ORS § 744.706 — OR Code / Title 56 / Chapter 744 / Section 744.706
744.706 Application for license
Status: in_force

(1) In order to obtain a license to transact business as a third party administrator, an applicant shall apply for the license on a form prescribed by the Director of the Department of Consumer and Business Services, with payment of any fee required for the application.

(2) The director may request biographical, organizational, locational, financial, employment and any other information on the application form that the director determines to be relevant to the evaluation of applications and to the granting of the license, including satisfactory evidence that the insurance required under ORS 744.726 (Errors and omissions insurance) has been procured and is in effect. The director may also require a statement of the business plan of the applicant. [1991 c.812 §5]

Source: Section 744.706 — Application for license , https://www.­oregonlegislature.­gov/bills_laws/ors/ors744.­html (accessed May 26, 2025).
ORS § 742.232 — OR Code / Title 56 / Chapter 742 / Section 742.232
742.232 Appraisal
Status: in_force

A fire insurance policy shall contain a provision as follows: “In case the insured and this company shall fail to agree as to the actual cash value or the amount of loss, then, on the written demand of either, each shall select a competent and disinterested appraiser and notify the other of the appraiser selected within 20 days of such demand. The appraisers shall first select a competent and disinterested umpire; and failing for 15 days to agree upon such umpire, then, on request of the insured or this company, such umpire shall be selected by a judge of a court of record in the state in which the property covered is located. The appraisers shall then appraise the loss, stating separately actual cash value and loss to each item; and, failing to agree, shall submit their differences, only, to the umpire. An award in writing, so itemized, of any two when filed with this company shall determine the amount of actual cash value and loss. Each appraiser shall be paid by the party selecting the appraiser and the expenses of appraisal and umpire shall be paid by the parties equally.” [Formerly 743.648]

Source: Section 742.232 — Appraisal , https://www.­oregonlegislature.­gov/bills_laws/ors/ors742.­html (accessed May 26, 2025).
ORS § 734.390 — OR Code / Title 56 / Chapter 734 / Section 734.390
734.390 Time to file claims
Status: in_force

(1) If upon the granting of an order of liquidation under this chapter, or at any time thereafter during the liquidation proceeding, the insurer shall not be clearly solvent, the court shall, after such notice and hearing as it considers proper, make an order declaring the insurer to be insolvent. Thereupon, regardless of any prior notice which may have been given to creditors, the Director of the Department of Consumer and Business Services shall notify all persons who may have claims against the insurer and who have not filed proper proofs thereof, to present the same to the director, at a place specified in the notice, within four months from the date of the entry of such insolvency order or within such longer time as the court shall prescribe. The last day for filing of proofs of claims shall be specified in the notice. The notice shall be given in a manner determined by the court.

(2) Proofs of claims may be filed subsequent to the date specified, but no such claim shall share in the distribution of the assets until all allowed claims, proofs of which have been filed on or before such date, have been paid in full. [1967 c.359 §293]

Source: Section 734.390 — Time to file claims , https://www.­oregonlegislature.­gov/bills_laws/ors/ors734.­html (accessed May 26, 2025).
ORS § 742.063 — OR Code / Title 56 / Chapter 742 / Section 742.063
742.063 Filing and approval of liability form that includes cost of defense within limits of liability
Status: in_force

(1) A liability insurance form that provides that the cost of defending a claim is included within the stated limits of liability may not be delivered or issued for delivery in this state until the form has been filed with and approved by the Director of the Department of Consumer and Business Services. In determining whether to approve or disapprove a form filed under this section, the director shall consider, in addition to the factors specified in ORS 742.005 (Grounds for disapproval of policy forms) , the circumstances and insurance needs of the proposed insureds.

(2) A liability insurance form filed under this section may not be approved unless the form contains a statement approved by the director disclosing that the costs of defending a claim under the policy are included in the policy limits. [Formerly 743.115]

Source: Section 742.063 — Filing and approval of liability form that includes cost of defense within limits of liability , https://www.­oregonlegislature.­gov/bills_laws/ors/ors742.­html (accessed May 26, 2025).
ORS § 744.810 — OR Code / Title 56 / Chapter 744 / Section 744.810
744.810 Conditions under which reinsurance intermediary manager and reinsurer may enter into transactions
Status: in_force

A reinsurance intermediary manager and the reinsurer it represents in that capacity may enter a transaction only pursuant to a written contract that specifies the responsibilities of each party and otherwise satisfies the requirements of this section. The contract must be approved by the board of directors of the reinsurer. Not later than the 30th day before the reinsurer assumes or cedes business through the reinsurance intermediary manager, a true copy of the approved contract must be filed with the Director of the Department of Consumer and Business Services for approval. The contract must at least provide that:

(1) The reinsurer may terminate the contract for cause upon written notice to the reinsurance intermediary manager, and the reinsurer may immediately suspend the authority of the reinsurance intermediary manager to assume or cede business during the pendency of any dispute regarding the cause for termination.

(2) The reinsurance intermediary manager must render accounts to the reinsurer, accurately detailing all material transactions and including information necessary to support all commissions, charges and other fees received by or owing to the reinsurance intermediary manager and remit all funds due under the contract to the reinsurer on not less than a monthly basis.

(3) All funds collected for the account of the reinsurer must be held by the reinsurance intermediary manager in a fiduciary capacity in a qualified United States financial institution as that term is described in ORS 744.804 (Conditions under which reinsurance intermediary broker and insurer may enter into transactions) . The reinsurance intermediary manager may retain not more than three months’ estimated claims payments and allocated loss adjustment expenses. The reinsurance intermediary manager must maintain a separate bank account for each reinsurer that it represents.

(4) A reinsurance intermediary manager must keep a complete record for each transaction of a contract of reinsurance as provided in this subsection. For each contract of reinsurance transacted by the reinsurance intermediary manager that is limited to first party property coverages, the reinsurance intermediary manager must keep the record for not less than five years after expiration of the contract of reinsurance. For all other contracts of reinsurance transacted by the reinsurance intermediary manager, the reinsurance intermediary manager must keep the record for not less than 10 years after expiration of each contract of reinsurance. The record must show all of the following:

(a) The type of contract, limits, underwriting restrictions, classes or risks and territory.

(b) The period of coverage, including effective and expiration dates, cancellation provisions and notice required of cancellation, and disposition of outstanding reserves on covered risks.

(c) Reporting and settlement requirements of balances.

(d) The rate used to compute the reinsurance premium.

(e) Names and addresses of reinsurers.

(f) The rates of all reinsurance commissions, including the commissions on any retrocessions handled by the reinsurance intermediary manager.

(g) Related correspondence and memoranda.

(h) Proof of placement.

(i) Specific information regarding retrocessions handled by the reinsurance intermediary manager, including the identity of retrocessionaires and percentage of each contract assumed or ceded.

(j) Financial records, including premium and loss accounts.

(k) The following written evidence, when the reinsurance intermediary manager places a reinsurance contract on behalf of a ceding insurer:

(A) When the contract is procured directly from any assuming reinsurer, written evidence that the assuming reinsurer has agreed to assume the risk; or

(B) When the contract is placed through a representative of the assuming reinsurer, other than an employee, written evidence that the reinsurer has delegated binding authority to the representative.

(5) The reinsurer must have access to and the right to copy all accounts and records maintained by the reinsurance intermediary manager that are related to its business. The reinsurance intermediary manager must maintain the accounts and records in a form usable by the reinsurer.

(6) The contract cannot be assigned in whole or in part by the reinsurance intermediary manager.

(7) The reinsurance intermediary manager must comply with the written underwriting and rating standards established by the insurer for the acceptance, rejection or cession of all risks.

(8) The contract must set forth the rates, terms and purposes of commissions, charges and other fees that the reinsurance intermediary manager may levy against the reinsurer.

(9) If the contract permits the reinsurance intermediary manager to settle claims on behalf of the reinsurer, all of the following provisions must apply:

(a) All claims must be reported to the reinsurer in a timely manner.

(b) A copy of the claim file must be sent to the reinsurer at its request or as soon as it becomes known that the claim:

(A) Has the potential of exceeding the lesser of an amount determined by the director or the limit set by the reinsurer;

(B) Involves a coverage dispute;

(C) May exceed the claims settlement authority of the reinsurance intermediary manager;

(D) Is open for more than six months; or

(E) Is closed by payment of the lesser of an amount set by the director or an amount set by the reinsurer.

(c) All claim files must be the joint property of the reinsurer and the reinsurance intermediary manager. However, upon an order of liquidation of the reinsurer, the files become the sole property of the reinsurer or its estate but the reinsurance intermediary manager shall have reasonable access to and the right to copy the files on a timely basis.

(d) Any settlement authority granted to the reinsurance intermediary manager may be terminated for cause upon written notice by the reinsurer to the reinsurance intermediary manager or upon the termination of the contract. The reinsurer may suspend the settlement authority during the pendency of the dispute regarding the cause of termination.

(10) If the contract provides for a sharing of interim profits by the reinsurance intermediary manager, the interim profits must not be paid until one year after the end of each underwriting period for property business and five years after the end of each underwriting period for casualty business, or a later period set by the director for specified lines of insurance, and not until the adequacy of loss reserves on remaining claims has been attested to by an actuary pursuant to ORS 744.814 (Prohibition on use of unlicensed reinsurance intermediary manager) .

(11) The reinsurance intermediary manager must annually provide the reinsurer with a statement of its financial condition that is prepared by an independent certified public accountant.

(12) Periodically, but not less frequently than semiannually, the reinsurer shall conduct an on-site review of the underwriting and claims processing operations of the reinsurance intermediary manager.

(13) The reinsurance intermediary manager must disclose to the reinsurer any relationship it has with any insurer prior to ceding or assuming any business with such insurer pursuant to the contract.

(14) Within the scope of the actual or apparent authority of the reinsurance intermediary manager, the acts of the reinsurance intermediary manager are considered to be the acts of the reinsurer on whose behalf it is acting. [1993 c.447 §79; 2003 c.364 §32]

Source: Section 744.810 — Conditions under which reinsurance intermediary manager and reinsurer may enter into transactions , https://www.­oregonlegislature.­gov/bills_laws/ors/ors744.­html (accessed May 26, 2025).
ORS § 732.105 — OR Code / Title 56 / Chapter 732 / Section 732.105
732.105 Filing articles of incorporation and surety bond, letter of credit or deposit
Status: in_force

The incorporators shall file with the Director of the Department of Consumer and Business Services within six months of the issuance of the organization permit under ORS 732.055 (Approval or disapproval of application for permit) :

(1) Duplicate originals of the articles of incorporation signed by all of the incorporators.

(2) A corporate surety bond payable to the director and the director’s successors, as trustee, in the sum of $25,000, or, in lieu thereof, a like amount in an irrevocable letter of credit issued by an insured institution as defined in ORS 706.008 (Additional definitions for Bank Act) or in approved securities or cash, conditioned upon the faithful accounting to the insurer upon completion of its organization and the receipt of its certificate of authority from the director, or to the shareholders, members, applicants for policies and creditors, or to the trustee, receiver or assignee of the insurer, duly appointed in any proceeding in any court or department of competent jurisdiction in this state, in accordance with their respective rights in case the organization of the insurer is not completed and the certificate of authority is not procured from the director. Such bond, letter of credit or deposit shall be in the form prescribed by the director. [1967 c.359 §156; 1991 c.331 §127; 1997 c.631 §546]

Source: Section 732.105 — Filing articles of incorporation and surety bond, letter of credit or deposit , https://www.­oregonlegislature.­gov/bills_laws/ors/ors732.­html (accessed May 26, 2025).
ORS § 731.086 — OR Code / Title 56 / Chapter 731 / Section 731.086
731.086 “Domestic risk.”
Status: in_force

“Domestic risk” means a subject of insurance resident, located or to be performed in this state. [1967 c.359 §18]

Source: Section 731.086 — “Domestic risk.” , https://www.­oregonlegislature.­gov/bills_laws/ors/ors731.­html (accessed May 26, 2025).
ORS § 733.090 — OR Code / Title 56 / Chapter 733 / Section 733.090
733.090 Unearned premium reserve and fund for title insurance
Status: in_force

(1) Each title insurer shall maintain a reserve for unearned premiums on its policies in force, which shall be charged as a liability in any determination of its financial condition. Such unearned premium liability shall be separate from and in addition to the insurer’s liability for incurred but unpaid losses and loss expenses.

(2) The amount of the unearned premium reserve shall be determined according to accounting procedures approved or required by the Director of the Department of Consumer and Business Services.

(3) A separate and distinct fund, known as the Title Insurance Unearned Premium Reserve Fund, shall be maintained by each title insurer in its treasury, as additional security to holders of its title insurance policies. The amount of the fund shall at least equal the amount of the unearned premium reserve liability determined in accordance with subsection (2) of this section. This fund shall be in addition to the insurer’s deposit with the Department of Consumer and Business Services and deposits required to be maintained with officials of other jurisdictions. The fund, to the extent of the unearned premium reserve on business in this state, shall be invested as provided for funds of a domestic insurer, except that ORS 733.630 (Investment in securities or obligations of certain corporations) , 733.670 (Investment of funds under “prudent investor” standard) and 733.690 (Investment of funds in title plant) shall not be applicable to investment of the fund. The remainder of the fund may be similarly invested, or may be invested as permitted by the laws of the insurer’s domicile. The insurer shall keep a separate record of the cash and investments of the fund, giving complete identification of the assets belonging to the fund and showing full particulars as to withdrawals and additions. No title insurance policies shall be issued by an insurer during a period when its unearned premium reserve fund is below the required amount. [1967 c.359 §216; 1999 c.196 §10; 2001 c.318 §9]

Source: Section 733.090 — Unearned premium reserve and fund for title insurance , https://www.­oregonlegislature.­gov/bills_laws/ors/ors733.­html (accessed May 26, 2025).
ORS § 744.528 — OR Code / Title 56 / Chapter 744 / Section 744.528
744.528 Nonresident adjuster qualifications
Status: in_force

(1) The Director of the Department of Consumer and Business Services may issue a license to engage in business as an adjuster in this state to a person who resides in another state or a province of Canada and is licensed as an adjuster in the state or province or in a designated home state if the state, province or designated home state in which the person is licensed gives the same privilege to a resident adjuster.

(2) An applicant for a license to engage in business as a nonresident adjuster must:

(a) Apply for the license as provided in ORS 744.518 (License application) ; and

(b) Pass an examination that the director by rule recognizes as adequately testing the applicant’s qualifications, competence and knowledge of the categories of insurance business and classes of insurance that the applicant intends to transact under a license and the applicant’s knowledge of an adjuster’s duties and responsibilities under the Insurance Code and other laws of this state, if the applicant is an individual and has not passed an examination with respect to a category of insurance business or class of insurance that the applicant intends to transact in this state. [1989 c.701 §46; 1991 c.810 §13; 2019 c.151 §27]

Source: Section 744.528 — Nonresident adjuster qualifications; rules , https://www.­oregonlegislature.­gov/bills_laws/ors/ors744.­html (accessed May 26, 2025).
ORS § 748.990 — OR Code / Title 56 / Chapter 748 / Section 748.990
748.990 Penalties
Status: in_force

(1) Any person who willfully makes a false or fraudulent statement in or relating to an application for membership, or for the purpose of obtaining money from or a benefit in any society, shall upon conviction be fined not less than $100 nor more than $500, imprisoned in the county jail for not less than 30 days nor more than one year, or both.

(2) Any person who willfully makes a false or fraudulent statement in any verified report or declaration under oath required or authorized by this chapter, or of any material fact or thing contained in a sworn statement concerning the death or disability of an insured for the purpose of procuring payment of a benefit named in the certificate, shall be guilty of perjury and shall be subject to the penalties prescribed by law.

(3) Any person who solicits membership for, or in any manner assists in procuring membership in, any society not licensed to do business in this state commits a Class C violation.

(4) Any person guilty of a willful violation of, or neglect or refusal to comply with, the provisions of this chapter for which a penalty is not otherwise prescribed, commits a Class C violation. [1987 c.490 §43; 1999 c.1051 §222]

Source: Section 748.990 — Penalties , https://www.­oregonlegislature.­gov/bills_laws/ors/ors748.­html (accessed May 26, 2025).
ORS § 750.055 — OR Code / Title 56 / Chapter 750 / Section 750.055
750.055 Other provisions applicable to health care service contractors
Status: in_force

(1) The following provisions apply to health care service contractors to the extent not inconsistent with the express provisions of ORS 750.005 (Definitions) to 750.095 (Requirements of contract between provider and subscriber) :

(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 731.362 (Requirements of foreign or alien insurers generally) , 731.382 (General eligibility for certificate of authority) , 731.385 (Standards for determining whether continued operation of insurer is hazardous) , 731.386 (Management of insurers) , 731.390 (Government insurers not to be authorized) , 731.398 (Amendment of certificate of authority) to 731.430 (Name of insurer) , 731.428 (Written consent to engage or participate in business of insurance) , 731.450 (Unrelated business prohibited) , 731.454 (Domestic insurers not to transact business in jurisdiction where not authorized) , 731.485 (Conditions under which insurer may limit insured’s choice of drug outlets and pharmacies) , as provided in subsection (2) of this section, ORS 731.488 (Annual audit of insurer) , 731.504 (Limit of risk) , 731.508 (Approved reinsurance) , 731.509 (Legislative intent) , 731.510 (Criteria for allowing reduction from liability for reinsurance) , 731.511 (Criteria to be met by assuming insurer in order to be accredited as reinsurer) , 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) , 731.730 (Insurer filings with National Association of Insurance Commissioners) , 731.731 (Immunity for certain persons dealing with information collected from filings under ORS 731.730) , 731.735 (Certain information confidential) , 731.737 (Immunity from liability for certain persons filing reports or furnishing information about specified activities to specified persons) , 731.750 (Confidentiality of report of material acquisitions or dispositions of assets, material nonrenewals, cancellations and revisions of ceded reinsurance agreements) , 731.752 (Confidentiality of report used for determination of required amount of capital or surplus) , 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 732.215 (Management contracts prohibited) , 732.220 (Exclusive agency contracts) , 732.230 (Order to cure impairment) , 732.245 (Home office) , 732.250 (Continuity of management in event of national emergency) , 732.320 (Supporting documents for expenditures) , 732.325 (Certain transactions and compensation between insurers and directors, trustees, officers, agents or employees prohibited) and 732.517 (Purpose of ORS 732.517 to 732.546) to 732.596 (Request by insurance holding company system for determination or acknowledgement of group-wide supervisor) , not including ORS 732.582 (Determination of reasonableness and adequacy of capital and surplus) , and ORS 732.650 (Definitions) to 732.689 (Retention of consultant to assist director’s review of corporate governance annual disclosure) .

(d) ORS 733.010 (Assets allowed) to 733.050 (Increase of inadequate reserves) , 733.080 (Reserves for health insurance) , 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 734.014 (Definitions) to 734.440 (Judgment upon assessment) .

(f) 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) , 742.065 (Insurance against risk of loss assumed under less than fully insured employee health benefit plan) , 742.150 (Approval by director) to 742.162 (Transfer and novation of policy effected by director) and 742.518 (Definitions for ORS 742.518 to 742.542) to 742.542 (Effect of personal injury protection benefits paid) .

(g) 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) , 743.022 (Premium rates for individual health benefit plans) , 743.023 (Electronic administration) , 743.025 (Annual report of information related to prescription drugs covered by health benefit plans) , 743.028 (Uniform health insurance claim forms) , 743.029 (Uniform standards for health care financial and administrative transactions) , 743.038 (Consent of individual required for life and health insurance) , 743.040 (Personal insurance, insurable interest and beneficiaries) , 743.044 (Life insurance for benefit of charity) , 743.050 (Exemption of proceeds of health insurance) , 743.100 (Short title) to 743.109 (Approval of certain policy forms containing specified provisions) , 743.402 (Exceptions to individual health insurance policy requirements) , 743.405 (General requirements for health insurance policies) , 743.406 (Required provisions in group health insurance policies) , 743.417 (Grace period for subsequent premium payments) , 743.472 (Permissible reasons for cancellation or refusal to renew) , 743.492 (Policy return and premium refund provision) , 743.495 (Use of terms “noncancelable” or “guaranteed renewable”) , 743.498 (Statement in policy of cancelability or renewability) , 743.522 (Additional groups designated by director) , 743.523 (Certain sales practices prohibited) , 743.524 (Eligibility of association to be group health policyholder) , 743.526 (Determination of whether trustees are policyholders) , 743.535 (Health benefit coverage for guaranteed association) , 743.550 (Student health insurance) , 743.650 (Long Term Care Insurance Act) to 743.656 (Eligibility for benefits) , 743.680 (Definitions for ORS 743.680 to 743.689) to 743.689 (Director’s authority upon violation of ORS 743.680 to 743.689) , 743.788 (Prescription drug identification card) , 743.790 (Rules for prescription drug identification cards) and 743B.221 (Assignment of beneficiaries to primary care providers) .

(h) 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.034 (Services provided by expanded practice dental hygienist) , 743A.036 (Services provided by licensed nurse practitioner or licensed physician assistant) , 743A.040 (Services provided by optometrist) , 743A.044 (Services provided by physician assistant) , 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 (Telemedicine 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 and assistive listening devices) , 743A.148 (Maxillofacial prosthetic services) , 743A.150 (Treatment of craniofacial anomaly) , 743A.160 (Alcoholism treatment) , 743A.168 (Behavioral health treatment) , 743A.169 (Behavioral and physical health services provided on same day or in same facility) , 743A.170 (Tobacco use cessation programs) , 743A.175 (Traumatic brain injury) , 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 assessments) , 743A.260 (Inmates) , 743A.310 (Primary care visits) and 743A.315 (Treatment for pediatric autoimmune neuropsychiatric disorders) and section 2, chapter 771, Oregon Laws 2013.

(i) ORS 743B.001 (Definitions) , 743B.003 (Purposes) to 743B.127 (Rules for ORS 743.022, 743B.125 and 743B.126) , 743B.128 (Exceptions to requirement to actively market all plans) , 743B.130 (Requirement to offer bronze and silver plans) , 743B.195 (Enforcement of Newborns’ and Mothers’ Health Protection Act of 1996) , 743B.197 (Health Care Consumer Protection Advisory Committee) , 743B.200 (Requirements for insurers offering managed health insurance) , 743B.202 (Requirements for insurers offering managed health or preferred provider organization insurance) , 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 (Required statements regarding external reviews) , 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.280 (Definitions for ORS 743B.280 to 743B.285) to 743B.285 (Rules) , 743B.287 (Balance billing prohibited for health care facility services) , 743B.300 (Disclosure of differences in replacement health insurance policies) , 743B.310 (Rescinding coverage) , 743B.320 (Minimum grace period) , 743B.323 (Separate notice to policyholder required before cancellation of individual or group health insurance policy for nonpayment of premium) , 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) to 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.450 (Prompt payment of claims) , 743B.451 (Refund of paid claims) , 743B.452 (Interest on unpaid claims) , 743B.453 (Underpayment of claims) , 743B.470 (Medicaid not considered in coverage eligibility determination) , 743B.475 (Guidelines for coordination of benefits) , 743B.505 (Provider networks) , 743B.550 (Disclosure of information) , 743B.555 (Confidential communications) , 743B.601 (Synchronization of prescription drug refills) , 743B.602 (Step therapy) and 743B.800 (Risk adjustment procedures) .

(j) The following provisions of ORS chapter 744:

(A) ORS 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 744.602 (Definitions) to 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.

(k) ORS 746.005 (Trade practices exempted from prohibitions) to 746.140 (Sale of life insurance with securities) , 746.160 (Practices injurious to free competition) , 746.220 (Debtor’s option in furnishing credit life or credit health insurance) to 746.370 (Records of insureds) , 746.600 (Definitions for ORS 746.600 to 746.690) , 746.605 (Purpose) , 746.607 (Use and disclosure of personal information) , 746.608 (Rules) , 746.610 (Application of ORS 746.600 to 746.690) , 746.615 (Pretext interviews prohibited) , 746.625 (Marketing and research surveys) , 746.635 (Investigative consumer reports) , 746.650 (Reasons for adverse underwriting decisions) , 746.655 (Information concerning previous adverse underwriting decisions) , 746.660 (Basing adverse underwriting decision on previous adverse decision) , 746.668 (Relationship of ORS 746.620, 746.630 and 746.665 to federal Fair Credit Reporting Act) , 746.670 (Investigatory powers) , 746.675 (Service of process on out-of-state insurance-support organizations) , 746.680 (Remedies) and 746.690 (Obtaining information under false pretenses prohibited) .

(2) The following provisions of the Insurance Code apply to health care service contractors except in the case of group practice health maintenance organizations that are federally qualified pursuant to Title XIII of the Public Health Service Act:

(a) ORS 731.485 (Conditions under which insurer may limit insured’s choice of drug outlets and pharmacies) , if the group practice health maintenance organization wholly owns and operates an in-house drug outlet.

(b) ORS 743A.024 (Services provided by clinical social worker) , unless the patient is referred by a physician, physician assistant or nurse practitioner associated with a group practice health maintenance organization.

(3) For the purposes of this section, health care service contractors are insurers.

(4) Any for-profit health care service contractor organized under the laws of any other state that is not governed by the insurance laws of the other state is subject to all requirements of ORS chapter 732.

(5) Intentionally left blank —Ed.

(a) A health care service contractor is a domestic insurance company for the purpose of determining whether the health care service contractor is a debtor, as defined in 11 U.S.C. 109.

(b) A health care service contractor’s classification as a domestic insurance company under paragraph (a) of this subsection does not subject the health care service contractor to ORS 734.510 (Definitions for ORS 734.510 to 734.710) to 734.710 (Administration of delinquency proceeding claims and expenses) .

(6) The Director of the Department of Consumer and Business Services may, after notice and hearing, adopt reasonable rules not inconsistent with this section and ORS 750.003 (Purpose) , 750.005 (Definitions) , 750.025 (Restricting distribution of income) and 750.045 (Required capitalization) that are necessary for the proper administration of these provisions. [1967 c.359 §659; 1969 c.336 §18; 1971 c.231 §41; 1973 c.143 §5; 1973 c.515 §6; 1973 c.613 §4a; 1975 c.135 §3; 1975 c.338 §4a; 1975 c.689 §4; 1975 c.784 §13c; 1977 c.402 §6; 1979 c.268 §7; 1979 c.708 §11; 1979 c.785 §22a; 1979 c.797 §3a; 1981 c.254 §3; 1981 c.319 §3; 1981 c.422 §6; 1981 c.649 §22; 1981 c.752 §14; 1983 c.601 §9; 1985 c.747 §68; 1985 c.827 §3; 1987 c.411 §3; 1987 c.720 §3; 1987 c.739 §5; 1987 c.774 §62; 1987 c.838 §16; 1989 c.255 §13; 1989 c.425 §15; 1989 c.474 §4; 1989 c.701 §76; 1989 c.784 §14; 1989 c.832 §3; 1989 c.1022 §11; 1991 c.182 §18; 1991 c.401 §33; 1991 c.673 §8; 1991 c.812 §24; 1991 c.875 §3; 1991 c.916 §19; 1993 c.391 §3; 1993 c.447 §118; 1993 c.649 §14; 1995 c.30 §13; 1995 c.506 §3; 1995 c.623 §3; 1995 c.638 §9; 1995 c.669 §3; 1995 c.672 §8; 1997 c.343 §22; 1997 c.496 §4; 1997 c.573 §4; 1997 c.759 §5; 1999 c.428 §§4,5; 1999 c.633 §§7,8; 1999 c.749 §§3,4; 1999 c.987 §§22,23; 2001 c.191 §60; 2001 c.266 §16; 2001 c.377 §20; 2001 c.742 §4; 2001 c.747 §6; 2003 c.87 §19; 2003 c.91 §5; 2003 c.137 §7; 2003 c.263 §3; 2003 c.363 §14; 2003 c.364 §169; 2003 c.748 §3; 2003 c.802 §172; 2005 c.22 §§500,501,502; 2005 c.255 §§4,5,6; 2005 c.418 §5; 2007 c.128 §§2,3; 2007 c.182 §§8,9; 2007 c.313 §§5,6; 2007 c.504 §§3,4; 2007 c.566 §§3,4; 2007 c.872 §§3,4; 2008 c.22 §§5,6; 2009 c.274 §§3,4; 2009 c.383 §3; 2009 c.384 §§3,4; 2009 c.423 §§3,4; 2009 c.503 §§3,4; 2009 c.553 §§3,4; 2009 c.630 §§3,4; 2009 c.807 §§5,6; 2011 c.130 §7; 2011 c.312 §3; 2011 c.500 §43; 2011 c.660 §26; 2011 c.716 §13; 2012 c.21 §3; 2013 c.682 §3; 2013 c.698 §33; 2013 c.771 §8; 2014 c.25 §§5,6; 2014 c.45 §§80,81; 2015 c.59 §§7,8; 2015 c.100 §§5,6; 2015 c.224 §§5,6; 2015 c.362 §§9,10; 2015 c.470 §§8,9; 2015 c.515 §§28,29; 2017 c.206 §§8,9; 2017 c.417 §§4,5; 2017 c.479 §§20,21; 2018 c.7 §9; 2019 c.13 §68; 2019 c.151 §37; 2019 c.441 §4; 2021 c.97 §84; 2022 c.37 §11; 2023 c.111 §4; 2023 c.152 §1]

Note: The amendments to 750.055 (Other provisions applicable to health care service contractors) by section 21, chapter 771, Oregon Laws 2013, become operative January 2, 2030. See section 24, chapter 771, Oregon Laws 2013, as amended by section 6, chapter 674, Oregon Laws 2015, and section 2, chapter 650, Oregon Laws 2021. The text that is operative on and after January 2, 2030, including amendments by section 7, chapter 25, Oregon Laws 2014, section 82, chapter 45, Oregon Laws 2014, section 9, chapter 59, Oregon Laws 2015, section 7, chapter 100, Oregon Laws 2015, section 7, chapter 224, Oregon Laws 2015, section 11, chapter 362, Oregon Laws 2015, section 10, chapter 470, Oregon Laws 2015, section 30, chapter 515, Oregon Laws 2015, section 10, chapter 206, Oregon Laws 2017, section 6, chapter 417, Oregon Laws 2017, section 22, chapter 479, Oregon Laws 2017, section 10, chapter 7, Oregon Laws 2018, section 69, chapter 13, Oregon Laws 2019, section 38, chapter 151, Oregon Laws 2019, section 5, chapter 441, Oregon Laws 2019, section 85, chapter 97, Oregon Laws 2021, section 12, chapter 37, Oregon Laws 2022, section 5, chapter 111, Oregon Laws 2023, and section 2, chapter 152, Oregon Laws 2023, is set forth for the user’s convenience.

750.055 (Other provisions applicable to health care service contractors) . (1) The following provisions apply to health care service contractors to the extent not inconsistent with the express provisions of ORS 750.005 (Definitions) to 750.095 (Requirements of contract between provider and subscriber) :

(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 731.362 (Requirements of foreign or alien insurers generally) , 731.382 (General eligibility for certificate of authority) , 731.385 (Standards for determining whether continued operation of insurer is hazardous) , 731.386 (Management of insurers) , 731.390 (Government insurers not to be authorized) , 731.398 (Amendment of certificate of authority) to 731.430 (Name of insurer) , 731.428 (Written consent to engage or participate in business of insurance) , 731.450 (Unrelated business prohibited) , 731.454 (Domestic insurers not to transact business in jurisdiction where not authorized) , 731.485 (Conditions under which insurer may limit insured’s choice of drug outlets and pharmacies) , as provided in subsection (2) of this section, ORS 731.488 (Annual audit of insurer) , 731.504 (Limit of risk) , 731.508 (Approved reinsurance) , 731.509 (Legislative intent) , 731.510 (Criteria for allowing reduction from liability for reinsurance) , 731.511 (Criteria to be met by assuming insurer in order to be accredited as reinsurer) , 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) , 731.730 (Insurer filings with National Association of Insurance Commissioners) , 731.731 (Immunity for certain persons dealing with information collected from filings under ORS 731.730) , 731.735 (Certain information confidential) , 731.737 (Immunity from liability for certain persons filing reports or furnishing information about specified activities to specified persons) , 731.750 (Confidentiality of report of material acquisitions or dispositions of assets, material nonrenewals, cancellations and revisions of ceded reinsurance agreements) , 731.752 (Confidentiality of report used for determination of required amount of capital or surplus) , 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 732.215 (Management contracts prohibited) , 732.220 (Exclusive agency contracts) , 732.230 (Order to cure impairment) , 732.245 (Home office) , 732.250 (Continuity of management in event of national emergency) , 732.320 (Supporting documents for expenditures) , 732.325 (Certain transactions and compensation between insurers and directors, trustees, officers, agents or employees prohibited) and 732.517 (Purpose of ORS 732.517 to 732.546) to 732.596 (Request by insurance holding company system for determination or acknowledgement of group-wide supervisor) , not including ORS 732.582 (Determination of reasonableness and adequacy of capital and surplus) , and ORS 732.650 (Definitions) to 732.689 (Retention of consultant to assist director’s review of corporate governance annual disclosure) .

(d) ORS 733.010 (Assets allowed) to 733.050 (Increase of inadequate reserves) , 733.080 (Reserves for health insurance) , 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 734.014 (Definitions) to 734.440 (Judgment upon assessment) .

(f) 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) , 742.065 (Insurance against risk of loss assumed under less than fully insured employee health benefit plan) , 742.150 (Approval by director) to 742.162 (Transfer and novation of policy effected by director) and 742.518 (Definitions for ORS 742.518 to 742.542) to 742.542 (Effect of personal injury protection benefits paid) .

(g) 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) , 743.022 (Premium rates for individual health benefit plans) , 743.023 (Electronic administration) , 743.025 (Annual report of information related to prescription drugs covered by health benefit plans) , 743.028 (Uniform health insurance claim forms) , 743.029 (Uniform standards for health care financial and administrative transactions) , 743.038 (Consent of individual required for life and health insurance) , 743.040 (Personal insurance, insurable interest and beneficiaries) , 743.044 (Life insurance for benefit of charity) , 743.050 (Exemption of proceeds of health insurance) , 743.100 (Short title) to 743.109 (Approval of certain policy forms containing specified provisions) , 743.402 (Exceptions to individual health insurance policy requirements) , 743.405 (General requirements for health insurance policies) , 743.406 (Required provisions in group health insurance policies) , 743.417 (Grace period for subsequent premium payments) , 743.472 (Permissible reasons for cancellation or refusal to renew) , 743.492 (Policy return and premium refund provision) , 743.495 (Use of terms “noncancelable” or “guaranteed renewable”) , 743.498 (Statement in policy of cancelability or renewability) , 743.522 (Additional groups designated by director) , 743.523 (Certain sales practices prohibited) , 743.524 (Eligibility of association to be group health policyholder) , 743.526 (Determination of whether trustees are policyholders) , 743.535 (Health benefit coverage for guaranteed association) , 743.550 (Student health insurance) , 743.650 (Long Term Care Insurance Act) to 743.656 (Eligibility for benefits) , 743.680 (Definitions for ORS 743.680 to 743.689) to 743.689 (Director’s authority upon violation of ORS 743.680 to 743.689) , 743.788 (Prescription drug identification card) , 743.790 (Rules for prescription drug identification cards) and 743B.221 (Assignment of beneficiaries to primary care providers) .

(h) 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.034 (Services provided by expanded practice dental hygienist) , 743A.036 (Services provided by licensed nurse practitioner or licensed physician assistant) , 743A.040 (Services provided by optometrist) , 743A.044 (Services provided by physician assistant) , 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 (Telemedicine 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 and assistive listening devices) , 743A.148 (Maxillofacial prosthetic services) , 743A.150 (Treatment of craniofacial anomaly) , 743A.160 (Alcoholism treatment) , 743A.168 (Behavioral health treatment) , 743A.169 (Behavioral and physical health services provided on same day or in same facility) , 743A.170 (Tobacco use cessation programs) , 743A.175 (Traumatic brain injury) , 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 assessments) , 743A.260 (Inmates) , 743A.310 (Primary care visits) and 743A.315 (Treatment for pediatric autoimmune neuropsychiatric disorders) .

(i) ORS 743B.001 (Definitions) , 743B.003 (Purposes) to 743B.127 (Rules for ORS 743.022, 743B.125 and 743B.126) , 743B.128 (Exceptions to requirement to actively market all plans) , 743B.130 (Requirement to offer bronze and silver plans) , 743B.195 (Enforcement of Newborns’ and Mothers’ Health Protection Act of 1996) , 743B.197 (Health Care Consumer Protection Advisory Committee) , 743B.200 (Requirements for insurers offering managed health insurance) , 743B.202 (Requirements for insurers offering managed health or preferred provider organization insurance) , 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 (Required statements regarding external reviews) , 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.280 (Definitions for ORS 743B.280 to 743B.285) to 743B.285 (Rules) , 743B.287 (Balance billing prohibited for health care facility services) , 743B.300 (Disclosure of differences in replacement health insurance policies) , 743B.310 (Rescinding coverage) , 743B.320 (Minimum grace period) , 743B.323 (Separate notice to policyholder required before cancellation of individual or group health insurance policy for nonpayment of premium) , 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) to 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.450 (Prompt payment of claims) , 743B.451 (Refund of paid claims) , 743B.452 (Interest on unpaid claims) , 743B.453 (Underpayment of claims) , 743B.470 (Medicaid not considered in coverage eligibility determination) , 743B.475 (Guidelines for coordination of benefits) , 743B.505 (Provider networks) , 743B.550 (Disclosure of information) , 743B.555 (Confidential communications) , 743B.601 (Synchronization of prescription drug refills) , 743B.602 (Step therapy) and 743B.800 (Risk adjustment procedures) .

(j) The following provisions of ORS chapter 744:

(A) ORS 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 744.602 (Definitions) to 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.

(k) ORS 746.005 (Trade practices exempted from prohibitions) to 746.140 (Sale of life insurance with securities) , 746.160 (Practices injurious to free competition) , 746.220 (Debtor’s option in furnishing credit life or credit health insurance) to 746.370 (Records of insureds) , 746.600 (Definitions for ORS 746.600 to 746.690) , 746.605 (Purpose) , 746.607 (Use and disclosure of personal information) , 746.608 (Rules) , 746.610 (Application of ORS 746.600 to 746.690) , 746.615 (Pretext interviews prohibited) , 746.625 (Marketing and research surveys) , 746.635 (Investigative consumer reports) , 746.650 (Reasons for adverse underwriting decisions) , 746.655 (Information concerning previous adverse underwriting decisions) , 746.660 (Basing adverse underwriting decision on previous adverse decision) , 746.668 (Relationship of ORS 746.620, 746.630 and 746.665 to federal Fair Credit Reporting Act) , 746.670 (Investigatory powers) , 746.675 (Service of process on out-of-state insurance-support organizations) , 746.680 (Remedies) and 746.690 (Obtaining information under false pretenses prohibited) .

(2) The following provisions of the Insurance Code apply to health care service contractors except in the case of group practice health maintenance organizations that are federally qualified pursuant to Title XIII of the Public Health Service Act:

(a) ORS 731.485 (Conditions under which insurer may limit insured’s choice of drug outlets and pharmacies) , if the group practice health maintenance organization wholly owns and operates an in-house drug outlet.

(b) ORS 743A.024 (Services provided by clinical social worker) , unless the patient is referred by a physician, physician assistant or nurse practitioner associated with a group practice health maintenance organization.

(3) For the purposes of this section, health care service contractors are insurers.

(4) Any for-profit health care service contractor organized under the laws of any other state that is not governed by the insurance laws of the other state is subject to all requirements of ORS chapter 732.

(5) Intentionally left blank —Ed.

(a) A health care service contractor is a domestic insurance company for the purpose of determining whether the health care service contractor is a debtor, as defined in 11 U.S.C. 109.

(b) A health care service contractor’s classification as a domestic insurance company under paragraph (a) of this subsection does not subject the health care service contractor to ORS 734.510 (Definitions for ORS 734.510 to 734.710) to 734.710 (Administration of delinquency proceeding claims and expenses) .

(6) The Director of the Department of Consumer and Business Services may, after notice and hearing, adopt reasonable rules not inconsistent with this section and ORS 750.003 (Purpose) , 750.005 (Definitions) , 750.025 (Restricting distribution of income) and 750.045 (Required capitalization) that are necessary for the proper administration of these provisions.

Source: Section 750.055 — Other provisions applicable to health care service contractors; rules , https://www.­oregonlegislature.­gov/bills_laws/ors/ors750.­html (accessed May 26, 2025).
ORS § 743a.168 — OR Code / Title 56 / Chapter 743a / Section 743a.168
743A.168 Behavioral health treatment
Status: in_force

(1) As used in this section:

(a) “Behavioral health assessment” means an evaluation by a provider, in person or using telemedicine, to determine a patient’s need for behavioral health treatment.

(b) “Behavioral health condition” has the meaning prescribed by rule by the Department of Consumer and Business Services.

(c) “Behavioral health crisis” means a disruption in an insured’s mental or emotional stability or functioning resulting in an urgent need for immediate outpatient treatment in an emergency department or admission to a hospital to prevent a serious deterioration in the insured’s mental or physical health.

(d) “Facility” means a corporate or governmental entity or other provider of services for the treatment of behavioral health conditions.

(e) “Generally accepted standards of care” means:

(A) Standards of care and clinical practice guidelines that:

(i) Are generally recognized by health care providers practicing in relevant clinical specialties; and

(ii) Are based on valid, evidence-based sources; and

(B) Products and services that:

(i) Address the specific needs of a patient for the purpose of screening for, preventing, diagnosing, managing or treating an illness, injury or condition or symptoms of an illness, injury or condition;

(ii) Are clinically appropriate in terms of type, frequency, extent, site and duration; and

(iii) Are not primarily for the economic benefit of an insurer or payer or for the convenience of a patient, treating physician or other health care provider.

(f) “Group health insurer” means an insurer, a health maintenance organization or a health care service contractor.

(g) “Median maximum allowable reimbursement rate” means the median of all maximum allowable reimbursement rates, minus incentive payments, paid for each billing code for each provider type during a calendar year.

(h) “Prior authorization” has the meaning given that term in ORS 743B.001 (Definitions) .

(i) “Program” means a particular type or level of service that is organizationally distinct within a facility.

(j) “Provider” means:

(A) A behavioral health professional or medical professional licensed or certified in this state who has met the credentialing requirement of a group health insurer or an issuer of an individual health benefit plan that is not a grandfathered health plan as defined in ORS 743B.005 (Definitions) and is otherwise eligible to receive reimbursement for coverage under the policy;

(B) A health care facility as defined in ORS 433.060 (Definitions for ORS 433.060 to 433.080) ;

(C) A residential facility as defined in ORS 430.010 (Definitions) ;

(D) A day or partial hospitalization program;

(E) An outpatient service as defined in ORS 430.010 (Definitions) ; or

(F) A provider organization certified by the Oregon Health Authority under subsection (9) of this section.

(k) “Relevant clinical specialties” includes but is not limited to:

(A) Psychiatry;

(B) Psychology;

(C) Clinical sociology;

(D) Addiction medicine and counseling; and

(E) Behavioral health treatment.

(L) “Standards of care and clinical practice guidelines” includes but is not limited to:

(A) Patient placement criteria;

(B) Recommendations of agencies of the federal government; and

(C) Drug labeling approved by the United States Food and Drug Administration.

(m) “Utilization review” has the meaning given that term in ORS 743B.001 (Definitions) .

(n) “Valid, evidence-based sources” includes but is not limited to:

(A) Peer-reviewed scientific studies and medical literature;

(B) Recommendations of nonprofit health care provider professional associations; and

(C) Specialty societies.

(2) A group health insurance policy or an individual health benefit plan that is not a grandfathered health plan providing coverage for hospital or medical expenses, other than limited benefit coverage, shall provide coverage for expenses arising from the diagnosis of behavioral health conditions and medically necessary behavioral health treatment at the same level as, and subject to limitations no more restrictive than, those imposed on coverage or reimbursement of expenses arising from treatment for other medical conditions. The following apply to coverage for behavioral health treatment:

(a) The coverage may be made subject to provisions of the policy that apply to other benefits under the policy, including but not limited to provisions relating to copayments, deductibles and coinsurance. Copayments, deductibles and coinsurance for treatment in health care facilities or residential facilities may not be greater than those under the policy for expenses of hospitalization in the treatment of other medical conditions. Copayments, deductibles and coinsurance for outpatient treatment may not be greater than those under the policy for expenses of outpatient treatment of other medical conditions.

(b) The coverage of behavioral health treatment may not be made subject to treatment limitations, limits on total payments for treatment, limits on duration of treatment or financial requirements unless similar limitations or requirements are imposed on coverage of other medical conditions. The coverage of eligible expenses of behavioral health treatment may be limited to treatment that is medically necessary as determined in accordance with this section and no more stringently under the policy than for other medical conditions.

(c) The coverage of behavioral health treatment must include:

(A) A behavioral health assessment;

(B) No less than the level of services determined to be medically necessary in a behavioral health assessment of the specific needs of a patient or in a patient’s care plan:

(i) To effectively treat the patient’s underlying behavioral health condition rather than the mere amelioration of current symptoms such as suicidal ideation or psychosis; and

(ii) For care following a behavioral health crisis, to transition the patient to a lower level of care;

(C) Treatment of co-occurring behavioral health conditions or medical conditions in a coordinated manner;

(D) Treatment at the least intensive and least restrictive level of care that is safe and most effective and meets the needs of the insured’s condition;

(E) A lower level or less intensive care only if it is comparably as safe and effective as treatment at a higher level of service or intensity;

(F) Treatment to maintain functioning or prevent deterioration;

(G) Treatment for an appropriate duration based on the insured’s particular needs;

(H) Treatment appropriate to the unique needs of children and adolescents;

(I) Treatment appropriate to the unique needs of older adults; and

(J) Coordinated care and case management as defined by the Department of Consumer and Business Services by rule.

(d) The coverage of behavioral health treatment may not limit coverage for treatment of pervasive or chronic behavioral health conditions to short-term or acute behavioral health treatment at any level of care or placement.

(e) A group health insurer or an issuer of an individual health benefit plan other than a grandfathered health plan shall have a network of providers of behavioral health treatment sufficient to meet the standards described in ORS 743B.505 (Provider networks) . If there is no in-network provider qualified to timely deliver, as defined by rule, medically necessary behavioral treatment to an insured in a geographic area, the group health insurer or issuer of an individual health benefit plan shall provide coverage of out-of-network medically necessary behavioral health treatment without any additional out-of-pocket costs if provided by an available out-of-network provider that enters into an agreement with the insurer to be reimbursed at in-network rates.

(f) A provider is eligible for reimbursement under this section if:

(A) The provider is approved or certified by the Oregon Health Authority;

(B) The provider is accredited for the particular level of care for which reimbursement is being requested by the Joint Commission or the Commission on Accreditation of Rehabilitation Facilities;

(C) The patient is staying overnight at the facility and is involved in a structured program at least eight hours per day, five days per week; or

(D) The provider is providing a covered benefit under the policy.

(g) A group health insurer or an issuer of an individual health benefit plan other than a grandfathered health plan must use the same methodology to set reimbursement rates paid to behavioral health treatment providers that the group health insurer or issuer of an individual health benefit plan uses to set reimbursement rates for medical and surgical treatment providers.

(h) A group health insurer or an issuer of an individual health benefit plan other than a grandfathered health plan must update the methodology and rates for reimbursing behavioral health treatment providers in a manner equivalent to the manner in which the group health insurer or issuer of an individual health benefit plan updates the methodology and rates for reimbursing medical and surgical treatment providers, unless otherwise required by federal law.

(i) A group health insurer or an issuer of an individual health benefit plan other than a grandfathered health plan that reimburses out-of-network providers for medical or surgical services must reimburse out-of-network behavioral health treatment providers on the same terms and at a rate that is in parity with the rate paid to medical or surgical treatment providers.

(j) Outpatient coverage of behavioral health treatment shall include follow-up in-home service or outpatient services if clinically indicated under criteria and guidelines described in subsection (5) of this section. The policy may limit coverage for in-home service to persons who are homebound under the care of a physician only if clinically indicated under criteria and guidelines described in subsection (5) of this section.

(k) Intentionally left blank —Ed.

(A) Subject to the patient or client confidentiality provisions of ORS 40.235 (Rule 504-1. Physician-patient privilege) relating to physicians, ORS 40.240 (Rule 504-2. Nurse-patient privilege) relating to nurse practitioners, ORS 40.230 (Rule 504. Psychotherapist-patient privilege) relating to psychologists, ORS 40.250 (Rule 504-4. Regulated social worker-client privilege) and 675.580 (Confidentiality of communication by client) relating to licensed clinical social workers and ORS 40.262 (Rule 507. Counselor-client privilege) relating to licensed professional counselors and licensed marriage and family therapists, a group health insurer or issuer of an individual health benefit plan may provide for review for level of treatment of admissions and continued stays for treatment in health facilities, residential facilities, day or partial hospitalization programs and outpatient services by either staff of a group health insurer or issuer of an individual health benefit plan or personnel under contract to the group health insurer or issuer of an individual health benefit plan that is not a grandfathered health plan, or by a utilization review contractor, who shall have the authority to certify for or deny level of payment.

(B) Review shall be made according to criteria made available to providers in advance upon request.

(C) Review shall be performed by or under the direction of a physician licensed under ORS 677.100 (Qualifications of applicant for license) to 677.228 (Automatic lapse of license for failure to pay registration fee or report change of location) , a psychologist licensed by the Oregon Board of Psychology, a clinical social worker licensed by the State Board of Licensed Social Workers or a professional counselor or marriage and family therapist licensed by the Oregon Board of Licensed Professional Counselors and Therapists, in accordance with standards of the National Committee for Quality Assurance or Medicare review standards of the Centers for Medicare and Medicaid Services.

(D) Review may involve prior approval, concurrent review of the continuation of treatment, post-treatment review or any combination of these. However, if prior approval is required, provision shall be made to allow for payment of urgent or emergency admissions, subject to subsequent review. If prior approval is not required, group health insurers and issuers of individual health benefit plans that are not grandfathered health plans shall permit providers, policyholders or persons acting on their behalf to make advance inquiries regarding the appropriateness of a particular admission to a treatment program. Group health insurers and issuers of individual health benefit plans that are not grandfathered health plans shall provide a timely response to such inquiries. Noncontracting providers must cooperate with these procedures to the same extent as contracting providers to be eligible for reimbursement.

(L) Health maintenance organizations may limit the receipt of covered services by enrollees to services provided by or upon referral by providers contracting with the health maintenance organization. Health maintenance organizations and health care service contractors may create substantive plan benefit and reimbursement differentials at the same level as, and subject to limitations no more restrictive than, those imposed on coverage or reimbursement of expenses arising out of other medical conditions and apply them to contracting and noncontracting providers.

(3) This section does not prohibit a group health insurer or issuer of an individual health benefit plan that is not a grandfathered health plan from managing the provision of benefits through common methods, including but not limited to selectively contracted panels, health plan benefit differential designs, preadmission screening, prior authorization of services, utilization review or other mechanisms designed to limit eligible expenses to those described in subsection (2)(b) of this section provided such methods comply with the requirements of this section.

(4) The Legislative Assembly finds that health care cost containment is necessary and intends to encourage health insurance plans designed to achieve cost containment by ensuring that reimbursement is limited to appropriate utilization under criteria incorporated into the insurance, either directly or by reference, in accordance with this section.

(5) Intentionally left blank —Ed.

(a) Any medical necessity, utilization or other clinical review conducted for the diagnosis, prevention or treatment of behavioral health conditions or relating to service intensity, level of care placement, continued stay or discharge must be based solely on the following:

(A) The current generally accepted standards of care.

(B) For level of care placement decisions, the most recent version of the levels of care placement criteria developed by the nonprofit professional association for the relevant clinical specialty.

(C) For medical necessity, utilization or other clinical review conducted for the diagnosis, prevention or treatment of behavioral health conditions that does not involve level of care placement decisions, other criteria and guidelines may be utilized if such criteria and guidelines are based on the current generally accepted standards of care including valid, evidence-based sources and current treatment criteria or practice guidelines developed by the nonprofit professional association for the relevant clinical specialty. Such other criteria and guidelines must be made publicly available and made available to insureds upon request to the extent permitted by copyright laws.

(b) This subsection does not prevent a group health insurer or an issuer of an individual health benefit plan other than a grandfathered health plan from using criteria that:

(A) Are outside the scope of criteria and guidelines described in paragraph (a)(B) of this subsection, if the guidelines were developed in accordance with the current generally accepted standards of care; or

(B) Are based on advancements in technology of types of care that are not addressed in the most recent versions of sources specified in paragraph (a)(B) of this subsection, if the guidelines were developed in accordance with current generally accepted standards of care.

(c) For all level of care placement decisions, an insurer shall authorize placement at the level of care consistent with the insured’s score or assessment using the relevant level of care placement criteria and guidelines as specified in paragraph (a)(B) of this subsection. If the level of care indicated by the criteria and guidelines is not available, the insurer shall authorize the next higher level of care. If there is disagreement about the appropriate level of care, the insurer shall provide to the provider of the service the full details of the insurer’s scoring or assessment using the relevant level of care placement criteria and guidelines specified in paragraph (a)(B) of this subsection.

(6) To ensure the proper use of any criteria and guidelines described in subsection (5) of this section, a group health insurer or an issuer of an individual health benefit plan shall provide, at no cost:

(a) A formal education program, presented by nonprofit clinical specialty associations or other entities authorized by the department, to educate the insurer’s or the issuer’s staff and any individuals described in subsection (2)(k) of this section who conduct reviews.

(b) To stakeholders, including participating providers and insureds, the criteria and guidelines described in subsection (5) of this section and any education or training materials or resources regarding the criteria and guidelines.

(7) This section does not prevent a group health insurer or issuer of an individual health benefit plan that is not a grandfathered health plan from contracting with providers of health care services to furnish services to policyholders or certificate holders according to ORS 743B.460 (Conditions for restricting payments to only in-network providers) or 750.005 (Definitions) , subject to the following conditions:

(a) A group health insurer or issuer of an individual health benefit plan that is not a grandfathered health plan is not required to contract with all providers that are eligible for reimbursement under this section.

(b) An insurer or health care service contractor shall, subject to subsection (2) of this section, pay benefits toward the covered charges of noncontracting providers of services for behavioral health treatment. The insured shall, subject to subsection (2) of this section, have the right to use the services of a noncontracting provider of behavioral health treatment, whether or not the behavioral health treatment is provided by contracting or noncontracting providers.

(8) Intentionally left blank —Ed.

(a) This section does not require coverage for:

(A) Educational or correctional services or sheltered living provided by a school or halfway house;

(B) A long-term residential mental health program that lasts longer than 45 days unless clinically indicated under criteria and guidelines described in subsection (5) of this section;

(C) Psychoanalysis or psychotherapy received as part of an educational or training program, regardless of diagnosis or symptoms that may be present;

(D) A court-ordered sex offender treatment program; or

(E) Support groups.

(b) Notwithstanding paragraph (a)(A) of this subsection, an insured may receive covered outpatient services under the terms of the insured’s policy while the insured is living temporarily in a sheltered living situation.

(9) The Oregon Health Authority shall establish a process for the certification of an organization described in subsection (1)(j)(F) of this section that:

(a) Is not otherwise subject to licensing or certification by the authority; and

(b) Does not contract with the authority, a subcontractor of the authority or a community mental health program.

(10) The Oregon Health Authority shall adopt by rule standards for the certification provided under subsection (9) of this section to ensure that a certified provider organization offers a distinct and specialized program for the treatment of mental or nervous conditions.

(11) The Oregon Health Authority may adopt by rule an application fee or a certification fee, or both, to be imposed on any provider organization that applies for certification under subsection (9) of this section. Any fees collected shall be paid into the Oregon Health Authority Fund established in ORS 413.101 (Oregon Health Authority Fund) and shall be used only for carrying out the provisions of subsection (9) of this section.

(12) The intent of the Legislative Assembly in adopting this section is to reserve benefits for different types of care to encourage cost effective care and to ensure continuing access to levels of care most appropriate for the insured’s condition and progress in accordance with this section. This section does not prohibit an insurer from requiring a provider organization certified by the Oregon Health Authority under subsection (9) of this section to meet the insurer’s credentialing requirements as a condition of entering into a contract.

(13) The Director of the Department of Consumer and Business Services and the Oregon Health Authority, after notice and hearing, may adopt reasonable rules not inconsistent with this section that are considered necessary for the proper administration of this section. The director shall adopt rules making it a violation of this section for a group health insurer or issuer of an individual health benefit plan other than a grandfathered health plan to require providers to bill using a specific billing code or to restrict the reimbursement paid for particular billing codes other than on the basis of medical necessity.

(14) This section does not:

(a) Prohibit an insured from receiving behavioral health treatment from an out-of-network provider or prevent an out-of-network behavioral health provider from billing the insured for any unreimbursed cost of treatment.

(b) Prohibit the use of value-based payment methods, including global budgets or capitated, bundled, risk-based or other value-based payment methods.

(c) Require that any value-based payment method reimburse behavioral health services based on an equivalent fee-for-service rate. [Formerly 743.556; 2009 c.442 §47; 2009 c.549 §11; 2013 c.375 §1; 2013 c.581 §1; 2013 c.681 §62; 2016 c.11 §7; 2017 c.6 §29; 2017 c.17 §57; 2017 c.273 §5; 2017 c.409 §35; 2019 c.284 §6; 2019 c.285 §5; 2021 c.629 §§5,8]

Note: Section 7, chapter 411, Oregon Laws 1987, provides:

Source: Section 743A.168 — Behavioral health treatment; qualified providers; rules , https://www.­oregonlegislature.­gov/bills_laws/ors/ors743A.­html (accessed May 26, 2025).
ORS § 743b.500 — OR Code / Title 56 / Chapter 743b / Section 743b.500
743B.500 Selling and leasing of provider panels by contracting entity
Status: in_force

As used in this section and ORS 743B.501 (Registration of contracting entity) to 743B.503 (Additional requirements for third party contracts) :

(1) Intentionally left blank —Ed.

(a) “Contracting entity” means any person that contracts directly with a provider for the delivery of health care services or contracts with a third party for the purpose of selling or making available to the third party the provider’s health care services or discounted rates or the services or rates of a provider panel under a provider network contract.

(b) “Contracting entity” includes a person under common ownership and control of a contracting entity.

(c) “Contracting entity” does not include:

(A) A managed care organization that is certified under ORS 656.260 (Certification procedure for managed health care provider) ;

(B) A discount medical plan organization as defined in ORS 735.631 (Definitions for ORS 735.631 to 735.643) ;

(C) The state medical assistance program;

(D) An independent practice association; or

(E) A self-funded, employer-sponsored health insurance plan regulated under the Employee Retirement Income Security Act of 1974, as codified and amended at 29 U.S.C. 1001, et seq., or any person that provides only administrative services to the self-funded employer-sponsored health insurance plan.

(2) “Health care services” means the treatment of humans for bodily injury, disablement or death by accidental means or as a result of sickness or childbirth, or in prevention of sickness, but does not include treatment for bodily injury, disablement or occupational diseases incurred as a result of employment.

(3) “Independent practice association” has the meaning given that term in ORS 743B.001 (Definitions) .

(4) “Person” has the meaning given that term in ORS 731.116 (“Person.”) .

(5) Intentionally left blank —Ed.

(a) “Provider” includes:

(A) A physician as defined in ORS 677.010 (Definitions for chapter) .

(B) A physician group, independent practice association, physician-controlled organization, hospital organization or other provider organization that contracts with a provider for the purpose of facilitating the provider’s participation in a provider network contract.

(C) A person licensed, certified or otherwise authorized or permitted by the laws of this state to administer medical services or mental health services in the ordinary course of business or practice of a profession.

(b) “Provider” does not include a contracting entity.

(6) “Provider network contract” means a contract between a provider and a contracting entity for the provision of health care services to patients other than Medicare enrollees or medical assistance recipients.

(7) Intentionally left blank —Ed.

(a) “Third party” means a person that enters into a contract with a contracting entity or with another party, other than a provider, for the right to exercise the rights of the contracting entity under a provider network contract.

(b) “Third party” includes any of the following:

(A) A payer that directly reimburses the cost of the delivery of health care services;

(B) A third party administrator or other entity that administers or processes claims on behalf of a payer;

(C) A preferred provider organization or network;

(D) A physician-controlled organization or a hospital organization; or

(E) An entity that is engaged in the electronic transmission of claims between a contracting entity and a payer and does not provide to another party access to the health care services and discounted rates of a provider.

(c) “Third party” does not include:

(A) Entities offering health care services under the same brand pursuant to a brand licensing agreement with the same licenser; or

(B) A self-funded, employer-sponsored health insurance plan regulated under the Employee Retirement Income Security Act of 1974, as codified and amended at 29 U.S.C. 1001, et seq., or any person that provides only administrative services to the self-funded employer-sponsored health insurance plan. [Formerly 743.082]

Note: 743B.500 (Selling and leasing of provider panels by contracting entity) , 743B.502 (Third party contracts for leasing of provider panels) and 743B.503 (Additional requirements for third party contracts) were enacted into law by the Legislative Assembly but were not added to or made a part of ORS chapter 743B or any series therein by legislative action. See Preface to Oregon Revised Statutes for further explanation.

Source: Section 743B.500 — Selling and leasing of provider panels by contracting entity; definitions , https://www.­oregonlegislature.­gov/bills_laws/ors/ors743B.­html (accessed May 26, 2025).
ORS § 734.047 — OR Code / Title 56 / Chapter 734 / Section 734.047
734.047 Time for correction of condition leading to order of supervision
Status: in_force

(1) An insurer placed under supervision must correct, eliminate or remedy the acts, transactions or practices that are the basis for the order of supervision and otherwise comply with the requirements of the Director of the Department of Consumer and Business Services within the period of time allowed by the director, not to exceed 60 days, after the date on which the order is served on the insurer.

(2) If the director determines that the conditions giving rise to the supervision still exist at the end of the supervision period established in subsection (1) of this section, the director may extend the period. [1989 c.425 §7; 1993 c.447 §89]

Source: Section 734.047 — Time for correction of condition leading to order of supervision , https://www.­oregonlegislature.­gov/bills_laws/ors/ors734.­html (accessed May 26, 2025).
ORS § 741.310 — OR Code / Title 56 / Chapter 741 / Section 741.310
741.310 Requirements for purchase of insurance through exchange and for participation of insurers in exchange
Status: in_force

(1) Intentionally left blank —Ed.

(a) Individuals and families may purchase qualified health plans through the health insurance exchange.

(b) The following groups may purchase qualified health plans through the Small Business Health Options Program:

(A) Small employers as defined in ORS 743B.005 (Definitions) ; and

(B) Districts and eligible employees of districts that are subject to ORS 243.886 (Limitations on district participation in benefit plans) , unless their participation is precluded by federal law.

(2) Intentionally left blank —Ed.

(a) Only individuals who purchase qualified health plans through the exchange may be eligible to receive premium tax credits under section 36B of the Internal Revenue Code and reduced cost-sharing under 42 U.S.C. 18071.

(b) Only employers that purchase health plans through the SHOP may be eligible to receive small employer health insurance credits under section 45R of the Internal Revenue Code.

(3) Only an insurer that has a certificate of authority to transact insurance in this state and that meets applicable state and federal requirements for participating in the exchange may offer a qualified health plan through the exchange. Any qualified health plan must be certified under ORS 741.002 (Duties, powers and functions of Oregon Health Authority) . Coordinated care organizations that do not have a certificate of authority to transact insurance may serve only medical assistance recipients through the exchange and may not offer qualified health plans.

(4) Intentionally left blank —Ed.

(a) The Oregon Health Authority shall adopt by rule uniform requirements, standards and criteria for the certification of qualified health plans, including requirements that a qualified health plan provide, at a minimum, essential health benefits and have acceptable consumer and provider satisfaction ratings.

(b) The authority may limit the number of qualified health plans that may be offered through the exchange as long as the same limit applies to all insurers.

(5) The authority shall certify as qualified a dental only health plan as permitted by federal law.

(6) The authority, in collaboration with the Department of Human Services, shall coordinate the application and enrollment processes for the exchange and the state medical assistance program.

(7) The authority may establish risk mediation programs within the exchange.

(8) The authority shall establish by rule a process for certifying insurance producers to facilitate the transaction of insurance through the exchange, in accordance with federal standards and policies.

(9) The authority is authorized to enter into contracts for the performance of the authority’s duties, functions or operations with respect to the exchange, including but not limited to contracting with:

(a) Insurers that meet the requirements of subsections (3) and (4) of this section, to offer qualified health plans through the exchange; and

(b) Navigators, in-person assisters and application counselors certified by the authority under ORS 741.002 (Duties, powers and functions of Oregon Health Authority) .

(10) Intentionally left blank —Ed.

(a) The authority shall consult with stakeholders, including but not limited to representatives of school administrators, school board members, school employees and the Oregon Educators Benefit Board, regarding the plans that may be offered through the exchange to districts and eligible employees of districts under subsection (1)(b)(B) of this section and the insurers that may offer the plans.

(b) The board and the authority shall each adopt rules to ensure that:

(A) Any plan offered under subsection (1)(b)(B) of this section is underwritten by an insurer using a single risk pool composed of all eligible employees who are enrolled or who will be enrolled in the plan both through the exchange and by the board; and

(B) In every plan offered under subsection (1)(b)(B) of this section, the coverage is comparable to plans offered by the board.

(11) The authority is authorized to apply for and accept federal grants, other federal funds and grants from nongovernmental organizations for purposes of developing, implementing and administering the exchange. Moneys received under this subsection shall be deposited in the Health Insurance Exchange Fund. [2011 c.415 §11; 2011 c.415 §12; 2012 c.38 §§10,11; 2012 c.107 §§96,97; 2013 c.421 §§1,2; 2015 c.3 §25; 2015 c.792 §§10,11; 2021 c.569 §28]

Source: Section 741.310 — Requirements for purchase of insurance through exchange and for participation of insurers in exchange , https://www.­oregonlegislature.­gov/bills_laws/ors/ors741.­html (accessed May 26, 2025).
ORS § 732.554 — OR Code / Title 56 / Chapter 732 / Section 732.554
732.554 Changes in registration information
Status: in_force

Each registered insurer shall keep current the information required to be disclosed on its registration statement by reporting all material changes or additions on amendment forms prescribed by the Director of the Department of Consumer and Business Services within 15 days after the end of the month in which the insurer learns of each such change or addition. However, except as provided in ORS 732.576 (Dividends and distributions) , each registered insurer shall so report all dividends and other distributions to shareholders within five business days following the declaration thereof and not less than 10 business days prior to payment of the dividends and distributions, commencing from the date of receipt of the report by the director. [Formerly 732.645]

Source: Section 732.554 — Changes in registration information; reports of distributions to shareholders , https://www.­oregonlegislature.­gov/bills_laws/ors/ors732.­html (accessed May 26, 2025).
ORS § 733.575 — OR Code / Title 56 / Chapter 733 / Section 733.575
733.575 Prohibited use of funds as compensating balances
Status: in_force

Except as provided in ORS 733.578 (Conditions necessary for investments used to provide compensating balances) , funds of an insurer shall not be used as compensating balances for loans to other persons, or otherwise pledged for the benefit of other persons. [1975 c.232 §2]

Source: Section 733.575 — Prohibited use of funds as compensating balances , https://www.­oregonlegislature.­gov/bills_laws/ors/ors733.­html (accessed May 26, 2025).
ORS § 732.544 — OR Code / Title 56 / Chapter 732 / Section 732.544
732.544 Director’s order
Status: in_force

(1) Intentionally left blank —Ed.

(a) The Director of the Department of Consumer and Business Services may issue an order with the effect described in paragraph (b) of this subsection if the director determines that an acquisition may substantially diminish competition in a line of insurance in this state or may tend to create a monopoly or if the director determines that a party to an acquisition has violated a provision of ORS 732.539 (Notification of acquisition) . The director shall issue the order together with findings of fact and conclusions of law that support the order.

(b) An order issued under paragraph (a) of this subsection may:

(A) Require an insurer to cease and desist from transacting insurance in this state in the line of insurance the director identifies in the director’s determination under paragraph (a) of this subsection; or

(B) Deny an application from an insurer for a certificate of authority to transact insurance in this state.

(2) The director may not issue an order under subsection (1) of this section unless the director:

(a) Provides a hearing to the person that will be subject to the order;

(b) Notifies the person of the impending order and the hearing within 30 days after the date on which the person submitted the notice described in ORS 732.539 (Notification of acquisition) and not less than 15 days before the date of the hearing; and

(c) Completes the hearing and issues the order not later than 60 days after the date on which the person submitted the notice described in ORS 732.539 (Notification of acquisition) .

(3) An order issued under subsection (1) of this section does not apply if an acquisition that is the subject of the order does not proceed.

(4) A person that violates an order issued under subsection (1) of this section may be subject to:

(a) A civil penalty under ORS 731.988 (Civil penalties) ; or

(b) A suspension or revocation of the person’s certificate of authority.

(5) Notwithstanding ORS 732.547 (Remedies for violation of ORS 732.517 to 732.546) (4), ORS 732.547 (Remedies for violation of ORS 732.517 to 732.546) (2) and (3) and 732.588 (Supervision, rehabilitation or liquidation) do not apply to an acquisition concerning which the director has issued an order under subsection (1) of this section. [2013 c.370 §8]

Source: Section 732.544 — Director’s order; effect; requirements for issuing; penalties , https://www.­oregonlegislature.­gov/bills_laws/ors/ors732.­html (accessed May 26, 2025).
ORS § 734.670 — OR Code / Title 56 / Chapter 734 / Section 734.670
734.670 Exemption of association from payment of fees and taxes
Status: in_force

Except for taxes levied on real or personal property, the Oregon Insurance Guaranty Association shall be exempt from the payment of all fees and taxes levied by this state or by any city, county, district or other political subdivision of this state. [1971 c.616 §19]

Source: Section 734.670 — Exemption of association from payment of fees and taxes , https://www.­oregonlegislature.­gov/bills_laws/ors/ors734.­html (accessed May 26, 2025).
ORS § 748.144 — OR Code / Title 56 / Chapter 748 / Section 748.144
748.144 Creation and operation of other organizations and entities
Status: in_force

(1) A society may create, maintain and operate, or may establish organizations to operate, not-for-profit institutions to further the purposes permitted by ORS 748.121 (Purposes, operation and powers) (2)(b). Such institutions may furnish services free or at a reasonable charge. Any real or personal property owned, held or leased by the society for this purpose shall be reported in every annual statement.

(2) No society shall own or operate funeral homes or undertaking establishments. [1987 c.490 §13]

Source: Section 748.144 — Creation and operation of other organizations and entities , https://www.­oregonlegislature.­gov/bills_laws/ors/ors748.­html (accessed May 26, 2025).
ORS § 742.009 — OR Code / Title 56 / Chapter 742 / Section 742.009
742.009 Regulation of sales material
Status: in_force

(1) The Director of the Department of Consumer and Business Services, if the director considers it necessary, may require the filing by an insurer or insurance producer of any sales presentation material for use in the sale or the presentation for sale of any policy. The director, within 60 days after the filing of the sales presentation material, shall disapprove any such sales presentation material if the director finds that, in whole or in part, it is false, deceptive or misleading. Upon disapproval, such sales presentation material shall not be made, issued, circulated, displayed or given other use by the insurer or by insurance producers.

(2) The director, by rule, shall require any insurance producer who sells or attempts to sell insurance to provide to each prospective insured such information as the director considers necessary to adequately inform the prospective insured regarding the insurance transaction. [Formerly 743.021; 2003 c.364 §100]

Source: Section 742.009 — Regulation of sales material; rules , https://www.­oregonlegislature.­gov/bills_laws/ors/ors742.­html (accessed May 26, 2025).
ORS § 742.028 — OR Code / Title 56 / Chapter 742 / Section 742.028
742.028 Additional policy contents
Status: in_force

A policy may contain additional provisions not inconsistent with the Insurance Code and which are:

(1) Required to be inserted by the laws of the insurer’s domicile;

(2) Necessary, on account of the manner in which the insurer is constituted or operated, in order to state the rights and obligations of the parties to the contract; or

(3) Desired by the insurer and neither prohibited by law nor in conflict with any provisions required to be included therein. [Formerly 743.060]

Source: Section 742.028 — Additional policy contents , https://www.­oregonlegislature.­gov/bills_laws/ors/ors742.­html (accessed May 26, 2025).
ORS § 731.136 — OR Code / Title 56 / Chapter 731 / Section 731.136
731.136 “State.”
Status: in_force

When used in context signifying a jurisdiction other than the State of Oregon, “state” means any state, district, territory, commonwealth or possession of the United States of America. [1967 c.359 §28; 2001 c.191 §22]

Source: Section 731.136 — “State.” , https://www.­oregonlegislature.­gov/bills_laws/ors/ors731.­html (accessed May 26, 2025).
ORS § 743.228 — OR Code / Title 56 / Chapter 743 / Section 743.228
743.228 Acts of corporate insured or beneficiary with respect to policy
Status: in_force

(1) Whenever a corporation organized under the laws of this state or qualified to do business in this state has caused to be insured the life of any director, officer, agent or employee, or whenever such corporation is named as a beneficiary in or assignee of any life insurance policy, due authority to effect, assign, release, relinquish, convert, surrender, change the beneficiary or take any other or different action with reference to such insurance shall be sufficiently evidenced to the insurer by a written statement under oath showing that such action has been approved by a majority of the board of directors. Such a statement shall be signed by the president and secretary of the corporation and bear the corporate seal.

(2) Such a statement shall be binding upon the corporation and shall protect the insurer concerned in any act done or suffered by it upon the faith thereof without further inquiry into the validity of the corporate authority or the regularity of the corporate proceedings.

(3) No person shall be disqualified by reason of interest in the subject matter from acting as a director or as a member of the executive committee of such a corporation on any corporate act touching such insurance. [Formerly 739.415]

Source: Section 743.228 — Acts of corporate insured or beneficiary with respect to policy , https://www.­oregonlegislature.­gov/bills_laws/ors/ors743.­html (accessed May 26, 2025).
ORS § 746.085 — OR Code / Title 56 / Chapter 746 / Section 746.085
746.085 Regulating replacement of life insurance
Status: in_force

In addition to all other powers of the Director of the Department of Consumer and Business Services with respect thereto, the director may issue rules:

(1) Requiring persons who replace, or offer or propose to replace, existing life insurance, to leave with the policyholder written, signed and dated statements which fully and correctly compare the terms, conditions and benefits of an existing policy with the proposed policy; and

(2) Limiting the commission or compensation payable to an insurance producer on account of a life insurance policy that provides a nonforfeiture value sold to replace an existing life insurance policy that provides a nonforfeiture value to the commission or compensation the insurance producer would have received if both the replaced and the replacement insurance policies had been carried by the insurer which issues the replacement policy. [1967 c.359 §575; 1971 c.231 §35; 2003 c.364 §137]

Source: Section 746.085 — Regulating replacement of life insurance; compensation of insurance producers; rules , https://www.­oregonlegislature.­gov/bills_laws/ors/ors746.­html (accessed May 26, 2025).
ORS § 743a.067 — OR Code / Title 56 / Chapter 743a / Section 743a.067
743A.067 Reproductive health services
Status: in_force

(1) As used in this section:

(a) “Contraceptives” means health care services, drugs, devices, products or medical procedures to prevent a pregnancy.

(b) “Enrollee” means an insured individual and the individual’s spouse, domestic partner and dependents who are beneficiaries under the insured individual’s health benefit plan.

(c) “Health benefit plan” has the meaning given that term in ORS 743B.005 (Definitions) , excluding Medicare Advantage Plans and including health benefit plans offering pharmacy benefits administered by a third party administrator or pharmacy benefit manager.

(d) “Prior authorization” has the meaning given that term in ORS 743B.001 (Definitions) .

(e) “Religious employer” has the meaning given that term in ORS 743A.066 (Contraceptives) .

(f) “Utilization review” has the meaning given that term in ORS 743B.001 (Definitions) .

(2) A health benefit plan offered in this state must provide coverage for all of the following services, drugs, devices, products and procedures:

(a) Well-woman care prescribed by the Department of Consumer and Business Services by rule consistent with guidelines published by the United States Health Resources and Services Administration.

(b) Counseling for sexually transmitted infections, including but not limited to human immunodeficiency virus and acquired immune deficiency syndrome.

(c) Screening for:

(A) Chlamydia;

(B) Gonorrhea;

(C) Hepatitis B;

(D) Hepatitis C;

(E) Human immunodeficiency virus and acquired immune deficiency syndrome;

(F) Human papillomavirus;

(G) Syphilis;

(H) Anemia;

(I) Urinary tract infection;

(J) Pregnancy;

(K) Rh incompatibility;

(L) Gestational diabetes;

(M) Osteoporosis;

(N) Breast cancer; and

(O) Cervical cancer.

(d) Screening to determine whether counseling related to the BRCA1 or BRCA2 genetic mutations is indicated and counseling related to the BRCA1 or BRCA2 genetic mutations if indicated.

(e) Screening and appropriate counseling or interventions for:

(A) Tobacco use; and

(B) Domestic and interpersonal violence.

(f) Folic acid supplements.

(g) Abortion.

(h) Breastfeeding comprehensive support, counseling and supplies.

(i) Breast cancer chemoprevention counseling.

(j) Any contraceptive drug, device or product approved by the United States Food and Drug Administration, subject to all of the following:

(A) If there is a therapeutic equivalent of a contraceptive drug, device or product approved by the United States Food and Drug Administration, a health benefit plan may provide coverage for either the requested contraceptive drug, device or product or for one or more therapeutic equivalents of the requested drug, device or product.

(B) If a contraceptive drug, device or product covered by the health benefit plan is deemed medically inadvisable by the enrollee’s provider, the health benefit plan must cover an alternative contraceptive drug, device or product prescribed by the provider.

(C) A health benefit plan must pay pharmacy claims for reimbursement of all contraceptive drugs available for over-the-counter sale that are approved by the United States Food and Drug Administration.

(D) A health benefit plan may not infringe upon an enrollee’s choice of contraceptive drug, device or product and may not require prior authorization, step therapy or other utilization review techniques for medically appropriate covered contraceptive drugs, devices or other products approved by the United States Food and Drug Administration.

(k) Voluntary sterilization.

(L) As a single claim or combined with other claims for covered services provided on the same day:

(A) Patient education and counseling on contraception and sterilization.

(B) Services related to sterilization or the administration and monitoring of contraceptive drugs, devices and products, including but not limited to:

(i) Management of side effects;

(ii) Counseling for continued adherence to a prescribed regimen;

(iii) Device insertion and removal; and

(iv) Provision of alternative contraceptive drugs, devices or products deemed medically appropriate in the judgment of the enrollee’s provider.

(m) Any additional preventive services for women that must be covered without cost sharing under 42 U.S.C. 300gg-13, as identified by the United States Preventive Services Task Force or the Health Resources and Services Administration of the United States Department of Health and Human Services as of January 1, 2017.

(3) A health benefit plan may not impose on an enrollee a deductible, coinsurance, copayment or any other cost-sharing requirement on the coverage required by this section. A health care provider shall be reimbursed for providing the services described in this section without any deduction for coinsurance, copayments or any other cost-sharing amounts.

(4) Except as authorized under this section, a health benefit plan may not impose any restrictions or delays on the coverage required by this section.

(5) This section does not exclude coverage for contraceptive drugs, devices or products prescribed by a provider, acting within the provider’s scope of practice, for:

(a) Reasons other than contraceptive purposes, such as decreasing the risk of ovarian cancer or eliminating symptoms of menopause; or

(b) Contraception that is necessary to preserve the life or health of an enrollee.

(6) This section does not limit the authority of the Department of Consumer and Business Services to ensure compliance with ORS 743A.063 (Ninety-day supply of prescription drug refills) and 743A.066 (Contraceptives) .

(7) This section does not require a health benefit plan to cover:

(a) Experimental or investigational treatments;

(b) Clinical trials or demonstration projects, except as provided in ORS 743A.192 (Clinical trials) ;

(c) Treatments that do not conform to acceptable and customary standards of medical practice;

(d) Treatments for which there is insufficient data to determine efficacy; or

(e) Abortion if the insurer offering the health benefit plan:

(A) Has a certificate of authority to transact insurance in this state issued by the Department of Consumer and Business Services; and

(B) Excluded coverage for abortion in all of its individual, small employer and large employer group plans during the 2017 plan year.

(8) If services, drugs, devices, products or procedures required by this section are provided by an out-of-network provider, the health benefit plan must cover the services, drugs, devices, products or procedures without imposing any cost-sharing requirement on the enrollee if:

(a) There is no in-network provider to furnish the service, drug, device, product or procedure that is geographically accessible or accessible in a reasonable amount of time, as defined by the Department of Consumer and Business Services by rule consistent with the requirements for provider networks in ORS 743B.505 (Provider networks) ; or

(b) An in-network provider is unable or unwilling to provide the service in a timely manner.

(9) An insurer may offer to a religious employer a health benefit plan that does not include coverage for contraceptives or abortion procedures that are contrary to the religious employer’s religious tenets only if the insurer notifies in writing all employees who may be enrolled in the health benefit plan of the contraceptives and procedures the employer refuses to cover for religious reasons.

(10) If the Department of Consumer and Business Services concludes that enforcement of this section may adversely affect the allocation of federal funds to this state, the department may grant an exemption to the requirements but only to the minimum extent necessary to ensure the continued receipt of federal funds.

(11) An insurer that is subject to this section shall make readily accessible to enrollees and potential enrollees, in a consumer-friendly format, information about the coverage of contraceptives by each health benefit plan and the coverage of other services, drugs, devices, products and procedures described in this section. The insurer must provide the information:

(a) On the insurer’s website; and

(b) In writing upon request by an enrollee or potential enrollee.

(12) This section does not prohibit an insurer from using reasonable medical management techniques to determine the frequency, method, treatment or setting for the coverage of services, drugs, devices, products and procedures described in subsection (2) of this section, other than coverage required by subsection (2)(g) and (j) of this section, if the techniques:

(a) Are consistent with the coverage requirements of subsection (2) of this section; and

(b) Do not result in the wholesale or indiscriminate denial of coverage for a service.

(13) This section is exempt from ORS 743A.001 (Automatic repeal of certain statutes on individual and group health insurance) . [2017 c.721 §2; 2019 c.284 §5; 2022 c.45 §12; 2023 c.228 §12]

Note: 743A.067 (Reproductive health services) was added to and made a part of the Insurance Code by legislative action but was not added to ORS chapter 743A or any series therein. See Preface to Oregon Revised Statutes for further explanation.

Source: Section 743A.067 — Reproductive health services , https://www.­oregonlegislature.­gov/bills_laws/ors/ors743A.­html (accessed May 26, 2025).
ORS § 743.477 — OR Code / Title 56 / Chapter 743 / Section 743.477
743.477 Illegal occupation
Status: in_force

A health insurance policy may contain a provision as follows: “ILLEGAL OCCUPATION: The insurer shall not be liable for any loss to which a contributing cause was the insured’s commission of or attempt to commit a felony or to which a contributing cause was the insured’s being engaged in an illegal occupation.” [1967 c.359 §451]

Source: Section 743.477 — Illegal occupation , https://www.­oregonlegislature.­gov/bills_laws/ors/ors743.­html (accessed May 26, 2025).
ORS § 732.539 — OR Code / Title 56 / Chapter 732 / Section 732.539
732.539 Notification of acquisition
Status: in_force

(1) Intentionally left blank —Ed.

(a) A person that proposes to acquire another person, or the person that would be subject to the acquisition, must notify the Director of the Department of Consumer and Business Services and wait for the period of time specified in subsection (3) of this section before completing the acquisition. The director shall treat a notice and information that a person submits in accordance with this section as confidential and as exempt from disclosure under ORS 192.311 (Definitions for ORS 192.311 to 192.478) to 192.478 (Exemption for Judicial Department) .

(b) A person that completes an acquisition without notifying the director as provided in this subsection may be subject to an order from the director under ORS 732.544 (Director’s order) .

(2) The director by rule shall prescribe the form and content of the notice that a person must submit under subsection (1) of this section and, in prescribing the form and content of the notice, shall consider the form and content of the notice that the National Association of Insurance Commissioners prescribes for markets in which, under ORS 732.537 (Application of ORS 732.527, 732.539, 732.542 and 732.544 to change of control of insurer) (2), completing an acquisition requires submitting a notice under this section. The director may require any additional information the director deems necessary to determine under ORS 732.542 (Monopoly or substantial diminishment of competition) whether the acquisition may substantially diminish competition in a line of insurance in this state or may tend to create a monopoly. The additional information may include an opinion from an economist that assesses what competitive impact the acquisition may have in this state. A person that submits an economist’s opinion under this subsection shall also submit a summary of the economist’s education and experience that reflect the economist’s ability to render an informed opinion.

(3) Intentionally left blank —Ed.

(a) A person may not proceed with an acquisition until 30 days after the director receives the notice under subsection (1) of this section, unless the director permits the acquisition to proceed earlier.

(b) During the period of time described in paragraph (a) of this subsection, the director may, only once, require the person to submit additional information related to the acquisition. If the director requires additional information, the person may not proceed with the acquisition until 30 days after the director receives the additional information, unless the director permits the acquisition to proceed earlier. [2013 c.370 §6]

Source: Section 732.539 — Notification of acquisition; confidentiality; order; rules; required information; waiting period , https://www.­oregonlegislature.­gov/bills_laws/ors/ors732.­html (accessed May 26, 2025).
ORS § 743a.068 — OR Code / Title 56 / Chapter 743a / Section 743a.068
743A.068 Orally administered anticancer medication
Status: in_force

(1) A health benefit plan that provides coverage for cancer chemotherapy treatment must provide coverage for a prescribed, orally administered anticancer medication used to kill or slow the growth of cancerous cells on a basis no less favorable than intravenously administered or injected cancer medications that are covered as medical benefits.

(2) As used in this section, “health benefit plan” has the meaning given that term in ORS 743B.005 (Definitions) .

(3) The provisions of ORS 743A.001 (Automatic repeal of certain statutes on individual and group health insurance) do not apply to this section. [2007 c.566 §2]

Note: 743A.068 (Orally administered anticancer medication) was added to and made a part of the Insurance Code by legislative action but was not added to ORS chapter 743A or any series therein. See Preface to Oregon Revised Statutes for further explanation.

Source: Section 743A.068 — Orally administered anticancer medication , https://www.­oregonlegislature.­gov/bills_laws/ors/ors743A.­html (accessed May 26, 2025).
ORS § 742.048 — OR Code / Title 56 / Chapter 742 / Section 742.048
742.048 Effective date and time of coverage
Status: in_force

(1) Except as provided in subsections (2), (4) and (5) of this section, every policy of insurance shall contain a provision stating that coverage commences at 12:01 a.m. of the date upon which the insurance takes effect.

(2) A policy of insurance may provide that the time at which coverage commences shall not be prior to the time at which the policy of insurance is applied for.

(3) Any statement of time in a policy shall mean time according to the legal standard of time in effect:

(a) If the policy insures real property, at the location of such property; or

(b) If the policy does not insure real property, at the principal place of business within Oregon of the insured; or, if the insured has no place of business within Oregon, at the residence within Oregon of the insured.

(4) A binder or other contract for temporary insurance may commence coverage at an hour different from 12:01 a.m. in order to provide coverage from the agreed hour of commencement of coverage to 12:01 a.m. of the date on which the written policy as to which such binder or other contract was issued takes effect.

(5) This section does not apply to life, health, mortgage, title, surety or wet marine and transportation insurance. [Formerly 743.080]

Source: Section 742.048 — Effective date and time of coverage; applicability , https://www.­oregonlegislature.­gov/bills_laws/ors/ors742.­html (accessed May 26, 2025).
ORS § 732.689 — OR Code / Title 56 / Chapter 732 / Section 732.689
732.689 Retention of consultant to assist director’s review of corporate governance annual disclosure
Status: in_force

(1) Intentionally left blank —Ed.

(a) The Director of the Department of Consumer and Business Services, at the expense of the insurer or insurance group from which the director receives a corporate governance annual disclosure, may retain a consultant, including an attorney, actuary, accountant or other expert, whenever the director reasonably requires assistance to review the corporate governance annual disclosure or related information and to evaluate the insurer’s or insurance group’s compliance with this section and ORS 732.680 (Submission of corporate governance annual disclosure) , 732.683 (Discretion as to form and content of responses to inquiries in corporate governance annual disclosure) and 732.686 (Maintenance of confidentiality and privilege) .

(b) A consultant that the director retains under paragraph (a) of this subsection shall:

(A) Act solely under the director’s supervision;

(B) Serve only in an advisory capacity; and

(C) Comply with the requirements for confidentiality set forth for the director in ORS 732.686 (Maintenance of confidentiality and privilege) .

(2) The director may not retain a consultant unless the consultant demonstrates to the director that the consultant:

(a) Does not have a conflict of interest; and

(b) Has internal procedures that enable the consultant to:

(A) Monitor and avoid conflicts of interest; and

(B) Comply with the requirements for confidentiality set forth for the director in ORS 732.686 (Maintenance of confidentiality and privilege) .

(3) The director shall enter into a written agreement with a consultant that the director retains under subsection (1) of this section, or with the National Association of Insurance Commissioners if the director consults with the association, that specifies how the consultant or association may share and use documents, materials or other information described in ORS 732.686 (Maintenance of confidentiality and privilege) (1)(a). The terms of the agreement must require the consultant or association to obtain written permission from the insurer or insurance group that is the source or subject of the documents, materials or other information before making the documents, materials or other information public and must specify:

(a) Procedures and protocols for keeping the documents, materials and other information secure and confidential;

(b) Conditions under which the consultant or the association may share the documents, materials or other information, including requirements that the recipient of the documents, materials or other information must:

(A) Agree in writing to keep the documents, materials and other information secure and confidential; and

(B) Verify in writing that the consultant or association has legal authority to keep the documents, materials or other information secure and confidential;

(c) That the consultant or association may share the documents, materials and other information only with regulatory agencies in states that are domiciles of the insurer that is the source or subject of the documents, materials or other information or of an insurer within the insurance group that is the source or subject of the documents, materials or other information;

(d) That the director retains ownership and control of the documents, materials or other information and that the consultant or association may use the documents, materials or other information only in accordance with the director’s specifications or under the director’s supervision;

(e) That the consultant or association may not store the documents, materials or other information in a permanent database or another form after the consultant or association completes the consultation or finishes assisting the director;

(f) That the consultant or association must immediately notify the director and the insurer or insurance group that is the source or subject of the documents, materials or other information if the consultant or association receives a subpoena or other request to disclose or produce the documents, materials or other information; and

(g) That the consultant or association agrees to permit the insurer or insurance group that is the source or subject of the documents, materials or other information to intervene in any administrative or judicial proceeding that might require the consultant or association to disclose or produce the documents, materials or other information. [2017 c.479 §8]

Note: See note under 732.650 (Definitions) .

PRODUCER-CONTROLLED PROPERTY AND CASUALTY INSURERS

Source: Section 732.689 — Retention of consultant to assist director’s review of corporate governance annual disclosure; consultant’s qualifications and duties; agreement with consultant , https://www.­oregonlegislature.­gov/bills_laws/ors/ors732.­html (accessed May 26, 2025).
ORS § 743.379 — OR Code / Title 56 / Chapter 743 / Section 743.379
743.379 Status of remuneration to creditor
Status: in_force

Notwithstanding the provisions of any other law of this state which may expressly or by construction provide otherwise, any commission or service fee or other benefit or return to any creditor arising out of the sale or provision of credit life and credit health insurance shall not be deemed interest or charges in connection with loans or credit transactions. [Formerly 739.603 and then 743.585]

Source: Section 743.379 — Status of remuneration to creditor , https://www.­oregonlegislature.­gov/bills_laws/ors/ors743.­html (accessed May 26, 2025).
ORS § 744.578 — OR Code / Title 56 / Chapter 744 / Section 744.578
744.578 Licensee’s place of business
Status: in_force

(1) Intentionally left blank —Ed.

(a) A licensee that is a resident shall maintain a principal place of business in this state in which the licensee engages in business as an adjuster. The principal place of business may be the licensee’s residence, but the principal place of business must be accessible to the public.

(b) If a licensee that is not a resident has a place of business in this state in which the licensee transacts insurance, the place of business is the licensee’s principal place of business in this state.

(2) A licensee shall keep at the licensee’s place of business all of the usual and customary records for the business in which the licensee engages and must make the records available to the Director of the Department of Consumer and Business Services for inspection during business hours. The licensee shall keep the records of each business transaction for three years after the conclusion of the transaction. [2019 c.151 §8]

Source: Section 744.578 — Licensee’s place of business , https://www.­oregonlegislature.­gov/bills_laws/ors/ors744.­html (accessed May 26, 2025).
ORS § 735.536 — OR Code / Title 56 / Chapter 735 / Section 735.536
735.536 Requirements for pharmacy benefit manager’s reimbursement for cost of drugs
Status: in_force

(1) As used in this section, “out-of-pocket cost” means the amount paid by an enrollee under the enrollee’s coverage, including deductibles, copayments, coinsurance or other expenses as prescribed by the Department of Consumer and Business Services by rule.

(2) A pharmacy benefit manager registered under ORS 735.532 (Registration of pharmacy benefit managers) :

(a) May not require a prescription to be filled or refilled by a mail order pharmacy as a condition for reimbursing the cost of the drug.

(b) Except as provided in paragraph (c) of this subsection, may require a prescription for a specialty drug to be filled or refilled at a specialty pharmacy as a condition for the reimbursement of the cost of a drug.

(c) Shall reimburse the cost of a specialty drug that is filled or refilled at a network pharmacy that is a long term care pharmacy.

(d) Intentionally left blank —Ed.

(A) Shall allow a network pharmacy to mail, ship or deliver prescription drugs to its patients as an ancillary service.

(B) Is not required to reimburse a delivery fee charged by a pharmacy for a delivery described in subparagraph (A) of this paragraph unless the fee is specified in the contract between the pharmacy benefit manager and the pharmacy.

(e) May not require a patient signature as proof of delivery of a mailed or shipped prescription drug if the network pharmacy:

(A) Intentionally left blank —Ed.

(i) Maintains a mailing or shipping log signed by a representative of the pharmacy; or

(ii) Maintains each notification of delivery provided by the United States Postal Service or a package delivery service; and

(B) Is responsible for the cost of mailing, shipping or delivering a replacement for a drug that was mailed or shipped but not received by the enrollee.

(f) May not penalize a network pharmacy for or otherwise directly or indirectly prevent a network pharmacy from informing an enrollee of the difference between the out-of-pocket cost to the enrollee to purchase a prescription drug using the enrollee’s pharmacy benefit and the pharmacy’s usual and customary charge for the prescription drug.

(3) The Department of Consumer and Business Services may adopt rules to carry out the provisions of this section. [2019 c.526 §2]

Note: See note under 735.530 (Definitions for ORS 735.530 to 735.552) .

Source: Section 735.536 — Requirements for pharmacy benefit manager’s reimbursement for cost of drugs; rules , https://www.­oregonlegislature.­gov/bills_laws/ors/ors735.­html (accessed May 26, 2025).
ORS § 748.414 — OR Code / Title 56 / Chapter 748 / Section 748.414
748.414 Funds exempt from certain taxes
Status: in_force

Every society organized or licensed under this chapter is hereby declared to be a charitable and benevolent institution, and all of its funds shall be exempt from all and every state, county, district, municipal and school tax, other than taxes on real estate and office equipment. [1987 c.490 §24]

Source: Section 748.414 — Funds exempt from certain taxes , https://www.­oregonlegislature.­gov/bills_laws/ors/ors748.­html (accessed May 26, 2025).
ORS § 731.304 — OR Code / Title 56 / Chapter 731 / Section 731.304
731.304 Investigation of persons transacting insurance
Status: in_force

The Director of the Department of Consumer and Business Services, whenever the director deems it advisable in the interest of policyholders or for the public good, shall investigate into the affairs of any person engaged in, proposing to engage in or claiming or advertising to engage in:

(1) Transacting insurance in this state;

(2) Organizing or receiving subscriptions for or disposing of the stock of or in any manner taking part in the formation or business of an insurer; or

(3) Holding capital stock of one or more insurers for the purpose of controlling the management thereof as voting trustee or otherwise. [1967 c.359 §69]

Source: Section 731.304 — Investigation of persons transacting insurance , https://www.­oregonlegislature.­gov/bills_laws/ors/ors731.­html (accessed May 26, 2025).
ORS § 731.482 — OR Code / Title 56 / Chapter 731 / Section 731.482
731.482 Withdrawal from, failure to renew or cancellation of line by commercial liability insurer
Status: in_force

(1) Except as provided in subsection (5) of this section, an insurance company selling commercial liability insurance and authorized to do business in Oregon may not withdraw from, fail to renew or cancel any line of insurance or class of business without supplying appropriate written justification to the Director of the Department of Consumer and Business Services.

(2) Justification for withdrawal, failure to renew or cancellation may include, but need not be limited to:

(a) Insufficient premium income;

(b) Loss experience or expectation of future loss in the particular line of insurance or class of business;

(c) Necessity for uncompetitive or uneconomic rate increases;

(d) Increased hazard in the risks assumed or material change in the line of insurance or class of business that could not have been reasonably contemplated by the insurance company at the time the company began selling the line of insurance or class of business in Oregon; or

(e) Change in the availability or costs of reinsurance.

(3) The director shall issue an order approving or disapproving the withdrawal from, failure to renew or cancellation of a line of insurance or class of business.

(4) An order issued under this section shall include a provision requiring the insurer to notify affected insureds at least 60 days before the effective date of any withdrawal, failure to renew or cancellation approved by the director.

(5) This section does not apply to a surplus lines insurer. [1987 c.774 §34]

Source: Section 731.482 — Withdrawal from, failure to renew or cancellation of line by commercial liability insurer , https://www.­oregonlegislature.­gov/bills_laws/ors/ors731.­html (accessed May 26, 2025).
ORS § 735.186 — OR Code / Title 56 / Chapter 735 / Section 735.186
735.186 Management of assets of captive reinsurer
Status: in_force

At least 35 percent of the assets of a captive reinsurer must be managed by an asset manager domiciled in this state. [2012 c.84 §20]

Note: See note under 735.150 (Definitions for ORS 735.150 to 735.190) .

Source: Section 735.186 — Management of assets of captive reinsurer , https://www.­oregonlegislature.­gov/bills_laws/ors/ors735.­html (accessed May 26, 2025).
ORS § 732.547 — OR Code / Title 56 / Chapter 732 / Section 732.547
732.547 Remedies for violation of ORS 732.517 to 732.546
Status: in_force

(1) Whenever it appears to the Director of the Department of Consumer and Business Services that any person has committed or is about to commit a violation of any provision of ORS 732.517 (Purpose of ORS 732.517 to 732.546) to 732.546 (Severability) or of any rule or order issued by the director under ORS 732.517 (Purpose of ORS 732.517 to 732.546) to 732.546 (Severability) , the director may apply to the Circuit Court for Marion County for an order enjoining the person, and any director, officer, employee or agent of the person, from the violation, and for such other equitable relief as the nature of the case and the interests of the policyholders, creditors and shareholders of any insurer or the public may require.

(2) No security that is the subject of any agreement or arrangement regarding acquisition, or that is acquired or to be acquired, in contravention of ORS 732.517 (Purpose of ORS 732.517 to 732.546) to 732.546 (Severability) or of any rule or order issued by the director under ORS 732.517 (Purpose of ORS 732.517 to 732.546) to 732.546 (Severability) , may be voted at any shareholder’s meeting, or may be counted for quorum purposes, and any action of shareholders requiring the affirmative vote of a percentage of shares may be taken as though such securities were not issued and outstanding. However, no action taken at any such meeting shall be invalidated by the voting of such securities unless the action would materially affect control of the insurer or unless the courts of this state have so ordered. If an insurer or the director has reason to believe that any security of the insurer has been or is about to be acquired in contravention of ORS 732.517 (Purpose of ORS 732.517 to 732.546) to 732.546 (Severability) or any rule or order issued by the director under ORS 732.517 (Purpose of ORS 732.517 to 732.546) to 732.546 (Severability) , the insurer or the director may apply to the Circuit Court for Marion County, or to the circuit court for the county in which the insurer has its principal place of business in this state, if any, to enjoin the violation, to enjoin the voting of any security so acquired, to void any vote of such security already cast at any meeting of shareholders, and for such other equitable relief as the nature of the case and the interests of the insurer’s policyholders, creditors and shareholders or the public may require.

(3) In any case in which a person has acquired or is proposing to acquire any voting securities of an insurer in violation of ORS 732.517 (Purpose of ORS 732.517 to 732.546) to 732.546 (Severability) or any rule or order issued by the director under ORS 732.517 (Purpose of ORS 732.517 to 732.546) to 732.546 (Severability) , the Circuit Court for Marion County, or the circuit court for the county in which the insurer has its principal place of business in this state, if any, upon the application of the insurer or the director and on such notice as the court deems appropriate, may seize or sequester any voting securities of the insurer owned directly or indirectly by the person, and issue any order with respect to the voting securities as may be appropriate to effect the provisions of ORS 732.517 (Purpose of ORS 732.517 to 732.546) to 732.546 (Severability) . Notwithstanding any other provision of law, for the purposes of this section, the situs of the ownership of the securities of domestic insurers is located in this state.

(4) The director may exercise remedies available under this section in addition to or in lieu of any other remedy or administrative action available to the director under the Insurance Code. [Formerly 732.543]

Source: Section 732.547 — Remedies for violation of ORS 732.517 to 732.546 , https://www.­oregonlegislature.­gov/bills_laws/ors/ors732.­html (accessed May 26, 2025).
ORS § 746.670 — OR Code / Title 56 / Chapter 746 / Section 746.670
746.670 Investigatory powers
Status: in_force

(1) The Director of the Department of Consumer and Business Services may examine and investigate into the affairs of any insurer or insurance producer transacting insurance in this state to determine whether it has been or is engaged in any conduct in violation of ORS 746.600 (Definitions for ORS 746.600 to 746.690) to 746.690 (Obtaining information under false pretenses prohibited) .

(2) The director may examine and investigate into the affairs of any insurance-support organization acting on behalf of an insurer or insurance producer which either transacts insurance in this state or transacts insurance outside this state which has an effect on a person residing in this state, in order to determine whether the insurance-support organization has been or is engaged in any conduct in violation of ORS 746.600 (Definitions for ORS 746.600 to 746.690) to 746.690 (Obtaining information under false pretenses prohibited) . [1981 c.649 §16; 1987 c.490 §54; 2003 c.87 §17; 2003 c.364 §164]

Source: Section 746.670 — Investigatory powers , https://www.­oregonlegislature.­gov/bills_laws/ors/ors746.­html (accessed May 26, 2025).
ORS § 735.215 — OR Code / Title 56 / Chapter 735 / Section 735.215
735.215 Findings prior to formation of joint underwriting association
Status: in_force

(1) The Director of the Department of Consumer and Business Services may mandate the formation of a joint underwriting association under ORS 735.220 (Formation of joint underwriting association) if after directing the formation of a market assistance plan and allowing it a reasonable time to alleviate insurance availability problems, the director finds that:

(a) There exist in Oregon certain businesses or service providers for which no commercial liability insurance is available; and

(b) There is a need in Oregon for the goods or services provided by these businesses or service providers and the lack of available commercial liability insurance will cause a substantial number of the entities to cease operations within the state.

(2) Notwithstanding subsection (1) of this section, if the lack of availability of insurance is due to legitimate insurance underwriting considerations, including past claims experience, licensing noncompliance or inadequate risk management, formation of a joint underwriting association shall not be appropriate.

(3) The director may make the findings required under subsection (1) of this section only after conducting a public hearing according to the applicable provisions of ORS chapter 183. The director must specify the specific classes of business or lines of insurance determined to be unavailable.

(4) At least once each year, the director shall hold a public hearing to determine if the classes of business or lines of insurance offered by the joint underwriting association are still unavailable in the voluntary insurance market. If any class or line is found to be available, the joint underwriting association shall cease to underwrite such class of business or line of insurance. [1987 c.774 §76]

Source: Section 735.215 — Findings prior to formation of joint underwriting association; hearing , https://www.­oregonlegislature.­gov/bills_laws/ors/ors735.­html (accessed May 26, 2025).
ORS § 743.686 — OR Code / Title 56 / Chapter 743 / Section 743.686
743.686 Right to return of policy
Status: in_force

Medicare supplement policies or certificates shall have a notice prominently printed on the first page of the policy or certificate or attached thereto stating in substance that the applicant shall have the right to return the policy or certificate within 30 days of its delivery and to have the premium refunded if, after examination of the policy or certificate, the applicant is not satisfied for any reason. Any refund made pursuant to this section shall be paid directly to the applicant by the insurer in a timely manner. [1989 c.255 §7]

Source: Section 743.686 — Right to return of policy; premium refund , https://www.­oregonlegislature.­gov/bills_laws/ors/ors743.­html (accessed May 26, 2025).
ORS § 744.321 — OR Code / Title 56 / Chapter 744 / Section 744.321
744.321 Life settlement providers
Status: in_force

(1) A person shall not act as a life settlement provider unless the person holds a license of life settlement provider issued by the Director of the Department of Consumer and Business Services.

(2) A life settlement provider may use the term “viatical settlement provider” to describe the business transacted under the license and may use the term “viatical settlement contract” instead of “life settlement contract.”

(3) A related provider trust must have a written agreement with a licensed life settlement provider under which the licensed life settlement provider is responsible for ensuring compliance with all statutory and regulatory requirements and under which the trust agrees to make all records and files related to life settlement transactions available to the director as if those records and files were maintained directly by the licensed life settlement provider. [1995 c.342 §3; 2009 c.711 §3]

Source: Section 744.321 — Life settlement providers , https://www.­oregonlegislature.­gov/bills_laws/ors/ors744.­html (accessed May 26, 2025).
ORS § 744.382 — OR Code / Title 56 / Chapter 744 / Section 744.382
744.382 Prohibitions on finder’s fee, solicitations, discrimination
Status: in_force

(1) A licensee may not pay or offer to pay a finder’s fee, commission or other compensation to a person described in this subsection, in connection with a policy insuring the life of an individual with a terminal illness or condition. The prohibition under this subsection applies with respect to payments or offers of payment to:

(a) The physician, naturopathic physician, attorney or accountant of the policyholder, of the certificate holder or of the insured individual when the individual is other than the policyholder or certificate holder.

(b) Any person other than a physician, naturopathic physician, attorney or accountant described in paragraph (a) of this subsection, who provides medical, legal or financial planning services to the policyholder, to the certificate holder or to the insured individual when the individual is other than the policyholder or certificate holder.

(c) Any person other than one described in paragraph (a) or (b) of this subsection who acts as an agent of the policyholder, certificate holder or insured individual.

(2) A licensee may not solicit an investor who could influence the treatment of the illness or condition of the individual whose life would be the subject of a life settlement contract.

(3) All information solicited or obtained from a policyholder or certificate holder by a licensee is subject to ORS 746.600 (Definitions for ORS 746.600 to 746.690) to 746.690 (Obtaining information under false pretenses prohibited) . For purposes of this subsection, a licensee is considered an insurance-support organization within the meaning of ORS 746.600 (Definitions for ORS 746.600 to 746.690) .

(4) A licensee may not discriminate in the making of a life settlement contract on the basis of race, religion, creed, sex, sexual orientation, gender identity, national origin, marital status, age, familial status or occupation or discriminate between persons who have dependents and persons who do not have dependents. [Formerly 744.353; 2017 c.356 §100; 2021 c.367 §48]

Source: Section 744.382 — Prohibitions on finder’s fee, solicitations, discrimination , https://www.­oregonlegislature.­gov/bills_laws/ors/ors744.­html (accessed May 26, 2025).
ORS § 743b.460 — OR Code / Title 56 / Chapter 743b / Section 743b.460
743B.460 Conditions for restricting payments to only in-network providers
Status: in_force

(1) An insurer may negotiate and enter into contracts for alternative rates of payment with providers to provide services covered by a group health insurance policy and may offer the benefit of such alternative rates to insureds who select such providers. An insurer may utilize such contracts by offering a choice of plans at the time an insured enrolls, one of which provides benefits only for services by members of a particular provider organization with whom the insurer has an agreement. If an insured chooses such a plan, benefits are payable only for services rendered by a member of that provider organization, unless such services were requested by a member of such organization or are rendered as the result of an emergency.

(2) Benefits paid by an insurer to a provider under subsection (1) of this section shall discharge the insurer’s obligation with respect to the amount of insurance so paid.

(3) Insurers shall provide group policyholders with a current roster of institutional and professional providers under contract to provide services at alternative rates under their group policy and shall also make such lists available for public inspection during regular business hours at the insurer’s principal office within this state. [Formerly 743.531]

Source: Section 743B.460 — Conditions for restricting payments to only in-network providers , https://www.­oregonlegislature.­gov/bills_laws/ors/ors743B.­html (accessed May 26, 2025).
ORS § 742.506 — OR Code / Title 56 / Chapter 742 / Section 742.506
742.506 Allocation of responsibility among insurers
Status: in_force

Notwithstanding the contrary provisions of any policy, the provisions of ORS 742.504 (Required provisions of uninsured motorist coverage) (9) shall control allocation of responsibility between insurers, except that if all policies potentially involved expressly allocate responsibility between insurers, or self-insurers, without repugnancy, then the terms of the policies shall control. [Formerly 743.795; 2015 c.5 §6]

Source: Section 742.506 — Allocation of responsibility among insurers , https://www.­oregonlegislature.­gov/bills_laws/ors/ors742.­html (accessed May 26, 2025).
ORS § 742.405 — OR Code / Title 56 / Chapter 742 / Section 742.405
742.405 Conditions for issuance of medical malpractice insurance
Status: in_force

(1) No insurer may require membership in a professional association as a condition of issuance of medical malpractice insurance to a physician. However, nothing in this subsection prohibits an insurer from requiring as a condition of coverage of a nonmember that the nonmember agrees to be subject to reasonable risk management, loss control or other similar programs and conditions to which members are subject, whether imposed by the insurer or the association.

(2) No insurer who issues medical malpractice insurance to a physician may assess any surcharge or offer any discount to the physician based on whether or not the physician is a member of a professional association.

(3) For purposes of this section, joint underwriting associations and risk retention groups shall be considered insurers. [Formerly 743.771]

Note: 742.405 (Conditions for issuance of medical malpractice insurance) was added to and made a part of the Insurance Code by legislative action but was not added to ORS chapter 742 or any series therein. See Preface to Oregon Revised Statutes for further explanation.

Source: Section 742.405 — Conditions for issuance of medical malpractice insurance , https://www.­oregonlegislature.­gov/bills_laws/ors/ors742.­html (accessed May 26, 2025).
ORS § 744.700 — OR Code / Title 56 / Chapter 744 / Section 744.700
744.700 Definitions for ORS 744.700 to 744.740
Status: in_force

As used in ORS 744.700 (Definitions for ORS 744.700 to 744.740) to 744.740 (Responsibility of insurer using third party administrator) :

(1) “Affiliate” of, or person “affiliated” with, a specific person means any person who directly or indirectly through one or more intermediaries, controls or is controlled by, or is under common control with, a specified person.

(2) “Control” has the meaning given that term in ORS 732.548 (Definitions for ORS 732.517 to 732.596) .

(3) “Insurer” includes a health care service contractor, a multiple employer welfare arrangement or any other person providing a plan of insurance subject to state insurance regulation. “Insurer” does not include a bona fide employee benefit plan established by an employer or an employee organization, or both, for which the insurance laws of this state are preempted pursuant to the Employee Retirement Income Security Act of 1974.

(4) “Underwrite” or “underwriting” includes the acceptance of employer or individual applications for coverage of individuals in accordance with the written rules of the insurer, the overall planning and coordinating of an insurance program and the ability to procure bonds and excess insurance. [1991 c.812 §2]

Source: Section 744.700 — Definitions for ORS 744.700 to 744.740 , https://www.­oregonlegislature.­gov/bills_laws/ors/ors744.­html (accessed May 26, 2025).
ORS § 742.282 — OR Code / Title 56 / Chapter 742 / Section 742.282
742.282 Limitations on issuance of mortgage insurance
Status: in_force

(1) No mortgage insurer shall provide insurance with respect to an obligation which exceeds, solely or in combination with liens existing at the time the insured loan is made:

(a) Ninety-five percent of the fair market value of the securing property at the time the loan is made, or such higher percentage as may be authorized by the Director of the Department of Consumer and Business Services and permitted by the insurer’s domicile, if the obligation insured is secured by a mortgage, deed of trust or other instrument constituting a first lien or first charge.

(b) Ninety percent of the fair market value of the securing property at the time the loan is made, or such higher percentage as may be authorized by the director and permitted by the insurer’s domicile, if the obligation insured is secured by a mortgage, deed of trust or other instrument constituting a junior lien or junior charge. In determining the 90 percent limitation, the full amount of a line of credit to be secured by a junior lien shall be considered the amount of the loan.

(2) A mortgage insurer at its option may limit its coverage net of reinsurance to a maximum of 25 percent of the amount of the obligation insured if the obligation insured is secured by a mortgage, deed of trust or other instrument constituting a first lien or first charge. In such event, the mortgage insurer may, in lieu of acquiring title to the property securing the obligation and paying the entire obligation, elect to pay its coverage percent of the obligation. In computing the aggregate amount of insured obligations under ORS 731.516 (Mortgage insurance limitation) , only the percent of the coverage net of reinsurance on the insured obligation shall be included in the aggregate amount.

(3) A mortgage insurer may insure an obligation secured by a mortgage, deed of trust or other instrument constituting a junior lien or junior charge, subject to the following provisions:

(a) The mortgage insurer shall limit its coverage net of reinsurance to a maximum of 25 percent of the amount of the obligation insured and all liens existing at the time the insured loan is made. In computing the aggregate amount of insured obligations under ORS 731.516 (Mortgage insurance limitation) , only the percent of the coverage net of reinsurance shall be included in the aggregate amount.

(b) Notwithstanding paragraph (a) of this subsection, the mortgage insurer may elect to insure a portfolio of loans secured by instruments constituting a junior lien on real estate, provided that the total amount at risk in any one portfolio shall not at any time exceed 20 percent of the original principal mortgage loans insured.

(c) In lieu of acquiring title to the property securing an obligation to which this subsection applies and paying the entire obligation, the mortgage insurer may elect to pay its coverage percent of the obligation.

(4) A mortgagor shall not be required to pay, directly or indirectly, the cost of mortgage insurance on a loan secured by a junior lien when the indebtedness evidencing that loan, combined with all existing mortgage loan amounts at the time the loan is made, is less than 60 percent of the fair market value of the real estate at the time the junior loan is made. No mortgagee or financial institution shall be required to obtain mortgage insurance or junior lien mortgage insurance by reason of this section.

(5) No mortgage insurer shall issue a policy of lease insurance with respect to real property not improved by a building or buildings designed to be occupied for industrial or commercial purposes. [Formerly 746.030 and then 743.705; 1991 c.67 §197; 1995 c.582 §2]

Source: Section 742.282 — Limitations on issuance of mortgage insurance , https://www.­oregonlegislature.­gov/bills_laws/ors/ors742.­html (accessed May 26, 2025).
ORS § 733.080 — OR Code / Title 56 / Chapter 733 / Section 733.080
733.080 Reserves for health insurance
Status: in_force

For all health insurance policies the insurer shall maintain reserves which place a sound value on its liabilities under such policies and which are not less than the reserves according to appropriate standards set forth in rules issued by the Director of the Department of Consumer and Business Services. Except for policies of credit health insurance, such reserves for nondisabled lives shall not be less in the aggregate than the pro rata gross unearned premiums for such policies calculated in accordance with ORS 733.060 (Unearned premium reserve) . [1967 c.359 §215; 1971 c.231 §18]

Source: Section 733.080 — Reserves for health insurance , https://www.­oregonlegislature.­gov/bills_laws/ors/ors733.­html (accessed May 26, 2025).
ORS § 742.464 — OR Code / Title 56 / Chapter 742 / Section 742.464
742.464 Excess coverage permitted
Status: in_force

Any policy which grants the coverage required for a motor vehicle liability insurance policy under ORS 742.450 (Contents of motor vehicle liability policy) , 806.080 (Insurance) and 806.270 (Certificate of insurance) may also grant any lawful coverage in excess of or in addition to the required coverage, and such excess or additional coverage shall not be subject to the provisions of ORS 742.031 (Bankruptcy clause required in certain liability policies) , 742.400 (Duty to report claim of professional negligence to licensing board) and 742.450 (Contents of motor vehicle liability policy) to 742.464 (Excess coverage permitted) . With respect to a policy which grants such excess or additional coverage only that part of the coverage which is required by ORS 806.080 (Insurance) and 806.270 (Certificate of insurance) is subject to the requirements of those sections. [Formerly 486.566 and then 743.785]

Source: Section 742.464 — Excess coverage permitted; combining policies to meet requirements , https://www.­oregonlegislature.­gov/bills_laws/ors/ors742.­html (accessed May 26, 2025).
ORS § 746.120 — OR Code / Title 56 / Chapter 746 / Section 746.120
746.120 Illegal dealing in premiums
Status: in_force

No person shall willfully collect any sum as premium or charge for insurance which is not then provided, or is not in due course to be provided subject to acceptance of the risk by the insurer, under an insurance policy issued by an insurer in conformity to the Insurance Code. [1967 c.359 §579]

Source: Section 746.120 — Illegal dealing in premiums , https://www.­oregonlegislature.­gov/bills_laws/ors/ors746.­html (accessed May 26, 2025).
ORS § 735.188 — OR Code / Title 56 / Chapter 735 / Section 735.188
735.188 Application of captive reinsurer for certificate of authority
Status: in_force

If permitted by its articles of incorporation or charter, and in accordance with ORS 735.158 (Certificate of authority) and 735.190 (Incorporation of captive reinsurer) , a captive reinsurer may apply to the Director of the Department of Consumer and Business Services for a certificate of authority to transact reinsurance. [2012 c.84 §21]

Note: See note under 735.150 (Definitions for ORS 735.150 to 735.190) .

Source: Section 735.188 — Application of captive reinsurer for certificate of authority , https://www.­oregonlegislature.­gov/bills_laws/ors/ors735.­html (accessed May 26, 2025).
ORS § 743.330 — OR Code / Title 56 / Chapter 743 / Section 743.330
743.330 Issuance of certificates
Status: in_force

A group life insurance policy shall contain a provision that the insurer will issue to the policyholder for delivery to each person insured an individual certificate setting forth a statement as to the insurance protection to which the person is entitled, to whom the insurance benefits are payable, and the rights and conditions set forth in ORS 743.333 (Termination of individual coverage) , 743.336 (Termination of policy or class of insured persons) and 743.339 (Death during period for conversion to individual policy) . [1967 c.359 §421]

Source: Section 743.330 — Issuance of certificates , https://www.­oregonlegislature.­gov/bills_laws/ors/ors743.­html (accessed May 26, 2025).
ORS § 742.706 — OR Code / Title 56 / Chapter 742 / Section 742.706
742.706 Renewal
Status: in_force

(1) If an insurer offers or purports to renew a commercial liability policy, but on terms less favorable to the insured or at higher rates, the new terms or rates may take effect on the renewal date, if the insurer provides the insured, and the insurance producer if any, 45 days’ written notice. If the insurer does not provide such notice, the insured may cancel the renewal policy within 45 days after receipt of the notice or delivery of the renewal policy. Earned premium for the period of time the renewal policy was in force shall be calculated pro rata at the lower of the current or previous year’s rate. If the insured accepts the renewal, any premium increase or changes in terms shall be effective immediately following the prior policy’s expiration date.

(2) Nonrenewal of a commercial liability policy shall not be effective until at least 45 days after the insured receives a written notice of nonrenewal. If, after an insurer provides a notice of nonrenewal as described in this subsection, the insurer extends the policy 90 days or less, an additional notice of nonrenewal is not required with respect to the extension.

(3) Subsection (1) of this section does not apply:

(a) If the change is a rate, form or plan filed with the Director of the Department of Consumer and Business Services and applicable to the entire line of insurance or class of business to which the policy belongs; or

(b) To a premium increase based on the altered nature or extent of the risk insured against.

(4) If a commercial liability policy is issued for a term longer than one year, and for additional consideration a premium is guaranteed, the insurer may not refuse to renew the policy or increase the premium for the term of that policy. [Formerly 743.946; 2003 c.364 §105; 2005 c.102 §1]

Source: Section 742.706 — Renewal; nonrenewal , https://www.­oregonlegislature.­gov/bills_laws/ors/ors742.­html (accessed May 26, 2025).
ORS § 744.814 — OR Code / Title 56 / Chapter 744 / Section 744.814
744.814 Prohibition on use of unlicensed reinsurance intermediary manager
Status: in_force

(1) A reinsurer may not engage the services of any person to act as a reinsurance intermediary manager on its behalf unless the person is licensed to act as a reinsurance intermediary manager as required by ORS 744.800 (Qualifications for reinsurance intermediary brokers and managers) .

(2) A reinsurer shall annually obtain a copy of statements of the financial condition of each reinsurance intermediary manager that the reinsurer has engaged. Each statement must be prepared by an independent certified public accountant in a form acceptable to the Director of the Department of Consumer and Business Services.

(3) If a reinsurance intermediary manager establishes loss reserves, the reinsurer shall annually obtain the opinion of an actuary who is in good standing of the American Academy of Actuaries, attesting to the adequacy of loss reserves established for losses incurred and outstanding on business produced by the reinsurance intermediary manager. The opinion must be in addition to any other required loss reserve certification.

(4) Binding authority for all retrocessional contracts or participation in reinsurance syndicates must rest with an officer of the reinsurer who is not affiliated with the reinsurance intermediary manager.

(5) Not later than the 30th day after termination of a contract with a reinsurance intermediary manager, the reinsurer shall provide written notification of the termination to the director.

(6) A reinsurer may not appoint to its board of directors any officer, director, employee, controlling shareholder or subproducer of its reinsurance intermediary manager. This subsection does not apply to relationships governed by ORS 732.517 (Purpose of ORS 732.517 to 732.546) to 732.596 (Request by insurance holding company system for determination or acknowledgement of group-wide supervisor) . [1993 c.447 §81; 2003 c.364 §34]

Source: Section 744.814 — Prohibition on use of unlicensed reinsurance intermediary manager; requirement that reinsurer obtain financial statement of reinsurance intermediary manager and opinion of actuary , https://www.­oregonlegislature.­gov/bills_laws/ors/ors744.­html (accessed May 26, 2025).
ORS § 732.624 — OR Code / Title 56 / Chapter 732 / Section 732.624
732.624 Approval by Director of Department of Consumer and Business Services of mutual holding company restructuring plan
Status: in_force

(1) The Director of the Department of Consumer and Business Services shall approve, conditionally approve or disapprove a plan of restructuring and other documents submitted under ORS 732.622 (Restructuring of mutual holding company) according to the standards established in ORS 732.626 (Plan review and approval) . The director must take such action not later than the 60th day after the director has received a completed filing of the plan and all information requested by the director or not later than the 30th day after the completion of a hearing on the plan, whichever date is later.

(2) At any time before approval of a plan by the director, the board of directors of the mutual holding company may amend or withdraw the plan.

(3) After approval by the director, the plan must be approved by the eligible members of the mutual holding company. Approval by the eligible members is subject to the following requirements:

(a) All eligible members must be given notice of the plan and of their opportunity to vote on the plan. A copy of the plan or a summary of the plan must accompany the notice. The notice shall be mailed to the last known address of each eligible member, as shown on the records of the mutual holding company, not later than the 45th day after approval of the plan by the director. The meeting of the eligible members at which a vote on the plan will occur shall be set for a date that is not earlier than the 30th day after the date on which the mutual holding company mailed the notice of the meeting. If the mutual holding company complies substantially and in good faith with the notice requirements of this section, the mutual holding company’s failure to give any member or members any required notice does not impair the validity of any action taken under this section.

(b) The vote required for approval must be conducted as provided in ORS 732.620 (Status of mutual holding company as corporation) , except as follows:

(A) Only eligible members may vote on the plan.

(B) An eligible member may vote in person or by proxy at the meeting at which the plan is voted upon.

(4) The plan shall be carried out in accordance with its terms on the effective date of the restructuring. A restructuring may be carried out through any method approved by the director, including, but not limited to, the organization of an interim subsidiary of the mutual holding company and the merger of the mutual holding company with and into such subsidiary.

(5) The restructured stock holding company and any other corporation included in the plan of restructuring shall be organized at the time or times set forth in the plan.

(6) Upon the effective date of the restructuring, the membership interests of all members of the restructuring mutual holding company, whether or not eligible members, shall be extinguished, and the eligible members of the restructuring mutual holding company shall be entitled to receive any form of consideration described in ORS 732.612 (Consideration for membership interest in converting or reorganizing mutual insurer) in accordance with the plan. In applying ORS 732.612 (Consideration for membership interest in converting or reorganizing mutual insurer) to the members of the restructuring mutual holding company, references in ORS 732.612 (Consideration for membership interest in converting or reorganizing mutual insurer) to the “converting mutual insurer” shall mean the restructuring mutual holding company, and references to the policies of the eligible members shall mean those policies of the eligible members that result in membership in the restructuring mutual holding company. For this purpose, ORS 732.612 (Consideration for membership interest in converting or reorganizing mutual insurer) shall be construed and applied so that the effect upon the eligible members of the restructuring mutual holding company is similar to the effect upon the eligible members of a converting mutual insurer. If the consideration for the membership interests of the eligible members is nontransferable subscription rights to purchase shares of capital stock of the issuer, the plan must set the pro forma market value of the restructured stock holding company in the same manner as the pro forma market value of the converted stock insurer is determined in accordance with ORS 732.612 (Consideration for membership interest in converting or reorganizing mutual insurer) . If shares of capital stock of the issuer constitute the only consideration to be received by the eligible members of the restructuring mutual holding company and the plan does not provide for the sale of additional shares of capital stock or other securities of the issuer, the plan does not need to include the valuation of the restructuring mutual holding company.

(7) Unless otherwise specified in the plan, the directors and officers of the restructuring mutual holding company shall serve as directors and officers of the restructured stock holding company until new directors and officers are elected.

(8) The director retains jurisdiction over the restructured stock holding company and any direct or indirect subsidiary of the restructured stock holding company as provided in this section and as provided in ORS 732.517 (Purpose of ORS 732.517 to 732.546) to 732.596 (Request by insurance holding company system for determination or acknowledgement of group-wide supervisor) .

(9) A restructured stock holding company shall automatically be a party to any rehabilitation or liquidation proceeding involving a converted stock insurer if the restructuring mutual holding company would have been a party to such proceeding under ORS 732.620 (Status of mutual holding company as corporation) . [1997 c.771 §12]

Source: Section 732.624 — Approval by Director of Department of Consumer and Business Services of mutual holding company restructuring plan; approval by members; effect of restructuring , https://www.­oregonlegislature.­gov/bills_laws/ors/ors732.­html (accessed May 26, 2025).
ORS § 735.465 — OR Code / Title 56 / Chapter 735 / Section 735.465
735.465 Monthly reports
Status: in_force

(1) On or before the end of each month, each surplus lines licensee shall file with the Director of the Department of Consumer and Business Services, as prescribed by the director, a verified report of all surplus lines insurance transacted on Oregon home state risks during the preceding 90 days. The report need not show transacted surplus lines insurance that was reported in an earlier report. The report shall show:

(a) Aggregate gross premiums written;

(b) Aggregate return premiums; and

(c) Amount of aggregate tax.

(2) The director may direct that reports required under subsection (1) of this section be made to the Surplus Line Association of Oregon and that the Surplus Line Association of Oregon file a combined report thereof with the director. The director may also require that reports required under subsection (1) of this section be made electronically but may exempt a licensee from the requirement for good cause shown.

(3) For the purpose of collecting taxes on insurance covering Oregon home state risks when the insurance is placed outside this state, the director may establish by rule requirements for filing reports on surplus lines insurance transacted outside this state on Oregon home state risks. [1987 c.774 §130; 2001 c.191 §48; 2007 c.71 §236; 2011 c.660 §17]

Source: Section 735.465 — Monthly reports; rules , https://www.­oregonlegislature.­gov/bills_laws/ors/ors735.­html (accessed May 26, 2025).
ORS § 731.731 — OR Code / Title 56 / Chapter 731 / Section 731.731
731.731 Immunity for certain persons dealing with information collected from filings under ORS 731.730
Status: in_force

Except in the case of malfeasance in office or willful or wanton neglect of duty or authority, there shall be no liability on the part of, and no cause of action of any nature shall arise against, any of the following persons by virtue of their collection, review, analysis or dissemination of the data and information collected from the filings required by ORS 731.730 (Insurer filings with National Association of Insurance Commissioners) :

(1) Members of the National Association of Insurance Commissioners and the delegates and authorized committees, subcommittees and task forces of the National Association of Insurance Commissioners.

(2) Employees of the National Association of Insurance Commissioners.

(3) The Director of the Department of Consumer and Business Services or any representative of the director.

(4) The insurance regulatory official of another state or any representative of such an official. [1993 c.447 §101]

Source: Section 731.731 — Immunity for certain persons dealing with information collected from filings under ORS 731.730 , https://www.­oregonlegislature.­gov/bills_laws/ors/ors731.­html (accessed May 26, 2025).
ORS § 748.142 — OR Code / Title 56 / Chapter 748 / Section 748.142
748.142 Amendment of society laws
Status: in_force

(1) A domestic society may amend its laws in accordance with the provisions thereof by action of its supreme governing body at any regular or special meeting thereof or, if its laws so provide, by referendum. The referendum may be held in accordance with the provisions of its laws by the vote of the voting members of the society, by the vote of delegates or representatives of voting members or by the vote of local lodges. A society may provide for voting by mail. No amendment submitted for adoption by referendum shall be adopted unless, within six months from the date of submission, a majority of the members voting have signified their consent to the amendment by one of the methods specified in this chapter.

(2) No amendment to the laws of any domestic society shall take effect unless approved by the Director of the Department of Consumer and Business Services. The director shall approve the amendment if the director finds that it has been duly adopted and is not inconsistent with any requirement of the laws of this state or with the character, objects and purposes of the society. Unless the director shall disapprove any such amendment within 60 days after the filing, the amendment shall be considered approved. The approval or disapproval of the director shall be in writing and mailed to the secretary or corresponding officer of the society at its principal office. In case the director disapproves the amendment, the reasons shall be stated in the written notice.

(3) Within 90 days from the approval by the director, all such amendments, or a synopsis thereof, shall be furnished to all members of the society either by mail or by publication in full in the official publication of the society. The affidavit of any officer of the society or of anyone authorized by it to mail any amendments, or synopses thereof, stating facts which show that the amendments have been duly addressed and mailed, shall be prima facie evidence that the amendments, or synopsis thereof, have been furnished to the addressee.

(4) Every foreign or alien society authorized to do business in this state shall file with the director a duly certified copy of all amendments of, or additions to, its laws within 90 days after the enactment of the amendments.

(5) Printed copies of the laws as amended, certified by the secretary or corresponding officer of the society, shall be prima facie evidence of the legal adoption thereof. [1987 c.490 §12]

Source: Section 748.142 — Amendment of society laws , https://www.­oregonlegislature.­gov/bills_laws/ors/ors748.­html (accessed May 26, 2025).
ORS § 742.260 — OR Code / Title 56 / Chapter 742 / Section 742.260
742.260 Cancellation of homeowner or fire policy
Status: in_force

(1) An insurer offering homeowner or renter liability or fire insurance may not cancel or refuse to issue or renew a policy on a private home solely on the basis that the policyholder operates a child care facility if the policyholder is registered or certified pursuant to ORS 329A.250 (Definitions for ORS 329A.030, 329A.250 to 329A.450 and 329A.500) to 329A.450 (Assistance to staff of facility) .

(2) A homeowner or renter liability or fire insurance policy may not provide coverage for losses arising out of or in connection with child care provided by a registered or certified child care facility. Coverage for losses arising out of or in connection with child care by a registered or certified child care facility may be provided only by a separate policy or indorsement for which premiums are assessed and paid.

(3) As used in this section, “child care facility” has the meaning given in ORS 329A.250 (Definitions for ORS 329A.030, 329A.250 to 329A.450 and 329A.500) . [1995 c.685 §2; 1999 c.743 §23; 2022 c.27 §19]

Source: Section 742.260 — Cancellation of homeowner or fire policy; coverage for child care; definition , https://www.­oregonlegislature.­gov/bills_laws/ors/ors742.­html (accessed May 26, 2025).
ORS § 735.095 — OR Code / Title 56 / Chapter 735 / Section 735.095
735.095 Contents of plan of operation
Status: in_force

The plan shall:

(1) Establish procedures for the submission and processing of applications for insurance and the payment of claims for losses.

(2) Establish procedures for record keeping, payment of other expenses and administration of all other financial affairs of the Oregon FAIR Plan Association.

(3) Establish times and places for meetings of the board.

(4) Establish procedures for selection of members of the board and for approval of such selections by the Director of the Department of Consumer and Business Services.

(5) Establish a procedure for appeal to the director of final actions or decisions of the association.

(6) Establish such other procedures as may be necessary or proper to carry out the duties and powers of the association.

(7) Provide that the association shall file periodically with the director statements of the insurance provided through the association and estimates of anticipated claims against the association. [1971 c.321 §11; 1979 c.818 §4]

Source: Section 735.095 — Contents of plan of operation , https://www.­oregonlegislature.­gov/bills_laws/ors/ors735.­html (accessed May 26, 2025).
ORS § 743b.220 — OR Code / Title 56 / Chapter 743b / Section 743b.220
743B.220 Requirements for insurers that require designation of participating primary care physician
Status: in_force

(1) All insurers offering a health benefit plan in this state that requires an enrollee to designate a participating primary care physician shall:

(a) Permit the enrollee to change participating primary care physicians at will, except that the enrollee may be restricted to making changes no more frequently than two times in any 12-month period and may be limited to designating only those participating primary care physicians accepting new patients.

(b) Have available for employer purchasers of group health plans a point-of-service benefit plan providing for payment for the services of a provider on a fee-for-service or discounted fee-for-service basis with reasonable access to a broad array of licensed providers in the insurer’s geographic service area. Any higher premium for the point-of-service benefit plan may not exceed true actuarial cost, including administrative costs, to the insurer.

(2) A health maintenance organization that is exempt from federal income tax under Internal Revenue Code section 501(c)(3) or (4) shall not be required to offer a point-of-service benefit plan as required by subsection (1)(b) of this section if offering such a plan could result in loss of federal tax-exempt status. Until such time as the federal government establishes guidelines for health maintenance organizations exempt from federal income tax that offer point-of-service benefit plans, such a health maintenance organization shall not be required to offer a point-of-service benefit plan if:

(a) Enrollment in Internal Revenue Code section 501(m) coverages exceeds five percent of its business; or

(b) Revenue from Internal Revenue Code section 501(m) coverages exceeds five percent of its revenue.

(3) A health maintenance organization that is federally qualified under 42 U.S.C. 300e et seq. shall not be required to offer a point-of-service benefit plan in a manner or to an extent that is inconsistent with federal law and regulation. [Formerly 743.808]

Source: Section 743B.220 — Requirements for insurers that require designation of participating primary care physician; exceptions , https://www.­oregonlegislature.­gov/bills_laws/ors/ors743B.­html (accessed May 26, 2025).
ORS § 743.665 — OR Code / Title 56 / Chapter 743 / Section 743.665
743.665 Prompt pay requirements
Status: in_force

The Director of the Department of Consumer and Business Services shall adopt by rule prompt payment requirements for long term care insurance. The rules shall include a definition of “claim” and a definition of “clean claim.” In adopting the rules, the director shall consider the prompt payment requirements in long term care insurance model acts developed by the National Association of Insurance Commissioners. [2011 c.69 §2]

Source: Section 743.665 — Prompt pay requirements; rules , https://www.­oregonlegislature.­gov/bills_laws/ors/ors743.­html (accessed May 26, 2025).
ORS § 744.306 — OR Code / Title 56 / Chapter 744 / Section 744.306
744.306 Contract between insurer and managing general agent
Status: in_force

A person acting as a managing general agent shall not place business with an insurer unless a written contract is in force between the parties. The following requirements apply to such a contract:

(1) The contract must set forth the responsibilities of each party.

(2) The contract must specify the division of responsibility for a particular function, when both parties share responsibility for the function.

(3) The contract must include at least the following provisions:

(a) That the insurer may terminate the contract for cause upon written notice to the managing general agent, and may suspend the underwriting authority of the managing general agent while any dispute regarding the cause for termination is pending.

(b) That at least monthly, the managing general agent shall report all transactions and remit all funds due under the contract to the insurer.

(c) That with respect to all funds collected by a managing general agent for the account of an insurer, the managing general agent must comply with ORS 744.083 (Trust account for premium funds) or 744.084 (Certificate of deposit in lieu of trust account) , except that the managing general agent may retain in the account an amount not exceeding three months’ estimated claims payments and allocated loss adjustment expenses.

(d) That the managing general agent shall maintain separate records of business written by the managing general agent. Further, that the managing general agent shall allow the insurer access to all accounts and records related to its business, shall keep all such accounts and records in a form usable by the insurer and shall allow the insurer to copy all such accounts and records.

(e) That the managing general agent shall not assign the contract either in whole or part.

(f) Appropriate underwriting guidelines, including:

(A) The maximum annual premium volume;

(B) The basis of the rates to be charged;

(C) The types of risks that may be written;

(D) Maximum limits of liability;

(E) Applicable exclusions;

(F) Territorial limitations;

(G) Policy cancellation provisions; and

(H) The maximum policy period.

(g) That the insurer may cancel or nonrenew any policy of insurance, subject to applicable statutes and rules governing cancellation and nonrenewal of insurance policies.

(h) Provisions addressing the timely transmission of the data, when electronic claims files exist.

(i) That if the contract provides for a sharing of interim profits of the managing general agent and if the managing general agent has the authority to determine the amount of the interim profits by establishing loss reserves or controlling claim payments, or in any other manner, interim profits shall not be paid to the managing general agent until one year after they are earned for property or surety insurance business and five years after they are earned on casualty business and not until the profits have been verified pursuant to ORS 744.313 (Financial examination) .

(j) That a managing general agent shall not do any of the following:

(A) Bind reinsurance or retrocessions on behalf of the insurer, except that the managing general agent may bind facultative reinsurance contracts pursuant to obligatory facultative agreements if the contract with the insurer contains reinsurance underwriting guidelines that include, for both reinsurance assumed and ceded, a list of reinsurers with which the automatic agreements are in effect, the coverage and amounts or percentages that may be reinsured and commission schedules.

(B) Commit the insurer to participate in insurance or reinsurance syndicates.

(C) Appoint any insurance producer without assuring that the insurance producer is licensed in this state to transact the type of insurance for which the insurance producer is appointed.

(D) Collect any payment from a reinsurer or commit the insurer to any claim settlement with a reinsurer without prior approval of the insurer. The contract must also provide that if prior approval is given, the managing general agent must forward a report to the insurer promptly.

(E) Appoint a submanaging general agent.

(k) Provisions establishing which disputes, if any, arising under the contract shall be decided by arbitration, mediation or other means of dispute resolution.

(L) If the managing general agent will calculate the loss reserves or a portion thereof, provisions:

(A) That the insurer is ultimately responsible for reporting the loss reserves; and

(B) That the insurer shall annually obtain the opinion of an actuary attesting to the adequacy of loss reserves calculated for losses incurred and outstanding on business produced by the managing general agent, in addition to any other required loss reserve actuarial opinion, as provided in ORS 744.313 (Financial examination) .

(4) In addition to the requirements of subsection (3) of this section, if the contract permits the managing general agent to settle claims on behalf of the insurer, the contract must also include at least the following provisions:

(a) The time requirements within which the managing general agent must report claims to the insurer.

(b) A requirement that the managing general agent must send a copy of the claim file or report of claim to the insurer at its request or as soon as it becomes known to the managing general agent that the claim:

(A) Has the potential of exceeding an amount determined by the Director of the Department of Consumer and Business Services or the limit set by the insurer, whichever is less;

(B) Involves a coverage dispute;

(C) May exceed the claim settlement authority of the managing general agent; or

(D) Is of a serious nature as predetermined by the insurer by written guidelines.

(c) A provision establishing the settlement authority granted the managing general agent for claims in general and specific guidelines for handling claims that exceed the amount established by the director or the insurer, whichever is less.

(d) A provision that all claim files are the joint property of the insurer and managing general agent, except upon an order of liquidation of the insurer, and that in the event of such an order:

(A) The files become the sole property of the insurer or its estate; and

(B) The managing general agent shall have reasonable access to and the right to copy the files on a timely basis.

(e) A provision that the insurer may terminate for cause any settlement authority granted to the managing general agent upon written notice by the insurer to the managing general agent or upon the termination of the contract, and that the insurer may suspend the settlement authority during the pendency of any dispute regarding the cause for termination.

(5) The contract must provide that the insurer may not allow the managing general agent to pay or commit the insurer to pay a claim in excess of a specified amount, net of reinsurance, without approval by the insurer. The amount shall not exceed the amount established in ORS 744.308 (Limitations on authority of insurer and managing general agent) . [1991 c.495 §5; 2003 c.364 §120]

Source: Section 744.306 — Contract between insurer and managing general agent , https://www.­oregonlegislature.­gov/bills_laws/ors/ors744.­html (accessed May 26, 2025).
ORS § 735.315 — OR Code / Title 56 / Chapter 735 / Section 735.315
735.315 Foreign risk retention groups
Status: in_force

Risk retention groups chartered in states other than this state and seeking to do business as a risk retention group in this state must observe and abide by the laws of this state as follows:

(1) Before transacting insurance in this state, a risk retention group shall submit to the director:

(a) A statement identifying the state or states in which the risk retention group is chartered and licensed as a liability insurance company, its date of chartering, its principal place of business and such information, including information on its membership, as the director may require to verify that the risk retention group is qualified under ORS 735.305 (Definitions for ORS 735.300 to 735.365) (11);

(b) A copy of its plan of operation or a feasibility study and revisions of such plan or study submitted to its state of domicile. The requirement of the submission of a plan of operation or a feasibility study shall not apply with respect to any line or classification of liability insurance that:

(A) Was defined in the federal Product Liability Risk Retention Act of 1981, as amended by the Risk Retention Amendments of 1986, before October 27, 1986; and

(B) Was offered before October 27, 1986, by any risk retention group that had been chartered and operating for not less than three years before October 27, 1986; and

(c) A statement of registration that designates the director as its agent for the purpose of receiving service of legal documents or process.

(2) A risk retention group doing business in this state shall submit to the director:

(a) A copy of the group’s financial statement submitted to its state of domicile, which shall be certified by an independent public accountant and contain a statement of opinion on loss and loss adjustment expense reserves made by a member of the American Academy of Actuaries or a qualified loss reserve specialist, under criteria established by the National Association of Insurance Commissioners;

(b) A copy of each examination of the risk retention group as certified by the director or public official conducting the examination;

(c) Upon request by the director, a copy of any audit performed with respect to the risk retention group; and

(d) Such information as may be required to verify its continuing qualification as a risk retention group under ORS 735.305 (Definitions for ORS 735.300 to 735.365) (11).

(3) A risk retention group is subject to taxation in this state as follows:

(a) All premiums paid for coverage within this state to risk retention groups shall be subject to taxation at the rate applicable to foreign admitted insurers and the taxes owing shall be subject to the same interest, fines and penalties for nonpayment as those applicable to foreign admitted insurers.

(b) To the extent insurance producers are used, they shall report and pay the taxes for the premiums for the risks that they have placed with or on behalf of a risk retention group not organized in this state.

(c) To the extent insurance producers are not used or fail to pay the tax, each risk retention group shall pay the tax for risks insured within the state. Further, each risk retention group shall report all premiums paid to it for risks insured within the state.

(4) A risk retention group and its agents and representatives shall comply with ORS 746.230 (Unfair claim settlement practices) and 746.240 (Undefined trade practices injurious to public prohibited) . If the director seeks an injunction regarding such conduct, the injunction must be obtained from a court of competent jurisdiction.

(5) A risk retention group must submit to an examination by the director to determine its financial condition if the director of the jurisdiction in which the group is chartered has not initiated an examination or does not initiate an examination within 60 days after a request by the director of this state. Any such examination shall be coordinated to avoid unjustified repetition. Examinations may be conducted in accordance with the examiner handbook of the National Association of Insurance Commissioners.

(6) A policy issued by a risk retention group shall contain in 10 point type on the front page and the declaration page, the following notice:

Notice

This policy is issued by your risk retention group. Your risk retention group may not be subject to all of the insurance laws and rules of your state. State insurance insolvency guaranty funds are not available for your risk retention group.

(7) The following acts by a risk retention group are prohibited:

(a) The solicitation or sale of insurance by a risk retention group to any person who is not eligible for membership in such group; and

(b) The solicitation or sale of insurance by, or operation of, a risk retention group that is in a hazardous financial condition or is financially impaired.

(8) No risk retention group shall be allowed to do business in this state if an insurer is directly or indirectly a member or owner of the risk retention group, other than in the case of a risk retention group all of whose members are insurers.

(9) No risk retention group may offer insurance policy coverage prohibited by the Insurance Code.

(10) A risk retention group not organized in this state and doing business in this state must comply with a lawful order issued in a voluntary dissolution proceeding or in a delinquency proceeding commenced by the insurance commissioner of any state if there has been a finding of financial impairment after an examination under subsection (5) of this section. [1987 c.774 §101; 2003 c.364 §92]

Source: Section 735.315 — Foreign risk retention groups; conditions of doing business in Oregon; prohibited acts , https://www.­oregonlegislature.­gov/bills_laws/ors/ors735.­html (accessed May 26, 2025).
ORS § 734.380 — OR Code / Title 56 / Chapter 734 / Section 734.380
734.380 Allowance of certain claims
Status: in_force

(1) A contingent claim against an insurer or a claim based upon a cause of action or suit against an insured of an insurer shall be filed, presented and reported in the same manner and within the same time limitations as provided in this chapter for a noncontingent claim. Such claims shall be allowed to share in a distribution of assets in the same manner as noncontingent claims of the same class and priority, provided that before any such sharing and distribution:

(a) If the claim is a contingent claim against the insurer, it becomes an absolute claim either as a result of proof presented or litigation; or

(b) If the claim is based upon a cause of action or suit against an insured of the insurer, a judgment is obtained against the insured or it may be reasonably inferred from proof presented that the claimant would be able to obtain such a judgment; in no case, however, shall all of the claims so presented and allowed arising out of a single act of the insured exceed the maximum liability of the insurer under its policy with or affecting the insured.

(2) Nothing in subsection (1) of this section shall prevent or bar the Director of the Department of Consumer and Business Services from compromising a disputed claim with the claimant, whether contingent or noncontingent, if such compromise is justified and supported by the facts and circumstances.

(3) If full or partial distribution to noncontingent claimants is authorized or directed by the court prior to satisfaction of the requirements of subsection (1)(a) or (b) of this section, with respect to particular claims the director shall retain a sum equal to the amount which would have been paid on the contingent claim if such requirements had then been met. The amount so withheld shall be distributed to the person or persons found by the court to be entitled thereto at such time as the claim is fully established as provided in subsection (1) of this section, or the director is satisfied that the claim is without merit or cannot be so proved or established, or the statute of limitations, if timely asserted, would bar further consideration or recovery thereon.

(4) No judgment entered after the date of entry of a liquidation order shall be considered in the liquidation proceedings as evidence of liability or of the amount of damages, and no judgment entered on default or inquest or by collusion after commencement of a delinquency proceeding shall be considered as conclusive evidence in the liquidation proceeding, either of liability or of the amount of damages. [1967 c.359 §292]

Source: Section 734.380 — Allowance of certain claims , https://www.­oregonlegislature.­gov/bills_laws/ors/ors734.­html (accessed May 26, 2025).
ORS § 750.337 — OR Code / Title 56 / Chapter 750 / Section 750.337
750.337 Exclusion from membership in guaranty funds, joint underwriting associations and other pools
Status: in_force

(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 or similar mechanism in this state. Neither such a trust nor its insureds may receive any benefit from any such fund for claims arising out of the operations of the multiple employer welfare arrangement.

(2) A trust carrying out a multiple employer welfare arrangement may not participate in any joint underwriting association or mandatory liability pool established under the laws of this state. [1993 c.615 §21; 1995 c.603 §39]

Note: See note under 750.301 (Definitions for ORS 750.301 to 750.341) .

Source: Section 750.337 — Exclusion from membership in guaranty funds, joint underwriting associations and other pools , https://www.­oregonlegislature.­gov/bills_laws/ors/ors750.­html (accessed May 26, 2025).
ORS § 732.245 — OR Code / Title 56 / Chapter 732 / Section 732.245
732.245 Home office
Status: in_force

(1) Except as provided in subsection (4) of this section, every domestic insurer shall have and maintain the domestic insurer’s principal place of business and home office in this state, and shall keep within this state accurate and complete accounts and records of the domestic insurer’s assets, transactions, and affairs in accordance with the provisions of the Insurance Code.

(2) Every domestic insurer shall have and maintain the domestic insurer’s assets in this state, except as to:

(a) Real property and personal property appurtenant to real property that is lawfully owned by the insurer and located outside this state; and

(b) Such property of the insurer as may be customary, necessary and convenient to enable and facilitate the operation of the domestic insurer’s branch offices and regional home offices located outside this state as referred to in subsection (4) of this section.

(3) Removal or attempted removal of all or a material part of the records or assets of a domestic insurer from this state except pursuant to a merger approved by the Director of the Department of Consumer and Business Services under ORS 732.517 (Purpose of ORS 732.517 to 732.546) to 732.546 (Severability) , or for such reasonable purposes and periods of time as may be approved by the director in writing in advance of such removal, or concealment or attempted concealment of records or assets or a material part of the records or assets from the director, is prohibited. The director may apply under ORS 734.150 (Grounds for rehabilitation of domestic insurers) for an order to rehabilitate a domestic insurer that violates this section.

(4) Intentionally left blank —Ed.

(a) A domestic insurer that has and maintains a principal place of business and a home office in this state may keep electronic records in this or another state. If the domestic insurer keeps electronic records in another state, the domestic insurer shall provide the director with access to the electronic records in a manner that allows the director to examine the insurer as if the electronic records were located in this state.

(b) A domestic insurer complies with the requirement set forth in paragraph (a) of this subsection if the domestic insurer:

(A) Provides the director with electronic access to, or printed copies of, all records that the director determines are necessary to conduct an examination of the domestic insurer:

(i) Within 24 hours after the director requests the records or at a mutually agreed time;

(ii) At the domestic insurer’s principal place of business or home office in this state; and

(iii) With in-person or telephone access to the person that prepared the records, if the director requests access to the person; or

(B) Makes the records available for examination at an office outside this state if the domestic insurer pays the director’s transportation and related expenses as provided in ORS 731.316 (Expenses of examination of insurer) .

(5) This section does not prohibit an insurer from:

(a) Establishing and maintaining branch offices or regional home offices in other states where necessary or convenient to the transaction of the domestic insurer’s business, and keeping therein the detailed records and assets customary and necessary for the servicing of the domestic insurer’s insurance in force and affairs in the territory served by the office, as long as such records and assets are made readily available at such office for examination by the director at the director’s request;

(b) Having, depositing or transmitting funds and assets of the insurer in or to jurisdictions outside of this state required by the law of such jurisdiction or as reasonably and customarily required in the regular course of the domestic insurer’s business; or

(c) Using custodial arrangements for the holding of securities owned by the insurer, either in or outside of this state, and either segregated from or commingled with securities owned by others, if the arrangements conform to rules adopted by the director for safeguarding the assets and facilitating the director’s examination of insurers using such custodial arrangements. [1967 c.359 §172; 1979 c.846 §3; 1993 c.447 §108; 2017 c.479 §9]

Source: Section 732.245 — Home office; records, assets; unlawful removal; rules , https://www.­oregonlegislature.­gov/bills_laws/ors/ors732.­html (accessed May 26, 2025).