This page contains rules recently adopted by the Insurance Division. For each rule, you will find a link to the certificate and order and to the adopted text.
Amending and Suspending Oregon Administrative Rules Relating to Extending Continuation of Health Benefit Plans and Eligibility for Federal Subsidy through March 31, 2010
This rulemaking amends temporary rules adopted December 22, 2009 to reflect changes necessary to reflect changes to and an extension of the federal subsidy program until March 31, 2010. These amendments to the rules are necessary to correctly align the state continuation program with the federal provisions, which provide a subsidy for Oregonians who continue their health insurance coverage in the state continuation program.
Oregonians who lose their jobs have two options to continue coverage under their group health plan. If their former employer has twenty or more workers, they are eligible under the Consolidated Omnibus Budget Reconciliation Act (COBRA). If their former employer has fewer than twenty workers, they are eligible under Oregon’s state continuation law. In February 2009, the federal economic stimulus package extended 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 2009 Oregon Legislative Assembly enacted House Bill 2433, which extended 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 including additional extensions of the period of eligibility to match future extensions or changes in the federal subsidy or COBRA program. On December 19, 2009, President Obama signed HR 3326, the Fiscal Year 2010 Defense Appropriations Act, which extended eligibility for COBRA benefits to February 28, 2010 and the duration of the subsidy to 15 months. In response to that federal Act, the Division adopted temporary rules to match extensions of the federal benefits included in HR 3326. A new federal act, HR 4691 now extends the eligibility period for the American Recovery and Reinvestment Act premium subsidy for an additional 31 days (through March 31, 2010) and clarifies eligibility for the subsidy resulting from an involuntary termination of employment that follows a period of reduction in hours of work that caused an individual to lose health benefits under a group health benefit plan. These temporary rules make the same changes to the state continuation program allowing Oregonians enrolled in the state continuation plans to receive the maximum subsidy provided by the federal law.
Adopting and Amending Oregon Administrative Rules Relating to Health Insurance Public Rate Review and Confidentiality of Filing Documents
These rules implement provisions enacted by the 2009 Legislative Assembly pertaining to the review of proposed schedule or table of premium rates filed for health benefit plans for small employers, individual health benefit plans and portability health benefit plans. The rules clarify the public process established by the Legislative Assembly for these filings and for individual and small employer group plans, specify the materials that must be submitted in a schedule or table of premium rate filing. The rules specify that all materials are available to the public for review. For those filings, the rules also provide clarification of the factors the Director of the Department of Consumer and Business Services will consider in approving, disapproving or modifying the proposed rates and for approving the amount of an increase or decrease in administrative expenses that may be included in a rate.
Adopting and Amending Oregon Administrative Rules Relating to Treatment of reinsurance reserve credits or assets under agreements entered prior to November 9, 1995
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.
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