OAR 836-043-0017
Plan Administrator

(1)

The Plan Administrator is a rating organization for workers’ compensation insurance in Oregon that is designated as the plan administrator by the Director. The National Council on Compensation Inc. is designated as the Plan Administrator. The Plan Administrator shall continue to serve from the effective date of the Plan unless the Plan Administrator resigns. The Plan Administrator must give advance written notice of its resignation to the Director at least one year in advance of the effective date of resignation.

(2)

The Plan Administrator has the following duties and responsibilities in addition to any others set forth in the Plan and the organizing principles:

(a)

Determining the methodology and formula for making assignments to servicing carriers pursuant to OAR 836-043-0060 (Assignment Formula) and securing the necessary information in order to make the assignments;

(b)

Developing and implementing assigned risk operating rules and forms approved by the Director to the extent necessary to carry out the purposes of the Plan;

(c)

Processing assigned risk applications pursuant to OAR 836-043-0041 (Application Review);

(d)

Establishing written Assigned Carrier Performance Standards for servicing carriers, subject to approval by the Insurance Commissioner, including, but not limited to:

(A)

Verification of ongoing Plan eligibility of the employer;

(B)

Issuance of policies and endorsements;

(C)

Filings with administrative agencies;

(D)

Maintenance of premiums on policies, consistent with manual rules, rates, rating plans, and classifications;

(E)

Completion and billing of final audits;

(F)

Collection of premium;

(G)

Claim services, including investigation, disability management and medical cost control;

(H)

Loss control services and safety information to encourage employers to make safety a part of their business;

(I)

Payment of producer fees;

(J)

Issuance of renewal proposals and non-renewal notices;

(K)

Assurance of insured and insurer compliance with all terms and conditions of the policy contract;

(L)

Resolution of complaints and response to insured and insurance producer inquiries; and

(M)

Reporting financial and statistical data;

(e)

Monitoring servicing carrier performance and enforcing Assigned Carrier Performance Standards and incentives;

(f)

Administering the dispute resolution mechanism as provided in OAR 836-043-0070;

(g)

Developing and implementing assigned risk operating rules and forms to the extent necessary to carry out the purposes of the Plan;

(h)

Informing the Insurance Commissioner of any insurer that is not participating in this Plan;

(i)

Monitoring the performance and operation of the Plan and initiating amendments thereto as appropriate;

(j)

Determining the expenses for operation of the Plan, including but not limited to the Plan Administrator’s fees or legal expenses associated with Plan matters, and assess each insurer participating in the Plan for those expenses on an equitable basis as determined by the Plan Administrator and approved by the Director; and

(k)

Developing and administering a take-out credit program as provided in OAR 836-043-0076 (Takeout Credit).

(3)

The Plan Administrator shall also publish and make available to all affected insurers and producers, upon request and at no charge, both the necessary information for placement in the Plan and the listings of all employers that have been placed into the Plan. The listings shall include each employer’s name, address, policy expiration date, latest experience modification, if applicable, the Simplified Assigned Risk Adjustment Program factor and the governing class code.

(4)

The Plan Administrator shall monitor compliance by servicing carriers with occupational safety and health consultative service requirements of ORS 731.480 (Workers’ compensation policies). The Plan Administrator shall file with the Insurance Commissioner by May 1 of each year a report regarding such compliance for the preceding calendar year. The Plan Administrator shall also determine the expenses for operation of the Plan, not including the Plan Administrator’s expenses incurred in connection with responsibilities it has under the Articles, and shall assess each insurer participating in the Plan for those expenses on an equitable basis as determined by the Plan Administrator.

Source: Rule 836-043-0017 — Plan Administrator, https://secure.­sos.­state.­or.­us/oard/view.­action?ruleNumber=836-043-0017.

836–043–0001
Statutory Authority 836–043–0005
Definitions for the Workers’ Compensation Insurance Plan 836–043–0009
Participation by Insurers and Insurance Producers 836–043–0017
Plan Administrator 836–043–0021
Servicing Carriers 836–043–0024
Right to Apply 836–043–0028
Application by Electronic Transmission or Telephone 836–043–0032
Nonelectronic Application 836–043–0034
Surety Bonds 836–043–0041
Application Review 836–043–0044
Binding Coverage 836–043–0046
Rates and Forms, Policy Term, Additional Coverages and Other Provisions 836–043–0048
Additional States’ Coverage 836–043–0050
Interstate Assignments 836–043–0053
Premium Obligations 836–043–0056
Insurer Cancellation and Nonrenewal of Workers’ Compensation Insurance Policies or Surety Bonds 836–043–0060
Assignment Formula 836–043–0062
Issuance and Continuation of Policy 836–043–0064
Renewal, Nonrenewal 836–043–0066
Reassignment 836–043–0068
Cancellation 836–043–0071
Dispute Resolution Procedures 836–043–0072
Voluntary Coverage 836–043–0076
Takeout Credit 836–043–0079
Notification of Outstanding Premium 836–043–0082
Policyholder Services 836–043–0087
Producer Changes and Compensation 836–043–0089
Confidentiality of Information 836–043–0091
Self-Funded Plan 836–043–0101
Statutory Authority 836–043–0105
Definitions 836–043–0110
Insurer Premium Audit Program 836–043–0115
Insurer Audit Procedure Guide 836–043–0120
Minimum Standards of Insured Education Program 836–043–0125
Purpose 836–043–0130
Selection of Risks for Test Audit 836–043–0135
Test Audits 836–043–0145
Disposition of Test Audits 836–043–0150
Summary of Test Audit Results 836–043–0155
Test Audit Standards 836–043–0165
Monitoring Audit Program System 836–043–0170
Premium Audit Hearings 836–043–0175
Statutory Authority 836–043–0180
Definitions 836–043–0185
Insurer Classification Notice 836–043–0200
Statutory Authority 836–043–0210
Definitions 836–043–0220
Committee Participation 836–043–0230
Committee Operating Rules 836–043–0240
Committee Activities 836–043–0300
Qualifications for Workers’ Compensation Rating Oganizations 836–043–0310
Exchange of Data Among Workers’ Compensation Rating Organizations 836–043–0320
Competitive Selection Process
Last Updated

Jun. 24, 2021

Rule 836-043-0017’s source at or​.us