ORS 750.085
Offer of replacement coverage upon order of liquidation

  • procedure
  • rules

(1)

If a final order of liquidation with a finding of insolvency has been entered with respect to a health care service contractor by a court of competent jurisdiction in the domicile of the health care service contractor, subscribers of the health care service contractor must be offered replacement coverage as provided in this section.

(2)

All insurers and health care service contractors that participated with the insolvent health care service contractor in the open enrollment process at the last regular open enrollment period for a group shall offer members of the group that are subscribers of the insolvent health care service contractor an open enrollment period that the Director of the Department of Consumer and Business Services establishes by rule, commencing on the date on which the final order of liquidation with a finding of insolvency was entered. Each of the insurers and health care service contractors shall offer the subscribers of the insolvent health care service contractor the same coverages and rates that the insurer or health care service contractor had offered to members of the group at the group’s last regular open enrollment period.

(3)

If no other insurer or health care service contractor offered health insurance coverage to a group or groups whose members are enrolled with the insolvent health care service contractor, or if the other insurers and health care service contractors lack sufficient health care delivery resources to assure that health care services will be available and accessible to all of the group subscribers of the insolvent health care service contractor, the Director of the Department of Consumer and Business Services shall equitably allocate the contract or contracts for the group or groups among all health care service contractors that operate within a portion of the service area of the insolvent health care service contractor. The director shall take into consideration the health care delivery resources of each health care service contractor. Each health care service contractor to which a group or groups are so allocated shall offer to each such group the existing coverage of the health care service contractor, at rates determined by the health care service contractor in accordance with the health care service contractor’s existing rating methodology. Each health care service contractor to whom a group or groups are allocated may reevaluate the group or groups at the end of the contractual period or at the end of six months after the allocation, whichever occurs first, in order to determine the appropriate premium for each such group.

(4)

The director shall equitably allocate the nongroup subscribers of the insolvent health care service contractor that are unable to obtain other coverage among all health care service contractors that operate within a portion of the service area of the insolvent health care service contractor. The director shall take into consideration the health care delivery resources of each health care service contractor. Each health care service contractor to which nongroup subscribers are allocated shall offer the health care service contractor’s existing individual or conversion coverage to nongroup subscribers, at rates determined in accordance with the health care service contractor’s existing rating methodology. A health care service contractor that does not offer direct nongroup enrollment may aggregate all of the allocated nongroup subscribers into one group for rating and coverage purposes. [1989 c.783 §2; 2017 c.479 §23]

Source: Section 750.085 — Offer of replacement coverage upon order of liquidation; procedure; rules, https://www.­oregonlegislature.­gov/bills_laws/ors/ors750.­html.

750.003
Purpose
750.005
Definitions
750.015
Management to include representatives of public
750.025
Restricting distribution of income
750.035
Regulation of hospital care associations under prior law
750.045
Required capitalization
750.055
Other provisions applicable to health care service contractors
750.059
Exemption of group practice maintenance organizations from reimbursement requirement for services provided by state hospital or state-approved program
750.065
Payment or reimbursement for services within scope of practice of optometrists
750.085
Offer of replacement coverage upon order of liquidation
750.095
Requirements of contract between provider and subscriber
750.301
Definitions for ORS 750.301 to 750.341
750.303
Conditions for use of multiple employer welfare arrangement
750.305
Application for certificate
750.307
Requirements for association or group
750.309
Requirements for trust
750.311
Multiple employer welfare arrangements established in another state
750.313
Issuance or refusal of certificate of multiple employer welfare arrangement
750.315
Maintenance of reserves
750.317
Board of trustees
750.318
Officers and persons appointed to act on behalf of board
750.319
Salaries
750.321
Assessment
750.323
Notice of coverage under plan
750.325
Filings by trust
750.327
Examinations
750.329
Taxation
750.331
Prohibited activities for trustee or officer
750.333
Applicable provisions of Insurance Code
750.335
Delinquency proceedings
750.337
Exclusion from membership in guaranty funds, joint underwriting associations and other pools
750.339
Liability of excess loss insurer
750.341
Requirement for multiple employer welfare arrangement to become traditional insurer
750.505
Definitions for ORS 750.505 to 750.715
750.515
Certificate of registration required
750.525
Inapplicability of ORS 750.505 to 750.715 to certain legal services
750.535
Registration requirements
750.545
Application
750.555
Issuance of certificate of registration
750.565
Duration of certificate
750.575
Grounds for suspension or revocation of certificate or refusal to issue or renew certificate
750.585
Written provider agreement with providing attorney
750.595
Membership agreement
750.605
Unfair, discriminatory or misleading provisions in agreements prohibited
750.615
Deposit to reimburse members for unearned premiums required
750.625
Paying providing attorney contingent on claims experience prohibited
750.635
Registered agent and registered office in state required
750.645
Annual report
750.655
Filing schedule of legal service rates required
750.675
Filing of provider and membership agreement with director
750.685
Indemnification insurance or bond required
750.695
ORS 750.505 to 750.715 not to affect regulation of practice of law
750.705
Application of Insurance Code
750.715
Rules
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