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

 

DIVISION 200

DEPARTMENT REGULATORY PROGRAMS

Service Contracts

836-200-0000

Statutory Authority; Registration; Fees; Expiration; Renewal

(1) OAR 836-200-0000 to 836-200-0060 are adopted under the authority of ORS 646.267 and 646.285 for the purpose of implementing ORS 646.263 to 646.285.

(2) The fee for filing a registration as an obligor of service contracts is $200. The fee under this section (2) must be included with the filing.

(3) The fee for annual renewal of a registration as an obligor of service contracts is $50.

(4) A registration expires on July 1 unless it is renewed on or before that date. A registrant must renew the registration by submitting the renewal fee to the Director of the Department of Consumer and Business Services.

(5) A registrant shall immediately notify the Director of any change in the information submitted in the registration of the registrant.

(6) ORS 646.263 to 646.285 and OAR 836-200-0000 to 836-200-0060 apply to merchandise and not to real property.

Stat. Auth.: ORS 646.267 & ORS 646.285
Stats. Implemented: ORS 646.263 - ORS 646.285
Hist.: ID 6-1995(Temp), f. & cert. ef. 9-12-95; ID 7-1996, f. & cert. ef. 5-28-96; ID 8-1997, f. & cert. ef. 7-10-97

836-200-0010

Assessments

(1) An obligor shall pay an annual assessment as required in ORS 646.281 in the amount of $75. The amount of the assessment is based on the expected costs of this registration program.

(2) Assessments under section (1) of this rule shall be imposed and collected annually unless the Director determines that additional amounts need to be assessed and collected in order to support the legislatively authorized budget of the Department with respect to its functions under ORS 646.263 to 646.285 or in order to support changes in the budget authorized by the Emergency Board. The additional amounts shall be assessed as provided in this rule.

(3) The Director shall assess a registrant only if the registrant is authorized to transact service contracts at the time of billing.

(4) A registrant must pay each assessment imposed under this rule not later than the 30th day after the date of the billing of the assessment by the Department. A registrant shall pay interest at nine percent per annum on any assessment that is not paid when due.

(5) In the event the Director determines that an assessment or a part thereof paid by a registrant is in excess of the amount legally due and payable to the Department, if the amount of the refund is less than $50, the Department shall pay the refund only upon receipt of a written request from the registrant. The written request must be received by the Department not later than three years from the date the assessment was paid to the Department.

Stat. Auth.: ORS 646.285
Stats. Implemented: ORS 646.285
Hist.: ID 7-1996, f. & cert. ef. 5-28-96; ID 8-1997, f. & cert. ef. 7-10-97

836-200-0020

Filing Procedures

(1) An applicant for registration must include proof of financial stability with the registration application. The proof must satisfy applicable requirements of OAR 836-200-0030 and 836-200-0040, or ORS 646.267(6).

(2) An applicant for registration must file with the Director a copy of the service contract form or forms that the applicant intends to use as a registrant in Oregon.

(3) A registrant must file with the Director all amendments to its service contract form or forms used in Oregon that change any contract term or condition applicable to the contract's use in Oregon, and all new contract forms to be used in Oregon. A registrant need not file any amendment that changes a contract only in graphics or form, and not substantively.

Stat. Auth.: ORS 646.267 & 646.285
Stats. Implemented: ORS 646.263-646.285
Hist.: ID 6-1995(Temp), f. & cert. ef. 9-12-95; ID 7-1996, f. & cert. ef. 5-28-96; ID 18-2006, f. & cert. ef. 9-8-06

836-200-0030

Form 10 K and Other Financial Stability Filings

(1) As provided in ORS 646.267, a registrant or applicant for registration may submit as proof of financial stability its own most recent Form 10-K that is filed with the Securities and Exchange Commission or, if the obligor's financial statements are consolidated with those of its parent company, may file the most recent Form 10-K of its parent company.

(2) A registrant or applicant for registration that is incorporated in another country may submit as proof of financial stability its own most recent Form 20-F or Form 40-F that is filed with the Securities and Exchange Commissioner, or may file the most recent Form 20-F or Form 40-F of its parent company if the obligor's financial statements are consolidated with those of its parent company, if the Form 20-F or Form 40-F shows a net worth of the obligor or its parent of at least $100 million in United States funds.

(3) A registrant or applicant for registration that is incorporated in another country that is a signing party to the North American Free Trade Agreement may submit as proof of financial stability its own most recent filing in its domiciliary country that the Securities and Exchange Commission recognizes as equivalent to the Form 10-K. If the parent company of the registrant or applicant is incorporated in another country that is a signing party to the North American Free Trade Agreement, the registrant or applicant may file the most recent filing by its parent company in the domiciliary country that the Securities and Exchange Commission recognizes as equivalent to the Form 10-K. A filing described in this section (3) is acceptable as proof of financial stability only if the filing shows a net worth of the obligor or its parent of at least $100 million in United States funds.

(4) A registrant or applicant who submits the Form 10-K, Form 20-F or Form 40-F of its parent company, or submits a filing described in section (3) of this rule that is filed by its parent company must include with the filing a statement by the parent company to the effect that:

(a) The company is the parent of the registrant; and

(b) The parent company agrees to guarantee the obligations of the registrant relating to service contracts sold by the obligor in this state.

(5) A statement described in section (4) of this rule must be signed by a director or officer of the parent company who is authorized by the parent company to sign such an agreement.

(6) A statement described in section (4) of this rule, when filed as proof of financial stability, shall be considered to be signed by a person who was authorized by the parent company to sign the agreement.

(7) A statement described in section (4) of this rule may be revoked by the parent company only if:

(a) The registrant gives notice of the revocation not later than the 60th day before the effective date of the revocation;

(b) The parent company agrees that it will continue to be liable for the obligations of the registrant relating to service contracts sold by the obligor in this state that are outstanding as of the effective date of revocation, or the registrant submits other proof satisfactory to the Director that a successor person is likewise obligated; and

(c) The registrant files proof of financial stability that replaces or succeeds the proof of financial stability guaranteed by the parent company.

(8) A registrant or applicant that maintains a net worth or shareholders' equity of at least $100,000,000 but who is not required to file a Form 10-K with the Securities and Exchange Commission may file a copy of the obligor's most recently audited annual financial statements to satisfy the requirement of ORS 646.267(5)(a), instead of the Form 10-K, Form 20-F or Form 40-F of its parent company or the filing described in section (3) of this rule. A registrant or applicant that substitutes an audited annual financial statement for a Form 10-K shall file a copy of its most recent audited annual financial statement annually with the director. The copy of the annual financial statements filed under this section shall be considered to be signed by a person who was authorized by the registrant or applicant to sign the agreement.

(9) If a registrant has submitted its Form 10-K or other proof of financial stability under this rule or has submitted the parent company's Form 10-K or other proof of financial stability of the parent under this rule, the registrant or its parent company must continue to be qualified to file the Form 10-K or other proof as long as the Form 10K or other submission is relied upon as proof of financial stability. A registrant must notify the Director if the net worth of the company that filed the Form 10-K or other proof of financial stability, whether the company is itself or the parent company, falls below $100 million or if the company is no longer publicly held.

(10) If a registrant goes out of business or if the registration of a registrant expires or is suspended or revoked:

(a) A parent company that is bound by a statement described in section (4) of this rule continues to be responsible for all obligations of the registrant that are still outstanding.

(b) A registrant that is qualified under section (8) of this rule continues to be responsible for all obligations of the registrant that are still outstanding.

(11) For the purpose of payment under a guarantee described in this rule, an obligor fails to perform under the service contract when the obligor fails to perform as agreed in the service contract by a date that is not later than the 60th day after the date of the demand for performance or by a date specified in the service contract for performance, whichever date is earlier.

(12) A registrant or applicant that is qualified under section (8) of this rule shall perform as agreed in the service contract by a date that is not later than the 60th day after the date of the demand for performance or by a date specified in the service contract for performance, whichever date is earlier.

Stat. Auth.: ORS 646.267 & ORS 646.285
Stats. Implemented: ORS 646.263 - ORS 646.285
Hist.: ID 6-1995(Temp), f. & cert. ef. 9-12-95; ID 7-1996, f. & cert. ef. 5-28-96; ID 21-2002f. & cert. ef. 10-30-02

836-200-0040

Reimbursement Insurance Policy

(1) When an obligor or applicant for registration relies on a reimbursement insurance policy for purposes of the financial stability requirement in ORS 646.267, the obligor or applicant must submit a copy of the policy to the Director.

(2) A reimbursement insurance policy insuring service contracts issued, sold or offered for sale in this state shall conspicuously state that, upon failure of the obligor to perform under the contract, the insurer that issued the policy shall pay on behalf of the obligor any sums the obligor is legally obligated to pay or shall provide the service that the obligor is legally obligated to perform according to the obligor's contractual obligations under the service contracts issued by the obligor. The following is an example of wording that will be acceptable for the purpose of this section:

Upon failure of the obligor to perform under the contract, _________ (name of insurer issuing policy) shall pay on behalf of the obligor any sums the obligor is legally obligated to pay or shall provide the service that the obligor is legally obligated to perform according to the obligor's contractual obligation under the service contracts issued by the obligor, and _________ (insurer) will pay claims against the obligor for return of the unearned purchase price of the service contract.

(3) For the purpose of payment under a reimbursement insurance policy, an obligor fails to perform under the service contract when the obligor fails to perform as agreed in the service contract by a date that is not later than the 60th day after the date of the demand for performance or by a date specified in the service contract for performance, whichever date is earlier.

Stat. Auth.: ORS 646.267 & ORS 646.285
Stats. Implemented: ORS 646.263 - ORS 646.285
Hist.: ID 6-1995(Temp), f. & cert. ef. 9-12-95; ID 7-1996, f. & cert. ef. 5-28-96

836-200-0050

Registration Requirements Not Exclusive

Compliance with the filing requirements of OAR 836-200-0000 to 836-200-0060 are additional to and not in lieu of filing and other requirements established by law for the purpose of doing business in this state, including but not limited to compliance with filing requirements of the Secretary of State applicable to assumed business names and applicable to the business structure of an applicant.

Stat. Auth.: ORS 646.267 & ORS 646.285
Stats. Implemented: ORS 646.263 - ORS 646.285
Hist.: ID 6-1995(Temp), f. & cert. ef. 9-12-95; ID 7-1996, f. & cert. ef. 5-28-96

836-200-0055

Annual Report

For the purpose of enabling the Director to determine the assessment against each registrant according to the formula established in 836-200-0010, each registrant shall file a report for the preceding calendar year with the Director on or before March 1 of each year, or within such extension of time therefor as the Director may grant. The first report must be filed on or before March 1, 1997, for calendar year 1996. The report shall be in the form specified by the Director, shall contain the total number of service contracts produced in Oregon by the registrant during the preceding calendar year and shall be verified as follows:

(1) If the registrant is a corporation, by at least two principal officers of the registrant.

(2) If the registrant is a partnership, by two partners.

(3) If the registrant is neither a corporation nor a partnership, by its president and secretary.

Stat. Auth.: ORS 646.267 & ORS 646.285
Stats. Implemented: ORS 646.263 - ORS 646.285
Hist.: ID 7-1996, f. & cert. ef. 5-28-96

836-200-0060

Service on Registrant

The Director may make service on a registrant at the address shown on the current registration of the registrant on file with the Director, in the manner provided in ORS 183.310 to 183.550.

Stat. Auth.: ORS 646.267 & ORS 646.285
Stats. Implemented: ORS 646.263 - ORS 646.285
Hist.: ID 6-1995(Temp), f. & cert. ef. 9-12-95; ID 7-1996, f. & cert. ef. 5-28-96

836-200-0100

Notice, Collision Damage Waivers

For purposes of ORS 646.859, which provides that an auto rental agency offering collision damage waivers shall post a sign approved by the Department, the Department shall consider a sign approved if the sign meets the following requirements:

(1) The sign must state the following in bold type that is at least 1.25 inches high:

OUR CONTRACTS OFFER OPTIONAL COLLISION DAMAGE WAIVERS AT AN ADDITIONAL COST.

(2) The sign must be posted in the place of business of the auto rental agency in a location that is conspicuous to the public.

Stat. Auth.: ORS 705.135
Stats. Implemented: ORS 646.859
Hist.: IF 8-1989, f. 11-6-89, cert. ef. 12-11-89; Renumbered from 440-010-0001, ID 17-2006, f. & cert. ef. 8-11-06

Vehicle Protection Product Warranties

836-200-0105

Statutory Authority; Registration; Fees; Expiration; Renewal

(1) OAR 836-200-0100 to 836-200-0140 are adopted under the authority of section 11, ch. 685, Oregon Laws 2007, for the purpose of implementing Sections 1 to 11, Ch. 685, Oregon Laws 2007.

(2) The fee for submitting a Registration Application is $70.

(3) The fee for annual renewal of a Registration is $25.

Stat. Auth.: ORS 731.244; 2007 OL Ch. 685, Sec. 11
Stats Implemented: 2007 OL Ch. 685, Sec. 1 - 11
Hist.: ID 4-2008, f. & cert. ef. 4-7-08

836-200-0110

Registration Procedures

(1) A warrantor of a vehicle protection product shall register with the Department of Consumer and Business Services by submitting to the Director a completed Warrantor of Vehicle Protection Product Registration Application on the form prescribed by the Director.

(2) A warrantor must include with the Registration Application a copy of each warranty form to be used in this state, and any amendments to the form that the warrantor proposes to use in the state of Oregon. A warrantor need not include any amendment that:

(a) Changes a warranty only in graphics or form, and not substantively; or

(b) Is a direct translation of the warranty form the warrantor proposes to use into a language other than English.

(3) A warrantor must also include with the Registration Application a copy of a warranty reimbursement insurance policy the warrantor intends to use to demonstrate the warrantor’s financial responsibility.

(4) A warrantor must include the registration fee with the Registration Application.

(5) A registration is not effective until the warrantor receives written notification from the Director.

(6) A warrantor must renew a registration by submitting to the Director on or before December 31 of each calendar year the renewal fee and a completed Warrantor of Vehicle Protection Product Renewal Form on the form prescribed by the Director.

(7) A warrantor shall notify the Director in writing of any change in the information contained in the Registration Application not later than 30 days after the information has changed.

Stat. Auth.: ORS 731.244; 2007 OL Ch. 685, Sec. 11
Stats Implemented: 2007 OL Ch. 685, Sec. 4
Hist.: ID 4-2008, f. & cert. ef. 4-7-08

836-200-0120

Warranty

To comply with the requirement in Section 3, Ch. 685, Oregon Laws 2007 that each warranty must list the name, mailing address, and telephone number for the Insurance Division, Department of Consumer and Business Services, a warrantor shall include the contact information for the Consumer Advocacy Unit as set out on the Web site for the Insurance Division at insurance.oregon.gov.

Stat. Auth.: ORS 731.244; 2007 OL Ch. 685, Sec. 11
Stats Implemented: 2007 OL Ch. 685, Sec. 3
Hist.: ID 4-2008, f. & cert. ef. 4-7-08

836-200-0130

Reimbursement Insurance Policy

(1) A reimbursement insurer must deliver to the warrantor and the Director of the Department of Consumer and Business Services the written notice of cancellation for a reimbursement insurance policy as required by Section 6(2), Ch. 685, Oregon Laws 2007 not later than 30 days prior to the effective date of the cancellation.

(2) A warrantor must discontinue offering vehicle protection product warranties as of the date of cancellation of the reimbursement insurance until the warrantor obtains new reimbursement insurance.

(3) A warrantor must deliver a copy of the new reimbursement policy to the Director within 10 business days of the warrantor’s receipt of the new reimbursement policy.

Stat. Auth.: ORS 731.244; 2007 OL Ch. 685, Sec. 11
Stats Implemented: 2007 OL Ch. 685, Sec. 5 & 6
Hist.: ID 4-2008, f. & cert. ef. 4-7-08

836-200-0140

Registration Requirements Not Exclusive

Compliance with the registration requirements of OAR 836-200-0100 to 836-200-0140 is additional to and not in lieu of any other requirements established by law for the purpose of doing business in this state, including but not limited to compliance with filing requirements of the Secretary of State applicable to assumed business names and applicable to the business structure of an applicant.

Stat. Auth.: ORS 731.244; 2007 OL Ch. 685, Sec. 11
Stats Implemented: 2007 OL Ch. 685, Sec. 11
Hist.: ID 4-2008, f. & cert. ef. 4-7-08

Discount Medical Plan Organizations

836-200-0200

License, Discount Medical Plan Organization; Renewal

(1) An applicant for a license to operate as a discount medical plan organization shall apply for the license by completing and submitting to the Director the application form prescribed by the Director. The application form shall request the information required by section 5, chapter 272, Oregon Laws 2007 and this rule.

(2) To enable the Director to determine whether an applicant is financially responsible, the application shall require the following information:

(a) Whether the applicant has ever filed for bankruptcy or been adjudged a bankrupt.

(b) An audited annual financial statement for the most recent year or alternatively, an unaudited financial statement and the applicable signed federal tax form of the applicant for the most recent year, to prove that the applicant is solvent and has a continuing income stream. An applicant may submit a consolidated financial statement if the statement clearly segregates and reports the affairs of the applicant. The applicable federal tax form for the purpose of this subsection is as follows:

(A) For an individual, Form 1040.

(B) For a corporation, Form 1120.

(C) For a subchapter S corporation, Form 1120S.

(D) For a partnership, Form 1065.

(E) For a limited liability company, the form that the company files for federal income tax purposes.

(c) If the applicant is a corporation that is newly formed for the purpose of transacting business as a discount medical plan organization, the statements and forms required under subsection (b) of this section as they may be available, and the applicant’s business plan, including three years of projections of net worth, revenue, expenses and net income.

(3) To enable the Director to determine whether an applicant has adequate experience and expertise to operate a discount medical plan organization, an applicant shall indicate, as provided in the application, all states and provinces of Canada in which the applicant currently holds a license, registration or certificate of authority to transact business as a discount medical plan organization, or has held such a license or certificate within ten years prior to the date of the application.

(4) To enable the Director to determine whether an applicant is of good character, an applicant shall indicate, as provided in the application, whether any license or registration of the applicant to act in any occupational or professional capacity has ever been refused, revoked or suspended in this or any other state, and whether the applicant has otherwise ever been the subject of an enforcement action taken by a licensing or registration agency. If the applicant's answer is affirmative in any respect, the applicant must also provide the name and address of the licensing or registration agency, the date of the complaint or the action taken against the license or registration, a description of the nature of the complaint or the reason for the action taken against the license or registration, and, with regard to a complaint, a description of the licensing or registering agency's disposition of the complaint.

(5) In addition to the requirements of sections (3) and (4) of this rule, to enable the Director further to determine whether an applicant has adequate experience and expertise to operate a discount medical plan organization and whether an applicant is of good character, an applicant shall submit with the application a copy of the NAIC biographical affidavit, completed by the following individuals:

(a) Each member of the board of directors, executive committee or other governing board or committee of the discount medical plan organization;

(b) Each principal officer in the case of a corporation or each partner or member in the case of a partnership or association who holds an interest of ten percent or more in the partnership or association; and

(c) Each shareholder holding directly or indirectly ten percent or more of the voting securities of the discount medical plan organization.

(6) A licensee must renew a license by submitting to the Director a completed license renewal application on the form prescribed by the Director, not later than the 30th day after receiving a notice of renewal from the Director.

Stat. Auth.: ORS 731.244 & 742.426
Stats. Implemented: ORS 742.426
Hist.: ID 5-2008, f. & cert. ef. 4-14-08

836-200-0210

Renewal of expired license

(1) A person whose license as a discount medical plan organization has expired may renew the license by submitting a completed license renewal application on the form prescribed by the Director, not later than the 90th day after the date the license expired and if:

(a) The license was not suspended or revoked by the Director, or not renewed, on any ground under Section 11, Chapter 272, Oregon Laws 2007; and

(b) The Director is satisfied that the person meets the requirements for the license in Section 5, Chapter 272, Oregon Laws 2007.

(2) A person who does not renew an expired license as provided in this rule may obtain a license only if the person applies and qualifies for and is issued the license in the same manner as a person who initially applies for the license.

Stat. Auth.: ORS 731.244 & 742.430
Stats. Implemented: ORS 742.430
Hist.: ID 5-2008, f. & cert. ef. 4-14-08

836-200-0215

One-time processing fee, cancelled application

A discount medical plan organization may retain a one-time processing fee that is not more than $30 when the organization refunds fees, service or subscription charges, dues or other consideration paid by a member who cancels a discount medical plan as provided in Section 8, Chapter 272, Oregon Laws 2007.

Stat. Auth.: ORS 731.244 & 742.432
Stats. Implemented: ORS 742.432
Hist.: ID 5-2008, f. & cert. ef. 4-14-08

836-200-0220

License Requirement Not Exclusive

Compliance with the licensing requirement of OAR 836-200-0200 is additional to and not in lieu of any other requirements established by law for the purpose of doing business in this state, including but not limited to compliance with filing requirements of the Secretary of State applicable to assumed business names and applicable to the business structure of an applicant.

Stat. Auth.: ORS 731.244
Stats. Implemented: ORS 742.426
Hist.: ID 5-2008, f. & cert. ef. 4-14-08

836-200-0250

Purpose and Authority

OAR 836-200-0255 is adopted to implement the provisions of Section 3, chapter 561, Oregon Laws 2011. OAR 836-014-0255 applies to a contracting entity as defined in Section 1, chapter 561, Oregon Laws 2011 (Enrolled Senate Bill 634) other than an entity operating under a certificate of authority or license issued by the Department of Consumer and Business Services that enters into or renews a contract subject to Section 4, chapter 561, Oregon Laws 2011 on or after January 1, 2012.

Stat. Auth.: ORS 731.244 & sec. 3, ch. 561, OL 2011 (Enrolled SB 634)
Stat. Implemented.: Sec. 1 to 5, ch. 561, OL 2011 (Enrolled SB 634))
Hist.: ID 18-2011, f. 11-16-2011, cert. ef. 1-1-2012

836-200-0255

Registration of Contracting Entity

(1) A contracting entity, as defined in Section 1, chapter 561, Oregon Laws 2011 (Enrolled Senate Bill 634), that is not operating under a certificate of authority or license issued by the Department of Consumer and Business Services shall register annually with the Department of Consumer and Business Services by submitting the following information to the department in the manner requested by the Director, along with a $150 fee:

(a) The official name of the entity and any secondary, alternative or substitute designations;

(b) The mailing address and telephone number of the headquarters of the entity; and

(c) The name and phone number of a representative of the entity who shall serve as the primary contact for the department.

(2) The requirements of this rule do not apply to a contracting entity that is under common ownership and control of a contracting entity that is licensed by or has a certificate of authority from the department.

Stat. Auth.: ORS 731.244 & sec. 3, ch. 561, OL 2011 (Enrolled SB 634)
Stat. Implemented.: Sec. 1 to 5, ch. 561, OL 2011 (Enrolled SB 634))
Hist.: ID 18-2011, f. 11-16-2011, cert. ef. 1-1-2012

Retainer Medical Practices

836-200-0300

Statement of Purpose; Authority

OAR 836-200-0300 to 836-200-0315 are adopted by the Director of the Department of Consumer and Business Services pursuant to sections 2 and 3, chapter 499, Oregon Laws 2011 (Enrolled Senate Bill 86). The purpose of OAR 836-200-0300 to 836-200-0315 is to establish the requirements for initial certification, disclosure requirements and certification renewal, for a retainer medical practice.

Stat. Auth.: ORS 731.244 & sec. 2, 3, ch. 499, OL 2011 (Enrolled SB 86)
Stats. Implemented: sec. 2, 3, ch. 499, OL 2011 (Enrolled SB 86)
Hist.: ID 19-2011, f. 11-29-11, cert. ef. 1-1-12

836-200-0305

Retainer Medical Practice Application for Certification

(1) The Director of the Department of Consumer and Business Services may certify a retainer medical practice for a period of one year or more, if the applicant:

(a) Acts in accordance with the attestations required by paragraph (c) of this section;

(b) Complies with and meets the requirements of OAR 836-200-0300 to 836-200-0315 and sections 2 and 3, chapter 499, Oregon Laws 2011 (Enrolled Senate Bill 86); and

(c) Completes and submits to the satisfaction of the director a retainer medical practice application as set forth on the website for the Insurance Division of the Department of Consumer and Business Services at www.insurance.oregon.gov. As required on the form, the applicant shall:

(A) Attest to the following:

(i) Under the retainer medical agreement providers providing services are licensed or certified under ORS chapters 677, 678, 684, or 685 and the services provided will be limited to primary care services allowed within the scope of such licenses or certifications.

(ii) The applicant is not and has never been authorized in this or any other state to transact insurance or act as an insurer, managed care organization, health care services contractor, or similar entity;

(iii) The applicant is not controlled by any person described in subparagraph (ii) of this paragraph;

(iv) The applicant will structure the retainer medical practice to ensure that all services promised under the retainer medical agreement are within the capacity of the practice to provide in a timely manner;

(v) The applicant is financially responsible and has the necessary business experience or expertise to operate the practice;

(vi) The applicant will not discriminate based on race, religion, gender, sexual identity, sexual preference, or health status;

(vii) The applicant is authorized to conduct business in the State of Oregon and has complied with all registration requirements of this State; and

(viii) The information provided in the application and all supplemental and additional information is true and complete, and the applicant will submit to the jurisdiction of the courts of the State of Oregon.

(B) Establish to the satisfaction of the director that the applicant is financially responsible. To establish that an applicant is financially responsible, the applicant must provide all of the following:

(i) A statement of whether the applicant has filed for bankruptcy during the 25- year period prior to the application or renewal.

(ii) The applicant’s business plan, including a discussion of how the applicant intends to monitor the practice to ensure the services promised under the retainer medical agreement are provided in a timely manner. The plan must include a clear description of how the retainer medical practice will ensure repayment of retainer medical fees paid in advance if the retainer medical practice is unable to provide the services promised under the retainer medical agreement.

(iii) A copy of any marketing materials and the retainer medical agreement that will be used for the 12-month certification period and each subsequent renewal. The agreement must include provisions that obligate the retainer medical practice to reimburse retainer medical patients for retainer medical fees paid in advance in the event the retainer medical practice is unable to provide services promised under the retainer medical agreement.

(C) Establish that the applicant has the necessary experience and expertise to operate a retainer medical practice by providing all of the following:

(i) The name of any other jurisdiction in which the applicant currently holds a license, registration or certification to transact business as a retainer medical practice or similar entity, or has held such a license or certification within ten years prior to the date of the application.

(ii) A statement of whether any license or registration of the applicant or any person with control of the applicant has ever been denied, suspended, revoked or not renewed in this or any other state and whether the applicant or any person with control of the applicant has otherwise ever been the subject of an enforcement action taken by a licensing or registration agency. For any action taken, the applicant shall provide the name and address of the licensing or registration agency, the date of the action taken against the license or registration and a description of the reason for the action taken against the license or registration.

(iii) A biographical affidavit in the form and manner prescribed by the director, completed by each member of the board of directors, executive committee, or other governing board or committee of the applicant; and

(iv) A statement describing the background or training of the applicant that provides the necessary business experience or expertise to operate a retainer medical practice. The statement shall include the number of years the applicant has been in practice. The statement may also include a description of any similar business the applicant has operated, how many years the applicant operated the similar business and any pertinent training or experience the applicant has completed that has allowed the applicant to develop the necessary experience or expertise to operate a practice. The experience need not be specific to a retainer medical practice.

(D) Provide the names and Oregon license numbers of all providers providing services through the medical retainer practice.

(E) Provide the physical and mailing address, telephone number, facsimile number, email address and website address for each location providing retainer medical services.

(F) Provide the name and address for service of process for the retainer medical practice.

(G) Provide the name, mailing address, telephone number, signature and email address of the person completing the application on behalf of the applicant.

(H) Provide all names, including assumed business names, under which the retainer medical practice will operate, market or otherwise do business.

(2) (a) A retainer medical practice certification issued on or before February 1 of any given year is valid through January 31 of the following year.

(b) A retainer medical practice certification issued after February 1 of any given year is valid through January 31 of the second year following the year of certification.

Stat. Auth.: ORS 731.244 & sec. 2, 3, ch. 499, OL 2011 (Enrolled SB 86)
Stats. Implemented: ORS 731.244, sec. 2, 3, ch. 499, OL 2011 (Enrolled SB 86)
Hist.: ID 19-2011, f. 11-29-11, cert. ef. 1-1-12

836-200-0310

Retainer Medical Practice Application for Renewal

(1) The director may renew a retainer medical practice certification if the practice complies with all of the following:

(a) The retainer medical practice completes and submits to the satisfaction of the director a retainer medical practice renewal application as set forth on the website for the Insurance Division of the Department of Consumer and Business Services at www.insurance.oregon.gov. The renewal application must be submitted annually before February 1 of each year in accordance with OAR 836-200-0305(2).

(b) The retainer medical practice acts in accordance with the attestations required by OAR 836-200-0305(1).

(c) The retainer medical practice shall provide with the renewal application, the following information for the prior calendar year through December 31:

(A) The total number of retainer medical patients under agreement with the retainer medical practice;

(B) The total number of retainer medical patients that voluntarily terminated the retainer medical agreement;

(C) The total number of patients with whom the retainer medical practice terminated an agreement and the reasons for the terminations;

(D) The total number of applicants declined by the retainer medical practice and the reasons for the declinations; and

(E) Any changes to the information submitted on the applicant’s original application for certification.

(2) The director shall use the information required by section (1) of this rule to determine whether the retainer medical practice meets the requirements of, and complies with, section 2, chapter 499, Oregon Laws 2011 (Enrolled Senate Bill 86) for purposes of renewing a certification.

(3) A renewal certification shall be for a period of one year.

Stat. Auth.: ORS 731.244 & sec. 2, 3, ch. 499, OL 2011 (Enrolled SB 86)
Stats. Implemented: ORS 731.244, sec. 2, 3, ch. 499, OL 2011 (Enrolled SB 86)
Hist.: ID 19-2011, f. 11-29-11, cert. ef. 1-1-12

836-200-0315

Disclosures; Form and Contents

(1) The disclosures required by Section 2(4), chapter 499, Oregon Laws 2011 shall be in 12-point font or larger, on the first content page of marketing materials, including websites, and in the first content page of contracts with retainer medical patients, including the retainer medical agreement.

(2) In addition to the disclosures required by Section 2(4), chapter 499, Oregon Laws 2011, a retainer medical practice shall make the following written information available to retainer medical patients and prospective retainer medical patients by prominently disclosing, in 12-point font or larger, in all marketing materials, including websites and in the medical retainer agreement:

(a) “The Department of Consumer and Business Services issued a certification to this practice. You can contact consumer advocates at the Department of Consumer and Business Services at (888) 977-4894, dcbs.insmail@state.or.us, or www.insurance.oregon.gov.”;

(b) A statement explaining the retainer medical practice’s cancellation and refund policy;

(c) A statement explaining how fees are charged by the retainer medical practice; and

(d) A list of services included for the fees charged.

Stat. Auth.: ORS 731.244 & sec. 2, 3, ch. 499, OL 2011 (Enrolled SB 86)
Stats. Implemented: ORS 731.244, sec. 2, 3, ch. 499, OL 2011 (Enrolled SB 86)
Hist.: ID 19-2011, f. 11-29-11, cert. ef. 1-1-12

Pharmacy Benefit Managers

836-200-0401

Statement of Purpose; Authority; Applicability

(1) OAR 836-200-00401 to 836-200-0421 are adopted under the authority of section 3, chapter 570, Oregon Laws 2013 for the purpose of implementing sections 2 and 3, chapter 570, Oregon Laws 2013.

(2) For any registration completed between January 2, 2014 and August 31, 2015 the first annual renewal of the registration shall be September 1, 2015.

Stat. Auth.: ORS 731.244, 735.532
Stats. Implemented: ORS 735.530, 735.532
Hist. : ID 12-2014, f. & cert. ef. 7-21-14

836-200-0406

Application Requirements for Pharmacy Benefit Manager

(1) Each pharmacy benefit manager conducting business in Oregon must register with the Department of Consumer and Business Services. To register as a pharmacy benefit manager, the entity must complete a Pharmacy Benefit Manager Application, Exhibit 1 of this rule.

(2) An applicant for registration as a pharmacy benefit manager shall include in the application:

(a) The identity of the pharmacy benefit manager;

(b) The name, business address and contact person for the pharmacy benefit manager: and

(c) Where applicable, the FEIN number for the entity.

(3) A pharmacy benefit manager shall provide information on any material modification to the information provided by the pharmacy benefit manager in its application for registration not later than 30 days after the modification.

(4) The application for registration as a pharmacy benefit manager must include a fee of $50. The fee under this section must be submitted with the filing.

Stat. Auth.: ORS 731.244, 735.532
Stats. Implemented: ORS 735.530,735.532
Hist. : ID 12-2014, f. & cert. ef. 7-21-14

836-200-0411

Renewal of Pharmacy Benefit Registration

(1) All pharmacy benefit registrations expire on September 1 unless renewed on or before that date. A registrant must renew the registration by submitting a renewal application and renewal fee to the Director of the Department of Consumer and Business Services. The application to renew a registration as a pharmacy benefit manager must include a renewal fee of $50.

(2) A registered pharmacy benefit manager shall include with the renewal application any change in the information submitted since the registrant initially registered or last renewed the pharmacy benefit manager registration.

Stat. Auth.: ORS 731.244, 735.532
Stats. Implemented: ORS 735.530,735.532
Hist. : ID 12-2014, f. & cert. ef. 7-21-14

836-200-0416

Registration Requirements Not Exclusive

Compliance with the filing requirements of OAR 836-200-0401 to 836-200-0421 are additional to and not in lieu of filing and other requirements established by law for the purpose of doing business in this state, including but not limited to compliance with filing requirements of the Secretary of State applicable to assumed business names and applicable to the business structure of an applicant.

Stat. Auth.: ORS 731.244, 735.532
Stats. Implemented: ORS 735.530,735.532
Hist. : ID 12-2014, f. & cert. ef. 7-21-14

836-200-0421

Service on Registrant

The Director of the Department of Consumer and Business Services may make service on a registered pharmacy benefit manager at the address shown on the current registration of the pharmacy benefit manager on file with the director, in the manner provided in ORS 183.310 to 183.550.

Stat. Auth.: ORS 731.244, 735.532
Stats. Implemented: ORS 735.530,735.532
Hist. : ID 12-2014, f. & cert. ef. 7-21-14

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