reglab/statecodes huggingface dataset:
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 741 - Health Insurance Exchange › Section 741.003 - Duties and powers of director.

(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 to 741.540.
(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]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 741 - Health Insurance Exchange › Section 741.008 - Criminal records check; fingerprints required; persons subject to requirement.

The Oregon Health Authority shall conduct a state or nationwide criminal records check under ORS 181A.195 on, and for that purpose may require the fingerprints of, a person who:
(1) Is employed by or applying for employment with the authority in a position related to the administration of the health insurance exchange; or
(2) Is, or will be, providing services to the authority in a position related to the administration of the health insurance exchange:
(a) In which the person is providing information technology services and has control over, or access to, information technology systems that would allow the person to harm the information technology systems or the information contained in the systems;
(b) In which the person has access to information that is confidential or for which state or federal laws, rules or regulations prohibit disclosure;
(c) That has payroll functions or in which the person has responsibility for receiving, receipting or depositing money or negotiable instruments, for billing, collections or other financial transactions or for purchasing or selling property or has access to property held in trust or to private property in the temporary custody of the authority;
(d) That has mailroom duties as a primary duty or job function;
(e) In which the person has responsibility for auditing the authority;
(f) That has personnel or human resources functions as a primary responsibility;
(g) In which the person has access to Social Security numbers, dates of birth or criminal background information; or
(h) In which the person has access to tax or financial information about individuals or business entities. [Formerly 741.255; 2021 c.569 §21]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 741 - Health Insurance Exchange › Section 741.012 - State-administered technology platform.

The Oregon Health Authority shall procure and administer an information technology platform or service, separate from the federal platform, to provide electronic access to the health insurance exchange in this state on and after November 1, 2026. [2023 c.585 §2]
Note:
The amendments to 741.012 by section 5, 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.
The Oregon Health Authority shall procure and administer an information technology platform or service, separate from the federal platform, to provide electronic access to the health insurance exchange in this state.
Note:
Section 7, chapter 585, Oregon Laws 2023, provides:
Sec. 7.
(1) The amendments to section 2 of this 2023 Act [741.012] by section 5 of this 2023 Act and the amendments to ORS 741.105 and 741.300 by sections 3 and 4 of this 2023 Act become operative on November 1, 2026.
(2) The Oregon Health Authority shall take all steps prior to the operative date specified in subsection (1) of this section that are necessary to carry out the amendments to section 2 of this 2023 Act by section 5 of this 2023 Act and the amendments to ORS 741.105 and 741.300 by sections 3 and 4 of this 2023 Act on the operative date specified in subsection (1) of this section.
[2023 c.585 §7]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 741 - Health Insurance Exchange › Section 741.102 - Health Insurance Exchange Fund.

The Health Insurance Exchange Fund is established in the State Treasury, separate and distinct from the General Fund. Interest earned by the Health Insurance Exchange Fund shall be credited to the fund. The Health Insurance Exchange Fund consists of moneys received by the Oregon Health Authority under ORS 741.001 to 741.540. Moneys in the fund are continuously appropriated to the authority for carrying out the purposes of ORS 741.001 to 741.540. [2015 c.3 §14; 2015 c.3 §15; 2021 c.569 §22]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 741 - Health Insurance Exchange › Section 741.220 - Financial and performance audits of health insurance exchange accounts; report of audit.

(1) The Oregon Health Authority shall keep an accurate accounting of the operation and all activities, receipts and expenditures of the authority with respect to the health insurance exchange.
(2) The Secretary of State shall conduct an annual financial audit of the authority’s revenues and expenditures in carrying out ORS 741.001 to 741.540. The audit shall include but is not limited to:
(a) A review of the sources and uses of the moneys in the Health Insurance Exchange Fund;
(b) A review of charges and fees imposed and collected pursuant to ORS 741.105; and
(c) A review of premiums collected and remitted.
(3) Every two years, the Secretary of State shall conduct a performance audit of the exchange.
(4) The Director of the Oregon Health Authority and employees of the authority responsible for administering the health insurance exchange shall cooperate with the Secretary of State in the audits and reviews conducted under subsections (2) and (3) of this section.
(5) The audits shall be conducted using generally accepted accounting principles and any financial integrity requirements of federal authorities.
(6) The cost of the audits required by subsections (2) and (3) of this section shall be paid by the authority.
(7) The Secretary of State shall issue a report to the Governor, the President of the Senate, the Speaker of the House of Representatives, the Oregon Health Authority, the Oregon Health Policy Board and appropriate federal authorities on the results of each audit conducted pursuant to this section, including any recommendations for corrective actions. The report shall be available for public inspection, in accordance with the Secretary of State’s established rules and procedures governing public disclosure of audit documents.
(8) To the extent the audit requirements under this section are similar to any audit requirements imposed on the authority by federal authorities, the Secretary of State and the authority shall make reasonable efforts to coordinate with the federal authorities to promote efficiency and the best use of resources in the timing and provision of information.
(9) Not later than the 90th day after the Secretary of State completes and delivers an audit report issued under subsection (7) of this section, the director shall notify the Secretary of State in writing of the corrective actions taken or to be taken, if any, in response to any recommendations in the report. The Secretary of State may extend the 90-day period for good cause. [2011 c.415 §21; 2012 c.38 §6; 2012 c.107 §93; 2015 c.3 §20; 2021 c.569 §25]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 741 - Health Insurance Exchange › Section 741.222 - Annual reports to Legislative Assembly.

(1) The Director of the Oregon Health Authority shall report to the Legislative Assembly each year on:
(a) The financial condition of the health insurance exchange, including actual and projected revenues and expenses of the administrative operations of the exchange and commissions paid to insurance producers out of fees collected under ORS 741.105 (6);
(b) The operation of the Small Business Health Options Program;
(c) The development of the information technology system for the exchange; and
(d) Any other information requested by the leadership of the Legislative Assembly.
(2) The director shall provide to the Legislative Assembly, the Governor and the Oregon Health Policy Board, not later than April 15 of each year:
(a) A report covering the activities and operations of the authority in administering the health insurance exchange during the previous year of operations;
(b) A statement of the financial condition, as of December 31 of the previous year, of the Health Insurance Exchange Fund; and
(c) Recommendations, if any, for additional groups to be eligible to purchase qualified health plans through the exchange under ORS 741.310. [2011 c.415 §22; 2012 c.38 §18; 2012 c.107 §95; 2013 c.368 §§1,3; 2015 c.3 §§21,22; 2021 c.569 §26; 2023 c.584 §5]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 741 - Health Insurance Exchange › Section 741.340 - Health benefit plans offered through exchange.

The Oregon Health Authority, in developing and offering the health benefit package required by ORS 413.011 (1)(j), may not establish policies or procedures that discourage insurers from offering more comprehensive health benefit plans that provide greater consumer choice at a higher cost. The health benefit package approved by the Oregon Health Policy Board shall:
(1) Promote the provision of services through an integrated health home model that reduces unnecessary hospitalizations and emergency department visits.
(2) Require little or no cost sharing for evidence-based preventive care and services, such as care and services that have been shown to prevent acute exacerbations of disease symptoms in individuals with chronic illnesses.
(3) Create incentives for individuals to actively participate in their own health care and to maintain or improve their health status.
(4) Require a greater contribution by an enrollee to the cost of elective or discretionary health services.
(5) Include a defined set of health care services that are affordable, financially sustainable and based upon the prioritized list of health services developed and updated by the Health Evidence Review Commission under ORS 414.690. [Formerly 413.064]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 741 - Health Insurance Exchange › Section 741.342 - Small Business Health Options Program.

Health benefit plans offered through a Small Business Health Options Program, as defined in ORS 741.300, are subject to ORS 743.004, 743.022, 743.535 and 743B.003 to 743B.127 and to other provisions of the Insurance Code applicable to small employer group health insurance. [2015 c.3 §36]
Note:
741.342 was added to and made a part of the Insurance Code by legislative action but was not added to ORS chapter 741 or any series therein. See Preface to Oregon Revised Statutes for further explanation.
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 741 - Health Insurance Exchange › Section 741.381 - Application of antitrust laws.

The activities of insurers working under the direction of the Oregon Health Authority and the Department of Consumer and Business Services pursuant to ORS 413.011 (1)(j) or participating in the health insurance exchange administered under ORS 741.002 do not constitute a conspiracy or restraint of trade or an illegal monopoly, nor are they carried out for the purposes of lessening competition or fixing prices arbitrarily. [Formerly 413.075; 2012 c.38 §19; 2015 c.3 §26]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 741 - Health Insurance Exchange › Section 741.390 - False or misleading filings prohibited.

A person may not file or cause to be filed with the Oregon Health Authority any article, certificate, report, statement, application or any other information related to the health insurance exchange required or permitted by the authority to be filed, that is known by the person to be false or misleading in any material respect. [2011 c.415 §24; 2015 c.3 §28; 2021 c.569 §29]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 741 - Health Insurance Exchange › Section 741.400 - Service of eligibility notices; when notice becomes final order; opportunity to contest actual receipt of notice.

(1) The Oregon Health Authority may serve by regular mail or, if requested by the recipient, by electronic mail a notice described in ORS 183.415 of the authority’s determination of:
(a) A person’s eligibility to purchase or to continue to purchase a qualified health plan through the health insurance exchange;
(b) A person’s eligibility for a premium tax credit for purchasing a qualified health plan or the amount of the person’s premium tax credit; or
(c) A person’s eligibility for cost-sharing reductions for qualified health plans and the amount of the person’s cost-sharing reduction.
(2) The legal presumption described in ORS 40.135 (1)(q) does not apply to a notice that is served by regular or electronic mail in accordance with subsection (1) of this section.
(3) Except as provided in subsection (4) of this section, a contested case notice served in accordance with subsection (1) of this section that complies with ORS 183.415 but for service by regular or electronic mail becomes a final order against a party and is not subject to ORS 183.470 (2), upon the earlier of the following:
(a) If the party fails to request a hearing, the day after the date prescribed in the notice as the deadline for requesting a hearing.
(b) The date the authority or the Office of Administrative Hearings mails an order dismissing a hearing request because:
(A) The party withdraws the request for hearing; or
(B) Neither the party nor the party’s representative appears on the date and at the time set for hearing.
(4) The authority shall prescribe by rule a period of not less than 60 days after a notice becomes a final order under subsection (3) of this section within which a party may request a hearing under this subsection. If a party requests a hearing within the period prescribed under this subsection, the authority shall do one of the following:
(a) If the authority finds that the party did not receive the written notice and did not have actual knowledge of the notice, refer the request for hearing to the Office of Administrative Hearings for a contested case proceeding on the merits of the authority’s intended action described in the notice.
(b) Refer the request for hearing to the Office of Administrative Hearings for a contested case proceeding to determine whether the party received the written notice or had actual knowledge of the notice. The authority must show that the party had actual knowledge of the notice or that the authority mailed the notice to the party’s correct address or sent an electronic notice to the party’s correct electronic mail address.
(5) If a party informs the authority that the party did not receive a notice served by regular or electronic mail in accordance with subsection (1) of this section, the authority shall advise the party of the right to request a hearing under subsection (4) of this section. [2013 c.678 §2; 2015 c.3 §29; 2021 c.569 §30]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 741 - Health Insurance Exchange › Section 741.500 - Required documentation; rules.

(1)(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, 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]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 741 - Health Insurance Exchange › Section 741.520 - Agreements with other agencies regarding sharing and use of confidential information; contents.

(1) The Director of the Oregon Health Authority may enter into agreements governing the sharing and use of information consistent with this section and ORS 741.510 with other state or federal health insurance exchanges or regulatory authorities, the Department of Consumer and Business Services, the Department of Revenue, law enforcement agencies or federal authorities.
(2) An agreement under this section must specify the duration of the agreement, the purpose of the agreement, the methods that may be employed for terminating the agreement and any other necessary and proper matters.
(3) An agreement under this section does not relieve the director of any obligation or responsibility imposed by law.
(4) The director may expend funds and may supply services for the purpose of carrying out an agreement under this section. [2011 c.415 §16; 2015 c.3 §32; 2021 c.569 §33]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 741 - Health Insurance Exchange › Section 741.540 - Complaints and investigations confidential; permitted disclosures.

(1) A complaint made to the Oregon Health Authority or the Department of Consumer and Business Services with respect to any prospective or certified qualified health plan, and the record thereof, shall be confidential and may not be disclosed except as provided in ORS 741.510 and 741.520. No such complaint, or the record thereof, shall be used by the authority or the department in any action, suit or proceeding except in the investigation or prosecution of apparent violations of ORS 741.310 or other law.
(2) Data gathered pursuant to an investigation of a complaint by the authority or the department shall be confidential, may not be disclosed except as provided in ORS 741.510 and 741.520 and may not be used in any action, suit or proceeding except in the investigation or prosecution of apparent violations of ORS 741.310 or other law.
(3) Notwithstanding subsections (1) and (2) of this section, the authority and the department shall establish a method for making available to the public an annual statistical report containing the number, percentage, type and disposition of complaints received by the authority and the department against each health plan that is certified or that has been certified as a qualified health plan by the authority. [2011 c.415 §23; 2015 c.3 §33; 2021 c.569 §34]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 741 - Health Insurance Exchange › Section 741.800 - Insurer to notify health care provider of qualified health plan coverage.

Upon receipt of any inquiry from a health care provider regarding the eligibility, coverage or benefits of an insured under an enrollee’s plan, an insurer shall notify the health care provider, in the manner prescribed by the insurer, that the coverage is provided through a qualified health plan. [2015 c.580 §3]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 741 - Health Insurance Exchange › Section 741.801 - Insurer to notify health care provider that enrollee is in grace period; effect of failure to provide notice.

(1) As used in this section and ORS 741.800:
(a) "Enrollee" means a person who is:
(A) Enrolled in a qualified health plan purchased through the health insurance exchange;
(B) Responsible for paying the premium on the qualified health plan and has paid at least one premium; and
(C) Receiving an advance payment of the premium tax credit under section 36B of the Internal Revenue Code.
(b) "Grace period" means the period of three consecutive months during which an enrollee’s coverage continues under a qualified health plan without the payment of premiums.
(c) "Health insurance exchange" has the meaning given that term in ORS 741.300.
(d) "Qualified health plan" means a plan that is certified as a qualified health plan in accordance with ORS 741.310.
(2) If an enrollee fails to pay a premium for a qualified health plan, the insurer shall notify any health care provider that the enrollee is in a grace period if the provider requests information from the insurer regarding the eligibility, coverage or benefits of the insureds under the enrollee’s plan.
(3) If an insurer terminates the coverage of an enrollee based on the nonpayment of premiums during a grace period, the insurer shall pay a claim for reimbursement by a health care provider of a service performed during the grace period if:
(a) The insurer fails to notify the health care provider as required by subsection (2) of this section;
(b) The service is covered by the enrollee’s plan; and
(c) The health care provider requests the information described in subsection (2) of this section not more than seven business days before providing the service and the insurer provides the information to the health care provider no later than two business days after the date of the provider’s request.
(4) The requirements of this section may not be waived by agreement, and any provision of a contract entered into on or after January 1, 2016, that purports to waive the requirements of this section or that conflicts with the requirements of this section is null and void. [2015 c.580 §2]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 741 - Health Insurance Exchange › Section 741.802 - Authority to produce written informational materials.

The Oregon Health Authority shall produce written materials containing information for consumers about the requirements for paying the premiums for qualified health plans. The authority shall distribute the materials to health care providers upon request. [2015 c.580 §4; 2021 c.569 §35]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 741 - Health Insurance Exchange › Section 741.900 - Civil penalties.

(1) The Director of the Oregon Health Authority, in accordance with ORS 183.745, may impose a civil penalty for a violation of ORS 741.390 of no more than $10,000.
(2) All penalties recovered under this section shall be deposited in the Health Insurance Exchange Fund. [2011 c.415 §25; 2015 c.3 §34; 2021 c.569 §36]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 742 - Insurance Policies Generally; Property and Casualty Policies › Section 742.001 - Scope of ORS chapters 742, 743, 743A and 743B.

Except as specifically provided in ORS 750.055 and 750.333, this chapter and ORS chapters 743, 743A and 743B apply to all insurance policies delivered or issued for delivery in this state except:
(1) Reinsurance.
(2) Wet marine and transportation insurance policies.
(3) Surplus lines insurance policies. [Formerly 743.003; 2005 c.185 §14; 2017 c.206 §2]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 742 - Insurance Policies Generally; Property and Casualty Policies › Section 742.003 - Filing and approval of policy forms; rules.

(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, 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]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 742 - Insurance Policies Generally; Property and Casualty Policies › Section 742.005 - Grounds for disapproval of policy forms.

The Director of the Department of Consumer and Business Services shall disapprove any form requiring the director’s approval:
(1) If the director finds it does not comply with the law;
(2) If the director finds it contains any provision, including statement of premium, or has any label, description of its contents, title, heading, backing or other indication of its provisions, which is unintelligible, uncertain, ambiguous or abstruse, or likely to mislead a person to whom the policy is offered, delivered or issued;
(3) If, in the director’s judgment, its use would be prejudicial to the interests of the insurer’s policyholders;
(4) If the director finds it contains provisions which are unjust, unfair or inequitable;
(5) If the director finds sales presentation material disapproved by the director pursuant to ORS 742.009 is being used with respect to the form; or
(6) If, with respect to any of the following forms, the director finds the benefits provided therein are not reasonable in relation to the premium charged:
(a) Individual health insurance policy forms, including benefit certificates issued by fraternal benefit societies and individual policies issued by health care service contractors, but excluding policies referred to in ORS 743.402 as exempt from the application of ORS 743.405 to 743.498 and 743A.160;
(b) Small employer group health benefit plan forms for small employers as that term is defined in ORS 743B.005, including small employer group policies issued by health care service contractors; or
(c) Credit life and credit health insurance forms subject to ORS 743.371 to 743.380. [Formerly 743.009; 1991 c.182 §1; 1999 c.987 §4; 2017 c.206 §15]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 742 - Insurance Policies Generally; Property and Casualty Policies › Section 742.007 - Director’s withdrawal of approval.

(1) The Director of the Department of Consumer and Business Services may, at any time after a hearing held not less than 20 days after written notice to the insurer, withdraw the director’s approval of any form on any ground set forth in ORS 742.005. The written notice of such hearing shall state the reason for the proposed withdrawal.
(2) When the director notifies an insurer of a hearing on a form under subsection (1) of this section, if the director in the director’s own discretion determines that the public may suffer serious injury because of continued use of the form, the director also may order the insurer to suspend delivery of the form in this state until the director has decided whether to withdraw approval of the form.
(3) No insurer shall deliver in this state:
(a) A form subject to an order of suspension under subsection (2) of this section, after the effective date of the order and until the director withdraws the order.
(b) A form for which the director has withdrawn approval, after the effective date of such withdrawal. The effective date of withdrawal shall be as the director may prescribe but not less than 30 days after the giving of notice of withdrawal. [Formerly 743.012]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 742 - Insurance Policies Generally; Property and Casualty Policies › Section 742.008 - Health savings account exemption from prohibition on deductible.

(1) As used in this section:
(a) "Health benefit plan" has the meaning given that term in ORS 743B.005.
(b) "Health savings account" means an account established under section 223 of the Internal Revenue Code.
(2) This section applies to a health benefit plan that is:
(a) Offered by a carrier as a plan that qualifies for a health savings account distribution; and
(b) Subject to a provision of the Insurance Code that prohibits a health benefit plan from applying a deductible to a specified health care service that is reimbursed by the health benefit plan.
(3) The Department of Consumer and Business Services may approve a filing under ORS 742.003 for a health benefit plan described in subsection (2) of this section if:
(a) The health benefit plan would be approved but for the failure of the plan to comply with the provision described in subsection (2)(b) of this section;
(b) A deductible must be applied to the specified health care service for the plan to qualify for a distribution from a health savings account; and
(c) The health benefit plan complies with all other applicable provisions of the Insurance Code. [2018 c.43 §3]
Note:
742.008 was added to and made a part of the Insurance Code by legislative action but was not added to ORS chapter 742 or any series therein. See Preface to Oregon Revised Statutes for further explanation.
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 742 - Insurance Policies Generally; Property and Casualty Policies › Section 742.009 - Regulation of sales material; rules.

(1) The Director of the Department of Consumer and Business Services, if the director considers it necessary, may require the filing by an insurer or insurance producer of any sales presentation material for use in the sale or the presentation for sale of any policy. The director, within 60 days after the filing of the sales presentation material, shall disapprove any such sales presentation material if the director finds that, in whole or in part, it is false, deceptive or misleading. Upon disapproval, such sales presentation material shall not be made, issued, circulated, displayed or given other use by the insurer or by insurance producers.
(2) The director, by rule, shall require any insurance producer who sells or attempts to sell insurance to provide to each prospective insured such information as the director considers necessary to adequately inform the prospective insured regarding the insurance transaction. [Formerly 743.021; 2003 c.364 §100]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 742 - Insurance Policies Generally; Property and Casualty Policies › Section 742.010

[Amended by 1953 c.718 §3; 1959 c.281 §1; 1965 c.611 §2; 1967 c.359 §654; renumbered 750.005]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 742 - Insurance Policies Generally; Property and Casualty Policies › Section 742.011 - Insurable interest in property.

No policy of insurance of property or of any interest in property or arising from property shall be enforceable as to the insurance except for the benefit of persons having an insurable interest in the things insured as at the time of the loss. [Formerly 743.033]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 742 - Insurance Policies Generally; Property and Casualty Policies › Section 742.013 - Representations in applications.

(1) All statements and descriptions in any application for an insurance policy by or in behalf of the insured, shall be deemed to be representations and not warranties. Misrepresentations, omissions, concealments of facts and incorrect statements shall not prevent a recovery under the policy unless the misrepresentations, omissions, concealments of fact and incorrect statements:
(a) Are contained in a written application for the insurance policy, and a copy of the application is indorsed upon or attached to the insurance policy when issued;
(b) Are shown by the insurer to be material, and the insurer also shows reliance thereon; and
(c) Are either:
(A) Fraudulent; or
(B) Material either to the acceptance of the risk or to the hazard assumed by the insurer.
(2) This section does not apply to surety insurance. [Formerly 743.042]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 742 - Insurance Policies Generally; Property and Casualty Policies › Section 742.016 - Policy constitutes entire contract; oral representations by insured.

(1) Except as provided in ORS 742.043, every contract of insurance shall be construed according to the terms and conditions of the policy. When the contract is made pursuant to a written application therefor, if the insurer delivers a copy of such application with the policy to the insured, thereupon such application shall become a part of the insurance policy. Any application that is not so delivered to the insured shall not be a part of the insurance policy and the insurer shall be precluded from introducing such application as evidence in any action based upon or involving the policy. Any oral representations by the insured that are not included in an application shall not be a part of the insurance policy and the insurer shall be precluded from introducing such representations as evidence in any action based upon or involving the policy.
(2) If any life or health insurance policy is reinstated or renewed, and the insured or assignee or beneficiary with a vested interest under such policy shall make written request to the insurer for a copy of the application, if any, for such reinstatement or renewal, the insurer shall, within 30 days after the receipt at its home or branch office of such request and of satisfactory evidence of such requesting beneficiary’s vested interest, deliver or mail to the person making such request a copy of such application. If such copy shall not be so delivered or mailed, the insurer shall be precluded from introducing such application as evidence in any action based upon or involving such policy or its reinstatement or renewal.
(3) This section does not apply to surety insurance. [Formerly 736.305 and then 743.045]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 742 - Insurance Policies Generally; Property and Casualty Policies › Section 742.018 - Provision for construction according to foreign law prohibited.

No policy of insurance shall contain any condition, stipulation or agreement requiring such policy to be construed according to the laws of any other state or country. Any such condition, stipulation or agreement shall be invalid. [Formerly 736.315 and then 743.048]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 742 - Insurance Policies Generally; Property and Casualty Policies › Section 742.021 - Standard provisions in general.

(1) Insurance policies shall contain such standard or uniform provisions as are required by the applicable provisions of the Insurance Code. However, the insurer may at its option substitute for one or more of such provisions corresponding provisions of different wording approved by the Director of the Department of Consumer and Business Services which are in each instance not less favorable in any respect to the insured or the beneficiary.
(2) If any standard or uniform provision is in whole or in part inapplicable to or inconsistent with the coverage provided by a particular form of policy the insurer, with the approval of the director, shall omit from such policy any inapplicable provision or part of a provision, and shall modify any inconsistent provision or part of a provision in such manner as to make the provision as contained in the policy consistent with the coverage provided by the policy.
(3) Except as provided in subsection (2) of this section, no policy shall contain any provision inconsistent with or contradictory to any standard or uniform provision used or required to be used. [Formerly 743.051]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 742 - Insurance Policies Generally; Property and Casualty Policies › Section 742.023 - Contents of policies in general.

(1) Every policy shall specify:
(a) The names of the parties to the contract.
(b) The subject of the insurance.
(c) The hazards or perils insured against.
(d) The time when the insurance thereunder takes effect and the period during which the insurance is to continue.
(e) The premium.
(f) The conditions and provisions pertaining to the insurance.
(2) If under the policy the exact amount of premium is determinable only at stated intervals or termination of the contract, a statement of the basis and rates upon which the premium is to be determined and paid shall be included.
(3) This section does not apply to surety insurance policies, or to group life or health insurance policies. [Formerly 743.054]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 742 - Insurance Policies Generally; Property and Casualty Policies › Section 742.026 - Underwriters’ and combination policies.

(1) Two or more authorized insurers may jointly issue, and shall be jointly and severally liable on, an underwriters’ policy bearing their names. Any one insurer may issue policies in the name of an underwriter’s department and such policy shall plainly show the true name of the insurer.
(2) Two or more insurers may, with the approval of the Director of the Department of Consumer and Business Services, issue a combination policy which shall contain provisions substantially as follows:
(a) That the insurers executing the policy shall be severally liable for the full amount of any loss or damage, according to the terms of the policy, or for specified percentages or amounts thereof, aggregating the full amount of insurance under the policy, and
(b) That service of process, or of any notice or proof of loss required by such policy, upon any of the insurers executing the policy, shall constitute service upon all such insurers.
(3) This section does not apply to co-surety obligations. [Formerly 743.057]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 742 - Insurance Policies Generally; Property and Casualty Policies › Section 742.028 - Additional policy contents.

A policy may contain additional provisions not inconsistent with the Insurance Code and which are:
(1) Required to be inserted by the laws of the insurer’s domicile;
(2) Necessary, on account of the manner in which the insurer is constituted or operated, in order to state the rights and obligations of the parties to the contract; or
(3) Desired by the insurer and neither prohibited by law nor in conflict with any provisions required to be included therein. [Formerly 743.060]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 742 - Insurance Policies Generally; Property and Casualty Policies › Section 742.031 - Bankruptcy clause required in certain liability policies.

A policy of insurance against loss or damage resulting from accident to or injury suffered by an employee or other person and for which the person insured is liable, or against loss or damage to property caused by horses or by any vehicle drawn, propelled or operated by any motive power, and for which loss or damage the person insured is liable, shall contain within such policy a provision substantially as follows: "Bankruptcy or insolvency of the insured shall not relieve the insurer of any of its obligations hereunder. If any person or legal representative of the person shall obtain final judgment against the insured because of any such injuries, and execution thereon is returned unsatisfied by reason of bankruptcy, insolvency or any other cause, or if such judgment is not satisfied within 30 days after it is rendered, then such person or legal representatives of the person may proceed against the insurer to recover the amount of such judgment, either at law or in equity, but not exceeding the limit of this policy applicable thereto." [Formerly 743.783 and then 743.772]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 742 - Insurance Policies Generally; Property and Casualty Policies › Section 742.033 - Charter and bylaw provisions.

No policy shall contain any provision purporting to make any portion of the charter, bylaws or other constituent document of the insurer (other than the subscriber’s agreement or power of attorney of a reciprocal insurer) a part of the contract unless such portion is set forth in full in the policy. Any policy provision in violation of this section shall be invalid. [Formerly 743.063]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 742 - Insurance Policies Generally; Property and Casualty Policies › Section 742.036 - Assessment policies, special contents.

Every policy issued on the assessment plan, and the form of any application for such a policy to be signed by the applicant, shall have conspicuously printed near the top of the face thereof in boldfaced type of a size not smaller than used for any caption in the policy or application, as applicable, the words "The policyholder is subject to assessment by the company" or such other words as the Director of the Department of Consumer and Business Services may require. [Formerly 743.066]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 742 - Insurance Policies Generally; Property and Casualty Policies › Section 742.038 - Validity and construction of noncomplying forms.

(1) A policy in violation of the Insurance Code, but otherwise binding on the insurer, shall be held valid, but shall be construed as provided in the Insurance Code.
(2) Any insurance policy issued and otherwise valid which contains any condition, omission or provision not in compliance with the Insurance Code, shall not be thereby rendered invalid but shall be construed and applied in accordance with such conditions and provisions as would have applied had such policy been in full compliance with the Insurance Code. [Formerly 743.069]
2023 Oregon Revised Statutes › Volume : 18 - Financial Institutions, Insurance › Chapter 742 - Insurance Policies Generally; Property and Casualty Policies › Section 742.041 - Permissible classes of insurance in one policy.

(1) Except as provided in this section, when more than one class of insurance as defined in ORS 731.150 to 731.194 is effected by an insurer each class shall be written in a separate and distinct policy. Any such policy may be canceled, surrendered or otherwise terminated without affecting other premiums paid or policies held by the same insured.
(2) Except as provided in this section, the same policy shall not include insurance coverages as to which the liability of the insurer for unearned premiums or the reserve for unpaid, deferred or undetermined loss claims is estimated in a different manner.
(3) Insurance in one policy may be effected upon automobiles and vehicles, and the accessories and other property transported upon and used in connection therewith, against loss or damage by fire, collision and explosion, and against loss by legal liability for damage to persons or property, or both, resulting from the maintenance, use or operation of such automobiles or vehicles, and against loss by burglary, embezzlement or theft, or any one or more of them. Premiums and losses for such insurance are to be reported to the Director of the Department of Consumer and Business Services under the title "automobile insurance." For this purpose an insurer need not use the standard fire insurance policy required by ORS 742.202.
(4) Insurance in one policy may be effected against loss or damage of property and against personal injury and death, and liability therefor, from explosion of steam boilers, tanks and engines, pipes and machinery connected therewith, and breakage of flywheels and machinery. Premiums and losses for such insurance are to be reported to the director under the title "steam boiler insurance."
(5) Insurance under the classes of life and health insurance may be effected in one policy.
(6) Insurance in one policy effected against any physical loss or damage occurring to properties may include coverage as to other perils, either on an unspecified basis as to coverage or for a single premium.
(7) Insurance in one policy effected against loss or destruction of baggage while traveling which is written on a single premium nonrenewable basis may include travel ticket health insurance benefits.
(8) Insurance under more than one class of insurance may be effected in one policy if the director finds that the issuance of the policy is in the best interest of the public. [Formerly 736.310 and then 743.072; 2005 c.185 §2]