Oregon Administrative Code

836-074-0048 Other Trust Account Requirements OAR 836-074-0005 to 836-074-0050 do not prohibit an insurer from establishing requirements applicable to trust accounts of insurance producers of the insurer, if the requirements are more restrictive than the provisions of 836-074-000…

836-074-0050 Single Account for Affiliated Persons (1) An insurance producer that is a firm or corporation may use one premium fund trust account for the funds received by an affiliated person operating under its license. (2) An affiliated person of an insurance producer that is …

836-075-0000 Third Party Administrators; License Application; Required Information An applicant for a third party administrator license shall provide the following electronically in accordance with directions set forth on the Division of Financial Regulation website of the Depart…

836-075-0010 Completion of Application The Director may reject a third party administrator license application if it has not been completed by the 90th day after its filing. Statutory/Other Authority: ORS 731.244, 744.303, 744.635, 744.704, 744.706, 744.712 & 744.726 Statutes/Oth…

836-075-0020 Amendment of License Application Information A third party administrator shall notify the Director in writing when the third party administrator changes its principal place of business. The notice shall include the following: (1) The new street address, including cit…

836-075-0030 Third Party Administrator License Renewal (1) A third party administrator applying for renewal of the license must do the following, as applicable: (a) Not later than the license expiration date, submit electronically a completed renewal application in accordance wit…

836-075-0040 Annual Report Requirements (1) A third party administrator shall include in the annual report required in ORS 744.738 the balance sheet and income statement of the third party administrator for the immediately preceding calendar year. The balance sheet and income sta…

836-075-0045 Format and Instructions for Report Required by ORS 743.818 (1) As used in this rule: (a) “Covered lives” means Oregon residents who are employees, dependents of employees, or individuals otherwise eligible for an individual, student health, association, group or self…

836-075-0050 Exemptions from Third Party Administrator License Requirements (1) This rule is adopted under the authority of ORS 731.244 and 744.704 for the purpose of establishing exemptions under and implementing 744.704(1)(p). The persons described in this rule are exempt from …

836-075-0060 ERISA Exemption Registration (1) A person who is required by ORS 744.714 to register with the Director annually, verifying the person’s status as qualifying under 744.704(1)(L) for the exemption from the licensing requirement for third party administrators in 744.702…

836-075-0070 Errors and Omissions Insurance; Third Party Administrators (1) The amount of insurance for which a third party administrator as described in ORS 744.702 must maintain a certificate of errors and omissions insurance with the Director as required by 744.726 is $500,000…

836-080-0001 Statutory Authority; Purpose; Applicability (1) OAR 836-080-0001 to 836-080-0043 are adopted pursuant to the general rulemaking authority of the Director of the Department of Consumer and Business Services in ORS 731.244 and the specific authority in 746.085(1), for …

836-080-0005 Definitions (1) "Direct-response solicitation" means a solicitation through a sponsoring or endorsing entity or individually solely through mails, telephone, the Internet or other mass communication media. (2) "Existing insurer" means the insurer whose policy or cont…

836-080-0014 Duties of Agent (1) An insurance producer who initiates an application shall submit to the insurer, with or as part of the application, a statement signed by both the applicant and the insurance producer as to whether the applicant has existing policies or contracts …

836-080-0022 Duties of Insurers that Use Agents Insurance Producers Each insurer that uses an insurance producer shall: (1) Maintain a system of supervision and control to insure compliance with the requirements of OAR 836-080-0001 to 836-080-0043. The system shall do at least th…

836-080-0029 Duties of Replacing Insurers that Use Agents (1) When a replacement is involved in the transaction, the replacing insurer shall: (a) Verify that the required forms are received and are in compliance with OAR 836-080-0001 to 836-080-0043; (b) Notify any other existing…

836-080-0034 Duties of the Existing Insurer When a replacement is involved in a transaction, the existing insurer shall: (1) Retain and be able to produce all replacement notifications received, indexed by replacing insurer, for at least five years or until the conclusion of the …

836-080-0039 Duties of Insurers with Respect to Direct Response Solicitations (1) In the case of an application that is initiated as a result of a direct response solicitation, the insurer shall require, with or as part of each completed application for a policy or contract, a st…

836-080-0043 Violations and Penalties (1) Any failure to comply with OAR 836-080-0001 to 836-080-0043 shall be considered an unfair trade practice for purposes of ORS 746.240. Examples of violations include: (a) Any deceptive or misleading information set forth in sales material;…

836-080-0050 Authority; Purpose and Scope OAR 836-080-0055 is issued under ORS 743.731 and the general rulemaking authority of the Director of the Department of Consumer and Business Services set forth in ORS 731.244(2). The purpose of OAR 836-080-0055 is to identify particular i…

836-080-0055 Unfair Discrimination Identified Distinctions based on sex, sexual orientation or marital status made in the following matters constitute unfair discrimination: (1) The availability of a particular insurance policy. (2) The availability of a particular amount of insu…

836-080-0080 Definition, Claims Handling Services; Claims Procedures and Information (1) As used in ORS 743.911 and 743.913: (a) "Clean claim" means a claim under a health benefit plan that has no defect, impropriety, lack of any required substantiating documentation or particula…

836-080-0085 Annual Report; Sampling (1) Each insurer shall report to the Director annually on its compliance with Section 2, Chapter 747, Oregon Laws 2001 (Enrolled Senate Bill 894), governing claims received by an insurer from a provider on behalf of an enrollee, according to t…

836-080-0090 Suitability in the Sale of Life Insurance A person may not recommend to a consumer the purchase, sale or replacement of a life insurance policy, or any rider, endorsement or amendment to the policy, without reasonable grounds to believe that the recommendation or tra…

836-080-0105 Statutory Authority; Purpose; Effective Date (1) OAR 836-080-0105 to 836-080-0155 are adopted pursuant to the general rulemaking authority of the Commissioner in ORS 731.244 to aid in the effectuation of ORS Chapter 746, especially the enforcement of 746.015, 746.075…

836-080-0110 Applicability OAR 836-080-0105 to 836-080-0155: (1) Apply to all authorized insurers, whether stock, mutual, or reciprocal, and to the State Accident Insurance Fund. (2) Apply to those forms of property and casualty insurance known by custom as “commercial lines”; an…

836-080-0115 Definitions As used in OAR 836-080-0105 to 836-080-0155, unless the context requires otherwise: (1) “Dividend statement” has the meaning given the term by OAR 836-080-0130. (2) “Insurer” has the meaning given the term by ORS 731.106 and includes the State Accident In…

836-080-0120 Statement as to Participation Required Upon Request Before Delivery of Policy; Provision Required in Participating Policy; Contents of Provision (1) Upon the request of a policy-holder to an insurer, the policyholder is entitled to receive a written statement, before…

836-080-0125 Prohibited Representations Regarding Participation Rights Prior to the declaration of a dividend, an insurer shall not represent, orally or in writing, that the insurer agrees or will agree: (1) To pay a specified amount as a dividend; or (2) To a formula that fixes,…

836-080-0130 Dividend Statement Permitted; Required to Be Written; Prohibited and Permitted Advice (1) An insurer may advise a policy holder of the kinds of information the insurer expects to take into consideration in determining whether to declare a dividend and the amount ther…

836-080-0135 Dividend Rights Accrue Upon Declaration of Dividends; Contents of Dividend Declaration Resolution (1) The right of a policyholder to a dividend, or to a determination of whether any dividend will be paid to the policyholder or the amount of a dividend that will be pa…

836-080-0140 Unfair Discrimination in Allocation of Dividends Prohibited; Criteria for Allocation; Prima Facie Evidence of Unfair Discrimination (1) An insurer shall not unfairly discriminate in the allocation of dividends. (2) The dividend plans, scales, tables, formulas, schedu…

836-080-0145 Unfair Forfeiture of Dividend for Failure to Renew Prohibited An insurer shall not reduce or deny a policyholder dividend because of the policy-holder’s refusal to accept renewal of the policy or another policy from the same insurer. A reasonable change in the time s…

836-080-0150 Policyholder Dividend Rights of Group Members and Dividend Group Policyholders; Reduction or Denial Without Prior Advice Prohibited; “Dividend Group” Defined; Standards for Dividend Groups (1) When used in this section: (a) “Group” means a collection of insurance buy…

836-080-0155 False or Deceptive Publications by Insurer Prohibited An insurer shall not knowingly adopt, or cause or permit to be issued, circulated or used, any representation, plan, schedule, letter, or advertising material of any kind stating or implying that the insurer has a…

836-080-0160 Use of Special Certifications and Professional Designations by Insurance Producers (1) A person may not use a certification or designation that falsely indicates or implies that the person has special certification or training, in connection with the offer, sale or p…

836-080-0165 Notice of Division of Financial Regulation Assistance (1) An insurer shall include in an individual annuity contract and with any subsequent offer for sale of additional coverage in connection with the annuity a statement to the effect that the Division of Financial …

836-080-0170 Statutory Authority; Purpose (1) OAR 836-080-0170 to 836-080-0190 are issued under the general rulemaking authority of the director in ORS 731.244 to aid in the effectuation of ORS Chapter 746, especially the provisions of ORS 746.100, 746.110, and 746.240. Additiona…

836-080-0172 Applicability and Disclosure Forms (1)(a) Except as provided in OAR 836-080-0172(1)(b), OAR 836-080-0170 to 836-080-0190 applies to any sale or recommendation of an annuity. (b) OAR 836-080-0170 to 836-080-0190 does not apply to the transactions described in ORS 743.…

836-080-0178 Definitions (1)(a) “Annuity” means: (A) An agreement to make periodic payments, whether fixed or variable, in an amount: (i) That is individually solicited, whether the agreement is classified as an individual annuity or a group annuity; and (ii) In which the obligat…

836-080-0183 Insurance Producer Training (1) A producer may not solicit the sale of an annuity unless the producer has knowledge that is adequate to make a recommendation of the annuity, has complied with the insurer’s standards for product training, and meets the requirements of…

836-080-0185 Compliance Mitigation; Penalties Violation of any provision of OAR 836-080-0170 to 836-080-0190 is an unfair trade practice under ORS 746.240. Statutory/Other Authority: ORS 731.244 & 743.262 Statutes/Other Implemented: ORS 746.100, 746.110, 746.240 & 743.262 History…

836-080-0190 Annuity Sales; Disclosure Not a Defense The fact that a person made a disclosure to a consumer about the nature of an annuity in connection with the sale of the annuity to the consumer is not a defense by itself to a determination by the director under OAR 836-080-01…

836-080-0193 Operative Date The revisions to OAR 836-080-0170 to 836-080-0190 become operative on August 12, 2024. Statutory/Other Authority: ORS 731.244 & 743.262 Statutes/Other Implemented: ORS 746.100, 746.110, 746.240 & 743.262 History: ID 19-2024, amend filed 08/12/2024, eff…

836-080-0195 Oregon opt-out from certain Interstate Insurance Product Regulation Compact Uniform Standards (1) The purpose of this rule is to exercise the opt out provisions of the Interstate Insurance Product Regulation Compact (Compact) pursuant to ORS 732.820, Article VII. (2)…

836-080-0200 Electronic Payment of Claims (1) An insurer may pay claim proceeds through a prepaid card, direct deposit system, automated teller machine card or debit card, or other means of electronic transfer if the claimant elects payment by one of those methods and specifies t…

836-080-0205 Statutory Authority, Purpose, and Applicability (1) OAR 836-080-0205 to 836-080-0250 are adopted by the Director of the Department of Consumer and Business Services pursuant to the director’s general rulemaking authority in ORS 731.244, to aid in the proper effectuat…

836-080-0210 Definitions As used in OAR 836-080-0205 to 836-080-0240, unless the context requires otherwise: (1) "Claim file" includes, but is not limited to, microfilm files, computer information systems and other types of files, containing information on individual claims witho…

836-080-0215 Claim Files An insurer’s claim files shall contain the information pertaining to each claim in sufficient detail that pertinent events and their dates can be reconstructed. Statutory/Other Authority: ORS 731 Statutes/Other Implemented: ORS 746.230(1)(d) History: IC 2…

836-080-0220 Misrepresentation and Other Prohibited Claim Practices An insurer shall not: (1) Fail to fully disclose to a first party claimant all pertinent benefits, coverages and other provisions of an insurance policy under which the claim is asserted. (2) Conceal from a first…