Or. Admin. R. ch. 836, div. 52 – Insurance Policies | Midpage

Collections
Oregon Administrative Rules

52

Or. Admin. R. ch. 836, div. 52

Insurance Policies

Department of Consumer and Business Services

0103Purpose 0107Authority 0114Applicability and Scope 0119Definitions 0124Policy Definitions and Terms 0129Policy Provisions 0132Benefit Standards for 2010 Standardized Medicare Supplement Benefit Plan Policies or Certificates Issued for Delivery with an Effective Date of Coverage on or After June 1, 2010 0133Benefit Standards for 1990 Standardized Medicare Supplement Benefit Plan Policies or Certificates Issued for Delivery on or After July 1, 1992 and with an Effective Date of Coverage Prior to June 1, 2010 0134Minimum Benefit Standards for Policies or Certificates Issued for Delivery Prior to July 1, 1992 0136Standard Medicare Supplement Benefit Plans for 1990 Standardized Medicare Supplement Benefit Plan Policies or Certificates Issued for Delivery on or After July 1, 1992 and with an Effective Date of Coverage Prior to June 1, 2010 0138Open Enrollment 0139Medicare Select Policies and Certificates 0140Standards for Claims Payment 0141Standard Medicare Supplement Benefit Plans for 2010 Standardized Medicare Supplement Benefit Plan Policies or Certificates with an Effective Date of Coverage on or After June 1, 2010 0142Guaranteed Issue for Eligible Persons 0143Annual Opportunity to Select Another Medicare Supplement Policy or Certificate 0144Standard Medicare Supplement Benefit Plans for 2020 Standardized Medicare Supplement Benefit Plan Policies or Certificates Issued for Delivery to Individuals Newly Eligible for Medicare on or after January 1, 2020.0145Loss Ratio Standards and Refund or Credit of Premium 0151Filing and Approval of Policies and Certificates and Premium Rates 0156Permitted Compensation Arrangements 0160Required Disclosure Provisions 0165Requirements for Application Forms, Replacement Coverage 0170Filing Requirements for Advertising 0175Standards for Marketing 0180Appropriateness of Recommended Purchase and Excessive Insurance 0185Reporting of Multiple Policies 0190Prohibition Against Preexisting Conditions, Waiting Periods, Elimination Periods and Probationary Periods in Replacement Policies and Certificates 0192Prohibition Against Use of Genetic Information and Requests for Genetic Testing 0194Separability 0225Durational Limits for Health Maintenance Organizations 0230Provider Services Limits for Insurers and Health Care Contractors 0500Statutory Authority; Applicability 0508Definitions 0516Policy Definitions 0526Policy Practices and Provisions 0531Long Term Care Insurance Partnership Program 0546Required Policy Provisions 0556Required Disclosure of Rating Practices to Consumers 0566Initial Rate Filing Requirements 0576Prohibition Against Post-Claims Underwriting, Applications 0586Minimum Standards for Home Health and Community Care Benefits in Long-Term Care Insurance Policies 0596Standards for Covered Services 0606Use and Definition of “Home” or Similar Wording 0616Requirement to Offer Inflation Protection 0626Requirements for Application Forms and Replacement Coverage 0636Reporting Requirements 0637Annual Rate Certification Requirements 0639Training for Insurance Producers 0646Benefits Provided Through Advancement of Life Insurance Proceeds 0656Reserve Standards 0666Loss Ratio 0676Premium Rate Schedule Increases 0680Premium Rate Schedule Increases for Policies Subject to Loss Ratio Limits Related to Original Filings 0686Filing Requirements for Out-of-State Group Policies 0696Filing Requirements for Advertising 0706Standards for Marketing 0716Disclosure Statement 0726Suitability 0736Prohibition Against Preexisting Conditions, Waiting Periods and Probationary Periods in Replacement Policies and Certificates 0738Availability of New Services or Providers 0740Right to Reduce Coverage and Lower Premiums 0746Nonforfeiture Benefit Requirement 0756Standards for Benefit Triggers 0766Additional Standards for Benefit Triggers for Qualified Long-Term Care Insurance Contracts 0768Appealing An Insurer’s Determination That The Benefit Trigger Is Not Met 0770Prompt Payment of Clean Claims 0776Standard Format Outline of Coverage 0786Requirement to Deliver Shopper’s Guide 0790Disclosure of Benefits Paid 0800Purpose; Applicability 0810Replacement Upon Termination 0840Termination of Coverage 0850Multiple Employer Trusts 0860Form of Notice to Group Policyholder 1000Prosthetic and Orthotic Devices