OAR 945-030-0030: Administrative Charge on Insurers and Health Care Service Contractors

(1) Effective January 1, 2015, each health insurer or health care service contractor offering: (a) Qualified health plans through the Marketplace shall pay a monthly administrative charge equal to $9.66 times the number of members enrolled through the Marketplace in that month. (b) Stand alone dental plans through the Marketplace shall pay a monthly administrative charge equal to $0.97 times the number of members enrolled through the Marketplace in that month. (2) Effective January 1, 2016, each health insurer or health care service contractor offering: (a) Qualified health plans through the Marketplace shall pay a monthly administrative charge equal to $9.66 times the number of members enrolled through the Marketplace in that month (b) Stand alone dental plans through the Marketplace shall pay a monthly administrative charge equal to $0.97 times the number of members enrolled through the Marketplace in that month. (3) Effective January 1, 2017, each health insurer or health care service contractor offering: (a) Qualified health plans through the Marketplace shall pay a monthly administrative charge equal to $6.00 times the number of members enrolled through the Marketplace in that month. (b) Stand alone dental plans through the Marketplace shall pay a monthly administrative charge equal to $0.57 times the number of members enrolled through the Marketplace in that month. (4) Effective January 1, 2018, each health insurer or health care service contractor offering: (a) Qualified health plans through the Marketplace shall pay a monthly administrative charge equal to $6.00 times the number of members enrolled through the Marketplace in that month. (b) Stand alone dental plans through the Marketplace shall pay a monthly administrative charge equal to $0.57 times the number of members enrolled through the Marketplace in that month. (5) Effective January 1, 2020, each health insurer or health care service contractor offering: (a) Qualified health plans through the Marketplace shall pay a monthly administrative charge equal to $5.50 times the number of members enrolled through the Marketplace in that month. (b) Stand alone dental plans through the Marketplace shall pay a monthly administrative charge equal to $0.36 times the number of members enrolled through the Marketplace in that month. (6) Effective January 1, 2021, each health insurer or health care service contractor offering: (a) Qualified health plans through the Marketplace shall pay a monthly administrative charge equal to $5.50 times the number of members enrolled through the Marketplace in that month. (b) Stand alone dental plans through the Marketplace shall pay a monthly administrative charge equal to $0.36 times the number of members enrolled through the Marketplace in that month. (7) Effective January 1, 2022, each health insurer or health care service contractor offering: (a) Qualified health plans through the Marketplace shall pay a monthly administrative charge equal to $5.50 times the number of members enrolled through the Marketplace in that month. (b) Stand alone dental plans through the Marketplace shall pay a monthly administrative charge equal to $0.36 times the number of members enrolled through the Marketplace in that month. (8) Effective January 1, 2023, each health insurer or health care service contractor offering: (a) Qualified health plans through the Marketplace shall pay a monthly administrative charge equal to $5.50 times the number of members enrolled through the Marketplace in that month. (b) Stand alone dental plans through the Marketplace shall pay a monthly administrative charge equal to $0.36 times the number of members enrolled through the Marketplace in that month. (9) Effective January 1, 2024, each health insurer or health care service contractor offering: (a) Qualified health plans through the Marketplace shall pay a monthly administrative charge equal to $5.50 times the number of members enrolled through the Marketplace in that month. (b) Stand alone dental plans through the Marketplace shall pay a monthly administrative charge equal to $0.36 times the number of members enrolled through the Marketplace in that month. (10) Effective January 1, 2025, each health insurer or health care service contractor offering: (a) Qualified health plans through the Marketplace shall pay a monthly administrative charge equal to $5.50 times the number of members enrolled through the Marketplace in that month. (b) Stand alone dental plans through the Marketplace shall pay a monthly administrative charge equal to $0.36 times the number of members enrolled through the Marketplace in that month. (11) Effective January 1, 2026, each health insurer or health care service contractor offering: (a) Qualified health plans through the Marketplace shall pay a monthly administrative charge equal to $6.85 times the number of members enrolled through the Marketplace in that month. (b) Stand alone dental plans through the Marketplace shall pay a monthly administrative charge equal to $0.45 times the number of members enrolled through the Marketplace in that month.