OAR 436-050-0195
Requirements for Changes in Self-Insured Employer Entity

(1) Notification of changes in entity, contact information, or ownership. If there is any change in the entity, changes in addresses, telephone numbers, and points of contact, or ownership of a self-insured employer, the self-insured employer must notify the director in writing within 30 days after the change occurs.
(2) Adding or deleting entities. If a self-insured employer wishes to add or delete entities to a self-insured employer’s certification:
(a) The self-insured employer must submit a completed Form 1865, “Endorsement to Include Legal Entity in Self-Insured Certification,” signed by an officer of the self-insured employer;
(b) Each entity must enter into an agreement, signed by an officer of the entity, making the entity jointly and severally liable for the payment of any compensation and moneys due to the director by the certified self-insured employer or any other entity included in the self-insured employer’s certification; and
(c) The director will determine, based on the information provided, the effect of the change on the deposit required and whether the entities can be combined for experience rating purposes.
(3) Failure to provide notification. Failure to provide notification as required under this rule may result in assessment of penalties, revocation of self-insurance certification, or both.

Source: Rule 436-050-0195 — Requirements for Changes in Self-Insured Employer Entity, https://secure.­sos.­state.­or.­us/oard/view.­action?ruleNumber=436-050-0195.

436‑050‑0003
Purpose and Applicability 436‑050‑0005
Definitions 436‑050‑0008
Requests for Hearings or Administrative Review 436‑050‑0015
Suspension and Revocation of Authorization to Issue Workers’ Compensation Insurance Policies 436‑050‑0025
Service of the Notice of Civil Penalty Orders 436‑050‑0040
Responsibility for Providing Coverage When a Contract is Awarded 436‑050‑0045
Nonsubject Workers 436‑050‑0050
Corporate Officers, Limited Liability Company Members, Partners 436‑050‑0055
Extraterritorial Coverage 436‑050‑0110
Notice of Insurer’s Place of Business in State 436‑050‑0120
Records Insurers Must Keep in Oregon 436‑050‑0150
Qualifications of a Self-Insured Employer 436‑050‑0160
Applying for Certification as a Self-Insured Employer 436‑050‑0165
Security Deposit Requirements 436‑050‑0170
Excess Insurance Requirements 436‑050‑0175
Annual Reporting Requirements 436‑050‑0180
Determination of Amount of Self-Insured Employer’s Deposit 436‑050‑0185
Qualifications for Deposit Exemption for Self-Insured Cities, Counties, and Qualified Self-Insured Employer Groups, Application Procedures, Conditions and Requirements, Revocation and Requalification 436‑050‑0190
Using Self-Insured Employers’ Security Deposit/Self-Insured Employer Adjustment Reserve/Self-Insured Employer Group Adjustment Reserve/Director-Ordered Assessments of Private Employer Members of Self-Insured Employer Groups 436‑050‑0195
Requirements for Changes in Self-Insured Employer Entity 436‑050‑0200
Self-Insured Certification Cancellation 436‑050‑0205
Notice of Self-Insurer’s Personal Elections 436‑050‑0210
Notice of Self-Insurer’s Place of Business in State 436‑050‑0220
Records Self-Insured Employer Must Keep in Oregon 436‑050‑0230
Out-of-State Recordkeeping and Claims Processing by Self-Insured Employer 436‑050‑0260
Qualifications of a Self-Insured Employer Group 436‑050‑0270
Applying for Certification as a Self-Insured Employer Group: Private Employers 436‑050‑0280
Applying for Certification as a Self-Insured Employer Group: Governmental Subdivisions 436‑050‑0290
Commencement/Termination/Cancellation of Employers with a Self-Insured Employer Group 436‑050‑0300
Self-Insured Employer Group, Common Claims Fund 436‑050‑0340
Group Self-Insurance Revocation
Last Updated

Jun. 8, 2021

Rule 436-050-0195’s source at or​.us