Oregon Administrative Rules
Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION
Division 52 - INSURANCE POLICIES
Section 836-052-0508 - Definitions

(a) "Applicant;"

(b) "Benefit trigger;"

(c) "Certificate;"

(d) "Group long term care insurance;"

(e) "Long term care insurance;"

(f) "Policy;" and

(g) "Qualified long term care insurance."

(a) "Independent review organization" means an organization qualified under OAR 836-052-0768(5) that conducts independent reviews of long term care benefit trigger decisions.

(b) "Licensed health care professional" means an individual qualified by education and experience in an appropriate field, to determine, by record review, an insured's actual functional or cognitive impairment.

(c) "Qualified actuary" means a member in good standing of the American Academy of Actuaries.

(d) "Similar policy forms" means all of the long term care insurance policies and certificates issued by an insurer in the same long term care benefit classification as the policy form being considered. Certificates of groups that meet the definition of ORS 743.652(3)(a) are not considered similar to certificates or policies otherwise issued as long term care insurance, but are similar to other comparable certificates with the same long term care benefit classifications.