Oregon Administrative Code

836-020-0270 Introductory, Initial, or Special Offers (1)(a) An advertisement shall not directly or by implication represent that a policy or combination of policies is an introductory, initial, or special offer, that applicants will receive substantial advantages not available a…

836-020-0275 Statements About an Insurer An advertisement shall not contain statements which are untrue in fact, or misleading by implication, with respect to the assets, corporate structure, financial standing, age, or relative position of the insurer in the insurance business. …

836-020-0280 Enforcement Procedures (1) Advertising File. Each insurer shall maintain at its home or principal office a complete file containing every advertisement prepared for its individual policies, and typical advertisements prepared for its blanket, franchise and group poli…

836-020-0285 Prior Approval No advertising which includes an application or enrollment form may be used without its prior approval by the Insurance Commissioner. Statutory/Other Authority: ORS 731, 743 & 746 Statutes/Other Implemented: ORS 742.009 & 746.075 History: IC 53, f. 3-5…

836-020-0290 Severability If any portion of this rule, or the applicability of this rule to any person or circumstance, is held invalid by a court, the remainder of the rule or the applicability of the rule to other persons or circumstances shall not be affected thereby. Statutor…

836-020-0295 Effective Date This rule shall be effective March 15, 1973. Statutory/Other Authority: ORS 731, 743 & 746 Statutes/Other Implemented: ORS 742.009 & 746.075 History: IC 53, f. 3-5-73, ef. 3-15-73

836-020-0300 Statutory Authority (1) OAR 836-020-0300 to 836-020-0305 are adopted by the Director of the Department of Insurance and Finance pursuant to the requirements of ORS 742.009, 743.010, and 743.013 (Section 2, Chapter 474, Oregon Laws 1989). (2) OAR 836-020-0300 to 836-0…

836-020-0305 Disclosure; Application for Coverage (1) When an insurance producer or representative of an insurer accepts an application for individual health insurance coverage other than coverage described in section (2) of this rule, the insurance producer or representative sha…

836-020-0770 Authority, Purpose and Effective Date of OAR 836-020-0770 to 836-020-0806 (1) OAR 836-020-0770 to 836-020-0806 are adopted by the Director of the Department of Consumer and Business Services pursuant to the authority of ORS 731.244 and 743.552, for the purpose of imp…

836-020-0775 Definitions As used in OAR 836-020-0770 to 836-020-0806: (1) "Allowable expense," except as otherwise provided in this rule or as otherwise used in a statute, is defined and its use is governed by the following: (a) The term means any health care expense, including c…

836-020-0780 Use of Model COB Contract Provision (1) Appendix A (Exhibit 1 to this rule) contains a model COB provision for use in contracts. The use of this model COB provision is subject to OAR 836-020-0785(1), (2) and (3). (2) Appendix B (Exhibit 2 to this rule) is a plain lan…

836-020-0785 Rules for Coordination of Benefits When a person is covered by two or more plans, the rules for determining the order of benefit payments are as follows: (1)(a) The primary plan shall pay or provide its benefits as if the secondary plan or plans did not exist. (b) If…

836-020-0791 Procedure to be Followed by Secondary Plan to Calculate Benefits and Pay a Claim (1) In determining the amount to be paid by the secondary plan on a claim, should the plan wish to coordinate benefits, the secondary plan shall calculate the benefits it would have paid…

836-020-0796 Notice to Covered Persons A plan shall, in its explanation of benefits provided to covered persons, include the following language: “If you are covered by more than one health benefit plan, you should file all your claims with each plan.” Statutory/Other Authority: O…

836-020-0801 Miscellaneous Provisions (1) A secondary plan that provides benefits in the form of services may recover the reasonable cash value of the services from the primary plan to the extent that benefits for the services are covered by the primary plan and have not already …

836-020-0806 Effective Date for Existing Contracts (1) The amendments to OAR 836-020-0770, 836-020-0775 and 836-020-0785 apply to a contract that provides health care benefits and that was issued before January 1, 2015 must comply with the amendments to OAR 836-020-0770, 836-020-…

836-024-0003 Statutory Authority; Purpose OAR 836-024-0003 to 836-024-0055 are authorized by ORS 732.415(4). These rules are adopted to carry out the purposes of 732.415, to prevent fraud or deception in connection with the solicitation of proxies, consents, and other authorizati…

836-024-0004 Application of OAR 836-024-0003 to 836-024-0055 (1) A domestic stock insurer that has a class of equity securities held of record by 300 or more persons, or any director, officer or employee of that insurer, or any other person, may not solicit or permit the use of t…

836-024-0006 Definitions As used in OAR 836-024-0003 to 836-024-0055, unless the context otherwise requires: (1) An “affiliate” of, or a person affiliated with, a specified person is a person that directly, or indirectly through one or more intermediaries, controls, or is control…

836-024-0008 Solicitations to which OAR 836-024-0003 to 836-024-0055 Apply OAR 836-024-0041 applies to every solicitation that is subject to 836-024-0004. 836-024-0006 to 836-024-0039 and 836-024-0046 apply to every solicitation that is subject to 836-024-0004 except the followin…

836-024-0026 Information to Be Furnished to Security Holders (1) A solicitation subject to OAR 836-024-0003 to 836-024-0055 may not be made unless each person solicited is concurrently furnished or has previously been furnished with a written proxy statement containing the inform…

836-024-0031 Requirements as to Proxy (1) The form of proxy shall: (a) Indicate in bold-face type whether the proxy is solicited on behalf of the issuer’s board of directors, and if not, by whom it is solicited; (b) Provide a specifically designed blank space for dating the proxy…

836-024-0033 Presentation of Information in Proxy Statement (1) The information included in the proxy statement shall be clearly presented. The statements made must be divided into groups according to subject matter. The various groups of statements must be preceded by appropriat…

836-024-0036 Material Required to Be Filed (1) Two preliminary copies of the proxy statement and form of proxy, and any other soliciting material to be furnished to security holders with the proxy, or the information pursuant to Schedule C, shall be filed with the Director at lea…

836-024-0038 Mailing Communications for Security Holders (1) If the management of the issuer has made or intends to make any solicitation subject to OAR 836-024-0003 to 836-024-0055, the issuer shall perform any act described in this rule that is requested in writing with respect…

836-024-0039 Proposals of Security Holders (1) As used in this rule, “proponent” means a holder or holders of an issuer’s securities. (2) An issuer shall set forth a proposal for action in its proxy statement if the proponent notifies the issuer as provided in this section and if…

836-024-0041 False or Misleading Statements A proxy statement, form of proxy, notice of meeting, information statement, and any other communication, written or oral, that is subject to OAR 836-024-0003 to 836-024-0055 may not contain any statement that: (1) At the time and in the…

836-024-0046 Prohibition of Certain Solicitations A person making a solicitation may not solicit any undated or postdated proxy, or any proxy that provides it will be considered to be dated as of any date subsequent to the date on which it is signed by the security holder. Statut…

836-024-0051 Special Provisions Applicable to Election Contests; Definition OAR 836-024-0051 to 836-024-0055 apply to a solicitation by any person or group for the purpose of opposing a solicitation by another person or group regarding the election or removal of directors at an a…

836-024-0053 Filings Required in an Election Contest (1) A solicitation may not be made by a person other than the issuer unless a statement in duplicate containing the information specified by Schedule B and a copy of any material proposed to be distributed to security holders i…

836-024-0054 Counter Solicitations Prior to Furnishing Required Written Proxy Statement Notwithstanding the provisions of OAR 836-024-0026(1), a solicitation subject to 836-024-0051 to 836-024-0055 may be made prior to furnishing security holders with a written proxy statement co…

836-024-0055 Filing Requirements for Preliminary Solicitation Material (1) Two copies of any soliciting material proposed to be sent or given to security holders prior to the furnishing of the proxy statement required by OAR 836-024-0026(1) shall be filed with the Director in pre…

836-024-0100 Statutory authority; purpose (1) OAR 836-024-0100 to 836-024-0220 are adopted under the authority of ORS 731.244, 732.420, 732.430, 732.435, 732.445, 732.450 and 732.455, for the purpose of implementing 732.420 to 732.455. (2) OAR 836-024-0100 to 836-024-0220 apply t…

836-024-0105 Definitions As used in OAR 836-024-0100 to 836-024-0220: (1) “Class” means all securities of an insurer that are of substantially similar character and in which the holders enjoy substantially similar rights and privileges. (2) “Equity security” as defined in ORS 732…

836-024-0110 Securities “Held of Record” for Purpose of ORS 732.425 (1) To determine for the purpose of ORS 732.425 whether the equity securities of an insurer are held of record by 100 or more persons, securities are considered to be “held of record” by each person who is identi…

836-024-0115 Filing of Statements (1) A person who is required by ORS 732.430 to file a statement of beneficial ownership of equity securities shall file the initial statement on Form 3, which is prescribed in Exhibit 1 to this rule. A person who is required by ORS 732.430 to fil…

836-024-0120 Ownership of more than 10 percent of an equity security (1) When it is to be determined for the purpose of ORS 732.430 whether a person is the beneficial owner, directly or indirectly, of more than 10 percent of any class of any equity security, the class of the equi…

836-024-0125 Disclaimer of Beneficial Ownership A person who files a statement may declare expressly in the statement that the filing may not be construed as an admission that the person is the beneficial owner for the purpose of ORS 732.420 to 732.455 of any equity securities co…

836-024-0130 Exemptions from ORS 732.430 and 732.435 (1) Securities held by the following persons are exempt from ORS 732.430 and 732.435 for 12 months following the date of the person’s appointment and qualification: (a) An executor or administrator of the estate of a decedent; …

836-024-0135 Exemptions from ORS 732.420 to 732.455 of Securities Purchased or Sold by Odd-lot Dealers Securities purchased or sold by an odd-lot dealer are exempt from ORS 732.420 to 732.455 with respect to participation by the odd-lot dealer when the securities are purchased or…

836-024-0140 Certain Transactions Subject to ORS 732.430 Acquisition or disposition of the privilege of a transferable option, put, call, spread or straddle is a change in the beneficial ownership of the security to which the privilege relates. A person who acquires or disposes o…

836-024-0145 Ownership of Securities Held in Trust (1) Beneficial ownership of a security for the purpose of ORS 732.430 includes any of the following: (a) Ownership of securities as a trustee when either the trustee or members of the immediate family of the trustee have a vested…

836-024-0150 Exemption for Small Transactions (1) An acquisition of securities is exempt from ORS 732.430 when the person effecting the acquisition: (a) Does not effect any disposition of securities of the same class, other than by gift, within six months of the acquisition; and …

836-024-0155 Exemption from ORS 732.435 That Need not be Reported Under ORS 732.430 A transaction that has been or is exempted from the requirements of ORS 732.430 is also exempted from 732.435 to the extent that the transaction would otherwise be subject to 732.435. Statutory/Ot…

836-024-0160 Exemption from ORS 732.435 of Certain Transactions Effected in Connection with a Distribution (1) If the following conditions apply, a transaction of purchase and sale, or sale and purchase, of a security that is effected in connection with the distribution of a subs…

836-024-0165 Exemption from ORS 732.435 of Acquisitions of Shares of Stock and Stock Options under Certain Stock Bonus, Stock Option or Similar plans When a director or officer of an insurer issuing stock or a stock option acquires shares of the insurer’s stock pursuant to a stoc…

836-024-0170 Exemption from ORS 732.435 of Certain Transactions in Which Securities are Received by Redeeming other Securities An acquisition of an equity security, other than a convertible security or right to purchase a security, by a director or officer of the insurer issuing …

836-024-0175 Exemption of long Term Profits Incident to Sales Within Six Months of the Exercise of an Option (1) As provided in section (2) of this rule, the Director exempts as not comprehended within the purposes of ORS 732.435 any transaction or transactions involving the purc…

836-024-0180 Exemption from ORS 732.435 of Certain Acquisitions and Dispositions of Securities Pursuant to Merger or Consolidation (1) The Director exempts as not comprehended within the purposes of ORS 732.435 the following transactions: (a) The acquisition of a security of an i…

836-024-0185 Exemption from ORS 732.435 of Transactions Involving the Deposit or Withdrawal of Equity Securities Under a Voting Trust or Deposit Agreement (1) If substantially all of the assets held under a voting trust or deposit agreement immediately after the deposit of a secu…