Or. Admin. Code § 836-150-0030

Current through Register Vol. 64, No. 1, January 1, 2025

Section 836-150-0030 - Information Reporting

(1) As a condition of receiving reinsurance payments from the Oregon Reinsurance Program, a reinsurance eligible issuer must provide, for each benefit year, the following information to the department in the form and manner prescribed by the department:

(a) The name and company code assigned to the reinsurance eligible issuer by the National Association of Insurance Commissioners;

(b) The identification number assigned to the reinsurance eligible issuer by the Health Insurance Oversight System (HIOS);

(c) The total amount of the reinsurance eligible issuer's reinsurance eligible claims for the benefit year;

(d) The portion of the reinsurance eligible issuer's total reinsurance eligible claims for the benefit year that fall between the attachment point and reinsurance cap;

(e) A summary data file containing the following information for each reinsurance eligible individual with claims for which reinsurance payments are being requested:

(A) The member identification number assigned by the reinsurance eligible issuer to the reinsurance eligible individual;

(B) The start and end dates of coverage for the reinsurance eligible individual;

(C) The HIOS plan identification number for the reinsurance eligible health benefit plan in which the reinsurance eligible individual was enrolled;

(D) The total amount of reinsurance eligible claims for the reinsurance eligible individual for the benefit year; and

(E) The total amount of reinsurance eligible claims for the reinsurance eligible individual for the benefit year that fall between the attachment point and reinsurance cap;

(f) A detailed claims file extracted from the reinsurance eligible issuer's claims processing system that includes the issuer's complete record of all reinsurance eligible claims for the benefit year;

(g) An attestation signed by an executive officer of the reinsurance eligible issuer stating that the information is accurate as of the date of submission; and

(h) Any other information requested by the department.

(2) As a condition of receiving reinsurance payments from the Oregon Reinsurance Program, a reinsurance eligible issuer must submit the information required under this rule to the department:

(a) Using a secure method of transmission approved by the department; and

(b) On or before July 15 of the year following the benefit year for which the reinsurance payment is requested.

Or. Admin. Code § 836-150-0030

ID 38-2018, adopt filed 12/19/2018, effective 1/1/2019

Statutory/Other Authority: ORS 731.244 & 2017 Or Laws ch 538 sec 19

Statutes/Other Implemented: 2017 Or Laws ch 538 sec 18-21