Fillable oregon omip assessment form

Description
OAR 443-005-0070(4)(B), EXHIBIT 1 Oregon Medical Insurance Pool Assessment Reduction Application & Worksheet Page 1 Company Name: DCBS #: Company Address: This application applies only to individual health insurance plans sold in Oregon and is reported quarterly by an insurer that has voluntarily elected to participate in the OMIP Assessment Reduction Program, as defined in OAR 443-005-0070
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oregon omip assessment
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