An insurer that issues a policy for worker's compensation
insurance including a large deductible provision must use a provision which
satisfies requirements of OAR
836-054-0210 and has been
approved by the Director and must file rating plans for determining premium
credits or rating modifications with the Director according to ORS
737.320 and OAR
836-042-0001 to
836-042-0045 and which satisfy
these additional requirements:
(1)
Such rating plans must be based on actuarial assumptions and methods similar to
and not circumventing the design of retrospective rating plans approved by the
Director.
(2) A deductible credit
or rating modification must be the final rating step so that the insurer may
distinguish the amount of credit or modification premium and the policy premium
prior to the credit or modification. An insurer may compute premium discounts
based on premium amounts after deductible credits if the insurer can
demonstrate that greater premium equity is achieved and that data
distinguishing the various premium elements will be maintained.
(3) Such rating plans may not contain
provisions which cannot be approved under the unfair discrimination provisions
of OAR
836-042-0025.
(4) A deductible credit or rating
modification must recognize expenses which vary with net earned premium after
such credits or modifications
(5)
Prospective experience rating plans based on prior claims experience must use
losses valued on a gross basis prior to deductible provisions.
(7) Minimum eligibility for a large
deductible provision must be not less than $500,000 estimated country-wide
annual premium prior to large deductible credits or premium credits based on
premium size. The minimum deductible limit per claim for each injury or illness
may not be less than $75,000. An aggregate limit for deductible amounts for all
claims may be specified but may not be less than the deductible limit per
claim.
Notes
Or. Admin. Code
§
836-042-0080
ID 4-1995, f. 7-21-95,
cert. ef. 10-1-95; ID 11-2010, f. 5-4-10, cert. ef.
7-1-10
Stat. Auth.: ORS
731.244
Stats. Implemented: ORS 737,
737.310 &
742.001 -
742.007
