Oregon Administrative Rules
Chapter 945 - OREGON HEALTH AUTHORITY HEALTH INSURANCE MARKETPLACE
Division 30 - ADMINISTRATIVE CHARGE FOR OPERATING EXPENSES
Section 945-030-0030 - Administrative Charge on Insurers and Health Care Service Contractors

Universal Citation: OR Admin Rules 945-030-0030

Current through Register Vol. 63, No. 3, March 1, 2024

(1) Effective January 1, 2015, each health insurer or health care service contractor offering:

(a) Qualified health plans through the Marketplace shall pay a monthly administrative charge equal to $9.66 times the number of members enrolled through the Marketplace in that month.

(b) Stand alone dental plans through the Marketplace shall pay a monthly administrative charge equal to $0.97 times the number of members enrolled through the Marketplace in that month.

(2) Effective January 1, 2016, each health insurer or health care service contractor offering:

(a) Qualified health plans through the Marketplace shall pay a monthly administrative charge equal to $9.66 times the number of members enrolled through the Marketplace in that month

(b) Stand alone dental plans through the Marketplace shall pay a monthly administrative charge equal to $0.97 times the number of members enrolled through the Marketplace in that month.

(3) Effective January 1, 2017, each health insurer or health care service contractor offering:

(a) Qualified health plans through the Marketplace shall pay a monthly administrative charge equal to $6.00 times the number of members enrolled through the Marketplace in that month.

(b) Stand alone dental plans through the Marketplace shall pay a monthly administrative charge equal to $0.57 times the number of members enrolled through the Marketplace in that month.

(4) Effective January 1, 2018, each health insurer or health care service contractor offering:

(a) Qualified health plans through the Marketplace shall pay a monthly administrative charge equal to $6.00 times the number of members enrolled through the Marketplace in that month.

(b) Stand alone dental plans through the Marketplace shall pay a monthly administrative charge equal to $0.57 times the number of members enrolled through the Marketplace in that month.

(5) Effective January 1, 2020, each health insurer or health care service contractor offering:

(a) Qualified health plans through the Marketplace shall pay a monthly administrative charge equal to $5.50 times the number of members enrolled through the Marketplace in that month.

(b) Stand alone dental plans through the Marketplace shall pay a monthly administrative charge equal to $0.36 times the number of members enrolled through the Marketplace in that month.

(6) Effective January 1, 2021, each health insurer or health care service contractor offering:

(a) Qualified health plans through the Marketplace shall pay a monthly administrative charge equal to $5.50 times the number of members enrolled through the Marketplace in that month.

(b) Stand alone dental plans through the Marketplace shall pay a monthly administrative charge equal to $0.36 times the number of members enrolled through the Marketplace in that month.

(7) Effective January 1, 2022, each health insurer or health care service contractor offering:

(a) Qualified health plans through the Marketplace shall pay a monthly administrative charge equal to $5.50 times the number of members enrolled through the Marketplace in that month.

(b) Stand alone dental plans through the Marketplace shall pay a monthly administrative charge equal to $0.36 times the number of members enrolled through the Marketplace in that month.

(8) Effective January 1, 2023, each health insurer or health care service contractor offering:

(a) Qualified health plans through the Marketplace shall pay a monthly administrative charge equal to $5.50 times the number of members enrolled through the Marketplace in that month.

(b) Stand alone dental plans through the Marketplace shall pay a monthly administrative charge equal to $0.36 times the number of members enrolled through the Marketplace in that month.

(9) Effective January 1, 2024, each health insurer or health care service contractor offering:

(a) Qualified health plans through the Marketplace shall pay a monthly administrative charge equal to $5.50 times the number of members enrolled through the Marketplace in that month.

(b) Stand alone dental plans through the Marketplace shall pay a monthly administrative charge equal to $0.36 times the number of members enrolled through the Marketplace in that month.

Statutory/Other Authority: ORS 741.002

Statutes/Other Implemented: ORS 741.105

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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