Or. Admin. Code § 410-141-5010 - FINANCIAL SOLVENCY REGULATION: Procedure for General Financial Reporting and for Determining Financial Solvency Matters

(1) The Authority shall determine financial solvency of a CCO in accordance with OAR 410-141-5005 through OAR 410-141-5469, and the terms of the CCO Contract.

(2) The Authority shall collaborate with DCBS to review CCO financial reports and evaluate financial solvency and may enter into a cooperative agreement with the DCBS to carry out the provisions of OAR 410-141-5005 to OAR 410-141-5469. Only the Authority may take enforcement action or other regulatory sanctions related to OAR 410-141-5005 to OAR 410-141-5380 and the CCO Contract.

(3) When DCBS is working cooperatively with the Authority to carry out the provisions of OAR 410-141-5005 to OAR 410-141-5380:

(a) Any reference to the Authority in these rules shall include DCBS;

(b) Where these rules specify that the Authority may request or receive information or provide a response or take any action, DCBS may act on behalf of the Authority;

(c) CCOs are not required to file financial reports with both the Authority and DCBS except as may otherwise be provided in the CCO Contract;

(d) A response to DCBS shall be considered a response to the Authority, consistent with the objective of providing a single point of reporting by CCOs.

(4) CCO Contract Applicants. Applicants for a CCO Contract shall submit all required information to the Authority as part of the application process, and the Authority shall transmit certain information to DCBS, as necessary, for its review. In making its determination about the qualifications of the applicant, the Authority shall consult with DCBS about the financial materials and reports submitted with the application.

(5) The Authority may address inquiries to or request additional information or clarification from a CCO or its officers in relation to the activities or condition of the CCO or any other matter connected with its transactions.

(a) All such persons shall promptly and truthfully reply to the inquiries using the form of communication required by the Authority and, if the Authority requires, verified by an officer of the CCO;

(b) No person shall file or cause to be filed with the Authority or the Department any report, statement, application, article, or any other information required or permitted to be filed and known to such person to be false or misleading in any material respect.

(6) CCOs may be required to use specific required reporting forms or documents in order to supply information related to financial responsibility, financial solvency, and financial management. The Authority or DCBS, as applicable, shall provide supplemental instructions about the use of these forms.

(7) The standards established in OAR 410-141-5005 through OAR 410-141-5380 are intended align with the regulation of domestic insurers, to the extent the provisions are applicable to CCOs and are in accordance with ORS Chapters 413 and 414. Any reference in these rules to the Insurance Code or to rules or regulations adopted by DCBS under the Insurance Code shall not make a CCO subject to regulation as an insurer, but instead shall be construed to adopt and incorporate such rules by reference as Authority rules applicable to CCOs.

Notes

Or. Admin. Code § 410-141-5010

DMAP 58-2019, adopt filed 12/18/2019, effective 1/1/2020; DMAP 143-2024, amend filed 12/29/2024, effective 1/1/2025

Statutory/Other Authority: ORS 413.042, 414.572, 414.591 & 414.605

Statutes/Other Implemented: ORS 414.570-414.686 & ORS 415.001-415.430