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The Oregon Administrative Rules contain OARs filed through July 15, 2014
 
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DEPARTMENT OF CONSUMER AND BUSINESS SERVICES,
INSURANCE DIVISION

 

DIVISION 20

ADVERTISEMENTS OF HEALTH INSURANCE

836-020-0200

Purpose and Authority

The purpose of this rule is to assure truthful and adequate disclosure of all material and relevant information in the advertising of health insurance. This purpose is intended to be accomplished by the establishment of minimum standards and guidelines of conduct for such advertising. This rule is promulgated under the provisions of ORS 731.244, 742.009 and 746.075.

Stat. Auth.: ORS 731.244
Stats. Implemented: ORS 742.009 & ORS 746.075
Hist.: IC 53, f. 3-5-73, ef. 3-15-73; ID 15-1996, f. & cert. ef. 11-12-96

836-020-0205

Applicability

(1) This rule applies to all health insurance advertisements intended for presentation, distribution, or dissemination in this state.

(2) Every insurer shall establish and maintain a system of control over the content, form, and method of presentation, distribution, and dissemination of all such advertisements of its policies. All such advertisements, regardless of by whom written, created, designed, presented, distributed, or disseminated, shall be the responsibility of the insurer whose policies are advertised.

Stat. Auth.: ORS 731, ORS 743 & ORS 746
Stats. Implemented: ORS 742.009 & ORS 746.075
Hist.: IC 53, f. 3-5-73, ef. 3-15-73

836-020-0210

Definitions

(1) Definitions given in the Insurance Code and in this rule govern the construction of this rule.

(2) "Advertisement" includes:

(a) Written, oral, and pictorial material used in direct mail, newspapers, magazines, radio scripts, TV scripts, billboards, and other similar mediums for reaching the public;

(b) Written, oral, and pictorial material intended for individual presentation to the public, including, but not limited to, circulars, leaflets, booklets, depictions, illustrations; and

(c) Written, oral, and pictorial material prepared for any other use by insurance producers or other representatives of an insurer.

(3) "Policy" includes any certificate of insurance or statement of coverage.

(4) "Insurer" includes fraternal benefit societies and health care service contractors.

(5) "Health Insurance" does not include incidental coverages issued with or supplemental to liability insurance, or coverages included within the Insurance Code definition of life insurance.

(6) "Exception" means any policy provision whereby coverage for a specified hazard is entirely eliminated. An "exception" is a statement of a risk not assumed under the policy.

(7) "Reduction" means any policy provision which reduces the amount of the policy benefit. Under the terms of a "reduction", a risk of loss is assumed but payment upon the occurrence of such loss is limited to some amount or period that is less than would otherwise be the case had the reduction provision not been used.

(8) "Limitation" means any policy provision which restricts coverage under the policy, other than an "exception" or a "reduction".

Stat. Auth.: ORS 731, 743 & 746
Stats. Implemented: ORS 742.009 & 746.075
Hist.: IC 53, f. 3-5-73, ef. 3-15-73; ID 8-2005, f. 5-18-05, cert. ef. 8-1-05

836-020-0215

Method of Disclosure of Required Information

All information required to be disclosed by this rule shall be set out conspicuously, and in close conjunction with the statements to which the information relates or under appropriate captions of sufficient prominence that the information is not minimized, rendered obscure, presented in an ambiguous fashion or so intermingled with the content of the advertisement as to be confusing or misleading.

Stat. Auth.: ORS 731, ORS 743 & ORS 746
Stats. Implemented: ORS 742.009 & ORS 746.075
Hist.: IC 53, f. 3-5-73, ef. 3-15-73

836-020-0220

Form and Content of Advertisements

(1) The form and content of an advertisement shall be sufficiently complete and clear to avoid deception or the capacity or tendency to mislead or deceive. Whether an advertisement has a capacity or tendency to mislead or deceive will be determined by the Insurance Commissioner from the overall impression that the advertisement may reasonably be expected to create upon a person of average education or intelligence within the segment of the public to which it is directed.

(2) Advertisements shall be truthful and not misleading in fact or in implication. Words or phrases, the meaning of which is clear only by implication or by familiarity with insurance terminology, shall not be used.

Stat. Auth.: ORS 731, ORS 743 & ORS 746
Stats. Implemented: ORS 742.009 & ORS 746.075
Hist.: IC 53, f. 3-5-73, ef. 3-15-73

836-020-0225

Advertisements of Benefits Payable, Losses Covered, or Premiums Payable

(1) Deceptive Words, Phrases, or Illustrations Prohibited:

(a) No advertisement shall omit particular information or use particular words, phrases, statements, references, or illustrations if the omission of such information or use of such words, phrases, statements, references, or illustrations has the capacity, tendency, or effect of misleading or deceiving prospective purchasers as to the nature or extent of any policy benefit payable, loss covered, or premium payable. The fact that the offered policy is made available to a prospective insured for inspection prior to consummation of sale, or that an offer is made to refund the premium if the purchaser is not satisfied, does not remedy misleading statements;

(b) No advertisement shall use words or phrases such as "all", "full", "complete", "comprehensive", "unlimited", "up to", "as high as", "this policy will help pay your hospital and surgical bills", "this policy will help fill some of the gaps that Medicare and your present insurance leave out", "this policy will help to replace your income" (when used in reference to loss-of-time benefits), or similar words or phrases, in a manner which exaggerates any benefit beyond the terms of the policy;

(c) No advertisement shall contain descriptions of a policy limitation, exception, or reduction worded in a positive manner to imply that it is a benefit. Examples of this are describing a waiting period as a "benefit builder", or stating that "even pre-existing conditions are covered after two years". Words and phrases used in an advertisement to describe policy limitations, exceptions, or reductions shall fairly and accurately describe the negative features of the limitation, exception, or reduction;

(d) No advertisement of a benefit for which payment is conditional upon confinement in a hospital or similar facility shall use words or phrases such as "tax free", "extra cash", "extra income", "extra pay", or substantially similar words or phrases in a manner which has the capacity, tendency, or effect of misleading prospective purchasers into believing that the policy advertised will in some way enable them to make a profit from being hospitalized. This rule does not prohibit the use of complete and accurate terminology explaining the federal Internal Revenue Service rules applicable to the taxation of various types of health insurance benefits. It is noted that such rules provide that premiums paid for and benefits received from hospital indemnity policies are subject to the same rule as loss-of-time premiums and benefits, and are not afforded the same favorable tax treatment as expense-incurred hospital, medical, and surgical benefit coverages;

(e) No advertisement of a hospital or similar facility confinement benefit shall advertise that the amount of the benefit is payable on a monthly or weekly basis when, in fact, the amount of the benefit payable is on a daily pro rata basis relating to the number of days of confinement. When the policy contains a limit on the number of days of coverage provided, the limit must appear in the advertisement;

(f) No advertisement of a policy covering only one or more specified diseases shall imply coverage beyond the terms of the policy. Several synonymous terms shall not be used to refer to any one disease so as to imply broader coverage than is the fact;

(g) An advertisement for a policy providing benefits for specified illnesses only, such as cancer, or for specified accidents only, such as automobile accidents, shall clearly and conspicuously in prominent type state the limited nature of the policy;

(h) An advertisement of an insurance policy sold by direct mail shall not imply that, because "no insurance agent will call and no commission will be paid to agents", it is a "low cost plan", or use similar phrases. A statement that "no agent will call" is not of itself misleading.

(2) Limitations, Exceptions, and Reductions:

(a) When an advertisement refers to a dollar amount of a benefit, a period of time for which a benefit is payable, the cost of the policy or of a specific policy benefit, or the loss for which such benefit is payable, it shall also disclose the limitations, exceptions, and reductions affecting the basic provisions of the policy without which disclosure the advertisement would have the capacity or tendency to mislead or deceive;

(b) When a policy contains a waiting elimination, probationary or similar time period between the effective date of the policy and the effective date of coverage under the policy, or a time period between the date a loss occurs and the date benefits begin to accrue for such loss, an advertisement to which the preceding paragraph is applicable shall disclose the existence of such periods;

(c) An advertisement shall not use the words "only", "just", "merely", "minimum", or similar words or phrases to describe the applicability of any exceptions and reductions. An example is: "This policy is subject to the following minimum exceptions and reductions:".

(3) Pre-Existing Conditions:

(a) An advertisement to which section (2) of this rule is applicable shall disclose in negative terms the extent to which any loss is not covered if the cause of the loss is traceable to a condition existing prior to the effective date of the policy. No use of the term "pre-existing condition" shall be made without an appropriate definition or description;

(b) When a policy does not cover losses resulting from pre-existing conditions, no advertisement of the policy shall state or imply that the applicant's physical condition or medical history will not affect the issuance of the policy or payment of claim thereunder. This paragraph prohibits the use of the phrase "no medical examination required" and phrases of similar import, but does not prohibit explaining "automatic issue";

(c) When an advertisement contains an application form to be completed by the applicant and returned by mail for a direct response insurance coverage, the application form shall contain a question or statement, immediately preceding the blank space for the applicant's signature, which reflects the pre-existing condition provisions of the policy. The question or statement shall be substantially as follows:

(A) (Question) "Do you understand that this policy will not pay benefits during the first ______ year(s) after the issue date for a disease or physical condition which you now have or have had in the past?"

(B) (Statement) "I understand that this policy will not pay benefits for any loss incurred during the first year(s) after the issue date on account of a disease or physical condition which I now have or have had in the past."

Stat. Auth.: ORS 731, ORS 743 & ORS 746
Stats. Implemented: ORS 742.009 & ORS 746.075
Hist.: IC 53, f. 3-5-73, ef. 3-15-73

836-020-0230

Necessity for Disclosing Policy Provisions Relating to Renewal, Cancellation, and Termination

When an advertisement refers to a dollar amount of a benefit, a period of time for which a benefit is payable, the cost of the policy or of a specific policy benefit, or the loss for which such benefit is payable, it shall also disclose the provisions relating to renewal, cancellation, and termination and any modification of benefits or losses covered or increase in premiums because of age or other reasons, in a manner which shall not minimize or render obscure the qualifying conditions.

Stat. Auth.: ORS 731, ORS 743 & ORS 746
Stats. Implemented: ORS 742.009 & ORS 746.075
Hist.: IC 53, f. 3-5-73, ef. 3-15-73

836-020-0235

Testimonials or Endorsements by Third Parties

(1) Testimonials used in advertisements must be genuine, represent the current opinion of the author, be applicable to the policy advertised and be accurately reproduced. The insurer in using a testimonial makes as its own all of the statements contained therein, and the entire advertisement including such testimonial is subject to all the provisions of this rule.

(2) If the person making a testimonial, an endorsement, or an appraisal has a financial interest in the insurer or a related entity, as a stockholder, director, officer, employee or otherwise, this fact shall be disclosed in the advertisement. If a person is compensated for making a testimonial, endorsement or appraisal, this fact shall be disclosed in the advertisement by the phrase "paid endorsement" or its equivalent. This subsection does not require disclosure of payment of "union scale" for TV or radio performances. The payment of substantial amounts, directly or indirectly, for travel or entertainment or similar expenditures for filming or recording of TV or radio advertisements requires disclosure.

(3) An advertisement shall not state or imply that the insurer or the policy has been approved or endorsed by any individual, group of individuals, society, association or other person, unless such is the fact and unless any proprietary relationship between such person and the insurer is disclosed. If the person making the endorsement or testimonial has been formed by the insurer, or is owned or controlled by the insurer or the persons who own or control the insurer, this fact shall be disclosed in the advertisement.

(4) When a testimonial refers to benefits received under a policy, the specific claim data, including claim number, date of loss and other pertinent information, shall be retained by the insurer for inspection for a period of four years or until the filing of the next regular report of examination of the insurer, whichever is the longer period of time.

Stat. Auth.: ORS 731, ORS 743 & ORS 746
Stats. Implemented: ORS 742.009 & ORS 746.075
Hist.: IC 53, f. 3-5-73, ef. 3-15-73

836-020-0240

Use of Statistics

(1) An advertisement stating the dollar amount of claims paid, the number of persons insured or similar statistical information relating to an insurer or policy shall not use irrelevant facts, and must accurately reflect all of the relevant facts. Such an advertisement shall not imply that the statistics are derived from the advertised policy unless such is the fact. When the statistics are applicable to other policies or plans, the advertisement shall specifically so state.

(2) An advertisement shall not represent or imply that claim settlements by the insurer are "liberal" or "generous" or use words of similar import, or represent or imply that claim settle-ments are or will be beyond the actual terms of the policy. No unusual amount paid for a unique claim under an advertised policy shall be used.

(3) The source of any statistics used in an advertisement shall be identified in the advertisement.

Stat. Auth.: ORS 731, ORS 743 & ORS 746
Stats. Implemented: ORS 742.009 & ORS 746.075
Hist.: IC 53, f. 3-5-73, ef. 3-15-73

836-020-0245

Identification of Plan or Number of Policies

(1) When a choice of the amount of benefits is referred to, an advertisement shall disclose that the amount of benefits depends on the plan selected and that the premium will vary with the amount of benefits selected.

(2) When an advertisement refers to various benefits which may be contained in two or more policies other than group master policies, the advertisement shall disclose that such benefits are provided only through a combination of such policies.

Stat. Auth.: ORS 731, ORS 743 & ORS 746
Stats. Implemented: ORS 742.009 & ORS 746.075
Hist.: IC 53, f. 3-5-73, ef. 3-15-73

836-020-0250

Disparaging Comparisons and Statements

An advertisement shall not directly or indirectly make unfair or incomplete comparisons of policies or benefits, or comparisons of non-comparable policies, of other insurers, shall not disparage other insurers or their policies, services or business methods, and shall not disparage or unfairly characterize other methods of marketing insurance.

Stat. Auth.: ORS 731, ORS 743 & ORS 746
Stats. Implemented: ORS 742.009 & ORS 746.075
Hist.: IC 53, f. 3-5-73, ef. 3-15-73

836-020-0255

Licensed Jurisdictions and Status of Insurer

(1) An advertisement which is intended to be seen or heard beyond the limits of the jurisdictions in which the insurer is licensed shall not imply licensing beyond those limits.

(2) An advertisement shall not create the impression directly or indirectly that the insurer, its financial condition or status, the payment of its claims, or the merits, desirability or advisability of its policy forms or kinds or plans of insurance are approved, endorsed or accredited by this state or the federal government or any agency or official of either.

(3) If an advertisement states either that the insurer or the policy being offered is approved or licensed by this state or its Insurance Commissioner, it must also qualify the statement with words: "This does not constitute a recommendation or endorsement of (this company) (this policy)" or equivalent words.

Stat. Auth.: ORS 731, ORS 743 & ORS 746
Stats. Implemented: ORS 742.009 & ORS 746.075
Hist.: IC 53, f. 3-5-73, ef. 3-15-73

836-020-0260

Identity of Insurer and Policy

(1) The name of the actual insurer and, except for general invitations to inquire about details of individual policies, the form number or numbers of the policy advertised shall be clearly identified in all advertisements.

(2) No advertisement shall use any material, envelope, or combination of words or symbols which, by content, phraseology, shape, color, or other characteristics, is similar to material, envelopes, or combinations of words or symbols used by an agency of the federal government or this state, or which is otherwise of such a nature as to tend to confuse or mislead prospective insureds into believing that the solicitation is connected with an agency of the federal or a state government.

Stat. Auth.: ORS 731, ORS 743 & ORS 746
Stats. Implemented: ORS 742.009 & ORS 746.075
Hist.: IC 53, f. 3-5-73, ef. 3-15-73

836-020-0265

Group or Quasi-Group Implication

An advertisement of a particular policy shall not state or imply that prospective insureds become group or quasi-group members covered under a group policy and as such enjoy special rates or underwriting privileges, unless such is the fact.

Stat. Auth.: ORS 731, ORS 743 & ORS 746
Stats. Implemented: ORS 742.009 & ORS 746.075
Hist.: IC 53, f. 3-5-73, ef. 3-15-73

836-020-0270

Introductory, Initial, or Special Offers

(1)(a) An advertisement shall not directly or by implication represent that a policy or combination of policies is an introductory, initial, or special offer, that applicants will receive substantial advantages not available at a later date, or that the offer is available only to a specified group of individuals, unless such is the fact. An advertisement shall not contain phrases describing an enrollment period as "special" or "limited", or similar words or phrases, if the insurer uses such enrollment periods as its usual method of marketing health insurance;

(b) An enrollment period during which a particular insurance coverage may be purchased on an individual basis shall not be offered unless there has been a lapse of not less than three months between the close of the immediately preceding enrollment period for the same coverage and the opening of the new enrollment period. The advertisement shall indicate the date by which the applicant must mail the application, which shall be not less than ten days and not more than forty days from the date that such enrollment period is advertised in this state for the first time. This requirement applies to all advertising media used by the insurer. It does not apply to solicitations of employees or members of a group or association who are eligible under the Insurance Code for group, blanket, or franchise health insurance. All affiliated insurers in a group of insurers under common management or control are considered as one insurer for the purpose of this paragraph. "A particular insurance coverage" refers for the purpose of this paragraph to an insurance policy which provides substantially different benefits than those contained in any other policy of the insurer. Different terms of renewability, an increase or decrease in the dollar amount of benefits or an increase or decrease in any elimination period or waiting period from those available during an enrollment period for another policy shall not be considered sufficient to constitute a different coverage which is eligible for concurrent or overlapping enrollment periods.

(2) An advertisement shall not offer a policy which utilizes a reduced initial premium rate in a manner which overemphasizes the availability and the amount of the initial reduced premium. When an insurer charges an initial premium that differs in amount from the amount of the renewal premium payable on the same mode, the advertisement shall not display the amount of the reduced initial premium either more frequently or more prominently than the renewal premium, and both the initial reduced premium and the renewal premium shall be stated in a juxtaposition in each portion of the advertisement where the initial reduced premium appears.

(3) An advertisement shall not offer special awards such as a "safe driver's award".

(4)(a) If benefits are less for a particular age group, the reduced benefits for that group must be prominently set out in a separate section of an advertisement in such a manner that it would normally come to the attention of a casual reader;

(b) An advertisement for a policy covering accidental injury only must prominently state that illness or disease is not covered;

(c) An insurer soliciting business from customers, employees, or members of a particular company, employer, union, or other person must display the name of the insurer as prominently as that of the company, employer, union, or such other person, and must clearly indicate that there is no affiliation between the insurer and such person unless some significant affiliation does in fact exist.

(5)(a) An advertisement of an individual policy which provides for a direct response by including an application or enrollment form shall contain a "policy summary" setting out the essential features of the policy that will be issued upon acceptance of an application by the insurer;

(b) The policy summary shall be prominently displayed and readily distinguishable from all other portions of the advertisement. The policy summary shall explain the essential features of the policy in simple, concise, and readily understandable language, as in the following example:

POLICY SUMMARY

(or other descriptive title)

-A- This policy provides $16.27 daily hospital benefits.

-B- This policy is guaranteed renewable to age 65.

-C- The insurance company can change the premium.

-D- Pre-existing conditions are not covered for the first two years.

-E- Benefits are payable from the first day of accidents and the eighth day of sickness.

-F- Benefits are reduced at age 65.

-G- This policy does not cover mental illness, alcoholism, or drug addiction.

-H- (Other significant policy provisions).

Stat. Auth.: ORS 731, ORS 743 & ORS 746
Stats. Implemented: ORS 742.009 & ORS 746.075
Hist.: IC 53, f. 3-5-73, ef. 3-15-73; ID 2-1987, f. & ef. 3-3-87

836-020-0275

Statements About an Insurer

An advertisement shall not contain statements which are untrue in fact, or misleading by implication, with respect to the assets, corporate structure, financial standing, age, or relative position of the insurer in the insurance business. An advertisement shall not contain a recommendation by any commercial rating system unless it clearly indicates the purpose of the recommendation and the limitations of the scope and extent of the recommendation.

Stat. Auth.: ORS 731, ORS 743 & ORS 746
Stats. Implemented: ORS 742.009 & ORS 746.075
Hist.: IC 53, f. 3-5-73, ef. 3-15-73

836-020-0280

Enforcement Procedures

(1) Advertising File. Each insurer shall maintain at its home or principal office a complete file containing every advertisement prepared for its individual policies, and typical advertisements prepared for its blanket, franchise and group policies, for dissemination after the effective date of this rule in this or any other state, whether or not licensed in such other state. A notation shall be attached to each advertisement which shall indicate the manner and extent of distribution and the form number of any individual policy advertised. This file shall be available at all times for inspection by the Insurance Commissioner. Advertisements shall be maintained in the file for a period of four years or until the filing of the next regular report of examination of the insurer, whichever is the longer period of time.

(2) Statement of Compliance. Each insurer subject to this rule must file with its annual statement a statement of compliance executed by an authorized officer of the insurer. The officer shall state that, to the best of his knowledge, information and belief, the advertisements disseminated by the insurer during the preceding calendar year complied, or were made to comply, in all respects with this rule.

Stat. Auth.: ORS 731, ORS 743 & ORS 746
Stats. Implemented: ORS 742.009 & ORS 746.075
Hist.: IC 53, f. 3-5-73, ef. 3-15-73

836-020-0285

Prior Approval

No advertising which includes an application or enrollment form may be used without its prior approval by the Insurance Commissioner.

Stat. Auth.: ORS 731, ORS 743 & ORS 746
Stats. Implemented: ORS 742.009 & ORS 746.075
Hist.: IC 53, f. 3-5-73, ef. 3-15-73

836-020-0290

Severability

If any portion of this rule, or the applicability of this rule to any person or circumstance, is held invalid by a court, the remainder of the rule or the applicability of the rule to other persons or circumstances shall not be affected thereby.

Stat. Auth.: ORS 731, ORS 743 & ORS 746
Stats. Implemented: ORS 742.009 & ORS 746.075
Hist.: IC 53, f. 3-5-73, ef. 3-15-73

836-020-0295

Effective Date

This rule shall be effective March 15, 1973.

Stat. Auth.: ORS 731, ORS 743 & ORS 746
Stats. Implemented: ORS 742.009 & ORS 746.075
Hist.: IC 53, f. 3-5-73, ef. 3-15-73

Disclosure of Health Insurance Coverages

836-020-0300

Statutory Authority

(1) OAR 836-020-0300 to 836-020-0305 are adopted by the Director of the Department of Insurance and Finance pursuant to the requirements of ORS 742.009, 743.010 and 743.013 (Section 2, Chapter 474, Oregon Laws 1989).

(2) OAR 836-020-0300 to 836-020-0305 apply to solicitations of health insurance occurring on or after September 1, 1990.

Stat. Auth.: ORS 731, ORS 742 & ORS 743
Stats. Implemented: ORS 742.009, ORS 743.010 & ORS 743.013
Hist.: ID 12-1990, f. 6-12-90, cert. ef. 9-1-90

836-020-0305

Disclosure; Application for Coverage

(1) When an insurance producer or representative of an insurer accepts an application for individual health insurance coverage other than coverage described in section (2) of this rule, the insurance producer or representative shall provide the applicant the documents required under this section. In the case of direct response solicitations of such individual health insurance coverage, the documents required under this section must be provided in conjunction with any application form. The following are the documents required to be provided under this section:

(a) A completed disclosure statement in the form shown in Exhibit 1 to this rule;

(b) An outline of coverage in the form shown for the applicable coverage in Exhibit 2 to this rule. If the offered policy provides coverage other than a coverage described in an outline of coverage in Exhibit 2 to this rule, the insurance producer or representative or the direct response insurer must deliver an outline that has first been approved by the Director under section (6) of this rule.

(2) When an insurance producer or representative of an insurer accepts an application for individual accidental death and dismemberment insurance, accident only insurance or hospital indemnity insurance, the insurance producer or representative shall provide the applicant the documents required under this section. In the case of direct response solicitations of such insurance, the documents required under this section must be provided in conjunction with any application form. The following are the documents required to be provided under this section:

(a) A completed disclosure statement in the form shown in Exhibit 3 to this rule;

(b) An outline of coverage in the form shown for the applicable coverage in Exhibit 2 to this rule. If the offered policy provides coverage other than a coverage described in an outline of coverage in Exhibit 2 to this rule, the insurance producer, representative or insurer must deliver an outline that has first been approved by the Director under section (5) of this rule.

(3) When an insurance producer or representative of an insurer accepts an application for group health insurance coverage, including group accidental death and dismemberment insurance, accident only insurance or hospital indemnity insurance, the insurance producer or representative shall provide to the applicant an outline of coverage in the form shown for the applicable coverage in Exhibit 2 to this rule. In the case of direct response solicitations, the outline must be provided in conjunction with any application form. If the offered policy provides coverage other than a coverage described in an outline of coverage in Exhibit 2 to this rule, the outline must first be approved by the Director under section (5) of this rule.

(4) For purposes of sections (1) to (3) of this rule, the following forms shall be used for the following coverages:

(a) Exhibit 2, form A, shall be used for comprehensive major medical expense coverage;

(b) Exhibit 2, form B, shall be used for hospital confinement indemnity coverage;

(c) Exhibit 2, form C, shall be used for accidental death and dismemberment only coverage and for accident only coverage;

(d) Exhibit 2, form D, shall be used for specified illness or specified accident coverage;

(e) Exhibit 2, form E, shall be used for limited benefit health coverage;

(f) Exhibit 2, form F, shall be used for basic hospital and medical-surgical expense coverage.

(5) An insurance producer or representative of an insurer may use a form or material other than the statements set forth in Exhibits 1 and 3 to this rule or the outlines set forth in Exhibit 2 to this rule only if the form or material is first approved by the Director for the purpose of disclosure under this rule. Forms and other material submitted under this section are subject to the standards for advertising under OAR 836-020-0220 and 836-020-0225.

(6) When an insurance producer or representative of an insurer provides an applicant the applicable information required under section (1), (2) or (3) of this rule, or a form or material approved under section (5) of this rule, the insurance producer or representative shall obtain from the applicant an acknowledgement that the applicable information required under this rule was provided. In the case of direct response solicitations, the insurer or its representative or agent shall maintain proof that the documents required under this rule have been mailed to the applicant.

(7) This rule applies to all solicitations for health insurance, whether for initial, replacement or added coverage, except for solicitations for the following:

(a) Renewal of a health insurance policy, unless the application is to be used for the purpose of underwriting the policyholder;

(b) Medicare supplement insurance policies;

(c) Long term care insurance policies;

(d) Disability income insurance policies, as exempted from these rules under ORS 743.013;

(e) Accidental death and dismemberment insurance coverage and accident only insurance coverage when sold as a rider to a life insurance policy;

(f) Any individual policy issued under a conversion privilege in an insurance policy or contract.

[[ED. NOTE: Exhibits referenced are available from the agency.]

Stat. Auth.: ORS 731, 742 & 743
Stats. Implemented: ORS 742.009, 743.010 & 743.013
Hist.: ID 12-1990, f. 6-12-90, cert. ef. 9-1-90; ID 8-2005, f. 5-18-05, cert. ef. 8-1-05

Use of Coordination of Benefits Provisions

836-020-0770

Authority, Purpose and Effective Date of OAR 836-020-0770 to 836-020-0806

(1) OAR 836-020-0770 to 836-020-0806 are adopted by the Director of the Department of Consumer and Business Services pursuant to the authority of ORS 731.244 and 743.552, for the purpose of implementing 743.552.

(2) The purpose of OAR 836-020-0770 to 836-020-0806 is to:

(a) Establish a uniform order of benefit determination under which plans pay claims;

(b) Reduce duplication of benefits by permitting a reduction of the benefits to be paid by plans that, as provided in OAR 836-020-0770 to 836-020-0806, do not have to pay their benefits first; and

(c) Provide greater efficiency in the processing of claims when a person is covered under more than one plan.

Stat. Auth: ORS 731.244, 743.552
Stats. Implemented: ORS 743.552
Hist.: ID 14-2006, f. & cert. ef. 7-20-06; ID 3-2007, f. & cert. ef. 2-12-07; ID 12-2013, f. 12-31-13, cert. ef. 1-1-14

836-020-0775

Definitions

As used in OAR 836-020-0770 to 836-020-0806:

(1) "Allowable expense," except as otherwise provided in this rule or as otherwise used in a statute, is defined and its use is governed by the following:

(a) The term means any health care expense, including coinsurance or copayments and without reduction for any applicable deductible, that is covered in full or in part by any of the plans covering the person.

(b) If a plan is advised by a covered person that all plans covering the person are high-deductible health plans and the person intends to contribute to a health savings account established in accordance with Section 223 of the Internal Revenue Code of 1986, the primary high-deductible health plan's deductible is not an allowable expense, except for any health care expense incurred that may not be subject to the deductible as described in section 223(c)(2)(C) of the Internal Revenue Code of 1986.

(c) An expense or a portion of an expense that is not covered by any of the plans is not an allowable expense.

(d) Any expense that a provider by law or in accordance with a contractual agreement is prohibited from charging a covered person is not an allowable expense.

(e) The following are examples of expenses that are not allowable expenses:

(A) If a person is confined in a private hospital room, the difference between the cost of a semi-private room in the hospital and the private room is not an allowable expense, unless one of the plans provides coverage for private hospital room expenses.

(B) If a person is covered by two or more plans that compute their benefit payments on the basis of usual and customary fees or relative value schedule reimbursement or other similar reimbursement methodology, any amount charged by the provider in excess of the highest reimbursement amount for a specified benefit is not an allowable expense.

(C) If a person is covered by two or more plans that provide benefits or services on the basis of negotiated fees, any amount in excess of the highest of the negotiated fees is not an allowable expense.

(D) If a person is covered by one plan that calculates its benefits or services on the basis of usual and customary fees or relative value schedule reimbursement or other similar reimbursement methodology and another plan that provides its benefits or services on the basis of negotiated fees, the primary plan's payment arrangement shall be the allowable expense for all plans. However, if the provider has contracted with the secondary plan to provide the benefit or service for a specific negotiated fee or payment amount that is different than the primary plan's payment arrangement and if the provider's contract permits, that negotiated fee or payment shall be the allowable expense used by the secondary plan to determine its benefits.

(f) The definition of "allowable expense" may exclude certain types of coverage or benefits such as dental care, vision care, prescription drug or hearing aids. A plan that limits the application of COB to certain coverages or benefits may limit the definition of allowable expense in its contract to expenses that are similar to the expenses that it provides. When COB is restricted to specific coverages or benefits in a contract, the definition of allowable expense shall include similar expenses to which COB applies.

(g) When a plan provides benefits in the form of services, the reasonable cash value of each service is considered an allowable expense and a benefit paid.

(h) The amount of the reduction may be excluded from allowable expense when a covered person's benefits are reduced under a primary plan:

(A) Because the covered person does not comply with the plan provisions concerning second surgical opinions or precertification of admissions or services; or

(B) Because the covered person has a lower benefit for the reason that the covered person did not use a preferred provider.

(2) "Birthday" refers only to month and day in a calendar year and does not include the year in which the individual is born.

(3) "Claim" means a request that benefits of a plan be provided or paid. The benefits claimed may be in the form of:

(a) Services, including supplies;

(b) Payment for all or a portion of the expenses incurred;

(c) A combination of subsections (a) and (b) of this section; or

(d) An indemnification.

(4) "Closed panel plan" means a plan that provides health benefits to covered persons primarily in the form of services through a panel of providers that have contracted with or are employed by the plan, and that excludes benefits for services provided by other providers, except in cases of emergency or referral by a panel member.

(5) "Consolidated Omnibus Budget Reconciliation Act of 1985" or "COBRA" means coverage provided under a right of continuation pursuant to federal law.

(6) "Coordination of benefits" or "COB" means a provision establishing an order in which plans pay their claims, and permitting secondary plans to reduce their benefits so that the combined benefits of all plans do not exceed total allowable expenses.

(7) "Custodial parent" means:

(a) The parent awarded custody of a child by a court decree; or

(b) In the absence of a court decree, the parent with whom the child resides more than one half of the calendar year without regard to any temporary visitation.

(8) "Group-type contract:"

(a) Means a contract that is not available to the general public and is obtained and maintained only because of membership in or a connection with a particular organization or group, including blanket coverage; and.

(b) Does not include an individually underwritten and issued guaranteed renewable policy even if the policy is purchased through payroll deduction at a premium savings to the insured since the insured would have the right to maintain or renew the policy independently of continued employment with the employer.

(9) "High-deductible health plan" has the meaning given the term under section 223 of the Internal Revenue Code of 1986, as amended by the Medicare Prescription Drug, Improvement and Modernization Act of 2003.

(10) "Hospital indemnity benefits:"

(a) Means benefits not related to expenses incurred; and

(b) "Hospital indemnity benefits" does not include reimbursement-type benefits even if they are designed or administered to give the insured the right to elect indemnity-type benefits at the time of claim.

(11) "Plan" is defined and its use is governed by the following:

(a) “Plan” means a form of coverage with which coordination is allowed. Separate parts of a plan for members of a group that are provided through alternative contracts that are intended to be part of a coordinated package of benefits are considered one plan and there is no COB among the separate parts of the plan.

(b) If a plan coordinates benefits, its contract shall state the types of coverage that will be considered in applying the COB provision of that contract. Whether the contract uses the term "plan" or some other term such as "program," the contractual definition may be no broader than the definition of "plan" in this subsection. The definition of "plan" in the model COB provision in Appendix A (Exhibit 1 to OAR 836-020-0780) is an example.

(c) "Plan" includes:

(A) Group and individual insurance contracts and subscriber contracts;

(B) Uninsured arrangements of group or group-type coverage;

(C) Group and individual coverage through closed panel plans;

(D) Group-type contracts;

(E) The medical care components of group long-term care contracts, such as skilled nursing care; and

(E) The medical care components of group long-term care contracts, such as skilled nursing care; and

(F) Medicare or other governmental benefits, as permitted by law, except as provided in subsection (d)(H) of this section. That part of the definition of plan may be limited to the hospital, medical and surgical benefits of the governmental program;and

(G) Group and individual insurance contracts and subscriber contracts that pay or reimburse for the cost of dental care.

(d) "Plan" does not include:

(A) Independent, noncoordinated hospital indemnity coverage benefits or other fixed indemnity coverage;

(B) Accident only coverage;

(C) Specified disease or specified accident coverage;

(D) School accident-type coverages that cover students for accidents only, including athletic injuries, either on a twenty-four-hour basis or on a "to and from school" basis;

(E) Benefits provided in group long-term care insurance policies for non-medical services, including for example, personal care, adult day care, homemaker services, assistance with activities of daily living, respite care and custodial care or for contracts that pay a fixed daily benefit without regard to expenses incurred or the receipt of services;

(F) Medicare supplement policies;

(G) A state plan under Medicaid; or

(H) A governmental plan, that by law provides benefits that are in excess of those of any private insurance plan or other non-governmental plan.

(12) "Primary plan" means a plan whose benefits for a person's health care coverage must be determined without taking the existence of any other plan into consideration. A plan is a primary plan if:

(a) The plan has no order of benefit determination rules or its rules differ from those permitted by OAR 836-020-0770 to 836-020-0806; or

(b) All plans that cover the person use the order of benefit determination rules required by OAR 836-020-0770 to 836-020-0806, and under those rules the plan determines its benefits first.

(13) "Secondary plan" means a plan that is not a primary plan.

[ED. NOTE: Appendices referenced are available from the agency.]

Stat. Auth: ORS 731.244, 743.552
Stats. Implemented: ORS 743.552
Hist.: ID 14-2006, f. & cert. ef. 7-20-06; ID 12-2013, f. 12-31-13, cert. ef. 1-1-14

836-020-0780

Use of Model COB Contract Provision

(1) Appendix A (Exhibit 1 to this rule) contains a model COB provision for use in contracts. The use of this model COB provision is subject to OAR 836-020-0785(1), (2) and (3).

(2) Appendix B (Exhibit 2 to this rule) is a plain language description of the COB process that explains to the covered person how health plans will implement coordination of benefits. It is not intended to replace or change the provisions that are set forth in the contract. Its purpose is to explain the process by which the two or more plans will pay for or provide benefits.

(3) The COB provision contained in Appendix A and the plain language explanation in Appendix B do not have to use the specific words and format shown in Appendix A or Appendix B. Changes may be made to fit the language and style of the rest of the contract or to reflect differences among plans that provide services, that pay benefits for expenses incurred and that indemnify. No substantive changes are permitted.

(4) A COB provision may not be used that permits a plan to reduce its benefits on the basis that:

(a) Another plan exists and the covered person did not enroll in that plan;

(b) A person is eligible or could have been covered under another plan, except with respect to Part B of Medicare; or

(c) A person has elected an option under another plan providing a lower level of benefits than another option that could have been elected.

(5) A plan may not contain a provision that its benefits are "always excess" or "always secondary" except in accordance with the rules permitted by OAR 836-020-0770 to 836-020-0806.

(6) Under the terms of a closed panel plan, benefits are not payable if the covered person does not use the services of a closed panel provider. In most instances, COB does not occur if a covered person is enrolled in two or more closed panel plans and obtains services from a provider in one of the closed panel plans because the other closed panel plan (the one whose providers were not used) has no liability. However, COB may occur during the plan year when the covered person receives emergency services that would have been covered by both plans. Then the secondary plan shall use OAR 836-020-0790 to determine the amount it should pay for the benefit.

(7) A plan may not use a COB provision, or any other provision that allows it to reduce its benefits with respect to any other coverage its insured may have, that does not meet the definition of plan in OAR 836-020-0775.

[ED. NOTE: Appendices referenced are available from the agency.]

Stat. Auth: ORS 731.244, 743.552
Stats. Implemented: ORS 743.552
Hist.: ID 14-2006, f. & cert. ef. 7-20-06; ID 12-2013, f. 12-31-13, cert. ef. 1-1-14

836-020-0785

Rules for Coordination of Benefits

When a person is covered by two or more plans, the rules for determining the order of benefit payments are as follows:

(1)(a) The primary plan shall pay or provide its benefits as if the secondary plan or plans did not exist.

(b) If the primary plan is a closed panel plan and the secondary plan is not a closed panel plan, the secondary plan shall pay or provide benefits as if it were the primary plan when a covered person uses a non-panel provider, except for emergency services or authorized referrals that are paid or provided by the primary plan.

(c) When multiple contracts providing coordinated coverage are treated as a single plan under OAR 836-020-0770 to 836-020-0806, this rule applies only to the plan as a whole, and coordination among the component contracts is governed by the terms of the contracts. If more than one carrier pays or provides benefits under the plan, the carrier designated as primary within the plan shall be responsible for the plan's compliance with 836-020-0770 to 836-020-0806.

(d) If a person is covered by more than one secondary plan, the order of benefit determination rules of OAR 836-020-0770 to 836-020-0806 decide the order in which secondary plans benefits are determined in relation to each other. Each secondary plan shall take into consideration the benefits of the primary plan or plans and the benefits of any other plan that, under the rules of 836-020-0770 to 836-020-0806, has its benefits determined before those of that secondary plan.

(2)(a) Except as provided in subsection (b) of this section, a plan that does not contain order of benefit determination provisions that are consistent with OAR 836-020-0770 to 836-020-0806 is always the primary plan unless the provisions of both plans, regardless of the provisions of this subsection, state that the complying plan is primary.

(b) Coverage that is obtained by virtue of membership in a group and designed to supplement a part of a basic package of benefits may provide that the supplementary coverage shall be excess to any other parts of the plan provided by the contract holder. Examples of these types of situations are major medical coverages that are superimposed over base plan hospital and surgical benefits, and insurance type coverages that are written in connection with a closed panel plan to provide out-of-network benefits.

(3) A plan may take into consideration the benefits paid or provided by another plan only when, under the rules of OAR 836-020-0770 to 836-020-0806, it is secondary to that other plan.

(4) Order of benefit determination: Each plan must determine its order of benefits using the first of the following rules that applies:

(a) Rule regarding non-dependent or dependent:

(A) Subject to paragraph (B) of this subsection, the plan that covers the person other than as a dependent, for example as an employee, member, subscriber or retiree, is the primary plan and the plan that covers the person as a dependent is the secondary plan.

(B)(i) If the person is a Medicare beneficiary, and, as a result of the provisions of Title XVIII of the Social Security Act and implementing regulations, Medicare is:

(I) Secondary to the plan covering the person as a dependent; and

(II) Primary to the plan covering the person as other than a dependent (e.g. a retired employee),

(C) Then the order of benefits is reversed so that the plan covering the person as an employee, member, subscriber or retiree is the secondary plan and the other plan covering the person as a dependent is the primary plan.

(b) Rule regarding dependent child covered under more than one plan. Unless there is a court decree stating otherwise, plans covering a dependent child shall determine the order of benefits as follows:

(A) For a dependent child whose parents are married or are living together, whether or not they have ever been married:

(i) The plan of the parent whose birthday falls earlier in the calendar year is the primary plan; or

(ii) If both parents have the same birthday, the plan that has covered the parent longest is the primary plan.

(B) For a dependent child whose parents are divorced or separated or are not living together, whether or not they have ever been married:

(i) If a court decree states that one of the parents is responsible for the dependent child's health care expenses or health care coverage and the plan of that parent has actual knowledge of those terms, that plan is primary. If the parent with responsibility has no health care coverage for the dependent child's health care expenses, but that parent's spouse does, that parent's spouse's plan is the primary plan. This subparagraph does not apply with respect to any plan year during which benefits are paid or provided before the entity has actual knowledge of the court decree provision;

(ii) If a court decree states that both parents are responsible for the dependent child's health care expenses or health care coverage, the provisions of paragraph (A) of this subsection determines the order of benefits;

(iii) If a court decree states that the parents have joint custody without specifying that one parent has responsibility for the health care expenses or health care coverage of the dependent child, the provisions of paragraph (A) of this subsection determines the order of benefits; or

(iv) If there is no court decree allocating responsibility for the child's health care expenses or health care coverage, the order of benefits for the child are as follows:

(I) The plan covering the custodial parent;

(II) The plan covering the custodial parent's spouse;

(III) The plan covering the non-custodial parent; and then

(IV) The plan covering the non-custodial parent's spouse.

(C) For a dependent child covered under more than one plan of individuals who are not the parents of the child, the order of benefits shall be determined, as applicable, under paragraph (A) or (B) of this subsection as if those individuals were parents of the child.

(D) For a dependent child:

(i) Who has coverage under either or both parents’ plans and who also has coverage as a dependent under a spouse’s plan, the rule in subsection (e) of this section applies.

(ii) In the event the dependent child’s coverage under the spouse’s plan began on the same date as the dependent child’s coverage under either or both parents’ plans, the order of benefits shall be determined by applying the birthday rule in paragraph (A) of this subsection to the dependent child’s parent and the dependent’s spouse.

(c) Rule regarding active employee or retired or laid-off employee:

(A) The plan that covers a person as an active employee that is, an employee who is neither laid off nor retired or as a dependent of an active employee is the primary plan. The plan covering that same person as a retired or laid-off employee or as a dependent of a retired or laid-off employee is the secondary plan.

(B) If the other plan does not have this rule, and as a result, the plans do not agree on the order of benefits, this rule is ignored.

(C) This rule does not apply if the rule in subsection (a) of this section can determine the order of benefits.

(d) Rule regarding COBRA or state continuation coverage:

(A) If a person whose coverage is provided pursuant to COBRA or under a right of continuation pursuant to state or other federal law is covered under another plan, the plan covering the person as an employee, member, subscriber or retiree or covering the person as a dependent of an employee, member, subscriber or retiree is the primary plan and the plan covering that same person pursuant to COBRA or under a right of continuation pursuant to state or other federal law is the secondary plan.

(B) If the other plan does not have this rule, and if, as a result, the plans do not agree on the order of benefits, this rule is ignored.

(C) This rule does not apply if the rule in subsection (a) of this section can determine the order of benefits

(e) Rule regarding longer or shorter length of coverage:

(A) If the preceding rules in this section do not determine the order of benefits, the plan that covered the person for the longer period of time is the primary plan and the plan that covered the person for the shorter period of time is the secondary plan.

(B) To determine the length of time a person has been covered under a plan, two successive plans shall be treated as one if the covered person was eligible under the second plan within 24 hours after coverage under the first plan ended.

(C) The start of a new plan does not include:

(i) A change in the amount or scope of a plan's benefits;

(ii) A change in the entity that pays, provides or administers the plan's benefits; or

(iii) A change from one type of plan to another, such as from a single employer plan to a multiple employer plan.

(D) The person's length of time covered under a plan is measured from the person's first date of coverage under that plan. If that date is not readily available for a group plan, the date the person first became a member of the group shall be used as the date from which to determine the length of time the person's coverage under the present plan has been in force.

(f) If none of the preceding rules of this section determines the order of benefits, the allowable expenses shall be shared equally between the plans.

Stat. Auth: ORS 731.244, 743.552
Stats. Implemented: ORS 743.552
Hist.: ID 14-2006, f. & cert. ef. 7-20-06; ID 12-2013, f. 12-31-13, cert. ef. 1-1-14

836-020-0791

Procedure to be Followed by Secondary Plan to Calculate Benefits and Pay a Claim

(1) In determining the amount to be paid by the secondary plan on a claim, should the plan wish to coordinate benefits, the secondary plan shall calculate the benefits it would have paid on the claim in the absence of other health care coverage and apply that calculated amount to any allowable expense under its plan that is unpaid by the primary plan.

(2) The secondary plan may reduce its payment by the amount so that, when combined with the amount paid by the primary plan, the total benefits paid or provided by all plans for the claim do not exceed 100 percent of the total allowable expense for that claim.

(3) In addition, the secondary plan shall credit to its plan deductible any amounts it would have credited to its deductible in the absence of other health care coverage.

Stat. Auth: ORS 731.244, 743.552
Stats. Implemented: 743.549, 743.552
Hist.: ID 14-2006, f. & cert. ef. 7-20-06

836-020-0796

Notice to Covered Persons

A plan shall, in its explanation of benefits provided to covered persons, include the following language: "If you are covered by more than one health benefit plan, you should file all your claims with each plan."

Stat. Auth: ORS 731.244, 743.552
Stats. Implemented: 743.549, 743.552
Hist.: ID 14-2006, f. & cert. ef. 7-20-06

836-020-0801

Miscellaneous Provisions

(1) A secondary plan that provides benefits in the form of services may recover the reasonable cash value of the services from the primary plan to the extent that benefits for the services are covered by the primary plan and have not already been paid or provided by the primary plan. Nothing in this section may be interpreted to require a plan to reimburse a covered person in cash for the value of services provided by a plan that provides benefits in the form of services.

(2)(a) A plan with order of benefit determination rules that comply with OAR 836-020-0770 to 836-020-0805 (complying plan) may coordinate its benefits with a plan that is "excess" or "always secondary" or that uses order of benefit determination rules that are inconsistent with those contained in 836-020-0770 to 836-020-0805 (non-complying plan) on the following basis:

(A) If the complying plan is the primary plan, it shall pay or provide its benefits first;

(B) If the complying plan is the secondary plan, it shall pay or provide its benefits first, but the amount of the benefits payable shall be determined as if the complying plan were the secondary plan. In such a situation, the payment shall be the limit of the complying plan's liability; and

(C) If the non-complying plan does not provide the information needed by the complying plan to determine its benefits within a reasonable time after it is requested to do so, the complying plan shall assume that the benefits of the non-complying plan are identical to its own, and shall pay its benefits accordingly. If, within two years of payment, the complying plan receives information as to the actual benefits of the non-complying plan, it shall adjust payments accordingly.

(b) If the non-complying plan reduces its benefits so that the covered person receives less in benefits than the covered person would have received had the complying plan paid or provided its benefits as the secondary plan and the non-complying plan paid or provided its benefits as the primary plan, and governing state law allows the right of subrogation set forth in subsection (c) of this section, then the complying plan shall advance to the covered person or on behalf of the covered person an amount equal to the difference.

(c) The complying plan may not advance more than the complying plan would have paid had it been the primary plan less any amount it previously paid for the same expense or service. In consideration of the advance, the complying plan shall be subrogated to all rights of the covered person against the non-complying plan. The advance by the complying plan shall also be without prejudice to any claim it may have against a non-complying plan in the absence of subrogation.

(3) COB differs from subrogation. Provisions for one may be included in health care benefits contracts without compelling the inclusion or exclusion of the other.

(4) If the plans cannot agree on the order of benefits within 30 calendar days after the plans have received all of the information needed to pay the claim, the plans shall immediately pay the claim in equal shares and determine their relative liabilities following payment, except that no plan shall be required to pay more than it would have paid had it been the primary plan.

Stat. Auth: ORS 731.244, 743.552
Stats. Implemented: 743.549, 743.552
Hist.: ID 14-2006, f. & cert. ef. 7-20-06

836-020-0806

Effective Date for Existing Contracts

(1) The amendments to OAR 836-020-0770, 836-020-0775 and 836-020-0785 apply to a contract that provides health care benefits and that was issued before January 1, 2015 must comply with the amendments to OAR 836-020-0770, 836-020-0775 and 836-020-0806 that are effective on January 1, 2014 by:

(a) The next anniversary date or renewal date of the contract; or

(b) The expiration of any applicable collectively bargained contract pursuant to which it was written.

(2) A question of the order of benefits between a contract operating under OAR 836-020-0770, 836-020-0775 and 836-020-0785 as amended effective January 1, 2014 for contracts issued or renewed on or after January 1, 2015 and a contract operating under the provisions of OAR 836-020-0770, 836-020-0775 and 836-020-0785 for contracts issued or renewed prior to January 1, 2015 is governed by the version of the rules in effect prior to amendment of the rules effective on January 1, 2014.

Stat. Auth: ORS 731.244, 743.552
Stats. Implemented: ORS 743.552
Hist.: ID 14-2006, f. & cert. ef. 7-20-06; ID 12-2013, f. 12-31-13, cert. ef. 1-1-14

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