OAR 836-043-0044
Binding Coverage


(1)

The Plan Administrator may issue binders to eligible employers in accordance with the provisions of this Plan. The servicing carrier shall provide coverage under any binder issued by the Plan Administrator, subject to the provisions of the Plan, any applicable policy terms or conditions, and any applicable laws, rules, or regulations. The Plan Administrator shall send copies of the binder to the employer’s representative, if any, the servicing carrier to which the Plan Administrator assigned the employer and the Director of the Department of Consumer and Business Services.

(2)

The Plan Administrator shall issue a binder for an employer when the Plan Administrator determines all of the following occur:

(a)

The employer is eligible for coverage;

(b)

The Plan Administrator has received an application that is complete and signed by an officer, owner or other designee with power of attorney and includes any additional information within the established time frame; and

(c)

The Plan Administrator has received the total initial premium or deposit premium within the established time frame.

(3)

After the Plan Administrator binds coverage, the Plan Administrator shall provide the servicing carrier with the following:

(a)

A copy of the binder;

(b)

The initial or deposit premium;

(c)

The application forms as set forth in Exhibits 1 and 2 to OAR 836-043-0024 (Right to Apply);

(d)

Copies of any provided election or rejection forms;

(e)

Other forms submitted during the application review process; and

(f)

Any information to assist the servicing carrier in providing the proper coverage and correct rates including but not limited to experience rating modification worksheet data, NCCI’s Inspection and Classification Report, and change of ownership information form if applicable.

(4)

Upon receipt of the assignment package, the servicing carrier shall review the documents to ensure that all documentation needed to properly issue the policy is attached. Based on the separate review of the servicing carrier , the servicing carrier may request additional information or premium from the employer. The servicing carrier must receive all additional requested information or premium before the servicing carrier issues a policy.

(5)

The servicing carrier shall issue the policy in accordance with Plan rules, state law and the Assigned Carrier Performance Standards.

(6)

The binder or verification page remains in effect until cancelled or until the servicing carrier issues a policy in accordance with the Assigned Carrier Performance Standards or state law. If the Plan Administrator does not issue a binder, coverage does not exist.

(7)

Intentionally left blank —Ed.

(a)

The employer or the representative of the employer may request an effective date no later than sixty days after the date of application. However, such requested effective date must be the later of the following:

(A)

The established effective date as outlined in the tables set forth in subsection (8) of this rule;

(B)

The date of expiration of existing coverage; or

(C)

A date the employer requested.

(b)

To secure a requested effective date, the employer or the representative of the employer shall:

(A)

Submit to the Plan Administrator a signed and completed application as described in Exhibits 1 and 2 to OAR 836-043-0024 (Right to Apply) using one of the submission methods described in OAR 836-043-0024 (Right to Apply)(5).

(B)

For an application submitted by U.S. Postal Service or private overnight delivery service, at a minimum, include in the application submission the required critical threshold elements as defined in NCCI’s Assigned Risk Supplement to the Basic Manual.

(C)

If submitting an application via mail or an overnight delivery service, include the appropriate initial or deposit premium. The Plan Administrator will consider the receipt of the application at the specified mailing address receipt.

(8)

The earliest effective date for coverage is dependent on the method used to submit the application and shall be determined in accordance with the following tables: [Table not included. See ED. NOTE.]

(9)

If the Plan Administrator fails to issue a binder to an eligible employer by the 14th day after receiving a completed application and the total initial or deposit premium, coverage is bound at 12:01 a.m. on the later of the dates specified in section (8) of this rule.

(10)

A binder issued to a worker leasing company applicant in compliance with requirements for an initial worker leasing company license under OAR 436-050-0440 is extended as provided in this section until the Director of the Department of Consumer and Business Services either licenses or refuses to license the applicant, as follows:

(a)

The binder is conditional upon the subsequent initial worker leasing company licensing by the Director. The binder does not obligate the Plan to provide coverage to the worker leasing company for its clients until the worker leasing company is licensed by the Director of the Department of Consumer and Business Services.

(b)

Upon the conditional binding of the applicant worker leasing company, the Plan Administrator shall send the binder to those entities listed in section (1) of this rule, except for the servicing carrier.

(c)

Upon the initial licensing of a worker leasing company applicant by the Director of the Department of Consumer and Business Services, and receipt of proof of licensing, the Plan Administrator shall assign an unconditional binder to a servicing carrier and send an unconditional binder to all entities listed in section (1) of this rule.

(d)

Upon the refusal to license a worker leasing company applicant by the Director of the Department of Consumer and Business Services, and upon receipt of proof of refusal, the Plan Administrator shall send notice to all entities listed in section (1) of this rule that the conditional binder has been rescinded and the applicant was not covered.
[ED. NOTE: Tables referenced are available from the agency.]
836‑043‑0001
Statutory Authority
836‑043‑0005
Definitions for the Workers’ Compensation Insurance Plan
836‑043‑0009
Participation by Insurers and Insurance Producers
836‑043‑0017
Plan Administrator
836‑043‑0021
Servicing Carriers
836‑043‑0024
Right to Apply
836‑043‑0028
Application by Electronic Transmission or Telephone
836‑043‑0032
Nonelectronic Application
836‑043‑0034
Surety Bonds
836‑043‑0041
Application Review
836‑043‑0044
Binding Coverage
836‑043‑0046
Rates and Forms, Policy Term, Additional Coverages and Other Provisions
836‑043‑0048
Additional States’ Coverage
836‑043‑0050
Interstate Assignments
836‑043‑0053
Premium Obligations
836‑043‑0056
Insurer Cancellation and Nonrenewal of Workers’ Compensation Insurance Policies or Surety Bonds
836‑043‑0060
Assignment Formula
836‑043‑0062
Issuance and Continuation of Policy
836‑043‑0064
Renewal, Nonrenewal
836‑043‑0066
Reassignment
836‑043‑0068
Cancellation
836‑043‑0071
Dispute Resolution Procedures
836‑043‑0072
Voluntary Coverage
836‑043‑0076
Takeout Credit
836‑043‑0079
Notification of Outstanding Premium
836‑043‑0082
Policyholder Services
836‑043‑0087
Producer Changes and Compensation
836‑043‑0089
Confidentiality of Information
836‑043‑0091
Self-Funded Plan
836‑043‑0101
Statutory Authority
836‑043‑0105
Definitions
836‑043‑0110
Insurer Premium Audit Program
836‑043‑0115
Insurer Audit Procedure Guide
836‑043‑0120
Minimum Standards of Insured Education Program
836‑043‑0125
Purpose
836‑043‑0130
Selection of Risks for Test Audit
836‑043‑0135
Test Audits
836‑043‑0145
Disposition of Test Audits
836‑043‑0150
Summary of Test Audit Results
836‑043‑0155
Test Audit Standards
836‑043‑0165
Monitoring Audit Program System
836‑043‑0170
Premium Audit Hearings
836‑043‑0175
Statutory Authority
836‑043‑0180
Definitions
836‑043‑0185
Insurer Classification Notice
836‑043‑0200
Statutory Authority
836‑043‑0210
Definitions
836‑043‑0220
Committee Participation
836‑043‑0230
Committee Operating Rules
836‑043‑0240
Committee Activities
836‑043‑0300
Qualifications for Workers’ Compensation Rating Oganizations
836‑043‑0310
Exchange of Data Among Workers’ Compensation Rating Organizations
836‑043‑0320
Competitive Selection Process
Last Updated

Jun. 8, 2021

Rule 836-043-0044’s source at or​.us