1. (1) The bureau shall submit individual results of each test audit to the office or offices designated by the insurer as soon as the bureau audit is completed.
2. (2) For audits that do not result in a significant premium difference, defined as in excess of $500 in premium or in excess of two percent of the total standard premium, whichever is greater, the bureau shall provide the insurer with the policy numbers and the named insureds for all test audits closed without change.
3. (3) For audits that result in a significant premium difference, the bureau shall provide the insurer with a report explaining the difference and the effect of such difference upon the total premium. An example of this report template is located on the Department of Consumer and Business Services, Division of Financial Regulation website at dfr.oregon.gov.
4. (4) Results of test audits of individual insurers shall be confidential data under ORS 731.312.
5. (5) Immediately upon receipt of the bureau's report, the insurer shall determine whether it agrees with the bureau's findings, auditing the insured if necessary. If the insurer agrees with the bureau's findings, the insurer shall file the corrected information on the original or, if necessary, on a revised unit statistical report. When the net premium difference is not sufficient to qualify as an "error" but a single difference is sufficiently large to qualify as an error prior to any offsetting premium amounts, the insurer shall be advised of such differences by an "advisory" notice. Also, when individual claims have been assigned to an incorrect classification an "advisory" notice shall also be submitted to the insurer. Upon receipt of the "advisory" notice, the insurer shall report such payrolls or losses on the initial or, if necessary, a "C" (corrected) Unit Statistical Report. All test audit differences must be closed within sixty days of notification unless the insurer requests an extension and the request is approved by the bureau.
6. (6) When classifications utilized by the insurer are found to be in error, the bureau shall take the normal appropriate action to secure compliance.
7. (7) Findings resulting from test audits shall not be utilized in any action by an insurer to enforce premium collections.
8. (8) If there is disagreement with the bureau's findings, the insurer shall communicate with the designated contact at the National Council on Compensation Insurance office to resolve areas of contention.
9. (9) When an insurer is unable to resolve test audit differences with the bureau staff, the insurer may present an appeal to the committee.
10. (10) When an insurer is unable to resolve test audit differences with the committee, the insurer may present an appeal to the director for final determination.

Statutory/Other Authority

ORS 731.244 & ORS 737.318

Statutes/Other Implemented

ORS 737.318

History

ID 5-2019, amend filed 04/19/2019, effective 07/01/2019
ID 13-2012, f. 7-16-12, cert. ef. 1-1-13
ID 11-1994, f. 12-19-94, cert. ef. 1-1-95
ID 1-1988, f. & cert. ef. 1-20-88