(1) The following persons are exempt from the licensing requirement for third party administrators in ORS 744.702 and from all other provisions of ORS 744.700 to 744.740 applicable to third party administrators:
(a) A person licensed under ORS 744.002 as an adjuster, whose activities are limited to adjustment of claims and whose activities do not include the activities of a third party administrator.
(b) A person licensed as an insurance producer as required by ORS 744.053 and authorized to transact life or health insurance in this state, whose activities are limited exclusively to the sale of insurance and whose activities do not include the activities of a third party administrator.
(c) An employer acting as a third party administrator on behalf of:
(A) Its employees;
(B) The employees of one or more subsidiary or affiliated corporations of the employer; or
(C) The employees of one or more persons with a dealership, franchise, distributorship or other similar arrangement with the employers.
(d) A union, or an affiliate thereof, acting as a third party administrator on behalf of its members.
(e) An insurer that is authorized to transact insurance in this state with respect to a policy issued and delivered in and pursuant to the laws of this state or another state.
(f) A creditor acting on behalf of its debtors with respect to insurance covering a debt between the creditor and its debtors.
(g) A trust and the trustees, agents and employees of the trust, when acting pursuant to the trust, if the trust is established in conformity with 29 U.S.C. 186.
(h) A trust exempt from taxation under section 501(a) of the Internal Revenue Code, its trustees and employees acting pursuant to the trust, or a voluntary employees beneficiary association described in section 501(c) of the Internal Revenue Code, its agents and employees and a custodian and the custodianís agents and employees acting pursuant to a custodian account meeting the requirements of section 401(f) of the Internal Revenue Code.
(i) A financial institution that is subject to supervision or examination by federal or state financial institution regulatory authorities, or a mortgage lender, to the extent the financial institution or mortgage lender collects and remits premiums to licensed insurance producers or authorized insurers in connection with loan payments.
(j) A company that issues credit cards and advances for and collects premiums or charges from its credit card holders who have authorized collection. The exemption under this paragraph applies only if the company does not adjust or settle claims.
(k) A person who adjusts or settles claims in the normal course of practice or employment as an attorney at law. The exemption under this subsection applies only if the person does not collect charges or premiums in connection with life insurance or health insurance coverage.
(L) A person who acts solely as an administrator of one or more bona fide employee benefit plans established by an employer or an employee organization, or both, for which the Insurance Code is preempted pursuant to the Employee Retirement Income Security Act of 1974. A person to whom this paragraph applies must comply with the requirements of ORS 744.714.
(m) The Oregon Medical Insurance Pool Board, established under ORS 735.600 to 735.650, and the administering insurer or insurers for the board, for services provided pursuant to ORS 735.600 to 735.650.
(n) An entity or association owned by or composed of like employers who administer partially or fully self-insured plans for employees of the employers or association members.
(o) A trust established by a cooperative body formed between cities, counties, districts or other political subdivisions of this state, or between any combination of such entities, and the trustees, agents and employees acting pursuant to the trust.
(p) Any person designated by the Director of the Department of Consumer and Business Services by rule.
(2) A third party administrator is not required to be licensed as a third party administrator in this state if the following conditions are met:
(a) The third party administrator has its principal place of business in another state;
(b) The third party administrator is not soliciting business as a third party administrator in this state; and
(c) In the case of any group policy or plan of insurance serviced by the third party administrator, the lesser of five percent or 100 certificate holders reside in this state. [1991 c.812 §4; 2001 c.191 §40; 2003 c.364 §128]Section: Previous 744.645 744.650 744.655 744.660 744.665 744.700 744.702 744.704 744.706 744.708 744.710 744.712 744.714 744.716 744.718 Next
Last modified: August 7, 2008