Rules affected: OAR 836-053-0013
Refiled to remove the word "Draft" on Exhibits.
Need for the Rule:
ORS 743B.130 requires the Department of Consumer and Business Services (DCBS) to prescribe by rule the form, level of coverage, and benefit design for bronze and silver health benefit plans that must be offered by insurance carriers. These plans must meet federal requirements issued by the Department of Health and Human Services (HHS). Each year, HHS updates the actuarial value (AV) calculator used for determining coverage levels. Changes may include costs, plan designs, populations, developments in the function and operation of the AV calculator and other actuarially relevant factors.
As a result of changes made to the federal AV calculator for 2020, the AV for the standard bronze and silver plans prescribed in OAR 836-053-0013 exceeded federal requirements. Failure to update the rule would result in DCBS requiring carriers to submit plans that are illegal with respect to federal law.
This year, HHS released the AV calculator later than in previous years. As a result, rulemaking would not be able to be completed in time for carriers to submit plans in May for review.
Filed: March 21, 2019
Effective: March 21, 2019 through September 13, 2019