OR DFR Bulletin 2020-05
OR DFR Bulletin 2020-05: Withdrawal of Oregon Insurance Division Bulletin INS 2010-01s
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350 Winter Street NE, Room 200, P.O. Box 14480, Salem, Oregon 97309-0405
503-947-7872
dcbs.oregon.gov
Oregon Division of Financial Regulation Bulletin No. DFR 2020-5
TO:
All Entities Transacting Health Insurance in Oregon
DATE:
March 3, 2020
RE:
Withdrawal of Oregon Insurance Division Bulletin INS 2010-01
Purpose
This bulletin withdraws Oregon Insurance Division Bulletin INS 2010-01 .
Authority
•
ORS 743B.013
•
ORS 743B.105
•
ORS 743B.110
•
ORS 743B.125
Background
The Department of Consumer and Business Services (department) issued Bulletin INS 2010-01
to clarify that, consistent with then-applicable federal requirements of the Health Insurance
Portability and Accountability Act of 1996 (HIP AA), a health benefit plan ( or coverage provided
to specific individuals under a health benefit plan) cannot be canceled or non-renewed based on a
misrepresentation unless the misrepresentation is both material and intentional.
Since Bulletin INS 2010-01 was issued, HIP AA requirements regarding the cancellation and
renewability of health insurance coverage have been superseded by the Patient Protection and
Affordable Care Act (ACA). Relevant Oregon statutes have also been amended to clarify that
health benefit coverage may only be non-renewed in the event of an intentional
misrepresentation of a material fact as prohibited by the terms of the plan. Because of these
changes, the guidance provided by Bulletin INS 2010-01 is no longer necessary.
Guidance for insurers and other regulated entities
Health insurance carriers and other parties seeking guidance on Oregon's requirements related to
renewal and cancelation of health benefit plans are advised to consult ORS 743B.013 (small
group plans), ORS 743B.105 (other group plans), or ORS 743B.125 (individual plans). Federal
requirements for guaranteed renewability may be found at 42 U.S.C. § 300gg- 2, 42 U.S.C. § ggÂ
42, and regulations adopted thereunder.
Nothing in this bulletin shall be constrned to limit the department's authority under the Oregon
Insurance Code or its ability to continue enforcing the laws of the State of Oregon.
This bulletin takes effect immediately. It remains in effect until superseded by a further bulletin
of the Di vision of Financial Regulation.
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Date
Administrator/Insurance Commissioner
Division of Financial Regulation