ORS 415.011¹
Oregon Health Authority regulation of financial solvency of CCOs to align with regulation of domestic insurers
  • rules

(1) The Oregon Health Authority may adopt rules to carry out the provisions of ORS 415.012 (Definitions for ORS 415.012 to 415.430) to 415.430 (Liability of member of CCO to pay provider for cost of care).

(2) The authority shall adopt rules for regulating the financial solvency of coordinated care organizations that align with the following provisions of the Insurance Code regulating domestic insurers, to the extent the provisions regarding insurers are applicable to coordinated care organizations and are in accordance with ORS chapters 413 and 414:

(a) ORS 731.385 (Standards for determining whether continued operation of insurer is hazardous);

(b) ORS 731.504 (Limit of risk);

(c) ORS 731.508 (Approved reinsurance);

(d) ORS 731.509 (Legislative intent) (1) to (10) and (12);

(e) ORS 731.574 (Annual financial statement) (1) to (5);

(f) ORS 731.730 (Insurer filings with National Association of Insurance Commissioners);

(g) ORS 731.988 (Civil penalties);

(h) ORS 732.235 (Voluntary dissolution of insurer);

(i) ORS 732.517 (Purpose of ORS 732.517 to 732.546) to 732.546 (Severability), other than ORS 732.527 (Approval of acquisition by chief insurance regulatory officials of two or more jurisdictions), 732.531 (Acquisition of assets or insurance of mutual or reciprocal insurers) and 732.541 (Jurisdiction over person obtaining or attempting to obtain control);

(j) ORS 732.548 (Definitions for ORS 732.517 to 732.596);

(k) ORS 732.549 (Subsidiaries);

(L) ORS 732.551 (Registration of insurer members of holding company systems);

(m) ORS 732.552 (Registration statement);

(n) ORS 732.553 (Certain information not required to be disclosed);

(o) ORS 732.554 (Changes in registration information);

(p) ORS 732.556 (Requirement that certain persons provide information to insurers);

(q) ORS 732.558 (Termination of registration by director);

(r) ORS 732.564 (Registration for affiliated insurers);

(s) ORS 732.566 (Exemption from ORS 732.517 to 732.596 by director);

(t) ORS 732.567 (Presumption of control);

(u) ORS 732.568 (Disclaimer of affiliation);

(v) ORS 732.569 (Annual enterprise risk report);

(w) ORS 732.574 (Standards for transactions within holding company);

(x) ORS 732.576 (Dividends and distributions);

(y) ORS 732.578 (Liability of officers and directors of insurer that is subject to registration);

(z) ORS 732.592 (Recovery from parent corporation or holding company if domestic insurer ordered into liquidation or rehabilitation);

(aa) ORS 733.010 (Assets allowed) to 733.050 (Increase of inadequate reserves);

(bb) ORS 733.140 (Disallowance of “wash” transactions) to 733.170 (Accounts and records);

(cc) ORS 733.510 (Investments of insurers) to 733.680 (Acquisition and retention of personal property generally);

(dd) ORS 733.695 (Investment of funds in obligations that are not investment quality) to 733.780 (Prohibited investments); and

(ee) ORS 734.014 (Definitions).

(3) Rules adopted by the authority in accordance with ORS 731.385 (Standards for determining whether continued operation of insurer is hazardous) that establish minimum standards for risk-based capital may not require a coordinated care organization to take preventive or corrective measures to increase the coordinated care organization’s capital, surplus or reserves to achieve more than 200 percent of the minimum risk-based capital. [2019 c.478 §53]

Note: Section 54c, chapter 478, Oregon Laws 2019, provides:

Sec. 54c. (1) The Oregon Health Authority shall convene an advisory group consisting of one representative from each coordinated care organization that contracts with the authority. The advisory group shall recommend standards for reconciling the differences between the financial reporting required by the National Association of Insurance Commissioners and the financial reporting that the authority needs to regulate coordinated care organizations as required by state and federal law.

(2) No later than September 15, 2020, the authority shall submit a report of the advisory group’s recommendations to the interim committees of the Legislative Assembly related to health. The report must include:

(a) Recommendations for reducing redundant or duplicative reporting requirements; and

(b) Standard templates for any reporting required by the authority of financial information that is in addition to the financial information reported in the National Association of Insurance Commissioners’ financial reporting requirements. [2019 c.478 §54c]

1 Legislative Counsel Committee, CHAPTER 415—Financial Regulation of Coordinated Care Organizations, https://­www.­oregonlegislature.­gov/­bills_laws/­ors/­ors415.­html (2019) (last ac­cessed May 16, 2020).
 
2 OregonLaws.org contains the con­tents of Volume 21 of the ORS, inserted along­side the per­tin­ent statutes. See the preface to the ORS An­no­ta­tions for more information.
 
3 OregonLaws.org assembles these lists by analyzing references between Sections. Each listed item refers back to the current Section in its own text. The result reveals relationships in the code that may not have otherwise been apparent. Currency Information