The Oregon Insurance Division regulates rates for small employer and individual health insurance plans. Small employers are those with 50 or fewer employees. Individual health plans are for the self-employed and others who are not covered through an employer and buy a plan on their own. This can be for one person or a family. The state does not regulate rates for large employers or public entities, such as a school district or the State of Oregon.
Rate review approves a "base rate" for insurance company health plans plus the factors that determine the actual rate you pay. Your personal cost for health insurance may be more or less than the base rate. It depends on your age, how many family members are on the plan, where you live, and whether you use tobacco.
Click on the "new rate requests" tab after May 31 to find links to company rate requests. You will also find links to how you can comment about a rate request. Click on the "public hearings" button to see when rate hearings will be streamed live. You can also sign up for e-notify. We will email you when an insurance company files for new rates and when we post rate decisions.
Companies must pay rebates to individual and small-group policyholders if they fail to spend at least 80 percent of premiums on medical care and quality improvement versus administrative costs. They must spend at least 85 percent of premiums on these activities in the large group market or pay a rebate. The division does not approve rate requests that anticipate rebates.