Applicable provisions of Insurance Code
- • rules
(1) The following provisions apply to trusts carrying out a multiple employer welfare arrangement:
(a) ORS 705.137 (Information that is confidential or not subject to disclosure), 705.138 (Confidential and privileged documents) and 705.139 (Agreements with other agencies regarding sharing and use of confidential information).
(b) ORS 731.004 (Short title) to 731.150 (Definitions of classes of insurance not mutually exclusive), 731.162 (“Health insurance”), 731.216 (Administrative power of director) to 731.268 (Use of reproductions and certified copies as evidence), 731.296 (Director’s inquiries) to 731.316 (Expenses of examination of insurer), 731.324 (Service of process on Secretary of State), 731.328 (Deposits by unauthorized insurers in actions or proceedings), 731.378 (Foreign and alien insurers exempt from laws governing admission of foreign and alien corporations), 731.386 (Management of insurers), 731.390 (Government insurers not to be authorized), 731.398 (Amendment of certificate of authority), 731.406 (What certificate evidences), 731.410 (Continuance, expiration or reinstatement of certificate of authority), 731.414 (Suspension or revocation of certificate of authority), 731.418 (Grounds for suspension or revocation of certificate of authority) to 731.434 (Registered office and agent), 731.454 (Domestic insurers not to transact business in jurisdiction where not authorized), 731.484 (Prohibition on certain sales related to group health and group life insurance), 731.486 (Exemption from definition of “transact insurance” for group health and life policies), 731.488 (Annual audit of insurer), 731.512 (Withdrawal of insurer), 731.574 (Annual financial statement) to 731.620 (Assignment of deposited securities), 731.640 (Eligible deposits) to 731.652 (Proofs for release of deposit to insurers), 731.804 (Assessments), 731.808 (“Gross amount of premiums” defined) and 731.844 (No personal liability for paying invalid tax) to 731.992 (Criminal penalty).
(c) ORS 733.010 (Assets allowed) to 733.050 (Increase of inadequate reserves), 733.140 (Disallowance of “wash” transactions) to 733.170 (Accounts and records), 733.210 (Director’s determinations), 733.510 (Investments of insurers) to 733.680 (Acquisition and retention of personal property generally) and 733.695 (Investment of funds in obligations that are not investment quality) to 733.780 (Prohibited investments).
(e) ORS 742.001 (Scope of ORS chapters 742, 743, 743A and 743B) to 742.009 (Regulation of sales material), 742.013 (Representations in applications), 742.016 (Policy constitutes entire contract), 742.061 (Recovery of attorney fees in action on policy or contractor’s bond) and 742.065 (Insurance against risk of loss assumed under less than fully insured employee health benefit plan).
(f) ORS 743.004 (Submission of information by carriers offering health benefit plans), 743.005 (Protection of health information report), 743.007 (Data reporting), 743.008 (Reporting requirements), 743.010 (Health insurance policy and health benefit plan forms), 743.018 (Filing of rates for life and health insurance), 743.020 (Rate filing to include statement of administrative expenses), 743.023 (Electronic administration), 743.028 (Uniform health insurance claim forms), 743.029 (Uniform standards for health care financial and administrative transactions), 743.053 (Prohibition on requirement that death or dismemberment occur in less than 180 days after accident), 743.405 (General requirements for health insurance policies), 743.406 (Required provisions in group health insurance policies), 743.524 (Eligibility of association to be group health policyholder), 743.526 (Determination of whether trustees are policyholders) and 743.535 (Health benefit coverage for guaranteed association).
(g) ORS 743A.010 (Services provided by state hospital or state approved program), 743A.012 (Emergency services), 743A.014 (Payments for ambulance care and transportation), 743A.020 (Services provided by acupuncturist), 743A.024 (Services provided by clinical social worker), 743A.034 (Services provided by expanded practice dental hygienist), 743A.036 (Services provided by certified nurse practitioner or licensed physician assistant), 743A.040 (Services provided by optometrist), 743A.048 (Services provided by psychologist), 743A.051 (Services provided by pharmacist), 743A.052 (Services provided by professional counselor or marriage and family therapist), 743A.058 (Telemedical services), 743A.060 (Definition for ORS 743A.062), 743A.062 (Prescription drugs), 743A.063 (Ninety-day supply of prescription drug refills), 743A.064 (Prescription drugs dispensed at rural health clinics), 743A.065 (Early refills of prescription eye drops for treatment of glaucoma), 743A.066 (Contraceptives), 743A.068 (Orally administered anticancer medication), 743A.070 (Nonprescription enteral formula for home use), 743A.080 (Pregnancy and childbirth expenses), 743A.082 (Diabetes management for pregnant women), 743A.084 (Unmarried women and their children), 743A.088 (Use by mother of diethylstilbestrol), 743A.090 (Natural and adopted children), 743A.100 (Mammograms), 743A.104 (Pelvic examinations and Pap smear examinations), 743A.105 (HPV vaccine), 743A.108 (Physical examination of breast), 743A.110 (Mastectomy-related services), 743A.124 (Colorectal cancer screenings and laboratory tests), 743A.140 (Bilateral cochlear implants), 743A.141 (Hearing aids), 743A.148 (Maxillofacial prosthetic services), 743A.150 (Treatment of craniofacial anomaly), 743A.160 (Alcoholism treatment), 743A.168 (Treatment of chemical dependency, including alcoholism, and mental or nervous conditions), 743A.170 (Tobacco use cessation programs), 743A.175 (Traumatic brain injury), 743A.180 (Tourette Syndrome), 743A.185 (Telemedical health services for treatment of diabetes), 743A.188 (Inborn errors of metabolism), 743A.190 (Children with pervasive developmental disorder), 743A.192 (Clinical trials), 743A.250 (Emergency eye care services), 743A.252 (Child abuse medical assessments) and 743A.260 (Inmates).
(h) ORS 743B.001 (Definitions), 743B.003 (Purposes) to 743B.127 (Rules for ORS 743.022, 743B.125 and 743B.126) (except 743B.125 (Individual health benefit plans) to 743B.127 (Rules for ORS 743.022, 743B.125 and 743B.126)), 743B.195 (Enforcement of Newborns’ and Mothers’ Health Protection Act of 1996) to 743B.204 (Required managed health insurance contract provision), 743B.220 (Requirements for insurers that require designation of participating primary care physician), 743B.222 (Designation of women’s health care provider as primary care provider), 743B.225 (Continuity of care), 743B.227 (Referrals to specialists), 743B.250 (Required notices to applicants and enrollees), 743B.252 (External review), 743B.253 (Director to contract with independent review organizations to provide external review), 743B.254 (Notice to enrollee of right to sue if insurer does not follow decision of independent review organization), 743B.255 (Enrollee application for external review), 743B.256 (Duties of independent review organizations), 743B.257 (Civil penalty for failure to comply by insurer that agreed to be bound by decision), 743B.258 (Private right of action), 743B.310 (Rescinding coverage), 743B.320 (Minimum grace period), 743B.321 (Applicability of ORS 743B.320), 743B.330 (Notice to policyholder required for cancellation or nonrenewal of health benefit plan), 743B.340 (When group health insurance policies to continue in effect upon payment of premium by insured individual), 743B.341 (Continuation of benefits after termination of group health insurance policy), 743B.342 (Continuation of benefits after injury or illness covered by workers’ compensation), 743B.343 (Availability of continued coverage under group policy for surviving, divorced or separated spouse 55 or older), 743B.344 (Procedure for obtaining continuation of coverage under ORS 743B.343), 743B.345 (Premium for continuation of coverage under ORS 743B.344), 743B.347 (Continuation of coverage under group policy upon termination of membership in group health insurance policy), 743B.400 (Decisions regarding health care facility length of stay, level of care and follow-up care), 743B.403 (Insurer prohibited practices), 743B.407 (Naturopathic physicians), 743B.420 (Prior authorization requirements), 743B.423 (Utilization review requirements for insurers offering health benefit plan), 743B.451 (Refund of paid claims), 743B.453 (Underpayment of claims), 743B.470 (Medicaid not considered in coverage eligibility determination), 743B.505 (Provider networks), 743B.550 (Disclosure of information), 743B.555 (Confidential communications) and 743B.601 (Synchronization of prescription drug refills).
(i) The following provisions of ORS chapter 744:
(A) ORS 744.001 (License application) to 744.009 (Renewal of expired license), 744.011 (Director’s authority to investigate licensee), 744.013 (Disciplinary actions against applicant, adjuster or insurance consultant), 744.014 (Condition of probation on license or on category or class of insurance), 744.018 (Reinstatement of license), 744.022 (Authorized activities) to 744.033 (Manner of application or notification), 744.037 (Fees), 744.052 (Definitions for ORS 744.052 to 744.089) to 744.089 (Report of administrative action taken against insurance producer), 744.091 (Additional conditions under which person licensed as insurer or insurance producer may charge commission or service fee) and 744.093 (Solicitation or sale of insurance policy by retail insurance producer or wholesale insurance producer), relating to the regulation of insurance producers;
(B) ORS 744.605 (Insurance consultant’s license required), 744.609 (Exemptions), 744.619 (Qualifications for resident insurance consultant’s license), 744.621 (Nonresident insurance consultant license), 744.626 (Classes of insurance for consultants), 744.631 (Change of circumstance of nonresident insurance consultant), 744.635 (Errors and omissions insurance), 744.650 (Disclosure by insurance consultants), 744.655 (Rebates prohibited) and 744.665 (Continuing education), relating to the regulation of insurance consultants; and
(C) ORS 744.700 (Definitions for ORS 744.700 to 744.740) to 744.740 (Responsibility of insurer using third party administrator), relating to the regulation of third party administrators.
(j) ORS 746.005 (Trade practices exempted from prohibitions) to 746.140 (Sale of life insurance with securities), 746.160 (Practices injurious to free competition) and 746.220 (Debtor’s option in furnishing credit life or credit health insurance) to 746.370 (Records of insureds).
(2) For the purposes of this section:
(a) A trust carrying out a multiple employer welfare arrangement shall be considered an insurer.
(b) References to certificates of authority shall be considered references to certificates of multiple employer welfare arrangement.
(c) Contributions shall be considered premiums.
(3) The provision of health benefits under ORS 750.301 (Definitions for ORS 750.301 to 750.341) to 750.341 (Requirement for multiple employer welfare arrangement to become traditional insurer) shall be considered to be the transaction of health insurance.
(4) The Department of Consumer and Business Services may adopt rules that are necessary to implement the provisions of ORS 750.301 (Definitions for ORS 750.301 to 750.341) to 750.341 (Requirement for multiple employer welfare arrangement to become traditional insurer). [1993 c.615 §19; 1995 c.506 §4; 1995 c.603 §30; 1995 c.669 §4; 1995 c.672 §9; 1997 c.343 §23; 1997 c.496 §5; 1997 c.759 §6; 1999 c.428 §§7,8; 1999 c.429 §§3,4; 1999 c.633 §§9,10; 1999 c.749 §§6,7; 1999 c.987 §§25,26; 2001 c.266 §17; 2001 c.742 §5; 2003 c.87 §25; 2003 c.91 §6; 2003 c.137 §8; 2003 c.263 §4; 2003 c.363 §15; 2003 c.364 §170; 2003 c.446 §3; 2003 c.748 §4; 2005 c.418 §6; 2007 c.182 §§10,11,12; 2007 c.313 §§7,8,9; 2007 c.504 §§5,6,7; 2007 c.566 §§5,6,7; 2007 c.872 §§5,6,7; 2008 c.22 §§7,8,9; 2009 c.274 §§5,6,7; 2009 c.383 §§4,5; 2009 c.384 §§5,6,7; 2009 c.423 §§5,6,7; 2009 c.503 §§5,6,7; 2009 c.549 §12; 2009 c.553 §§5,6,7; 2009 c.630 §§5,6,7; 2009 c.703 §§2,3,4; 2009 c.807 §§7,8,9; 2011 c.130 §8; 2011 c.312 §4; 2011 c.500 §44; 2011 c.660 §27; 2011 c.716 §14; 2012 c.21 §4; 2013 c.682 §4; 2014 c.25 §8; 2015 c.59 §10; 2015 c.100 §8; 2015 c.224 §8; 2015 c.362 §12; 2015 c.470 §11; 2017 c.206 §11]
Note: See note under 750.301 (Definitions for ORS 750.301 to 750.341).
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.