Oregon Administrative Rules
Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION
Division 53 - HEALTH BENEFIT PLANS
Section 836-053-0014 - Standards and Process for Shortened Period of Market Prohibition
Current through Register Vol. 63, No. 9, September 1, 2024
(1) In order to be eligible for consideration by the director for a shortened period of prohibition under ORS 743B.012, 743B.104 or 743B.126, a carrier must have met at least one of the following conditions upon exiting:
(2) A carrier seeking consideration for a shortened period of prohibition under ORS 743B.012, 743B.104 or 743B.126, must submit a formal, written request no later than August 1, two years prior to the plan year the carrier intends to offer its products in a market.
(3) The request for reentry must be in writing and include:
(4) The department must provide notice to the public by August 15th of the year that the request was made, indicating that a carrier intends to reenter the market under a shortened period of prohibition and post to its website the letter submitted by the carrier.
(5) If the department does not receive the required materials identified in section (6) by the due date it will consider the carrier's intentions to reenter the market to be withdrawn.
(6) After submission of a formal request for reentry, a carrier must provide required materials to be submitted for consideration for a shortened period of prohibition by no later than November 1, two years prior to the plan year the carrier intends to offer its products in the market. The required materials shall be confidential pursuant to ORS 192.501(2) and ORS 731.752 and must include the following:
(7) Within seven business days after receiving a formal request and supporting documentation for reentry, the director must determine whether the application is complete.
(8) By January 15, one year prior to the plan year the carrier intends to offer its products in the market, the director must issue a decision approving or disapproving a shortened period of prohibition under ORS 743B.012, 743B.104 or 743B.126. A decision of approval to reenter the market under a shortened timeframe is contingent upon approval of rates in accordance with ORS 743.018 and section (9) of this rule and that are consistent with the information in the applications materials submitted under sections (3) and (6) of this rule.
(9) After a carrier is approved for reentry into the market it exited, the carrier shall; subject to applicable law:
Statutory/Other Authority: ORS 743B.012, 743B.104, 743B.126 & 2017 Or Laws, ch 260, sec 4-7
Statutes/Other Implemented: ORS 743B.012, 743B.104, 743B.126 & 2017 Or Laws, ch 260, sec 4-7