Oregon Health Insurance Marketplace laws and rules
Proposed rules
2026 Health Insurance Marketplace Qualified Health Plan and Stand Alone Dental Plan Annual Assessment Rates
Permanent rule hearing notice filing date: TBD
Rule Hearing Date: 6/18/2025
Amends: OAR 945-030-0030
Need for the rule and description: ORS 741.105 and Senate Bill 65 (2021) require the Oregon Health Authority (OHA) to establish assessment rates for qualified health plans and stand alone dental plans sold through the Health Insurance Marketplace. The assessment is the funding source for the Oregon Health Insurance Marketplace’s operations and support for qualified health plan enrollment. These rates are reviewed annually, adjusted based on budget and enrollment projections, and updated by amending 945-030-0030.
Adopted rules
Permanent rule hearing notice filing date: 3/29/2024
Rule Hearing Date: 4/18/2024
Permanent rule filing date: 6/3/2024
Amends: OAR 945-030-0030
Need for the rule and description: The proposed amendment to OAR 945-030-0030 establishes the assessment fees for qualified health plans and stand-alone dental plans for calendar year 2025.
ORS 741.105 and Senate Bill 65 (2021) require the Oregon Health Authority (OHA) to establish assessment rates for
qualified health plans and stand alone dental plans sold through the Health Insurance Marketplace. The assessment is
the funding source for the Oregon Health Insurance Marketplace’s operations and support for qualified health plan
enrollment. These rates are reviewed annually, adjusted based on budget and enrollment projections, and updated by
amending 945-030-0030.
The amendment maintains the assessment rates of $5.50 per member per month (PMPM) for qualified health plans and
$0.36 PMPM for stand-alone dental plans in calendar year 2025.