On Jan. 25, ORE INS issued guidance on Paid Leave Oregon program.
ORE INS issued Bulletin No. DFR 2024-1 providing guidance on Paid Leave Oregon (PLO) as an other benefit in relation to Short-term disability (STD) benefits.
Policy Provisions
Many STD policies include other income or other benefit provisions, requiring the worker to apply for that other benefit before receiving any STD benefits.
Further, if the worker applies and receives any such other benefits, the STD benefit will be reduced by the amount the worker received under the other benefit clause.
ORE INS Expectations
Some insurers have started requiring their insureds to apply for PLO before receiving any STD benefit and have reduced the STD benefit by the amount of PLO benefits.
ORE INS underscored that if the policy allows this tactic, it must also clearly and conspicuously disclose to consumers about PLO benefits and the potential impact.
All insurers should continue to offer actuarially sound rates that factor all reductions in STD benefits, including those made to account for availability of PLO benefits.
Further, ORE INS stated that if terms of STD policy require insured to apply for and, if eligible, receive PLO and benefits will be decreased, premiums should decrease too.
Oct. 2024 ORE INS Short-Term Disability and Paid Leave
On Oct. 10, 2024, ORE INS issued Bulletin DRF 2024-8 replacing data in Bulletin DFR 2024-1 on other income, other benefit and STD benefits from Jan. 2024.
Reminds insurers that if an STD policy allows reduction for STD, all documents must inform consumers they might be eligible for leave under Paid Leave Oregon program.
May also clearly and conspicuously require consumer to apply for Paid Leave Oregon and, if so, extent to which such application must be pursued or appealed by work.
Finally, must clearly and conspicuously disclose the extent to which STD benefits will be reduced on account of Paid Leave Oregon benefits received by the worker.
Now, effective Dec. 1, 2024, ORE INS is requiring insurers to submit updated plan documents for approval at the earlier of 18 months after this bulletin or at renewal.
Alternatively, when appropriate, insurers may file an endorsement with renewal.
