Oregon Administrative Rules
Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION
Division 150 - OREGON REINSURANCE PROGRAM
Section 836-150-0030 - Information Reporting
Universal Citation: OR Admin Rules 836-150-0030
Current through Register Vol. 63, No. 9, September 1, 2024
(1) As a condition of receiving reinsurance payments from the Oregon Reinsurance Program, a reinsurance eligible issuer must provide, for each benefit year, the following information to the department in the form and manner prescribed by the department:
(a) The name and company code
assigned to the reinsurance eligible issuer by the National Association of
Insurance Commissioners;
(b) The
identification number assigned to the reinsurance eligible issuer by the Health
Insurance Oversight System (HIOS);
(c) The total amount of the reinsurance
eligible issuer's reinsurance eligible claims for the benefit year;
(d) The portion of the reinsurance eligible
issuer's total reinsurance eligible claims for the benefit year that fall
between the attachment point and reinsurance cap;
(e) A summary data file containing the
following information for each reinsurance eligible individual with claims for
which reinsurance payments are being requested:
(A) The member identification number assigned
by the reinsurance eligible issuer to the reinsurance eligible
individual;
(B) The start and end
dates of coverage for the reinsurance eligible individual;
(C) The HIOS plan identification number for
the reinsurance eligible health benefit plan in which the reinsurance eligible
individual was enrolled;
(D) The
total amount of reinsurance eligible claims for the reinsurance eligible
individual for the benefit year; and
(E) The total amount of reinsurance eligible
claims for the reinsurance eligible individual for the benefit year that fall
between the attachment point and reinsurance cap;
(f) A detailed claims file extracted from the
reinsurance eligible issuer's claims processing system that includes the
issuer's complete record of all reinsurance eligible claims for the benefit
year;
(g) An attestation signed by
an executive officer of the reinsurance eligible issuer stating that the
information is accurate as of the date of submission; and
(h) Any other information requested by the
department.
(2) As a condition of receiving reinsurance payments from the Oregon Reinsurance Program, a reinsurance eligible issuer must submit the information required under this rule to the department:
(a) Using
a secure method of transmission approved by the department; and
(b) On or before July 15 of the year
following the benefit year for which the reinsurance payment is
requested.
Statutory/Other Authority: ORS 731.244 & 2017 Or Laws ch 538 sec 19
Statutes/Other Implemented: 2017 Or Laws ch 538 sec 18-21
Disclaimer: These regulations may not be the most recent version. Oregon may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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