OAR 836-085-0215
Insurer Implementation of Employer Experience Rating Modifications
(1)
An insurer may apply to a policy for an individual employer as of the policy inception date, or as of the normal anniversary rating date, if different, the experience rating modification factors for the employer received by the insurer from the rating organization within 90 days from the inception of the policy or normal anniversary rating date, if the insurer has provided a tentative experience modification endorsement in compliance with OAR 836-085-0210 (Adjustment for Experience of Employer; Calculation of Tentative Modification Factors), or normal anniversary rating endorsement, to the insured at policy issuance.(2)
An insurer shall not apply to a policy for an individual employer the individual employer experience rating modification factors received by the insurer from the rating organization or produced by an insurer that produces its individual employer experience rating modification factors pursuant to OAR 836-042-0015 (Workers’ Compensation Filings — Procedural Rules for Insurers and Rating Organizations) after 90 days from the inception of the policy, or normal anniversary rating date, if different, until a date at least 30 days after the insurer has provided notice to the individual employer of the experience rating modification factor by endorsement. Prior to that date, the insurer may apply to the policy a tentative experience rating endorsement issued in compliance with 836-085-0210 (Adjustment for Experience of Employer; Calculation of Tentative Modification Factors).(3)
An insurer shall not apply to a policy of an individual employer the employer experience rating modification factors received by the insurer from the rating organization or produced by an insurer that produces its individual employer experience rating modification factors pursuant to OAR 836-042-0015 (Workers’ Compensation Filings — Procedural Rules for Insurers and Rating Organizations) if application of the procedures in sections (1) and (2) of this rule will result in implementation of the factors less than 90 days before the expiration date or subsequent anniversary rating date of the policy. However, the insurer shall provide written notice of the inapplicable experience rating modification to the employer.(4)
Notwithstanding sections (1), (2), and (3) of this rule, any employer experience rating modification factors received by the insurer from the rating organization or produced by an insurer that produces its individual employer experience rating modification factors pursuant to OAR 836-042-0015 (Workers’ Compensation Filings — Procedural Rules for Insurers and Rating Organizations) prior to policy or rating period expiration that results in a premium reduction to that employer shall be applied to the policy as of the inception date of that policy or the applicable anniversary rating date.(5)
This rule applies to intrastate and interstate experience rating modification factors.(6)
This rule does not apply to experience rating modification factors that result from changes in the ownership of the insured operation.(7)
If an employer is a client of a worker leasing company, as established under ORS 656.850 (License), the provisions of this rule are modified as follows:(a)
Sections (1), (2) and (3) of this rule apply if the leasing company has filed a worker leasing notice naming the client with the Workers’ Compensation Division and the insurer within 30 days of the date leased workers were first provided to the client;(b)
When the leasing company files the worker leasing notice with its insurer for an experience rated client 31 or more days after the date leased workers were first provided to the client, an insurer may apply an experience rating modification factor to a client’s premium as of the date the leased workers were first provided, if the insurer receives such factors from the rating organization within 90 days of the date the worker leasing notice is received by the insurer. Prior to the receipt of the experience rating modification factor, the insurer may apply a tentative factor to the client’s premium in compliance with OAR 836-085-0210 (Adjustment for Experience of Employer; Calculation of Tentative Modification Factors) and by giving written notice to the leasing company;(c)
An insurer may not apply an experience rating modification factor to a client’s premium from the date leased workers were first provided if the factor is received from the rating organization more than 90 days after the insurer’s receipt of the client’s worker leasing notice, until a date at least 30 days after the insurer has provided notice to the leasing company; and(d)
Notwithstanding subsections (a), (b) and (c) of this section, any client experience rating modification factors received by the insurer for a client that results in a premium reduction to that client shall be applied as of the date leased workers were first provided by the leasing company to the client.
Source:
Rule 836-085-0215 — Insurer Implementation of Employer Experience Rating Modifications, https://secure.sos.state.or.us/oard/view.action?ruleNumber=836-085-0215.