Recently adopted rules

Rules affected: OAR 836-080-0900, 836-080-0905

Rules summary: Defines covered loss and innocent person and language used for co-insureds in personal property and casualty policies.

Filed: 02/09/2023

Effective: 03/01/2023

Documents: Permanent Administrative Order

Rules affected: 836-053-0015

Rules summary: Revises methodology for determining whether an employer is a small or large employer for purposes of purchasing a group health benefit plan under the Oregon Insurance Code. Adopts Exhibit B titled “Second Revised Counting Methodology for Determining Small or Large Group" and makes the counting guidance provided under Exhibit B mandatory for plan years beginning on or after January 1, 2024.

Filed: 01/26/2023

Effective: 01/01/2024

Documents: Permanent Administrative Order

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Rules affected: 836-150-0040

Rules summary: Amended to define payment parameters for plan year 2023.

Filed: 01/24/2023

Effective: 01/31/2023

Documents: Permanent Administrative Order

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Rules affected: 836-012-0200, 836-012-0210, 836-012-0220, 836-012-0230, 836-012-0240, 836-012-0250, 836-012-0260, 836-012-0270

Rules summary: Provides a reference to the relevant statute through which the rules can be adopted. Adds definitions for the following terms: “actuarial method," covered policies," “non-covered policies," “required level of primary security," primary security," “other security," “valuation manual," “director," and “NAIC." Describes the purpose and intent of the rules. Clarifies that the rules apply to reinsurance treaties that cede liabilities pertaining to covered policies issued by any life insurance company domiciled in Oregon. Describes situations in which the rules do not apply. Specifies the actuarial method to establish the required level of primary security for each reinsurance treaty subject to the rules. Outlines the requirements for covered policies to obtain credit for reinsurance at the inception date and on an on-going basis as well as steps for remediation. Requires insurers to comply with and not avoid the requirements of the rule.

Filed: 12/27/2022

Effective: 1/1/2023

Documents: Permanent Administrative Order​​

Rules affected: 836-052-0138, 836-052-0142, 836-052-0143, 836-052-0156

Rules summary: Rule allows guaranteed issue of Medicare Supplement policies to individuals who qualify for Medicare by reason of disability and move to Oregon from a state that does not permit Medicare Supplement policies to be issued to persons under age 65. Rule adds guaranteed issue for individuals who lose Tricare that supplements Medicare to the current rule and removes outdated “conversion" and “portability" plans from the types of plans that supplement Medicare. Rule extends the guaranteed issue window for the birthday rule to include the period 30 days prior to the person's birthdate. Requires commissions or other compensation to an insurance producer or other representative for the sale or renewal of a guaranteed issue Medicare supplement policy or certificate to be made on the same basis as for any other Medicare supplement policy or certificate.

Filed: 12/22/2022

Effective: 1/1/2023

Documents: Permanent Administrative Order​​

​Rules affected: 836-053-0012, 836-053-0320, 836-053-1403, 836-053-1404, 836-053-1405, 836-053-1407, 836-053-1408

Rules summary: Removes the definition of “mental or nervous condition." Adds a definition for “behavioral health condition", changes wording from "mental health condition" to "behavioral health condition" and updates the version of the diagnostic materials used for the purpose for defining terms. Adds LGBTQ+ as a category in which insurers must report on their efforts to address enrollees network adequacy needs, including various types of essential community providers in its network. Updates statutory citations. Removes the definition of “chemical dependency." Adds definitions for “Behavioral health condition" and “Generally accepted standards of care." Updates requirements for coverage of behavioral health conditions to comply with statute, and adds additional requirements for medical necessity, utilization or other clinical review, including level of care placement decisions. Amends terminology to replace the word “mental" with “behavioral" and remove the terms “nervous" and “chemical" from the rule. Requires insurers to provide enrollees with the process and guidelines used to conduct medical necessity, utilization or other clinical determinations of benefits for behavioral health conditions.

Filed: 12/22/2022

Effective: 1/1/2023

Documents: Permanent Administrative Order​

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​​​​​​​Rules affected: OAR 836-085-0055

Rule Summary:

Amend in order to clarify notice period requirements for commercial liability insurance policy cancellations as outlined within the published DFR product standards.

Filed: Sept. 23, 2022

Effective: Oct. ​1, 2022

Documents:

• Permanent Administrative Order

​​​​​Rules affected: OAR 836-053-0006

Rule Summary:

Defines the term “employer association” and specifies the items that a health insurance carrier must provide to the department for approval prior to issuing group health benefit coverage to an employer association. Requires carriers to notify the department of any changes to the required information at least annually

Filed: August 31, 2022

Effective: September 1, 2022

Documents:

• Permanent Administrative Order

​​​​​Rules affected: OAR 836-042-0045

Rule Summary:

Amended for revisions to become effective on or before October 1, 2022, is prescribed as the statistical plan for workers’ compensation and employers' liability insurance.

Filed: August 29, 2022

Effective: September 1, 2022

Documents:

• Permanent Administrative Order

Rules affected: OAR 836-080-0900, 836-080-0905

Rules summary: Defines covered loss and innocent person and language used for co-insureds in personal property and casualty policies.

Filed: 02/09/2023

Effective: 03/01/2023​

Documents: Permanent Administrative Order