There is a newer version of the Oregon Revised Statutes
2013 Oregon Revised Statutes
Volume : 16 - Financial Institutions, Insurance
Chapter 743 - Health and Life Insurance
GENERAL PROVISIONS- Section 743.010 - Health insurance policy and health benefit plan forms; rules.
- Section 743.011
- Section 743.012
- Section 743.013 - Disclosure of differences in replacement health insurance policies; nonduplication for persons 65 and older; rules.
- Section 743.015 - Filing and approval of credit life and credit health insurance forms; filing of rates.
- Section 743.018 - Filing of rates for life and health insurance; rules.
- Section 743.019 - Public comment on proposed rates for health insurance.
- Section 743.020 - Rate filing to include statement of administrative expenses; rules.
- Section 743.021
- Section 743.024 - Personal insurance, insurable interest and beneficiaries.
- Section 743.027 - Consent of individual required for life and health insurance; exceptions.
- Section 743.028 - Uniform health insurance claim forms.
- Section 743.030 - Life insurance for benefit of charity.
- Section 743.033
- Section 743.036
- Section 743.037
- Section 743.039 - Alteration of application for life or health insurance.
- Section 743.041 - Payment discharges insurer.
- Section 743.042
- Section 743.043 - Assignment of policies.
- Section 743.045
- Section 743.046 - Exemption of proceeds of individual life insurance other than annuities.
- Section 743.047 - Exemption of proceeds of group life insurance.
- Section 743.048
- Section 743.049 - Exemption of proceeds of annuity policies; assignability of rights.
- Section 743.050 - Exemption of proceeds of health insurance.
- Section 743.051
- Section 743.052
- Section 743.053 - Prohibition on requirement that death or dismemberment occur in less than 180 days after accident.
- Section 743.054
- Section 743.055
- Section 743.056 - Insurer may not refuse to defend or pay claim based on provider's disclosure of adverse event or provider's participation in mediation.
- Section 743.057
- Section 743.060
- Section 743.061 - Uniform standards for health care financial and administrative transactions; rules.
- Section 743.062 - Stakeholder work group to recommend uniform standards.
- Section 743.063
- Section 743.064 - Coordination with Oregon Health Authority concerning uniform standards; Department of Human Services to be subject to standards.
- Section 743.065 - Uniform prior authorization form for prescription drug benefits; consultation with Oregon Health Authority; rules.
- Section 743.066
- Section 743.069
- Section 743.072
- Section 743.075
- Section 743.078
- Section 743.080
- Section 743.081
- Section 743.082 - Selling and leasing of provider panels by contracting entity; definitions.
- Note 743.082, 743.085 and 743.086
- Section 743.083 - Registration of contracting entity.
- Section 743.084
- Section 743.085 - Third party contracts for leasing of provider panels; requirements.
- Section 743.086 - Additional requirements for third party contracts.
- Section 743.087
- Section 743.090
- Section 743.093
- Section 743.096
- Section 743.099
- Section 743.100 - Short title.
- Section 743.101 - Purpose.
- Section 743.102
- Section 743.103 - Definitions for ORS 743.100 to 743.109.
- Section 743.104 - Scope of ORS 743.100 to 743.109.
- Section 743.105
- Section 743.106 - Reading ease standards for life and health insurance policies.
- Section 743.107 - When director may authorize lower standards.
- Section 743.108
- Section 743.109 - Approval of certain policy forms containing specified provisions; conditions for approval.
- Section 743.111
- Section 743.114
- Section 743.115
- Section 743.116
- Section 743.117
- Section 743.118
- Section 743.119
- Section 743.120
- Section 743.123
- Section 743.125
- Section 743.128
- Section 743.132
- Section 743.135
- Section 743.138
- Section 743.140
- Section 743.143
- Section 743.145
- Section 743.147
- Section 743.150 - Scope of ORS 743.150, 743.153 and 743.156.
- Section 743.153 - Statement of benefits.
- Section 743.154 - Acceleration of death benefits; rules.
- Section 743.156 - Statement of premium.
- Section 743.159 - Scope of ORS 743.162 to 743.243.
- Section 743.162 - Payment of premium.
- Section 743.165 - Grace period.
- Section 743.168 - Incontestability.
- Section 743.171 - Incontestability and limitation of liability after reinstatement.
- Section 743.174 - Entire contract.
- Section 743.177 - Statements of insured.
- Section 743.180 - Misstatement of age.
- Section 743.183 - Dividends.
- Section 743.186 - Policy loan.
- Section 743.187 - Maximum interest rate on policy loan; adjustable interest rate.
- Section 743.189 - Reinstatement.
- Section 743.192 - Payment of claim; payment of interest upon failure to pay proceeds.
- Section 743.195 - Installment payments.
- Section 743.198 - Title.
- Section 743.201 - Beneficiary of industrial policies.
- Section 743.204 - Standard Nonforfeiture Law for Life Insurance; applicability.
- Section 743.207 - Required provisions relating to nonforfeiture.
- Section 743.210 - Determination of cash surrender values; applicability to certain policies.
- Section 743.213 - Determination of paid-up nonforfeiture benefits.
- Section 743.215 - Calculation of adjusted premiums.
- Section 743.216 - Adjusted premiums; applicability.
- Section 743.218 - Requirements for determination of future premium amounts or minimum values.
- Section 743.219 - Supplemental rules for calculating nonforfeiture benefits.
- Section 743.221 - Cash surrender values upon default in premium payment.
- Section 743.222 - Policy benefits and premiums that shall be disregarded in calculating cash surrender values and paid-up nonforfeiture benefits.
- Section 743.225 - Prohibited provisions.
- Section 743.228 - Acts of corporate insured or beneficiary with respect to policy.
- Section 743.230 - Variable life policy provisions.
- Section 743.231 - "Profit-sharing policy" defined.
- Section 743.234 - "Charter policy" or "founders policy" defined.
- Section 743.237 - "Coupon policy" defined.
- Section 743.240 - Profit-sharing, charter or founders policies prohibited.
- Section 743.243 - Restrictions on form of coupon policy.
- Section 743.245 - Variable life insurance policy provisions.
- Section 743.247 - Notice to variable life insurance policyholders.
- Section 743.252 - Scope of ORS 743.255 to 743.273.
- Section 743.255 - Grace period for annuities.
- Section 743.258 - Incontestability.
- Section 743.261 - Entire contract.
- Section 743.264 - Misstatement of age or sex.
- Section 743.267 - Dividends.
- Section 743.268 - Advancement of policy loans.
- Section 743.269 - Periodic payments for period certain.
- Section 743.270 - Reinstatement.
- Section 743.271 - Periodic stipulated payments on variable annuities.
- Section 743.272 - Computing benefits.
- Section 743.273 - Standard provisions of reversionary annuities.
- Section 743.275 - Standard Nonforfeiture Law for Individual Deferred Annuities; application.
- Section 743.278 - Required provisions in annuity policies; exception.
- Section 743.281
- Section 743.284 - Computation of benefits.
- Section 743.287 - Commencement of annuity payments at optional maturity dates; calculation of benefits.
- Section 743.290 - Notice of nonpayment of certain benefits to be included in annuity policy.
- Section 743.293 - Minimum forfeiture amounts for annuity policies; rules.
- Section 743.295 - Effect of certain life insurance and disability benefits on minimum nonforfeiture amounts.
- Section 743.303 - Requirements for issuance of group life insurance policies.
- Section 743.306 - Required provisions in group life insurance policies.
- Section 743.309 - Nonforfeiture provisions.
- Section 743.312 - Grace period.
- Section 743.315 - Incontestability.
- Section 743.318 - Application; representations by policyholders and insureds.
- Section 743.321 - Evidence of insurability.
- Section 743.324 - Misstatement of age.
- Section 743.327 - Payments under policy; payment of interest upon failure to pay proceeds.
- Section 743.330 - Issuance of certificates.
- Section 743.333 - Termination of individual coverage.
- Section 743.336 - Termination of policy or class of insured persons.
- Section 743.339 - Death during period for conversion to individual policy.
- Section 743.342 - Statement furnished to insured under credit life insurance policy.
- Section 743.345 - Assignability of group life policies.
- Section 743.348 - Certain sales practices prohibited.
- Section 743.350
- Section 743.351 - Eligibility of association to be group life policyholder; rules.
- Section 743.353
- Section 743.354 - Requirements for certain group life policies issued to trustees of certain funds; rules.
- Section 743.356 - Continuing coverage upon replacement of group life policy.
- Section 743.357
- Section 743.358 - Borrowing by certificate holders under group life policy.
- Section 743.360 - Alternative group life insurance coverage.
- Section 743.362
- Section 743.365
- Section 743.368
- Section 743.370
- Section 743.371 - Definitions for credit life and credit health insurance provisions.
- Section 743.372 - Applicability of credit life and credit health insurance provisions.
- Section 743.373 - Forms of credit life and credit health insurance.
- Section 743.374 - Limits on amount of credit life insurance.
- Section 743.375 - Limit on amount of credit health insurance.
- Section 743.376 - Duration of credit life and credit health insurance.
- Section 743.377 - Credit life and credit health insurance policy or group certificate; contents; delivery of policy, certificate or copy of application.
- Section 743.378 - Charges and refunds to debtor.
- Section 743.379 - Status of remuneration to creditor.
- Section 743.380 - Claim report and payment.
- Section 743.402 - Exceptions to individual health insurance policy requirements.
- Section 743.405 - General requirements for health insurance policies.
- Section 743.408 - Mandatory provisions.
- Section 743.411 - Entire contract; changes.
- Section 743.412
- Section 743.414 - Time limit on certain defenses; incontestability.
- Section 743.417 - Grace period.
- Section 743.420 - Reinstatement.
- Section 743.423 - Notice of claim.
- Section 743.426 - Claim forms.
- Section 743.429 - Proofs of loss.
- Section 743.432 - Time of payment of claims.
- Section 743.435 - Payment of claims.
- Section 743.438 - Physical examinations and autopsy.
- Section 743.441 - Legal actions.
- Section 743.444 - Change of beneficiary.
- Section 743.447 - Optional provisions.
- Section 743.450 - Change of occupation.
- Section 743.453 - Misstatement of age.
- Section 743.456 - Other insurance in same insurer.
- Section 743.459 - Insurance with other insurers; expense incurred benefits.
- Section 743.462 - Insurance with other insurers; other than expense incurred benefits.
- Section 743.465 - Relation of earnings to insurance.
- Section 743.468 - Unpaid premium.
- Section 743.471 - Cancellation.
- Section 743.472 - Permissible reasons for cancellation or refusal to renew.
- Section 743.474 - Conformity with state statutes.
- Section 743.477 - Illegal occupation.
- Section 743.480
- Section 743.483 - Arrangement of provisions.
- Section 743.486 - Scope of term "insured" in statutory policy provisions.
- Section 743.489 - Extension of coverage beyond policy period; effect of misstatement of age.
- Section 743.492 - Policy return and premium refund provision.
- Section 743.495 - Use of terms "noncancelable" or "guaranteed renewable"; synonymous terms.
- Section 743.498 - Statement in policy of cancelability or renewability.
- Section 743.499 - Notice to policyholder required for cancellation or nonrenewal of health benefit plan; effect of failure to give notice.
- Section 743.516
- Section 743.519
- Section 743.520
- Section 743.522 - Additional groups designated by director.
- Section 743.523 - Certain sales practices prohibited.
- Section 743.524 - Eligibility of association to be group health policyholder; rules.
- Section 743.525
- Section 743.526 - Determination of whether trustees are policyholders; consequences; rules.
- Section 743.527 - When group health insurance policies to continue in effect upon payment of premium by insured individual.
- Section 743.528 - Required provisions in group health insurance policies.
- Section 743.529 - Continuation of benefits after termination of group health insurance policy; rules.
- Section 743.530 - Continuation of benefits after injury or illness covered by workers' compensation.
- Section 743.531 - Direct payment of hospital and medical services; rate limitations.
- Section 743.532
- Section 743.533 - Leased workers; offering group health insurance.
- Section 743.534 - "Blanket health insurance" defined.
- Section 743.537 - Required provisions for blanket health insurance policies.
- Section 743.540 - Application and certificates not required for blanket health insurance policies.
- Section 743.543 - Payment of benefits under blanket health insurance policies.
- Section 743.546 - Exemption of policy form approval for blanket health insurance policies.
- Section 743.549
- Section 743.550 - Student health insurance.
- Section 743.551 - Student health benefit plans; rules.
- Section 743.552 - Guidelines for coordination of benefits; rules.
- Section 743.555
- Section 743.556
- Section 743.557
- Section 743.558
- Section 743.559
- Section 743.560 - Minimum grace period; notice upon termination of policy; effect of failure to notify.
- Section 743.561
- Section 743.562 - Applicability of ORS 743.560.
- Section 743.564
- Section 743.565 - Separate notice to policyholder required before cancellation of individual or group health insurance policy for nonpayment of premium.
- Section 743.566 - Rules for certain notice requirements.
- Section 743.567
- Section 743.570
- Section 743.573
- Section 743.576
- Section 743.579
- Section 743.582
- Section 743.585
- Section 743.588
- Section 743.600 - Availability of continued coverage under group policy for surviving, divorced or separated spouse 55 or older.
- Section 743.601 - Procedure for obtaining continuation of coverage under ORS 743.600.
- Section 743.602 - Premium for continuation of coverage under ORS 743.600; termination of right to continuation.
- Section 743.603
- Section 743.606
- Section 743.607
- Section 743.609
- Section 743.610 - Continuation of coverage under group policy upon termination of membership in group health insurance policy; applicability of waiting period to rehired employee.
- Section 743.611
- Section 743.612
- Section 743.613
- Section 743.614
- Section 743.615
- Section 743.616
- Section 743.617
- Section 743.618
- Section 743.619
- Section 743.620
- Section 743.621
- Section 743.622
- Section 743.624
- Section 743.627
- Section 743.630
- Section 743.633
- Section 743.636
- Section 743.639
- Section 743.642
- Section 743.645
- Section 743.648
- Section 743.650 - Long Term Care Insurance Act; purpose; application.
- Section 743.651
- Section 743.652 - Definitions for ORS 743.650 to 743.665.
- Section 743.653 - Prohibition on certain policies.
- Section 743.654
- Section 743.655 - Rules; disclosure; contents of policy.
- Section 743.656 - Eligibility for benefits; providers required to be covered.
- Section 743.657
- Section 743.660
- Section 743.662 - Rescission of policy and denial of claims.
- Section 743.663
- Section 743.664 - Offer of nonforfeiture benefit; rules.
- Section 743.665 - Prompt pay requirements; rules.
- Section 743.666
- Section 743.669
- Section 743.672
- Section 743.675
- Section 743.678
- Section 743.680 - Definitions for ORS 743.680 to 743.689.
- Section 743.681
- Section 743.682 - Application of ORS 743.680 to 743.689.
- Section 743.683 - Policy contents; standards for benefit and claims payments; rules.
- Section 743.684 - Filing of policy; loss ratio standards; insurance producer compensation.
- Section 743.685 - Outline of coverage; information brochure; rules.
- Section 743.686 - Right to return of policy; premium refund.
- Section 743.687 - Advertising.
- Section 743.688 - Rules.
- Section 743.689 - Director's authority upon violation of ORS 743.680 to 743.689.
- Section 743.690
- Section 743.691
- Section 743.693
- Section 743.694
- Section 743.695
- Section 743.697
- Section 743.699
- Section 743.700
- Section 743.701
- Section 743.702
- Section 743.703
- Section 743.704
- Section 743.705
- Section 743.706
- Section 743.707
- Section 743.708
- Section 743.709
- Section 743.710
- Section 743.711
- Section 743.712
- Section 743.713
- Section 743.714
- Section 743.715
- Section 743.716
- Section 743.717
- Section 743.718
- Section 743.719
- Section 743.720
- Section 743.721
- Section 743.722
- Section 743.723
- Section 743.724
- Section 743.725
- Section 743.726
- Section 743.727
- Section 743.728
- Section 743.729
- Section 743.730 - Definitions for ORS 743.730 to 743.773.
- Section 743.731 - Purposes.
- Section 743.732
- Section 743.733 - Issuance of group health benefit plan to affiliated group of employers; determination of number of employees for purpose of determining eligibility as small employer.
- Section 743.734 - Group health benefit plans subject to provisions of specified laws; exemptions.
- Section 743.735
- Section 743.736 - Requirement to offer all health benefit plans to small employers; offering of plan by carriers; exceptions.
- Section 743.737 - Requirements for small employer health benefit plans.
- Section 743.738
- Section 743.739
- Section 743.740
- Section 743.741
- Section 743.742
- Section 743.743
- Section 743.744
- Section 743.745 - Requirements for health benefit plans; director's authority to regulate small group and individual plans; allowable preexisting condition exclusions.
- Section 743.746
- Section 743.747
- Section 743.748 - Submission of information by carriers offering health benefit plans.
- Section 743.749 - Certifications and disclosure of coverage.
- Section 743.750
- Section 743.751 - Use of health-related information in group health benefit plans.
- Section 743.752 - Coverage in group health benefit plans; consideration of prospective enrollee health status restricted; effect of discontinuing offer of plans; exceptions; coverage by multiple employer welfare arrangements.
- Section 743.753
- Section 743.754 - Requirements for group health benefit plans other than small employer plans.
- Section 743.755
- Section 743.756
- Section 743.757 - Health benefit coverage for guaranteed association.
- Section 743.758 - Implementation of federal laws; rules.
- Section 743.759
- Section 743.760
- Section 743.761
- Section 743.762
- Section 743.763
- Section 743.764 - Preventive health services; coverage; cost sharing.
- Section 743.765
- Section 743.766 - Individual health benefit plans; waiting or exclusion periods; preexisting condition exclusions; essential health benefits.
- Section 743.767 - Premium rates for individual health benefit plans.
- Section 743.768
- Section 743.769 - Carrier marketing of individual health benefit plans; rules; duties of carrier regarding applications; effect of discontinuing offer of plans.
- Section 743.770
- Section 743.771
- Section 743.772
- Section 743.773 - Rules for ORS 743.766 to 743.769.
- Section 743.774
- Section 743.775 - Submission of information by carriers offering individual health benefit plans.
- Section 743.776
- Section 743.777 - Electronic administration; discounted rates; requirements.
- Section 743.778
- Section 743.779
- Section 743.780
- Section 743.781
- Section 743.782
- Section 743.783
- Section 743.784
- Section 743.785
- Section 743.786
- Section 743.787 - Definitions for ORS 743.788.
- Section 743.788 - Prescription drug identification card.
- Section 743.789
- Section 743.790 - Rules for prescription drug identification cards.
- Section 743.791
- Section 743.792
- Section 743.793
- Section 743.794
- Section 743.795
- Section 743.796
- Section 743.797
- Section 743.798
- Section 743.799
- Section 743.800
- Section 743.801 - Definitions.
- Section 743.802
- Section 743.803 - Medical services contract provisions; nonprovider party prohibitions; future contracts.
- Note 743.803, 743.806 and 743.811
- Section 743.804 - Required notices to applicants and enrollees; grievances, internal appeals and external reviews.
- Section 743.805
- Section 743.806 - Utilization review requirements for medical services contracts to which insurer not party; right to appeal.
- Section 743.807 - Utilization review requirements for insurers offering health benefit plan.
- Section 743.808 - Requirements for insurers that require designation of participating primary care physician; exceptions.
- Section 743.809
- Section 743.810
- Section 743.811 - Applicability.
- Section 743.812
- Section 743.813
- Section 743.814 - Requirements for insurers offering managed health insurance; quality assessment; rules.
- Section 743.815
- Section 743.816
- Section 743.817 - Requirements for insurers offering managed health or preferred provider organization insurance; rules; opportunity to participate.
- Section 743.818 - Data reporting.
- Section 743.819 - Reporting requirements; rules.
- Section 743.820
- Section 743.821 - Required managed health insurance contract provision; enrollee liability.
- Section 743.822 - Requirement to offer bronze and silver plans; rules.
- Note 743.822, 743.824 and 743.826
- Section 743.823 - Enforcement of Newborns' and Mothers' Health Protection Act of 1996.
- Section 743.824 - Cash dividends for healthy behaviors.
- Section 743.825
- Section 743.826 - Requirements for catastrophic plans.
- Section 743.827 - Health Care Consumer Protection Advisory Committee.
- Section 743.828
- Section 743.829 - Decisions regarding health care facility length of stay, level of care and follow-up care.
- Section 743.830
- Section 743.831 - Consortium established; managed health care performance.
- Section 743.833
- Section 743.834 - Insurer prohibited practices; patient communication and referral.
- Section 743.835
- Section 743.837 - Prior authorization requirements.
- Section 743.839 - Disclosure of information.
- Section 743.840
- Section 743.842
- Section 743.845 - Designation of women's health care provider as primary care provider; direct access to women's health care provider.
- Section 743.847 - Medicaid not considered in coverage eligibility determination; claims for services paid for by medical assistance; prohibited ground for denial of enrollment of child; insurer duties.
- Section 743.850
- Section 743.851
- Section 743.852
- Section 743.853
- Section 743.854 - Continuity of care.
- Section 743.855
- Section 743.856 - Referrals to specialists.
- Section 743.857 - External review; rules.
- Section 743.858 - Director to contract with independent review organizations to provide external review; rules.
- Section 743.859 - Notice to enrollee of right to sue if insurer does not follow decision of independent review organization.
- Section 743.860
- Section 743.861 - Enrollee application for external review; when enrollee deemed to have exhausted internal appeal.
- Section 743.862 - Duties of independent review organizations; expedited reviews.
- Section 743.863 - Civil penalty for failure to comply by insurer that agreed to be bound by decision.
- Section 743.864 - Private right of action.
- Section 743.865
- Section 743.866
- Section 743.868
- Section 743.870
- Section 743.871 - Definitions for ORS 743.871 to 743.893.
- Section 743.874 - Estimate of costs for in-network procedure or service.
- Section 743.875
- Section 743.876 - Estimate of costs for out-of-network procedure or service.
- Section 743.878 - Submission of methodology used to determine insurer's allowable charges.
- Section 743.880
- Section 743.883 - Alternative mechanism for disclosure of costs and charges.
- Section 743.885
- Section 743.890
- Section 743.893 - Rules.
- Section 743.894 - Rescinding coverage; permissible bases; notice; rules.
- Section 743.900
- Section 743.905
- Section 743.910
- Section 743.911 - Payment or denial of health benefit plan claims; rules.
- Section 743.912 - Refund of paid claims.
- Section 743.913 - Interest on unpaid claims.
- Section 743.915
- Section 743.916
- Section 743.917 - Underpayment of claims.
- Section 743.918 - Claims submitted during credentialing period.
- Section 743.920
- Section 743.921 - Payment of ambulatory surgical center claims.
Disclaimer: These codes may not be the most recent version. Oregon may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.
