Proposed rules

​Rules affected: OAR 441-710-0527

Defines the inexact term “regular” as it applies to the number of board meeting under the Act.

During the 2017 legislative session, House Bill 2161 amended ORS 723.292 eliminating the requirement that a credit union’s board of directors “meet at least 10 times, in 10 separate months, during each calendar year.” ORS 723.292, as amended, states: “The board of directors of a credit union shall hold regular meetings. The Director of the Department of Consumer and Business Services may specify by rule the minimum frequency of meetings of the board of directors.”

To provide guidance as to the number of board meetings necessary to satisfy ORS 723.292, the Division of Financial Regulation (Division), on behalf of the Director of the Department of Consumer and Business Services, is proposing to adopt a rule defining “regular board meetings” to mean a “minimum of six regular meetings per calendar year with at least one of the six meetings to be held each quarter.”

The proposed rule excludes a credit union’s annual meeting, committee meetings, or special meetings from being counted as a regular board meeting. The proposed rule also requires credit unions to specify the number and frequency of regular meetings in their bylaws.

Filed: October 17, 2018

Public hearing: November 28, 2018 9:00 a.m.

Last day for public comment: December 5, 2018, 5 p.m.

Documents

• Notice of proposed rulemaking

​Rules affected: OAR 836-053-1600, 836-053-1605, 836-053-1610, 836-053-1615

Adopt definitions of: anesthesia conversion factor; base units; base rate; CMS; CPT; CPI adjustment; director; geographic rating area; modifier adjustment; out-of-network reimbursement; physical status units; Q modifier adjustment; and time units.

ORS 743B.287, as amended by Senate Bill 1549 (2018), requires an insurer offering a health benefit plan and a health care service contractor to reimburse an out-of-network provider for emergency services or other covered inpatient or outpatient services provided at an in-network health care facility. The statute directs the Department of Consumer and Business Services (DCBS) to promulgate rules for calculating reimbursement rates.

The statute requires that reimbursement be equal to the median allowed amount paid to in-network health care providers by commercial insurers in this state, based on data collected under ORS 442.466 for the 2015 calendar year, adjusted annually using the U.S. City Average Consumer Price Index for All Urban Consumers (All Items) (CPI-U) as published by the Bureau of Labor Statistics of the United States Department of Labor. It allows reimbursement to be adjusted based on the differences in allowed amounts paid to health care providers in certain geographic areas of this state.

Filed: October 23, 2018

Public hearing: November 27, 2018 1:30 p.m.

Last day for public comment: December 4, 2018, 5 p.m.

Documents

• Notice of proposed rulemaking

​Rules affected: OAR 836-011-0000

Rule Summary:
Amends for the purpose of prescribing: (1) the required financial statement forms, with instructions, to be filed annually by insurers; (2) the required financial statement forms, with instructions, to be filed quarterly by insurers; and (3) the required annual statement supplements, with instructions, to be filed by insurers, for the 2018 annual and 2019 quarterly reporting years.

Need for Rules:
ORS 731.574 requires insurers to file annual financial statements with the Director of the Department of Consumer and Business Services, and authorizes the Director to prescribe use of the annual statement blank and instructions prepared by the National Association of Insurance Commissioners (NAIC) for such purpose. The Director has chosen to exercise such authority through rulemaking, and has routinely updated the rule to reflect the then current blanks and instructions.

Commencing with the 2018 reporting year, the Director added a NAIC quarterly statement blank requirement to the rule in response to a concern that it did not clearly express such filing expectation. Inclusion of the quarterly statement blank requirement provides guidance to insurers, and is consistent with accreditation standards established by the NAIC.

Filed: October 24, 2018

Public hearing: November 27, 2018 9:00 a.m.

Last day for public comment: December 4, 2018, 5 p.m.

Public comments received:

• 11/27/18: Jason R. Moreland PEMCO Mutual Insurance Company

Documents

• Notice of proposed rulemaking

​Rules affected: OAR 836-150-0010, 836-150-0020, 836-150-0030, 836-150-0040, 836-150-0050, 836-150-0060

Need for Rules:
These rules adopt definitions, reporting requirements, and payment processes for the Oregon Reinsurance Program, which was established by the Oregon Legislature in 2017 (Enrolled House Bill 2391). The rules also establish the attachment point, coinsurance rate, and reinsurance cap that will be used to calculate payments under the program for benefit years 2018 and 2019. The rules are necessary to ensure that the program is administered in a fair and equal manner for all participating issuers and to ensure that the program achieves its purposes of stabilizing rates and premiums for individual health benefit plans and providing greater financial certainty to consumers of health insurance in Oregon.

Filed: October 29, 2018

Public hearing: November 27, 2018 11:00 a.m.

Last day for public comment: December 4, 2018, 5 p.m.

Documents

• Notice of proposed rulemaking

​Rules affected: OAR 836-031-0270

Rule Summary:
The rule sets forth the minimum standards to be used by insurers for the valuation of specified benefits, and the computation of contract reserves and claim reserves, for individual and group health insurance policies.

Need for Rules:
ORS 733.080 requires insurers to maintain reserves for health insurance policies “which place a sound value on its liabilities under such policies and which are not less than the reserves according to appropriate standards set forth in rules issued by the Director of the Department of Consumer and Business Services.” Adoption of such standards establishes clear guidelines for the industry and regulator alike and increases consumer protection through greater assurance of adequate reserves.

Filed: October 26, 2018

Public hearing: November 27, 2018 10:00 a.m.

Last day for public comment: December 4, 2018, 5 p.m.

Public comments received

• American Council of Life Insurers (ACLI)

Documents

• Notice of proposed rulemaking

​Rules affected: OAR 836-031-0605

Rule Summary:
Designates the version of the Valuation Manual insurers must use in establishing principle-based reserves beginning January 1, 2019, and confirms that the operative date of the Valuation Manual is January 1, 2017 under section 16(2) of Oregon Laws 2015 chapter 547.

Need for Rules:
Insurers in Oregon, like other states, must keep sufficient capital in reserve in order to pay claims, and use actual experience of policyholders when calculating claims reserves by means of principle-based reserving. The Director is authorized to prescribe use of the Valuation Manual, developed by the National Association of Insurance Commissioners (NAIC), to make those calculations, and has done so through rulemaking. To the extent that the NAIC revises the Valuation Manual from time-to-time, adoption of the Valuation Manual is updated accordingly. This rulemaking designates the version of the Valuation Manual insurers must use in establishing principle-based reserves beginning January 1, 2019, and confirms that the operative date of the Valuation Manual is January 1, 2017 under section 16(2) of Oregon Laws 2015 chapter 547.

Filed: October 29, 2018

Public hearing: November 27, 2018 9:00 a.m.

Last day for public comment: December 4, 2018, 5 p.m.

Documents

• Notice of proposed rulemaking