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This page contains notices of proposed rulemaking by the Insurance Division. For each rulemaking, you will find the hearing date (if any) and the deadline for comment, as well as the notice of hearing and the text of the proposal.

These proposed rules were developed in response to numerous complaints received by the Department of Consumer and Business Services regarding open enrollment periods and unexpected rate increases with respect to Medicare supplement policies. To address these complaints, the proposed rules:

• Clarify that for a person who receives "retroactive" eligibility for Medicare as a result of an appeal of an initial denial for eligibility, the six month open enrollment period begins after the person is notified of their eligibility, not on the date the person's eligibility has been backdated to.
• Adopt a "birthday rule" for Medicare supplement policies to allow an individual the opportunity to change Medicare supplement plans (as long as the new policy has the same or lesser benefits) with guaranteed issue and nondiscrimination in rating once per year for a period of thirty days beginning on the individual's birthday.

This rulemaking prescribes, for reporting year 2011, the required forms for the annual and supplemental financial statements required of insurers and health care service contractors under ORS 731.574, as well as the necessary instructions for completing the forms.

The proposed amendments to the rule also add information about how to inspect the instructions and forms necessary to complete the annual financial statements.

Senate Bill 738 requires that a health insurance policy covering dental health services must cover services provided by an expanded practice dental hygienist if the same services would be covered when provided by a licensed dentist and the expanded practice dental hygienist has entered into a provider contract with the insurer. Section 12 of SB 738 requires the Department of Consumer and Business Services (DCBS) to adopt rules requiring health insurers to report to DCBS on the reimbursement of services to expanded practice dental hygienists and requires DCBS to report the reimbursement information to the Oregon Board of Dentistry (OBD).

This new rule would establish those reporting requirements for health insurers that provide coverage for dental services in Oregon. The rule also defines “expanded practice dental hygienist” and “health insurer” for purposes of the reporting requirement.

This rule amendment will require health insurers to include, as a component of a small employer or individual health benefit plan rate filing, a document containing, among other important disclosures, summary information breaking down the expenditure of premium contributions, and further breaking down expenditures on medical claims. The Department of Consumer and Business Services intends to reference a federal form that contains these and other disclosures, which insurers will already be required to submit for certain rate filings. 

The department requests public comment on the content of the federal document and whether it will meet the needs of the department and consumers to clarify the basis for a rate change, including information about medical claims costs and a breakdown of insurer expenditures that make up the average rate.  The department would also request comments on the administrative costs of implementing this requirement.