2021 Oregon Revised Statutes
Chapter 743 - Health and Life Insurance
Section 743.215 - Calculation of adjusted premiums.


(2) Except as provided in subsection (8) of this section, the adjusted premiums referred to in ORS 743.210 for any life insurance policy to which this section applies shall be calculated as provided in this subsection, on an annual basis, as a uniform percentage of the respective premiums specified in the policy for each policy year, excluding amounts payable as extra premiums to cover impairments or special hazards and excluding any uniform annual contract charge or policy fee specified in the policy statement of the method to be used in calculating the cash surrender values and paid-up nonforfeiture benefits. This percentage shall be such that the present value, at the date of issue of the policy, of all such adjusted premiums shall equal the sum of:
(a) The present value at the policy issue date of the future guaranteed benefits provided for by the policy;
(b) One percent of either the amount of insurance, if the insurance is uniform in amount, or the average of the amounts of insurance at the beginning of each of the first 10 policy years; and
(c) One hundred twenty-five percent of the nonforfeiture net level premium as defined in subsection (3) of this section. For this purpose, any excess of the nonforfeiture net level premium over four percent of such uniform or average amount of insurance shall be disregarded.
(3) The nonforfeiture net level premium referred to in subsection (2) of this section shall equal the present value, at the date of issue of the policy, of the guaranteed benefits provided for by the policy divided by the present value, at the date of issue of the policy, of an annuity of one per annum payable on the date of issue and on each anniversary of the policy on which a premium falls due.
(4) In the case of policies which provide, on a basis guaranteed in the policy, for unscheduled changes in benefits or premiums, or which provide an option for changes in benefits or premiums other than by change to a new policy, the adjusted premiums and present values shall initially be calculated on the assumption that future benefits and premiums do not change from those stipulated by the policy at the date of issue. At the time of any such change in the benefits or premiums the future adjusted premiums, nonforfeiture net level premiums and present values shall be recalculated as provided in subsection (5) of this section on the assumption that future benefits and premiums do not change from those stipulated by the policy immediately after the change.
(5) Except as otherwise provided in subsection (8) of this section, the recalculated future adjusted premiums referred to in subsection (4) of this section shall be calculated as provided in this subsection, on an annual basis, as a uniform percentage of the respective future premiums specified in the policy for each policy year, excluding amounts payable as extra premiums to cover impairments and special hazards and excluding any uniform annual contract charge or policy fee specified in the policy statement of the method to be used in calculating the cash surrender values and paid-up nonforfeiture benefits. This percentage shall be such that the present value, at the date of change to the newly defined benefits or premiums, of all such future adjusted premiums shall equal A plus B minus C, where these amounts are defined as follows:
(a) "A" equals the present value, as of the date of change, of the future guaranteed benefits provided for by the policy.
(b) "B" equals the additional expense allowance, if any, for the policy, as defined in subsection (6) of this section.
(c) "C" equals the cash surrender value under the policy, if any, or present value of any paid-up nonforfeiture benefit under the policy, as of the date of change.
(6) The additional expense allowance at the date of the change to the newly defined benefits or premiums, as referred to in subsection (5) of this section, shall equal the sum of:
(a) One percent of the excess, if positive, of the average of the amounts of insurance at the beginning of each of the first 10 policy years subsequent to the change, over the average of the amounts of insurance, as defined before the change, at the beginning of each of the first 10 policy years subsequent to the last previous change or the policy issue date if there has been no change.
(b) One hundred twenty-five percent of the change, if positive, in the amount of the nonforfeiture net level premium from the amount applicable prior to the change in policy benefits or premiums to the amount of the recalculated nonforfeiture net level premium determined from subsection (7) of this section as of the date of the change in policy benefits or premiums.
(7) The recalculated nonforfeiture net level premium referred to in subsection (6) of this section shall equal Y divided by Z, where these amounts are defined as follows:
(a) "Y" equals the sum of:
(A) The nonforfeiture net level premium applicable prior to the change times the present value at the date of change of an annuity of one per annum payable on each anniversary of the policy, on or subsequent to the date of the change, on which a premium would have fallen due had the change not occurred; and
(B) The present value at the date of change of the increase in future guaranteed benefits provided for by the policy.
(b) "Z" equals the present value at the date of change of an annuity of one per annum payable on each anniversary of the policy, on or subsequent to the date of change, on which a premium falls due.
(8) Notwithstanding any other provisions of this section, the provisions of this subsection shall apply in the case of a policy issued on a substandard basis which provides reduced graded amounts of insurance determined so that, in each policy year, the policy has the same tabular mortality cost as for an otherwise similar policy of a higher nongraded amount or amounts of insurance issued on the standard basis. Adjusted premiums and present values for a policy on such a substandard basis may be calculated as if the policy were issued to provide such a higher nongraded amount or amounts of insurance on the standard basis.
(9) Except as provided in subsection (10) of this section, all adjusted premiums and present values referred to in the Standard Nonforfeiture Law for Life Insurance shall, for all policies of life insurance to which this section applies, be calculated on the mortality and interest bases as follows:
(a) For ordinary life insurance mortality:
(A) The Commissioners 1980 Standard Ordinary Mortality Table shall be used; or
(B) At the option of the insurer for any one or more specified plans of life insurance, the Commissioners 1980 Standard Ordinary Mortality Table with Ten-Year Select Mortality Factors may be used instead of such table without Ten-Year Select Mortality Factors.
(b) For industrial life insurance mortality, the Commissioners 1961 Standard Industrial Mortality Table shall be used.
(c) For all policies issued in a particular calendar year, an interest rate shall be used which does not exceed the nonforfeiture interest rate, as defined in subsection (11) of this section, for policies issued in that year.
(10) The following provisions shall also apply, for policies to which this section applies, to the calculation of premiums and values referred to in the Standard Nonforfeiture Law for Life Insurance:
(a) At the option of the insurer, such calculations for all policies issued in a particular calendar year may be made on the basis of an interest rate which does not exceed the nonforfeiture interest rate, as defined in subsection (11) of this section, for policies issued in the last preceding calendar year.
(b) Under any paid-up nonforfeiture benefit, including any paid-up dividend additions, any cash surrender value available, whether or not required by ORS 743.207, shall be calculated on the basis of the mortality table and interest rate used in determining the amount of such paid-up nonforfeiture benefit and paid-up dividend additions.
(c) An insurer shall calculate the amount of any guaranteed paid-up nonforfeiture benefit, including any paid-up additions, on the basis of an interest rate no lower than that specified in the policy for calculating cash surrender values.
(d) In calculating the present value of any paid-up term insurance with accompanying pure endowment, if any, offered as a nonforfeiture benefit, the rates of mortality assumed may be not more than those shown in the Commissioners 1980 Extended Term Insurance Table for policies of ordinary life insurance, and not more than those shown in the Commissioners 1961 Industrial Extended Term Insurance Table for policies of industrial life insurance.
(e) For insurance issued on a substandard basis, the calculation of premiums and values may be based on appropriate modifications of the mortality tables referred to in subsection (9) of this section and in this subsection.
(f) Any ordinary life mortality tables adopted after 1980 by the National Association of Insurance Commissioners that are approved under rules issued by the director for use in determining the minimum nonforfeiture standard may be substituted for the Commissioners 1980 Standard Ordinary Mortality Table with or without Ten-Year Select Mortality Factors, or for the Commissioners 1980 Extended Term Insurance Table.
(g) Any industrial life mortality tables adopted after 1980 by the National Association of Insurance Commissioners that are approved under rules issued by the director for use in determining the minimum nonforfeiture standard may be substituted for the Commissioners 1961 Standard Industrial Mortality Table or the Commissioners 1961 Industrial Extended Term Insurance Table.
(11) The nonforfeiture interest rate for any policy issued in a particular calendar year shall equal 125 percent of the calendar year statutory valuation interest rate for such policy as defined in the Standard Valuation Law, rounded to the nearer one-quarter of one percent.
(12) Notwithstanding any other provision in this chapter or ORS chapter 743A, for any previously approved policy form, any refiling of nonforfeiture values or their methods of computation which involves only a change in the interest rate or mortality table used to compute nonforfeiture values shall not of itself require refiling of any other provisions of that policy form. [1981 c.609 §17; 1983 c.282 §1]

Structure 2021 Oregon Revised Statutes

2021 Oregon Revised Statutes

Volume : 18 - Financial Institutions, Insurance

Chapter 743 - Health and Life Insurance

Section 743.004 - Submission of information by carriers offering health benefit plans.

Section 743.005 - Protection of health information report.

Section 743.007 - Data reporting.

Section 743.008 - Reporting requirements; rules.

Section 743.009

Section 743.010 - Health insurance policy and health benefit plan forms; expenditures on primary care; rules.

Section 743.015 - Filing and approval of credit life and credit health insurance forms; filing of rates.

Section 743.018 - Filing of rates for life and health insurance; rules.

Section 743.019 - Procedure for review of proposed rates for health benefit plans; rules.

Section 743.020 - Rate filing to include statement of administrative expenses; rules.

Section 743.022 - Premium rates for individual health benefit plans.

Section 743.023 - Electronic administration; discounted rates; requirements.

Section 743.025 - Rate filing to include prescription drug cost information; reports to Legislative Assembly.

Section 743.029 - Uniform standards for health care financial and administrative transactions; rules.

Section 743.031 - Stakeholder work group to recommend uniform standards.

Section 743.034 - Coordination with Oregon Health Authority concerning uniform standards; Department of Human Services to be subject to standards.

Section 743.035 - Uniform prior authorization form for prescription drug benefits; consultation with Oregon Health Authority; rules.

Section 743.038 - Consent of individual required for life and health insurance; exceptions.

Section 743.039 - Alteration of application for life or health insurance.

Section 743.040 - Personal insurance, insurable interest and beneficiaries.

Section 743.044 - Life insurance for benefit of charity.

Section 743.046 - Exemption of proceeds of individual life insurance other than annuities.

Section 743.047 - Exemption of proceeds of group life insurance.

Section 743.049 - Exemption of proceeds of annuity policies; assignability of rights.

Section 743.101 - Purpose.

Section 743.104 - Scope of ORS 743.100 to 743.109.

Section 743.106 - Reading ease standards for life and health insurance policies.

Section 743.107 - When director may authorize lower standards.

Section 743.154 - Acceleration of death benefits; rules.

Section 743.168 - Incontestability.

Section 743.171 - Incontestability and limitation of liability after reinstatement.

Section 743.183 - Dividends.

Section 743.186 - Policy loan.

Section 743.187 - Maximum interest rate on policy loan; adjustable interest rate.

Section 743.192 - Payment of claim; payment of interest upon failure to pay proceeds.

Section 743.204 - Standard Nonforfeiture Law for Life Insurance; applicability.

Section 743.207 - Required provisions relating to nonforfeiture.

Section 743.210 - Determination of cash surrender values; applicability to certain policies.

Section 743.215 - Calculation of adjusted premiums.

Section 743.216 - Adjusted premiums; applicability.

Section 743.218 - Requirements for determination of future premium amounts or minimum values.

Section 743.219 - Supplemental rules for calculating nonforfeiture benefits.

Section 743.221 - Cash surrender values upon default in premium payment.

Section 743.222 - Policy benefits and premiums that shall be disregarded in calculating cash surrender values and paid-up nonforfeiture benefits.

Section 743.225 - Prohibited provisions.

Section 743.228 - Acts of corporate insured or beneficiary with respect to policy.

Section 743.230 - Variable life policy provisions.

Section 743.231 - "Profit-sharing policy" defined.

Section 743.234 - "Charter policy" or "founders policy" defined.

Section 743.243 - Restrictions on form of coupon policy.

Section 743.247 - Notice to variable life insurance policyholders.

Section 743.268 - Advancement of policy loans.

Section 743.271 - Periodic stipulated payments on variable annuities.

Section 743.272 - Computing benefits.

Section 743.273 - Standard provisions of reversionary annuities.

Section 743.275 - Standard Nonforfeiture Law for Individual Deferred Annuities; application.

Section 743.278 - Required provisions in annuity policies; exception.

Section 743.284 - Computation of benefits.

Section 743.287 - Commencement of annuity payments at optional maturity dates; calculation of benefits.

Section 743.293 - Minimum forfeiture amounts for annuity policies; rules.

Section 743.295 - Effect of certain life insurance and disability benefits on minimum nonforfeiture amounts.

Section 743.298 - Penalties, fees or charges; rules.

Section 743.303 - Requirements for issuance of group life insurance policies.

Section 743.306 - Required provisions in group life insurance policies.

Section 743.327 - Payments under policy; payment of interest upon failure to pay proceeds.

Section 743.333 - Termination of individual coverage.

Section 743.336 - Termination of policy or class of insured persons.

Section 743.348 - Certain sales practices prohibited.

Section 743.351 - Eligibility of association to be group life policyholder; rules.

Section 743.354 - Requirements for certain group life policies issued to trustees of certain funds; rules.

Section 743.356 - Continuing coverage upon replacement of group life policy.

Section 743.358 - Borrowing by certificate holders under group life policy.

Section 743.360 - Alternative group life insurance coverage.

Section 743.371 - Definitions for credit life and credit health insurance provisions.

Section 743.372 - Applicability of credit life and credit health insurance provisions.

Section 743.373 - Forms of credit life and credit health insurance.

Section 743.374 - Limits on amount of credit life insurance.

Section 743.376 - Duration of credit life and credit health insurance.

Section 743.377 - Credit life and credit health insurance policy or group certificate; contents; delivery of policy, certificate or copy of application.

Section 743.378 - Charges and refunds to debtor.

Section 743.380 - Claim report and payment.

Section 743.402 - Exceptions to individual health insurance policy requirements.

Section 743.405 - General requirements for health insurance policies.

Section 743.406 - Required provisions in group health insurance policies.

Section 743.414 - Time limit on certain defenses; incontestability.

Section 743.416 - Due date for first premium payment.

Section 743.417 - Grace period for subsequent premium payments; cancellation and nonrenewal.

Section 743.420 - Reinstatement.

Section 743.423 - Notice of claim.

Section 743.435 - Payment of claims.

Section 743.444 - Change of beneficiary.

Section 743.456 - Other insurance in same insurer.

Section 743.459 - Insurance with other insurers; expense incurred benefits.

Section 743.462 - Insurance with other insurers; other than expense incurred benefits.

Section 743.465 - Relation of earnings to insurance.

Section 743.472 - Permissible reasons for cancellation or refusal to renew.

Section 743.495 - Use of terms "noncancelable" or "guaranteed renewable"; synonymous terms.

Section 743.498 - Statement in policy of cancelability or renewability.

Section 743.521 - Leased workers; offering group health insurance.

Section 743.522 - Additional groups designated by director.

Section 743.523 - Certain sales practices prohibited.

Section 743.524 - Eligibility of association to be group health policyholder; rules.

Section 743.526 - Determination of whether trustees are policyholders; consequences; rules.

Section 743.535 - Health benefit coverage for guaranteed association.

Section 743.536 - "Blanket health insurance" defined.

Section 743.550 - Student health insurance.

Section 743.551 - Student health benefit plans; rules.

Section 743.650 - Long Term Care Insurance Act; purpose; application.

Section 743.652 - Definitions for ORS 743.650 to 743.665.

Section 743.655 - Rules; disclosure; contents of policy.

Section 743.656 - Eligibility for benefits; providers required to be covered.

Section 743.658 - Notice of lapse or termination; rules.

Section 743.662 - Rescission of policy and denial of claims.

Section 743.664 - Offer of nonforfeiture benefit; rules.

Section 743.680 - Definitions for ORS 743.680 to 743.689.

Section 743.682 - Application of ORS 743.680 to 743.689.

Section 743.683 - Policy contents; standards for benefit and claims payments; rules.

Section 743.684 - Filing of policy; loss ratio standards; insurance producer compensation.

Section 743.685 - Outline of coverage; information brochure; rules.

Section 743.787 - Definitions for ORS 743.788.

Section 743.788 - Prescription drug identification card.

Section 743.824 - Cash dividends for healthy behaviors.

Section 743.826 - Requirements for catastrophic plans.