Or. Admin. Code § 836-020-0770

Current through Register Vol. 63, No. 12, December 1, 2024

Section 836-020-0770 - Authority, Purpose and Effective Date of OAR 836-020-0770to 836-020-0805

(1) OAR 836-020-0770 to 836-020-0805 are adopted by the Director of the Department of Consumer and Business Services pursuant to the authority of ORS 731.244 and 743.552, for the purpose of implementing 743.549 and 743.552.

(2) The purpose of OAR 836-020-0770 to 836-020-0805 is to:

(a) Establish a uniform order of benefit determination under which plans pay claims;

(b) Reduce duplication of benefits by permitting a reduction of the benefits to be paid by plans that, as provided in OAR 836-020-0770 to 836-020-0805, do not have to pay their benefits first; and

(c) Provide greater efficiency in the processing of claims when a person is covered under more than one plan.

(3) Insurers must make their plans compliant with OAR 836-020-0770 to 836-020-0805 not later than January 1, 2008. Until the date on which an insurer makes a plan of the insurer compliant, the plan shall continue to be subject to the prior rules, 836-020-0700 to 836-020-0765. In the event a question of order of benefit determination arises between a plan operating under 836-020-0770 to 836-020-0805 and a plan operating under the prior rules, 836-020-0700 to 836-020-0765, the order of benefit determination shall be governed by the prior rules.

(4) The Director shall review OAR 836-020-0770 to 836-020-0805 after January 1, 2010 to evaluate their effect in the group health insurance marketplace, upon consumers and upon the costs of coordinating health insurance benefits, and to determine whether further rulemaking is called for.

Or. Admin. Code § 836-020-0770

ID 14-2006, f. & cert. ef. 7-20-06; ID 3-2007, f. & cert. ef. 2-12-07

Stat. Auth: ORS 731.244, 743.552

Stats. Implemented: 743.549, 743.552