(1) Each carrier offering a health benefit plan shall submit to the Director of the Department of Consumer and Business Services on or before April 1 of each year a report that contains:
(a) The following information for the preceding year that is derived from the exhibit of premiums, enrollment and utilization included in the carrier’s annual report:
(A) The total number of members;
(B) The total amount of premiums;
(C) The total amount of costs for claims;
(D) The medical loss ratio;
(E) The average amount of premiums per member per month; and
(F) The percentage change in the average premium per member per month, measured from the previous year.
(b) The following aggregate financial information for the preceding year that is derived from the carrier’s annual report:
(A) The total amount of general administrative expenses, including identification of the five largest nonmedical administrative expenses and the assessment against the carrier for the Oregon Medical Insurance Pool;
(B) The total amount of the surplus maintained;
(C) The total amount of the reserves maintained for unpaid claims;
(D) The total net underwriting gain or loss; and
(E) The carrier’s net income after taxes.
(c) The retention rate and claims experience of employer groups within the plan for the preceding year for association health plans as described in ORS 743.734 (7). This information is not subject to public disclosure under ORS chapter 192.
(2) A carrier shall electronically submit the information described in subsection (1) of this section in a format and according to instructions prescribed by the Department of Consumer and Business Services by rule after obtaining a recommendation from the Health Insurance Reform Advisory Committee.
(3) The advisory committee shall evaluate the reporting requirements under subsection (1)(a) of this section by the following market segments:
(a) Individual health benefit plans;
(b) Health benefit plans for small employers;
(c) Health benefit plans for employers described in ORS 743.733;
(d) Health benefit plans for employers with more than 50 employees; and
(e) Association health plans described in ORS 743.734 (7).
(4) The department shall make the information reported under this section available to the public through a searchable public website on the Internet. [2005 c.765 §2; 2007 c.752 §5]
Note: The amendments to 743.748 by section 10, chapter 752, Oregon Laws 2007, become operative January 2, 2014. See section 13, chapter 752, Oregon Laws 2007. The text that is operative on and after January 2, 2014, is set forth for the user’s convenience.
743.748. (1) Each carrier offering a health benefit plan shall submit to the Director of the Department of Consumer and Business Services on or before April 1 of each year a report that contains:
(a) The following information for the preceding year that is derived from the exhibit of premiums, enrollment and utilization included in the carrier’s annual report:
(A) The total number of members;
(B) The total amount of premiums;
(C) The total amount of costs for claims;
(D) The medical loss ratio;
(E) The average amount of premiums per member per month; and
(F) The percentage change in the average premium per member per month, measured from the previous year.
(b) The following aggregate financial information for the preceding year that is derived from the carrier’s annual report:
(A) The total amount of general administrative expenses, including identification of the five largest nonmedical administrative expenses and the assessment against the carrier for the Oregon Medical Insurance Pool;
(B) The total amount of the surplus maintained;
(C) The total amount of the reserves maintained for unpaid claims;
(D) The total net underwriting gain or loss; and
(E) The carrier’s net income after taxes.
(2) A carrier shall electronically submit the information described in subsection (1) of this section in a format and according to instructions prescribed by the Department of Consumer and Business Services by rule after obtaining a recommendation from the Health Insurance Reform Advisory Committee.
(3) The advisory committee shall evaluate the reporting requirements under subsection (1)(a) of this section by the following market segments:
(a) Individual health benefit plans;
(b) Health benefit plans for small employers;
(c) Health benefit plans for employers described in ORS 743.733; and
(d) Health benefit plans for employers with more than 50 employees.
(4) The department shall make the information reported under this section available to the public through a searchable public website on the Internet.
Section: Previous 743.741 743.742 743.743 743.744 743.745 743.746 743.747 743.748 743.749 743.750 743.751 743.752 743.753 743.754 743.755 NextLast modified: August 7, 2008