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Oregonians who lose their jobs have two options to continue coverage under their group health plan. If their former employer has 20 or more workers, they are eligible under the Consolidated Omnibus Budget Reconciliation Act (COBRA). If their former employer has fewer than 20 workers, they are eligible under Oregon's state continuation law. The federal economic stimulus package extends a 65-percent subsidy for up to nine months of coverage. Recognizing the need for changes to state law to allow Oregonians to obtain the full advantage of the federal subsidy, the Oregon Legislative Assembly enacted House Bill 2433, which extends the period of eligibility for state continuation coverage from six months to nine months and allows the Director of the Department of Consumer and Business Services to adopt rules as necessary to allow Oregonians to take full advantage of the benefits provided by the federal law.  On April 28, 2009, the Director adopted temporary rules OAR 836-053-0850T, 836-053-0855T, 836-053-0860T, 836-053-0865T (the temporary rules) that enacted the following provisions to implement House Bill 2433:

• Extend the period of continuation coverage for assistance eligible individuals (AEIs) to provide coverage periods of  no less than nine months
• Allow an independent election of coverage for all qualified beneficiaries
• Create a second election opportunity for state continuation coverage for AEIs who experienced a qualifying event on or after 09/01/08 and before April 28, 2009 and either did not elect or whose continuation coverage ended for any reason (e.g., lapse due to nonpayment, expiration of 6-month coverage period)
• Establish notice requirements for insurers
• Specify that enrollees who take advantage of the second election opportunity are provided a period of continuous coverage for purposes of calculating creditable coverage

Adoption of these rules will enable Oregonians who are covered by the state's continuation of health benefit program (“mini COBRA”) to receive the same level of benefits and have the same access to benefits under the state program as Oregonians who are eligible to receive benefits under the federal Consolidated Omnibus Budget Reconciliation Act (COBRA) program and under the American Recovery and Reinvestment Act of 2009.  These rules are intended to carry out the intent of HB 2433 in making the state program consistent with federal law to the maximum extent possible.
 
Because the temporary rules expire on October 24, 2009, these permanent rules will repeal the temporary rules and enact permanent rules that continue the above outlined provisions to implement chapter 73, Oregon Law 2009 (Enrolled House Bill 2433).

House Bill 2116 was enacted by the Legislative Assembly in June 2009 and takes effect September 28, 2009.  The bill establishes a one percent assessment on health insurers based on the gross amount of premiums earned by the insurer during each calendar quarter.  The bill includes an option for the insurers to include the amount of the assessment in their premium rates.  For existing approved rates, insurers may include an additional one percent beginning October 1, 2009, without submitting their premium rate to the Insurance Division for review and approval.  If an insurer opts to include the additional one percent, the insurer must include a notice with all consumer billings explaining the increase.  The notice must comply with the form of notice prescribed by the Division.

These rules are necessary to fully implement the provisions of chapter 867, Oregon Laws 2009, including clarification of certain terms, information about reporting requirements relating to the assessment and requirements for an insurer that chooses to add the one percent assessment to an existing approved rate.

Because the bill takes effect September 28, 2009 and the assessment applies to the calendar quarter beginning October 1, 2009, it is necessary for the Division to adopt these temporary rules to provide guidance before the insurers must begin implementing the assessment.  The Division anticipates adopting permanent rules to replace these temporary rules.

This rulemaking amends recent changes to the Oregon Practitioner Credentialing Application and the Oregon Practitioner Recredentialing Application recommended by the Advisory Committee on Physician Credentialing Information in the Office for Oregon Health Policy and Research. The changes bring Oregon standards into compliance with national and federal standards. The applications allow collection of uniform information needed by health care service contractors to credential and recredential physicians seeking designation as participating providers for health plans. The Director of DCBS and the Director of Human Services are required to adopt identical rules in a timely manner to carry out the recommendations.

The Oregon Practitioner Credentialing Application and the Oregon Practitioner Recredentialing Application with the  changes adopted by this rule are available for review through the Insurance Division website at www.oregoninsurance.org.  Then click on "Laws, Rules and Bulletins."  If you wish to have a paper copy of the applications, please call 503-947-7272.

NAIC accreditation Part A Laws & Regulations standards require states to include in statute or regulation a provision that insurers reduce to zero any reserve credits or assets established with respect to existing reinsurance agreements entered into prior to the effective date of the Life and Health Reinsurance Agreements Model Regulation (OAR 836-012-0300 to 836-012-0330) which would not be recognized under the provisions of this regulation.  This requirement was contained in OAR 836-012-0330, which was repealed September 26, 2006.  The purpose of the 2006 rulemaking was to correct and update erroneous or superseded statutory, rule and other references in OAR chapter 836; to eliminate and replace obsolete material; and to make other editorial and nonsubstantive changes.

OAR 836-012-0330 appears to have been repealed in error.  The repeal of that rule removed the prohibition of an insurer reporting reserve credits or assets established with respect to existing reinsurance agreements entered into prior to the effective date of the Life and Health Reinsurance Agreements Model Regulation.  The repeal violates the Reinsurance Ceded accreditation standard, Part A, 10(m).

In order to remain accredited, the Division must enact this replacement rule prior to July 10, 2009.  The replacement rule simply states that any reserve credits or assets established with respect to reinsurance agreements entered into prior to November 9, 1995 that would not be entitled to recognition under the provisions of OAR 836-012-0300 to 836-012-0330 must be reduced to zero for purposes of the insurer’s annual statement filing.

The Division is undergoing an accreditation review at this time; this rule must be adopted before the review can proceed.