Oregon Statutes - Chapter 750 - Health Care Service Contractors; Multiple Employer Welfare Arrangements; Legal Expense Organizations

• 750.003   Purpose.
  The purpose of this section and ORS 750.005, 750.025 and 750.045 is to encourage and guarantee the development of health care service contractors by licensing...
• 750.005   Definitions.
  As used in ORS 750.005 to 750.095: (1) “Claims” means any amount incurred by the insurer covering contracted benefits. (2) “Complementary health services” means the...
• 750.010   [Amended by 1957 c.301 §1; 1961 c.116 §1; 1967 c.359 §548; renumbered 744.305]
• 750.015   Management to include representatives of public.
  (1) Except as provided in subsection (2) of this section, not less than one-third of the group of persons vested with the management of the...
• 750.020   [Amended by 1961 c.116 §2; 1967 c.359 §549; renumbered 744.315]
• 750.025   Restricting distribution of income; representation as health maintenance organization.
  (1) A health care service contractor which is a not-for-profit corporation, shall not distribute, upon liquidation or otherwise, any part of its income to its...
• 750.030   [Repealed by 1967 c.359 §704]
• 750.035   Regulation of hospital care associations under prior law; exceptions.
  (1) Notwithstanding any other provision of law, except as provided in subsection (2) of this section, any persons doing a hospital association business, as defined...
• 750.040   [Amended by 1967 c.359 §552; renumbered 744.345]
• 750.045   Required capitalization; bond, security or letter of credit; exemptions; rules.
  (1) A health care service contractor that is a for-profit or not-for-profit corporation shall possess and thereafter maintain capital or surplus, or any combination thereof,...
• 750.047   [1993 c.447 §115a; repealed by 2005 c.255 §7]
• 750.050   [Amended by 1961 c.116 §3; 1967 c.359 §553; renumbered 744.355]
• 750.055   Other provisions applicable to health care service contractors; rules.
  (1) The following provisions of the Insurance Code apply to health care service contractors to the extent not inconsistent with the express provisions of ORS...
• 750.059   Exemption of group practice maintenance organizations from reimbursement requirement for services provided by state hospital or state-approved program.
  ORS 743A.010 does not apply to group practice maintenance organizations that are federally qualified pursuant to Title XIII of the Public Health Service Act (42...
• 750.060   [Amended by 1967 c.359 §555; renumbered 744.375]
• 750.065   Payment or reimbursement for services within scope of practice of optometrists.
  Notwithstanding any provision of contract or agreement entered into by a corporation, association, society, firm, partnership or individual doing business as a hospital association or...
• 750.070   [Repealed by 1967 c.359 §704]
• 750.075   [1979 c.799 §3; repealed by 1991 c.958 §6]
• 750.080   [Amended by 1967 c.359 §557; renumbered 744.396]
• 750.085   Offer of replacement coverage upon order of liquidation; procedure.
  (1) When a final order of liquidation with a finding of insolvency has been entered with respect to a health care service contractor by a...
• 750.090   [Amended by 1967 c.359 §558; renumbered 744.405]
• 750.095   Requirements of contract between provider and subscriber; content.
  (1) For the purpose of this section only, and only in the event of a finding of impairment by the Director of the Department of...
• 750.100   [Amended by 1967 c.359 §556; renumbered 744.385]
• 750.110   [Repealed by 1967 c.359 §704]
• 750.210   [Repealed by 1967 c.359 §704]
• 750.220   [Repealed by 1967 c.359 §704]
• 750.230   [Repealed by 1967 c.359 §704]
• 750.240   [Repealed by 1967 c.359 §704]
• 750.250   [Repealed by 1967 c.359 §704]
• 750.260   [Repealed by 1967 c.359 §704]
• 750.270   [Repealed by 1967 c.359 §704]
• 750.300   [1973 c.97 §3; repealed by 1989 c.331 §35]
• 750.301   Definitions for ORS 750.301 to 750.341.
  As used in ORS 750.301 to 750.341, “multiple employer welfare arrangement” has the meaning given that term in section 3 of the federal Employee Retirement...
• 750.303   Conditions for use of multiple employer welfare arrangement; permitted coverage.
  (1) An association or group of employers shall not provide health benefits to employees of the association or employees of any of the employers through...
• 750.305   Application for certificate.
  An association or group of employers seeking to provide health benefits through a multiple employer welfare arrangement must apply for a certificate of multiple employer...
• 750.307   Requirements for association or group.
  A trust carrying out a multiple employer welfare arrangement must be established and maintained by an association or group of employers meeting the following requirements:...
• 750.309   Requirements for trust.
  The following requirements apply to the trust carrying out a multiple employer welfare arrangement: (1) The trust must hold and maintain adequate facilities for purposes...
• 750.310   [1973 c.97 §4; repealed by 1989 c.331 §35]
• 750.311   Multiple employer welfare arrangements established in another state.
  An association or group of employers may provide health benefits in this state through a multiple employer welfare arrangement established in another state if the...
• 750.313   Issuance or refusal of certificate of multiple employer welfare arrangement.
  (1) The Director of the Department of Consumer and Business Services shall issue a certificate of multiple employer welfare arrangement to a multiple employer welfare...
• 750.315   Maintenance of reserves; actuarial opinion; rules.
  (1) For purposes of carrying out a multiple employer welfare arrangement, a trust shall maintain adequate reserves. Reserves must be held in cash or obligations...
• 750.317   Board of trustees.
  (1) The powers of a multiple employer welfare arrangement, except as otherwise provided, must be exercised by a board of trustees chosen to carry out...
• 750.318   Officers and persons appointed to act on behalf of board; bond.
  (1) The board of trustees of a trust carrying out a multiple employer welfare arrangement shall select officers as designated in the articles or bylaws...
• 750.319   Salaries; other compensation.
  (1) The trust carrying out a multiple employer welfare arrangement may not pay any salary, compensation or emolument to any officer or trustee of the...
• 750.320   [1973 c.97 §5; repealed by 1989 c.331 §35]
• 750.321   Assessment; maintenance of capital and surplus.
  (1) Benefit plans issued by a trust must provide for a charge or deposit payable in cash and, except as provided in this section, for...
• 750.323   Notice of coverage under plan.
  (1) A trust shall provide notice of the following in writing to each individual applying to be covered by a multiple employer welfare arrangement: (a)...
• 750.325   Filings by trust.
  (1) Each multiple employer welfare arrangement holding a certificate of multiple employer welfare arrangement must file an annual financial statement with the Director of the...
• 750.327   Examinations.
  A multiple employer welfare arrangement and its board of trustees and each administrator, insurer or trustee related to the trust or multiple employer welfare arrangement...
• 750.329   Taxation.
  (1) A multiple employer welfare arrangement is subject to taxation to the same extent and in the same manner as an insurer transacting health insurance...
• 750.330   [1973 c.97 §7; 1989 c.331 §26; renumbered 750.655 in 1989]
• 750.331   Prohibited activities for trustee or officer.
  In addition to limitations and restrictions imposed by the federal Employee Retirement Income Security Act of 1974, as amended, 29 U.S.C. 1001 et seq., on...
• 750.333   Applicable provisions of Insurance Code.
  (1) The following provisions of the Insurance Code apply to trusts carrying out a multiple employer welfare arrangement: (a) ORS 731.004 to 731.150, 731.162, 731.216...
• 750.335   Delinquency proceedings.
  The Director of the Department of Consumer and Business Services may initiate and carry out supervision and delinquency proceedings against a trust carrying out a...
• 750.337   Exclusion from membership in guaranty funds, joint underwriting associations and other pools.
  (1) A trust carrying out a multiple employer welfare arrangement may not be permitted to join or contribute financially to any insurance insolvency guaranty fund...
• 750.339   Liability of excess loss insurer.
  An insurer who provides excess loss insurance under ORS 750.309 to a multiple employer welfare arrangement that is offering or providing health benefits in this...
• 750.340   [1973 c.97 §6; 1975 c.769 §9; 1989 c.331 §27; renumbered 750.705 in 1989]
• 750.341   Requirement for multiple employer welfare arrangement to become traditional insurer.
  A trust carrying out a multiple employer welfare arrangement shall not provide coverage to more than 20,000 lives unless the trust first obtains a certificate...
• 750.505   Definitions for ORS 750.505 to 750.715.
  As used in ORS 750.505 to 750.715: (1) “Legal expense organization” or “organization” means any person or group of persons who provide or offer to...
• 750.515   Certificate of registration required.
  A person shall not transact business as a legal expense organization or otherwise offer, provide, market or do business on behalf of a plan unless...
• 750.525   Inapplicability of ORS 750.505 to 750.715 to certain legal services.
  ORS 750.505 to 750.715 do not apply to the following arrangements: (1) Retainer contracts made by an attorney or firm of attorneys with a specific...
• 750.535   Registration requirements.
  An applicant for registration as a legal expense organization must do all of the following in order to obtain registration: (1) Apply for the registration...
• 750.545   Application; fee.
  (1) An applicant for a certificate of registration shall apply to the Director of the Department of Consumer and Business Services on a form prescribed...
• 750.555   Issuance of certificate of registration.
  (1) If the Director of the Department of Consumer and Business Services determines that an applicant has satisfied all requirements of ORS 750.535 and 750.545,...
• 750.565   Duration of certificate; renewal; fee.
  (1) A certificate of registration of a legal expense organization is effective for one year from the date of issue. (2) A legal expense organization...
• 750.575   Grounds for suspension or revocation of certificate or refusal to issue or renew certificate.
  (1) The Director of the Department of Consumer and Business Services may suspend, revoke, refuse to issue or refuse to renew a certificate of registration...
• 750.585   Written provider agreement with providing attorney.
  An organization shall not operate or offer a plan in this state unless the organization first enters into a written provider agreement with the providing...
• 750.595   Membership agreement.
  An organization must provide a membership agreement to each member of a group that is a party to a legal expense plan. Each membership agreement...
• 750.605   Unfair, discriminatory or misleading provisions in agreements prohibited; record of transactions.
  (1) No provider agreement or membership agreement may contain provisions that are unfair, discriminatory or misleading, that encourage misrepresentation or misunderstandings of the agreement, that...
• 750.615   Deposit to reimburse members for unearned premiums required.
  An organization shall deposit in an account that is maintained separately from operating funds an amount reasonably calculated to reimburse plan members for unearned premiums....
• 750.625   Paying providing attorney contingent on claims experience prohibited.
  Compensation paid to a providing attorney shall not be contingent on claims experience. This section does not prevent the compensation of a providing attorney from...
• 750.635   Registered agent and registered office in state required.
  (1) Each organization shall continuously maintain in this state a registered agent and registered office that may be, but need not be, the same as...
• 750.645   Annual report; content; names of sales and marketing representatives to be submitted.
  (1) Each organization shall provide annually to the Director of the Department of Consumer and Business Services in as much detail as the director may...
• 750.655   Filing schedule of legal service rates required.
  A legal expense organization shall file with the Director of the Department of Consumer and Business Services all schedules and tables of premium rates for...
• 750.675   Filing of provider and membership agreement with director.
  An organization shall file with the Director of the Department of Consumer and Business Services a copy of the current membership agreement forms and the...
• 750.685   Indemnification insurance or bond required.
  (1) Except as otherwise provided in this section, no legal expense plan shall be issued, sold or offered for sale in this state unless the...
• 750.695   ORS 750.505 to 750.715 not to affect regulation of practice of law; plan not subject to Insurance Code.
  (1) ORS 750.505 to 750.715 do not affect the regulation of the practice of law. (2) Except as provided in ORS 750.505 to 750.715, legal...
• 750.705   Application of Insurance Code.
  (1) The following provisions of the Insurance Code apply to legal expense organizations to the extent not inconsistent with the express provisions of ORS 750.505...
• 750.715   Rules.
  The Director of the Department of Consumer and Business Services may make rules in order to carry out ORS 750.505 to 750.715. [1989 c.331 §21]

Last modified: August 7, 2008