Oregon Administrative Rules
Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION
Division 53 - HEALTH BENEFIT PLANS
Section 836-053-0615 - Carrier Reporting Requirements
Universal Citation: OR Admin Rules 836-053-0615
Current through Register Vol. 63, No. 9, September 1, 2024
(1) In order to comply with the requirements of section 3, chapter 470, Oregon Laws 2015, not later than December 1, 2015, carriers and third party administrators shall submit the following to the Department of Consumer and Business Services:
(a) Information about internal and external
education and outreach activities that the carrier or third party administrator
will conduct to inform Oregonians about their right to have protected health
information redirected. The information reported shall include mechanisms the
carrier or third party administrator proposes to use to assess the
effectiveness of the education and outreach activities.
(b) Baseline data for the period of October
1, 2014 through September 30, 2015 that explains:
(A) The total number of requests to redirect
confidential information received by the carrier or third party administrator
and of these, the number of requests to redirect confidential information that
are received via:
(i) Telephone;
(ii) Email; and
(iii) Hard copy.
(B) The timeliness of processing the
redirection requests segregated by method of request.
(C) The number of complaints and grievances
received related to confidential communications. This number must also include
the applicable grievances tracked in accordance with OAR
836-053-1080.
(D) Total number of enrolled members.
(E) Total number of policyholders
or certificate holders.
(F) Total
number of dependent members.
(2) Not later than September 1, 2016, carriers and third party administrators shall submit to the department the following data for the period of January 1, 2016 through June 30, 2016:
(a)
(A) The
total number of requests to redirect confidential information received by the
carrier or third party administrator and of these, the number of requests to
redirect confidential information that are received via:
(i) Telephone;
(ii) Email;
(iii) Hard copy.
(B) The timeliness of processing the
redirection requests segregated by method of request.
(C) The number of complaints and grievances
received related to confidential communications.
(D) Total number of enrolled members.
(E) Total number of policyholders
or certificate holders.
(F) Total
number of dependent members.
(b) The following information to assist the
department in determining the extent and effectiveness of the education and
outreach activities conducted by the carrier or third party administrator:
(A) Explanation of how and when the process
was presented to members; and
(B)
Copies of outreach and education materials used over the period of January 1,
2016 through June 30, 2016.
Stat. Auth: ORS 731.244 & OL 2015, Ch 470 Sections 2 & 3
Stats. Implemented: Ch 470, OL 2015 Ch 470 Sections 2, 3 & 12
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.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.
