Oregon Administrative Code

836-031-0810 2001 CSO Preferred Class Structure Table (1) At the election of the insurer, for each calendar year of issue, for any one or more specified plans of insurance and subject to satisfying the conditions stated in OAR 836-031-0800 to 836-031-0815, the 2001 CSO Preferred …

836-031-0815 Conditions (1) For each plan of insurance with separate rates for preferred and standard nonsmoker lives, an insurer may use the super preferred nonsmoker, preferred nonsmoker, and residual standard nonsmoker tables to substitute for the nonsmoker mortality table fou…

836-031-0855 Recoupment of Assessments by Oregon Insurance Guaranty Association (1) This rule is adopted under the authority of ORS 731.244 and 734.579, for the purpose of implementing 734.579, relating to the recoupment by insurers of assessments made by the Oregon Insurance Gua…

836-033-0105 Statutory Authority; Purpose OAR 836-033-0110 is adopted pursuant to ORS 733.550(3), which grants the Commissioner authority to prescribe standards to be applied to determine if obligations invested in by an insurer are “amply secured obligations” under the statutes …

836-033-0110 “Amply Secured Obligations” Defined In addition to those obligations referred to in ORS 733.550(1) and (2), an “amply secured obligation” is one that is eligible for amortization within the requirements adopted by the Subcommittee on Valuation of Securities of the Na…

836-033-0120 Purpose and Authority; Definition (1) OAR 836-033-0120 and 836-033-0130 implement ORS 733.695 by establishing which obligations are not of investment grade and regulating the acts and practices of insurers with respect to the concentration of such obligations. (2) Fo…

836-033-0130 Investments in Medium Grade and Lower Grade Obligations (1) An insurer may acquire or hold obligations that are not investment grade only as provided in this rule. For purposes of this rule, an obligation is not investment grade if the obligation is either of the fol…

836-042-0001 Statutory Authority; Purpose and Effective Date (1) OAR 836-042-0001 to 836-042-0035 are adopted pursuant to the general rulemaking authority of the Director in ORS 731.244. (2) The purpose and applicability of OAR 836-042-0001 to 836-042-0035 is to effectuate orderl…

836-042-0005 Definitions As used in OAR 836-042-0001 to 836-042-0035, unless the context requires otherwise: (1) “Anniversary rating date” means the month and day that rates, rating plans and rating systems are initially applied to a policy in effect and each annual anniversary t…

836-042-0015 Workers’ Compensation Filings — Procedural Rules for Insurers and Rating Organizations (1) Every workers' compensation insurer shall file with the Director copies of the workers' compensation insurance premium rates to be used by it. An insurer may satisfy this requi…

836-042-0020 Insurers Must Demonstrate Statistical Reporting Ability (1) Any insurer filing a workers’ compensation insurance exposure base, classification or classification system, must demonstrate how statistical experience data will be converted for purposes of statistical rep…

836-042-0025 Workers’ Compensation Filings Standards for Unfair Discrimination (1) Except for revisions solely attributable to legislative enactments, changes in administrative rules or orders, or approved by the Director to prevent an impairment, or applying to state agencies, w…

836-042-0035 Workers’ Compensation Policy Forms Filings by Insurers Workers’ compensation insurance must be written using policy forms filed by the rating organization of which the insurer is a member except that if the insurer files a rating plan or rating system requiring a pol…

836-042-0040 Statutory Authority; Purpose and Effective Date Statutory Authority; Purpose and Effective Date (1) OAR 836-042-0040 through 836-042-0045 are adopted by the director pursuant to the requirements of ORS 737.225(4). (2) The purpose and applicability of these rules is t…

836-042-0043 Definition As used in OAR 836-042-0040 through 836-042-0045, unless the context requires otherwise: "Workers' compensation insurance" means insurance providing coverage for the obligations of an employer arising from illness or injury to workers whether such obligati…

836-042-0045 Workers’ Compensation Statistical Plan (1) The Statistical Plan for Workers' Compensation and Employers' Liability Insurance, 2008 Edition, filed by the National Council on Compensation Insurance and approved by the director to become effective January 1, 2009, and r…

836-042-0050 Statutory Authority; Purpose and Applicability (1) OAR 836-042-0050 to 836-042-0060 are adopted pursuant to the general rulemaking authority of the Director in ORS 731.244 and the specific authority of 737.310, which authorizes the Director to prescribe by rule the c…

836-042-0055 Definitions, Payroll Inclusions and Exclusions (1) As used in OAR 836-042-0050 to 836-042-0060, unless the context requires otherwise: (a) “Classification” means a grouping of insurance risks according to a classification system used by an insurer. (b) “Classificatio…

836-042-0060 Conditions for Division of Payroll of Individual Employees (1) When there is an interchange of labor, the payroll of an individual employee shall be divided and allocated among the classification or classifications that may be properly assigned to the employer, provi…

836-042-0070 Statutory Authority and Purpose OAR 836-042-0070 to 836-042-0090 are adopted pursuant to the general rulemaking authority of the Director of the Department of Consumer and Business Services in ORS 731.244 to specify for insurers offering large deductible provisions o…

836-042-0075 Definitions As used in OAR 836-042-0070 to 836-042-0090: (a) “Insurer” means any insurer authorized to write workers’ compensation insurance and includes the State Accident Insurance Fund Corporation. (2) “Director” means the Director of the Department of Consumer an…

836-042-0080 Rate Filing Requirements and Standards An insurer that issues a policy for worker's compensation insurance including a large deductible provision must use a provision which satisfies requirements of OAR 836-054-0210 and has been approved by the Director and must file…

836-042-0085 Statistical Data Maintenance and Reporting Requirements An insurer that issues a policy for worker's compensation insurance including a large deductible provision must: (1) Maintain policy premium data distinguishing credit or modification premium for large deductibl…

836-042-0090 Trade Practices Found Injurious to the Insurance-Buying Public (1) Failure of an insurer to comply with OAR 836-042-0080, 836-042-0085 or 836-054-0210 constitutes an unfair trade practice under ORS 746.240. (2) Failure of an insurer to delete a large deductible provi…

836-042-0100 Statutory Authority and Purpose OAR 836-042-0100 to 836-042-0115 are adopted under the Director’s authority in ORS 737.325(1) to modify filing requirements for insurers offering to classes of risks Large Risk Alternative Rating Plans which include workers’ compensati…

836-042-0105 Definitions As used in OAR 836-042-0100 to 836-042-0115: (1) “Affiliate Insurer” means an insurer that directly or indirectly through one or more intermediaries, controls, or is controlled by, or is under common control with, the insurer specified where control is de…

836-042-0110 Rate Filing Requirements The Director may approve retrospective rating plans and large deductible rating plans as mutually agreed upon between insurer and eligible employer under the following conditions: (1) The rating plan is filed with director according to ORS 73…

836-042-0115 Trade Practices Found Injurious to the Insurance Buying Public Failure of an insurer to comply with OAR 836-042-0110 constitutes an unfair claims practice under ORS 746.240. Statutory/Other Authority: ORS 731.244 & 737.325(1) Statutes/Other Implemented: ORS 746.240 H…

836-042-0201 Statutory Authority; Purpose; Effective Date (1) OAR 836-042-0201 to 836-042-0225 are adopted under the general rulemaking authority of the Insurance Commissioner in ORS 731.244 and the specific authority relating to workers’ compensation insurance rating groups in O…

836-042-0205 Definitions As used in OAR 836-042-0201 to 836-042-0225 unless the context requires otherwise: (1) “Anniversary Rating Date” means the month and day that a rating plan is initially applied to a policy and each annual anniversary thereafter, unless a different date is…

836-042-0210 Rating Plans for which Employers May Be Combined; Retrospective Rating Deposit Required; When Group Rating May Be Applied (1) An insurer may use the combined experience of a group of employers for experience rating, retrospective rating, or premium discounting of wor…

836-042-0215 Consent to Group Rating Required Before Policy Issuance; Provision Required in Consent Form; Contents of Consent Form (1) An insurer intending to combine the experience of a group of employers for rating purposes may not issue a policy to a member of the group unless…

836-042-0220 Filing Requirements and Procedural Rules (1) Before issuing any policies to group members that are to be rated by the combined experience of the group: (a) The insurer must file the following with the Director for each group: (A) The name and nature of the organizati…

836-042-0225 Criteria for Grouping; Criteria for Substantially Similar Occupations Within Organization; Open Enrollment Required An insurer may combine for rating purposes the experience of a group of employers which it covers for workers’ compensation insurance only if: (1) All …

836-042-0300 Statutory Authority; Purpose; Applicability; Effective Date (1) OAR 836-42-300 to 836-042-0322 are adopted under the specific authority of the Insurance Commissioner in ORS 737.600, to make rules needed to allow mass marketing plans in personal lines casualty and pro…

836-042-0302 Definitions As used in OAR 836-042-0300 to 836-042-0322 unless the context requires otherwise: (1) “Mass marketing plan” means a method of selling property-casualty personal lines insurance to members of a particular association which has agreed to or otherwise endor…

836-042-0304 Fictitious Arrangement Prohibited (1) No insurer shall sell insurance under a mass marketing plan to members of any association without the approval of the Commissioner. (2) The Commissioner will not approve any mass marketing plan unless it meets the requirements of…

836-042-0306 Premium Rates Premium rates under a mass marketing plan shall comply with the standards in the Insurance Code and shall not be excessive, inadequate, or unfairly discriminatory. Rates will not be deemed unfairly discriminatory when premiums differ between policy hold…

836-042-0308 Statistics An insurer selling insurance under mass marketing plans shall maintain separate relevant statistics as to loss and expense experience. Statutory/Other Authority: ORS 731 Statutes/Other Implemented: ORS 737.600(3)(d) History: IC 8-1983, f. & ef. 11-10-83…

836-042-0310 Producers A person shall not act as an insurance producer in connection with a mass marketing plan for any kind of insurance unless such person is licensed as an insurance producer to transact casualty insurance. Statutory/Other Authority: ORS 731 & 744 Statutes/Othe…

836-042-0312 Compulsory Participation Prohibited No insurer shall sell insurance under a mass marketing plan if purchase under the plan is a condition of employment or of membership in any association, or if any employee or member would be subject to any penalty for non-participa…

836-042-0314 Tie-In Sales Prohibited No insurer shall sell insurance under a mass marketing plan if: (1) The purchase of insurance under the plan is contingent upon the purchase of any other insurance, product, or service; or (2) The purchase or price of any other insurance, prod…

836-042-0316 Disclosure Required Every insurer or insurance producer selling insurance under a mass marketing plan shall make full and fair disclosure to prospective insureds prior to sale of all features of the plan, whether favorable or unfavorable, including but not limited to…

836-042-0318 Underwriting Standards No insurer shall use substantially more restrictive underwriting standards for individual risk selection in a mass marketing plan than the standards used by the insurer for individual risk selection in the sale in this state of the same kind of…

836-042-0320 Cancellation and Non-Renewal (1) For purposes of Sections 742.562 and 742.566 of the Insurance Code, limiting the cancellation and non-renewal of insurance policies, the failure of an association, to remit premiums when due for any reason (including but not limited t…

836-042-0322 Compulsory Facilities An insurer or insurance producer selling insurance under a mass marketing plan shall help any members who apply for but are denied insurance under the plan to obtain insurance through some other appropriate insurance plan, such as the assigned r…

836-042-0400 Statutory Authority; Purpose; Applicability; Effective Date (1) OAR 836-042-0400 to 836-042-0430 are adopted under the authority of ORS 737.600. (2) OAR 836-042-0430 is adopted to enable the Department to: (a) Regulate the sale of casualty insurance in this state on …

836-042-0405 Definitions As used in OAR 836-042-0400 to 836-042-0430: (1) “Casualty Insurance” as defined in ORS 731.158 and as used in 836-042-0400 to 836-042-0430 means liability or casualty insurance as used in 737.600(3)(f). (2) “Rating System” means a collection of rating pl…

836-042-0410 Commercial Risks; Prohibition; Requirements; Filing (1) An insurer may not sell casualty insurance on commercial risks under a group policy to members of a group unless: (a) The insurer has satisfied the filing requirements of this rule with respect to that policy; a…

836-042-0415 Day Care Facilities; Prohibition; Requirements; Filing (1) An insurer may not sell insurance under a group policy to members of a group of day care facilities unless: (a) The insurer has satisfied the filing requirements of this rule with respect to that policy; and …