OAR 836-042-0215: Consent to Group Rating Required Before Policy Issuance; Provision Required in Consent Form; Contents of Consent Form

(1) An insurer intending to combine the experience of a group of employers for rating purposes may not issue a policy to a member of the group unless it has secured a signed consent to group rating from each group member. (2) The form used by the insurer to secure consent to group rating must be approved by the Director. The form must include the following wording, or substantially equivalent wording approved by the Director: “The premium you must pay for this insurance will be determined in part by the consolidated experience of all members of the group in which you participate." (3) The consent to group rating form must include the following: (a) Name and address of the group member; (b) Name, title and signature of the person giving consent; (c) Name and nature of the organization to which employers in the group belong; (d) Specific description of how the combined experience of the group will be used for rating the group member; and (e) The period covered by policies to be used for deriving the combined experience of group members.