Or. Admin. Code § 836-080-0635

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

Section 836-080-0635 - Initial Notice to Consumers

(1) A licensee shall provide an initial notice as provided in OAR 836-080-0620(1) and also subsequently when further personal financial information is collected in connection with a renewal or reinstatement of a health insurance policy.

(2) A licensee is not required to provide an initial notice to a consumer for purposes of OAR 836-080-0620 if any of the following circumstances applies:

(a) If the licensee does not disclose any nonpublic personal financial information about the consumer to any nonaffiliated third party other than as authorized by OAR 836-080-0670 and 836-080-0675 and the licensee does not have a customer relationship with the consumer.

(b) If the licensee has a customer relationship with the consumer and the consumer consents to the licensee's searching for health insurance coverage to replace existing coverage or to perform another health insurance service for the consumer, and if disclosure of personal financial information of the consumer meets the conditions specified in OAR 836-080-0670.

(c) If a notice has been provided by an affiliated licensee, as long as the notice clearly identifies all licensees to whom the notice applies and is accurate with respect to the licensee and the other institutions.

(3) For the purpose of the notice requirement of OAR 836-080-0620, pursuant to which a licensee shall provide notice of personal financial information practices to a consumer who becomes a customer of the licensee not later than the date that the licensee establishes a continuing relationship with the consumer, a continuing relationship between a licensee and consumer is established when the consumer, as shown in the following examples:

(a) Becomes a health insurance policyholder of a licensee that is an insurer, when the insurer delivers a health insurance policy or contract to the consumer, or in the case of a licensee that is an insurance producer, obtains health insurance through that licensee; or

(b) Agrees to obtain financial, economic or investment advisory services relating to health insurance products or services for a fee from the licensee.

(4) When an existing customer obtains a new health insurance product or service from a licensee that is to be used primarily for personal, family or household purposes, either of the following provisions may apply to a licensee regarding the initial notice requirements of OAR 836-080-0620 and:

(a) The licensee may provide a revised policy notice as provided in OAR 836-080-0655; or

(b) If the initial, revised or annual notice that the licensee most recently provided to that customer was accurate with respect to the new health insurance product or service, the licensee does not need to provide a new privacy notice under OAR 836-080-0620.

(5) A licensee may provide the initial notice required by OAR 836-080-0620 within a reasonable time after the licensee establishes a customer relationship if establishing the customer relationship is not at the customer's election or if providing notice not later than when the licensee establishes a customer relationship would substantially delay the customer's transaction and the customer agrees to receive the notice at a later time. The following are examples of exceptions for purposes of this section:

(a) Not at the customer's election: Establishing a customer relationship is not at the customer's election if a licensee acquires or is assigned a customer's health insurance policy from another financial institution or residual market mechanism and the customer does not have a choice about the licensee's acquisition or assignment.

(b) Substantial delay of a customer's transaction: Providing notice not later than when a licensee establishes a customer relationship would substantially delay the customer's transaction when the licensee and the individual agree over the telephone to enter into a customer relationship involving prompt delivery of the health insurance product or service.

(c) No substantial delay of a customer's transaction: Providing notice not later than when a licensee establishes a customer relationship would not substantially delay the customer's transaction when the relationship is initiated in person at the licensee's office or through other means by which the customer may view the notice, such as on a website.

(6) When a licensee is required to deliver an initial privacy notice by OAR 836-080-0620, the licensee shall deliver it according to 836-080-0660. If the licensee uses an abbreviated notice according to 836-080-0620, the licensee may deliver the privacy notice as provided in 836-080-0640(8).

(7) A licensee that uses a standard privacy notice to comply with the requirements of the federal Gramm-Leach-Bliley Act of 1999 and its implementing regulations for its business as a financial institution or that uses such a standard privacy notice for its health insurance business in two or more states may comply with the initial privacy notice requirement by using either of the following options:

(a) By using the standard privacy notice and another supplementary privacy notice that includes the elements required by OAR 836-080-0615, 836-080-0620 and 836-080-0650 that are not contained in the standard privacy notice. The supplementary privacy notice must prominently and clearly state that any rights an individual may have as described in that notice are not abridged or limited by the standard privacy notice that the individual may receive separately.

(b) By using a single Oregon-specific privacy notice that complies in its entirety with OAR 836-080-0615 and 836-080-0620, if allowed under federal law.

Or. Admin. Code § 836-080-0635

ID 4-2005, f. & cert. ef. 4-1-05

Stat. Auth.: ORS 731.244 & 746.608

Stats. Implemented: ORS 746.600 & 746.607