reglab/statecodes huggingface dataset:
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 85 - PRACTICES INJURIOUS TO PUBLIC OR FREE COMPETITION › Section 836-085-0035 - Cancellation or Nonrenewal Notice

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 If a risk sharing plan exists under ORS Chapter 735 for the kind of coverage
			 cancelled or nonrenewed, notice of cancellation or nonrenewal required under
			 OAR 836-085-0010(2)  is not effective unless the notice contains adequate
			 instructions to the policyholder and if one exists, the insurance producer for
			 applying for insurance through a risk sharing plan under ORS Chapter
			 735.
(2) Adequate instructions
			 under section (1) of this rule must direct the policyholder to the agent of the
			 notifying insurer for assistance or, if no agent exists, must provide that the
			 insurer will directly assist in submission of the application.
Stat. Auth.: ORS 731
Stats. Implemented: ORS
				  746.045,
				  746.055,
				  746.160(3)
				  & 746.240
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 85 - PRACTICES INJURIOUS TO PUBLIC OR FREE COMPETITION › Section 836-085-0040 - Cancellation for Nonpayment of Premium

Current through Register Vol. 63, No. 7, July 1, 2024
OAR 836-085-0035  does not apply if the ground for cancellation
				or nonrenewal is nonpayment of the premium and if the notice so
				states.
Stat. Auth.: ORS 731
Stats. Implemented: ORS
				  746.045, ORS
				  746.055, ORS
				  746.160(3)
				  & ORS 746.240
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 85 - PRACTICES INJURIOUS TO PUBLIC OR FREE COMPETITION › Section 836-085-0045 - Unfair Trade Practices

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 Failure of an insurer to comply with OAR 836-085-0010  to 836-085-0050  constitutes an unfair trade practice under ORS
			 746.240.
(2) Midterm premium increase or a policy
			 coverage reduction attempted or executed in nonconformance with ORS
			 737.330 or
			 743.006 constitutes an unfair
			 trade practice under 746.240.
(3) Block Cancellations or Nonrenewals of
			 entire lines of insurance or withdrawal of classes of business are presumed to
			 be unfairly discriminatory and constitute an unfair trade practice under ORS
			 746.240, unless prior
			 authorization is received.
(4)
			 Termination of an appointed insurance producer, or an attempt of such
			 termination, solely to achieve block cancellation or nonrenewal of entire lines
			 of insurance or other such instant reunderwriting of an insurance producer book
			 of business shall be presumed to constitute an unfair trade practice under ORS
			 746.240 an unfair trade practice
			 detrimental to free competition under
			 746.160.
(5) Any nonrenewal will be expected to be for
			 justifiable cause; and:
(a) Inability to
			 substantiate justifiable cause for nonrenewal will be subject to Insurance
			 Division review; and
(b)
			 Unjustified nonrenewals of such frequency as to indicate a general business
			 practice shall be presumed to constitute an unfair trade practice under ORS
			 746.240.
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 85 - PRACTICES INJURIOUS TO PUBLIC OR FREE COMPETITION › Section 836-085-0050 - Proof of Notice

Current through Register Vol. 63, No. 7, July 1, 2024
A post office certificate of mailing to the named insured at
				the named insured's last-known address shall constitute conclusive proof that
				the named insured received the notice of cancellation or nonrenewal on the
				third calendar day after the date of the certificate of
				mailing.
Stat. Auth.: ORS 731
Stats. Implemented: ORS
				  746.045, ORS
				  746.055, ORS
				  746.160(3)
				  & ORS 746.240
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 85 - PRACTICES INJURIOUS TO PUBLIC OR FREE COMPETITION › Section 836-085-0055 - Cancellation and Renewal of Commercial Package Policies

Current through Register Vol. 63, No. 7, July 1, 2024
(1) A commercial package policy that includes
			 commercial liability insurance coverage is subject to ORS
			 742.702 (Grounds for cancellation) and ORS
			 742.706(Renewal),
			 governing the cancellation and renewal of commercial liability insurance
			 policies. For purposes of this rule, "commercial liability insurance" has the
			 meaning given that term in ORS
			 731.074 ("Commercial liability insurance").
(2) An insurer may cancel a commercial
			 package policy that includes commercial liability insurance if:
(a) At least 10 working days prior written or
			 electronic notice is given for non-payment of premium; or
(b) At least 30 days prior written or
			 electronic notice is given for any other statutorily permitted
			 reason.
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 85 - PRACTICES INJURIOUS TO PUBLIC OR FREE COMPETITION › Section 836-085-0201 - Statutory Authority; Purpose; Applicability

Current through Register Vol. 63, No. 7, July 1, 2024
(1) OAR 836-085-0201  to 836-085-0230  are
			 adopted pursuant to the specific authority of
			 737.322, and the general
			 rulemaking authority of the Director in ORS
			 731.244, to carry out ORS
			 746.240 and the orderly
			 administration of ORS Chapter 737 with respect to the workers' compensation
			 experience rating system and its supporting statistical plan.
(2) The purpose of OAR 836-085-0201  to
			 836-085-0230  is to amend the authorized workers' compensation experience rating
			 system for timely apprising insured employers of their premium modification
			 factors so the employers can make necessary adjustments in the cost of goods or
			 services sold.
(3) OAR 836-085-0201  to 836-085-0230  apply to all workers' compensation policies delivered or issued
			 for delivery to employers in this state.
Stat. Auth.: ORS 731 & 737
Stats. Implemented: ORS
				  737.322(2)
				  & 746.240
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 85 - PRACTICES INJURIOUS TO PUBLIC OR FREE COMPETITION › Section 836-085-0205 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
As used in OAR 836-085-0201  to 836-085-0230, unless the context
				requires otherwise:
(1) "Experience
			 Rating" means the prospective modification of a workers' compensation insurance
			 premium according to the
Experience Rating Plan Manual
of the
			 National Council on Compensation Insurance filed with the Director, or an
			 alternative plan otherwise authorized pursuant to OAR
			 836-042-0015(6)(b).
(2) "Insurer"
			 means any person authorized to write workers' compensation insurance in this
			 state and includes the State Accident Insurance Fund Corporation.
(3) "Modification Factor" means the numerical
			 result of an experience rating calculation.
(4) "Normal Anniversary Rating Date" means
			 the date the rates and experience rating modification for an individual
			 employer changes, as established by the rating organization.
(5) "Premium" means the contractual amount
			 charged to an insured for insurance for a specified period of time, regardless
			 of the timing of actual charges.
(6) "Rating Plan" means any set of rules and
			 values filed with the Director of the Department of Insurance and Finance and
			 used by an insurer to calculate premiums.
(7) "Statistical Plan" means the uniform
			 statistical plan for workers' compensation insurance statistics as prescribed
			 by OAR 836-042-0045.
(8) "Tentative
			 Experience Modification Endorsement" is the form of prior notice to the
			 employer of the tentative modification factor calculation by the insurer for
			 use in policy issuance.
(9)
			 "Workers' Compensation Insurance" means insurance providing coverage for the
			 obligation of an employer arising from illness or injury to workers whether
			 such obligation is imposed by ORS Chapter 656 of this state, similar laws of
			 the United States or agreements between states.
Publications: The publication(s) referred to or incorporated
				  by reference in this rule are available from the
				  agency.
Stat. Auth.: ORS 731 & ORS 737
Stats. Implemented: ORS
				  737.322(2)
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 85 - PRACTICES INJURIOUS TO PUBLIC OR FREE COMPETITION › Section 836-085-0210 - Adjustment for Experience of Employer; Calculation of Tentative Modification Factors

Current through Register Vol. 63, No. 7, July 1, 2024
For purposes of OAR 836-085-0201  to 836-085-0230:
(1) An insurer shall adjust for experience of
			 an employer by multiplying the insurance premium by the modification
			 factor.
(2) An insurer shall
			 calculate tentative modification factors in accordance with experience data
			 known or discoverable by the insurer and in accordance with the provisions and
			 formulas of the experience rating plan authorized by OAR
			 836-042-0015(6).
Stat. Auth.: ORS 731 & ORS 737
Stats. Implemented: ORS
				  737.322(2)
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 85 - PRACTICES INJURIOUS TO PUBLIC OR FREE COMPETITION › Section 836-085-0217 - Employer Failure to Cooperate; Appeal

Current through Register Vol. 63, No. 7, July 1, 2024
(1) As provided in this rule, sections (2)
			 and (3) of OAR 836-085-0215  do not apply if the rating organization is unable
			 to calculate the modification factor for an insured employer because the
			 employer has failed to cooperate in audits or because of other material fault
			 attributable to the employer or an agent of the employer.
(2) An employer may appeal application of
			 experience modification factors under section (1) of this rule by applying to
			 the Administrator of the Insurance Division for a hearing not later than the
			 30th day after the insurer notifies the employer that the insure intends to
			 apply the factors because of the employer's noncooperation or other material
			 fault. The Administrator shall hold a hearing on the appeal as provided in ORS
			 737.505, and may affirm or deny
			 the appeal.
(3) An appeal under
			 section (2) of this rule shall stay the application of the experience
			 modification factors under section (1) of this rule.
Stat. Auth.: ORS 731 & ORS 737
Stats. Implemented: ORS
				  737.322(2)
				  & ORS 746.240
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 85 - PRACTICES INJURIOUS TO PUBLIC OR FREE COMPETITION › Section 836-085-0225 - Unfair Trade Practices

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 Retroactive application of experience rating modification factors in any manner
			 other than provided for in OAR 836-085-0215  constitutes an unfair trade
			 practice under ORS 746.240.
(2) Failure of an insurer or rating
			 organization to comply with the statistical reporting requirements of OAR
			 836-042-0045  constitutes an unfair trade practice under ORS
			 746.240.
Stat. Auth.: ORS 731 & ORS 737
Stats. Implemented: ORS
				  737.322(2)
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 85 - PRACTICES INJURIOUS TO PUBLIC OR FREE COMPETITION › Section 836-085-0230 - Penalties for Late Submission of Rating Data

Current through Register Vol. 63, No. 7, July 1, 2024
(1) When the Director imposes a civil penalty
			 for violation of OAR 836-042-0045, the civil penalty shall be not less than
			 $100 for each failure by the insurer to submit the data on the date that the
			 submission of data is due. The Director may increase the civil penalty by $100
			 with respect to each such failure for each 30-day period following the due date
			 in which the insurer continues the failure to submit the data.
(2) With respect to each calendar month in
			 which an insurer has failed to submit data, for all failures by the insurer to
			 submit data during that month, including continuing failures, the Director
			 shall not impose civil penalties under section (1) of this rule that exceed
			 $10,000 in the aggregate.
(3)
			 Failure by an insurer to submit data for an individual employer after
			 imposition of civil penalty under section (1) of this rule may result in
			 suspension of the insurer's certificate of authority.
Stat. Auth.: ORS 731 & ORS 737
Stats. Implemented: ORS
				  737.322(2)
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 100 - HEALTH INSURANCE REFORM › Section 836-100-0100 - Authority; Purpose; Scope

Current through Register Vol. 63, No. 7, July 1, 2024
(1) OAR
			 836-100-0100  to 836-100-0120  are adopted by the Director of the Department of
			 Consumer and Business Services pursuant to section 2, chapter 130, Oregon Laws
			 2011 (Enrolled Senate Bill 94). The purpose of OAR 836-100-0100  to 836-100-0120  is to establish the uniform administrative standards that health insurers and
			 health care entities are required to comply with under section 2, chapter 130,
			 Oregon Laws 2011 (Enrolled Senate Bill 94). The uniform standards have been
			 developed by the Office for Oregon Health Policy and Research in consultation
			 with stakeholders pursuant to section 3, chapter 130, Oregon Laws 2011
			 (Enrolled Senate Bill 94).
(2) The
			 uniform standards adopted under OAR 836-100-0100  to 836-100-0120  apply to all
			 health insurers and health care entities in Oregon as specified in each
			 companion guide.
Stat. Auth.: ORS
				  731.244 & 2011 OL Ch. 130
				  Sec. 2 (Enrolled SB 94)
Stats. Implemented: 2011 OL Ch. 130 Sec. 2 (Enrolled SB
				  94)
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 100 - HEALTH INSURANCE REFORM › Section 836-100-0105 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
(1) "Electronic
			 transaction" means to conduct a transaction:
(a) Through the use of a computer program or
			 an electronic or other automated means independently to initiate an action or
			 respond to electronic records or performances in whole or in part, without
			 review or action by an individual; or
(b) Through the use of a web portal or the
			 internet.
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 100 - HEALTH INSURANCE REFORM › Section 836-100-0110 - Adoption of Standards

Current through Register Vol. 63, No. 7, July 1, 2024
(1) All
			 health insurers and health care entities must conduct eligibility benefit
			 inquiry and response transactions with health care providers as electronic
			 transactions that conform to the uniform standards developed by the Office for
			 Oregon Health Policy and Research pursuant to section 3, chapter 130, Oregon
			 Laws 2011 (Enrolled Senate Bill 94) as set forth in the Oregon Companion Guide
			 for Health Care Eligibility Benefit Inquiry and Response in accordance with the
			 following schedule:
(a) On and after January
			 1, 2012 for those health care providers that submit the inquiry electronically
			 on the effective date of these rules.
(b) On and after October 1, 2012, for all
			 inquiries from all health care providers.
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 100 - HEALTH INSURANCE REFORM › Section 836-100-0115 - Waiver

Current through Register Vol. 63, No. 7, July 1, 2024
(1) If a health
			 insurer or health care entity demonstrates that the insurer or entity is
			 certified by the Council for Affordable Quality Healthcare's (CAQH) Committee
			 on Operating Rules for Information Exchange (CORE), the Director of the
			 Department of Consumer and Business Services shall grant a waiver from the
			 requirement to comply with the Oregon Companion Guide. A health insurer or
			 health care entity granted a waiver under this subsection shall be deemed in
			 compliance with the standards of the applicable Oregon Companion
			 Guide.
(2) Until January 1, 2014,
			 the Director of the Department of Consumer and Business Services may grant a
			 waiver to a health insurer or health care entity subject to OAR 836-100-0110  that demonstrates that the health insurer or health care entity is unable to
			 comply with its provisions, or for whom compliance would be an undue hardship.
			 A health insurer or health care entity requesting a waiver must submit a letter
			 of need to the director. If the health insurer or health care entity requires
			 an extension of the waiver, the health insurer or health care entity may apply
			 to the Director of the Department of Consumer and Business Services for a
			 temporary waiver of some or all of the provisions of the applicable Oregon
			 Companion Guide. The waiver request must:
(a)
			 Specify the name of the Oregon Companion Guide for which the waiver is
			 requested;
(b) Indicate whether the
			 waiver is for the entire Oregon Companion Guide or for specific provisions in
			 the Oregon Companion Guide for which a waiver is requested.
(c) Explain the reasons the health insurer or
			 health care entity is unable to comply or for which compliance would cause
			 undue hardship, including systemic or structural impediments, financial
			 hardship, and any other factors the health insurer or health care entity
			 believes pertinent to the request.
(d) Specify the period of time for which the
			 waiver is requested. After January 1, 2014, an insurer or health care entity
			 may not request a waiver for a period longer than twelve months. An insurer or
			 entity may request a waiver for an additional twelve months as previous waivers
			 lapse.
(e) Include the insurer's or
			 entity's plan for coming into compliance with the provisions of OAR
			 836-100-0110  during the time granted by the waiver.
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 100 - HEALTH INSURANCE REFORM › Section 836-100-0120 - Review and Update of Standards

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The Department of Consumer and Business
			 Services and the Oregon Health Authority shall jointly appoint an Oregon
			 Companion Guide Oversight Committee. The members appointed to the committee
			 must demonstrate knowledge of the transactions subject to the Oregon Companion
			 Guides, financial knowledge, operational industry or business expertise, or
			 knowledge of the technology necessary to implement the requirements of the
			 companion guides.
(2) The Oregon
			 Companion Guide Oversight Committee shall meet as needed to review the
			 implementation of the administrative standards encompassed by the Oregon
			 Companion Guides. The committee shall address issues identified by the
			 Department of Consumer and Business Services and the Oregon Health Authority,
			 including but not limited to:
(a) Consider and
			 make recommendations to Oregon Health Authority and Department of Consumer and
			 Business Services about needed changes to the guides in order to keep the guide
			 up to date with industry and federal government driven changes.
(b) Provide reports to Department of Consumer
			 and Business Services and Oregon Health Authority regarding health insurer and
			 provider participation, successes and areas for improvement.
(c) Review any proposed changes developed by
			 Oregon Health Authority to the standards or companion guides.
(d) Review any proposed changes developed by
			 Department of Consumer and Business Services to the rules requiring compliance
			 with the companion guides.
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 150 - OREGON REINSURANCE PROGRAM › Section 836-150-0010 - Purpose and Statutory Authority

Current through Register Vol. 63, No. 7, July 1, 2024
The purpose of OAR 836-150-0010  to 836-150-0060  is to
				administer the Oregon Reinsurance Program established in the Department of
				Consumer and Business Services for the purposes of stabilizing the rates and
				premiums for individual health benefit plans and providing greater financial
				certainty to consumers of health insurance in this state.
Statutory/Other Authority: ORS
				  731.244 & 2017 Or Laws
				  ch 538 sec 19
Statutes/Other Implemented: 2017 Or Laws ch 538 sec
				  18-21
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 150 - OREGON REINSURANCE PROGRAM › Section 836-150-0020 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
The terms used in OAR 836-150-0010  to 836-150-0060  have the
				meaning prescribed in section 19, chapter 538, Oregon Laws 2017 (Enrolled House
				Bill 2391) and:
(1) "Benefit year"
			 means a calendar year beginning on or after January 1, 2018 for which a
			 reinsurance eligible health benefit plan provides health insurance
			 coverage.
(2) "Department" means
			 the Oregon Department of Consumer and Business Services.
(3) "Reinsurance eligible claim" means a
			 claim for services covered under a reinsurance eligible health benefit plan
			 that is incurred by a reinsurance eligible issuer during a benefit year and
			 paid by the reinsurance eligible issuer before July 1 of the following
			 year.
(4) "Reinsurance eligible
			 issuer" means an insurer or health care service contractor who offers a
			 reinsurance eligible health benefit plan to reinsurance eligible
			 individuals.
(5) "Reinsurance
			 payment" means payments issued to a reinsurance eligible issuer in accordance
			 with section 2(3), chapter 538 Oregon Laws 2017 (Enrolled House Bill 2391) and
			 OAR 836-150-0050.
Statutory/Other Authority: ORS
				  731.244 & 2017 Or Laws
				  ch 538 sec 19
Statutes/Other Implemented: 2017 Or Laws ch 538 sec
				  18-21
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 150 - OREGON REINSURANCE PROGRAM › Section 836-150-0030 - Information Reporting

Current through Register Vol. 63, No. 7, July 1, 2024
(1) As a
			 condition of receiving reinsurance payments from the Oregon Reinsurance
			 Program, a reinsurance eligible issuer must provide, for each benefit year, the
			 following information to the department in the form and manner prescribed by
			 the department:
(a) The name and company code
			 assigned to the reinsurance eligible issuer by the National Association of
			 Insurance Commissioners;
(b) The
			 identification number assigned to the reinsurance eligible issuer by the Health
			 Insurance Oversight System (HIOS);
(c) The total amount of the reinsurance
			 eligible issuer's reinsurance eligible claims for the benefit year;
(d) The portion of the reinsurance eligible
			 issuer's total reinsurance eligible claims for the benefit year that fall
			 between the attachment point and reinsurance cap;
(e) A summary data file containing the
			 following information for each reinsurance eligible individual with claims for
			 which reinsurance payments are being requested:
(A) The member identification number assigned
			 by the reinsurance eligible issuer to the reinsurance eligible
			 individual;
(B) The start and end
			 dates of coverage for the reinsurance eligible individual;
(C) The HIOS plan identification number for
			 the reinsurance eligible health benefit plan in which the reinsurance eligible
			 individual was enrolled;
(D) The
			 total amount of reinsurance eligible claims for the reinsurance eligible
			 individual for the benefit year; and
(E) The total amount of reinsurance eligible
			 claims for the reinsurance eligible individual for the benefit year that fall
			 between the attachment point and reinsurance cap;
(f) A detailed claims file extracted from the
			 reinsurance eligible issuer's claims processing system that includes the
			 issuer's complete record of all reinsurance eligible claims for the benefit
			 year;
(g) An attestation signed by
			 an executive officer of the reinsurance eligible issuer stating that the
			 information is accurate as of the date of submission; and
(h) Any other information requested by the
			 department.
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 150 - OREGON REINSURANCE PROGRAM › Section 836-150-0040 - Reinsurance Parameters

Current through Register Vol. 63, No. 7, July 1, 2024
(1) For
			 the benefit year beginning on January 1, 2020 the parameters for the Oregon
			 Reinsurance Program are:
(a) An attachment
			 point of $90,000;
(b) A reinsurance
			 cap of $1,000,000; and
(c) A
			 coinsurance rate of fifty percent.
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 150 - OREGON REINSURANCE PROGRAM › Section 836-150-0050 - Reinsurance Payments

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The
			 department will calculate the total reinsurance payment owed to each
			 reinsurance eligible issuer.
(a) Subject to
			 paragraph (b) and (c) of this rule, the reinsurance payment made to each
			 reinsurance eligible issuer for a benefit year will be the product of the
			 coinsurance rate and the portion of the reinsurance eligible issuer's total
			 reinsurance eligible claims for the benefit year that fall between the
			 attachment point and the reinsurance cap.
(b) If the total reinsurance payments
			 calculated under paragraph (a) of this rule would exceed the total dollar
			 amount budgeted for the reinsurance program in a benefit year, the department
			 may uniformly reduce the coinsurance rate for all reinsurance eligible issuers
			 in that benefit year. If the department elects to reduce the coinsurance rate
			 under this paragraph, the department will reduce the coinsurance rate only to
			 the extent necessary to ensure that reinsurance payments do not exceed the
			 total dollar amount budgeted for the benefit year.
(c) In making the calculation under paragraph
			 (a), the department may disregard any or all reinsurance eligible claims
			 reported by a reinsurance eligible issuer under OAR 836-150-0030  that cannot be
			 verified as part of the audit described under OAR 836-150-0060(1).
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 150 - OREGON REINSURANCE PROGRAM › Section 836-150-0060 - Duties of the Administrator

Current through Register Vol. 63, No. 7, July 1, 2024
As administrator of the Oregon Reinsurance program, the
				department will:
(1) Conduct an audit
			 of the information submitted under 836-150-0030.
(2) Notify reinsurance eligible issuers of
			 the results of the calculation described under 836-150-0050, including any
			 modifications of the coinsurance rate.
(3) Issue reinsurance payments to each
			 reinsurance eligible issuer in accordance with OAR 836-150-0050.
Statutory/Other Authority: ORS
				  731.244 & 2017 Or Laws
				  ch 538 sec 19
Statutes/Other Implemented: 2017 Or Laws ch 538 sec
				  18-21
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 200 - DEPARTMENT REGULATORY PROGRAMS › Section 836-200-0000 - Statutory Authority; Registration; Fees; Expiration; Renewal

Current through Register Vol. 63, No. 7, July 1, 2024
(1) OAR
			 836-200-0000  to 836-200-0060  are adopted under the authority of ORS
			 646.267 and
			 646.285 for the purpose of
			 implementing ORS 646.263 to
			 646.285.
(2) The fee for filing a registration as an
			 obligor of service contracts is $200. The fee under this section (2) must be
			 included with the filing.
(3) The
			 fee for annual renewal of a registration as an obligor of service contracts is
			 $50.
(4) A registration expires on
			 July 1 unless it is renewed on or before that date. A registrant must renew the
			 registration by submitting the renewal fee to the Director of the Department of
			 Consumer and Business Services.
(5)
			 A registrant shall immediately notify the Director of any change in the
			 information submitted in the registration of the registrant.
(6) ORS
			 646.263 to
			 646.285 and OAR 836-200-0000  to
			 836-200-0060  apply to merchandise and not to real property.
Stat. Auth.: ORS
				  646.267 & ORS
				  646.285
Stats. Implemented: ORS
				  646.263 - ORS
				  646.285
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 200 - DEPARTMENT REGULATORY PROGRAMS › Section 836-200-0010 - Assessments

Current through Register Vol. 63, No. 7, July 1, 2024
(1) An obligor
			 shall pay an annual assessment as required in ORS
			 646.281 in the amount of $75.
			 The amount of the assessment is based on the expected costs of this
			 registration program.
(2)
			 Assessments under section (1) of this rule shall be imposed and collected
			 annually unless the Director determines that additional amounts need to be
			 assessed and collected in order to support the legislatively authorized budget
			 of the Department with respect to its functions under ORS
			 646.263 to
			 646.285 or in order to support
			 changes in the budget authorized by the Emergency Board. The additional amounts
			 shall be assessed as provided in this rule.
(3) The Director shall assess a registrant
			 only if the registrant is authorized to transact service contracts at the time
			 of billing.
(4) A registrant must
			 pay each assessment imposed under this rule not later than the 30th day after
			 the date of the billing of the assessment by the Department. A registrant shall
			 pay interest at nine percent per annum on any assessment that is not paid when
			 due.
(5) In the event the Director
			 determines that an assessment or a part thereof paid by a registrant is in
			 excess of the amount legally due and payable to the Department, if the amount
			 of the refund is less than $50, the Department shall pay the refund only upon
			 receipt of a written request from the registrant. The written request must be
			 received by the Department not later than three years from the date the
			 assessment was paid to the Department.
Stat. Auth.: ORS
				  646.285
Stats. Implemented: ORS
				  646.285
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 200 - DEPARTMENT REGULATORY PROGRAMS › Section 836-200-0020 - Filing Procedures

Current through Register Vol. 63, No. 7, July 1, 2024
(1) An
			 applicant for registration must include proof of financial stability with the
			 registration application. The proof must satisfy applicable requirements of OAR
			 836-200-0030  and 836-200-0040, or ORS
			 646.267(6).
(2) An applicant for registration must file
			 with the Director a copy of the service contract form or forms that the
			 applicant intends to use as a registrant in Oregon.
(3) A registrant must file with the Director
			 all amendments to its service contract form or forms used in Oregon that change
			 any contract term or condition applicable to the contract's use in Oregon, and
			 all new contract forms to be used in Oregon. A registrant need not file any
			 amendment that changes a contract only in graphics or form, and not
			 substantively.
Stat. Auth.: ORS
				  646.267 &
				  646.285
Stats. Implemented: ORS
				  646.263-646.285
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 200 - DEPARTMENT REGULATORY PROGRAMS › Section 836-200-0030 - Form 10 K and Other Financial Stability Filings

Current through Register Vol. 63, No. 7, July 1, 2024
(1) As provided in ORS
			 646.267, a registrant or
			 applicant for registration may submit as proof of financial stability its own
			 most recent Form 10-K that is filed with the Securities and Exchange Commission
			 or, if the obligor's financial statements are consolidated with those of its
			 parent company, may file the most recent Form 10-K of its parent
			 company.
(2) A registrant or
			 applicant for registration that is incorporated in another country may submit
			 as proof of financial stability its own most recent Form 20-F or Form 40-F that
			 is filed with the Securities and Exchange Commissioner, or may file the most
			 recent Form 20-F or Form 40-F of its parent company if the obligor's financial
			 statements are consolidated with those of its parent company, if the Form 20-F
			 or Form 40-F shows a net worth of the obligor or its parent of at least $100
			 million in United States funds.
(3)
			 A registrant or applicant for registration that is incorporated in another
			 country that is a signing party to the North American Free Trade Agreement may
			 submit as proof of financial stability its own most recent filing in its
			 domiciliary country that the Securities and Exchange Commission recognizes as
			 equivalent to the Form 10-K. If the parent company of the registrant or
			 applicant is incorporated in another country that is a signing party to the
			 North American Free Trade Agreement, the registrant or applicant may file the
			 most recent filing by its parent company in the domiciliary country that the
			 Securities and Exchange Commission recognizes as equivalent to the Form 10-K. A
			 filing described in this section (3) is acceptable as proof of financial
			 stability only if the filing shows a net worth of the obligor or its parent of
			 at least $100 million in United States funds.
(4) A registrant or applicant who submits the
			 Form 10-K, Form 20-F or Form 40-F of its parent company, or submits a filing
			 described in section (3) of this rule that is filed by its parent company must
			 include with the filing a statement by the parent company to the effect that:
(a) The company is the parent of the
			 registrant; and
(b) The parent
			 company agrees to guarantee the obligations of the registrant relating to
			 service contracts sold by the obligor in this state.
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 200 - DEPARTMENT REGULATORY PROGRAMS › Section 836-200-0040 - Reimbursement Insurance Policy

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 When an obligor or applicant for registration relies on a reimbursement
			 insurance policy for purposes of the financial stability requirement in ORS
			 646.267, the obligor or
			 applicant must submit a copy of the policy to the Director.
(2) A reimbursement insurance policy insuring
			 service contracts issued, sold or offered for sale in this state shall
			 conspicuously state that, upon failure of the obligor to perform under the
			 contract, the insurer that issued the policy shall pay on behalf of the obligor
			 any sums the obligor is legally obligated to pay or shall provide the service
			 that the obligor is legally obligated to perform according to the obligor's
			 contractual obligations under the service contracts issued by the obligor. The
			 following is an example of wording that will be acceptable for the purpose of
			 this section:
Upon failure of the obligor to perform under the
				contract, _________ (name of insurer issuing policy) shall pay on behalf of the
				obligor any sums the obligor is legally obligated to pay or shall provide the
				service that the obligor is legally obligated to perform according to the
				obligor's contractual obligation under the service contracts issued by the
				obligor, and _________ (insurer) will pay claims against the obligor for return
				of the unearned purchase price of the service contract.
(3) For the purpose of payment
			 under a reimbursement insurance policy, an obligor fails to perform under the
			 service contract when the obligor fails to perform as agreed in the service
			 contract by a date that is not later than the 60th day after the date of the
			 demand for performance or by a date specified in the service contract for
			 performance, whichever date is earlier.
Stat. Auth.: ORS
				  646.267 & ORS
				  646.285
Stats. Implemented: ORS
				  646.263 - ORS
				  646.285
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 200 - DEPARTMENT REGULATORY PROGRAMS › Section 836-200-0050 - Registration Requirements Not Exclusive

Current through Register Vol. 63, No. 7, July 1, 2024
Compliance with the filing requirements of OAR 836-200-0000  to
				836-200-0060  are additional to and not in lieu of filing and other requirements
				established by law for the purpose of doing business in this state, including
				but not limited to compliance with filing requirements of the Secretary of
				State applicable to assumed business names and applicable to the business
				structure of an applicant.
Stat. Auth.: ORS
				  646.267 & ORS
				  646.285
Stats. Implemented: ORS
				  646.263 - ORS
				  646.285
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 200 - DEPARTMENT REGULATORY PROGRAMS › Section 836-200-0055 - Annual Report

Current through Register Vol. 63, No. 7, July 1, 2024
For the purpose of enabling the Director to determine the
				assessment against each registrant according to the formula established in
				836-200-0010, each registrant shall file a report for the preceding calendar
				year with the Director on or before March 1 of each year, or within such
				extension of time therefor as the Director may grant. The first report must be
				filed on or before March 1, 1997, for calendar year 1996. The report shall be
				in the form specified by the Director, shall contain the total number of
				service contracts produced in Oregon by the registrant during the preceding
				calendar year and shall be verified as follows:
(1) If the registrant is a corporation, by at
			 least two principal officers of the registrant.
(2) If the registrant is a partnership, by
			 two partners.
(3) If the registrant
			 is neither a corporation nor a partnership, by its president and
			 secretary.
Stat. Auth.: ORS
				  646.267 & ORS
				  646.285
Stats. Implemented: ORS
				  646.263 - ORS
				  646.285
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 200 - DEPARTMENT REGULATORY PROGRAMS › Section 836-200-0060 - Service on Registrant

Current through Register Vol. 63, No. 7, July 1, 2024
The Director may make service on a registrant at the address
				shown on the current registration of the registrant on file with the Director,
				in the manner provided in ORS
				183.310 to
				183.550.
Stat. Auth.: ORS
				  646.267 & ORS
				  646.285
Stats. Implemented: ORS
				  646.263 - ORS
				  646.285
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 200 - DEPARTMENT REGULATORY PROGRAMS › Section 836-200-0100 - Notice, Collision Damage Waivers

Current through Register Vol. 63, No. 7, July 1, 2024
For purposes of ORS
				646.859, which provides that an
				auto rental agency offering collision damage waivers shall post a sign approved
				by the Department, the Department shall consider a sign approved if the sign
				meets the following requirements:
(1)
			 The sign must state the following in bold type that is at least 1.25 inches
			 high:
OUR CONTRACTS OFFER OPTIONAL COLLISION DAMAGE WAIVERS AT AN
				ADDITIONAL COST.
(2) The
			 sign must be posted in the place of business of the auto rental agency in a
			 location that is conspicuous to the public.
Stat. Auth.: ORS
				  705.135
Stats. Implemented: ORS
				  646.859
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 200 - DEPARTMENT REGULATORY PROGRAMS › Section 836-200-0105 - Statutory Authority; Registration; Fees; Expiration; Renewal

Current through Register Vol. 63, No. 7, July 1, 2024
(1) OAR
			 836-200-0100  to 836-200-0140  are adopted under the authority of section 11, ch.
			 685, Oregon Laws 2007, for the purpose of implementing Sections 1 to 11, Ch.
			 685, Oregon Laws 2007.
(2) The fee
			 for submitting a Registration Application is $70.
(3) The fee for annual renewal of a
			 Registration is $25.
Stat. Auth.: ORS
				  731.244; 2007 OL Ch. 685, Sec.
				  11
Stats Implemented: 2007 OL Ch. 685, Sec. 1 -
				  11
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 200 - DEPARTMENT REGULATORY PROGRAMS › Section 836-200-0110 - Registration Procedures

Current through Register Vol. 63, No. 7, July 1, 2024
(1) A
			 warrantor of a vehicle protection product shall register with the Department of
			 Consumer and Business Services by submitting to the Director a completed
			 Warrantor of Vehicle Protection Product Registration Application on the form
			 prescribed by the Director.
(2) A
			 warrantor must include with the Registration Application a copy of each
			 warranty form to be used in this state, and any amendments to the form that the
			 warrantor proposes to use in the state of Oregon. A warrantor need not include
			 any amendment that:
(a) Changes a warranty
			 only in graphics or form, and not substantively; or
(b) Is a direct translation of the warranty
			 form the warrantor proposes to use into a language other than
			 English.
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 200 - DEPARTMENT REGULATORY PROGRAMS › Section 836-200-0120 - Warranty

Current through Register Vol. 63, No. 7, July 1, 2024
To comply with the requirement in section 3, chapter 685,
				Oregon Laws 2007 that each warranty must list the name, mailing address, and
				telephone number for the Division of Financial Regulation, Department of
				Consumer and Business Services, a warrantor shall include the contact
				information for Consumer Advocacy as set out on the website for the Division of
				Financial Regulation at dfr.oregon.gov.
Statutory/Other Authority: ORS
				  731.244, Or Laws 2007, ch 685
				  & sec 11
Statutes/Other Implemented: Or Laws 2007, ch 685 & sec
				  3
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 200 - DEPARTMENT REGULATORY PROGRAMS › Section 836-200-0130 - Reimbursement Insurance Policy

Current through Register Vol. 63, No. 7, July 1, 2024
(1) A
			 reimbursement insurer must deliver to the warrantor and the Director of the
			 Department of Consumer and Business Services the written notice of cancellation
			 for a reimbursement insurance policy as required by Section 6(2), Ch. 685,
			 Oregon Laws 2007 not later than 30 days prior to the effective date of the
			 cancellation.
(2) A warrantor must
			 discontinue offering vehicle protection product warranties as of the date of
			 cancellation of the reimbursement insurance until the warrantor obtains new
			 reimbursement insurance.
(3) A
			 warrantor must deliver a copy of the new reimbursement policy to the Director
			 within 10 business days of the warrantor's receipt of the new reimbursement
			 policy.
Stat. Auth.: ORS
				  731.244; 2007 OL Ch. 685, Sec.
				  11
Stats Implemented: 2007 OL Ch. 685, Sec. 5 &
				  6
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 200 - DEPARTMENT REGULATORY PROGRAMS › Section 836-200-0140 - Registration Requirements Not Exclusive

Current through Register Vol. 63, No. 7, July 1, 2024
Compliance with the registration requirements of OAR
				836-200-0100  to 836-200-0140  is additional to and not in lieu of any other
				requirements established by law for the purpose of doing business in this
				state, including but not limited to compliance with filing requirements of the
				Secretary of State applicable to assumed business names and applicable to the
				business structure of an applicant.
Stat. Auth.: ORS
				  731.244; 2007 OL Ch. 685, Sec.
				  11
Stats Implemented: 2007 OL Ch. 685, Sec.
				  11
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 200 - DEPARTMENT REGULATORY PROGRAMS › Section 836-200-0200 - License, Discount Medical Plan Organization; Renewal

Current through Register Vol. 63, No. 7, July 1, 2024
(1) An applicant for a license to operate as
			 a discount medical plan organization shall apply for the license by completing
			 and submitting to the Director the application form prescribed by the Director.
			 The application form shall request the information required by section 5,
			 chapter 272, Oregon Laws 2007 and this rule.
(2) To enable the Director to determine
			 whether an applicant is financially responsible, the application shall require
			 the following information:
(a) Whether the
			 applicant has ever filed for bankruptcy or been adjudged a bankrupt.
(b) An audited annual financial statement for
			 the most recent year or alternatively, an unaudited financial statement and the
			 applicable signed federal tax form of the applicant for the most recent year,
			 to prove that the applicant is solvent and has a continuing income stream. An
			 applicant may submit a consolidated financial statement if the statement
			 clearly segregates and reports the affairs of the applicant. The applicable
			 federal tax form for the purpose of this subsection is as follows:
(A) For an individual, Form 1040.
(B) For a corporation, Form 1120.
(C) For a subchapter S corporation, Form
			 1120S.
(D) For a partnership, Form
			 1065.
(E) For a limited liability
			 company, the form that the company files for federal income tax
			 purposes.
(c) If the
			 applicant is a corporation that is newly formed for the purpose of transacting
			 business as a discount medical plan organization, the statements and forms
			 required under subsection (b) of this section as they may be available, and the
			 applicant's business plan, including three years of projections of net worth,
			 revenue, expenses and net income.
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 200 - DEPARTMENT REGULATORY PROGRAMS › Section 836-200-0210 - Renewal of expired license

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 A person whose license as a discount medical plan organization has expired may
			 renew the license by submitting a completed license renewal application on the
			 form prescribed by the Director, not later than the 90th day after the date the
			 license expired and if:
(a) The license was
			 not suspended or revoked by the Director, or not renewed, on any ground under
			 Section 11, Chapter 272, Oregon Laws 2007; and
(b) The Director is satisfied that the person
			 meets the requirements for the license in Section 5, Chapter 272, Oregon Laws
			 2007.
Oregon Administrative Rules › Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION › Division 200 - DEPARTMENT REGULATORY PROGRAMS › Section 836-200-0215 - One-time processing fee, cancelled application

Current through Register Vol. 63, No. 7, July 1, 2024
A discount medical plan organization may retain a one-time
				processing fee that is not more than $30 when the organization refunds fees,
				service or subscription charges, dues or other consideration paid by a member
				who cancels a discount medical plan as provided in Section 8, Chapter 272,
				Oregon Laws 2007.
Stat. Auth.: ORS
				  731.244 &
				  742.432
Stats. Implemented: ORS
				  742.432