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August 1, 2023

The Oregon Division of Financial Regulation (DFR) has revised its methodology for determining whether an employer is a small or large employer for purposes of purchasing a group health benefit plan under the Oregon Insurance Code. The DFR has adopted Exhibit B, titled “Second Revised Counting Methodology for Determining Small or Large Group” (Exhibit B to OAR 836-053-0015) and made the counting guidance provided under Exhibit B mandatory for plan years beginning on or after Jan. 1, 2024.

The DFR’s methodology includes the following guidance:

• Temporary and seasonal employees will be counted for the purpose of group size determination.
• Exhibit B has the following guidance effective for plan years beginning Jan. 1, 2024:
  • An employer is not considered to have more than 50 full-time employees (including FTE employees) if both of the following apply:
    1. The employer's workforce exceeds 50 full-time employees (including FTE employees) for 120 days or fewer during the calendar year, and
    2. The employees in excess of 50 employed during such 120-day period are seasonal workers.

Although temporary and seasonal employees are counted for group size determination, they’re not eligible for coverage with us.

We’ve updated our instructions for determining workforce size in our Oregon small and midsize group annual certification form and online systems to remove temporary and seasonal employees from the list of workers who shouldn't be counted. We've also added the above guidance regarding seasonal employees. Employers are required to complete the version of the form linked above for effective dates beginning Jan. 1, 2024. Incorrect forms won't be accepted.

We mailed the first annual certification request letters to groups with January 2024 renewals in July. Employers are encouraged to complete their annual certification online. Paper certification forms will be mailed in August to groups that haven’t responded to the July letter.

When following the DFR’s new group-size determination methodology, some employers with temporary and seasonal employees may have larger average employee counts than in the past. This might result in their changing from small group (1-50) to large (51+). These changes aren't applicable for groups in Clark County, Washington.

Questions? Please contact your account representative.