Or. Admin. Code § 836-052-0860

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

Section 836-052-0860 - Form of Notice to Group Policyholder

(1) The form of the notice required by ORS 743.560 shall be as established in this rule. The form shall be printed in 12 point type, one point leaded, and shall provide at least the following:

(a) The date of the notice;

(b) A statement to the effect that the group coverage provided through the group policyholder by the insurer has terminated or will terminate, and the effective date of termination. If termination will occur because of nonpayment of premium, the statement must also provide that the premium was not received, that the policy will be terminated as of the premium due date if the premium is not received by the end of the grace period applicable to the policy and that the insurer will furnish no further notice as to termination, and must include the date of termination. The effective date of a termination for a reason other than nonpayment of premium shall be the date preceding the first day that a group policyholder is effectively without coverage under the group health insurance policy;

(c) The number of the group health insurance policy;

(d) The name of the employer;

(e) An explanation of the rights of the certificate holders under federal law and state law regarding the continuation of coverage.

(2) In the notice to a group policyholder under this rule, the insurer need include only the information that applies to the group policyholder and certificate holder,

(3) An insurer may satisfy the notice requirements of ORS 743.560(2) and (3) in a single notice that is given at least 10 days prior to the end of the grace period under the policy. The notice must also satisfy the requirements of ORS 743.565.

(4) Notice of the availability of portability coverage is satisfied by compliance with the notice requirements of OAR 836-053-0750, relating to portability coverage.

(5) An insurer may give the notice required by ORS 743.560 electronically if each of the parties to the insurance policy has agreed to accept electronic notice pursuant to 84.013 and the notice and procedures followed by the parties otherwise satisfy the provisions of the Uniform Electronic Transactions Act at 84.001 to 84.070.

Or. Admin. Code § 836-052-0860

ID 9-1992, f. 5-26-92, cert. ef. 7-1-92; ID 5-2002, f. & cert. ef. 2-6-02; ID 19-2006, f. & cert. ef. 9-26-06

Stat. Auth.: ORS 731.244, 743.526, 743.560 & 743.562

Stats. Implemented: ORS 743.560