Get Or 440-4978 2018-2025

Filling out the OR 440-4978 form is an essential part of ensuring compliance with Oregon's insurance regulations. This guide provides clear instructions on navigating the form, ensuring users can complete it accurately and efficiently.

Follow the steps to complete the OR 440-4978 form online

1. Click the ‘Get Form’ button to obtain the form and open it in the editor.
2. Once the form is open, enter the insurer name in the designated field. This information is critical for identifying the submitting party.
3. Fill in the date of submission on the form. Ensure the date is correct to maintain accurate records.
4. Indicate the Type of Insurance (TOI) by selecting from the options available: H10I for individual health-dental or H10G for group health-dental.
5. Complete the marketing section, specifying whether it pertains to small group coverage, and note if the dental plan is inside or outside the exchange.
6. Provide all required documents as listed in the submission guidelines, ensuring no section is left blank. Use 'Not applicable' only if the item does not pertain to your filing.
7. Review the general requirements and ensure that the filing description or cover letter includes all necessary details, such as changes from previously approved forms.
8. Attach any additional forms or supporting documentation, such as the Certificate of Compliance and readability certifications.
9. Before completing, double-check all entries for accuracy and completeness.
10. Once satisfied, save your changes. You can download, print, or share the completed form as needed.

Complete your filing by submitting the OR 440-4978 form online today!