As used in ORS 735.600 to 735.650:
(1) “Benefits plan” means the coverages to be offered by the pool to eligible persons pursuant to ORS 735.600 to 735.650.
(2) “Board” means the Oregon Medical Insurance Pool Board.
(3) “Insured” means any individual resident of this state who is eligible to receive benefits from any insurer.
(4) “Insurer” means:
(a) Any insurer as defined in ORS 731.106 or fraternal benefit society as defined in ORS 748.106 required to have a certificate of authority to transact health insurance business in this state, and any health care service contractor as defined in ORS 750.005, issuing medical insurance in this state on or after September 27, 1987.
(b) Any reinsurer reinsuring medical insurance in this state on or after September 27, 1987.
(c) To the extent consistent with federal law, any self-insurance arrangement covered by the Employee Retirement Income Security Act of 1974, as amended, that provides health care benefits in this state on or after September 27, 1987.
(d) All self-insurance arrangements not covered by the Employee Retirement Income Security Act of 1974, as amended, that provides health care benefits in this state on or after September 27, 1987.
(5) “Medical insurance” means any health insurance benefits payable on the basis of hospital, surgical or medical expenses incurred and any health care service contractor subscriber contract. Medical insurance does not include accident only, disability income, hospital confinement indemnity, dental or credit insurance, coverage issued as a supplement to liability insurance, coverage issued as a supplement to Medicare, insurance arising out of a workers’ compensation or similar law, automobile medical-payment insurance or insurance under which benefits are payable with or without regard to fault and which is statutorily required to be contained in any liability insurance policy or equivalent self-insurance.
(6) “Medicare” means coverage under Part A, Part B and Part D of Title XVIII of the Social Security Act, 42 U.S.C. 1395 et seq., as amended.
(7) “Plan of operation” means the plan of operation of the pool, including articles, bylaws and operating rules, adopted by the board pursuant to ORS 735.600 to 735.650.
(8) “Pool” means the Oregon Medical Insurance Pool as created by ORS 735.610.
(9) “Reinsurer” means any insurer as defined in ORS 731.106 from whom any person providing medical insurance to Oregon insureds procures insurance for itself in the insurer, with respect to all or part of the medical insurance risk of the person.
(10) “Self-insurance arrangement” means any plan, program, contract or any other arrangement under which one or more employers, unions or other organizations provide health care services or benefits to their employees or members in this state, either directly or indirectly through a trust or third party administrator, unless the health care services or benefits are provided by an insurance policy issued by an insurer other than a self-insurance arrangement. [1987 c.838 §3; 1989 c.838 §6; 2003 c.33 §4; 2005 c.634 §4]
Section: Previous 735.475 735.480 735.485 735.490 735.492 735.495 735.600 735.605 735.610 735.612 735.614 735.615 735.616 735.620 735.625 NextLast modified: August 7, 2008