Current through Register Vol. 63, No. 9, September 1, 2024
(1) The
Plan Administrator may issue binders to eligible employers in accordance with
the provisions of this Plan. The servicing carrier shall provide coverage under
any binder issued by the Plan Administrator, subject to the provisions of the
Plan, any applicable policy terms or conditions, and any applicable laws,
rules, or regulations. The Plan Administrator shall send copies of the binder
to the employer's representative, if any, the servicing carrier to which the
Plan Administrator assigned the employer and the Director of the Department of
Consumer and Business Services.
(2)
The Plan Administrator shall issue a binder for an employer when the Plan
Administrator determines all of the following occur:
(a) The employer is eligible for
coverage;
(b) The Plan
Administrator has received an application that is complete and signed by an
officer, owner or other designee with power of attorney and includes any
additional information within the established time frame; and
(c) The Plan Administrator has received the
total initial premium or deposit premium within the established time
frame.
(3) After the
Plan Administrator binds coverage, the Plan Administrator shall provide the
servicing carrier with the following:
(a) A
copy of the binder;
(b) The initial
or deposit premium;
(c) The
application forms as set forth in Exhibits 1 and 2 to OAR
836-043-0024;
(d) Copies of any provided election or
rejection forms;
(e) Other forms
submitted during the application review process; and
(f) Any information to assist the servicing
carrier in providing the proper coverage and correct rates including but not
limited to experience rating modification worksheet data, NCCI's Inspection and
Classification Report, and change of ownership information form if
applicable.
(4) Upon
receipt of the assignment package, the servicing carrier shall review the
documents to ensure that all documentation needed to properly issue the policy
is attached. Based on the separate review of the servicing carrier, the
servicing carrier may request additional information or premium from the
employer. The servicing carrier must receive all additional requested
information or premium before the servicing carrier issues a policy.
(5) The servicing carrier shall issue the
policy in accordance with Plan rules, state law and the Assigned Carrier
Performance Standards.
(6) The
binder or verification page remains in effect until cancelled or until the
servicing carrier issues a policy in accordance with the Assigned Carrier
Performance Standards or state law. If the Plan Administrator does not issue a
binder, coverage does not exist.
(7)
(a) The
employer or the representative of the employer may request an effective date no
later than sixty days after the date of application. However, such requested
effective date must be the later of the following:
(A) The established effective date as
outlined in the tables set forth in subsection (8) of this rule;
(B) The date of expiration of existing
coverage; or
(C) A date the
employer requested.
(b)
To secure a requested effective date, the employer or the representative of the
employer shall:
(A) Submit to the Plan
Administrator a signed and completed application as described in Exhibits 1 and
2 to OAR 836-043-0024 using one of the
submission methods described in OAR
836-043-0024(5).
(B) For an application submitted by U.S.
Postal Service or private overnight delivery service, at a minimum, include in
the application submission the required critical threshold elements as defined
in NCCI's Assigned Risk Supplement to the Basic Manual.
(C) If submitting an application via mail or
an overnight delivery service, include the appropriate initial or deposit
premium. The Plan Administrator will consider the receipt of the application at
the specified mailing address receipt.
(8) The earliest effective date for coverage
is dependent on the method used to submit the application and shall be
determined in accordance with the following tables: [Table not included. See
ED. NOTE.]
(9) If the Plan
Administrator fails to issue a binder to an eligible employer by the 14th day
after receiving a completed application and the total initial or deposit
premium, coverage is bound at 12:01 a.m. on the later of the dates specified in
section (8) of this rule.
(10) A
binder issued to a worker leasing company applicant in compliance with
requirements for an initial worker leasing company license under OAR
436-050-0440 is extended as
provided in this section until the Director of the Department of Consumer and
Business Services either licenses or refuses to license the applicant, as
follows:
(a) The binder is conditional upon
the subsequent initial worker leasing company licensing by the Director. The
binder does not obligate the Plan to provide coverage to the worker leasing
company for its clients until the worker leasing company is licensed by the
Director of the Department of Consumer and Business Services.
(b) Upon the conditional binding of the
applicant worker leasing company, the Plan Administrator shall send the binder
to those entities listed in section (1) of this rule, except for the servicing
carrier.
(c) Upon the initial
licensing of a worker leasing company applicant by the Director of the
Department of Consumer and Business Services, and receipt of proof of
licensing, the Plan Administrator shall assign an unconditional binder to a
servicing carrier and send an unconditional binder to all entities listed in
section (1) of this rule.
(d) Upon
the refusal to license a worker leasing company applicant by the Director of
the Department of Consumer and Business Services, and upon receipt of proof of
refusal, the Plan Administrator shall send notice to all entities listed in
section (1) of this rule that the conditional binder has been rescinded and the
applicant was not covered.
Tables referenced are available from the
agency.
Stat. Auth.: ORS
656.427,
656.730 &
731.244
Stats. Implemented: ORS
656.427,
656.730 &
737.265
