OAR 836-031-0220
Principles Governing Reserves


(1)

When an insurer determines that health insurance reserves meeting the minimum standards specified in OAR 836-031-0200 (Scope, Authority; Statutes Implemented; Application) to 836-031-0300 (Reserves for Waiver of Premium) are inadequate, increased reserves shall be held and shall be considered the minimum reserves for that insurer.

(2)

With respect to any block of contracts, or with respect to an insurer’s health insurance business as a whole, a prospective gross premium valuation is the ultimate test of reserve adequacy as of a given valuation date. Such a gross premium valuation must take into account, for all contracts in force, including those in a claims status or in a continuation of benefits status on the valuation date, the present value as of the valuation date of the following:

(a)

All expected benefits unpaid;

(b)

All expected expenses unpaid; and

(c)

All unearned or expected premiums, adjusted for future premium increases reasonably expected to be put into effect.

(3)

A gross premium valuation described in section (2) of this rule is to be performed whenever a significant doubt exists as to reserve adequacy with respect to any major block of contracts, or with respect to the insurer’s health insurance business as a whole. In the event inadequacy is found to exist, immediate loss recognition shall be made and the reserves restored to adequacy. Adequate reserves (inclusive of claim, premium and contract reserves, if any) by this standard shall be held with respect to all contracts, regardless of whether contract reserves are required for such contracts under OAR 836-031-0200 (Scope, Authority; Statutes Implemented; Application) to 836-031-0300 (Reserves for Waiver of Premium).

(4)

Whenever minimum reserves as defined in OAR 836-031-0200 (Scope, Authority; Statutes Implemented; Application) to 836-031-0300 (Reserves for Waiver of Premium) exceed reserve requirements as determined by a prospective gross premium valuation, such minimum reserves remain the minimum requirement under OAR 836-031-0200 (Scope, Authority; Statutes Implemented; Application) to 836-031-0300 (Reserves for Waiver of Premium).

(5)

Adequacy of an insurer’s health insurance reserves is determined on the basis of all three categories of reserves, including claim reserves, premium reserves and contract reserves, combined.

Source: Rule 836-031-0220 — Principles Governing Reserves, https://secure.­sos.­state.­or.­us/oard/view.­action?ruleNumber=836-031-0220.

836–031–0200
Scope, Authority
836–031–0210
Definitions, Application and Explanation of Technical Terms Used
836–031–0220
Principles Governing Reserves
836–031–0230
Claim Reserves
836–031–0240
Premium Reserves
836–031–0250
Contract Reserves
836–031–0260
Reinsurance
836–031–0270
Specific Standards for Morbidity
836–031–0280
Specific Standards for Interest
836–031–0290
Specific Standards for Mortality
836–031–0300
Reserves for Waiver of Premium
836–031–0400
Allowed Assets
836–031–0410
Title Insurance Unearned Premium Reserve
836–031–0600
Purpose
836–031–0605
Valuation Manual
836–031–0610
Authority
836–031–0620
Scope
836–031–0630
Definitions
836–031–0640
General Requirements
836–031–0670
Statement of Actuarial Opinion Based On an Asset Adequacy Analysis
836–031–0680
Description of Actuarial Memorandum Including an Asset Adequacy Analysis and Regulatory Asset Adequacy Summary
836–031–0690
Additional Considerations for Analysis
836–031–0750
Purpose, Authority and Applicability
836–031–0755
Applicability
836–031–0760
Definitions
836–031–0765
General Calculation Requirements for Basic Reserves and Premium Deficiency Reserves
836–031–0770
Calculation of Minimum Valuation Standard for Policies with Guaranteed Nonlevel Gross Premiums or Guaranteed Nonlevel Benefits (Other than Universal Life Policies)
836–031–0775
Calculation of Minimum Valuation Standard for Flexible Premium and Fixed Premium Universal Life Insurance Policies that Contain Provisions Resulting in the Ability of a Policyowner to Keep a Policy in Force Over a Secondary Guarantee Period
836–031–0800
Purpose, authority
836–031–0805
Definitions
836–031–0810
2001 CSO Preferred Class Structure Table
836–031–0815
Conditions
836–031–0855
Recoupment of Assessments by Oregon Insurance Guaranty Association
Last Updated

Jun. 8, 2021

Rule 836-031-0220’s source at or​.us