2013 Oregon Revised Statutes
Volume : 16 - Financial Institutions, Insurance
Chapter 743 - Health and Life Insurance
Section 743.499 - Notice to policyholder required for cancellation or nonrenewal of health benefit plan; effect of failure to give notice.

(1) As used in this section, "health benefit plan" has the meaning given that term in ORS 743.730.

(2) An insurer shall notify a policyholder in writing if the insurer cancels or does not renew the policyholder's individual health benefit plan. The notice shall be sent to the policyholder's last-known mailing address by first class mail in a specially marked envelope or, if the policyholder has elected to receive communications from the insurer electronically, to the policyholder's last-known electronic mail address using a mechanism that will confirm delivery to the address.

(3) If the cancellation or nonrenewal results in a refund to the policyholder of all or part of a premium, the insurer must mail with the refund a written explanation that includes:

(a) The effective date of the cancellation;

(b) The reason for the cancellation; and

(c) The time period to which the refund is applicable.

(4) For any cancellation or nonrenewal due to a reported death of the policyholder, the insurer must:

(a) Confirm the accuracy of the reported death.

(b) If the death is confirmed:

(A) Provide any dependents covered by the plan with information about how to continue coverage or obtain alternative coverage; and

(B) Issue any refund that is due to the estate of the deceased in accordance with subsection (3) of this section.

(5) If an insurer cancels or does not renew an individual health benefit plan and fails to comply with the requirements of this section, the insurer shall continue the coverage under the plan for the policyholder and any dependents covered by the plan until the date that the insurer has complied with the requirements of this section. The insurer shall waive any premiums owed for the period during which the coverage was continued under this subsection and shall process all claims incurred by the policyholder or any covered dependents according to the terms of the plan.

(6) This section does not apply:

(a) To a cancellation requested by the policyholder if the insurer documents the request and confirms the request with the policyholder;

(b) To a cancellation or nonrenewal that results from a policyholder making a change in coverage with the same insurer; or

(c) To a cancellation due to nonpayment of premium. [2011 c.500 §4a; 2012 c.24 §1]

Note: 743.499 was added to and made a part of the Insurance Code by legislative action but was not added to ORS chapter 743 or any series therein. See Preface to Oregon Revised Statutes for further explanation.