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Oregonians who lose their jobs have two options to continue coverage under their group health plan. If their former employer has 20 or more workers, they are eligible under the federal Consolidated Omnibus Budget Reconciliation Act (COBRA). If their former employer has fewer than 20 workers, they are eligible under Oregon's state continuation law. The federal economic stimulus package extends a 65-percent subsidy for up to nine months of coverage. Recognizing the need for changes to state law to allow Oregonians to obtain the full advantage of the federal subsidy, the Oregon Legislative Assembly enacted House Bill 2433, which extends the period of eligibility for state continuation coverage from six to nine months and allows the Director of the Department of Consumer and Business Services to adopt rules as necessary to allow Oregonians to take full advantage of the benefits provided by the federal law. 

The Legislative Assembly declared an emergency exists so House Bill 2433 could take effect immediately upon passage, and on April 28, 2009, the director adopted temporary rules OAR 836-053-0850T, 836-053-0855T, 836-053-0860T, 836-053-0865T (the Temporary Rules) in recognition of the need to expedite the rules to put in place the mechanisms to facilitate Oregonians obtaining the subsidy.  These temporary rules were replaced by permanent rules that became effective October 23, 2009.

The director again adopted temporary rules in December 2009,  March 2010 and April 2010 in response to federal extensions and changes to the federal subsidy program.

These rules enact permanent provisions that establish the requisite notice insurers must provide to assistance eligible individuals, revise the dates of eligibility for the federal subsidy and establish eligibility requirements to maximize the benefit.  The existing temporary rules expire June 16, 2010 and these rules are intended to replace the current permanent rules and all temporary amendments to those rules in their entirety.

These adopted and amended rules:

• Modify filing requirements to allow Oregon Large Risk Alternative Rating Plans to include workers' compensation insurance, provided the insured has countrywide workers' compensation standard premium in excess of $500,000.
• Allow large deductible rating plans to reduce the minimum employer eligibility from $750,000 to $500,000 in countrywide workers' compensation standard premium. Because large deductible rating plans can be written as Large Risk Alternative Rating Plans, the rule amendments will avert inconsistencies within the rules governing workers' compensation rating plans.

This rule creates the process the Director of the Department of Consumer and Business Services will use to consider a request to waive the 95 percent retention rate requirements of ORS 743.734.  Under Oregon law (ORS 743.734), an association health plan must retain 95 percent of its enrollees in order to be exempt from small employer group rating laws.  An association health plan that fails to meet this requirement has 12 months within which to correct the deficiency in retention.  If the association fails to correct the deficiency the association health plan must be rated under small group rating laws, which may result in significant rate increases. 

The rule requires association health plans seeking a waiver to submit a written request to the director between the 3rd and 6th month of the 12-month correction period.  With the request for waiver, the association health plans must submit information about the small employer groups covered by the association plan and why some groups left the association plan.  The information required that will allow the director to understand why the association failed to meet the retention rate and to determine whether the association engaged in any practice that caused, or was designed to cause, any small employer group to terminate coverage under the plan.

The rules require the director to consider the waiver request and within 90 days after the director receives the request, to deny the request of allow a waiver of the 95 percent retention requirement of ORS 743.734(7). The director must find that the association health plan did not engage in any practice that caused, or was designed to cause, any small employer group to terminate coverage under the plan.  The director may establish the period of time that the waiver will be in effect and may withdraw a waiver at any time if an association health plan fails to comply with any requirement of the rule or if the director finds that that an association health plan engaged in any practice that caused, or was designed to cause, any small employer group to terminate coverage under the plan.

At the expiration of a waiver, an association health plan is exempt from ORS 743.734(1) if the association satisfies the requirements of ORS 743.734(7) and (8).  An association health plan that is denied a request for waiver may not qualify for the exemption from ORS 743.734(1) or submit an additional request for waiver until at least one year after the end of the correction period.

This rulemaking permanently adopts temporary rules that expire on March 26, 2010 and makes some clarifications in response to questions raised as HB 2116 was implemented. House Bill 2116 was enacted by the Legislative Assembly in June 2009 and took effect September 28, 2009.  The bill established a one percent assessment on health insurers based on the gross amount of premiums earned by the insurer during each calendar quarter.  The bill included an option for the insurers to include the amount of the assessment in their premium rates.  For existing approved rates, insurers were allowed to include an additional one percent beginning October 1, 2009, without submitting their premium rate to the Insurance Division for review and approval.  If an insurer opted to include the additional one percent, the insurer was required to include a notice with all consumer billings explaining the increase.

In February 2010, the Legislative Assembly amended ORS 743.961 to correct a problem identified in the original bill.  SB 1047 clarified that only premiums from health plan policies delivered or issued for delivery in Oregon were subject to the assessment, not policies insuring Oregon residents but issued in another state.  The rules adopted reflect this correction in the assessment.

These rules are necessary to fully implement the health plan premium assessment, including clarification of certain terms and information about reporting requirements relating to the assessment and requirements for an insurer that chooses to add the one percent assessment to an existing approved rate.

NAIC accreditation Part A Laws & Regulation standards require states to include in statute or regulation a provision that insurers reduce to zero any reserve credits or assets established with respect to existing reinsurance agreements entered into prior to the effective date of the Life and Health Reinsurance Agreements Model Regulation (OAR 836-012-0300 to 836-012-0332) which would not be recognized under the provisions of this regulation.  This requirement was contained in OAR 836-012-0330, repealed September 26, 2006. 

This rule was repealed in a 2006 rulemaking, the purpose of which was to correct and update erroneous or superseded statutory, rule and other references in OAR chapter 836; to eliminate and replace obsolete material; and to make other editorial and non-substantive changes.

This rule appears to have been repealed in error.  The repeal of this rule removed the prohibition of an insurer reporting reserve credits or assets established with respect to existing reinsurance agreements entered into prior to the effective date of the Life and Health Reinsurance Agreements Model Regulation.  This repeal violates the Reinsurance Ceded accreditation standard, Part A, 10(m).

In order to remain accredited, the Division must re-adopt and retain this rule until the NAIC accreditation standards are adjusted.  The replacement rule simple states that any reserve credits or assets established with respect to reinsurance agreements entered into prior to November 9, 1995 that would not be entitled to recognition under the provisions of OAR 836-012-0300 to 836-012-0332 must be reduced to zero for purposes of the insurer’s annual statement filing.

These adopted and amended rules:

• Explain that the agency will charge a fee for the actual cost of a criminal records check, among the fees that apply to the issuance of licenses for insurance producers, adjusters and consultants. OAR 836-009-0007(4)(e);
• Provide consistent expiration time frames for producer, adjuster, and consultant licenses. OAR 836-009-0007(6);
• Clarify that the exemption to the adjuster licensing examination in ORS 744.535(2) applies only to non-resident adjuster licensing. OAR 836-071-0101(3);
• Designate crop insurance as a distinct class of insurance for the purpose of licensing crop adjusters, and that effective Feb. 1, 2011, to qualify as a crop adjuster, an applicant must pass – with an 80% minimum score – an examination given by the director. OAR 836-071-0113 & 0127;
• Require crop adjusters wishing to renew their licenses to furnish evidence of current Federal Crop Insurance Corporation certification. OAR 836-071-0130(2)(d);
• Update the name of the National Association of Securities Dealers (NASD), now the Financial Industry Regulatory Authority (FINRA). OAR 836-071-0185

This rulemaking proposes to adopt rules to fully implement chapter 711, Oregon Laws 2009 (Enrolled Senate Bill 973) enacted by the 2009 Legislative Assembly.  The legislation established statutory requirements related to the use and marketing of life settlement agreements in Oregon and expanded regulation of these agreements beyond the use of life settlement agreements by terminally ill policyholders.

These rules include clarification of the process for applying for a broker, provider and investment agent license and setting the fee for each application and for renewal of the licenses; clarification of reporting requirements; disclosure requirements; and notice requirements for life insurers.