ORS 737.318 Premium audit program for workers’ compensation insurance; rules; penalties

A workers’ compensation insurer shall maintain a premium audit program to aid in achieving equitable premium charges to Oregon employers and for the collection of credible statewide data for ratemaking.

The Director of the Department of Consumer and Business Services shall prescribe by rule a premium audit program system for workers’ compensation insurance.

The premium audit system shall include provisions for:

Employer education of the audit reporting function of the rating system;

A continuing test audit program providing for auditing of all insurers;

A continuous monitoring of the audit program system pursuant to ORS 737.235;

An appeal process pursuant to ORS 737.505 for employers to question the results of a premium audit. This process must include written notification to the employer that is included in the final premium audit billing that informs the employer of appeal rights to the director under ORS 737.505, of the requirement that a written request to initiate an appeal must be received by the director not later than the 60th day after the employer receives the final premium audit billing and of any other information the director may request by rule; and

Civil penalties pursuant to ORS 731.988 for violations of prescribed standards of the premium audit system.

Notwithstanding ORS 737.505, the provisions of this section apply to all premium audit disputes between employers and insurers in existence on July 20, 1987, regardless of the policy year involved or the date of the final audit billing.