1. (1) This rule establishes the methodology for defining a small employer to be used in any instance in which the definition set forth in ORS 743B.005 would apply and in rules of the Department of Consumer and Business Services implementing the Insurance Code.

2. (2) For purposes of determining the number of employees in a group health benefit plan, insurers and producers should follow:

   1. (a) For plan years beginning before January 1, 2024, the guidance entitled, “Revised Counting Methodology for Determining Small or Large Group,” as set forth in Exhibit A of this rule; and

   2. (b) For plan years beginning on or after January 1, 2024, the guidance entitled “Second Revised Counting Methodology for Determining Small or Large Group,” as set forth in Exhibit B of this rule.

      [ED. NOTE: To view attachments referenced in rule text, click here for PDF copy.]

Statutory/Other Authority

ORS 731.244, ORS 743B.003 & 743B.020

Statutes/Other Implemented

ORS 743B.003, 743B.020 & 743B.100

History

ID 2-2023, amend filed 01/26/2023, effective 01/01/2024
ID 11-2017, amend filed 11/22/2017, effective 01/01/2018
ID 3-2017, f. & cert. ef. 3-9-17
ID 4-2016, f. & cert. ef. 4-8-16
ID 12-2015(Temp), f. & cert. ef. 10-16-15 thru 4-11-16