OAR 836-031-0270
Specific Standards for Morbidity

The following standards apply to morbidity:
(1) Minimum morbidity standards for valuation of specified benefits provided in individual health insurance policies are as follows:
(a) For disability income benefits due to accident or sickness:
(A) Contract reserves:
(i) Contracts issued on or after January 1, 1965 and prior to January 1, 1987: The 1964 Commissioners Disability Table (64 CDT) or, at the option of the insurer, a more recent table approved by the Director;
(ii) Contracts issued on or after January 1, 1995 and prior to January 1, 2017: the 1985 Commissioners Individual Disability Tables A (85CIDA) or the 1985 Commissioners Individual Disability Tables B (85CIDB). Each insurer shall elect, with respect to all individual contracts issued in any one statement year, whether it will use Tables A or Tables B as the minimum standard. An insurer may, however, elect to use the other tables with respect to any subsequent statement year;
(iii) Contracts issued during 1987 through 1994: Optional use of either the 1964 Table or the 1985 Tables as provided in paragraph (ii) of this subsection;
(iv) Contracts issued on or after January 1, 2017 and prior to January 1, 2020: the 1985 Tables as provided in paragraph (ii) of this subsection or, at the election of the insurer, the 2013 Individual Disability Income (IDI) Valuation Table (with modifiers as described in Actuarial Guideline L); and,
(v) Contracts issued on or after January 1, 2020: the 2013 IDI Valuation Table (with modifiers as described in Actuarial Guideline L).
(B) Claim reserves: The minimum morbidity standard in effect for contract reserves on currently issued contracts, as of the date the claim is incurred: provided, however, an insurer may make a one-time election to apply the minimum standard then in effect to all open claims.
(b) For hospital benefits, surgical benefits and maternity benefits (scheduled benefits or fixed time period benefits only):
(A) Contract reserves:
(i) Contracts issued on or after January 1, 1955, and before January 1, 1982: The 1956 Intercompany Hospital-Surgical Tables; and
(ii) Contracts issued on or after January 1, 1982: the 1974 Medical Expense Tables, Table A, Transactions of the Society of Actuaries, Volume XXX, pg. 63. Refer to the paper (in the same volume, pg. 9) to which this table is appended, including its discussions, for methods of adjustment for benefits not directly valued in Table A: Development of the 1974 Medical Expense Benefits, Houghton and Wolf.
(B) Claim reserves: No specific standard. See subsection (e) of this section.
(c) Cancer expense benefits (Scheduled benefits or fixed time period benefits only):
(A) Contract reserves:
(i) Contracts issued on or after January 1, 1986 and prior to January 1, 2018: the 1985 NAIC Cancer Claim Cost Tables (1985 CCCT);
(ii) Contracts issued on or after January 1, 2018 and prior to January 1, 2019: the 1985 CCCT or, at the election of the insurer, the 2016 Cancer Claim Cost Valuation Tables (2016 CCCVT); and,
(iii) Contracts issued on or after January 1, 2019: the 2016 CCCVT.
(B) Claim reserves: No specific standard. See subsection (e) of this section.
(d) Accidental death benefits:
(A) Contract reserves: Contracts issued on or after January 1, 1965: the 1959 Accidental Death Benefits Table.
(B) Claim reserves: Actual amount incurred.
(e) Other individual contract benefits:
(A) Contract reserves: For all other individual contract benefits, morbidity assumptions are to be determined by using tables established for reserve purposes by a qualified actuary and acceptable to the Director;
(B) Claim reserves: For all benefits other than disability, claim reserves are to be determined by using tables established for reserve purposes by a qualified actuary and acceptable to the Director.
(2) Minimum morbidity standards for valuation of specified benefits for group health insurance policies are as follows:
(a) For disability income benefits due to accident or sickness:
(A) Contract reserves:
(i) Contracts issued prior to January 1, 1995: Use of the 87CGDT is optional;
(ii) Contracts issued on or after January 1, 1995 and prior to October 1, 2014: the 1987 Commissioners Group Disability Income Table (87CGDT);
(iii) Contracts issued on or after October 1, 2014 and prior to January 1, 2017: the 87CGDT or, at the election of the insurer, the 2012 Group Long-Term Disability (GLTD) Valuation Table (with consideration of Actuarial Guideline XLVII); and
(iv) Contracts issued on or after January 1, 2017: the 2012 GLTD Valuation Table (with consideration of Actuarial Guideline XLVII).
(B) Claim reserves: The minimum morbidity standard in effect for contract reserves on currently issued contracts, as of the date the claim is incurred; provided, however, an insurer may make a one-time election to apply the minimum standard then in effect to all open claims.
(b) Other group contract benefits:
(A) Contract reserves: For all other group contract benefits, morbidity assumptions are to be determined by using tables established for reserve purposes by a qualified actuary and acceptable to the Director;
(B) Claim reserves: For all benefits other than disability, claim reserves are to be determined by using tables established for reserve purposes by a qualified actuary and acceptable to the Director.

Source: Rule 836-031-0270 — Specific Standards for Morbidity, https://secure.­sos.­state.­or.­us/oard/view.­action?ruleNumber=836-031-0270 (accessed May 26, 2025).

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

May 26, 2025

Rule 836-031-0270's source at or​.us