Or. Admin. R. 836-052-0790

Current through Register Vol. 63, No. 9, September 1, 2024

Section 836-052-0790 - Disclosure of Benefits Paid

(1) Each insurer shall provide at a minimum the following information at least quarterly to each insured, or a designee of the insured, who is currently receiving, or has received during that quarter, any benefits under a qualified long term care partnership insurance policy:

(a) The total benefits paid by the insurer for services rendered during the quarter;

(b) The total amount of benefits paid to date under the policy; and

(c) A general disclosure statement that informs the policyholder or the designee of the policyholder:

(A) The benefits paid are pursuant to a long term care partnership policy; and

(B) To determine if the benefits paid would qualify for asset protection, the policyholder should contact their local Medicaid office.

(2) An insurer shall provide the information required under section (1) of this rule each quarter until the claim is no longer active. The insurer may include the information required in section (1) of this rule either in a separate report to the insured or as part of the explanation of benefits provided to the insured when the insurer pays benefits under the long term care partnership policy.

Or. Admin. R. 836-052-0790

ID 4-2011, f. & cert. ef. 2-10-11

Stat. Auth.: ORS 731.244, 743.655, 743.656 & 746.240

Stats. Implemented: ORS 743.650, 743.655 & 743.656