New Developments – Hot Topics
Product Standards update and reminders (4/4/2013)
Please plan to attend one of the upcoming online Health
Insurance Exchange SERFF Plan Management webinars
The webinars will introduce the SERFF Plan Management functionality and demonstrate how to submit and review Qualified Health Plans in SERFF. (2/15/2013)
When Filing Pediatric Dental in 2014 Form Filings
When filing the forms you may bracket the pediatric dental benefits and in the event that quality health plans (QHPs) are not required to include pediatric dental benefits. This will allow for the provision to be deleted or added based on future guidance. (12/6/2012)
Overview of Form and Plan Filing — 11/8/12 (11/6/2012)
New and Updated Product Standards
The Rates and Forms unit has been busy updating product standards and creating new ones for use when filing 2014 Form filings. (10/1/2012)
Personal Vehicle Sharing
Guidelines for acceptable amendments and language. (7/17/2012)
IIPRC Filing Guidelines
To help filers submit accurate and complete filings, we have created some guidelines for IIPRC filings. (7/17/2012)
Updates to Product Standards posted
The current forms list was updated and now includes hyperlinks to each form for your convenience. A summary of other changes is listed in the link above. (7/17/2012)
The Current Forms List and eleven Life and Annuity Product Standards have been updated.
Portability Rate Review (10/12/11)
CMS has determined that portability plans are subject to federal rate review as individual policies and carriers must file the preliminary justification when requesting increases of 10% or more.
Product Standards update (10/05/10)
The Division has implemented a product standard review schedule of at least once every 3 years. If new laws or legislation occur, product standards will be revised as soon as possible.
New and Innovative Product Designs (09/23/10)
The Oregon Insurance Division encourages and recognizes that in order for Insurers to maintain competitive strategies it may be necessary to file new product designs that are not defined by statute, are out of the ordinary, or may not fit into a particular category of insurance.
Risk Purchasing Groups (RPG)
or Risk Retention Groups (RRG) (08/09/10)
The Oregon Insurance Division Rates & Forms Unit does not review rates or review and approve forms for Risk Purchasing Groups (RPG) or Risk Retention Groups (RRG)– except as described below:
As a courtesy and for the convenience of the group, the Oregon Insurance Division has agreed to review Oregon Medical Association Risk Purchasing Group filings on a file and use basis.
Even though filing is not required, all forms must comply with insurance regulations and provide mandated coverage or benefits required by Oregon law.
Modification and Discontinuance of
Health Benefit Plans (07/27/10)
Any change to a health benefit plan (ORS 743.019(a)) is either a modification or a discontinuation. In 2004, the Oregon Insurance Division created form 440-2896 as a tool to provide Industry a standardized format for reporting the necessary information. With recent changes to the market place, the form was reviewed and revised to include questions related to portability and the new Patient Protection Affordability Care Act (PPACA). We made these revisions, sought Industry input, and have finalized the changes to the new form.
Inland Marine Rate,
Rule, Form Filing Requirements Revised
Clarification regarding the Insurance Division's guidelines for the filing requirements of Inland Marine forms, rates & rules.
Product Standard Requirement Discontinued
Effective April 1, 2010, the Oregon Insurance Division (OID) will no longer require Product Standards to be submitted with property, casualty, life, annuities, and health rate filings. This change will NOT affect health insurance form filings, or product standards that are combined with a transmittal. Please refer to the current forms list when creating a filing to verify which product standards are required to be submitted with filings.
It will take some time to implement the changes to our systems. We estimate completion of this project by January 2011. Your patience is requested while we make all the necessary modifications. Until this project is completed, the system may still prompt for product standards to be attached to the system. Please bypass the prompt, and indicate 'no longer required' in the comment box.
During the review of a filing, an analyst may request the product standard to be submitted. If a product standard is attached to a filing, when not required, it will be accepted. (4/21/10)
P/C Duplicate Forms issue:
Before a filing is submitted via SERFF, please check your internal tracking system to see if the forms being submitted have already been approved for use in Oregon for a specific named insurance company. If they have, please send a Note to Reviewer in the original filing to let us know the forms will be used with an additional program or product. Once a form has been approved in Oregon for a specific insurance company, it does not need to be submitted again for that company unless it is being revised. If there are more than 5 duplicate forms, the filer will have 24 hours to withdraw the schedule item (also remove the attachment from the schedule item) containing duplicate documents from the filing. (4/6/10)
requirement on annuity contracts
Effective Oct. 1, 2008, any individual annuity contract or subsequent offer for sale of additional coverage in connection with an annuity must include notice that the Insurance Division helps consumers who have disputes with their insurer. For more information Click Here.(10/14/08)
Use of health questionnaires for determining health status of individual
enrollees or employer groups prior to enrollment
It has recently come to our attention that carriers issuing health benefit plans to employer groups in the State of Oregon are using prohibited health questionnaires to determine acceptance of employer groups and for rating purposes prior to enrollment. Such actions are in violation of the Oregon Insurance Code and may result in immediate enforcement actions. If necessary we will issue a bulletin concerning this matter in the near future.
Detailed information, including statutory references and examples of prohibited pre-enrollment questions, may be found on our website.
For more information or if you have additional questions, please contact: Rhonda Saunders-Ricks at firstname.lastname@example.org or by phone at 503-947-7270. (2/22/10)
Bulletin 2008-1: Filing Procedures for Compliance with Provisions of the Terrorism Risk Insurance Program Reauthorization Act of 2007. (3/17/10)
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Page updated: May 23, 2013