Form 440-4872 - Standards For Filing Individual And Small Group Health Benefit Plan Rates - Oregon Department Of Consumer And Business Service Page 2
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14GENERAL REQUIREMENTS FOR ALL SMALL GROUP AND INDIVIDUAL HBP RATE FILINGS
Category
Reference
Description of review standards requirements
Answers
Page #
Submission
OAR 836-010-
Required forms are located on SERFF or on our Web site:
package
0011
requirements
Paper filings: These items must be submitted with your filing for it to be
Yes N/A
accepted as complete:
NAIC transmittal form
Two self addressed stamped envelopes, one in which Insurance
Division can return the approved filing
Complete copy of the filing on a CD, with each document as a
separate PDF
Yes N/A
OAR 836-053-
Third party filer’s letter of authorization
0473 (2)(m)
Yes N/A
OAR 836-053-
Certification of compliance form signed and dated by an authorized
0471 (2)(l)
person
Yes N/A
OAR 836-010-
Product standards for rates with boxes checked. (this document)
0011(2)
Yes N/A
Draft letter to consumer advising them of the rate change will be
ORS 731.296
provided before the rate review is complete.
Effective for plan years on or after 1/1/2014, filings for “Grandfathered”
Grandfathered
Confirm
status health plans must be pooled separately from “Non-
Status
Grandfathered” status health plans. Each filing must stand alone.
Review
ORS 742.003(1),
The following are submitted in this filing for review (select one):
Yes No
requested
OAR 836-010-
1. New rate filing
0011(3),
2. Rate change
ORS 743.767,
3. Continued use of existing rates
OAR 836-010-
The annual geographic average rate (GAR) filing is satisfied through
0021(1)
the inclusion of GARs in the Rate Tables and Factors exhibit.
Form numbers
ORS 731.296
A list of policy form numbers to be listed on the Rate/Rule tab in
Confirm
SERFF.
440-4872 (4/4/13 INS)
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