OAR 836-150-0030
Information Reporting
(1)
As a condition of receiving reinsurance payments from the Oregon Reinsurance Program, a reinsurance eligible issuer must provide, for each benefit year, the following information to the department in the form and manner prescribed by the department:(a)
The name and company code assigned to the reinsurance eligible issuer by the National Association of Insurance Commissioners;(b)
The identification number assigned to the reinsurance eligible issuer by the Health Insurance Oversight System (HIOS);(c)
The total amount of the reinsurance eligible issuer’s reinsurance eligible claims for the benefit year;(d)
The portion of the reinsurance eligible issuer’s total reinsurance eligible claims for the benefit year that fall between the attachment point and reinsurance cap;(e)
A summary data file containing the following information for each reinsurance eligible individual with claims for which reinsurance payments are being requested:(A)
The member identification number assigned by the reinsurance eligible issuer to the reinsurance eligible individual;(B)
The start and end dates of coverage for the reinsurance eligible individual;(C)
The HIOS plan identification number for the reinsurance eligible health benefit plan in which the reinsurance eligible individual was enrolled;(D)
The total amount of reinsurance eligible claims for the reinsurance eligible individual for the benefit year; and(E)
The total amount of reinsurance eligible claims for the reinsurance eligible individual for the benefit year that fall between the attachment point and reinsurance cap;(f)
A detailed claims file extracted from the reinsurance eligible issuer’s claims processing system that includes the issuer’s complete record of all reinsurance eligible claims for the benefit year;(g)
An attestation signed by an executive officer of the reinsurance eligible issuer stating that the information is accurate as of the date of submission; and(h)
Any other information requested by the department.(2)
As a condition of receiving reinsurance payments from the Oregon Reinsurance Program, a reinsurance eligible issuer must submit the information required under this rule to the department:(a)
Using a secure method of transmission approved by the department; and(b)
On or before July 15 of the year following the benefit year for which the reinsurance payment is requested.
Source:
Rule 836-150-0030 — Information Reporting, https://secure.sos.state.or.us/oard/view.action?ruleNumber=836-150-0030.