1. (1) This rule applies to plan years beginning on and after January 1, 2026.

2. (2) Every insurer that offers a health benefit plan for small employers or an individual health benefit plan must file with each rate filing a consumer-friendly summary document that includes the following:

   1. (a) Filing company’s legal name;
   2. (b) Filing company’s website;
   3. (c) Filing company’s customer service phone number;
   4. (d) Rate Filing SERFF tracking number;
   5. (e) Requested average annual rate change expressed as a percentage;
   6. (f) Range of requested annual rate change, from minimum to maximum, expressed as a percentage;
   7. (g) Requested rate change effective date;
   8. (h) Plans impacted including number of plans discontinued, number of plans modified by the rate request, and number of new plans created by the rate request;
   9. (i) Covered lives impacted by the rate request;
   10. (j) Visual representation of changes in service areas in this state;

   11. (k) A breakdown of the rate request attributed to the following:

       1. (A) Dollar and percentage for medical trend;
       2. (B) Dollar and percentage for pharmacy trend;
       3. (C) Dollar and percentage from recent legislation;
       4. (D) Dollar and percentage for market-wide uncertainty;
       5. (E) Dollar and percentage for other significant drivers of the rate request;
   12. (l) A breakdown of retained premium and Medical Loss Ratio for the past three, full calendar years and;

   13. (m) A narrative description of any significant changes in networks and may include, but not be limited to:

       1. (A) Changes in network type, such as switching from a preferred provider organization (PPO) to an exclusive provider organization (EPO);
       2. (B) Changes in out of area coverages;
       3. (C) Changes to major health care provider network contracting including, but not limited to, adding or removing large regional hospital systems.

Statutory/Other Authority

ORS 731.244 & Or Laws 2025, ch 121

Statutes/Other Implemented

ORS 743B.130

History

ID 14-2026, minor correction filed 07/20/2026, effective 07/20/2026
ID 8-2026, minor correction filed 07/01/2026, effective 07/01/2026
ID 13-2025, adopt filed 12/15/2025, effective 01/01/2026