Salem – The Oregon Division of Financial Regulation (DFR) will begin its annual health insurance rate review process in June for the 2027 plan year, with state regulators warning that federal decisions could have a significant effect on what Oregonians pay for coverage next year.

Insurance companies submitting proposed 2027 rates are expected to cite several emerging federal factors in their filings.

“The loss of the federal Affordable Care Act (ACA) subsidies, impact of tariffs, and changing federal guidance have left more Oregonians vulnerable to health care costs generally,” said Oregon Insurance Commissioner TK Keen. “Oregonians who buy their own coverage or work for small businesses deserve to know about the rate filing process, what’s driving rates to increase or decrease, and how to share their perspective. This level of transparency and accountability is unprecedented for a rate review process, and one we take seriously as a regulator.”

The transparent, actuarial-driven process includes publication of planned rates and public hearings on the rate filings for the individual and small group markets. Each year, health insurance companies submit planned rates, which the division then reviews under strict actuarial standards to ensure the rates are sound and insurers remain solvent.

The division analyzes the rates to determine whether they are actuarially sound, a process that is a months-long review. Part of the analysis includes reviewing the rates to ensure they are not excessive, inadequate, or unfairly discriminatory, as well as whether the planned administrative expenses are reasonable. DFR does not create or establish rates but rather reviews the rate proposals of insurance companies and ensures that all statutory factors are considered.

Oregon also operates a reinsurance program that operates to offset costs in the individual market and reduces rates by 6 percent to 8 percent each year. That program, using a combination of federal and state funds, is particularly effective at offsetting high-dollar claims in the individual market. DFR is pursuing a renewal of this reinsurance program with support from Oregon Gov. Tina Kotek.

Who this process affects

This rate review process applies to Oregonians who purchase health coverage through the health insurance marketplace or directly from an insurance company, and to employees of small businesses with fewer than 50 employees.

As of December 2025, per DFR’s quarterly enrollment reports, the Oregon individual market covered 148,376 people (3.4 percent of Oregonians), while the small group market covered 137,485 people (3.2 percent). In total, these markets cover 285,861 people (roughly 6.6 percent). It does not affect people covered through Medicare, Medicaid/Oregon Health Plan, or large employer or self-insured plans.

DFR’s role in the process

Rate review is a technical, actuarially driven process designed to ensure that the rates insurance companies file are supported by relevant data. DFR’s review team examines each insurer filing in detail, scrutinizing projected medical costs, administrative expenses, utilization trends, and reserve adequacy. The question DFR is answering is not simply whether rates are high or low, but whether they accurately reflect the cost of providing coverage to Oregonians while keeping insurers financially stable.

DFR has authority under Oregon law to require insurers to justify every component of a rate request. If the division finds that projections are inflated or administrative costs are unreasonable, it will reduce rates accordingly. An insurer’s financial position and market stability are also key considerations that are analyzed throughout the process.

DFR has created a website to inform consumers of the process and provide key documents and a space for public comment.

What’s likely to drive rate requests this year

Historically, insurance companies have cited several factors for explaining the rates they are charging that centered on medical and pharmaceutical costs, utilization, and the existence of federal subsidies. For plan year 2027, Congress not extending the enhanced federal ACA subsidies, the impact of tariffs, and decreased enrollment numbers (shrinking the risk pool) are likely to be factors reflected in insurance companies’ filings. DFR’s actuaries will independently evaluate each of these justifications, rather than accepting them as submitted.

Anticipated key dates

• June 3: Rate filings due from health insurance companies
• July 13: First public hearing (virtual)
• July 31: Second public hearing (virtual, if needed)
• Early August: DFR issues preliminary rate decisions
• Early September: DFR issues final approval of rates

The June 3 filing date and July 13 public hearing date are set. The remaining dates may change based upon additional federal guidance. Last year, rates were delayed and not finalized until October due to delays from the federal government.

Public hearings and comments

DFR holds public hearings where insurance companies present their rate requests and respond to questions from DFR staff. The division encourages the public to attend and participate in this process. DFR accepts and reviews all public comments before final decisions are made. A link will be provided on www.oregonhealthrates.org for public comment closer to the hearing.

The most useful public input describes specific experiences with coverage, claims, network access, or plan changes. This type of input is context that helps DFR understand how rate decisions affect Oregonians and supplements the actuarial record.

The division will record the hearings and place them on the DFR rate review-specific website shortly after their conclusion.

DFR has a comprehensive overview of the rate review process, which can be found here.

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About Oregon DFR: The Division of Financial Regulation protects consumers and regulates insurance, depository institutions, trust companies, securities, and consumer financial products and services. The division is part of the Department of Consumer and Business Services, Oregon’s largest consumer protection and business regulatory agency. Visit dfr.oregon.gov and dcbs.oregon.gov.

Students at Crescent Valley High School in Corvallis, Parkrose High School in Portland, Henley High School in Klamath Falls, The Dalles High School, and Centennial High School and Center for Advanced Learning in Gresham have earned top prizes in a media contest designed to increase awareness about workplace safety and health for young workers.

The 2026 media contest, organized by the Oregon Young Employee Safety (O[yes]) Coalition, called on participants to create an ad – through a compelling graphic design or video – that captures the attention of teen workers and convinces them to take the Oregon Occupational Safety and Health Division’s (Oregon OSHA’s) heat-illness prevention online course. The idea is to show teen workers that the online course is an essential tool they can use to protect themselves from heat-related hazards while on the job – especially when they’re working during the summer months.

Participants got to choose the key message, theme, or tagline they believed would rivet their audience and prompt it to act. The target audience was teen workers or teens who are preparing to work for the first time. To compete, participants submitted either a graphic design or a video that is no more than 90 seconds in length.

The top three entries in each of the two media categories took home cash prizes ranging from $300 to $500. In each category, the first-place winner’s school, club, or organization received a matching award. Moreover, O[yes] will use the best of the submissions as ads in its ongoing efforts to improve on-the-job safety and health protections for teens.

The top winners in each category were:

Videos:

First place: Carlos Vanegas, Crescent Valley High School in Corvallis, Oregon
Second: James Mitseff, Parkrose High School in Portland, Oregon
Third: Toni Kimmel, Crescent Valley High School in Corvallis, Oregon

Graphic design:

First place: Pyper Fussell, Henley High School in Klamath Falls, Oregon
Second: Zachary Wilde, The Dalles High School
Third: Dai’Joniea Gray, Centennial High School and Center for Advanced Learning in Gresham, Oregon

Check out the contest submissions at https://youngemployeesafety.org/contest/past-winners/2025-2026-media-contest-winners/.

The mission of O[yes] is to prevent injuries and illnesses, and promote well-being to young workers. The nonprofit does this through outreach, advocacy, and sharing resources with young workers, educators, employers, parents, and labor organizations.

The contest sponsors are local Oregon chapters of the American Society of Safety Professionals, Construction Safety Summit, Central Oregon Safety & Health Association, Hoffman Construction Company, Oregon Institute of Occupational Health Sciences at Oregon Health & Science University, Oregon OSHA, SafeBuild Alliance, SAIF Corporation, and the SHARP Alliance.

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About Oregon OSHA: Oregon OSHA enforces the state’s workplace safety and health rules and works to improve workplace safety and health for all Oregon workers. The division is part of the Department of Consumer and Business Services, Oregon’s largest consumer protection and business regulatory agency. Visit osha.oregon.gov and dcbs.oregon.gov.

About the Oregon Young Employee Safety (O[yes]) Coalition: O[yes] is a nonprofit dedicated to preventing young worker injuries and fatalities. O[yes] members include safety and health professionals, educators, employers, labor and trade associations, and regulators. Visit youngemployeesafety.org.

The Oregon high school winners of a video and graphic design contest focused on improving young worker safety and health will be announced during a livestream event at 4 p.m. Tuesday, May 5.
 

Watch the livestream at https://youngemployeesafety.org/contest/.

The 2026 media contest, organized by the Oregon Young Employee Safety (O[yes]) Coalition, called on high school students across Oregon to create an ad – through a compelling graphic design or video – that captures the attention of teen workers and convinces them to take the Oregon Occupational Safety and Health Division’s (Oregon OSHA’s) heat-illness prevention online course. The idea is to show teen workers that the online course is an essential tool they can use to protect themselves from heat-related hazards while on the job – especially when they’re working during the summer months.

Participants got to choose the key message, theme, or tagline they believed would rivet their audience and prompt it to act. The target audience is teen workers or teens who are preparing to work for the first time. To compete, participants submitted either a graphic design or a video that was no more than 90 seconds in length.

The top three entries in each of the two media categories will take home cash prizes ranging from $300 to $500. In each category, the first-place winner’s school, club, or organization will receive a matching award. Moreover, O[yes] will use the best of the submissions as ads in its ongoing efforts to improve on-the-job safety and health protections for teens.

The contest sponsors are local Oregon chapters of the American Society of Safety Professionals, Construction Safety Summit, Central Oregon Safety & Health Association, Hoffman Construction Company, Oregon Institute of Occupational Health Sciences at Oregon Health & Science University, Oregon OSHA, SafeBuild Alliance, SAIF Corporation, and the SHARP Alliance.

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About Oregon OSHA: Oregon OSHA enforces the state’s workplace safety and health rules and works to improve workplace safety and health for all Oregon workers. The division is part of the Department of Consumer and Business Services, Oregon’s largest consumer protection and business regulatory agency. Visit osha.oregon.gov and dcbs.oregon.gov.

About the Oregon Young Employee Safety (O[yes]) Coalition: O[yes] is a nonprofit dedicated to preventing young worker injuries and fatalities. O[yes] members include safety and health professionals, educators, employers, labor and trade associations, and regulators. Visit youngemployeesafety.org.

Salem – The Oregon Division of Financial Regulation (DFR) has issued a cease-and-desist order to ClearShare Health and its affiliates after determining that the entities have been operating a program that, based on DFR’s investigation, functions as a business of insurance in Oregon without first obtaining a certificate of authority. The order also alleges they were providing services without first obtaining a third-party administrator license, conduct DFR found to violate the Oregon Insurance Code.

ClearShare Health’s affiliates include Clearwater Benefits LLC, Clearwater Benefits Administrators LLC, and Clearwater Benefits Holdings LLC. The division also issued an order against Douglas Sherman, the co-founder of Clearwater Benefits LLC.

Under ClearShare’s cost-sharing program, which it refers to as “memberships,” consumers pay a monthly amount into a pool of money that is used to pay out members’ medical costs. According to information reviewed by DFR, which started its investigation in January 2026, ClearShare offers various tier levels consumers can choose that determine what medical expenses may be covered. People with pre-existing conditions or who are older than age 65 typically cannot participate in ClearShare’s program.

The order bars ClearShare Health and its affiliates from transacting insurance in Oregon, including but not limited to:

• Marketing, offering, or selling ClearShare Health memberships to Oregon residents
• Soliciting, collecting, or receiving any consideration, contribution, fee, or payment from Oregon residents for new ClearShare Health memberships or renewals of existing ClearShare Health memberships
• Representing that ClearShare Health memberships are not subject to regulation and oversight by DFR

The order allows these entities to continue to administer and pay medical expense submissions arising from ClearShare Health memberships that were in effect as of April 14, 2026, so that affected Oregon consumers can continue to have their medical expense submissions considered under their existing memberships.

This action is part of DFR’s ongoing efforts to pursue entities offering health insurance or marketing products that function as health insurance but are not properly licensed. DFR verifies that insurance companies are solvent (can pay their claims, make good on promises, etc.) and comply with Oregon law. ClearShare came under review after receiving multiple consumer complaints.

Consumers are often faced with health insurance choices, some of which may not be licensed by the state, or that claim to be in compliance with Affordable Care Act (ACA) plans when in fact they do not offer ACA-level coverage. These unlicensed activities also weaken the licensed, commercial risk pool by removing members from that pool. DFR has previously warned consumers that the ever-changing dynamics of the health insurance market this year has caused a rise in fraudulent activity with a press release in January.

DFR reminds consumers as they shop for health insurance to research each plan to make sure it provides the coverages you need, or will need, and that plans are in full compliance with the ACA. DFR’s website has tools to help you check a license, answer questions you may have, and file a complaint. If you need to talk with a health insurance advocate, you can call 888-877-4894 (toll-free) or email dfr.insurancehelp@dcbs.oregon.gov.

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About Oregon DFR: The Division of Financial Regulation protects consumers and regulates insurance, depository institutions, trust companies, securities, and consumer financial products and services. The division is part of the Department of Consumer and Business Services, Oregon’s largest consumer protection and business regulatory agency. Visit dfr.oregon.gov and dcbs.oregon.gov.