Chapter 750 — Chapter 750

ORS 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]

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ORS 750.005 Definitions. As used in ORS 750.005 to 750.095

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ORS 750.010 [Amended by 1957 c.301 §1; 1961 c.116 §1; 1967 c.359 §548; renumbered 744.305]

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ORS 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

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ORS 750.020 [Amended by 1961 c.116 §2; 1967 c.359 §549; renumbered 744.315]

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ORS 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

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ORS 750.030 [Repealed by 1967 c.359 §704]

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ORS 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)

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ORS 750.040 [Amended by 1967 c.359 §552; renumbered 744.345]

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ORS 750.045 Required capitalization; bond, security or letter of credit; exemptions. (1) A health care service contractor that is a for-profit or not-for-profit corporation shall possess and thereafter maintain capital or surplus, or any combination thereof, of not less than $2.5 million

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ORS 750.047 [1993 c.447 §115a; repealed by 2005 c.255 §7]

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ORS 750.050 [Amended by 1961 c.116 §3; 1967 c.359 §553; renumbered 744.355]

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ORS 750.055 (1) The following provisions apply to health care service contractors to the extent not inconsistent with the express provisions of ORS 750.005 to 750.095

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ORS 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]

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ORS 750.060 [Amended by 1967 c.359 §555; renumbered 744.375]

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ORS 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]

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ORS 750.070 [Repealed by 1967 c.359 §704]

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ORS 750.075 [1979 c.799 §3; repealed by 1991 c.958 §6]

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ORS 750.080 [Amended by 1967 c.359 §557; renumbered 744.396]

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ORS 750.085 Offer of replacement coverage upon order of liquidation; procedure; rules. (1) If a final order of liquidation with a finding of insolvency has been entered with respect to a health care service contractor by a court of competent jurisdiction in the domicile of the health care service contractor, subscribers of the health care service contractor must be offered replacement coverage as provided in this section

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ORS 750.090 [Amended by 1967 c.359 §558; renumbered 744.405]

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ORS 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

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ORS 750.100 [Amended by 1967 c.359 §556; renumbered 744.385]

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ORS 750.110 [Repealed by 1967 c.359 §704]

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ORS 750.210 [Repealed by 1967 c.359 §704]

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ORS 750.220 [Repealed by 1967 c.359 §704]

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ORS 750.230 [Repealed by 1967 c.359 §704]

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ORS 750.240 [Repealed by 1967 c.359 §704]

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ORS 750.250 [Repealed by 1967 c.359 §704]

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ORS 750.260 [Repealed by 1967 c.359 §704]

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ORS 750.270 [Repealed by 1967 c.359 §704]

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ORS 750.300 [1973 c.97 §3; repealed by 1989 c.331 §35]

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ORS 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]

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ORS 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

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ORS 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

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ORS 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

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ORS 750.309 Requirements for trust. The following requirements apply to the trust carrying out a multiple employer welfare arrangement

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ORS 750.310 [1973 c.97 §4; repealed by 1989 c.331 §35]

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ORS 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]

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ORS 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

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ORS 750.315 Maintenance of reserves; actuarial opinion; rules. (1) For purposes of carrying out a multiple employer welfare arrangement, a trust shall maintain adequate reserves. Reserves must be held in cash or obligations guaranteed by the United States or invested in a registered investment company and invested exclusively in cash or obligations guaranteed by the United States. Reserves must be calculated with proper actuarial calculations of all of the following

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ORS 750.317 Board of trustees. (1) The powers of a multiple employer welfare arrangement, except as otherwise provided, must be exercised by a board of trustees chosen to carry out the purposes of the trust agreement. At least 50 percent of the trustees shall be persons who are covered under the multiple employer welfare arrangement. A trustee may not be an owner, officer or employee of a third party administrator who is licensed pursuant to ORS 744.700 to 744.740 and provides services to a multiple employer welfare arrangement

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ORS 750.318 Officers and persons appointed to act on behalf of board; bond. (1) The board of trustees of a trust carrying out a multiple employer welfare arrangement shall select officers as designated in the articles or bylaws and may appoint persons to act on behalf of the board as the board determines to be necessary for transacting the business of the multiple employer welfare arrangement

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ORS 750.319 Salaries; other compensation. (1) The trust carrying out a multiple employer welfare arrangement may not pay any salary, compensation or emolument to any officer or trustee of the trust unless the payment is first authorized by a majority vote of the board of trustees

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ORS 750.320 [1973 c.97 §5; repealed by 1989 c.331 §35]

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ORS 750.321 Assessment; maintenance of capital and surplus. (1) Benefit plans issued by a trust must provide for a charge or deposit payable in cash and, except as provided in this section, for an assessment against member employers for purposes of subsection (2) of this section at least equal to one month’s contribution by the employer. The assessment may be prefunded. A member employer may not be liable under this subsection for an amount greater than the charge or deposit required in the plan

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ORS 750.323 Notice of coverage under plan. (1) A trust shall provide notice of the following in writing to each individual applying to be covered by a multiple employer welfare arrangement

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ORS 750.325 Filings by trust. (1) Each multiple employer welfare arrangement holding a certificate of multiple employer welfare arrangement must file an annual financial statement with the Director of the Department of Consumer and Business Services. The statement must conform to the requirements of ORS 731.574 applicable to annual statements filed by insurers. The director may request additional filings as the director determines necessary

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ORS 750.327 Examinations. A multiple employer welfare arrangement and its board of trustees and each administrator, insurer or trustee related to the trust or multiple employer welfare arrangement are subject to investigation and examination in the same manner and to the same extent as an insurer under ORS 731.296 to 731.316. [1993 c.615 §16]

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ORS 750.329 Taxation. (1) A multiple employer welfare arrangement is subject to taxation to the same extent and in the same manner as an insurer transacting health insurance in this state

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