Around the PIA Western Alliance States – Week of June 2, 2025
Published June 3, 2025 at 12:01 PM · News Releases and Bulletins
Oregon — The Oregon Division of Financial Regulation has issued a bulletin that provides guidance on filing rates and forms: This bulletin provides guidance on filing rates and forms with the Division of Financial Regulation (DFR) and replaces Oregon Insurance Division Bulletin 2006-5.
GUIDANCE FOR INSURERS
Oregon uses the System for Electronic Rate and Form Filing (SERFF). Each SERFF filing requirement and the required documents listed on our website and/or in the SERFF filing system must be included for the filing to be considered complete.
Click here to review this bulletin:
Oregon — The Oregon Division of Financial Regulation recently announced the following proposed rulemaking:
Filing Caption: Oregon election to opt-out from two Interstate Insurance Product Regulation Compact Uniform Standards
Rule Proposed: 836-080-0195
Rule Summary: This rule exercises the opt-out provisions of the Interstate Insurance Product Regulation Compact (Compact). The director of the Department of Consumer and Business Services considered and found the protections offered to Oregon residents from following Compact Uniform Standards are not adequate:
1) Standards for Individual Deferred Index Linked Variable Annuity Contracts; and
2) Additional Standards for Market Value Adjustment Feature for Modified Guaranteed Annuities and Index-Linked Variable Annuities.
Filed: May 27, 2025
Hearing Date/Time: June 23, 2025, 9:00 AM, Pacific Time
This is a hybrid meeting conducted in-person and virtually via Microsoft Teams. See Notice of Proposed Rulemaking for Teams meeting instructions.
Last day/time to offer comment: June 30, 2025, 5:00 PM
Oregon — The Oregon Division of Financial Regulation recently announced the following proposed rulemaking:
Filing Caption: The Licensing of Public Adjusters
Rules Proposed: 836-071-1100, 836-071-1105, 836-071-1110, 836-071-1115, 836-071-1120, 836-071-1125, 836-071-1130, 836-071-0135, 836-071-1140, 836-071-1145, 836-071-1150, 836-071-1155, 836-071-1160, 836-071-1165, 836-071-1170, 836-071-1175, 836-071-1180, 836-071-1185, 836-071-1190, 836-071-1195
Rules Summary: By adding/distinguishing a public adjuster license type from an independent adjuster type through rulemaking, the adjuster licensing process will be simplified for both the licensing section of the application, and the applying adjusters. Rulemaking is intended to clarify the roles and responsibilities of each adjuster type, further reduce potential for conflicts of interest, and add better regulatory oversight and consumer protection for distinctly different adjuster disciplines.
Filed: May 28, 2025
Hearing Date/Time: June 23, 2025, 10:00 AM, Pacific Time
This is a hybrid meeting conducted in-person and virtually via Microsoft Teams. See Notice of Proposed Rulemaking for Teams meeting instructions.
Last day/time to offer comment: June 30, 2025, 5:00 PM
Oregon — The Oregon Division of Financial Regulation recently announced the following proposed rulemaking:
Filing Caption: Updates to Pharmacy Benefit Manager Rules and DPT Insurer Reporting Rule
Rules Proposed: 836-053-1630, 836-200-0401, 836-200-0406, 836-200-0411, 836-200-0416, 836-200-0418, 836-200-0421, 836-200-0436, 836-200-0440
Rules Summary: The proposed rulemaking replaces references to registration throughout our current rules, encoded at OAR 836-200-0401 et seq with references to licensure. It also adds new data elements to our reporting rule and new market conduct requirements. It also adds language clarifying the bar on retaliation against pharmacies, noting that a pharmacy claims audit may be considered retaliation under certain circumstances. Finally, the rulemaking includes substantial revisions to the language related to pharmacy reimbursement in order to clarify expectations for PBMs when a pharmacy is reimbursed below acquisition cost under a maximum allowable cost schedule. The rulemaking also includes a proposed an amendment to OAR 836-053-1630, which relates to the requirement that insurers annually report certain information about prescription drugs dispensed in the prior year.
Filed: May 29, 2025
Hearing Date/Time: June 23, 2025, 11:00 AM, Pacific Time
This is a hybrid meeting conducted in-person and virtually via Microsoft Teams. See Notice of Proposed Rulemaking for Teams meeting instructions.
Last day/time to offer comment: June 30, 2025, 5:00 PM
Oregon. — Health Insurance: Oregonians continue to have at least five health insurance companies to choose from in every Oregon county as companies file 2026 health insurance rate requests for individual and small group markets
Salem – Oregon health insurers have submitted proposed 2026 rates for individual and small group plans, launching a months-long review process that includes public input and meetings.
Five insurers will again offer plans statewide (Moda, Bridgespan, PacificSource, Providence, and Regence), and Kaiser is offering insurance in 11 counties, giving six options to choose from in various areas around the state.
In the individual market, six companies submitted rate change requests ranging from an average increase of 3.9 percent (PacificSource) to 12.9 percent (Kaiser), for a weighted average increase of 9.7 percent. That average increase is slightly higher than last year’s requested weighted average increase of 9.3 percent.
In the small group market, eight companies submitted rate change requests ranging from an average increase of 5.1 percent (PacificSource) to 21.5 percent (Providence), for a weighted average increase of 11.5 percent, which is lower than last year’s 12.3 percent requested average increase.
The Oregon Reinsurance Program continues to help stabilize the market and lower rates. Reinsurance lowered rates by at least 6 percent for the eighth straight year. In fact, this year the reinsurance program resulted in a 9.2 percent average lower premium.
The rate filings also reference uncertainty and other changes for some insurers. For example, two insurers – UnitedHealthcare Inc. and UnitedHealthcare of Oregon – include a 2.7 percent impact due to prescription drug tariffs. Also, Regence filed a separate request to consider up to an additional $25 per member per month increase as part of its rate filing based on possible Oregon legislative changes. That request, which is subject to the Oregon Division of Financial Regulation’s (DFR) approval, is not included in the attached chart of rate change requests.
DFR, which approves all rate request changes, will also inquire further with insurers throughout the process about ongoing uncertainty at the federal level, including further tariffing of prescription drugs and medical equipment, key changes in laws and subsidies, and additional cost drivers that may be felt by consumers.
See the attached chart for the full list of rate change requests.
“Oregon’s insurance market continues to grow with Kaiser adding even more counties than last year and all other counties still having five carriers offering plans,” said Oregon Insurance Commissioner and Department of Consumer and Business Services Director Andrew R. Stolfi. “The economy, uncertainty caused by federal actions, and increased spending in some areas are driving prices higher than last year. Oregonians still have a lot of options to choose from and the Oregon Reinsurance Program continues to allow Oregonians to find reasonable rates.”
Virtual public meetings about the 2026 requested health insurance rates will be held Friday, June 20, from 8:30 to 11:30 a.m. and Friday, July 18, from noon to 3 p.m. A web address to watch the public meetings will be posted at oregonhealthrates.org. At the meetings, each insurance company will provide a brief presentation about its rate increase requests, answer questions from DFR employees, and hear public comment from Oregonians. The public also can comment on the proposed rates through June 20 at oregonhealthrates.org.
“We look forward to a thorough and transparent process putting these rate requests through a rigorous public review, and we encourage the public to join the virtual public meetings and provide feedback on their health insurance plans,” Stolfi said. “This public process not only helps keep insurance companies accountable, but it gives Oregonians the opportunity be part of the process.”
The requested rates are for plans that comply with the Affordable Care Act for small businesses and individuals who buy their own coverage rather than getting it through an employer.
Over the next two months, DFR will analyze the requested rates to ensure they adequately cover Oregonians’ health care costs. DFR must review and approve rates before they are charged to policyholders.
In addition to reviewing the rate filings to determine if the rate changes are justified, DFR continues to monitor the ongoing federal policy and financing uncertainties to evaluate their effect on consumers. For example, expanded advance premium tax credits, which help subsidize premiums for some consumers and were part of COVID funding packages, expire at the end of 2025. While the expiration of these credits do not affect the rates under review, these changes would result in higher consumer costs. DFR will continue to keep consumers informed about these impacts during the rate review process.
Preliminary decisions are expected to be announced in July, and final decisions will be made in August after the public meetings and comment period ends.
Oregon — To all insurance companies writing auto insurance in Oregon: The Oregon DMV requested that issuers of auto insurance policies be made aware of the following information. If you have questions, contact DMVDriverControl@odot.oregon.gov.
Online Collision Report Available at DMV2U
DMV recently launched the new service. The Online Collision Report Form is:
Accessible on a personal computer, tablet and smartphone.
A convenient, secure and fast method to send collision reports to DMV.
User-friendly and guides customers through the process.
A real-time submission with a confirmation email upon completion.
Available 24/7/365 with an option to save a draft and resume later.
How does this impact auto insurance issuers?
Drivers usually contact their insurance company as soon as possible after a collision. Insurers may make their clients aware of DMV’s new online service as well as reporting requirements.
Click here to review this memorandum: https://bit.ly/4kP4G8P
Washington — Insurers seek 21.2% average rate change for 2026 individual health insurance market: Fourteen health insurers have requested an average rate change of 21.2% for Washington state's 2026 Individual Health Insurance Market. Insurers base their requested rate changes on assumptions they make about the services their policyholders will use and the cost to deliver that care. The health plans and proposed rate changes are currently under review by the Office of the Insurance Commissioner.
Wellpoint Washington, Inc. is new to the market and plans to sell in Grays Harbor, King and Spokane counties.
A factor impacting the requested increase this year is that the Enhanced Advance Premium Tax Credits are set to expire on Dec. 31, 2025, unless Congress renews them. While the premium subsidies provided under the Affordable Care Act help many people qualify for coverage, a significant number of people still struggle to afford coverage. Enhanced tax credits were created under the American Rescue Plan Act in 2021, and extended through 2025 by the Inflation Reduction Act, to help people who make more than 400% of the Federal Poverty Level ($62,600) afford coverage and increase the amount of help for people who make less than that.
According to the Washington Health Benefit Exchange, as many as 80,000 people will drop coverage if the subsidies are not extended. Health plans took this into account when creating their request for 2026. Based on the assumptions in the initial requested rate changes, renewing the tax credits could reduce the proposed rate changes by as much as 6.4%. Washington state Insurance Commissioner Patty Kuderer advocated for an extension of these tax credits while in Washington, D.C. earlier this month for the National Association of Insurance Commissioners (NAIC) 2025 Commissioner Fly-In.
"These tax credits are how many people afford critical coverage that protects themselves and their families," said Kuderer. "I know many members of Congress understand this and hopefully, they will prevail in these negotiations. Thousands of people in Washington state and millions across the country depend on the individual market and can't afford to see prices rise unnecessarily."
Most people get health coverage through their jobs, but more than 300,000 people in Washington do not have employer-sponsored health insurance and must buy a plan in the individual market. Last year, 286,526 people bought through the Exchange and 77% qualified for either federal premium tax credits or state-funded Cascade Care Savings.