ORS § 743b.005 — OR Code / Title 56 / Chapter 743b / Section 743b.005
743B.005 Definitions
Status: in_force

For purposes of ORS 743.004 (Submission of information by carriers offering health benefit plans) , 743.007 (Data reporting) , 743.022 (Premium rates for individual health benefit plans) , 743.416 (Due date for first premium payment) , 743.417 (Grace period for subsequent premium payments) , 743.535 (Health benefit coverage for guaranteed association) , 743A.101 (Supplemental or diagnostic breast examinations) , 743B.003 (Purposes) to 743B.127 (Rules for ORS 743.022, 743B.125 and 743B.126) , 743B.109 (Short term health insurance policies) , 743B.128 (Exceptions to requirement to actively market all plans) , 743B.250 (Required notices to applicants and enrollees) and 743B.323 (Separate notice to policyholder required before cancellation of individual or group health insurance policy for nonpayment of premium) :

(1) “Actuarial certification” means a written statement by a member of the American Academy of Actuaries or other individual acceptable to the Director of the Department of Consumer and Business Services that a carrier is in compliance with the provisions of ORS 743B.012 (Requirement to offer all health benefit plans to small employers) based upon the person’s examination, including a review of the appropriate records and of the actuarial assumptions and methods used by the carrier in establishing premium rates for small employer health benefit plans.

(2) “Affiliate” of, or person “affiliated” with, a specified person means any carrier who, directly or indirectly through one or more intermediaries, controls or is controlled by or is under common control with a specified person. For purposes of this definition, “control” has the meaning given that term in ORS 732.548 (Definitions for ORS 732.517 to 732.596) .

(3) “Affiliation period” means, under the terms of a group health benefit plan issued by a health care service contractor, a period:

(a) That is applied uniformly and without regard to any health status related factors to an enrollee or late enrollee;

(b) That must expire before any coverage becomes effective under the plan for the enrollee or late enrollee;

(c) During which no premium shall be charged to the enrollee or late enrollee; and

(d) That begins on the enrollee’s or late enrollee’s first date of eligibility for coverage and runs concurrently with any eligibility waiting period under the plan.

(4) “Bona fide association” means an association that:

(a) Has been in active existence for at least five years;

(b) Has been formed and maintained in good faith for purposes other than obtaining insurance;

(c) Does not condition membership in the association on any factor relating to the health status of an individual or the individual’s dependent or employee;

(d) Makes health insurance coverage that is offered through the association available to all members of the association regardless of the health status of the member or individuals who are eligible for coverage through the member;

(e) Does not make health insurance coverage that is offered through the association available other than in connection with a member of the association;

(f) Has a constitution and bylaws; and

(g) Is not owned or controlled by a carrier, producer or affiliate of a carrier or producer.

(5) “Carrier” means any person who provides health benefit plans in this state, including:

(a) A licensed insurance company;

(b) A health care service contractor;

(c) A health maintenance organization;

(d) An association or group of employers that provides benefits by means of a multiple employer welfare arrangement and that:

(A) Is subject to ORS 750.301 (Definitions for ORS 750.301 to 750.341) to 750.341 (Requirement for multiple employer welfare arrangement to become traditional insurer) ; or

(B) Is fully insured and otherwise exempt under ORS 750.303 (Conditions for use of multiple employer welfare arrangement) (4) but elects to be governed by ORS 743B.010 (Issuance of group health benefit plan to affiliated group of employers) to 743B.013 (Requirements for small employer health benefit plans) ; or

(e) Any other person or corporation responsible for the payment of benefits or provision of services.

(6) “Dependent” means the spouse or child of an eligible employee, subject to applicable terms of the health benefit plan covering the employee.

(7) “Eligible employee” means an employee who is eligible for coverage under a group health benefit plan.

(8) “Employee” means any individual employed by an employer.

(9) “Enrollee” means an employee, dependent of the employee or an individual otherwise eligible for a group or individual health benefit plan who has enrolled for coverage under the terms of the plan.

(10) “Exchange” means the health insurance exchange as defined in ORS 741.300 (Definitions) .

(11) “Exclusion period” means a period during which specified treatments or services are excluded from coverage.

(12) “Financial impairment” means that a carrier is not insolvent and is:

(a) Considered by the director to be potentially unable to fulfill its contractual obligations; or

(b) Placed under an order of rehabilitation or conservation by a court of competent jurisdiction.

(13) Intentionally left blank —Ed.

(a) “Geographic average rate” means the arithmetical average of the lowest premium and the corresponding highest premium to be charged by a carrier in a geographic area established by the director for the carrier’s:

(A) Group health benefit plans offered to small employers; or

(B) Individual health benefit plans.

(b) “Geographic average rate” does not include premium differences that are due to differences in benefit design, age, tobacco use or family composition.

(14) “Grandfathered health plan” has the meaning prescribed by rule by the United States Secretaries of Labor, Health and Human Services and the Treasury pursuant to 42 U.S.C. 18011(e) that is in effect on January 1, 2017.

(15) “Group eligibility waiting period” means, with respect to a group health benefit plan, the period of employment or membership with the group that a prospective enrollee must complete before plan coverage begins.

(16) Intentionally left blank —Ed.

(a) “Health benefit plan” means any:

(A) Hospital expense, medical expense or hospital or medical expense policy or certificate;

(B) Subscriber contract of a health care service contractor as defined in ORS 750.005 (Definitions) ; or

(C) Plan provided by a multiple employer welfare arrangement or by another benefit arrangement defined in the federal Employee Retirement Income Security Act of 1974, as amended, to the extent that the plan is subject to state regulation.

(b) “Health benefit plan” does not include:

(A) Coverage for accident only, specific disease or condition only, credit or disability income;

(B) Coverage of Medicare services pursuant to contracts with the federal government;

(C) Medicare supplement insurance policies;

(D) Coverage of TRICARE services pursuant to contracts with the federal government;

(E) Benefits delivered through a flexible spending arrangement established pursuant to section 125 of the Internal Revenue Code of 1986, as amended, when the benefits are provided in addition to a group health benefit plan;

(F) Separately offered long term care insurance, including, but not limited to, coverage of nursing home care, home health care and community-based care;

(G) Independent, noncoordinated, hospital-only indemnity insurance or other fixed indemnity insurance;

(H) Short term health insurance policies;

(I) Dental only coverage;

(J) Vision only coverage;

(K) Stop-loss coverage that meets the requirements of ORS 742.065 (Insurance against risk of loss assumed under less than fully insured employee health benefit plan) ;

(L) Coverage issued as a supplement to liability insurance;

(M) Insurance arising out of a workers’ compensation or similar law;

(N) Automobile medical payment insurance or insurance under which benefits are payable with or without regard to fault and that is statutorily required to be contained in any liability insurance policy or equivalent self-insurance; or

(O) Any employee welfare benefit plan that is exempt from state regulation because of the federal Employee Retirement Income Security Act of 1974, as amended.

(17) “Individual health benefit plan” means a health benefit plan:

(a) That is issued to an individual policyholder; or

(b) That provides individual coverage through a trust, association or similar group, regardless of the situs of the policy or contract.

(18) “Initial enrollment period” means a period of at least 30 days following commencement of the first eligibility period for an individual.

(19) “Late enrollee” means an individual who enrolls in a group health benefit plan subsequent to the initial enrollment period during which the individual was eligible for coverage but declined to enroll. However, an eligible individual shall not be considered a late enrollee if:

(a) The individual qualifies for a special enrollment period in accordance with 42 U.S.C. 300gg or as prescribed by rule by the Department of Consumer and Business Services;

(b) The individual applies for coverage during an open enrollment period;

(c) A court issues an order that coverage be provided for a spouse or minor child under an employee’s employer sponsored health benefit plan and request for enrollment is made within 30 days after issuance of the court order;

(d) The individual is employed by an employer that offers multiple health benefit plans and the individual elects a different health benefit plan during an open enrollment period; or

(e) The individual’s coverage under Medicaid, Medicare, TRICARE, Indian Health Service or a publicly sponsored or subsidized health plan, including, but not limited to, the medical assistance program under ORS chapter 414, has been involuntarily terminated within 63 days after applying for coverage in a group health benefit plan.

(20) “Multiple employer welfare arrangement” means a multiple employer welfare arrangement as defined in section 3 of the federal Employee Retirement Income Security Act of 1974, as amended, 29 U.S.C. 1002, that is subject to ORS 750.301 (Definitions for ORS 750.301 to 750.341) to 750.341 (Requirement for multiple employer welfare arrangement to become traditional insurer) .

(21) “Preexisting condition exclusion” means a limitation or exclusion of benefits or a denial of coverage based on a medical condition being present before the effective date of coverage or before the date coverage is denied, whether or not any medical advice, diagnosis, care or treatment was recommended or received for the condition before the date of coverage or denial of coverage.

(22) “Premium” includes insurance premiums or other fees charged for a health benefit plan, including the costs of benefits paid or reimbursements made to or on behalf of enrollees covered by the plan.

(23) “Rating period” means the 12-month calendar period for which premium rates established by a carrier are in effect, as determined by the carrier.

(24) “Representative” does not include an insurance producer or an employee or authorized representative of an insurance producer or carrier.

(25) Intentionally left blank —Ed.

(a) “Short term health insurance policy” means a policy of health insurance that is in effect for a period of three months or less, including the term of a renewal of the policy.

(b) As used in this subsection, “term of a renewal” includes the term of a new short term health insurance policy issued by an insurer to a policyholder no later than 60 days after the expiration of a short term health insurance policy issued by the insurer to the policyholder.

(26) “Small employer” means an employer who employed an average of at least one but not more than 50 full-time equivalent employees on business days during the preceding calendar year and who employs at least one full-time equivalent employee on the first day of the plan year, determined in accordance with a methodology prescribed by the Department of Consumer and Business Services by rule. [Formerly 743.730; 2017 c.152 §§8,8a; 2021 c.205 §6; 2021 c.281 §2; 2023 c.468 §3]

EMPLOYER-SPONSORED HEALTH INSURANCE

Source: Section 743B.005 — Definitions , https://www.­oregonlegislature.­gov/bills_laws/ors/ors743B.­html (accessed May 26, 2025).
ORS § 742.003 — OR Code / Title 56 / Chapter 742 / Section 742.003
742.003 Filing and approval of policy forms
Status: in_force

(1) Except where otherwise provided by law, no basic policy form, or application form where written application is required and is to be made a part of the policy, or rider, indorsement or renewal certificate form shall 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. This section does not apply to:

(a) Forms of unique character which are designed for and used with respect to insurance upon a particular risk or subject;

(b) Forms issued at the request of a particular life or health insurance policy owner or certificate holder and which relate to the manner of distribution of benefits or to the reservation of rights and benefits thereunder;

(c) Forms of group life or health insurance policies, or both, that have been agreed upon as a result of negotiations between the policyholder and the insurer; or

(d) Forms complying with specific requirements regarding delivery or issuance for delivery in this state established by the director by rule.

(2) Except as provided in ORS 743.019 (Procedure for review of proposed rates for health benefit plans) , the director shall within 30 days after the filing of any such form approve or disapprove the form. The director shall give written notice of such action to the insurer proposing to deliver such form and when a form is disapproved the notice shall show wherein such form does not comply with the law.

(3) The 30-day period referred to in subsection (2) of this section may be extended by the director for an additional period not to exceed 30 days if the director gives written notice within the first 30-day period to the insurer proposing to deliver the form that the director needs such additional time for the consideration of such form.

(4) The director may at any time request an insurer to furnish the director a copy of any form exempted under subsection (1) of this section. [Formerly 736.300 and then 743.006; 2001 c.943 §7; 2015 c.88 §4]

Source: Section 742.003 — Filing and approval of policy forms; rules , https://www.­oregonlegislature.­gov/bills_laws/ors/ors742.­html (accessed May 26, 2025).
ORS § 744.362 — OR Code / Title 56 / Chapter 744 / Section 744.362
744.362 Disclosure by insurance company to policy owner
Status: in_force

(1) With respect to each policy issued by an insurance company, the insurance company shall provide notice to the owner of an individual life insurance policy when the insured person under such a policy is 60 years of age or older and:

(a) The life insurance company receives notice from such an owner of a request to surrender, in whole or in part, an individual policy;

(b) The life insurance company receives notice from such an owner of a request to receive an accelerated death benefit under an individual policy; or

(c) The life insurance company sends to such an owner all notices of lapse of an individual policy, other than a term policy.

(2) Intentionally left blank —Ed.

(a) The notice must consist of the following statement in large, bold or otherwise conspicuous typeface calculated to draw the eye: “Life insurance is a critical part of a broader financial plan. There are many options available, and you have the right to shop around and seek advice from different financial advisers in order to find the option best suited to your needs.”

(b) The communication of the notice must also contain a statement advising the recipient that the recipient may contact the Division of Financial Regulation of the Department of Consumer and Business Services for more information, and must include an address or other location or manner by which the recipient may contact the Division of Financial Regulation.

(c) The department shall adopt by rule the appropriate address or other location or manner of contact to be included in the required notice.

(3) Intentionally left blank —Ed.

(a) The Director of the Department of Consumer and Business Services shall make available to the public information designed to educate the consumer about the consumer’s rights as an owner of a life insurance policy. The information must be written in lay terms and must advise the consumer:

(A) That life insurance is a critical part of a broader financial plan, and that the consumer is encouraged, and has a right, to seek additional financial advice and opinions;

(B) That possible alternatives to lapse exist; and

(C) Of the definitions of common industry terms.

(b) The information described in paragraph (a) of this subsection may include brief descriptions of common products available from licensees. These products must be discussed in general terms for informative purposes only, and not be identifiable to any specific licensee. [2009 c.711 §22; 2017 c.17 §59]

Source: Section 744.362 — Disclosure by insurance company to policy owner; rules , https://www.­oregonlegislature.­gov/bills_laws/ors/ors744.­html (accessed May 26, 2025).
ORS § 746.650 — OR Code / Title 56 / Chapter 746 / Section 746.650
746.650 Reasons for adverse underwriting decisions
Status: in_force

Except as otherwise provided in ORS 743B.250 (Required notices to applicants and enrollees) , 743B.252 (External review) , 743B.255 (Enrollee application for external review) and 743B.422 (Utilization review requirements for medical services contracts to which insurer not party) :

(1) In the event of an adverse underwriting decision, the insurer or insurance producer responsible for the decision must:

(a) Either provide the consumer proposed for coverage with the specific reason or reasons for the adverse underwriting decision in writing or advise the consumer that upon written request the consumer may receive the specific reason or reasons in writing; and

(b) Provide the consumer proposed for coverage with a summary of the rights established under subsection (2) of this section and ORS 746.640 (Access to recorded personal information) and 746.645 (Correction, amendment or deletion of recorded personal information) .

(2) Upon receipt of a written request within 90 business days from the date of the mailing of notice or other communication of an adverse underwriting decision to a consumer proposed for coverage, the insurer or insurance producer shall furnish to the consumer within 21 business days from the date of receipt of the written request:

(a) The specific reason or reasons for the adverse underwriting decision, in writing, if this information was not initially furnished in writing pursuant to subsection (1) of this section;

(b) The specific items of personal information and privileged information that support these reasons, subject to the following:

(A) The insurer or insurance producer is not required to furnish specific items of privileged information if the insurer or insurance producer has a reasonable suspicion, based upon specific information available for review by the Director of the Department of Consumer and Business Services, that the consumer proposed for coverage has engaged in criminal activity, fraud, material misrepresentation or material nondisclosure; and

(B) Specific items of individually identifiable health information supplied by a health care provider shall be disclosed either directly to the consumer about whom the information relates or to a health care provider designated by the consumer and licensed to provide health care with respect to the condition to which the information relates, whichever the insurer or insurance producer prefers; and

(c) The names and addresses of the institutional sources that supplied the specific items of information described in paragraph (b) of this subsection. However, the identity of any health care provider must be disclosed either directly to the consumer or to the designated health care provider, whichever the insurer or insurance producer prefers.

(3) The obligations imposed by this section upon an insurer or insurance producer may be satisfied by another insurer or insurance producer authorized to act on its behalf.

(4) When an adverse underwriting decision results solely from an oral request or inquiry, the explanation of reasons and summary of rights required by subsection (1) of this section may be given orally.

(5) Notwithstanding subsection (1) of this section, when an adverse underwriting decision is based in whole or in part on credit history or insurance score, the insurer or insurance producer responsible for the decision must provide the consumer proposed for coverage with the specific reason or reasons for the adverse underwriting decision in writing. The notice must include the following:

(a) A summary of no more than four of the most significant credit reasons for the adverse underwriting decision, listed in decreasing order of importance, that clearly identifies the specific credit history or insurance score used to make the adverse underwriting decision. An insurer or insurance producer may not use “poor credit history” or a similar phrase as a reason for an adverse underwriting decision.

(b) The name, address and telephone number, including a toll-free telephone number, of the consumer reporting agency that provided the information for the consumer report.

(c) A statement that the consumer reporting agency used by the insurer or insurance producer to obtain the credit history of the consumer did not make the adverse underwriting decision and is unable to provide the consumer with specific reasons why the insurer or insurance producer made an adverse underwriting decision.

(d) Information on the right of the consumer:

(A) To obtain a free copy of the consumer’s consumer report from the consumer reporting agency described in paragraph (b) of this subsection, including the deadline, if any, for obtaining a copy; and

(B) To dispute the accuracy or completeness of any information in a consumer report furnished by the consumer reporting agency.

(6) Notwithstanding subsection (1) of this section, an insurer or insurance producer responsible for an adverse underwriting decision that is based in whole or in part on credit history or insurance score must provide the notice required by subsection (5) of this section only when the insurer or insurance producer makes the initial adverse underwriting decision regarding a consumer.

(7) Notwithstanding subsection (1) of this section, when an adverse underwriting decision relating to homeowner insurance is based in whole or in part on a loss history report, the insurer or insurance producer responsible for the decision must provide the consumer proposed for coverage with the specific reason or reasons for the adverse underwriting decision in writing. The notice must include the following:

(a) A description of a specific claim or claims that are the basis for the specific loss history report used to make the adverse underwriting decision.

(b) The name, address and telephone number, including a toll-free telephone number, of the consumer reporting agency that provided the information for the loss history report.

(c) A statement that the consumer reporting agency used by the insurer or insurance producer to obtain the loss history report of the consumer did not make the adverse underwriting decision and is unable to provide the consumer with specific reasons why the insurer or insurance producer made an adverse underwriting decision.

(d) Information on the right of the consumer:

(A) To obtain a free copy of the consumer’s loss history report from the consumer reporting agency described in paragraph (b) of this subsection, including the deadline, if any, for obtaining a copy; and

(B) To dispute the accuracy or completeness of any information in a loss history report furnished by the consumer reporting agency.

(8) When an adverse underwriting decision relating to homeowner insurance is based in part on credit history and in part on a loss history report, the insurer or insurance producer responsible for the adverse underwriting decision may provide the notices required by subsections (5) and (7) of this section in a single notice. [1981 c.649 §12; 2003 c.87 §15; 2003 c.364 §161; 2003 c.788 §2a; 2005 c.489 §7; 2011 c.500 §42]

Source: Section 746.650 — Reasons for adverse underwriting decisions , https://www.­oregonlegislature.­gov/bills_laws/ors/ors746.­html (accessed May 26, 2025).
ORS § 743b.347 — OR Code / Title 56 / Chapter 743b / Section 743b.347
743B.347 Continuation of coverage under group policy upon termination of membership in group health insurance policy
Status: in_force

(1) As used in this section:

(a) “Covered person” means an individual who was a certificate holder under a group health insurance policy:

(A) On the day before a qualifying event; and

(B) During the three-month period ending on the date of the qualifying event.

(b) “Qualified beneficiary” means:

(A) A spouse or dependent child of a covered person who, on the day before a qualifying event, was insured under the covered person’s group health insurance policy; or

(B) A child born to or adopted by a covered person during the period of the continuation of coverage under this section who would have been insured under the covered person’s policy if the child had been born or adopted on the day before the qualifying event.

(c) “Qualifying event” means the loss of membership in a group health insurance policy caused by:

(A) Voluntary or involuntary termination of the employment of a covered person;

(B) A reduction in hours worked by a covered person;

(C) A covered person becoming eligible for Medicare;

(D) A qualified beneficiary losing dependent child status under a covered person’s group health insurance policy;

(E) Termination of membership in the group covered by the group health insurance policy; or

(F) The death of a covered person.

(2) Intentionally left blank —Ed.

(a) A grandfathered health plan, as defined in ORS 743B.005 (Definitions) , providing coverage under a group health insurance policy for hospital or medical expenses, other than coverage limited to expenses from accidents or specific diseases, must contain a provision that a covered person and any qualified beneficiary may continue coverage under the policy as provided in this section.

(b) A group health insurance policy that provides coverage for one or more of the essential health benefits, other than a grandfathered health plan, must contain a provision that a covered person and any qualified beneficiary may continue coverage under the policy as provided in this section.

(3) Continuation of coverage is not available to a covered person or qualified beneficiary who is eligible for:

(a) Medicare; or

(b) The same coverage under any other program that was not covering the covered person or qualified beneficiary on the day before a qualifying event.

(4) The continued coverage must be offered in the same manner as it is provided to other certificate holders under the group health insurance policy.

(5) A covered person or qualified beneficiary must submit a written request for continuation of coverage to the insurer within the time prescribed by the insurer, except that an insurer may not require a request to be submitted less than 10 days after the later of:

(a) The date of a qualifying event; or

(b) The date the insurer provides the notice required by subsection (10) of this section.

(6) A covered person or qualified beneficiary who requests continuation of coverage shall pay the premium on a monthly basis and in advance to the insurer or to the employer or policyholder, whichever the group policy provides. The required premium payment may not exceed the group premium rate for the insurance being continued under the group policy as of the date the premium payment is due.

(7) Continuation of coverage as provided under this section ends on the earliest of the following dates:

(a) Nine months after the date of the qualifying event that was the basis for the continuation of coverage.

(b) The end of the period for which the last timely premium payment for the coverage is received by the insurer.

(c) The premium payment due date coinciding with or next following the date that continuation of coverage ceases to be available in accordance with subsection (3) of this section.

(d) The date that the policy is terminated. However, if the policyholder replaces the terminated policy with similar coverage under another group health insurance policy:

(A) The covered person and qualified beneficiaries may obtain coverage under the replacement policy for the balance of the period that the covered person or qualified beneficiary would have remained covered under the terminated policy in accordance with this section; and

(B) The terminated policy must continue to provide benefits to the covered person and qualified beneficiaries to the extent of that policy’s accrued liabilities and extensions of benefits as if the replacement had not occurred.

(8) A qualified beneficiary who is not eligible for continuation of coverage under ORS 743B.343 (Availability of continued coverage under group policy for surviving, divorced or separated spouse 55 or older) may continue coverage under this section upon the dissolution of marriage with or the death of the covered person in the same manner that a covered person may exercise the right to continue coverage under this section.

(9) A covered person rehired by an employer no later than nine months after the layoff of the covered person by the employer may not be subjected to a waiting period for coverage under the employer’s group health insurance policy if the covered person was eligible for coverage at the time of the layoff, regardless of whether the covered person continued coverage during the layoff.

(10) If an insurer terminates the group health insurance coverage of a covered person or qualified beneficiary without providing replacement coverage that meets the criteria in subsection (7)(d) of this section, the insurer shall provide written notice to the covered person and any qualified beneficiary no later than 10 days after the insurer is notified of the qualifying event under subsection (5) of this section. The notice shall include information prescribed by the Director of the Department of Consumer and Business Services.

(11) This section applies only to employers who are not required to make available continuation of health insurance benefits under Titles X and XXII of the Consolidated Omnibus Budget Reconciliation Act of 1985, as amended, P.L. 99-272, April 7, 1986. [Formerly 743.610]

Source: Section 743B.347 — Continuation of coverage under group policy upon termination of membership in group health insurance policy; applicability of waiting period to rehired employee , https://www.­oregonlegislature.­gov/bills_laws/ors/ors743B.­html (accessed May 26, 2025).
ORS § 732.085 — OR Code / Title 56 / Chapter 732 / Section 732.085
732.085 Incorporators
Status: in_force

One or more natural persons of the age of 21 years or older or one or more financially responsible corporations may act as incorporators of a domestic insurer upon compliance with the provisions of the Insurance Code. [1967 c.359 §154]

Source: Section 732.085 — Incorporators , https://www.­oregonlegislature.­gov/bills_laws/ors/ors732.­html (accessed May 26, 2025).
ORS § 731.414 — OR Code / Title 56 / Chapter 731 / Section 731.414
731.414 Suspension or revocation of certificate of authority
Status: in_force

(1) The Director of the Department of Consumer and Business Services shall refuse to continue, or shall suspend or revoke, an insurer’s certificate of authority if:

(a) As a foreign insurer, it no longer meets the requirements for the authority; or as a domestic insurer, it has failed to cure an impairment of required capitalization within the time allowed therefor by the director under ORS 732.230 (Order to cure impairment) ;

(b) The insurer knowingly exceeds its charter powers or powers granted under its certificate of authority; or

(c) As a foreign or alien insurer, its certificate of authority to transact insurance is suspended or revoked by its domicile.

(2) Except in cases of impairment of required capitalization or suspension or revocation by another domicile as referred to in subsection (1)(c) of this section, the director shall refuse, suspend or revoke the certificate of authority only after a hearing granted to the insurer, unless the insurer waives such hearing in writing. [1967 c.359 §88]

Source: Section 731.414 — Suspension or revocation of certificate of authority; mandatory grounds , https://www.­oregonlegislature.­gov/bills_laws/ors/ors731.­html (accessed May 26, 2025).
ORS § 744.354 — OR Code / Title 56 / Chapter 744 / Section 744.354
744.354 Disclosure by life settlement provider, broker or investment agent to policy owner
Status: in_force

(1) With an application for a life settlement, a life settlement provider or life settlement broker shall provide the owner with at least the following disclosures no later than the time the application for the life settlement contract is signed by all parties. The disclosures must be provided in a separate document that is signed by the owner and the life settlement provider or life settlement broker, and must provide the following information:

(a) There are possible alternatives to life settlement contracts, including any accelerated death benefits or policy loans offered under the owner’s life insurance policy.

(b) A life settlement broker represents exclusively the owner, and not the insurer or the life settlement provider, and owes a fiduciary duty to the owner, including a duty to act according to the owner’s instructions and in the best interest of the owner.

(c) Some or all of the proceeds of the life settlement may be taxable under federal and state income tax, and assistance should be sought from a professional tax adviser.

(d) Proceeds of the life settlement may be subject to the claims of creditors.

(e) Receipt of proceeds from a life settlement contract may affect the owner’s eligibility for public assistance or other government benefits or entitlements, and advice should be obtained from appropriate agencies. Receipt of proceeds from a life settlement contract may reduce the owner’s risk of becoming impoverished and becoming dependent on public assistance or other government benefits or entitlements.

(f) The owner has the right to rescind a life settlement contract before the earlier of 60 calendar days after the date upon which the life settlement contract is executed by all parties or 30 calendar days after the life settlement proceeds have been paid to the owner, as provided in ORS 744.364 (Life settlement contract requirements) (3). Rescission, if exercised by the owner, is effective only if both notice of the rescission is given, and the owner repays all proceeds and any premiums, loans and loan interest paid on account of the life settlement within the rescission period. If the insured dies during the rescission period, the life settlement contract shall be deemed to have been rescinded, subject to repayment by the owner or the owner’s estate of all life settlement proceeds and any premiums, loans and loan interest of the life settlement within 60 days of the insured’s death.

(g) Funds will be sent to the owner within three business days after the life settlement provider has received the insurer or group administrator’s written acknowledgment that ownership of the policy or interest in the certificate has been transferred and the beneficiary has been designated.

(h) Entering into a life settlement contract may prevent the owner from qualifying for new life insurance coverage in the future and may cause other rights or benefits, including conversion rights and waiver of premium benefits that may exist under the policy or certificate, to be forfeited by the owner. Assistance should be sought from a financial adviser.

(i) The following language: “All medical, financial or personal information solicited or obtained by a life settlement provider or life settlement broker about an insured, including the insured’s identity or the identity of family members, a spouse or a significant other may be disclosed as necessary to effect the life settlement between the owner and the life settlement provider. If you are asked to provide this information, you will be asked to consent to the disclosure. The information may be provided to someone who buys the policy or provides funds for the purchase. You may be asked to renew your permission to share information every two years.”

(j) Following execution of a life contract, the insured may be contacted for the purpose of determining the insured’s health status and to confirm the insured’s residential or business street address and telephone number, or as otherwise provided in ORS 744.318 (Definitions for ORS 744.318 to 744.384) to 744.384 (Rules) , 744.991 (Criminal penalties) and 744.992 (Civil penalties) . This contact is limited to once every three months if the insured has a life expectancy of more than one year, and to no more than once per month if the insured has a life expectancy of one year or less. All such contacts shall be made only by a life settlement provider licensed in the state in which the owner resided at the time of the life settlement, or by the authorized representative of a duly licensed life settlement provider.

(2) Prior to or concurrently with the disclosures required under subsection (1) of this section, the owner shall be given a brochure describing the process of life settlements. The Director of the Department of Consumer and Business Services shall develop and approve a form for the brochure.

(3) A life settlement provider shall provide the owner with at least the following disclosures no later than the date the life settlement contract is signed by all parties. The disclosures shall be conspicuously displayed in the life settlement contract or in a separate document signed by the owner and provide the following information:

(a) The affiliation, if any, between the life settlement provider and the issuer of the insurance policy to be settled;

(b) The name, business address and telephone number of the life settlement provider;

(c) Any affiliations or contractual arrangements between the life settlement provider and the life settlement purchaser;

(d) If an insurance policy to be settled has been issued as a joint policy or involves family riders or any coverage of a life other than the insured under the policy to be settled, information about the possible loss of coverage on the other lives under the policy and the need to consult with the owner’s insurance producer or the insurer issuing the policy for advice on the proposed life settlement;

(e) The dollar amount of the current death benefit payable to the life settlement provider under the policy or certificate. If known, disclosure of the availability of any additional guaranteed insurance benefits, the dollar amount of any accidental death and dismemberment benefits under the policy or certificate and the extent to which the owner’s interest in those benefits will be transferred as a result of the life settlement contract;

(f) If the funds will be escrowed with an independent third party during the transfer process, the name, business address and telephone number of the independent third party escrow agent, and the fact that the owner may inspect or receive copies of the relevant escrow or trust agreements or documents;

(g) The name, business address and telephone number of the life settlement broker;

(h) A full, complete and accurate description of all offers, counter-offers, acceptances and rejections relating to the proposed life settlement contract;

(i) A written disclosure of any affiliations or contractual arrangements between the life settlement broker and any person making an offer in connection with the proposed life settlement contracts;

(j) The amount and method of calculating the broker’s compensation. Compensation includes anything of value paid or given to a life settlement broker for the placement of a policy; and

(k) When any portion of the life settlement broker’s compensation, as described in paragraph (j) of this subsection, is taken from a proposed life settlement offer, disclosure of the total amount of the life settlement offer and the percentage of the life settlement offer comprised by the life settlement broker’s compensation.

(4) If the life settlement provider transfers ownership or changes the beneficiary of the insurance policy, the provider shall communicate in writing the change in ownership or beneficiary to the insured within 20 days after the change.

(5) A life settlement provider or its life settlement investment agent shall provide the life settlement purchaser with at least the following disclosures prior to the date the life settlement purchase agreement is signed by all parties. The disclosures must be conspicuously displayed in any life purchase contract or in a separate document signed by the life settlement purchaser and life settlement provider or life settlement investment agent, and must make the following disclosures to the life settlement purchaser:

(a) The purchaser shall receive no returns, such as dividends and interest, until the insured dies and a death claim payment is made.

(b) The actual annual rate of return on a life settlement contract is dependent upon an accurate projection of the insured’s life expectancy and the actual date of the insured’s death. An annual guaranteed rate of return is not determinable.

(c) The settled life insurance contract should not be considered a liquid purchase since it is impossible to predict the exact timing of its maturity and the funds probably are not available until the death of the insured. There is no established secondary market for resale of these products by the purchaser.

(d) The purchaser may lose all benefits or may receive substantially reduced benefits if the insurer goes out of business during the term of the life investment.

(e) The purchaser is responsible for payment of the insurance premium or other costs related to the policy, if required by the terms of the life purchase agreement. These payments may reduce the purchaser’s return. If a party other than the purchaser is responsible for the payment, the name and address of that party also shall be disclosed.

(f) Intentionally left blank —Ed.

(A) The purchaser is responsible for payment of the insurance premiums or other costs related to the policy.

(B) The amount of the premiums, if applicable.

(g) The name, business address and telephone number of the independent third party providing escrow services and the relationship to the broker.

(h) The amount of any trust fees or other expenses to be charged to the life settlement purchaser.

(i) Whether the purchaser is entitled to a refund of all or part of the purchaser’s investment under the settlement contract if the policy is later determined to be null and void.

(j) Intentionally left blank —Ed.

(A) Group policies may contain limitations or caps in the conversion rights, and additional premiums may have to be paid if the policy is converted.

(B) The name of the party responsible for the payment of the additional premiums.

(C) If a group policy is terminated and replaced by another group policy, there may be no right to convert the original coverage.

(k) The risks associated with policy contestability, including but not limited to the risk that the purchaser will have no claim or only a partial claim to death benefits should the insurer rescind the policy within the contestability period.

(L) Whether the purchaser will be the owner of the policy in addition to being the beneficiary and if the purchaser is the beneficiary only and not also the owner, the special risks associated with that status, including but not limited to the risk that the beneficiary may be changed or the premium may not be paid.

(m) The experience and qualifications of the person who determines the life expectancy of the insured, the information this projection is based on and the relationship of the projection maker to the life settlement provider, if any.

(6) Disclosure to a life settlement purchaser shall include distribution of a brochure describing the process of investment in life settlements, in a form to be developed and approved by the director.

(7) A life settlement provider or its life settlement investment agent shall provide the life settlement purchaser with at least the following disclosures no later than at the time of the assignment, transfer or sale of all or a portion of an insurance policy. The disclosures must be contained in a document signed by the life settlement purchaser and life settlement provider or life settlement investment agent, and must make the following disclosures to the life settlement purchaser:

(a) The life expectancy certifications obtained by the provider in the process of determining the price paid to the owner.

(b) If premium payments or other costs related to the policy have been escrowed, the date when the escrowed funds will be depleted, whether the purchaser is responsible for payment of premiums thereafter and, if so, the amount of the premiums.

(c) Whether or not premium payments or other costs related to the policy have been waived. If waived, whether or not the investor is responsible for payment of the premiums if the insurer that wrote the policy terminates the waiver after purchase, and the amount of those premiums.

(d) The type of policy offered or sold, such as whole life, term life, universal life or a group policy certificate, any additional benefits contained in the policy and the current status of the policy.

(e) If the policy is term insurance, the special risks associated with term insurance, including but not limited to the purchaser’s responsibility for additional premiums if the owner continues the term policy at the end of the current term.

(f) If the policy is contestable.

(g) If the insurer that wrote the policy has any additional rights that could negatively affect or extinguish the purchaser’s rights under the life settlement contract, what these rights are and under what conditions these rights are activated.

(h) The name and address of the person responsible for monitoring the insured’s condition. A description of how often the monitoring of the insured’s condition is done, how the date of death is determined and how and when this information is transmitted to the purchaser.

(8) The life settlement purchase agreement is voidable by the purchaser at any time within three days after the disclosures mandated by subsection (7) of this section are received by the purchaser. [2009 c.711 §11]

Source: Section 744.354 — Disclosure by life settlement provider, broker or investment agent to policy owner , https://www.­oregonlegislature.­gov/bills_laws/ors/ors744.­html (accessed May 26, 2025).
ORS § 750.705 — OR Code / Title 56 / Chapter 750 / Section 750.705
750.705 Application of Insurance Code
Status: in_force

(1) The following provisions of the Insurance Code apply to legal expense organizations to the extent not inconsistent with the express provisions of ORS 750.505 (Definitions for ORS 750.505 to 750.715) to 750.715 (Rules) :

(a) ORS 731.004 (Short title) to 731.026 (Application of Insurance Code to particular insurers) , 731.036 (Persons completely exempt from application of Insurance Code) to 731.150 (Definitions of classes of insurance not mutually exclusive) , 731.158 (“Casualty insurance.”) , 731.216 (Administrative power of director) to 731.362 (Requirements of foreign or alien insurers generally) , 731.385 (Standards for determining whether continued operation of insurer is hazardous) , 731.386 (Management of insurers) , 731.398 (Amendment of certificate of authority) to 731.430 (Name of insurer) , 731.450 (Unrelated business prohibited) , 731.454 (Domestic insurers not to transact business in jurisdiction where not authorized) , 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) , 731.640 (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) , 731.804 (Assessments) and 731.844 (No personal liability for paying invalid tax) to 731.992 (Criminal penalty) .

(b) ORS 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 732.546 (Severability) .

(c) ORS 733.010 (Assets allowed) to 733.050 (Increase of inadequate reserves) , 733.140 (Disallowance of “wash” transactions) to 733.170 (Accounts and records) , 733.210 (Director’s determinations) , 733.510 (Investments of insurers) to 733.680 (Acquisition and retention of personal property generally) and 733.710 (Investments authorized by prior law) to 733.780 (Prohibited investments) .

(d) ORS 737.205 (Filing rates, plans with director) , 737.215 (Effect of noncompliance with rating regulation) , 737.225 (Records requirements) , 737.235 (Examining rating systems of insurers) to 737.340 (Initiation of proceedings by aggrieved person to determine lawfulness of filings) and 737.505 (Insured entitled to rate information) .

(e) ORS 742.001 (Scope of ORS chapters 742, 743, 743A and 743B) to 742.009 (Regulation of sales material) , 742.013 (Representations in applications) to 742.056 (Certain conduct not deemed waiver) and 742.061 (Recovery of attorney fees in action on policy or contractor’s bond) .

(f) ORS 746.005 (Trade practices exempted from prohibitions) to 746.045 (Prohibition on rebates) , 746.065 (Personal or controlled insurance) , 746.075 (Misrepresentation generally) , 746.100 (Misrepresentation in insurance applications or transactions) to 746.130 (Insurance connected to sale or rental of property) , 746.160 (Practices injurious to free competition) and 746.230 (Unfair claim settlement practices) to 746.370 (Records of insureds) .

(2) For the purposes of this section only, legal expense organizations shall be considered insurers. [Formerly 750.340; 1993 c.447 §119; 1995 c.79 §366; 2003 c.802 §178; 2005 c.22 §503]

Source: Section 750.705 — Application of Insurance Code , https://www.­oregonlegislature.­gov/bills_laws/ors/ors750.­html (accessed May 26, 2025).
ORS § 735.160 — OR Code / Title 56 / Chapter 735 / Section 735.160
735.160 Business name
Status: in_force

A captive insurer may assume a business name only if consistent with the provisions of ORS 731.430 (Name of insurer) . [2012 c.84 §7]

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

Source: Section 735.160 — Business name , https://www.­oregonlegislature.­gov/bills_laws/ors/ors735.­html (accessed May 26, 2025).
ORS § 731.358 — OR Code / Title 56 / Chapter 731 / Section 731.358
731.358 Requirements of domestic insurers generally
Status: in_force

Upon application a domestic insurer shall be granted a certificate of authority to transact any class of insurance permitted by the Insurance Code and provided for in its articles of incorporation upon its compliance with all the laws of this state and the rules of the Department of Consumer and Business Services relating to such insurers. [Formerly 736.085]

Source: Section 731.358 — Requirements of domestic insurers generally , https://www.­oregonlegislature.­gov/bills_laws/ors/ors731.­html (accessed May 26, 2025).
ORS § 732.548 — OR Code / Title 56 / Chapter 732 / Section 732.548
732.548 Definitions for ORS 732.517 to 732.596
Status: in_force

As used 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) :

(1) “Affiliate” means a person that directly or indirectly, through one or more intermediaries, controls, is controlled by, or is under common control with, another person.

(2) “Control” means possessing the direct or indirect power to manage a person or set the person’s policies, whether by owning voting securities, by contract other than a commercial contract for goods or nonmanagement services, or otherwise, unless the power is the result of an official position or corporate office the person holds.

(3) “Enterprise risk” means an activity, circumstance, event or series of events that involve one or more of an insurer’s affiliates and that, if not remedied promptly, are likely to have an adverse material effect on the insurer’s or the insurance holding company system’s financial condition or liquidity, including but not limited to an activity, circumstance, event or series of events that would cause the insurer’s risk-based capital to fall into company action level or cause the Director of the Department of Consumer and Business Services to determine under ORS 731.385 (Standards for determining whether continued operation of insurer is hazardous) that the insurer is in hazardous financial condition.

(4) “Group-wide supervisor” means a regulatory official that has the authority to conduct and coordinate supervisory activities for an internationally active insurance group under ORS 732.594 (Director’s determination or acknowledgment of appropriate group-wide supervisor for internationally active insurance group) .

(5) “Insurance holding company system” means two or more affiliated persons, one or more of which is an insurer, and includes a financial holding company as described in section 103 of the federal Gramm-Leach-Bliley Act (P.L. 106-102).

(6) “Insurer” has the meaning given that term in ORS 731.106 (“Insurer.”) but does not include an agency, authority or instrumentality of the United States, the Commonwealth of Puerto Rico, another state or a political subdivision of another state.

(7) “Internationally active insurance group” means an insurance holding company system that includes an insurer that is registered under ORS 732.551 (Registration of insurer members of holding company systems) and that:

(a) Writes premiums in three or more countries;

(b) Writes 10 percent or more of the insurance holding company system’s total gross written premiums outside the United States; and

(c) Has $50 billion or more of total assets, or $10 billion or more of total gross written premiums, based on a three-year rolling average.

(8) Intentionally left blank —Ed.

(a) “Person” means an individual, corporation, limited liability company, partnership, association, joint stock company, trust or unincorporated organization, or an entity or combination of entities similar to the entities described in this paragraph.

(b) “Person” does not include:

(A) A joint venture partnership that is engaged exclusively in owning, managing, leasing or developing real or tangible personal property; or

(B) For the purposes of ORS 732.518 (Definitions for ORS 732.517 to 732.546) , 732.521 (Activities that are prohibited unless specified procedures followed) , 732.523 (Procedure for acquiring controlling interest of capital stock) , 732.526 (Hearing on proposed activity) and 732.528 (Approval of proposed activity) , a securities broker that holds, in the usual and customary broker’s function, less than 20 percent of the voting securities of an insurer or of any person that controls an insurer.

(9) “Security holder” means a person that owns a security of another person, including a security denominated as common stock, preferred stock or a debt obligation and any instrument that is convertible into or that is evidence of the right to acquire the security of another person.

(10) “Subsidiary” means an affiliate that a person controls directly or indirectly through one or more intermediaries.

(11) “Voting security” means a security that entitles the owner or holder of the security to vote at a meeting of shareholders, including a security that is convertible into a voting security or that is evidence of a right to acquire a voting security. [Formerly 732.605; 2001 c.377 §38; 2013 c.370 §22; 2017 c.479 §10]

Source: Section 732.548 — Definitions for ORS 732.517 to 732.596 , https://www.­oregonlegislature.­gov/bills_laws/ors/ors732.­html (accessed May 26, 2025).
ORS § 742.502 — OR Code / Title 56 / Chapter 742 / Section 742.502
742.502 Uninsured motorist coverage
Status: in_force

(1) Every motor vehicle liability policy that insures against a loss that a natural person suffers and that results from liability imposed by law for bodily injury or death that arises out of owning, maintaining or using a motor vehicle shall provide in the policy or by indorsement on the policy uninsured motorist coverage if the policy is either:

(a) Issued for delivery in this state; or

(b) Issued or delivered by an insurer that does business in this state with respect to any motor vehicle then principally used or principally garaged in this state.

(2) Intentionally left blank —Ed.

(a) A motor vehicle bodily injury liability policy must have the same limits for uninsured motorist coverage as for bodily injury liability coverage unless a named insured in writing elects lower limits. The insured may not elect limits lower than the amounts prescribed to meet the requirements of ORS 806.070 (Minimum payment schedule) for bodily injury or death. Uninsured motorist coverage must include underinsurance coverage for bodily injury or death caused by accident and arising out of the ownership, maintenance or use of a motor vehicle with motor vehicle liability insurance that provides recovery in an amount that is less than the sums that the insured or the heirs or legal representative of the insured is legally entitled to recover as damages for bodily injury or death that is caused by accident and that arises out of owning, maintaining or using an uninsured vehicle. Underinsurance coverage must be equal to the sums that the insured or the heirs or legal representative of the insured is legally entitled to recover as damages for bodily injury or death that is caused by accident and that arises out of owning, maintaining or using an uninsured vehicle up to the limits of the uninsured motorist coverage.

(b) If a named insured elects lower limits, the named insured shall sign a statement to elect lower limits within 60 days after the time the named insured makes the election. The statement must acknowledge that a named insured was offered uninsured motorist coverage with the limits equal to those for bodily injury liability. The statement must have a brief summary that is not part of the insurance contract and that describes what uninsured motorist coverage provides and what the underinsured coverage provides. The summary must also state the price for coverage with limits equal to the named insured’s bodily injury liability limits and the price for coverage with the lower limits the named insured requested. The statement remains in force until a named insured rescinds the statement in writing or until the motor vehicle bodily injury liability limits are changed. The Department of Consumer and Business Services shall approve the form of statement that complies with this paragraph.

(c) A statement electing lower limits need not be signed if vehicles are either added to or subtracted from a policy or if the policy is amended, renewed, modified or replaced by the same insurer or an insurer within a group of companies that is under common ownership or control, unless the liability limits of the policy are changed.

(3) The insurer that issues the policy may offer one or more options of uninsured motorist coverage that are larger than the amounts prescribed to meet the requirements of ORS 806.070 (Minimum payment schedule) and in excess of the limits provided under the policy for motor vehicle bodily injury liability insurance. Offers of uninsured motorist coverage must include underinsurance coverage for bodily injury or death that is caused by accident and that arises out of owning, maintaining or using a motor vehicle with motor vehicle liability insurance that provides recovery in an amount that is less than the sums that the insured or the heirs or legal representative of the insured is legally entitled to recover as damages for bodily injury or death that is caused by accident and that arises out of owning, maintaining or using an uninsured vehicle. Underinsurance coverage must be equal to the sums that the insured or the heirs or legal representative of the insured is legally entitled to recover as damages for bodily injury or death that is caused by accident and that arises from owning, maintaining or using an uninsured vehicle up to the limits of the uninsured motorist coverage.

(4) Underinsurance coverage is subject to ORS 742.504 (Required provisions of uninsured motorist coverage) and 742.542 (Effect of personal injury protection benefits paid) .

(5) Uninsured motorist coverage and underinsurance coverage must provide coverage for bodily injury or death if the amount of liability insurance recovered is less than the sums that the insured or the heirs or legal representative of the insured is legally entitled to recover as damages for bodily injury or death that is caused by accident and that arises out of owning, maintaining or using an uninsured vehicle.

(6) Uninsured motorist coverage and underinsurance coverage must provide coverage for bodily injury or death if the amount recovered from a self-insurer is less than the sums that the insured or the heirs or legal representative of the insured is legally entitled to recover as damages for bodily injury or death that is caused by accident and that arises out of owning, maintaining or using an uninsured vehicle.

(7) As used in this section and except as otherwise provided in this subsection, “amount recovered from other motor vehicle liability insurance policies” means the proceeds of liability insurance or the proceeds received from a public body under ORS 30.260 (Definitions for ORS 30.260 to 30.300) to 30.300 (ORS 30.260 to 30.300 exclusive) that are recovered by or on behalf of the injured party. Proceeds recovered on behalf of the injured party include proceeds the injured party’s insurer receives as reimbursement for personal injury protection benefits the insurer provides to the injured person, proceeds the medical providers of the injured person receive and proceeds received as attorney fees on the claim of the injured person. If applicable liability insurance policy limits are exhausted upon payment, settlement or judgment by division among two or more injured persons, “amount recovered from other motor vehicle liability insurance policies” means the proceeds that are recovered by or on behalf of the injured person but does not include any proceeds of the liability policy that other injured persons receive. [Formerly 743.789; 1993 c.709 §11; 1997 c.808 §1; 2003 c.220 §1; 2005 c.235 §1; 2007 c.287 §2; 2007 c.782 §2; 2009 c.67 §14; 2015 c.5 §2]

Source: Section 742.502 — Uninsured motorist coverage; underinsurance coverage , https://www.­oregonlegislature.­gov/bills_laws/ors/ors742.­html (accessed May 26, 2025).
ORS § 750.045 — OR Code / Title 56 / Chapter 750 / Section 750.045
750.045 Required capitalization
Status: in_force

(1) A health care service contractor that is a for-profit or not-for-profit corporation shall possess and thereafter maintain capital or surplus, or any combination thereof, of not less than $2.5 million.

(2) A health care service contractor that is a for-profit or not-for-profit corporation shall file a surety bond or such other bond or securities in the sum of $250,000 as are authorized by the Insurance Code as a guarantee of the due execution of the policies to be entered into by such contractor in accordance with ORS 750.005 (Definitions) to 750.095 (Requirements of contract between provider and subscriber) . In lieu of such bond or securities, a health care service contractor may file an irrevocable letter of credit issued by an insured institution as defined in ORS 706.008 (Additional definitions for Bank Act) in the sum of $250,000. This subsection does not apply to a health care service contractor that has at least 75 percent of its assets invested in health care service facilities pursuant to ORS 733.700 (Investment of funds in health care service facilities) .

(3) Subsections (1) and (2) of this section do not apply to a health care service contractor furnishing only complementary health services, dental service or optometrical service operated on a for-profit or not-for-profit basis if:

(a) The services referred to in this subsection maintain capital or surplus, or any combination thereof, of not less than $1 million.

(b) The services referred to in this subsection file a surety bond or other such bond or securities in the sum of $50,000 as are authorized by the Insurance Code as a guarantee of the due execution of the policies to be entered into by such contractor in accordance with ORS 750.005 (Definitions) to 750.095 (Requirements of contract between provider and subscriber) .

(4) A health care service contractor that is a for-profit or not-for-profit corporation applying for its original certificate of authority in this state shall possess, when first so authorized, additional capital or surplus, or any combination thereof, of not less than $500,000.

(5) For the protection of the public, the Director of the Department of Consumer and Business Services may require a health care service contractor to possess and maintain capital or surplus, or any combination thereof, in excess of the amount otherwise required under this section owing to the type, volume and nature of insurance business transacted by the health care service contractor, if the director determines that the greater amount is necessary for maintaining the health care service contractor’s solvency according to standards established by rule. In developing such standards, the director shall consider model standards adopted by the National Association of Insurance Commissioners or its successor organization. For the purpose of determining the reasonableness and adequacy of a health care service contractor’s capital and surplus, the director must consider at least the following factors, as applicable:

(a) The size of the health care service contractor, as measured by its assets, capital and surplus, reserves, premium writings, insurance in force and other appropriate criteria.

(b) The number of lives insured.

(c) The extent of the geographical dispersion of the lives insured by the health care service contractor.

(d) The nature and extent of the reinsurance program of the health care service contractor.

(e) The quality, diversification and liquidity of the investment portfolio of the health care service contractor.

(f) The recent past and projected future trend in the size of the investment portfolio of the health care service contractor.

(g) The combined capital and surplus maintained by comparable health care service contractors.

(h) The adequacy of the reserves of the health care service contractor.

(i) The quality and liquidity of investments in affiliates. The director may treat any such investment as a disallowed asset for purposes of determining the adequacy of combined capital and surplus whenever in the judgment of the director the investment so warrants.

(j) The quality of the earnings of the health care service contractor and the extent to which the reported earnings include extraordinary items. [Formerly 742.050; 1975 c.273 §1; 1977 c.402 §1; 1985 c.747 §67; 1991 c.331 §132; 1991 c.958 §4; 1997 c.631 §552; 2001 c.318 §6; 2003 c.33 §2]

Source: Section 750.045 — Required capitalization; bond, security or letter of credit; exemptions , https://www.­oregonlegislature.­gov/bills_laws/ors/ors750.­html (accessed May 26, 2025).
ORS § 742.521 — OR Code / Title 56 / Chapter 742 / Section 742.521
742.521 Conditions applicable to arbitration proceedings
Status: in_force

(1) Arbitration proceedings under ORS 742.520 (Personal injury protection benefits for motor vehicle liability policies) shall be conducted under local court rules in the county where the arbitration is held.

(2) Findings and awards made in an arbitration proceeding under this section:

(a) Are binding on the parties to the arbitration proceeding;

(b) Are not binding on any other party; and

(c) May not be used for the purpose of collateral estoppel. [2007 c.328 §3]

Note: 742.521 (Conditions applicable to arbitration proceedings) was added to and made a part of ORS chapter 742 by legislative action but was not added to any smaller series therein. See Preface to Oregon Revised Statutes for further explanation.

Source: Section 742.521 — Conditions applicable to arbitration proceedings , https://www.­oregonlegislature.­gov/bills_laws/ors/ors742.­html (accessed May 26, 2025).
ORS § 732.604 — OR Code / Title 56 / Chapter 732 / Section 732.604
732.604 Permissible actions of domestic mutual insurer
Status: in_force

(1) A domestic mutual insurer may engage in either of the following actions:

(a) A conversion to a domestic stock insurer; or

(b) A reorganization in which the domestic mutual insurer is converted to a domestic stock insurer; and

(A) A mutual holding company is organized; or

(B) A stock holding company is organized.

(2) A mutual holding company may restructure into a stock holding company, as provided in ORS 732.622 (Restructuring of mutual holding company) and 732.624 (Approval by Director of Department of Consumer and Business Services of mutual holding company restructuring plan) .

(3) A reorganization involving the organization of a mutual holding company also may include the organization of an intermediate stock holding company and any other corporation that is permitted to be organized under ORS 732.600 (Definitions for ORS 732.600 to 732.630) to 732.630 (Dissenters’ rights) . A reorganization involving the organization of a stock holding company also may include the organization of any other corporation that is permitted to be organized under ORS 732.600 (Definitions for ORS 732.600 to 732.630) to 732.630 (Dissenters’ rights) .

(4) The Director of the Department of Consumer and Business Services may adopt rules for any of the following purposes:

(a) Implementing ORS 732.600 (Definitions for ORS 732.600 to 732.630) to 732.630 (Dissenters’ rights) .

(b) Ensuring full and proper review of any action described in ORS 732.600 (Definitions for ORS 732.600 to 732.630) to 732.630 (Dissenters’ rights) .

(c) Protecting the rights of policyholders, members and the insurance-buying public with respect to a conversion, reorganization or restructuring. [1997 c.771 §3]

Source: Section 732.604 — Permissible actions of domestic mutual insurer; rules , https://www.­oregonlegislature.­gov/bills_laws/ors/ors732.­html (accessed May 26, 2025).
ORS § 743.187 — OR Code / Title 56 / Chapter 743 / Section 743.187
743.187 Maximum interest rate on policy loan
Status: in_force

(1) Except as provided otherwise in this section, the maximum interest rate in the policy loan provision required by ORS 743.186 (Policy loan) shall be eight percent per year. The insurer may include in the policy loan provision, in lieu of a fixed maximum interest rate, a provision for an adjustable interest rate. The adjustable interest rate provision must comply with this section. A limitation on interest rates under state law, other than a limitation contained in the Insurance Code, shall not apply to interest rates for life insurance policy loans unless the limitation specifically applies to life insurance policy loans.

(2) The adjustable interest rate provision:

(a) Shall state in substance that in accordance with the policy and the law of the jurisdiction in which the policy is delivered, the insurer will establish from time to time the interest rate for an existing or a new policy loan; and

(b) Shall set forth the dates on which the insurer will determine policy loan interest rates. These determination dates shall be at regular intervals no longer than one year and no shorter than three months.

(3) The maximum interest rate permitted for a policy loan under the adjustable interest rate provision shall be established by the provision as the higher of:

(a) The interest rate used to calculate cash surrender values under the policy during the same period, plus one percent; and

(b) The Moody’s Corporate Bond Yield Average - Monthly Average Corporates, as published by Moody’s Investors Service, Inc., for the calendar month which precedes by two months the month in which the determination date for the policy loan interest rate falls. However, if the Moody’s Corporate Bond Yield Average - Monthly Average Corporates is no longer published by Moody’s Investors Service, Inc., or if the National Association of Insurance Commissioners determines that the Moody’s Corporate Bond Yield Average - Monthly Average Corporates is no longer an appropriate rate for this purpose, the Director of the Department of Consumer and Business Services by rule may establish the method of determining the rate under this paragraph. The director’s rule, to the maximum extent reasonable, shall be consistent with the pertinent actions of the National Association of Insurance Commissioners.

(4) On any date specified in the adjustable interest rate provision of the policy for determining the policy loan interest rate:

(a) The insurer may increase the existing rate if the maximum rate permitted by the provision exceeds the existing rate by at least one-half of one percent. The increase shall not be less than one-half of one percent or more than the amount by which the permitted maximum rate exceeds the existing rate; and

(b) The insurer shall decrease the existing rate if the existing rate exceeds the maximum rate permitted by the provision by at least one-half of one percent. The decrease shall not be less than the amount by which the existing rate exceeds the permitted maximum rate.

(5) The insurer under the adjustable interest rate provision shall give notice of the policy loan interest rate and related matters to the policy owner and all other persons entitled to notice by the policy, as follows:

(a) In the case of a loan other than for payment of a premium to the insurer, the insurer shall give notice of the initial interest rate on the loan when the loan is made.

(b) In the case of a loan for payment of a premium to the insurer, the insurer shall give notice of the initial interest rate on the loan as soon as reasonably practicable after the loan is made. However, the insurer need not give this notice when an additional premium loan is made at the same interest rate then applicable to an existing premium loan to the borrower.

(c) In the case of a policy with an outstanding loan, the insurer shall give notice of each increase in the loan interest rate reasonably in advance of the increase.

(d) Notices given under this subsection shall include in substance the information required by subsection (2) of this section.

(6) Notwithstanding ORS 743.186 (Policy loan) , a policy shall not terminate in a particular policy year solely because a change in the policy loan interest rate during that year caused the total indebtedness under the policy to reach the policy loan value. The policy shall remain in force during that year unless and until it would have terminated in the absence of any policy loan interest rate change during that year. [1981 c.412 §20]

Source: Section 743.187 — Maximum interest rate on policy loan; adjustable interest rate , https://www.­oregonlegislature.­gov/bills_laws/ors/ors743.­html (accessed May 26, 2025).
ORS § 744.818 — OR Code / Title 56 / Chapter 744 / Section 744.818
744.818 Errors and omissions insurance for reinsurance intermediary manager
Status: in_force

(1) A resident reinsurance intermediary acting as a reinsurance intermediary manager shall maintain with the Director of the Department of Consumer and Business Services a current certificate of errors and omissions insurance in an amount established by the director by rule from an insurer authorized to do business in this state or from any other insurer acceptable to the director according to standards established by rule.

(2) If the director determines that errors and omissions insurance required under this section is not generally available at a reasonable cost, the director by rule may suspend the requirement of insurance, but must reimpose the requirement when the insurance becomes available once again. [1993 c.447 §83; 2003 c.364 §36]

Source: Section 744.818 — Errors and omissions insurance for reinsurance intermediary manager; rules , https://www.­oregonlegislature.­gov/bills_laws/ors/ors744.­html (accessed May 26, 2025).
ORS § 746.055 — OR Code / Title 56 / Chapter 746 / Section 746.055
746.055 Title insurance commissions, rebates and discounts
Status: in_force

With respect to title insurance, no commissions, rebates or discounts shall be paid, allowed or permitted to any person having an interest in or lien upon real property which is the subject of the title insurance involved, or to any person acting for or on behalf of a person with such an interest or lien. [Formerly 748.086]

Source: Section 746.055 — Title insurance commissions, rebates and discounts , https://www.­oregonlegislature.­gov/bills_laws/ors/ors746.­html (accessed May 26, 2025).
ORS § 744.338 — OR Code / Title 56 / Chapter 744 / Section 744.338
744.338 Suspension, revocation, refusal to issue or renew license
Status: in_force

(1) The Director of the Department of Consumer and Business Services may suspend, revoke, refuse to issue or refuse to renew a license of a licensee if the director finds one or more of the following with respect to the licensee or applicant for a license:

(a) Dishonesty, fraud or gross negligence in the conduct of business as a licensee, or the licensee or applicant is otherwise shown to be untrustworthy or incompetent to act as a licensee.

(b) The life settlement provider demonstrates a pattern of unreasonable payments to policyholders or certificate holders.

(c) Falsification by the applicant or licensee of an application for the license or renewal thereof, or misrepresentation or engagement in any other dishonest act in relation to the application.

(d) Conduct resulting in a conviction of a felony under the laws of any state or of the United States, to the extent that such conduct may be considered under ORS 670.280 (Denial, suspension or revocation of license based on criminal conviction) .

(e) Conviction of any crime, an essential element of which is dishonesty or fraud, under the laws of any state or of the United States.

(f) Refusal to renew or cancellation, revocation or suspension of authority to transact insurance or business as a life settlement provider, life settlement broker or similar entity in another state.

(g) Failure to pay a civil penalty imposed by final order of the director or to carry out terms of probation set by the director.

(h) Refusal by a licensee to be examined or to produce accounts, records or files for examination, refusal by any officers to give information with respect to the affairs of the licensee or refusal to perform any other legal obligation as to the examination when required by the director.

(i) Affiliation with or under the same general management or interlocking directorate or ownership as another life settlement provider or life settlement broker or an insurer, any of which unlawfully transacts business in this state.

(j) Failure at any time to meet any qualification for which issuance of the license could have been refused had the failure then existed and been known to the director.

(k) Violation of any rule or order of the director or any provision of the Insurance Code by a licensee or any officer, partner, member or key management personnel of the licensee.

(2) The director may suspend or refuse to renew a license immediately and without hearing if the director determines that one or both of the following circumstances exist:

(a) The licensee is insolvent.

(b) The financial condition or business practices of the licensee otherwise pose an imminent threat to the public health, safety or welfare of the residents of this state.

(3) A life settlement provider or life settlement broker holding a license that has not been renewed or has been revoked shall surrender the license to the director at the director’s request.

(4) The director may take any other administrative action authorized under the Insurance Code in addition to or in lieu of the actions authorized under this section. [1995 c.342 §10; 2009 c.711 §7]

Source: Section 744.338 — Suspension, revocation, refusal to issue or renew license , https://www.­oregonlegislature.­gov/bills_laws/ors/ors744.­html (accessed May 26, 2025).
ORS § 743.472 — OR Code / Title 56 / Chapter 743 / Section 743.472
743.472 Permissible reasons for cancellation or refusal to renew
Status: in_force

An insurer selling individual health insurance policies may cancel or refuse to renew an individual health insurance policy only if the insurer makes a determination to cancel or not to renew all policies of the same type and form as the individual policy, or if the ground for cancellation or nonrenewal is any of the following and is stated as a provision of the policy:

(1) A fraudulent or material misstatement made by the applicant in an application for the health policy. A material misstatement is subject to any time limit, as specified by law and included in the policy, for voiding the policy on the basis of a misstatement. For purposes of this subsection, a misstatement may include an incorrect statement or a misrepresentation, omission or concealment of fact;

(2) Excess or other insurance in the same insurer, as described in ORS 743.456 (Other insurance in same insurer) ;

(3) Nonpayment of premium; or

(4) Any other reason specified by the Director of the Department of Consumer and Business Services by rule. [1989 c.784 §18; 1991 c.182 §5]

Note: 743.472 (Permissible reasons for cancellation or refusal to renew) was added to and made a part of 743.405 (General requirements for health insurance policies) to 743.498 (Statement in policy of cancelability or renewability) by legislative action but was not added to any smaller series therein. See Preface to Oregon Revised Statutes for further explanation.

Source: Section 743.472 — Permissible reasons for cancellation or refusal to renew , https://www.­oregonlegislature.­gov/bills_laws/ors/ors743.­html (accessed May 26, 2025).
ORS § 743b.340 — OR Code / Title 56 / Chapter 743b / Section 743b.340
743B.340 When group health insurance policies to continue in effect upon payment of premium by insured individual
Status: in_force

(1) Every group health insurance policy delivered or issued for delivery in this state shall contain in substance the following provisions, applicable to the coverage for hospital or medical services or expenses provided under the policy:

(a) A provision that, when the premium for the policy or any part thereof is paid by an employer under the terms of a collective bargaining agreement, if there is a cessation of work by employees insured under the policy due to a strike or lockout, the policy, upon timely payment of the premium, will continue in effect with respect to those employees insured by the policy on the date of the cessation of work who continue to pay their individual contribution and who assume and pay the contribution due from the employer.

(b) A provision that, when an employee insured under the policy pays a contribution pursuant to paragraph (a) of this subsection, if the policyholder is not a trustee of a fund established or maintained in whole or in part by an employer, the employee’s individual contribution shall be:

(A) The rate in the policy, on the date cessation of work occurs, applicable to an individual in the class to which the employee belongs as set forth in the policy; or

(B) If the policy does not provide for a rate applicable to individuals, an amount equal to the amount determined by dividing the total monthly premium in effect under the policy at the date of cessation of work by the total number of persons insured under the policy on such date.

(c) A provision that, when an employee insured under the policy pays a contribution pursuant to paragraph (a) of this subsection, if the policyholder is a trustee of a fund established or maintained in whole or in part by an employer, the employee’s individual contribution shall be the amount which the employee and employer would have been required to contribute if the cessation of work had not occurred.

(2) Every group health insurance policy delivered or issued for delivery in this state may contain in substance the following provisions applicable to the coverage for hospital or medical services or expenses provided under the policy:

(a) A provision that, when employees insured under the policy pay contributions pursuant to subsection (1)(a) of this section, the continuation of insurance under the policy is contingent upon the collection of individual contributions by the union representing the employees when the policyholder is not a trustee and by the policyholder or the policyholder’s agent when the policyholder is a trustee.

(b) A provision that, when employees insured under the policy pay contributions pursuant to subsection (1)(a) of this section, the continuation of insurance under the policy on each employee is contingent upon timely payment of contributions by the employees and timely payment of the premium by the entity responsible for collecting the individual contributions.

(c) A provision that, when employees insured under the policy pay contributions pursuant to subsection (1)(a) of this section, each individual premium rate under the policy may be increased by not more than 20 percent, or by any higher percentage approved by the Director of the Department of Consumer and Business Services, during the period of cessation of work in order to provide sufficient compensation to the insurer for increased administrative costs and increased mortality and morbidity. If the policy contains the provision allowed under this paragraph, an employee’s contribution paid under subsection (1)(a) of this section shall be increased by the same percentage.

(d) A provision that, when the policy is a policy insuring employees and which may continue in effect as provided in subsection (1)(a) of this section, if the premium is unpaid at the date of cessation of work and the premium became due prior to such cessation of work, the continuation of insurance is contingent upon payment of the premium prior to the date the next premium becomes due under the terms of the policy.

(e) Any provision with respect to the continuation of the policy as provided in subsection (1)(a) of this section that the director may approve.

(3) Nothing in this section shall be deemed to limit any right which the insurer may have in accordance with the terms of a policy to increase or decrease the premium rates before, during or after a cessation of work by employees insured under the policy when the insurer had the right to increase the premium rates even if the cessation of work did not occur. If such a premium rate change is made, it shall be effective on such date as the insurer shall determine in accordance with the terms of the policy.

(4) Nothing in this section shall be deemed to require continuation of any coverage in a group health insurance policy insuring employees and which may continue in effect as provided in subsection (1)(a) of this section for longer than:

(a) The time that 75 percent of insured employees continue such coverage;

(b) For an individual employee, the time at which the employee takes full-time employment with another employer; or

(c) Six months after cessation of work by the insured employees. [Formerly 743.527]

Source: Section 743B.340 — When group health insurance policies to continue in effect upon payment of premium by insured individual , https://www.­oregonlegislature.­gov/bills_laws/ors/ors743B.­html (accessed May 26, 2025).
ORS § 743.050 — OR Code / Title 56 / Chapter 743 / Section 743.050
743.050 Exemption of proceeds of health insurance
Status: in_force

Except as may otherwise be expressly provided by the policy, the proceeds or avails of all health insurance policies and of provisions providing benefits on account of the insured’s disability which are supplemental to life insurance policies, issued before, on or after June 8, 1967, shall be exempt from all liability for any debt of the insured, and from any debt of the beneficiary existing at the time the proceeds are made available for the use of the beneficiary. [Formerly 743.108]

Source: Section 743.050 — Exemption of proceeds of health insurance , https://www.­oregonlegislature.­gov/bills_laws/ors/ors743.­html (accessed May 26, 2025).
ORS § 731.514 — OR Code / Title 56 / Chapter 731 / Section 731.514
731.514 Ceding insurer’s management of reinsurance recoverables
Status: in_force

(1) A ceding insurer shall manage the ceding insurer’s reinsurance recoverables in proportion to the ceding insurer’s book of business. A domestic ceding insurer shall notify the Director of the Department of Consumer and Business Services within 30 days after reinsurance recoverables from any single assuming insurer or group of affiliated assuming insurers exceeds or is likely to exceed 50 percent of the domestic ceding insurer’s surplus, as last reported to the ceding insurer’s policyholders. In the notification, the domestic ceding insurer shall demonstrate that the domestic ceding insurer is safely managing the exposure.

(2) A ceding insurer shall diversify the ceding insurer’s reinsurance program. A domestic ceding insurer shall notify the director within 30 days after ceding to any single assuming insurer or group of affiliated assuming insurers more than 20 percent of the ceding insurer’s gross written premium in the previous calendar year or after determining that the ceded reinsurance will likely exceed this percentage. In the notification, the domestic ceding insurer shall demonstrate that the domestic ceding insurer is safely managing the exposure. [2019 c.151 §2]

Source: Section 731.514 — Ceding insurer’s management of reinsurance recoverables; requirement to diversify reinsurance program , https://www.­oregonlegislature.­gov/bills_laws/ors/ors731.­html (accessed May 26, 2025).
ORS § 734.840 — OR Code / Title 56 / Chapter 734 / Section 734.840
734.840 Conduct of liquidation, rehabilitation or conservation proceeding involving impaired or insolvent insurer
Status: in_force

(1) Nothing in ORS 734.750 (Short title) to 734.890 (Association not to be used in sales or solicitation) shall be construed to reduce the liability for unpaid assessments of the insureds on an impaired or insolvent insurer operating under a plan with assessment liability.

(2) Records shall be kept of all negotiations and meetings in which the Oregon Life and Health Insurance Guaranty Association or its representatives are involved to discuss the activities of the association in carrying out its powers and duties under ORS 734.810 (Duties and powers of association) . Records of such negotiations or meetings shall be made public only upon the termination of a liquidation, rehabilitation or conservation proceeding involving the impaired or insolvent insurer, upon the termination of the impairment or insolvency of the insurer, or upon the order of a court of competent jurisdiction. Nothing in this subsection shall limit the duty of the association to render a report of its activities under ORS 734.850 (Examination and regulation of association by director) .

(3) For the purpose of carrying out its obligations under ORS 734.750 (Short title) to 734.890 (Association not to be used in sales or solicitation) , the association shall be considered to be a creditor of the impaired or insolvent insurer to the extent of assets attributable to covered policies reduced by any amounts to which the association is entitled as subrogee pursuant to ORS 734.810 (Duties and powers of association) (10). All assets of the impaired or insolvent insurer attributable to covered policies shall be used to continue all covered policies and pay all contractual obligations of the impaired or insolvent insurer as required by ORS 734.750 (Short title) to 734.890 (Association not to be used in sales or solicitation) . “Assets attributable to covered policies,” as used in this subsection, is that proportion of the assets which the reserves that should have been established for such policies bear to the reserves that should have been established for all policies of insurance written by the impaired or insolvent insurer.

(4) As a creditor of the impaired or insolvent insurer as established in subsection (3) of this section and consistent with the provisions of ORS 731.648 (Duration and release of deposit) , the association and other similar associations shall be entitled to receive a disbursement of assets out of the marshaled assets, from time to time as the assets become available to reimburse it, as a credit against the contractual obligations of the association as set forth in ORS 734.810 (Duties and powers of association) . If the liquidator has not, within 120 days of a final determination of insolvency of an insurer by the court, made an application to the court for the approval of a proposal to disburse assets out of marshaled assets to guaranty associations having obligations because of the insolvency, then the association may apply to the court for approval of the association’s own proposal to disburse those assets.

(5) Intentionally left blank —Ed.

(a) Prior to the termination of any liquidation, rehabilitation or conservation proceeding, the court may take into consideration the contributions of the respective parties, including the association, the shareholders and policyholders of the insolvent insurer and any other party with a bona fide interest, in making an equitable distribution of the ownership rights of such insolvent insurer. In such a determination, consideration shall be given to the welfare of the policyholders of the continuing or successor insurer.

(b) No distribution to stockholders, if any, of an impaired or insolvent insurer shall be made until and unless the total amount of valid claims of the association for funds expended in carrying out its powers and duties under ORS 734.810 (Duties and powers of association) with respect to such insurer have been fully recovered by the association.

(6) Intentionally left blank —Ed.

(a) If an order for liquidation or rehabilitation of an insurer domiciled in this state has been entered, the receiver appointed under such order shall have a right to recover on behalf of the insurer, from any affiliate that controlled it, the amount of distributions, other than stock dividends paid by the insurer on its capital stock, made at any time during the five years preceding the petition for liquidation or rehabilitation, subject to the limitations of paragraphs (b), (c) and (d) of this subsection.

(b) No such dividend shall be recoverable if the insurer shows that, when paid, the distribution was lawful and reasonable, and that the insurer did not know and could not reasonably have known that the distribution might adversely affect the ability of the insurer to fulfill its contractual obligations.

(c) Any person who was an affiliate that controlled the insurer at the time the distributions were paid shall be liable up to the amount of distributions the person received. Any person who was an affiliate that controlled the insurer at the time the distributions were declared shall be liable up to the amount of distributions the person would have received if they had been paid immediately. If two persons are liable with respect to the same distributions, they shall be jointly and severally liable.

(d) The maximum amount recoverable under this subsection shall be the amount needed in excess of all other available assets of the insolvent insurer to pay the contractual obligations of the insolvent insurer.

(e) If any person liable under paragraph (c) of this subsection is insolvent, all its affiliates that controlled it at the time the dividend was paid shall be jointly and severally liable for any resulting deficiency in the amount recovered from the insolvent affiliate. [1975 c.251 §15; 1991 c.811 §7; 2011 c.142 §8]

Source: Section 734.840 — Conduct of liquidation, rehabilitation or conservation proceeding involving impaired or insolvent insurer , https://www.­oregonlegislature.­gov/bills_laws/ors/ors734.­html (accessed May 26, 2025).
ORS § 735.176 — OR Code / Title 56 / Chapter 735 / Section 735.176
735.176 Compliance with sound actuarial principles
Status: in_force

Notwithstanding the limits of risk set forth in ORS 731.504 (Limit of risk) , any captive insurer for which the Director of the Department of Consumer and Business Services issues a certificate of authority under ORS 735.150 (Definitions for ORS 735.150 to 735.190) to 735.190 (Incorporation of captive reinsurer) must comply with sound actuarial principles as determined by the director and must submit reports demonstrating such compliance to the director. [2012 c.84 §15]

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

Source: Section 735.176 — Compliance with sound actuarial principles , https://www.­oregonlegislature.­gov/bills_laws/ors/ors735.­html (accessed May 26, 2025).
ORS § 748.412 — OR Code / Title 56 / Chapter 748 / Section 748.412
748.412 Investment of funds
Status: in_force

A society shall invest its funds only in investments that are authorized by the laws of this state for the investment of assets of life insurers and subject to the limitations thereon. Any foreign or alien society permitted or seeking to do business in this state which invests its funds in accordance with the laws of the state, district, territory, country or province in which it is incorporated, shall be held to meet the requirements of this section for the investment of funds. [1987 c.490 §22]

Source: Section 748.412 — Investment of funds , https://www.­oregonlegislature.­gov/bills_laws/ors/ors748.­html (accessed May 26, 2025).
ORS § 746.005 — OR Code / Title 56 / Chapter 746 / Section 746.005
746.005 Trade practices exempted from prohibitions
Status: in_force

Nothing in this chapter shall apply to wet marine and transportation insurance or prohibit any of the following practices:

(1) In the case of life insurance policies, paying bonuses to policyholders or otherwise abating their premiums in whole or in part out of surplus accumulated from nonparticipating insurance, provided that any such bonuses or abatement of premiums shall be fair and equitable to policyholders and for the best interests of the insurer and its policyholders;

(2) In the case of industrial life insurance policies, making allowance to policyholders who have continuously for a specified period made premium payments directly to an office of the insurer, in an amount which fairly represents the saving in collection expense;

(3) Readjustment of the rate of premium for a group life or health insurance policy based on the loss or expense experience thereunder, at the end of the first or any subsequent policy year, which may be made retroactive only for such policy year;

(4) Extension of credit for payment of premiums without any service charge or interest by the insurer or insurance producer for a period of not more than 90 days after the end of the month in which the policy becomes effective;

(5) Practices authorized pursuant to ORS 733.220 (Establishment and regulation of separate accounts to fund life insurance or annuities) and 733.230 (Transactions of separate accounts registered with Securities and Exchange Commission) ;

(6) The issuing of life or health insurance policies on a salary savings, bank draft, preauthorized check or payroll deduction plan or similar plan at a reduced rate reasonably related to the savings made by use of such plan; or

(7) The issuing of life or health insurance policies at rates less than the usual premium rates for such policies, or using modifications of premium rates based on amount of insurance, if such issuance or modification does not result in reduction in premium rates in excess of savings in administration and issuance expenses reasonably attributable to such policies. [Formerly 736.825; 1983 c.740 §254; 2003 c.364 §133]

Source: Section 746.005 — Trade practices exempted from prohibitions , https://www.­oregonlegislature.­gov/bills_laws/ors/ors746.­html (accessed May 26, 2025).
ORS § 735.550 — OR Code / Title 56 / Chapter 735 / Section 735.550
735.550 Pharmacy claims audits
Status: in_force

(1) Intentionally left blank —Ed.

(a) After conducting an audit, an entity must provide the pharmacy that is the subject of the audit with a preliminary report of the audit. The preliminary report must be received by the pharmacy no later than 45 days after the date on which the audit was completed and must be sent:

(A) By mail or common carrier with a return receipt requested; or

(B) Electronically with electronic receipt confirmation.

(b) An entity shall provide a pharmacy receiving a preliminary report under this subsection no fewer than 45 days after receiving the report to contest the report or any findings in the report in accordance with the appeals procedure established under ORS 735.542 (Pharmacy claims audits) (1) and to provide additional documentation in support of the claim. The entity shall consider a reasonable request for an extension of time to submit documentation to contest the report or any findings in the report.

(2) If an audit results in the dispute or denial of a claim, the entity conducting the audit shall allow the pharmacy to resubmit the claim using any commercially reasonable method, including facsimile, mail or electronic mail.

(3) An entity must provide a pharmacy that is the subject of an audit with a final report of the audit no later than 60 days after the later of the date the preliminary report was received or the date the pharmacy contested the report using the appeals procedure established under ORS 735.542 (Pharmacy claims audits) (1). The final report must include a final accounting of all moneys to be recovered by the entity.

(4) Recoupment of disputed funds from a pharmacy by an entity or repayment of funds to an entity by a pharmacy, unless otherwise agreed to by the entity and the pharmacy, shall occur after the audit and the appeals procedure established under ORS 735.542 (Pharmacy claims audits) (1) are final. If the identified discrepancy for an individual audit exceeds $40,000, any future payments to the pharmacy may be withheld by the entity until the audit and the appeals procedure established under ORS 735.542 (Pharmacy claims audits) (1) are final. [2013 c.570 §9]

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

Source: Section 735.550 — Pharmacy claims audits; reports of findings; opportunity to resubmit claim and to contest finding , https://www.­oregonlegislature.­gov/bills_laws/ors/ors735.­html (accessed May 26, 2025).
ORS § 746.660 — OR Code / Title 56 / Chapter 746 / Section 746.660
746.660 Basing adverse underwriting decision on previous adverse decision
Status: in_force

No insurer or insurance producer may base an adverse underwriting decision in whole or in part on:

(1) The fact of a previous adverse underwriting decision or on the fact that an individual previously obtained insurance coverage through a residual market mechanism. However, an insurer or insurance producer may base an adverse underwriting decision on further information obtained from an insurer or insurance producer responsible for a previous adverse underwriting decision.

(2) Personal information received from an insurance-support organization whose primary source of information is insurers. However, an insurer or insurance producer may base an adverse underwriting decision on further personal information obtained as the result of information received from such an insurance-support organization. [1981 c.649 §14; 2003 c.364 §163]

Source: Section 746.660 — Basing adverse underwriting decision on previous adverse decision , https://www.­oregonlegislature.­gov/bills_laws/ors/ors746.­html (accessed May 26, 2025).
ORS § 743b.103 — OR Code / Title 56 / Chapter 743b / Section 743b.103
743B.103 Use of health-related information
Status: in_force

(1) A carrier may not:

(a) Require an applicant to provide health-related information as a precondition for the issuance of an individual health benefit plan policy; or

(b) Deny coverage under an individual health benefit plan policy based on health-related information provided by the applicant.

(2) A carrier may require an enrollee in a health benefit plan to complete the standard health statement prescribed by the department for the purpose of:

(a) Managing the enrollee’s health care; or

(b) Administering:

(A) A program of health promotion or disease prevention, as described in 42 U.S.C. 300gg-4;

(B) A program to promote healthy behaviors under ORS 743.824 (Cash dividends for healthy behaviors) ; or

(C) A wellness program defined by the department by rule. [Formerly 743.751; 2021 c.281 §3]

Source: Section 743B.103 — Use of health-related information , https://www.­oregonlegislature.­gov/bills_laws/ors/ors743B.­html (accessed May 26, 2025).
ORS § 737.312 — OR Code / Title 56 / Chapter 737 / Section 737.312
737.312 Agreements among insurers for assignment of risks
Status: in_force

Agreements may be made among insurers with respect to the equitable apportionment among them of insurance which may be afforded applicants who are in good faith entitled to such insurance but who are unable to procure such insurance through ordinary methods. Such insurers may agree among themselves on the use of reasonable rate modifications for such insurance, such agreements and rate modifications to be subject to the approval of the Director of the Department of Consumer and Business Services. [Formerly 737.180]

Source: Section 737.312 — Agreements among insurers for assignment of risks; rate modifications , https://www.­oregonlegislature.­gov/bills_laws/ors/ors737.­html (accessed May 26, 2025).
ORS § 748.184 — OR Code / Title 56 / Chapter 748 / Section 748.184
748.184 Reinsurance
Status: in_force

(1) A domestic society may, by a reinsurance agreement, cede any individual risk or risks in whole or in part to an insurer, other than another fraternal benefit society, having the power to make reinsurance and authorized to do business in this state, or if not authorized, one which is approved by the Director of the Department of Consumer and Business Services, but no society may reinsure substantially all of its insurance in force without the written permission of the director. The society may take credit for the reserves on such ceded risks to the extent reinsured, but no credit shall be allowed as an admitted asset or as a deduction from liability, to a ceding society for reinsurance made, ceded, renewed or otherwise becoming effective after January 1, 1988, unless the reinsurance is payable by the assuming insurer on the basis of the liability of the ceding society under the contract or contracts reinsured without diminution because of the insolvency of the ceding society.

(2) Notwithstanding the limitation in subsection (1) of this section, a society may reinsure the risks of another society in a consolidation or merger approved by the director under ORS 748.148 (Consolidation and merger) . [1987 c.490 §14]

BENEFITS, BENEFICIARIES AND CONTRACTS GENERALLY

Source: Section 748.184 — Reinsurance , https://www.­oregonlegislature.­gov/bills_laws/ors/ors748.­html (accessed May 26, 2025).
ORS § 748.174 — OR Code / Title 56 / Chapter 748 / Section 748.174
748.174 Certificate of authority for foreign or alien society
Status: in_force

No foreign or alien society shall transact business in this state without a certificate of authority issued by the Director of the Department of Consumer and Business Services. Any foreign or alien society desiring admission to this state shall comply substantially with the requirements and limitations of this chapter applicable to domestic societies. Any foreign or alien society may be authorized to transact business in this state upon a showing that its assets are invested in accordance with the provisions of this chapter and upon filing with the director:

(1) A duly certified copy of its articles of incorporation;

(2) A copy of its bylaws, certified by its secretary or corresponding officer;

(3) A power of attorney to the director as required by the director;

(4) A statement of its business under oath of its president and secretary or corresponding officers in a form prescribed by the director, duly verified by an examination made by the supervising insurance official of its home state or other state, territory, province or country, satisfactory to the director;

(5) Certification from the proper official of its home state, territory, province or country that the society is legally incorporated and licensed to transact business in the state, territory, province or country;

(6) Copies of its certificate forms; and

(7) Such other information as the director may deem necessary. [1987 c.490 §30; 1991 c.182 §11]

Source: Section 748.174 — Certificate of authority for foreign or alien society , https://www.­oregonlegislature.­gov/bills_laws/ors/ors748.­html (accessed May 26, 2025).
ORS § 741.003 — OR Code / Title 56 / Chapter 741 / Section 741.003
741.003 Duties and powers of director
Status: in_force

(1) The health insurance exchange is under the supervision of the Director of the Oregon Health Authority.

(2) The director has such powers as are necessary to carry out ORS 741.001 (Health insurance exchange) to 741.540 (Complaints and investigations confidential) .

(3) The director may employ, supervise and terminate the employment of such staff as the director deems necessary. The director shall prescribe their duties and fix their compensation. Employees administering the exchange may not be individuals who are:

(a) Employed by, consultants to or members of a board of directors of:

(A) An insurer or third party administrator;

(B) An insurance producer; or

(C) A health care provider, health care facility or health clinic;

(b) Members, board members or employees of a trade association of:

(A) Insurers or third party administrators; or

(B) Health care providers, health care facilities or health clinics; or

(c) Health care providers, unless they receive no compensation for rendering services as health care providers and do not have ownership interests in professional health care practices. [Formerly 741.201; 2021 c.569 §19]

Source: Section 741.003 — Duties and powers of director , https://www.­oregonlegislature.­gov/bills_laws/ors/ors741.­html (accessed May 26, 2025).
ORS § 735.638 — OR Code / Title 56 / Chapter 735 / Section 735.638
735.638 Duties of discount medical plan organization
Status: in_force

A discount medical plan organization shall establish or provide, in connection with every discount medical plan:

(1) A 30-day period in which new plan members may review the discount medical plan and decide whether to continue or to cancel the plan for any reason. The discount medical plan organization shall provide to a member who cancels a discount medical plan within the 30-day period a full and unconditional refund for any fees, service or subscription charges, dues or other consideration the member paid, except that the discount medical plan organization may retain the amount of any one-time processing fee that is less than an amount established by the Director of the Department of Consumer and Business Services by rule. The 30-day period begins on the day following the date on which the member completed any application for the plan or the day following the date on which the member paid any fees, service or subscription charges, dues or other consideration, whichever is later.

(2) A standard set of procedures by which a new plan member may obtain a refund under subsection (1) of this section.

(3) A toll-free telephone line and an Internet website. The toll-free telephone line must enable plan members to contact the discount medical plan organization with questions and requests for assistance. The website must list all providers in the organization’s provider network, and the organization must provide the same information to plan members in writing upon request.

(4) Disclosures, in writing in a font not less than 12 points in size and on the first content page of advertisements, marketing materials or brochures made available to the public and relating to a discount medical plan, that:

(a) The discount medical plan is not insurance; and

(b) Plan members must pay for all medical and ancillary services, but will receive a discount from providers. [Formerly 742.432]

Note: See note under 735.631 (Definitions for ORS 735.631 to 735.643) .

Source: Section 735.638 — Duties of discount medical plan organization , https://www.­oregonlegislature.­gov/bills_laws/ors/ors735.­html (accessed May 26, 2025).
ORS § 743b.013 — OR Code / Title 56 / Chapter 743b / Section 743b.013
743B.013 Requirements for small employer health benefit plans
Status: in_force

(1) A health benefit plan issued to a small employer:

(a) Other than a grandfathered health plan, must cover essential health benefits consistent with 42 U.S.C. 300gg-11.

(b) May require an affiliation period that does not exceed two months for an enrollee or 90 days for a late enrollee.

(c) May not apply a preexisting condition exclusion to any enrollee.

(2) Late enrollees in a small employer health benefit plan may be subjected to a group eligibility waiting period that does not exceed 90 days.

(3) Each small employer health benefit plan is renewable with respect to all eligible enrollees at the option of the policyholder, small employer or contract holder unless:

(a) The policyholder, small employer or contract holder fails to pay the required premiums.

(b) The policyholder, small employer or contract holder or, with respect to coverage of individual enrollees, an enrollee or a representative of an enrollee engages in fraud or makes an intentional misrepresentation of a material fact as prohibited by the terms of the plan.

(c) The number of enrollees covered under the plan is less than the number or percentage of enrollees required by participation requirements under the plan.

(d) The small employer fails to comply with the contribution requirements under the health benefit plan.

(e) The carrier discontinues both offering and renewing all of the carrier’s small employer health benefit plans in this state or in a specified service area within this state. In order to discontinue plans under this paragraph, the carrier:

(A) Must give notice of the decision to the Department of Consumer and Business Services and to all policyholders covered by the plans;

(B) May not cancel coverage under the plans for 180 days after the date of the notice required under subparagraph (A) of this paragraph if coverage is discontinued in the entire state or in a specified service area, except that:

(i) The carrier shall cancel coverage in accordance with subparagraph (C) of this paragraph if the cancellation is for a specified service area in the circumstances described in subparagraph (C) of this paragraph; and

(ii) The Director of the Department of Consumer and Business Services may specify a cancellation date other than the cancellation date specified in this subparagraph if the carrier is subject to a delinquency proceeding, as defined in ORS 734.014 (Definitions) ; and

(C) May not cancel coverage under the plans for 90 days after the date of the notice required under subparagraph (A) of this paragraph if coverage is discontinued in a specified service area because of an inability to reach an agreement with the health care providers or organization of health care providers to provide services under the plans within the service area.

(f) The carrier discontinues both offering and renewing a small employer health benefit plan in a specified service area within this state because of an inability to reach an agreement with the health care providers or organization of health care providers to provide services under the plan within the service area. In order to discontinue a plan under this paragraph, the carrier:

(A) Must give notice to the department and to all policyholders covered by the plan;

(B) May not cancel coverage under the plan for 90 days after the date of the notice required under subparagraph (A) of this paragraph; and

(C) Must offer in writing to each small employer covered by the plan, all other small employer health benefit plans that the carrier offers to small employers in the specified service area. The carrier shall issue any such plans pursuant to the provisions of ORS 743B.010 (Issuance of group health benefit plan to affiliated group of employers) to 743B.013 (Requirements for small employer health benefit plans) . The carrier shall offer the plans at least 90 days prior to discontinuation.

(g) The carrier discontinues both offering and renewing a health benefit plan, other than a grandfathered health plan, for all small employers in this state or in a specified service area within this state, other than a plan discontinued under paragraph (f) of this subsection.

(h) The carrier discontinues both offering and renewing a grandfathered health plan for all small employers in this state or in a specified service area within this state, other than a plan discontinued under paragraph (f) of this subsection.

(i) With respect to plans that are being discontinued under paragraph (g) or (h) of this subsection, the carrier must:

(A) Offer in writing to each small employer covered by the plan, all other health benefit plans that the carrier offers to small employers in the specified service area.

(B) Issue any such plans pursuant to the provisions of ORS 743B.010 (Issuance of group health benefit plan to affiliated group of employers) to 743B.013 (Requirements for small employer health benefit plans) .

(C) Offer the plans at least 90 days prior to discontinuation.

(D) Act uniformly without regard to the claims experience of the affected policyholders or the health status of any current or prospective enrollee.

(j) The Director of the Department of Consumer and Business Services orders the carrier to discontinue coverage in accordance with procedures specified or approved by the director upon finding that the continuation of the coverage would:

(A) Not be in the best interests of the enrollees; or

(B) Impair the carrier’s ability to meet contractual obligations.

(k) In the case of a small employer health benefit plan that delivers covered services through a specified network of health care providers, there is no longer any enrollee who lives, resides or works in the service area of the provider network.

(L) In the case of a health benefit plan that is offered in the small employer market only to one or more bona fide associations, the membership of an employer in the association ceases and the termination of coverage is not related to the health status of any enrollee.

(4) A carrier may modify a small employer health benefit plan at the time of coverage renewal. The modification is not a discontinuation of the plan under subsection (3)(e), (g) and (h) of this section.

(5) Notwithstanding any provision of subsection (3) of this section to the contrary, a carrier may not rescind the coverage of an enrollee in a small employer health benefit plan unless:

(a) The enrollee or a person seeking coverage on behalf of the enrollee:

(A) Performs an act, practice or omission that constitutes fraud; or

(B) Makes an intentional misrepresentation of a material fact as prohibited by the terms of the plan;

(b) The carrier provides at least 30 days’ advance written notice, in the form and manner prescribed by the department, to the enrollee; and

(c) The carrier provides notice of the rescission to the department in the form, manner and time frame prescribed by the department by rule.

(6) Notwithstanding any provision of subsection (3) of this section to the contrary, a carrier may not rescind a small employer health benefit plan unless:

(a) The small employer or a representative of the small employer:

(A) Performs an act, practice or omission that constitutes fraud; or

(B) Makes an intentional misrepresentation of a material fact as prohibited by the terms of the plan;

(b) The carrier provides at least 30 days’ advance written notice, in the form and manner prescribed by the department, to each plan enrollee who would be affected by the rescission of coverage; and

(c) The carrier provides notice of the rescission to the department in the form, manner and time frame prescribed by the department by rule.

(7) Intentionally left blank —Ed.

(a) A carrier may continue to enforce reasonable employer participation and contribution requirements on small employers. However, participation and contribution requirements shall be applied uniformly among all small employer groups with the same number of eligible employees applying for coverage or receiving coverage from the carrier. In determining minimum participation requirements, a carrier shall count only those employees who are not covered by an existing group health benefit plan, Medicaid, Medicare, TRICARE, Indian Health Service or a publicly sponsored or subsidized health plan, including but not limited to the medical assistance program under ORS chapter 414.

(b) A carrier may not deny a small employer’s application for coverage under a health benefit plan based on participation or contribution requirements but may require small employers that do not meet participation or contribution requirements to enroll during the open enrollment period beginning November 15 and ending December 15.

(8) Premium rates for small employer health benefit plans, except grandfathered health plans, are subject to the following provisions:

(a) Each carrier must file with the department the initial geographic average rate and any changes in the geographic average rate with respect to each health benefit plan issued by the carrier to small employers.

(b) Intentionally left blank —Ed.

(A) The variations in premium rates charged during a rating period for health benefit plans issued to small employers must be based solely on the factors specified in subparagraph (B) of this paragraph. A carrier may elect which of the factors specified in subparagraph (B) of this paragraph apply to premium rates for health benefit plans for small employers. All other factors must be applied in the same actuarially sound way to all small employer health benefit plans.

(B) The variations in premium rates described in subparagraph (A) of this paragraph may be based only on one or more of the following factors as prescribed by the department by rule:

(i) The ages of enrolled employees and their dependents, except that the rate for adults may not vary by more than three to one;

(ii) The level at which enrolled employees and dependents of enrolled employees engage in tobacco use, except that the rate may not vary by more than 1.5 to one; and

(iii) Adjustments to reflect differences in family composition.

(C) A carrier shall apply the carrier’s schedule of premium rate variations as approved by the department and in accordance with this paragraph. Except as otherwise provided in this section, the premium rate established by a carrier for a small employer health benefit plan applies uniformly to all employees of the small employer enrolled in that plan.

(c) Except as provided in paragraph (b) of this subsection, the variation in premium rates between different health benefit plans offered by a carrier to small employers must be based solely on objective differences in plan design or coverage, age, tobacco use and family composition and must not include differences based on the risk characteristics of groups assumed to select a particular health benefit plan.

(d) A carrier may not increase the rates of a health benefit plan issued to a small employer more than once in a 12-month period. Annual rate increases are effective on the plan anniversary date of the health benefit plan issued to a small employer. The percentage increase in the premium rate charged to a small employer for a new rating period may not exceed the sum of the following:

(A) The percentage change in the geographic average rate measured from the first day of the prior rating period to the first day of the new period; and

(B) Any adjustment attributable to changes in age and differences in family composition.

(9) Premium rates for grandfathered health plans are subject to requirements prescribed by the department by rule.

(10) In connection with the offering for sale of any health benefit plan to a small employer, each carrier shall make a reasonable disclosure as part of the carrier’s solicitation and sales materials of:

(a) The full array of health benefit plans that are offered to small employers by the carrier;

(b) The authority of the carrier to adjust rates and premiums, and the extent to which the carrier considers age, tobacco use, family composition and geographic factors in establishing and adjusting rates and premiums; and

(c) The benefits and premiums for all health insurance coverage for which the employer is qualified.

(11) Intentionally left blank —Ed.

(a) Each carrier shall maintain at the carrier’s principal place of business a complete and detailed description of the carrier’s rating practices and renewal underwriting practices relating to the carrier’s small employer health benefit plans, including information and documentation that demonstrate that the carrier’s rating methods and practices are based upon commonly accepted actuarial practices and are in accordance with sound actuarial principles.

(b) A carrier offering a small employer health benefit plan shall file with the department at least once every 12 months an actuarial certification that the carrier is in compliance with ORS 743B.010 (Issuance of group health benefit plan to affiliated group of employers) to 743B.013 (Requirements for small employer health benefit plans) and that the rating methods of the carrier are actuarially sound. Each certification must be in a uniform form and manner and must contain such information as specified by the department. The carrier shall retain a copy of each certification at the carrier’s principal place of business. A carrier is not required to file the actuarial certification under this paragraph if the department has approved the carrier’s rate filing within the preceding 12-month period.

(c) A carrier shall make the information and documentation described in paragraph (a) of this subsection available to the department upon request. Except as provided in ORS 743.018 (Filing of rates for life and health insurance) and except in cases of violations of ORS 743B.010 (Issuance of group health benefit plan to affiliated group of employers) to 743B.013 (Requirements for small employer health benefit plans) , the information is proprietary and trade secret information and is not subject to disclosure to persons outside the department except as agreed to by the carrier or as ordered by a court of competent jurisdiction.

(12) A carrier may not provide any financial or other incentive to any insurance producer that would encourage the insurance producer to sell health benefit plans of the carrier to small employer groups based on a small employer group’s anticipated claims experience.

(13) For purposes of this section, the date a small employer health benefit plan is continued is the anniversary date of the first issuance of the health benefit plan.

(14) A carrier shall include a provision that offers coverage to all eligible employees of a small employer and to all dependents of the eligible employees to the extent the employer chooses to offer coverage to dependents.

(15) All small employer health benefit plans must contain special enrollment periods during which eligible employees and dependents may enroll for coverage, as provided by federal law and rules adopted by the department.

(16) A small employer health benefit plan may not impose annual or lifetime limits on the dollar amount of essential health benefits. [Formerly 743.737; 2017 c.479 §16a; 2017 c.701 §23]

Source: Section 743B.013 — Requirements for small employer health benefit plans , https://www.­oregonlegislature.­gov/bills_laws/ors/ors743B.­html (accessed May 26, 2025).
ORS § 735.260 — OR Code / Title 56 / Chapter 735 / Section 735.260
735.260 Rules
Status: in_force

The Director of the Department of Consumer and Business Services may adopt all rules necessary to insure the efficient, equitable operation of the market assistance plan or the joint underwriting association, including but not limited to rules requiring or limiting certain policy provisions. [1987 c.774 §85]

Source: Section 735.260 — Rules , https://www.­oregonlegislature.­gov/bills_laws/ors/ors735.­html (accessed May 26, 2025).
ORS § 737.230 — OR Code / Title 56 / Chapter 737 / Section 737.230
737.230 Data must include certain information
Status: in_force

The data collected and maintained by each insurer, rating organization or advisory organization pursuant to ORS 737.225 (Records requirements) shall be in sufficient detail to demonstrate the statistical significance of differences or correlations relevant to the rating plan definitions and rate differentials. [1979 c.870 §6]

Source: Section 737.230 — Data must include certain information , https://www.­oregonlegislature.­gov/bills_laws/ors/ors737.­html (accessed May 26, 2025).
ORS § 750.333 — OR Code / Title 56 / Chapter 750 / Section 750.333
750.333 Applicable provisions of Insurance Code
Status: in_force

(1) The following provisions apply to trusts carrying out a multiple employer welfare arrangement:

(a) ORS 705.137 (Information that is confidential or not subject to disclosure) , 705.138 (Confidential and privileged documents) and 705.139 (Agreements with other agencies regarding sharing and use of confidential information) .

(b) ORS 731.004 (Short title) to 731.150 (Definitions of classes of insurance not mutually exclusive) , 731.162 (“Health insurance.”) , 731.216 (Administrative power of director) to 731.268 (Use of reproductions and certified copies as evidence) , 731.296 (Director’s inquiries) to 731.316 (Expenses of examination of insurer) , 731.324 (Service of process on Secretary of State) , 731.328 (Deposits by unauthorized insurers in actions or proceedings) , 731.378 (Foreign and alien insurers exempt from laws governing admission of foreign and alien corporations) , 731.386 (Management of insurers) , 731.390 (Government insurers not to be authorized) , 731.398 (Amendment of certificate of authority) , 731.406 (What certificate evidences) , 731.410 (Continuance, expiration or reinstatement of certificate of authority) , 731.414 (Suspension or revocation of certificate of authority) , 731.418 (Grounds for suspension or revocation of certificate of authority) to 731.434 (Registered office and agent) , 731.454 (Domestic insurers not to transact business in jurisdiction where not authorized) , 731.484 (Prohibition on certain sales related to group health and group life insurance) , 731.486 (Exemption from definition of “transact insurance” for group health and life policies) , 731.488 (Annual audit of insurer) , 731.512 (Withdrawal of insurer) , 731.574 (Annual financial statement) to 731.620 (Assignment of deposited securities) , 731.640 (Eligible deposits) to 731.652 (Proofs for release of deposit to insurers) , 731.804 (Assessments) , 731.808 (“Gross amount of premiums” defined) and 731.844 (No personal liability for paying invalid tax) to 731.992 (Criminal penalty) .

(c) ORS 733.010 (Assets allowed) to 733.050 (Increase of inadequate reserves) , 733.140 (Disallowance of “wash” transactions) to 733.170 (Accounts and records) , 733.210 (Director’s determinations) , 733.510 (Investments of insurers) to 733.680 (Acquisition and retention of personal property generally) and 733.695 (Investment of funds in obligations that are not investment quality) to 733.780 (Prohibited investments) .

(d) ORS 734.014 (Definitions) to 734.440 (Judgment upon assessment) .

(e) ORS 742.001 (Scope of ORS chapters 742, 743, 743A and 743B) to 742.009 (Regulation of sales material) , 742.013 (Representations in applications) , 742.016 (Policy constitutes entire contract) , 742.061 (Recovery of attorney fees in action on policy or contractor’s bond) and 742.065 (Insurance against risk of loss assumed under less than fully insured employee health benefit plan) .

(f) ORS 743.004 (Submission of information by carriers offering health benefit plans) , 743.005 (Protection of health information report) , 743.007 (Data reporting) , 743.008 (Reporting requirements) , 743.010 (Health insurance policy and health benefit plan forms) , 743.018 (Filing of rates for life and health insurance) , 743.020 (Rate filing to include statement of administrative expenses) , 743.023 (Electronic administration) , 743.028 (Uniform health insurance claim forms) , 743.029 (Uniform standards for health care financial and administrative transactions) , 743.053 (Prohibition on requirement that death or dismemberment occur in less than 180 days after accident) , 743.405 (General requirements for health insurance policies) , 743.406 (Required provisions in group health insurance policies) , 743.524 (Eligibility of association to be group health policyholder) , 743.526 (Determination of whether trustees are policyholders) , 743.535 (Health benefit coverage for guaranteed association) and 743B.221 (Assignment of beneficiaries to primary care providers) .

(g) ORS 743A.010 (Services provided by state hospital or state approved program) , 743A.012 (Emergency services) , 743A.014 (Payments for ambulance care and transportation) , 743A.020 (Services provided by acupuncturist) , 743A.024 (Services provided by clinical social worker) , 743A.034 (Services provided by expanded practice dental hygienist) , 743A.036 (Services provided by licensed nurse practitioner or licensed physician assistant) , 743A.040 (Services provided by optometrist) , 743A.048 (Services provided by psychologist) , 743A.051 (Services provided by pharmacist) , 743A.052 (Services provided by professional counselor or marriage and family therapist) , 743A.058 (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.180 (Tourette Syndrome) , 743A.185 (Telemedical health services for treatment of diabetes) , 743A.188 (Inborn errors of metabolism) , 743A.190 (Children with pervasive developmental disorder) , 743A.192 (Clinical trials) , 743A.250 (Emergency eye care services) , 743A.252 (Child abuse assessments) , 743A.260 (Inmates) and 743A.310 (Primary care visits) .

(h) ORS 743B.001 (Definitions) , 743B.003 (Purposes) to 743B.127 (Rules for ORS 743.022, 743B.125 and 743B.126) (except 743B.125 (Individual health benefit plans) to 743B.127 (Rules for ORS 743.022, 743B.125 and 743B.126) ), 743B.195 (Enforcement of Newborns’ and Mothers’ Health Protection Act of 1996) , 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.310 (Rescinding coverage) , 743B.320 (Minimum grace period) , 743B.321 (Applicability of ORS 743B.320) , 743B.330 (Notice to policyholder required for cancellation or nonrenewal of health benefit plan) , 743B.340 (When group health insurance policies to continue in effect upon payment of premium by insured individual) , 743B.341 (Continuation of benefits after termination of group health insurance policy) , 743B.342 (Continuation of benefits after injury or illness covered by workers’ compensation) , 743B.343 (Availability of continued coverage under group policy for surviving, divorced or separated spouse 55 or older) , 743B.344 (Procedure for obtaining continuation of coverage under ORS 743B.343) , 743B.345 (Premium for continuation of coverage under ORS 743B.344) , 743B.347 (Continuation of coverage under group policy upon termination of membership in group health insurance policy) , 743B.400 (Decisions regarding health care facility length of stay, level of care and follow-up care) , 743B.403 (Insurer prohibited practices) , 743B.407 (Naturopathic physicians) , 743B.420 (Prior authorization requirements) , 743B.423 (Utilization review requirements for insurers offering health benefit plan) , 743B.451 (Refund of paid claims) , 743B.453 (Underpayment of claims) , 743B.470 (Medicaid not considered in coverage eligibility determination) , 743B.505 (Provider networks) , 743B.550 (Disclosure of information) , 743B.555 (Confidential communications) and 743B.601 (Synchronization of prescription drug refills) .

(i) The following provisions of ORS chapter 744:

(A) ORS 744.052 (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.

(j) ORS 746.005 (Trade practices exempted from prohibitions) to 746.140 (Sale of life insurance with securities) , 746.160 (Practices injurious to free competition) and 746.220 (Debtor’s option in furnishing credit life or credit health insurance) to 746.370 (Records of insureds) .

(2) For the purposes of this section:

(a) A trust carrying out a multiple employer welfare arrangement is an insurer.

(b) References to certificates of authority are references to certificates of multiple employer welfare arrangement.

(c) Contributions are premiums.

(3) The provision of health benefits under ORS 750.301 (Definitions for ORS 750.301 to 750.341) to 750.341 (Requirement for multiple employer welfare arrangement to become traditional insurer) is the transaction of health insurance.

(4) The Department of Consumer and Business Services may adopt rules that are necessary to implement the provisions of ORS 750.301 (Definitions for ORS 750.301 to 750.341) to 750.341 (Requirement for multiple employer welfare arrangement to become traditional insurer) . [1993 c.615 §19; 1995 c.506 §4; 1995 c.603 §30; 1995 c.669 §4; 1995 c.672 §9; 1997 c.343 §23; 1997 c.496 §5; 1997 c.759 §6; 1999 c.428 §§7,8; 1999 c.429 §§3,4; 1999 c.633 §§9,10; 1999 c.749 §§6,7; 1999 c.987 §§25,26; 2001 c.266 §17; 2001 c.742 §5; 2003 c.87 §25; 2003 c.91 §6; 2003 c.137 §8; 2003 c.263 §4; 2003 c.363 §15; 2003 c.364 §170; 2003 c.446 §3; 2003 c.748 §4; 2005 c.418 §6; 2007 c.182 §§10,11,12; 2007 c.313 §§7,8,9; 2007 c.504 §§5,6,7; 2007 c.566 §§5,6,7; 2007 c.872 §§5,6,7; 2008 c.22 §§7,8,9; 2009 c.274 §§5,6,7; 2009 c.383 §§4,5; 2009 c.384 §§5,6,7; 2009 c.423 §§5,6,7; 2009 c.503 §§5,6,7; 2009 c.549 §12; 2009 c.553 §§5,6,7; 2009 c.630 §§5,6,7; 2009 c.703 §§2,3,4; 2009 c.807 §§7,8,9; 2011 c.130 §8; 2011 c.312 §4; 2011 c.500 §44; 2011 c.660 §27; 2011 c.716 §14; 2012 c.21 §4; 2013 c.682 §4; 2014 c.25 §8; 2015 c.59 §10; 2015 c.100 §8; 2015 c.224 §8; 2015 c.362 §12; 2015 c.470 §11; 2017 c.206 §11; 2019 c.151 §39; 2021 c.97 §86; 2022 c.37 §13]

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

Source: Section 750.333 — Applicable provisions of Insurance Code; rules , https://www.­oregonlegislature.­gov/bills_laws/ors/ors750.­html (accessed May 26, 2025).
ORS § 743b.125 — OR Code / Title 56 / Chapter 743b / Section 743b.125
743B.125 Individual health benefit plans
Status: in_force

(1) With respect to coverage under an individual health benefit plan, a carrier may not impose a preexisting condition exclusion or an individual coverage waiting period.

(2) With respect to individual coverage under a grandfathered health plan, a carrier:

(a) May impose an exclusion period for specified covered services applicable to all individuals enrolling for the first time in the individual health benefit plan.

(b) May not impose a preexisting condition exclusion unless the exclusion complies with the following requirements:

(A) The exclusion applies only to a condition for which medical advice, diagnosis, care or treatment was recommended or received during the six-month period immediately preceding the individual’s effective date of coverage.

(B) The exclusion expires no later than six months after the individual’s effective date of coverage.

(c) May not impose a waiting period.

(3) An individual health benefit plan other than a grandfathered health plan must cover, at a minimum, all essential health benefits.

(4) Intentionally left blank —Ed.

(a) A carrier shall issue any individual health benefit plan offered by the carrier, other than a grandfathered health plan, to any individual who applies for the health benefit plan, if:

(A) The individual resides in the geographic area where the plan is offered;

(B) The individual agrees to make the required premium payments; and

(C) Issuance of the health benefit plan is not otherwise prohibited by law.

(b) The Department of Consumer and Business Services may allow a carrier to cap the number of individuals enrolled in an individual health benefit plan offered by the carrier if the department finds that issuing the health benefit plan to more individuals than are currently enrolled in the plan would have a material adverse effect upon the carrier’s ability to fulfill the carrier’s contractual obligations or result in the financial impairment of the carrier.

(c) Except as otherwise provided in this section and ORS 743.022 (Premium rates for individual health benefit plans) , a carrier offering an individual health benefit plan may not impose different terms or conditions on the coverage provided or the premium charged based on the actual or expected health status of an enrollee or prospective enrollee.

(5) A carrier shall renew an individual health benefit plan, including a health benefit plan issued through a bona fide association, unless:

(a) The policyholder fails to pay the required premiums.

(b) The policyholder or a representative of the policyholder engages in fraud or makes an intentional misrepresentation of a material fact as prohibited by the terms of the policy.

(c) The carrier discontinues both offering and renewing all of the carrier’s individual health benefit plans in this state or in a specified service area within this state. In order to discontinue the plans under this paragraph, the carrier:

(A) Shall give notice of the decision to the Department of Consumer and Business Services and to all policyholders covered by the plans;

(B) May not cancel coverage under the plans for 180 days after the date of the notice required under subparagraph (A) of this paragraph if coverage is discontinued in the entire state or in a specified service area, except that:

(i) The carrier shall cancel coverage in accordance with subparagraph (C) of this paragraph if the cancellation is for a specified service area in the circumstances described in subparagraph (C) of this paragraph; and

(ii) The Director of the Department of Consumer and Business Services may specify a cancellation date other than the cancellation date specified in this subparagraph if the carrier is subject to a delinquency proceeding, as defined in ORS 734.014 (Definitions) ; and

(C) May not cancel coverage under the plans for 90 days after the date of the notice required under subparagraph (A) of this paragraph if coverage is discontinued in a specified service area because of an inability to reach an agreement with the health care providers or organization of health care providers to provide services under the plans within the service area.

(d) The carrier discontinues both offering and renewing an individual health benefit plan in a specified service area within this state because of an inability to reach an agreement with the health care providers or organization of health care providers to provide services under the plan within the service area. In order to discontinue a plan under this paragraph, the carrier:

(A) Shall give notice of the decision to the department and to all policyholders covered by the plan;

(B) May not cancel coverage under the plan for 90 days after the date of the notice required under subparagraph (A) of this paragraph; and

(C) Shall offer in writing to each policyholder covered by the plan, all other individual health benefit plans that the carrier offers in the specified service area. The carrier shall offer the plans at least 90 days prior to discontinuation.

(e) The carrier discontinues both offering and renewing an individual health benefit plan, other than a grandfathered health plan, for all individuals in this state or in a specified service area within this state, other than a plan discontinued under paragraph (d) of this subsection.

(f) The carrier discontinues both offering and renewing a grandfathered health plan for all individuals in this state or in a specified service area within this state, other than a plan discontinued under paragraph (d) of this subsection.

(g) With respect to plans that are being discontinued under paragraph (e) or (f) of this subsection, the carrier shall:

(A) Offer in writing to each policyholder covered by the plan, all health benefit plans that the carrier offers to individuals in the specified service area.

(B) Offer the plans at least 90 days prior to discontinuation.

(C) Act uniformly without regard to the claims experience of the affected policyholders or the health status of any current or prospective enrollee.

(h) The Director of the Department of Consumer and Business Services orders the carrier to discontinue coverage in accordance with procedures specified or approved by the director upon finding that the continuation of the coverage would:

(A) Not be in the best interests of the enrollee; or

(B) Impair the carrier’s ability to meet the carrier’s contractual obligations.

(i) In the case of an individual health benefit plan that delivers covered services through a specified network of health care providers, the enrollee no longer lives, resides or works in the service area of the provider network and the termination of coverage is not related to the health status of any enrollee.

(j) In the case of a health benefit plan that is offered in the individual market only through one or more bona fide associations, the membership of an individual in the association ceases and the termination of coverage is not related to the health status of any enrollee.

(6) A carrier may modify an individual health benefit plan at the time of coverage renewal. The modification is not a discontinuation of the plan under subsection (5)(c), (e) and (f) of this section.

(7) Notwithstanding any other provision of this section, and subject to the provisions of ORS 743B.310 (Rescinding coverage) (2) and (4), a carrier may rescind an individual health benefit plan if the policyholder or a representative of the policyholder:

(a) Performs an act, practice or omission that constitutes fraud; or

(b) Makes an intentional misrepresentation of a material fact as prohibited by the terms of the policy.

(8) A carrier that continues to offer coverage in the individual market in this state is not required to offer coverage in all of the carrier’s individual health benefit plans. However, if a carrier elects to continue a plan that is closed to new individual policyholders instead of offering alternative coverage in the carrier’s other individual health benefit plans, the coverage for all existing policyholders in the closed plan is renewable in accordance with subsection (5) of this section.

(9) An individual health benefit plan may not impose annual or lifetime limits on the dollar amount of essential health benefits.

(10) A grandfathered health plan may not impose lifetime limits on the dollar amount of essential health benefits.

(11) This section does not require a carrier to actively market, offer, issue or accept applications for:

(a) A bona fide association health benefit plan from individuals who are not members of the bona fide association; or

(b) A grandfathered health plan from individuals who are not eligible for coverage under the plan. [Formerly 743.766; 2017 c.479 §18; 2019 c.285 §7; 2021 c.281 §4]

Source: Section 743B.125 — Individual health benefit plans; waiting or exclusion periods; preexisting condition exclusions; guaranteed issue and renewal , https://www.­oregonlegislature.­gov/bills_laws/ors/ors743B.­html (accessed May 26, 2025).
ORS § 743a.078 — OR Code / Title 56 / Chapter 743a / Section 743a.078
743A.078 Newborn nurse home visiting services
Status: in_force

(1) As used in this section, “carrier,” “enrollee” and “health benefit plan” have the meanings given those terms in ORS 743B.005 (Definitions) .

(2) A health benefit plan offered in this state must reimburse in full the cost to a provider of delivering universal newborn nurse home visiting services, as prescribed by the Oregon Health Authority by rule under ORS 433.301 (Newborn nurse home visiting services program) (7) and (8).

(3) The coverage must be provided without any cost-sharing, coinsurance or deductible applicable to the services.

(4) Carriers must offer the services in their health benefit plans but enrollees are not required to receive the services as a condition of coverage and may not be penalized or in any way discouraged from declining the services.

(5) A carrier must notify an enrollee about the services whenever an enrollee adds a newborn to coverage.

(6) A carrier may use in-network providers or may contract with local public health authorities to provide the services.

(7) Carriers shall report to the authority, in the form and manner prescribed by the authority, data regarding claims submitted for services covered under this section to monitor the provision of the services.

(8) This section is exempt from ORS 743A.001 (Automatic repeal of certain statutes on individual and group health insurance) . [2019 c.552 §3; 2022 c.94 §1]

Note: 743A.078 (Newborn nurse home visiting 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.078 — Newborn nurse home visiting services , https://www.­oregonlegislature.­gov/bills_laws/ors/ors743A.­html (accessed May 26, 2025).
ORS § 748.603 — OR Code / Title 56 / Chapter 748 / Section 748.603
748.603 Relationship to other insurance laws
Status: in_force

(1) Societies are governed by this chapter and are exempt from all other provisions of the insurance laws of this state unless expressly designated therein, or unless specifically made applicable by this chapter.

(2) ORS 705.137 (Information that is confidential or not subject to disclosure) , 705.139 (Agreements with other agencies regarding sharing and use of confidential information) , 731.004 (Short title) to 731.026 (Application of Insurance Code to particular insurers) , 731.036 (Persons completely exempt from application of Insurance Code) to 731.136 (“State.”) , 731.146 (“Transact insurance.”) to 731.156 (“Variable life insurance”) , 731.162 (“Health insurance.”) , 731.166 (“Industrial life insurance.”) , 731.170 (“Life insurance”) , 731.216 (Administrative power of director) to 731.268 (Use of reproductions and certified copies as evidence) , 731.296 (Director’s inquiries) , 731.324 (Service of process on Secretary of State) , 731.328 (Deposits by unauthorized insurers in actions or proceedings) , 731.354 (Certificate of authority required) , 731.356 (Unauthorized insurance transaction enforcement) , 731.358 (Requirements of domestic insurers generally) , 731.378 (Foreign and alien insurers exempt from laws governing admission of foreign and alien corporations) , 731.380 (Authority of foreign and alien insurers to take, acquire, hold and enforce notes secured by mortgages) , 731.381 (Exemption from taxes for foreign and alien insurers engaging in activities authorized by ORS 731.380) , 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) , 731.394 (Combinations of insuring powers in one insurer) , 731.396 (Certificate of authority and good financial condition required to issue variable life insurance or variable annuity policies) , 731.398 (Amendment of certificate of authority) , 731.402 (Issuance or refusal of certificate of authority) , 731.406 (What certificate evidences) , 731.410 (Continuance, expiration or reinstatement of certificate of authority) , 731.422 (Order of suspension, revocation or refusal) to 731.434 (Registered office and agent) , 731.446 (Policyholder deposits) to 731.454 (Domestic insurers not to transact business in jurisdiction where not authorized) , 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) , 731.592 (Reporting criminal conduct involving insurance) , 731.594 (Immunity from civil liability) , 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) , 731.804 (Assessments) , 731.844 (No personal liability for paying invalid tax) to 731.992 (Criminal penalty) , 731.870 (State of emergency) , 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) , 733.010 (Assets allowed) to 733.050 (Increase of inadequate reserves) , 733.080 (Reserves for health insurance) , 733.140 (Disallowance of “wash” transactions) to 733.210 (Director’s determinations) , 733.220 (Establishment and regulation of separate accounts to fund life insurance or annuities) , 733.510 (Investments of insurers) , 733.652 (Investment of funds of separate accounts) to 733.658 (Applicability of separate account investment limitations) , 733.730 (Approval by board of directors of investments and deposits) to 733.750 (Disposal of investments on order of director) , 742.001 (Scope of ORS chapters 742, 743, 743A and 743B) , 742.003 (Filing and approval of policy forms) , 742.005 (Grounds for disapproval of policy forms) , 742.007 (Director’s withdrawal of approval) , 742.009 (Regulation of sales material) , 742.013 (Representations in applications) to 742.021 (Standard provisions in general) , 742.028 (Additional policy contents) , 742.038 (Validity and construction of noncomplying forms) , 742.041 (Permissible classes of insurance in one policy) , 742.046 (Delivery of policy) , 742.051 (Renewal by certificate) , 742.150 (Approval by director) to 742.162 (Transfer and novation of policy effected by director) and 744.700 (Definitions for ORS 744.700 to 744.740) to 744.740 (Responsibility of insurer using third party administrator) and ORS chapters 734, 743, 743A and 743B apply to fraternal benefit societies to the extent not inconsistent with the express provisions of this chapter.

(3) For the purposes of this subsection and subsection (2) of this section, fraternal benefit societies shall be deemed insurers, and benefit certificates issued by fraternal benefit societies shall be deemed policies.

(4) Every society authorized to do business in this state shall be subject to the provisions of ORS chapter 746 relating to unfair trade practices. However, nothing in ORS chapter 746 shall be construed as applying to or affecting the right of any society to determine its eligibility requirements for membership, or be construed as applying to or affecting the offering of benefits exclusively to members or persons eligible for membership in the society by a subsidiary corporation or affiliated organization of the society. [1987 c.490 §§25,35,45; 1987 c.739 §4a; 1987 c.838 §15a; 1989 c.255 §12; 1989 c.474 §3; 1989 c.1022 §10; 1991 c.182 §17; 1991 c.401 §32; 1991 c.673 §7; 1991 c.812 §23; 1993 c.447 §117; 1995 c.30 §12; 1995 c.638 §8; 1999 c.633 §6; 2001 c.377 §19; 2003 c.802 §177; 2007 c.71 §243; 2008 c.22 §4; 2013 c.698 §32]

Source: Section 748.603 — Relationship to other insurance laws , https://www.­oregonlegislature.­gov/bills_laws/ors/ors748.­html (accessed May 26, 2025).
ORS § 733.030 — OR Code / Title 56 / Chapter 733 / Section 733.030
733.030 Liabilities in general
Status: in_force

In any determination of the financial condition of an insurer, liabilities to be charged against its assets shall be calculated in accordance with the Insurance Code and shall include:

(1) The amount necessary to pay all of its unpaid losses and claims incurred on or prior to the date of the statement, whether reported or unreported to the insurer, together with the expenses of adjustment or settlement thereof.

(2) For insurance other than specified in subsections (3) and (4) of this section, the amount of reserves equal to the unearned portions of the gross premiums charged on policies in force, calculated in accordance with the Insurance Code.

(3) For life insurance policies:

(a) Reserves on life insurance benefits, valued according to the tables of mortality, rates of interest, and valuation methods applicable thereto which are adopted pursuant to the Insurance Code.

(b) Reserves for disability benefits, for both active and disabled lives.

(c) Reserves for accidental death benefits.

(d) Any additional reserves considered to be necessary by the Director of the Department of Consumer and Business Services.

(4) For health insurance policies, the amount of reserves required pursuant to ORS 733.080 (Reserves for health insurance) .

(5) Taxes, expenses and other obligations due or accrued at the date of the statement.

(6) Any additional reserves for asset valuation contingencies or loss contingencies required by the Insurance Code or considered to be necessary by the director for the protection of policyholders and stockholders of the insurer. [1967 c.359 §210]

Source: Section 733.030 — Liabilities in general , https://www.­oregonlegislature.­gov/bills_laws/ors/ors733.­html (accessed May 26, 2025).
ORS § 743a.130 — OR Code / Title 56 / Chapter 743a / Section 743a.130
743A.130 Proton beam therapy
Status: in_force

(1) A health benefit plan, as defined in ORS 743B.005 (Definitions) , that provides coverage of radiation therapy for the treatment of prostate cancer must provide coverage for proton beam therapy for the treatment of prostate cancer on a basis no less favorable than the coverage of radiation therapy including with respect to prior authorization or other utilization review requirements.

(2) This section is exempt from ORS 743A.001 (Automatic repeal of certain statutes on individual and group health insurance) . [2019 c.466 §2; 2021 c.384 §1; 2023 c.106 §1]

Note: 743A.130 (Proton beam therapy) 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.130 — Proton beam therapy , https://www.­oregonlegislature.­gov/bills_laws/ors/ors743A.­html (accessed May 26, 2025).
ORS § 732.630 — OR Code / Title 56 / Chapter 732 / Section 732.630
732.630 Dissenters’ rights
Status: in_force

(1) Dissenters’ rights provided in ORS 60.551 (Definitions for ORS 60.551 to 60.594) to 60.594 (Court costs and counsel fees) are not available to any member, whether or not eligible, of a converting mutual insurer or a restructuring mutual holding company.

(2) An action challenging the validity of or arising from the conversion, reorganization or restructuring or other acts taken or proposed to be taken under the plan or ORS 732.600 (Definitions for ORS 732.600 to 732.630) to 732.630 (Dissenters’ rights) must be commenced not later than the 60th day after the effective date of the conversion, reorganization or restructuring or other acts so taken and may be pursued only if they are unlawful or fraudulent. There shall be a rebuttable presumption that any act set forth in an order of the Director of the Department of Consumer and Business Services is lawful. [1997 c.771 §15]

RISK MANAGEMENT FRAMEWORKS, OWN RISK AND SOLVENCY ASSESSMENTS AND CORPORATE GOVERNANCE ANNUAL DISCLOSURES

Source: Section 732.630 — Dissenters’ rights; action challenging validity of conversion, reorganization or restructuring , https://www.­oregonlegislature.­gov/bills_laws/ors/ors732.­html (accessed May 26, 2025).
ORS § 741.500 — OR Code / Title 56 / Chapter 741 / Section 741.500
741.500 Required documentation
Status: in_force

(1) Intentionally left blank —Ed.

(a) The Oregon Health Authority shall adopt by rule the information that must be documented in order for a person to qualify for:

(A) Qualified health plan coverage through the health insurance exchange;

(B) Premium tax credits; and

(C) Cost-sharing reductions.

(b) The documentation specified by the authority under this subsection shall include but is not limited to documentation of:

(A) The identity of the person;

(B) The status of the person as a United States citizen, or lawfully admitted noncitizen, and a resident of this state;

(C) Information concerning the income and resources of the person as necessary to establish the person’s financial eligibility for coverage, for premium tax credits and for cost-sharing reductions, which may include income tax return information and a Social Security number; and

(D) Employer identification information and employer-sponsored health insurance coverage information applicable to the person.

(2) The authority shall implement systems that provide electronic access to, and use, disclosure and validation of data needed to administer the exchange, to comply with federal data access and data exchange requirements and to streamline and simplify exchange processes.

(3) Information and data that the authority obtains under this section may be exchanged with other state or federal health insurance exchanges, with state or federal agencies and, subject to ORS 741.510 (Confidential information) , for the purpose of carrying out exchange responsibilities, including but not limited to:

(a) Establishing and verifying eligibility for:

(A) A state medical assistance program;

(B) The purchase of qualified health plans through the exchange; and

(C) Any other programs that are offered through the exchange;

(b) Establishing and verifying the amount of a person’s federal tax credit, cost-sharing reduction or premium assistance;

(c) Complying with other federal requirements; or

(d) Improving the operations of the exchange and for program analysis. [2011 c.415 §14; 2015 c.3 §30; 2021 c.569 §31; 2023 c.584 §4]

Source: Section 741.500 — Required documentation; rules , https://www.­oregonlegislature.­gov/bills_laws/ors/ors741.­html (accessed May 26, 2025).
ORS § 732.568 — OR Code / Title 56 / Chapter 732 / Section 732.568
732.568 Disclaimer of affiliation
Status: in_force

(1) Any person, insurer or member of an insurance holding company system may file with the Director of the Department of Consumer and Business Services a disclaimer of affiliation with any authorized insurer. The disclaimer must fully disclose all material relationships and bases for affiliation between the person, insurer or member and the insurer to which the disclaimer of affiliation applies, as well as the basis for disclaiming the affiliation.

(2) After the person, insurer or member files a disclaimer, the person, insurer or member and the insurer to which the disclaimer applies are relieved of any duty to register or report under 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) that may arise out of the insurer’s relationship with the person, insurer or member of the insurance holding company system that filed the disclaimer unless the director disallows the disclaimer.

(3) A disclaimer that the person, insurer or member of the insurance holding company system files under this section is effective unless within 30 days after the director receives the disclaimer the director notifies the person, the insurer or the member of the insurance holding company system that director has disallowed the disclaimer.

(4) The director shall grant a hearing if the person, insurer or member of an insurance holding company system that filed the disclaimer requests a hearing. [Formerly 732.695; 2013 c.370 §25]

Source: Section 732.568 — Disclaimer of affiliation; contents; subsequent duty to register; disallowance of disclaimers by director , https://www.­oregonlegislature.­gov/bills_laws/ors/ors732.­html (accessed May 26, 2025).
ORS § 748.403 — OR Code / Title 56 / Chapter 748 / Section 748.403
748.403 Standards of valuation for certificates
Status: in_force

(1) Standards of valuation for certificates issued prior to January 1, 1989, shall be those provided by the laws applicable immediately prior to January 1, 1988.

(2) The minimum standards of valuation for certificates issued on or after January 1, 1989, shall be based on the following tables:

(a) For certificates of life insurance, the Commissioner’s 1941 Standard Ordinary Mortality Table, the Commissioner’s 1941 Standard Industrial Mortality Table, the Commissioner’s 1958 Standard Ordinary Mortality Table, the Commissioner’s 1980 Standard Ordinary Mortality Table or any more recent table made applicable to life insurers; or

(b) For annuity and pure endowment certificates, for total and permanent disability benefits, for accidental death benefits and for noncancelable accident and health benefits, the tables that are authorized for use by life insurers in this state.

(3) The tables referred to in subsection (2) of this section shall be under valuation methods and standards, including interest assumptions, in accordance with the laws of this state applicable to life insurers issuing policies containing like benefits.

(4) The Director of the Department of Consumer and Business Services may accept other standards for valuation if the director finds that the reserves produced will not be less in the aggregate than reserves computed in accordance with the minimum valuation standard prescribed in subsection (2) of this section. The director may vary the standards of mortality applicable to all benefit contracts on substandard lives or other extra hazardous lives by any society authorized to do business in this state.

(5) Any society, with the consent of the director of insurance of the state of domicile of the society and under conditions the director may impose, may establish and maintain reserves on its certificates in excess of the reserves required, but the contractual rights of any benefit member shall not be affected. [1987 c.490 §26; 2005 c.22 §499]

Source: Section 748.403 — Standards of valuation for certificates , https://www.­oregonlegislature.­gov/bills_laws/ors/ors748.­html (accessed May 26, 2025).
ORS § 737.017 — OR Code / Title 56 / Chapter 737 / Section 737.017
737.017 “Member,” “subscriber” defined
Status: in_force

As used in this chapter, unless the context requires otherwise:

(1) “Member” means:

(a) An insurer that participates in or is entitled to participate in the management of a rating, advisory or other organization; or

(b) For purposes of workers’ compensation insurance, an insurer that is affiliated or associated with a rating, advisory or other organization by agreement with the organization for the purpose of obtaining the rates and rating manuals or the services offered by the organization.

(2) “Subscriber” means an insurer that is furnished at its request:

(a) With rates and rating manuals by a rating organization of which it is not a member; or

(b) With advisory services by an advisory organization of which it is not a member. [1969 c.690 §16; 1999 c.235 §6]

Source: Section 737.017 — “Member,” “subscriber” defined , https://www.­oregonlegislature.­gov/bills_laws/ors/ors737.­html (accessed May 26, 2025).
ORS § 741.300 — OR Code / Title 56 / Chapter 741 / Section 741.300
741.300 Definitions
Status: in_force

As used in ORS 741.001 (Health insurance exchange) to 741.540 (Complaints and investigations confidential) :

(1) “Coordinated care organization” has the meaning given that term in ORS 414.025 (Definitions for ORS chapters 411, 413 and 414) .

(2) “Essential health benefits” has the meaning given that term in ORS 731.097 (“Essential health benefits.”) .

(3) “Health benefit plan” has the meaning given that term in ORS 743B.005 (Definitions) .

(4) “Health care service contractor” has the meaning given that term in ORS 750.005 (Definitions) .

(5) “Health insurance” has the meaning given that term in ORS 731.162 (“Health insurance.”) , excluding disability income insurance.

(6) “Health insurance exchange” or “exchange” means the division of the Oregon Health Authority that operates an American Health Benefit Exchange as described in 42 U.S.C. 18031, 18032, 18033 and 18041.

(7) “Health plan” means a health benefit plan or dental only benefit plan offered by an insurer.

(8) “Insurance producer” has the meaning given that term in ORS 731.104 (“Insurance producer.”) .

(9) “Insurer” means an insurer as defined in ORS 731.106 (“Insurer.”) that offers health insurance, a health care service contractor, a prepaid managed care health services organization or a coordinated care organization.

(10) “Prepaid managed care health services organization” has the meaning given that term in ORS 414.025 (Definitions for ORS chapters 411, 413 and 414) .

(11) “Qualified health plan” means a health benefit plan certified by the authority in accordance with the requirements, standards and criteria adopted by the authority under ORS 741.310 (Requirements for purchase of insurance through exchange and for participation of insurers in exchange) .

(12) “Small Business Health Options Program” or “SHOP” means a health insurance exchange for small employers as described in 42 U.S.C. 18031.

(13) “State program” means a program providing medical assistance, as defined in ORS 414.025 (Definitions for ORS chapters 411, 413 and 414) , and any self-insured health benefit plan or health plan offered to employees by the Public Employees’ Benefit Board or the Oregon Educators Benefit Board. [2011 c.415 §1; 2013 c.681 §10; 2015 c.3 §24; 2015 c.792 §9; 2021 c.569 §27; 2023 c.9 §52]

Note: The amendments to 741.300 (Definitions) by section 4, chapter 585, Oregon Laws 2023, become operative November 1, 2026. See section 7, chapter 585, Oregon Laws 2023. The text that is operative on and after November 1, 2026, is set forth for the user’s convenience.

741.300 (Definitions) . As used in ORS 741.001 (Health insurance exchange) to 741.540 (Complaints and investigations confidential) :

(1) “Coordinated care organization” has the meaning given that term in ORS 414.025 (Definitions for ORS chapters 411, 413 and 414) .

(2) “Essential health benefits” has the meaning given that term in ORS 731.097 (“Essential health benefits.”) .

(3) “Health benefit plan” has the meaning given that term in ORS 743B.005 (Definitions) .

(4) “Health care service contractor” has the meaning given that term in ORS 750.005 (Definitions) .

(5) “Health insurance” has the meaning given that term in ORS 731.162 (“Health insurance.”) , excluding disability income insurance.

(6) “Health insurance exchange” or “exchange” means an American Health Benefit Exchange as described in 42 U.S.C. 18031, 18032, 18033 and 18041.

(7) “Health plan” means a health benefit plan or dental only benefit plan offered by an insurer.

(8) “Insurance producer” has the meaning given that term in ORS 731.104 (“Insurance producer.”) .

(9) “Insurer” means an insurer as defined in ORS 731.106 (“Insurer.”) that offers health insurance, a health care service contractor, a prepaid managed care health services organization or a coordinated care organization.

(10) “Prepaid managed care health services organization” has the meaning given that term in ORS 414.025 (Definitions for ORS chapters 411, 413 and 414) .

(11) “Qualified health plan” means a health benefit plan certified by the authority in accordance with the requirements, standards and criteria adopted by the authority under ORS 741.310 (Requirements for purchase of insurance through exchange and for participation of insurers in exchange) .

(12) “Small Business Health Options Program” or “SHOP” means a health insurance exchange for small employers as described in 42 U.S.C. 18031.

(13) “State program” means a program providing medical assistance, as defined in ORS 414.025 (Definitions for ORS chapters 411, 413 and 414) , and any self-insured health benefit plan or health plan offered to employees by the Public Employees’ Benefit Board or the Oregon Educators Benefit Board.

Source: Section 741.300 — Definitions , https://www.­oregonlegislature.­gov/bills_laws/ors/ors741.­html (accessed May 26, 2025).
ORS § 734.055 — OR Code / Title 56 / Chapter 734 / Section 734.055
734.055 Action against person violating order of supervision
Status: in_force

The Director of the Department of Consumer and Business Services or supervisor on behalf of an insurer under supervision may bring an action for damages against any person who violates any order of the director under ORS 734.043 (Supervision of insurer) if the violation reduces the net worth of the insurer or results in loss to the insurer that the insurer would not have suffered otherwise. The director or supervisor may recover damages to the extent of the reduction or loss. [1989 c.425 §9]

Source: Section 734.055 — Action against person violating order of supervision , https://www.­oregonlegislature.­gov/bills_laws/ors/ors734.­html (accessed May 26, 2025).
ORS § 731.450 — OR Code / Title 56 / Chapter 731 / Section 731.450
731.450 Unrelated business prohibited
Status: in_force

Except as authorized by the federal Gramm-Leach-Bliley Act (P.L. 106-102), an insurer may not engage in any business except the making of insurance or a kind of business related to the insurance business. However, a foreign or alien insurer may engage, outside this state, in any business permitted by its articles of incorporation and the laws of the state of its domicile; and a title insurer also may engage in business as an escrow agent; provided, however, that a title insurer engaging in business as an escrow agent shall be subject to the provisions of ORS 696.505 (Definitions for ORS 696.505 to 696.590) to 696.590 (Penalty amounts) in respect to its escrow activities. [1967 c.359 §97; 1971 c.398 §5; 1977 c.351 §13; 2001 c.377 §57]

Source: Section 731.450 — Unrelated business prohibited; exceptions; title insurer as escrow agent , https://www.­oregonlegislature.­gov/bills_laws/ors/ors731.­html (accessed May 26, 2025).
ORS § 746.615 — OR Code / Title 56 / Chapter 746 / Section 746.615
746.615 Pretext interviews prohibited
Status: in_force

An insurer, insurance producer or insurance-support organization may not use or authorize the use of pretext interviews to obtain personal information in connection with an insurance transaction. However, a pretext interview may be undertaken to obtain information from a person or institution that does not have a generally recognized or statutorily recognized privileged relationship with the person about whom the information relates, for the purpose of investigating a claim where, based upon specific information available for review by the Director of the Department of Consumer and Business Services, there is a reasonable basis for suspecting criminal activity, fraud, material misrepresentation or material nondisclosure in connection with the claim. [1981 c.649 §5; 2003 c.87 §9; 2003 c.364 §154]

Source: Section 746.615 — Pretext interviews prohibited , https://www.­oregonlegislature.­gov/bills_laws/ors/ors746.­html (accessed May 26, 2025).
ORS § 734.830 — OR Code / Title 56 / Chapter 734 / Section 734.830
734.830 Notifying director of impaired insurers
Status: in_force

To aid in the detection and prevention of insurer impairments and insolvencies:

(1) The board of directors shall, upon majority vote, notify the Director of the Department of Consumer and Business Services of any information indicating any member insurer may be an impaired insurer or insolvent insurer.

(2) The board of directors may, upon majority vote, request that the director order an examination of any member insurer which the board in good faith believes to be an impaired or insolvent insurer. The director may conduct such examination. The examination may be conducted as a National Association of Insurance Commissioners examination or may be conducted by such persons as the director designates. The cost of such examination shall be paid by the Oregon Life and Health Insurance Guaranty Association and the examination report shall be treated as are other examination reports in this state. In no event shall the examination report be released to the board of directors of the association prior to its release to the public, but this shall not excuse the director from the obligation to comply with subsection (3) of this section. The director shall notify the board of directors when the examination is completed. The request for an examination shall be kept on file by the director but it shall not be open to public inspection prior to the release of the examination report to the public and shall be released at that time only if the examination discloses that the examined insurer is an impaired insurer or insolvent insurer.

(3) The director shall report to the board of directors when the director has reasonable cause to believe that any member insurer examined at the request of the board of directors may be an impaired insurer or insolvent insurer.

(4) The board of directors may, upon majority vote, make reports and recommendations to the director upon any matter germane to the solvency, liquidation, rehabilitation or conservation of any member insurer. Such reports and recommendations shall not be considered public records.

(5) The board of directors may, upon majority vote, make recommendations to the director for the detection and prevention of insurer impairments or insolvencies.

(6) The board of directors shall, at the conclusion of any insurer impairment or insolvency in which the association carried out its duties under ORS 734.750 (Short title) to 734.890 (Association not to be used in sales or solicitation) or exercised any of its powers under ORS 734.750 (Short title) to 734.890 (Association not to be used in sales or solicitation) , prepare a report on the history and causes of such impairment or insolvency, based on the information available to the association, and submit such report to the director. [1975 c.251 §13]

Source: Section 734.830 — Notifying director of impaired insurers; examination; reports on impaired insurers , https://www.­oregonlegislature.­gov/bills_laws/ors/ors734.­html (accessed May 26, 2025).
ORS § 743a.188 — OR Code / Title 56 / Chapter 743a / Section 743a.188
743A.188 Inborn errors of metabolism
Status: in_force

(1) All individual and group health insurance policies providing coverage for hospital, medical or surgical expenses, other than coverage limited to expenses from accidents or specific diseases, shall include coverage for treatment of inborn errors of metabolism that involve amino acid, carbohydrate and fat metabolism and for which medically standard methods of diagnosis, treatment and monitoring exist, including quantification of metabolites in blood, urine or spinal fluid or enzyme or DNA confirmation in tissues. Coverage shall include expenses of diagnosing, monitoring and controlling the disorders by nutritional and medical assessment, including but not limited to clinical visits, biochemical analysis and medical foods used in the treatment of such disorders.

(2) As used in this section, “medical foods” means foods that are formulated to be consumed or administered enterally under the supervision of a physician, as defined in ORS 677.010 (Definitions for chapter) , that are specifically processed or formulated to be deficient in one or more of the nutrients present in typical nutritional counterparts, that are for the medical and nutritional management of patients with limited capacity to metabolize ordinary foodstuffs or certain nutrients contained therein or have other specific nutrient requirements as established by medical evaluation and that are essential to optimize growth, health and metabolic homeostasis.

(3) This section is exempt from ORS 743A.001 (Automatic repeal of certain statutes on individual and group health insurance) . [Formerly 743.726]

Source: Section 743A.188 — Inborn errors of metabolism , https://www.­oregonlegislature.­gov/bills_laws/ors/ors743A.­html (accessed May 26, 2025).
ORS § 731.142 — OR Code / Title 56 / Chapter 731 / Section 731.142
731.142 “Stock,” “mutual” and “reciprocal” insurer
Status: in_force

(1) “Stock insurer” means an incorporated insurer whose capital is divided into shares and owned by its stockholders.

(2) “Mutual insurer” means an incorporated insurer without capital stock and the governing body of which is elected by its policyholders. This definition does not exclude as a “mutual insurer” a foreign insurer found by the Director of the Department of Consumer and Business Services to be organized on the mutual plan under the laws of its domicile, but having temporary share capital or providing for election of the insurer’s governing body on a reasonable basis by policyholders and others.

(3) “Reciprocal insurer” means an unincorporated aggregation of persons known as “subscribers,” operating individually and collectively through an attorney in fact common to all such persons, interexchanging among themselves reciprocal agreements of indemnity. [1967 c.359 §29]

Source: Section 731.142 — “Stock,” “mutual” and “reciprocal” insurer , https://www.­oregonlegislature.­gov/bills_laws/ors/ors731.­html (accessed May 26, 2025).
ORS § 744.067 — OR Code / Title 56 / Chapter 744 / Section 744.067
744.067 Exemptions from prelicensing education or examination requirement
Status: in_force

(1) An individual who applies for a resident insurance producer license in this state who is or was previously licensed as an insurance producer for the same lines of authority in another state is not required to complete any prelicensing education or examination. The exemption under this subsection is available only if the individual is currently licensed in the other state or if the application is received by the Director of the Department of Consumer and Business Services not later than the 90th day after the applicant’s previous license was terminated and if the other state issues a certification that, at the time of termination, the applicant was in good standing in that state or the state’s Producer Database maintained by the National Association of Insurance Commissioners, its affiliates or subsidiaries indicate that the applicant is or was licensed in good standing for the class of insurance requested.

(2) A person licensed as an insurance producer in another state who moves to this state must apply for a resident insurance producer license not later than the 90th day after the date on which the person established legal residence in order to qualify for a resident insurance producer license pursuant to ORS 744.059 (Qualifications for license) . Neither prelicensing education nor an examination is required of a person to whom this subsection applies in order to obtain a license in a class of insurance described in ORS 744.062 (Issuance of insurance producer license) if the person held a license in that class in the other state, except when the director has determined otherwise by rule.

(3) An individual who holds an industry designation described in this subsection is not required to complete prelicensing education or the examination required in ORS 744.058 (Written examination) if the director is satisfied, by examination or otherwise, that the applicant is knowledgeable in the particulars of the applicable provisions of the Insurance Code. This subsection applies to:

(a) An applicant for a license authorizing the applicant to transact property or casualty insurance or both, upon whom the American Institute for Chartered Property Casualty Underwriters has conferred the Chartered Property Casualty Underwriter (C.P.C.U.) designation.

(b) An applicant for a license authorizing the applicant to transact life or health insurance, or both, upon whom the American College has conferred the Chartered Life Underwriter (C.L.U.) designation.

(4) The director may recognize one or more industry designations as exempting an applicant from the prelicensing education requirement or the examination required in ORS 744.058 (Written examination) or both. For each industry designation that the director recognizes and for the extent of the exemption to be given, the director shall consider the content, quality and scope of the educational program required for the designation as well as other factors determined by the director to be relevant.

(5) An individual is not required to complete prelicensing education or the examination required in ORS 744.058 (Written examination) or 744.064 (Persons licensed elsewhere) for the following licenses:

(a) A license authorizing the individual to transact a type of limited class insurance, except as the director otherwise provides by rule.

(b) A license authorizing the individual to transact title insurance. [2001 c.191 §10; 2003 c.364 §11]

Source: Section 744.067 — Exemptions from prelicensing education or examination requirement , https://www.­oregonlegislature.­gov/bills_laws/ors/ors744.­html (accessed May 26, 2025).
ORS § 732.672 — OR Code / Title 56 / Chapter 732 / Section 732.672
732.672 Confidentiality
Status: in_force

(1) All documents, materials or other information, including any own risk and solvency assessment summary report, that the Department of Consumer and Business Services possesses or controls, that the Director of the Department of Consumer and Business Services obtained or created or that were otherwise disclosed to the director or any other person in the course of implementing ORS 732.650 (Definitions) to 732.689 (Retention of consultant to assist director’s review of corporate governance annual disclosure) are confidential, are subject to the provisions of ORS 705.137 (Information that is confidential or not subject to disclosure) , 705.138 (Confidential and privileged documents) , 705.139 (Agreements with other agencies regarding sharing and use of confidential information) and 731.312 (Report of examination) and are not subject to disclosure under ORS 192.311 (Definitions for ORS 192.311 to 192.478) to 192.478 (Exemption for Judicial Department) .

(2) Notwithstanding subsection (1) of this section, the director may:

(a) Use the documents, materials or other information in any regulatory or legal action the director brings as a part of the director’s official duties.

(b) Share documents, materials or other information related to an own risk and solvency assessment, including confidential documents and information, only:

(A) As provided in 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) in response to a request from a chief insurance regulatory official, the National Association of Insurance Commissioners or a state, federal, foreign or international law enforcement agency; and

(B) After receiving written consent from the affected insurer.

(c) Share documents or materials or other information related to an own risk and solvency assessment with any third-party consultants the director designates, but only if the consultant:

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

(B) Demonstrates in writing and to the director’s satisfaction that the consultant has the capacity and legal authority to keep the documents, materials or other information confidential.

(3) In addition to the requirements of ORS 705.137 (Information that is confidential or not subject to disclosure) , 705.138 (Confidential and privileged documents) and 731.312 (Report of examination) , the director shall enter into a written agreement with the National Association of Insurance Commissioners or a third-party consultant that:

(a) Prohibits the National Association of Insurance Commissioners or a third-party consultant from storing the information the director or the department shares under ORS 732.650 (Definitions) to 732.689 (Retention of consultant to assist director’s review of corporate governance annual disclosure) in a permanent database after the underlying analysis is complete; and

(b) Requires that an affected insurer must give written consent before a third-party consultant may disclose any documents, material or information the director or the department shares under ORS 732.650 (Definitions) to 732.689 (Retention of consultant to assist director’s review of corporate governance annual disclosure) . [2015 c.547 §9]

Note: See note under 732.650 (Definitions) .

Source: Section 732.672 — Confidentiality; permissible disclosures; agreement with National Association of Insurance Commissioners , https://www.­oregonlegislature.­gov/bills_laws/ors/ors732.­html (accessed May 26, 2025).
ORS § 731.430 — OR Code / Title 56 / Chapter 731 / Section 731.430
731.430 Name of insurer
Status: reserved

(1) No insurer shall be formed or authorized to transact insurance in this state which has or will have, or which uses or will use as an assumed business name, a name or principal identifying name factor:

(a) That is the same as or deceptively similar to:

(A) Any other insurer so formed or authorized;

(B) Any name reserved or registered as authorized by this section;

(C) Any name on file with the Secretary of State pursuant to ORS chapter 60, 65 or 648; or

(D) The name of any insurer that was authorized to transact insurance in this state within the preceding 10 years if insurance policies issued by such other insurer still are outstanding in this state. With the consent of the insurer issuing such policies, the Director of the Department of Consumer and Business Services may waive this provision if the director finds that the waiver will not be detrimental to the public; or

(b) That is deceptive or misleading as to the type of organization of the insurer or that does not indicate the insurer is transacting insurance.

(2) Any insurer doing business in this state may file and register with the director in writing, in its articles of incorporation or otherwise, an assumed name that it will use in transacting insurance in this state. Such name may not be a name prohibited by subsection (1) of this section.

(3) Any person may reserve a name for use as a corporate name or an assumed business name in transacting insurance in this state by filing in writing with the director a reservation of such name. Such name may not be a name prohibited by subsection (1) of this section. Such reservation shall expire six months after the date of filing unless:

(a) If filed by an insurer, it is using such name as an authorized insurer; or

(b) If filed by a noninsurer, it has filed with the director a formal application for a permit to form an insurer in this state. If a valid reservation is on file, the director may accept the filing of a same or deceptively similar name by another person which filing shall become effective, in the order of filing, at the expiration of the six-month provision unless the original reservation does not expire pursuant to this subsection.

(4) When an insurer is merged as provided in the Insurance Code, the surviving insurer may retain the use of the name for a period of five years after the effective date of merger. If such name is retained, use of the same or deceptively similar name by other insurers shall be prohibited as specified under this section during the five-year period. [1967 c.359 §92; 1987 c.414 §161a; 1987 c.846 §2; 1993 c.447 §104]

Source: Section 731.430 — Name of insurer , https://www.­oregonlegislature.­gov/bills_laws/ors/ors731.­html (accessed May 26, 2025).