Or. Admin. Code § 836-043-0041

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

Section 836-043-0041 - Application Review

(1) Upon receiving an application submitted under OAR 836-043-0028 or 836-043-0032, the Plan Administrator shall review the application for completeness and determine whether the employer is eligible for coverage under the Plan.

(2) The Plan Administrator may request additional information to establish eligibility, to assign appropriate classification codes, to calculate applicable premiums and to otherwise appropriately process the application. The additional information may include:

(a) Tax documentation;

(b) Ownership information, including a request to complete and sign a change of ownership form;

(c) Contracts, including worker leasing company arrangements, temporary employment agency contract or franchise agreements;

(d) Supplemental worker leasing company applications;

(e) Additional information regarding short-term policies requests, such as verification of annualized payroll;

(f) Proof of declination of voluntary coverage;

(g) Prior policy information including claims and audits, corporate charters, Dun & Bradstreet, Inc. reports, signed financial statements and signed letters of explanation; and

(h) Any other information that the Plan Administrator considers necessary to process the application.

(3) The employer or its agent shall provide information and documentation requested by the Plan Administrator or provide an acceptable explanation for failure to provide the requested items not later than the second business day after the request or upon the mutually agreed-upon date.

(4) The Plan Administrator may return an incomplete application to the employer or its agent for completion or, with notice to the employer or its agent, the Plan Administrator may retain the application pending receipt of further information. The Plan Administrator may reject an application and the previously established effective date if the employer fails to comply in a timely manner with a request from the Plan Administrator.

(5) An employer or a representative of an employer may resubmit a complete application to the Plan Administrator for an application review and establishment of a new effective date in accordance with 836-043-0044.

Or. Admin. Code § 836-043-0041

ID 10-1996, f. 6-27-96, cert. ef. 7-1-96; ID 18-2008, f. 12-9-08, cert. ef. 1-1-09

Stat. Auth.: ORS 656.427, 656.730 & 731.244

Stats. Implemented: ORS 656.427, 656.730 & 737.265