Rates and forms

Current E-notifications sent by the Rates and Forms Section are available below.
Click on a title below for details.

2018

2019 Affordable Care Act medical plan form and binder product standards for Individual and Small Group Major Medical filings.

The Oregon Division of Financial Regulation has posted revised product standards intended to update Oregon’s guidance for the 2019 plan year. Revisions include an update to the bronze standard plan that removes the HSA requirement, an update to preventive services made necessary by HB 3391(2017), and a modification to the silver standard plan described in Exhibit 2 of OAR 836-053-0013. Rulemaking is not yet finalized on these items but we do not anticipate additional changes to the current drafts.

This e-notify was sent to the following groups:
● Product Standards updates

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Special Notice: Motor Vehicle (Automobile) Insurance Exclusions

TO: All Insurers writing Motor Vehicle Insurance
FROM: The Oregon Department of Consumer & Business Services Division of Financial Regulation
SUBJECT: Motor Vehicle (Automobile) Insurance Exclusions

The Division of Financial Regulation Product Regulation unit wants to remind insurers writing personal and commercial motor vehicle insurance that Oregon laws do not allow exclusions for criminal or illegal acts in a motor vehicle policy used to meet the financial responsibility requirements for Bodily Injury Liability (BI), Property Damage Liability (PD), Automobile Personal Injury Protection (APIP), or Uninsured Motorists/Underinsured Motorists coverage (UM/UIM).

Oregon Revised Statute (ORS) 742.450 and ORS 742.454 outline the required contents and list the allowable exclusions for any automobile policy being used to provide mandatory coverage for BI and PD Liability. ORS 742.530 lists allowable exclusions for APIP. There are no allowable exclusions in the UM/UIM sections of the Oregon Insurance Code.

This e-notify was sent to the following groups:
● New Developments
● Property and Casualty Insurance Issues

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Updated Product Standards

Items below were updated:

  • 440-4978 – Standard Provisions for Exchange Certified Pediatric Dental Forms (ACA Compliant/ Group and Individual) (Updated 3-20-18)

Updated to correct discrepancies between the current version of the Oregon Health Plan Children’s Health Insurance Plan and OAR 836-053-0012(2)(f).

This e-notify was distributed to the following groups:
Product Standards updates


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Updated Product Standards

Items below were updated:

  • 440-4978 – Pediatric Dental Forms & Rates.
  • 440-5352 – Limited Wraparound or similar coverage – fixed reference.

You can find a list of Current Filing Forms here: http://dfr.oregon.gov/rates-forms/Documents/current-filing-forms.pdf

This e-notify was distributed to the following groups:
Rates & Forms New Developments
Product Standards updates

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A new product standards for limited-wraparound coverage have been posted.

The DRAFT timelines for 2019 Binders have been posted. Once timelines have been confirmed by CMS we will post updated documents.

This e-notify was distributed to the following groups:
Rates & Forms New Developments

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2017

2018 Quarterly Rate Filing Deadlines

The filing the 2018 Quarterly Rate Filing Deadlines document has been posted to our website. The timeline impacts only Individual and Small Group Health Benefit Plans and Certified Pediatric Dental Plans. Updates include adding deadlines for filing optional Small Group quarterly Rate filings and removing deadlines that have passed.

To view the latest version of the timeline visit:

Regulatory guidance related to health reform
http://dfr.oregon.gov/business/insurance-industry/health-ins-regulation/Pages/regulatory-guid.aspx

2018 Quarterly Rate Filing Deadlines
http://dfr.oregon.gov/rates-forms/Documents/enotify-documents/2018-rate-filing-timelines.pdf

This e-notify was distributed to the following groups:
Rates & Forms New Developments​​

Product Standards update

The Division has updated the following product standards:

  • 440-2441A Transmittal & Standards for Group Health Coverage to be issued to an Association, or Trust Group
    (Updated 8-9-2017)
  • 440-3894 Certificate of Compliance
    (Issued updated ID 8-2017 to amend 836-010-0011 with name change of Division)
  • 440-3172E Standard Provisions for Individual and Group Short Term Major Medical
    (Updated 9-18-17)

This e-notify was distributed to the following groups:
● Rates & Forms Product Standards Update​​​

Oregon has made changes to the Detailed Filing Instructions for a wrap-up, and the Trust Agreement templates.

This new information can be found under Division of Financial Regulation, Business, Insurance rates and forms, Filing requirements, Wrap-up filings. The link is http://dfr.oregon.gov/rates-forms/Pages/wrap-up-filings.aspx

Primarily the changes affect the Trust Agreement, and which Trust Agreement template should be used when the insurer prepares the red-lined version for our review.

First of all, the deposit arrangement referenced in Exhibit B is between the Oregon Department of Consumer and Business Services and the Custodian (US Bank). The Treasurer of the State of Oregon is not involved.

Secondly, the point at which the Trust Agreement must be reviewed and approved for legal sufficiency by the Oregon Attorney General, is now based upon the deposit fund amount rather than the project value. The deposit fund is calculated by taking the project value and dividing it by $100 million, then taking the result times $25,000. For example a project valued at $2 Billion divided by $100 Million = 20 X $25,000 = a deposit in the amount of $500,000.

If you have any questions or concerns please contact Jan Vitus at jan.vitus@oregon.gov or by phone at 503 947 7278.

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