Rules affected: OAR 836-053-0013
Need for Rules:
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 2021, 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.
DCBS convened a Rulemaking Advisory Committee (RAC) that met on January 28, 2020. Representatives from consumer advocacy groups, insurers, and business groups participated in the RAC. Representatives from the agent community were invited but did not participate.
Filed: February 27, 2020
Public hearing: March 31, 2020, 11 a.m.
Last day for public comment: March 31, 2020, 5 p.m.