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Health enrollment reporting

Quarterly filing detail

Every quarter, insurers authorized for health in Oregon, third-party administrators(TPAs) licensed under ORS 744.702, and certain Oregon public entities must report Oregon lives covered under specific types of insurance or self-insured medical plans.

Reporting is required regardless of where the policy was issued or the premium written. Companies exempt from reporting must file an online exemption once each calendar year.

Quarterly health enrollment data is available on the Division of Financial Regulation website.

Enrollment is submitted through iReg via pipe (|) delimited .dat files. There are no forms to complete.

Contact validation

Companies and special districts must provide key contact information before filing enrollment or exemptions.

Adding comments

The division requests comments when:

  • Enrollment changes by a minimum of +/- 1,000 members or +/- 10 percent from one quarter to another, and
  • Exemptions are requested and "No lives to report" and "Other" are selected.
  • An insurer or TPA provides benefits or services to Oregon special districts, such as cities, counties, or school districts.
  • A TPA performs some, but not all, administrative functions on behalf of self-insured medical plans.
  • Oregon public entity lives are reported under categories 5.b and 6 shown under the self-insured category and subcategories.

Provide brief explanations for the enrollment change, the request for exemption, general administrative services provided when services are split - such as claims payment only. Insurers provide the number of self-insured Oregon public entity lives for which administrative services and stop loss insurance are provided.

Other comments may also be added. Comments must be added before uploading files or saving exemptions and are not publicly available.

Submitting data

To submit a data file:

  • Select the "Filings" tab, and then select the "Quarterly Enrollment" tab.
  • Select "Submit" from the Menu Items.
  • Browse to the .dat file in your system that you wish to upload.
  • Once selected, click the "Upload File" button.
  • You will receive immediate confirmation when your upload is complete.
  • Select data report to review and download your completed report. Review for accuracy. Corrections may be made by uploading a complete, revised data file.

Filing errors

At times, your file may contain errors. iReg will identify those errors. Common errors: "You are attempting to file multiple records or time periods." This error indicates either duplicate ZIP code records within your file or you are attempting to upload a file for a time period you have already reported. If you need help with your data file, download the complete list of errors.

Exemption filing

Exemptions are filed once per calendar year, and are due by May 1. New licensees that are exempt from reporting must file by the due date for the quarter in which your license becomes active.

To file an exemption:

  • Select the Quarterly Enrollment tab under Filings.
  • Select Request Exemption from the Menu Items on the left of the screen.
  • Add or update contact information.
  • Select the year and check the reason for exemption.

If you check No lives to report or Other, add an explanation for your company's exempt status. (e.g., reinsurance only, Medicare Part D only, pharmacy benefit or behavioral health care management only, private passenger auto only, etc.).

Note: No written premium and do not write in Oregon are not valid exemptions. Oregon lives are reported regardless of where the policy was issued or premium written.


Contact

971-345-1129
DFR.DataTeam@dcbs.oregon.gov

If emailing about an error, provide a screen shot of all errors and include your data file.