Regulatory Alerts2020-01-01 | Bulletin 2020-5Oregon Division of Financial Regulation Bulletin 2020-5: Withdrawal of Bulletin INS 2010-01
The Oregon Division of Financial Regulation withdraws Bulletin INS 2010-01, which previously outlined health insurance cancellation and non-renewal standards under HIPAA. This guidance is now obsolete because federal HIPAA rules were superseded by the Affordable Care Act and Oregon statutes were amended to restrict non-renewal exclusively to intentional misrepresentations of material facts. Regulated entities must instead consult Oregon Revised Statutes 743B.013, 743B.105, and 743B.125, along with applicable federal ACA provisions, to determine current lawful grounds for canceling or non-renewing health benefit plans.
~ w( 1 0.5 I Consumer and 0 Business Services ' 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was issued, HIP AA requirements regarding the cancellation and renewability of health insurance coverage have been superseded by the Patient Protection and Affordable Care Act (ACA).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. § gg42, 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. ]/3 (diJ'JD Date Administrator/Insurance Commissioner Division of Financial Regulation