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ORDER NO. 03-064

DEPARTMENT OF CONSUMER AND BUSINESS SERVICES

WORKERS’ COMPENSATION DIVISION

ELECTRONIC DATA INTERCHANGE

(7) Transactions to change the wrap-up indicator, business market, assignment date, and professional employer organization (worker leasing company) indicator are not capable of being processed by the division's information processing system.

Stat. Authority:  ORS 656.726(4)

Stat. Implemented:  ORS 656.264 and ORS 656.419

Hist:  Adopted 3/17/03 as Admin. Order 03-052, eff 4/1/03

Amended 12/3/03 as Admin. Order 03-064, eff. 1/1/04

436-160-0350Guaranty Contract Filing Requirements  

(1) For the purpose of these rules, an electronic guaranty contract consists of an executed trading partner agreement containing the guaranty described in subsection (2)(a) of this rule, and an accepted proof of coverage insured and employer electronic record.

(2) To file a guaranty contract via EDI, an insurer must do all of the following:

(a)  Enter into a trading partner agreement with the director pursuant to OAR 436-160-0020 that contains a statement of assumption of liability and guaranty of payment pursuant to ORS 656.419(1);

(b) Transmit an electronic record of the proof of coverage data elements identified as mandatory or required conditional pursuant to OAR 436-160-0310, including a unique FEIN for each legally distinct employer included in the establishing document transaction; and

(c) Transmit an establishing document transaction: binder, new policy, renew policy, rewrite/reissue policy, reinstatement, add location, add employer, or add jurisdiction.  A renew policy, add location, or add employer transaction will only establish a guaranty contract if the data elements have not previously been transmitted, the employer FEIN is not a duplicate per section (3) below, and coverage for that unique employer FEIN has not been previously established by the reporting carrier.  A reinstatement transaction will only establish a new guaranty contract if there is a lapse in coverage and the requirements of ORS 656.419 and OAR 436-160-0350 are otherwise met.

(3) A duplicate FEIN or a FEIN previously reported under the same policy will be recorded as an additional employer location and/or an assumed business name, but will not establish an additional guaranty contract.

(4) Reinstatement, rewrite, and reissue transaction types must follow a cancellation transaction.

(5) If an employer elects to include any non-subject worker(s) under coverage pursuant to ORS 656.419(2)(d), or subsequently to exclude such workers from coverage, the insurer must submit a transaction with a reason code for including or excluding a corporate officer, partner, member, sole proprietor, or any other person.

Stat. Authority:  ORS 656.726(4)

Stat. Implemented:  ORS 656.264, ORS 656.419*, ORS 656.423*, and ORS 656.427* *(sections 3, 4, & 5, chapter 170, Oregon Laws 2003)

Hist:  Adopted 3/17/03 as Admin. Order 03-052, eff 4/1/03

Amended 12/3/03 as Admin. Order 03-064, eff. 1/1/04

436-160-0360Guaranty Contract Terminations

436-160-0360Page 9436-160-0360

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