reglab/statecodes huggingface dataset:
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 748 - Fraternal Benefit Societies › Section 748.171 - Certificate of authority.

(1) A fraternal benefit society must obtain and maintain a certificate of authority in the manner provided for insurers in the Insurance Code.
(2) A certified copy or duplicate of the certificate of authority shall be prima facie evidence that the holder thereof is a fraternal benefit society within the meaning of this chapter. [1987 c.490 §28; 1989 c.413 §19; 1991 c.182 §10]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 748 - Fraternal Benefit Societies › Section 748.174 - Certificate of authority for foreign or alien society.

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]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 748 - Fraternal Benefit Societies › Section 748.177 - Authorization as mutual life insurance company.

Any domestic fraternal benefit society may be converted and authorized as a mutual life insurance company by compliance with all the requirements of the insurance laws of this state for mutual life insurance companies. A plan of conversion shall be prepared in writing by the board of directors setting forth in full the terms and conditions of conversion. The affirmative vote of two-thirds of all members of the supreme governing body at a regular or special meeting shall be necessary for the approval of the plan, or if the society is organized under the direct election method pursuant to ORS 748.112 (1)(a), the plan of conversion shall be submitted by mail to the benefit members. The affirmative vote of two-thirds of the benefit members voting thereon shall be necessary for the approval of the plan. No conversion shall take effect unless approved by the Director of the Department of Consumer and Business Services who may give approval if the director finds that the proposed change is in conformity with the requirements of law and not prejudicial to the certificate holders of the society. [1987 c.490 §16; 1991 c.182 §12]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 748 - Fraternal Benefit Societies › Section 748.181 - Insurance producers; licensing.

Insurance producers of societies shall be licensed in accordance with the provisions of ORS chapter 744 regulating the licensing, revocation, suspension or termination of license of resident and nonresident insurance producers. [1987 c.490 §34; 1989 c.701 §75; 2003 c.364 §168]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 748 - Fraternal Benefit Societies › Section 748.184 - Reinsurance.

(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. [1987 c.490 §14]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 748 - Fraternal Benefit Societies › Section 748.201 - Benefits.

(1) A society may provide in any form the following contractual benefits:
(a) Death benefits;
(b) Endowment benefits;
(c) Annuity benefits;
(d) Temporary or permanent disability benefits;
(e) Hospital, medical or nursing benefits;
(f) Monument or tombstone benefits to the memory of deceased members; and
(g) Such other benefits as authorized for life insurers and which are not inconsistent with this chapter, upon determination by the Director of the Department of Consumer and Business Services that the society is in compliance with all the requirements for a mutual life insurer to write such benefits.
(2) A society shall specify in its rules those persons who may be issued, or covered by, the contractual benefits in subsection (1) of this section, consistent with providing benefits to members and their dependents. A society may provide benefits on the lives of children under the minimum age for adult membership upon application of an adult person. [1987 c.490 §17]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 748 - Fraternal Benefit Societies › Section 748.204 - Beneficiaries.

(1) The owner of a benefit contract shall have the right at all times to change the beneficiary or beneficiaries in accordance with the laws or rules of the society unless the owner waives this right by specifically requesting in writing that the beneficiary designation be irrevocable. A society may, through its laws or rules, limit the scope of beneficiary designations and shall provide that no revocable beneficiary shall have or obtain any vested interest in the proceeds of any certificate until the certificate has become due and payable in conformity with the provisions of the benefit contract.
(2) A society may make provision for the payment of funeral benefits to the extent of the portion of any payment under a certificate as might reasonably appear to be due to any person equitably entitled thereto by reason of having incurred expense occasioned by the burial of the member, provided the portion paid shall not exceed $1,000.
(3) If, at the death of any person insured under a benefit contract, there is no lawful beneficiary to whom the proceeds shall be payable, the amount of the benefit, except to the extent that funeral benefits may be paid as provided in this chapter, shall be payable to the personal representative of the deceased insured, provided that if the owner of the certificate is other than the insured the proceeds shall be payable to that owner. [1987 c.490 §18]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 748 - Fraternal Benefit Societies › Section 748.207 - Benefits exempt from execution.

No money or other benefit, charity, relief or aid to be paid, provided or rendered by any society, shall be liable to attachment, garnishment or other process, or to be seized, taken, appropriated or applied by any legal or equitable process or operation of law to pay any debt or liability of a member or beneficiary, or any other person who may have a right thereunder, either before or after payment by the society. [1987 c.490 §19]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 748 - Fraternal Benefit Societies › Section 748.306 - Authority for group benefit certificates.

A fraternal benefit society may provide in its laws, in addition to other benefits provided, for the issuance of group benefit certificates if on the date when it enters upon business it has admitted assets which are greater than the sum of its accrued liabilities and reserves under all of its certificates when valued according to standards required for certificates issued after June 8, 1967. [1987 c.490 §36]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 748 - Fraternal Benefit Societies › Section 748.309 - Group membership; lodges.

(1) Group benefit certificates may provide for the payment of benefits in the event of the death, or death and disability, of:
(a) Persons engaged in a common enterprise or employment.
(b) The employees of any employer.
(2) Group certificates may be issued with or without medical examination and without limitation as to age.
(3) The society shall organize the persons or employees into a lodge or lodges with officers selected in the same manner as officers of other lodges and subject to the provisions of the laws of the society.
(4) Not less than 50 persons may be admitted to membership under one group without medical examination. [1987 c.490 §37]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 748 - Fraternal Benefit Societies › Section 748.312 - Membership in lodges organized under ORS 748.309.

If provided in the laws of the society, other persons may become members of a lodge organized under ORS 748.309 subsequent to its organization and may be initiated into and hold membership in the lodge. Individual benefit certificates may be issued to them. The lodges shall in all other respects be subject to the laws of the society. [1987 c.490 §40]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 748 - Fraternal Benefit Societies › Section 748.316 - Payments for group benefits.

(1) The monthly or other payments to be made to the society on or for any group benefit certificate may be made by the employer, or by the employer and employees jointly, or as provided in the contract.
(2) When the payments are made by the employer and the employees jointly and the benefits under the group certificate are offered to all eligible employees of the employer, not less than 75 percent of the employees must be included under the group certificate. [1987 c.490 §38]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 748 - Fraternal Benefit Societies › Section 748.319 - Group certificates issued by foreign or alien society or by domestic society in foreign or alien jurisdiction.

(1) A group certificate, when issued in this state by any foreign or alien society, may contain, when issued, any provision required by the laws of the state or country under which the society is organized.
(2) Group certificates issued in other states or countries by a domestic society may contain any provision required by the laws of the other state or country. [1987 c.490 §39]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 748 - Fraternal Benefit Societies › Section 748.322 - Continuation of membership in society after cancellation, discontinuance or nonrenewal of group certificate.

If any group certificate is canceled, discontinued or not renewed, or if any individual member of a group ceases to be a member of the group, the members of the group or any individual member who ceases to be a member of the group may be permitted to continue membership in the society for the same amount of protection at the required rate of monthly or other payment and in all other respects as provided in the laws of the society. [1987 c.490 §41]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 748 - Fraternal Benefit Societies › Section 748.401 - Value of benefit and amount of options.

(1) For certificates issued prior to January 1, 1989, the value of every paid-up nonforfeiture benefit and the amount of any cash surrender value, loan or other option granted shall comply with the provisions of law applicable immediately prior to January 1, 1988.
(2) For certificates issued on or after January 1, 1989, for which reserves are computed on the Commissioner’s 1941 Standard Ordinary Mortality Table, the Commissioner’s 1941 Standard Industrial Table, the Commissioner’s 1958 Standard Ordinary Mortality Table, the Commissioner’s 1980 Standard Mortality Table or any more recent table made applicable to life insurers, every paid-up nonforfeiture benefit and the amount of any cash surrender value, loan or other option granted may not be less than the corresponding amount ascertained in accordance with the laws of this state applicable to life insurers issuing policies containing like benefits based upon the tables. [1987 c.490 §21; 2005 c.22 §498]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 748 - Fraternal Benefit Societies › Section 748.403 - Standards of valuation for certificates.

(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]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 748 - Fraternal Benefit Societies › Section 748.406 - Financial statement; filing; fee; valuation.

(1) Every society transacting business in this state shall annually file with the Director of the Department of Consumer and Business Services on or before March 1, unless the time has been extended by the director, a true statement of its financial condition, transactions and affairs for the preceding calendar year and shall pay the applicable fee established by the director. The statement shall be in general form and context as approved by the National Association of Insurance Commissioners for fraternal benefit societies and as supplemented by additional information required by the director.
(2) As part of the annual statement required by subsection (1) of this section, on or before March 1, each society shall file with the director a valuation of its certificates in force on December 31 last preceding. The director may extend the time for filing the valuation for not more than two calendar months. The valuation shall be done in accordance with the standards specified in ORS 748.403. The valuation and underlying data shall be certified by a qualified actuary or, at the expense of the society, verified by the actuary of the department of insurance of the state of domicile of the society. [1987 c.490 §27; 1991 c.182 §14]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 748 - Fraternal Benefit Societies › Section 748.409 - Assets of society; variable contracts.

(1) All assets shall be held, invested and disbursed for the use and benefit of the society and no member or beneficiary shall have or acquire individual rights or become entitled to any apportionment on the surrender of any part, except as provided in the benefit contract.
(2) A society may create, maintain, invest, disburse and apply any special fund or funds necessary to carry out any purpose permitted by the laws of the society.
(3) Pursuant to resolution of its supreme governing body a society may:
(a) Establish and operate one or more separate accounts and issue contracts on a variable basis, subject to all the provisions of law regulating life insurers establishing accounts and issuing contracts;
(b) To the extent the society deems it necessary in order to comply with any applicable federal or state laws, adopt special procedures for the conduct of the business and affairs of a separate account;
(c) For persons having beneficial interest therein, provide special voting and other rights, including without limitation special rights and procedures relating to investment policy, investment advisory services, selection of certified public accounts and selection of a committee to manage the business and affairs of the account; and
(d) Issue contracts on a variable basis to which ORS 748.211 (2) and (4) shall not apply. [1987 c.490 §23]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 748 - Fraternal Benefit Societies › Section 748.412 - Investment of funds.

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]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 748 - Fraternal Benefit Societies › Section 748.414 - Funds exempt from certain taxes.

Every society organized or licensed under this chapter is hereby declared to be a charitable and benevolent institution, and all of its funds shall be exempt from all and every state, county, district, municipal and school tax, other than taxes on real estate and office equipment. [1987 c.490 §24]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 748 - Fraternal Benefit Societies › Section 748.501 - Examination.

(1) The Director of the Department of Consumer and Business Services, or any person the director may appoint, may examine any domestic, foreign or alien society transacting or applying for admission to transact business in this state in the same manner as authorized for examination of domestic, foreign or alien insurers. Requirements of notice and an opportunity to respond before findings are made public as provided in the laws regulating insurers shall also be applicable to the examination of societies.
(2) The expense of each examination and of each valuation, including compensation and actual expense of examiners, shall be paid by the society examined or whose certificates are valued, upon statements furnished by the director. [1987 c.490 §29]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 748 - Fraternal Benefit Societies › Section 748.506 - Investigation of foreign or alien society; notice of deficiencies; revocation or suspension of authority.

(1) The Director of the Department of Consumer and Business Services shall notify the society of any deficiency or deficiencies, and state in writing the reasons for dissatisfaction, when the director, upon investigation, finds that a foreign or alien society transacting or applying to transact business in this state:
(a) Has exceeded its powers;
(b) Has failed to comply with any of the provisions of this chapter;
(c) Is not fulfilling its contracts in good faith; or
(d) Is conducting its business fraudulently or in a manner hazardous to its members, creditors or the public.
(2) The director shall at once issue a written notice to the society requiring that the deficiency or deficiencies be corrected. After notice, the society shall have 30 days in which to comply with the director’s request for correction, and if the society fails to comply, the director shall notify the society of findings of noncompliance and require the society to show cause on a date named why its certificate of authority should not be suspended, revoked or refused. If on the named date the society does not present good and sufficient reason why its certificate of authority should not be suspended, revoked or refused, the director may suspend or refuse the certificate of authority until satisfactory evidence is furnished to the director that the suspension or refusal should be withdrawn or the director may revoke the certificate of authority of the society.
(3) Nothing contained in this section shall be taken or construed as preventing any foreign or alien society from continuing in good faith all contracts made in this state during the time the foreign or alien society was legally authorized to transact business as provided in this chapter. [1987 c.490 §32; 1991 c.182 §15]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 748 - Fraternal Benefit Societies › Section 748.509 - Validity of petition for injunction.

No application or petition for injunction against any domestic, foreign or alien society, or lodge thereof, shall be recognized in any court of this state unless made by the Attorney General upon request of the Director of the Department of Consumer and Business Services. [1987 c.490 §33]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 748 - Fraternal Benefit Societies › Section 748.603 - Relationship to other insurance laws.

(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, 705.139, 731.004 to 731.026, 731.036 to 731.136, 731.146 to 731.156, 731.162, 731.166, 731.170, 731.216 to 731.268, 731.296, 731.324, 731.328, 731.354, 731.356, 731.358, 731.378, 731.380, 731.381, 731.382, 731.385, 731.386, 731.390, 731.394, 731.396, 731.398, 731.402, 731.406, 731.410, 731.422 to 731.434, 731.446 to 731.454, 731.488, 731.504, 731.508, 731.509, 731.510, 731.511, 731.512, 731.592, 731.594, 731.730, 731.731, 731.735, 731.737, 731.750, 731.804, 731.844 to 731.992, 731.870, 732.245, 732.250, 732.320, 732.325, 733.010 to 733.050, 733.080, 733.140 to 733.210, 733.220, 733.510, 733.652 to 733.658, 733.730 to 733.750, 742.001, 742.003, 742.005, 742.007, 742.009, 742.013 to 742.021, 742.028, 742.038, 742.041, 742.046, 742.051, 742.150 to 742.162 and 744.700 to 744.740 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]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 748 - Fraternal Benefit Societies › Section 748.605 - Insurance against risk of loss under less than fully insured employee health benefit plan.

Insurance issued or delivered by a fraternal benefit society against the risk of economic loss assumed under a less than fully insured employee health benefit plan is subject to ORS 742.065. Such insurance is subject to ORS 748.603 but is otherwise not subject to the provisions of ORS chapter 748. [1993 c.649 §4]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 748 - Fraternal Benefit Societies › Section 748.990 - Penalties.

(1) Any person who willfully makes a false or fraudulent statement in or relating to an application for membership, or for the purpose of obtaining money from or a benefit in any society, shall upon conviction be fined not less than $100 nor more than $500, imprisoned in the county jail for not less than 30 days nor more than one year, or both.
(2) Any person who willfully makes a false or fraudulent statement in any verified report or declaration under oath required or authorized by this chapter, or of any material fact or thing contained in a sworn statement concerning the death or disability of an insured for the purpose of procuring payment of a benefit named in the certificate, shall be guilty of perjury and shall be subject to the penalties prescribed by law.
(3) Any person who solicits membership for, or in any manner assists in procuring membership in, any society not licensed to do business in this state commits a Class C violation.
(4) Any person guilty of a willful violation of, or neglect or refusal to comply with, the provisions of this chapter for which a penalty is not otherwise prescribed, commits a Class C violation. [1987 c.490 §43; 1999 c.1051 §222]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 750 - Health Care Service Contractors; Multiple Employer Welfare Arrangements; Legal Expense Organizations › Section 750.003 - Purpose.

The purpose of this section and ORS 750.005, 750.025 and 750.045 is to encourage and guarantee the development of health care service contractors by licensing and regulating their operation to ensure that they provide high quality health care services through state licensed organizations meeting reasonable standards as to administration, services and financial soundness. [1985 c.747 §64; 2015 c.515 §27]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 750 - Health Care Service Contractors; Multiple Employer Welfare Arrangements; Legal Expense Organizations › Section 750.005 - Definitions.

As used in ORS 750.005 to 750.095:
(1) "Claims" means any amount incurred by the insurer covering contracted benefits.
(2) "Complementary health services" means the following health care services:
(a) Chiropractic as defined in ORS 684.010;
(b) Naturopathic medicine as defined in ORS 685.010;
(c) Massage therapy as defined in ORS 687.011; or
(d) Acupuncture as defined in ORS 677.757.
(3) "Doctor" means any person lawfully licensed or authorized by statute to render any health care services.
(4) "Health care service contractor" means:
(a) Any corporation that is sponsored by or otherwise intimately connected with a group of doctors licensed by this state, or by a group of hospitals licensed by this state, or both, under contracts with groups of doctors or hospitals that include conditions holding the subscriber harmless in the event of nonpayment by the health care service contract as provided in ORS 750.095, and that accepts prepayment for health care services; or
(b) Any person referred to in ORS 750.035.
(5) "Health care services" means the furnishing of medicine, medical or surgical treatment, nursing, hospital service, dental service, optometrical service, complementary health services or any or all of the enumerated services or any other necessary services of like character, whether or not contingent upon sickness or personal injury, as well as the furnishing to any person of any and all other services and goods for the purpose of preventing, alleviating, curing or healing human illness, physical disability or injury.
(6) "Health maintenance organization" means any health care service contractor operated on a for-profit or not for-profit basis which:
(a) Qualifies under Title XIII of the Public Health Service Act; or
(b)(A) Provides or otherwise makes available to enrolled participants health care services, including at least the following basic health care services:
(i) Usual physician services;
(ii) Hospitalization;
(iii) Laboratory;
(iv) X-ray;
(v) Emergency and preventive services; and
(vi) Out-of-area coverage;
(B) Is compensated, except for copayments, for the provision of basic health care services listed in subparagraph (A) of this paragraph to enrolled participants on a predetermined periodic rate basis;
(C) Provides physicians’ services primarily directly through physicians who are either employees or partners of such organization, or through arrangements with individual physicians or one or more groups of physicians organized on a group practice or individual practice basis; and
(D) Employs the terms "health maintenance organization" or "HMO" in its name, contracts, literature or advertising media on or before July 13, 1985. [Formerly 742.010; 1973 c.515 §5; 1979 c.799 §1; 1985 c.747 §65; 1989 c.783 §4; 1991 c.958 §3; 2003 c.33 §1]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 750 - Health Care Service Contractors; Multiple Employer Welfare Arrangements; Legal Expense Organizations › Section 750.015 - Management to include representatives of public.

(1) Except as provided in subsection (2) of this section, at least one-third of the group of persons vested with managing the affairs of a health care service contractor, as defined in ORS 750.005 (4)(a), must be representatives of the public who are not:
(a) Practicing doctors; or
(b) Employees or trustees of a participant hospital.
(2)(a) Notwithstanding subsection (1) of this section, the group of persons vested with managing the affairs of a nonprofit private organization described in paragraph (b) of this subsection must have at least two representatives of the public who are not:
(A) Practicing doctors, as defined in ORS 750.005; or
(B) Employees or trustees of a participant hospital.
(b) This subsection applies to a nonprofit private organization that is a health maintenance organization, as defined in ORS 442.015, that is controlled by a single nonprofit hospital or by a group of nonprofit hospitals under common ownership and that operates in a county with a population of 200,000 or more. [Formerly 742.015; 1983 c.804 §1; 2003 c.33 §6; 2017 c.479 §19]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 750 - Health Care Service Contractors; Multiple Employer Welfare Arrangements; Legal Expense Organizations › Section 750.025 - Restricting distribution of income; representation as health maintenance organization.

(1) A health care service contractor which is a not-for-profit corporation, shall not distribute, upon liquidation or otherwise, any part of its income to its members, directors, trustees or officers except for the reasonable value of services rendered such contractor.
(2) An organization that does not meet the definition of health maintenance organization in ORS 750.005 shall not hold itself out to the public to be a health maintenance organization. [Formerly 742.025; 1985 c.747 §66]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 750 - Health Care Service Contractors; Multiple Employer Welfare Arrangements; Legal Expense Organizations › Section 750.035 - Regulation of hospital care associations under prior law; exceptions.

(1) Notwithstanding any other provision of law, except as provided in subsection (2) of this section, any persons doing a hospital association business, as defined in ORS 742.010 (1959 Replacement Part) in compliance with ORS chapter 742 (1959 Replacement Part) on August 12, 1965, may continue such business in compliance with ORS chapter 742 (1959 Replacement Part).
(2) Every person doing a hospital association business, as defined in ORS 742.010 (1959 Replacement Part), on August 12, 1965, shall comply with the provisions of ORS 750.045, 750.055, 750.085 and 750.095. [Formerly 742.035; 1989 c.783 §5]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 750 - Health Care Service Contractors; Multiple Employer Welfare Arrangements; Legal Expense Organizations › Section 750.059 - Exemption of group practice maintenance organizations from reimbursement requirement for services provided by state hospital or state-approved program.

ORS 743A.010 does not apply to group practice maintenance organizations that are federally qualified pursuant to Title XIII of the Public Health Service Act (42 U.S.C. 300e et seq.). [1981 c.422 §2; 1981 c.891 §3]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 750 - Health Care Service Contractors; Multiple Employer Welfare Arrangements; Legal Expense Organizations › Section 750.065 - Payment or reimbursement for services within scope of practice of optometrists.

Notwithstanding any provision of contract or agreement entered into by a corporation, association, society, firm, partnership or individual doing business as a hospital association or as a health care service contractor, whenever the contract or agreement provides for payment or reimbursement for a service that is within the lawful scope of practice of a licensed optometrist, the hospital association or health care service contractor shall provide payment or reimbursement for the service, whether the service is performed by a physician or a licensed optometrist. Unless the contract or agreement provides otherwise, there shall be no reimbursement for ophthalmic materials, lenses, spectacles, eyeglasses or appurtenances thereto. [1971 c.97 §2; 2005 c.442 §3]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 750 - Health Care Service Contractors; Multiple Employer Welfare Arrangements; Legal Expense Organizations › Section 750.095 - Requirements of contract between provider and subscriber; content.

(1) For the purpose of this section only, and only in the event of a finding of impairment by the Director of the Department of Consumer and Business Services or of a final order of liquidation, as described in ORS 750.085, any covered health care service furnished within the state by a provider to a subscriber of a health care service contractor shall be considered to have been furnished pursuant to a contract between the provider and the health care service contractor with whom the subscriber was enrolled when the services were furnished.
(2) Each contract between a health care service contractor and a provider of health care services shall provide that if the health care service contractor fails to pay for covered health care services as set forth in the subscriber’s evidence of coverage or contract, the subscriber is not liable to the provider for any amounts owed by the health care service contractor.
(3) If the contract between the contracting provider and the health care service contractor has not been reduced to writing or fails to contain the provisions required by subsection (2) of this section, the subscriber is not liable to the contracting provider for any amounts owed by the health care service contractor.
(4) No contracting provider or agent, trustee or assignee of the contracting provider may maintain a civil action against a subscriber to collect any amounts owed by the health care service contractor for which the subscriber is not liable to the contracting provider under this section.
(5) Nothing in this section impairs the right of a provider to charge, collect from, attempt to collect from or maintain a civil action against a subscriber for any of the following:
(a) Deductible, copayment or coinsurance amounts.
(b) Health care services not covered by the health care service contractor.
(c) Health care services rendered after the termination of the contract between the health care service contractor and the provider, unless the health care services were rendered during the confinement in an inpatient facility and the confinement began prior to the date of termination or unless the provider has assumed post-termination treatment obligations under the contract.
(6) Nothing in this section prohibits a subscriber from seeking noncovered health care services from a provider and accepting financial responsibility for these services.
(7) No health care service contractor shall limit the right of a provider of health care services to contract with the patient for payment of services not within the scope of the coverage offered by the health care service contractor. [1989 c.783 §3]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 750 - Health Care Service Contractors; Multiple Employer Welfare Arrangements; Legal Expense Organizations › Section 750.301 - Definitions for ORS 750.301 to 750.341.

As used in ORS 750.301 to 750.341, "multiple employer welfare arrangement" has the meaning given that term in section 3 of the federal Employee Retirement Income Security Act of 1974, as amended, 29 U.S.C. 1002. [1993 c.615 §2]
Note:
750.301 to 750.341 were added to and made a part of the Insurance Code by legislative action but were not added to ORS chapter 750 or any series therein. See Preface to Oregon Revised Statutes for further explanation.
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 750 - Health Care Service Contractors; Multiple Employer Welfare Arrangements; Legal Expense Organizations › Section 750.303 - Conditions for use of multiple employer welfare arrangement; permitted coverage.

(1) An association or group of employers shall not provide health benefits to employees of the association or employees of any of the employers through a multiple employer welfare arrangement in this state except as authorized by a subsisting certificate of multiple employer welfare arrangement issued by the Director of the Department of Consumer and Business Services.
(2) Only health benefits may be transacted through a multiple employer welfare arrangement. Health benefits may include benefits for disablement only if the benefits for disablement do not exceed $2,000 each year for each person covered by the disablement benefit.
(3) Life insurance or insurance for disablement other than benefits described in subsection (2) of this section, or both, may be provided through a multiple employer welfare arrangement only if the insurance benefits meet the following conditions:
(a) The insurance benefits must be fully insured through an authorized insurer.
(b) The insurance benefits must be ancillary to the health benefits being provided under subsection (2) of this section.
(4) ORS 750.301 to 750.341 do not apply to a multiple employer welfare arrangement that is fully insured within the meaning of section 514(b)(6) of the federal Employee Retirement Income Security Act of 1974, as amended, 29 U.S.C. 1144(b)(6). [1993 c.615 §3]
Note:
See note under 750.301.
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 750 - Health Care Service Contractors; Multiple Employer Welfare Arrangements; Legal Expense Organizations › Section 750.305 - Application for certificate.

An association or group of employers seeking to provide health benefits through a multiple employer welfare arrangement must apply for a certificate of multiple employer welfare arrangement on a form prescribed by the Director of the Department of Consumer and Business Services. The application must be completed and submitted to the director along with all of the following:
(1) Copies of all articles, bylaws, agreements and other documents or instruments describing the rights and obligations of employers, employees and beneficiaries with respect to the multiple employer welfare arrangement.
(2) A copy of the trust agreement of the multiple employer welfare arrangement.
(3) Current financial statements of the multiple employer welfare arrangement on the basis of statutory accounting principles.
(4) Proof of a bond for the purpose and in the form and amount required by ORS 750.318.
(5) A statement showing in full detail the plan for offering health care benefits through the multiple employer welfare arrangement. The plan must show that the association or group of employers and the trust meet the requirements of ORS 750.307 and 750.309 and must show the procedure established for handling claims for benefits in the event of dissolution of the multiple employer welfare arrangement.
(6) Copies of all contracts or other instruments proposed to be made, offered or sold through the multiple employer welfare arrangement to its member employers, together with a copy of its plan description and the proposed printed matter to be used in the solicitation of member employers.
(7) Evidence that the multiple employer welfare arrangement has applications from five or more employers meeting the requirements of ORS 750.307 and will provide similar benefits for 200 or more participating employees.
(8) Proof of adequate reserves according to the requirements of ORS 750.315.
(9) Proof of deposit with the Department of Consumer and Business Services of the initial amount required under ORS 750.309 (4) as a guarantee of the due execution of the trust obligation. [1993 c.615 §4; 1999 c.196 §13]
Note:
See note under 750.301.
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 750 - Health Care Service Contractors; Multiple Employer Welfare Arrangements; Legal Expense Organizations › Section 750.307 - Requirements for association or group.

A trust carrying out a multiple employer welfare arrangement must be established and maintained by an association or group of employers meeting the following requirements:
(1) The association or group must be composed of five or more employers that are in the same trade or industry, including employers in closely related businesses that provide support, services or supplies primarily to that trade or industry.
(2) The association or group must be engaged in substantive activity for its members other than sponsorship of an employee welfare benefit plan.
(3) At the time of application for a certificate of multiple employer welfare arrangement, the association or group must have applications for participation in the multiple employer welfare arrangement from five or more employers and show that it will provide similar benefits for 200 or more participating employees.
(4) The association or group must have been in existence as an association or group described in subsection (1) of this section for a period of not less than two years prior to the date of application for the certificate of multiple employer welfare arrangement.
(5) The association or group must establish and maintain an employee welfare benefit plan through the multiple employer welfare arrangement, and the plan must be controlled and sponsored directly by participating employers.
(6) The association or group must show that the annual gross contributions of the employee welfare benefit plan will be not less than $50,000 for a plan that provides only vision benefits, $175,000 for a plan that provides only dental benefits, and $450,000 for any other plan. [1993 c.615 §5]
Note:
See note under 750.301.
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 750 - Health Care Service Contractors; Multiple Employer Welfare Arrangements; Legal Expense Organizations › Section 750.311 - Multiple employer welfare arrangements established in another state.

An association or group of employers may provide health benefits in this state through a multiple employer welfare arrangement established in another state if the association or group of employers first obtains a certificate of multiple employer welfare arrangement in this state. Such a multiple employer welfare arrangement is a foreign multiple employer welfare arrangement. If the state in which the principal place of business of the multiple employer welfare arrangement is located issues certificates or licenses authorizing multiple employer welfare arrangements to transact insurance or provide health benefits, the foreign multiple employer welfare arrangement must show in its application that it is authorized to transact insurance or provide health benefits in that state. [1993 c.615 §7]
Note:
See note under 750.301.
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 750 - Health Care Service Contractors; Multiple Employer Welfare Arrangements; Legal Expense Organizations › Section 750.313 - Issuance or refusal of certificate of multiple employer welfare arrangement.

(1) The Director of the Department of Consumer and Business Services shall issue a certificate of multiple employer welfare arrangement to a multiple employer welfare arrangement by and through its board of trustees if, upon completion of the application for the certificate and upon investigation and review of all information acquired by the director, the director does all of the following:
(a) Approves the application for the certificate.
(b) Determines that the person applying for the certificate satisfies the requirements in ORS 750.305, 750.307 and 750.309 for qualifying for and holding a certificate of multiple employer welfare arrangement and satisfies all other applicable requirements in the Insurance Code.
(2) The director shall take all necessary action and shall either issue or refuse to issue a certificate within a reasonable time after the completion of the application for the certificate. [1993 c.615 §8]
Note:
See note under 750.301.