Get Reference Filing Adoption Form Adoption Of Rating Organization Prospective Loss Costs. Oregon

This guide provides clear instructions on how to complete the Reference Filing Adoption Form for the Adoption Of Rating Organization Prospective Loss Costs in Oregon. By following these steps, users can efficiently fill out the necessary information online.

Follow the steps to complete the form accurately

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by filling out the insurer name in the designated field. Ensure that you provide the full legal name of the insurer applying for the prospective loss costs.
3. Fill in the mailing address, including city, state, and ZIP code, to ensure correspondence is sent to the correct location.
4. Next, provide the toll-free or collect phone number, along with the fax number and email address to facilitate communication.
5. Indicate the line of insurance for which the form is being submitted. Be specific to avoid any confusion about the insurance type.
6. Enter the rating organization reference filing number and any required associated information.
7. Specify the proposed rate level change percentage and its effective date. This information is vital for establishing new rates.
8. Attach the 'Summary of Supporting Information Form', ensuring that a separate summary is utilized for each loss cost multiplier selected by the insurer.
9. Finally, check one of the options regarding the applicability of loss cost multipliers and expense constants, ensuring clarity on the scope of your filing.
10. Once all sections are completed, review the form for accuracy, save your changes, and then proceed to download, print, or share the form as needed.

Complete the Reference Filing Adoption Form online today to streamline your submissions and ensure compliance.