurer that issues a policy for worker's compensation
				insurance including a large deductible provision must use a provision which
				satisfies requirements of OAR 836-054-0210  and has been approved by the
				Director and must file rating plans for determining premium credits or rating
				modifications with the Director according to ORS
				737.320 and OAR 836-042-0001  to
				836-042-0045  and which satisfy these additional requirements:
(1) Such rating plans must be based on
			 actuarial assumptions and methods similar to and not circumventing the design
			 of retrospective rating plans approved by the Director.
(2) A deductible credit or rating
			 modification must be the final rating step so that the insurer may distinguish
			 the amount of credit or modification premium and the policy premium prior to
			 the credit or modification. An insurer may compute premium discounts based on
			 premium amounts after deductible credits if the insurer can demonstrate that
			 greater premium equity is achieved and that data distinguishing the various
			 premium elements will be maintained.
(3) Such rating plans may not contain
			 provisions which cannot be approved under the unfair discrimination provisions
			 of OAR 836-042-0025.
(4) A
			 deductible credit or rating modification must recognize expenses which vary
			 with net earned premium after such credits or modifications
(5) Prospective experience rating plans based
			 on prior claims experience must use losses valued on a gross basis prior to
			 deductible provisions.
(6) Large
			 deductible rating plans may not be applied to rating groups approved under OAR
			 836-042-0201  to 836-042-0225.
(7)
			 Minimum eligibility for a large deductible provision must be not less than
			 $500,000 estimated country-wide annual premium prior to large deductible
			 credits or premium credits based on premium size. The minimum deductible limit
			 per claim for each injury or illness may not be less than $75,000. An aggregate
			 limit for deductible amounts for all claims may be specified but may not be
			 less than the deductible limit per claim.
Stat. Auth.: ORS
				  731.244
Stats. Implemented: ORS 737,
				  737.310 &
				  742.001 -
				  742.007
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0085 - Statistical Data Maintenance and Reporting Requirements

Current through Register Vol. 63, No. 7, July 1, 2024
An insurer that issues a policy for worker's compensation
				insurance including a large deductible provision must:
(1) Maintain policy premium data
			 distinguishing credit or modification premium for large deductible
			 provisions;
(2) Report policy unit
			 statistical data with losses valued on a gross basis prior to deductible
			 provisions; and
(3) Separately
			 report financial experience data to a licensed rating organization including
			 premium prior to credits or modifications for large deductible provisions and
			 loss valued on a gross basis prior to deductible provisions.
Stat. Auth.: ORS
				  731.244
Stats. Implemented: ORS 737,
				  737.310 &
				  741.001 -
				  742.007
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0090 - Trade Practices Found Injurious to the Insurance-Buying Public

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Failure of an
			 insurer to comply with OAR 836-042-0080, 836-042-0085  or 836-054-0210  constitutes an unfair trade practice under ORS
			 746.240.
(2) Failure of an insurer to delete a large
			 deductible provision following discovery that an insured employer has on three
			 or more occasions during the policy period known of a workers' compensation
			 insurance claim for five (5) days or longer but has not reported the claim to
			 the insurer or has on any occasion within the policy period made direct payment
			 of claim costs constitutes an unfair trade practice under ORS
			 746.240.
(3) Failure of an insurer to include amounts
			 of premium credits or modifications for large deductible provisions in the base
			 for the assessment imposed by the Director pursuant to ORS
			 656.612 and to pay the
			 assessment on those amounts constitutes an unfair trade practice under ORS
			 746.240.
Stat. Auth.: ORS
				  731.244
Stats. Implemented: ORS
				  746.240
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0100 - Statutory Authority and Purpose

Current through Register Vol. 63, No. 7, July 1, 2024
OAR 836-042-0100  to 836-042-0115  are adopted under the
				Director's authority in ORS
				737.325(1) to
				modify filing requirements for insurers offering to classes of risks Large Risk
				Alternative Rating Plans which include workers' compensation.
Stat. Auth.: ORS
				  731.244 &
				  737.325(1)
Stats. Implemented: ORS 737,
				  737.310,
				  737.320 &
				  737.325(1)
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0105 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
As used in OAR 836-042-0100  to 836-042-0115:
(1) "Affiliate Insurer" means an insurer that
			 directly or indirectly through one or more intermediaries, controls, or is
			 controlled by, or is under common control with, the insurer specified where
			 control is defined by ORS
			 732.548(2).
(2) "Director" means the Director of the
			 Department of Consumer and Business Services.
(3) "Eligible Employer" means:
(a) An employer defined by ORS
			 656.005(13)
			 with:
(A) An insurer estimated annual
			 countrywide Workers' Compensation standard premium in excess of $500,000;
			 or
(B) An insurer estimated annual
			 countrywide premium in excess of $750,000 in combination with General
			 Liability, Automobile Liability, Hospital Professional Liability, Crime and
			 Glass, and Workers' Compensation provided Workers' Compensation countrywide
			 standard premium is in excess of $500,000.
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0110 - Rate Filing Requirements

Current through Register Vol. 63, No. 7, July 1, 2024
The Director may approve retrospective rating plans and large
				deductible rating plans as mutually agreed upon between insurer and eligible
				employer under the following conditions:
(1) The rating plan is filed with director
			 according to ORS 737.205,
			 737.310, and
			 737.320 containing rules
			 indicating the manner in which the rate is promulgated and how the resultant
			 premium is derived;
(2) The rating
			 plans which include large deductible options must comply with OAR 836-042-0070  to 836-042-0090  and 836-054-0201  to 836-054-0210;
(3) The insurer demonstrates rating plan
			 compliance with all workers' compensation financial and statistical reporting
			 as required by OAR 836-042-0040  to 836-042-0045;
(4) The use of the Large Risk Alternative
			 Rating Plans is an independent option and is not a substitute for, nor
			 incompatible with, Manual Rating, Experience Rating, Loss Rating, rating under
			 Loss Reimbursement or Deductible Plans, or any individual-risk rating rule
			 permitted by Oregon law; and
(5)
			 The insurer maintains documentation supporting the eligible employer's Large
			 Risk Alternative Rating Plan sufficient for examination under ORS
			 737.235.
Stat. Auth.: ORS
				  731.244 &
				  737.325(1)
Stats. Implemented: ORS 737,
				  737.205,
				  737.310,
				  737.320 &
				  737.325(1)
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0115 - Trade Practices Found Injurious to the Insurance Buying Public

Current through Register Vol. 63, No. 7, July 1, 2024
Failure of an insurer to comply with OAR 836-042-0110 constitutes an unfair claims practice under ORS
				746.240.
Stat. Auth.: ORS
				  731.244 &
				  737.325(1)
Stats. Implemented: ORS
				  746.240
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0201 - Statutory Authority; Purpose; Effective Date

Current through Register Vol. 63, No. 7, July 1, 2024
(1) OAR 836-042-0201  to 836-042-0225  are
			 adopted under the general rulemaking authority of the Insurance Commissioner in
			 ORS 731.244 and the specific
			 authority relating to workers' compensation insurance rating groups in ORS
			 737.316.
(2) The purpose of OAR 836-042-0201  to
			 836-042-0225  is to provide an orderly procedure for insurers to combine the
			 workers' compensation insurance experience of a group of employers for rating
			 purposes.
(3) OAR 836-042-0201  to
			 836-042-0225  become effective October 14, 1983.
Stat. Auth.: ORS
				  731.244 & ORS
				  737.316
Stats. Implemented: ORS
				  737.316
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0205 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
As used in OAR 836-042-0201  to 836-042-0225  unless the context
				requires otherwise:
(1) "Anniversary
			 Rating Date" means the month and day that a rating plan is initially applied to
			 a policy and each annual anniversary thereafter, unless a different date is
			 established by the rating organization to which the insurer belongs.
(2) "Combined Experience" means the sum of
			 workers' compensation insurance premium, claims, and payroll or other exposure
			 measures used by an insurer to rate individual members of a group of employers.
			 Data from all members of the group are included in the sum without further
			 modification or adjustment.
(3)
			 "Experience Rating" means any prospective modification of workers' compensation
			 insurance premium based on previous workers' compensation experience data for
			 an individual employer or a group of employers.
(4) "Group Anniversary Rating Date" means the
			 month and day the combined experience of a group of employers is initially used
			 to rate individual members of the group and each annual anniversary thereafter,
			 unless a different date is established with the approval of the Insurance
			 Commissioner.
(5) "Insurer" means
			 any person authorized to write workers' compensation insurance in this state
			 and includes the State Accident Insurance Fund Corporation.
(6) "Modification Factor" means the numerical
			 result of an experience rating calculation. Insurance premiums are multiplied
			 by this number to adjust for past experience of an employer or a group of
			 employers.
(7) "Premium" means the
			 contractual amount charged to an insured for insurance for a specific period of
			 time, regardless of the timing of actual charges.
(8) "Premium Discounting" means the
			 modification of workers' compensation insurance premium according to a rating
			 plan used by an insurer based solely upon a gradation of expense provisions
			 according to the amount of premium.
(9) "Rating Plan" means any set of rules and
			 values filed with the Insurance Commissioner and used by an insurer to
			 calculate premiums.
(10)
			 "Retrospective Rating" means adjustment of workers' compensation insurance
			 premium for the policies of a group of employers after the policies have
			 expired using the combined experience from those policies according to the
			 insurer's rating plan.
(11)
			 "Workers' Compensation Insurance" means insurance covering the obligations of
			 an employer arising from workers' illness or injury, whether an obligation is
			 imposed by ORS Chapter 656, similar laws of the United States, or agreements
			 between states.
Stat. Auth.: ORS
				  731.244 & ORS
				  737.316
Stats. Implemented: ORS
				  737.316
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0215 - Consent to Group Rating Required Before Policy Issuance; Provision Required in Consent Form; Contents of Consent Form

Current through Register Vol. 63, No. 7, July 1, 2024
(1) An insurer intending to combine the
			 experience of a group of employers for rating purposes may not issue a policy
			 to a member of the group unless it has secured a signed consent to group rating
			 from each group member.
(2) The
			 form used by the insurer to secure consent to group rating must be approved by
			 the Director. The form must include the following wording, or substantially
			 equivalent wording approved by the Director: "The premium you must pay for this
			 insurance will be determined in part by the consolidated experience of all
			 members of the group in which you participate."
(3) The consent to group rating form must
			 include the following:
(a) Name and address
			 of the group member;
(b) Name,
			 title and signature of the person giving consent;
(c) Name and nature of the organization to
			 which employers in the group belong;
(d) Specific description of how the combined
			 experience of the group will be used for rating the group member; and
(e) The period covered by policies to be used
			 for deriving the combined experience of group members.
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0220 - Filing Requirements and Procedural Rules

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Before issuing any policies to group
			 members that are to be rated by the combined experience of the group:
(a) The insurer must file the following with
			 the Director for each group:
(A) The name and
			 nature of the organization to which employers in the group belong;
(B) A copy of documentation forming the
			 organization;
(C) The number of
			 employers in the organization;
(D)
			 The number of covered workers employed by employers that have signed
			 consent-to-group-rating forms;
(E)
			 An explanation of how the grouping of employers is likely to improve accident
			 prevention and claims handling and reduce expenses;
(F) A specific description of how the
			 combined experience of the group will be used for rating group members;
			 and
(G) The initial group
			 anniversary rating date; and
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0225 - Criteria for Grouping; Criteria for Substantially Similar Occupations Within Organization; Open Enrollment Required

Current through Register Vol. 63, No. 7, July 1, 2024
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.
Stat. Auth.: ORS
				  731.244 & ORS
				  737.316
Stats. Implemented: ORS
				  737.316
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0300 - Statutory Authority; Purpose; Applicability; Effective Date

Current through Register Vol. 63, No. 7, July 1, 2024
(1) OAR 836-42-300
			 to 836-042-0322  are adopted under the specific authority of the Insurance
			 Commissioner in ORS 737.346, 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 737.346.
(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 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: The publication(s) referred to or incorporated
				  by reference in this rule are available from the
				  agency.
Stat. Auth.: ORS
				  731.244 & ORS
				  737.346
Stats. Implemented: ORS
				  737.346
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0302 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
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.
Stat. Auth.: ORS
				  731.244 & ORS
				  737.346
Stats. Implemented: ORS
				  737.346
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0304 - Fictitious Arrangement Prohibited

Current through Register Vol. 63, No. 7, July 1, 2024
(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 737.346(3)(d).
Stat. Auth.: ORS 731
Stats. Implemented: ORS
				  737.346(3)(d)
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0306 - Premium Rates

Current through Register Vol. 63, No. 7, July 1, 2024
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: The publication(s) referred to or incorporated
				  by reference in this rule are available from the
				  agency.
Stat. Auth.: ORS 731
Stats. Implemented: ORS
				  737.346(3)(d)
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0308 - Statistics

Current through Register Vol. 63, No. 7, July 1, 2024
An insurer selling insurance under mass marketing plans shall
				maintain separate relevant statistics as to loss and expense
				experience.
Stat. Auth.: ORS 731
Stats. Implemented: ORS
				  737.346(3)(d)
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0310 - Producers

Current through Register Vol. 63, No. 7, July 1, 2024
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.
Stat. Auth.: ORS 731 & 744
Stats. Implemented: ORS
				  737.346(3)(d)
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0312 - Compulsory Participation Prohibited

Current through Register Vol. 63, No. 7, July 1, 2024
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.
Stat. Auth.: ORS 731
Stats. Implemented: ORS
				  737.346(3)(d)
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0314 - Tie-In Sales Prohibited

Current through Register Vol. 63, No. 7, July 1, 2024
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.
Stat. Auth.: ORS 731
Stats. Implemented: ORS
				  737.346(3)(d)
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0316 - Disclosure Required

Current through Register Vol. 63, No. 7, July 1, 2024
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.
Stat. Auth.: ORS 731
Stats. Implemented: ORS
				  737.346(3)(d)
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0318 - Underwriting Standards

Current through Register Vol. 63, No. 7, July 1, 2024
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.
Stat. Auth.: ORS 731
Stats. Implemented: ORS
				  737.346(3)(d)
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0320 - Cancellation and Non-Renewal

Current through Register Vol. 63, No. 7, July 1, 2024
(1) For
			 purposes of
Sections
			 743.905
and
743.916
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: The publication(s) referred to or incorporated
				  by reference in this rule are available from the
				  agency.
Stat. Auth.: ORS 731
Stats. Implemented: ORS
				  737.346(3)(d)
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0322 - Compulsory Facilities

Current through Register Vol. 63, No. 7, July 1, 2024
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.
Stat. Auth.: ORS 731
Stats. Implemented: ORS
				  737.346(3)(d)
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0400 - Statutory Authority; Purpose; Applicability; Effective Date

Current through Register Vol. 63, No. 7, July 1, 2024
(1) OAR
			 836-042-0400  to 836-042-0430  are adopted under the authority of ORS
			 737.346.
(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 737.346(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
			 737.346(3)(g).
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0405 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
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
			 737.346(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.
Stat. Auth.: ORS 731 & 737
Stats. Implemented: ORS
				  737.346(3)(f)-(g)
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0410 - Commercial Risks; Prohibition; Requirements; Filing

Current through Register Vol. 63, No. 7, July 1, 2024
(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
			 737.346(3)(f).
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0415 - Day Care Facilities; Prohibition; Requirements; Filing

Current through Register Vol. 63, No. 7, July 1, 2024
(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.
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0420 - Anniversary Filings

Current through Register Vol. 63, No. 7, July 1, 2024
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.
Stat. Auth.: ORS 731 & ORS 737
Stats. Implemented: ORS
				  737.346(3)(f) -
				  ORS 737.346(3)(g)
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0425 - Statistics

Current through Register Vol. 63, No. 7, July 1, 2024
(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.
Stat. Auth.: ORS 731 & 737
Stats. Implemented: ORS
				  737.346(3)(f)-(g)
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0430 - Disclosure Required for Day Care Facilities

Current through Register Vol. 63, No. 7, July 1, 2024
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.
Stat. Auth.: ORS 731 & ORS 737
Stats. Implemented: ORS
				  737.346(3)(g)
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0501 - Statutory Authority; Purpose; Applicability; Effective Date

Current through Register Vol. 63, No. 7, July 1, 2024
(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.
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0505 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
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.
Stat. Auth.: ORS 731 & ORS 737
Stats. Implemented: ORS
				  737.207(2)
				  & ORS 737.320(6)
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0510 - Rates, Rating Plans System - Prior Review

Current through Register Vol. 63, No. 7, July 1, 2024
(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.
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0512 - Specified Commercial Liability Markets

Current through Register Vol. 63, No. 7, July 1, 2024
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.
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0515 - Commercial Liability Filings - Procedural Rules for Insurers and Rating Organizations

Current through Register Vol. 63, No. 7, July 1, 2024
(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.
Stat. Auth.: ORS 731 & 737
Stats. Implemented: ORS
				  737.207(3)
				  & 737.320(6)
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 42 - RATES AND RATEMAKING › Section 836-042-0520 - Supporting Data

Current through Register Vol. 63, No. 7, July 1, 2024
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.
Stat. Auth.: ORS 731 & ORS 737
Stats. Implemented: ORS
				  737.207(4)
				  & ORS 737.320(6)
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 43 - WORKERS'COMPENSATION INSURANCE RATING SYSTEM AND AUDIT PROCEDURES › Section 836-043-0001 - Statutory Authority; Purpose

Current through Register Vol. 63, No. 7, July 1, 2024
(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.
Stat. Auth.: ORS
				  656.427, ORS
				  656.730 & ORS
				  731.244
Stats. Implemented: ORS
				  656.427, ORS
				  656.730 & ORS
				  737.265
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 43 - WORKERS'COMPENSATION INSURANCE RATING SYSTEM AND AUDIT PROCEDURES › Section 836-043-0009 - Participation by Insurers and Insurance Producers

Current through Register Vol. 63, No. 7, July 1, 2024
(1) All insurers authorized to transact
			 workers' compensation insurance in Oregon are required to participate in the
			 Plan and subscribe to the organizing principles for Oregon.
(2) Failure of an insurer to comply with the
			 Plan is grounds for revocation of the insurer's certificate of authority to
			 transact workers' compensation insurance.
(3) Each insurance producer who is authorized
			 to transact the class of property and casualty insurance is authorized to
			 transact workers' compensation insurance offered by the Plan. The Director of
			 the Department of Consumer and Business Services may terminate a producer's
			 authority under this section for cause.
(4) An insurer may terminate participation in
			 this Plan as of the close of the calendar year in which its authority to write
			 workers' compensation is terminated. With respect to all policies in force on
			 the effective date of an insurer's termination, the liability of the
			 terminating insurer will cease on the succeeding anniversary date of each such
			 policy. Termination of participation does not discharge or otherwise affect
			 liabilities incurred prior to the anniversary date of such policies, and the
			 insurer will be charged or credited in due course with the insurer's proper
			 share of all expenses, losses, and profits allocable thereof.
(5) All insurers participating in the Plan
			 through the Reinsurance Agreements provided for in the organizing principles
			 shall share in the writings, expenses, servicing allowance and losses. Each
			 insurer's participation in the Plan shall:
(a)
			 Be in the proportion that the total net premiums of all members participating
			 in the Plan in Oregon during the preceding calendar years bear to the aggregate
			 direct premiums written in Oregon during the preceding calendar years by all
			 insurers participating through the Reinsurance Agreements;
(b) Except as provided in OAR
			 836-043-0017(2)(k), exclude that portion of the premiums attributable to the
			 operation of the Plan; and
(c) Be
			 determined on the basis of the direct premiums as reported in the most recent
			 annual reports filed with the regulatory authority.