Chapter 743 — Chapter 743

ORS 743.003 [1967 c.359 §335; renumbered 742.001 in 1989]

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ORS 743.004 Submission of information by carriers offering health benefit plans. (1) Each carrier offering a health benefit plan shall submit to the Director of the Department of Consumer and Business Services on or before April 1 of each year a report that contains

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ORS 743.005 Protection of health information report. (1) As used in this section

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ORS 743.006 [Formerly 736.300; renumbered 742.003 in 1989]

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ORS 743.007 Data reporting. (1) A carrier offering a health benefit plan, an insurer offering insurance against the risk of economic loss assumed under a less than fully insured employee health plan described in ORS 742.065 and a third party administrator licensed under ORS 744.702 shall annually submit to the Department of Consumer and Business Services, in a form and manner prescribed by the department, data concerning the number of covered lives of the carrier, insurer or third party administrator, reported by line of business and by zip code

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ORS 743.008 Reporting requirements; rules. The Department of Consumer and Business Services shall develop by rule reporting requirements as necessary for the consistent and efficient implementation of ORS 743B.200, 743B.202, 743B.250 and 743B.423. In order to minimize duplicative reporting requirements, the department shall accept copies of reports prepared for national accreditation organizations as sufficient to meet the reporting requirements developed pursuant to this section to the extent that the reports include the information required by the department pursuant to this section. [Formerly 743.819]

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ORS 743.009 [1967 c.359 §337; 1969 c.336 §11; 1973 c.608 §1; renumbered 742.005 in 1989]

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ORS 743.010 Health insurance policy and health benefit plan forms; expenditures on primary care; rules. (1) In addition to all other powers of the Director of the Department of Consumer and Business Services with respect thereto, the director may issue rules with respect to policy forms and health benefit plan forms described in ORS 742.005 (6)(a) and (b)

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ORS 743.011 [1985 c.827 §2; repealed by 1989 c.255 §15]

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ORS 743.012 [1967 c.359 §338; 1989 c.700 §13; renumbered 742.007 in 1989]

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ORS 743.013 [1989 c.474 §2; 2003 c.364 §106; renumbered 743B.300 in 2015]

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ORS 743.015 Filing and approval of credit life and credit health insurance forms; filing of rates. (1) All credit life and credit health insurance policies subject to ORS 743.371 to 743.380, and all certificates of insurance, notices of proposed insurance, applications for insurance, indorsements and riders used in connection with such kinds of policies, delivered or issued for delivery in this state and the schedules of premium rates pertaining thereto shall be filed with the Director of the Department of Consumer and Business Services. Such forms are subject to approval, disapproval or withdrawal of approval by the director as provided in ORS 742.003, 742.005 and 742.007

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ORS 743.018 Filing of rates for life and health insurance; rules. (1) Except for group life and health insurance, and except as provided in ORS 743.015, every insurer shall file with the Director of the Department of Consumer and Business Services all schedules and tables of premium rates for life and health insurance to be used on risks in this state, and shall file any amendments to or corrections of such schedules and tables. Premium rates are subject to approval, disapproval or withdrawal of approval by the director as provided in ORS 742.003, 742.005, 742.007 and, for health benefit plans as defined in ORS 743B.005, ORS 743.019

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ORS 743.019 Procedure for review of proposed rates for health benefit plans; rules. (1) When an insurer files a schedule or table of premium rates for individual or small employer health benefit plans under ORS 743.018, the Department of Consumer and Business Services shall open a 30-day public comment period on the rate filing that begins on the date the insurer files the schedule or table of premium rates. The department shall post all of the comments received to the department’s website without delay

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ORS 743.020 Rate filing to include statement of administrative expenses; rules. An insurer licensed by the Department of Consumer and Business Services shall include in any rate filing under ORS 743.018 with respect to individual and small employer health benefit plans, as defined in ORS 743B.005, a statement of administrative expenses in the form and manner prescribed by the department by rule. The statement must include, but is not limited to

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ORS 743.021 [1967 c.359 §341; 1971 c.231 §21; 1973 c.525 §1; renumbered 742.009 in 1989]

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ORS 743.022 Premium rates for individual health benefit plans. Premium rates for individual health benefit plans shall be subject to the following provisions

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ORS 743.023 Electronic administration; discounted rates; requirements. (1) As used in this section

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ORS 743.024 [1967 c.359 §342; renumbered 743.040 in 2015]

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ORS 743.025 Annual report of information related to prescription drugs covered by health benefit plans; reports to Legislative Assembly. (1) As used in this section, “health benefit plan” has the meaning given that term in ORS 743B.005

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ORS 743.027 [1967 c.359 §342a; 1991 c.182 §2; 2009 c.331 §1; 2015 c.629 §60; renumbered 743.038 in 2015]

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ORS 743.028 Uniform health insurance claim forms. The Director of the Department of Consumer and Business Services shall prescribe uniform health insurance claim forms which shall be used by all insurers transacting health insurance in this state and by all state agencies that require health insurance claim forms for their records. [1973 c.109 §2]

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ORS 743.029 Uniform standards for health care financial and administrative transactions; rules. (1) The Department of Consumer and Business Services may adopt by rule uniform standards applicable to persons listed in subsection (2) of this section for health care financial and administrative transactions, including uniform standards for

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ORS 743.030 [Formerly 739.420; renumbered 743.044 in 2015]

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ORS 743.031 Stakeholder work group to recommend uniform standards. (1) The Oregon Health Authority shall convene a stakeholder work group to recommend uniform standards for health care financial and administrative transactions, including, to the extent allowed by law, standards applicable to commercial health insurance plans, self-funded plans and state governmental health plans and programs

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ORS 743.033 [1967 c.359 §344; renumbered 742.011 in 1989]

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ORS 743.034 Coordination with Oregon Health Authority concerning uniform standards; Department of Human Services to be subject to standards. (1) The Department of Consumer and Business Services and the Oregon Health Authority shall confer before the department finalizes rules implementing uniform standards under ORS 743.029, for the purpose of reconciling any differences between the department’s and the authority’s requirements for health care financial and administrative transactions described in ORS 743.029. If the Department of Consumer and Business Services proposes to amend any rule concerning uniform standards for health care financial and administrative transactions under ORS 743.029 or the authority proposes to amend any rule in a manner that would be inconsistent with the uniform standards, the agency proposing to amend the rules shall notify the other agency. The agencies shall confer before a final rule is adopted to ensure that the standards remain uniform and consistent to the extent practicable

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ORS 743.035 Uniform prior authorization form for prescription drug benefits; consultation with Oregon Health Authority; rules. (1) The Department of Consumer and Business Services, in consultation with the Oregon Health Authority, shall develop by rule a form that providers in this state shall use to request prior authorization for prescription drug benefits. The form must

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ORS 743.036 [Formerly 736.330; 1973 c.823 §149; repealed by 1973 c.827 §83]

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ORS 743.037 [1973 c.521 §2; renumbered 743.721 in 1989]

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ORS 743.038 Consent of individual required for life and health insurance; exceptions. A life or health insurance policy upon an individual, except a policy of group life insurance or of group or blanket health insurance, may not be made or effectuated unless at the time of the making of the policy the individual insured, being of competent legal capacity to contract, applies therefor or has consented thereto in writing, except in the following cases

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ORS 743.039 Alteration of application for life or health insurance. (1) An application for a life insurance policy may not provide for alterations by any person other than the applicant in either the application or the policy to be issued thereon with respect to the amount of insurance, classification of risk, plan of insurance or the benefits unless the application contains a statement that no such changes are effective until approved in writing by the applicant

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ORS 743.040 Personal insurance, insurable interest and beneficiaries. (1) Any individual of competent legal capacity may procure or effect an insurance policy on the individual’s own life or body for the benefit of any person. However, except as provided in ORS 743.044, no person shall procure or cause to be procured any insurance policy upon the life or body of another unless the benefits under such policy are payable to the individual insured or the personal representatives of the individual, or to a person having, at the time such policy was entered into, an insurable interest in the individual insured

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ORS 743.041 Payment discharges insurer. Whenever the proceeds of or payments under a life or health insurance policy become payable in accordance with the terms of such policy, or the exercise of any right or privilege under such policy, and the insurer makes payment in accordance with the terms of the policy or in accordance with any written assignment of the policy, the person so designated as being entitled to the proceeds or payments shall be entitled to receive them and to give full acquittance therefor, and such payments shall fully discharge the insurer from all claims under the policy unless, before payment is made, the insurer has received at its home office written notice by or on behalf of some other person that such other person claims to be entitled to such proceeds or payments or some interest in the policy. [Formerly 743.084]

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ORS 743.042 [1967 c.359 §347; 1985 c.465 §1; renumbered 742.013 in 1989]

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ORS 743.043 Assignment of policies. A policy may be assignable or not assignable, as provided by its terms. Subject to its terms relating to assignability, any life or health insurance policy, under the terms of which the beneficiary may be changed upon the sole request of the insured or owner, may be assigned either by pledge or transfer of title, by an assignment executed by the insured or owner alone and delivered to the insurer, whether or not the pledgee or assignee is the insurer. Any such assignment shall entitle the insurer to deal with the assignee as the owner or pledgee of the policy in accordance with the terms of the assignment, until the insurer has received at its home office written notice of termination of the assignment or pledge, or written notice by or on behalf of some other person claiming some interest in the policy in conflict with the assignment. [Formerly 743.087]

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ORS 743.044 Life insurance for benefit of charity. (1) Life insurance policies may be effected although the person paying the consideration has no insurable interest in the life of the person insured if a charitable, benevolent, educational or religious institution is designated irrevocably as the beneficiary

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ORS 743.045 [Formerly 736.305; 1971 c.231 §22; 1985 c.465 §2; renumbered 742.016 in 1989]

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ORS 743.046 Exemption of proceeds of individual life insurance other than annuities. (1) When a policy of insurance is effected by any person on any person’s own life or on another life in favor of some person other than that person having an insurable interest in the life insured, the lawful beneficiary thereof, other than that person or that person’s legal representative, is entitled to its proceeds against the creditors or representatives of the person effecting the policy

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ORS 743.047 Exemption of proceeds of group life insurance. (1) A policy of group life insurance or the proceeds thereof payable to a person or persons other than the individual insured or the individual’s estate shall be exempt from debts and claims of creditors or representatives of the individual insured and, in the event of bankruptcy of the individual insured, from all demands in legal proceedings under such bankruptcy

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ORS 743.048 [Formerly 736.315; renumbered 742.018]

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ORS 743.049 Exemption of proceeds of annuity policies; assignability of rights. (1) The benefits, rights, privileges and options which are due or prospectively due an annuitant under any annuity policy issued before, on or after June 8, 1967, shall not be subject to execution, nor shall the annuitant be compelled to exercise any such rights, powers or options, nor shall creditors be allowed to interfere with or terminate the policy, except

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ORS 743.050 Exemption of proceeds of health insurance. Except as may otherwise be expressly provided by the policy, the proceeds or avails of all health insurance policies and of provisions providing benefits on account of the insured’s disability which are supplemental to life insurance policies, issued before, on or after June 8, 1967, shall be exempt from all liability for any debt of the insured, and from any debt of the beneficiary existing at the time the proceeds are made available for the use of the beneficiary. [Formerly 743.108]

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ORS 743.051 [1967 c.359 §350; renumbered 742.021 in 1989]

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ORS 743.052 [1971 c.372 §2; renumbered 743.719 in 1989]

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ORS 743.053 Prohibition on requirement that death or dismemberment occur in less than 180 days after accident. A life insurance policy or health insurance policy, whether group or individual, that contains provisions providing benefits in case of death or dismemberment by accident shall not require that the death or dismemberment occur less than 180 days after the date of the accident in order for benefits to be paid under the policy. [1991 c.182 §8]

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ORS 743.054 [1967 c.359 §351; renumbered 742.023 in 1989]

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ORS 743.055 [1991 c.875 §2; repealed by 1995 c.506 §11]

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ORS 743.056 [2011 c.30 §2; 2013 c.5 §§15,16; renumbered 742.407 in 2015]

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ORS 743.057 [1967 c.359 §352; renumbered 742.026 in 1989]

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