2013 Oregon Revised Statutes
Volume : 16 - Financial Institutions, Insurance
Chapter 743 - Health and Life Insurance
Section 743.951 - Payment procedures; right to hearing.

(1) As used in this section:

(a) "Insured" means an eligible employee or family member, as defined in ORS 243.105, who is covered by a self-insured health benefit plan under ORS 243.105 to 243.285.

(b) "Medical claim" means a request to a self-insured health benefit plan for payment for a health care item or service provided to an insured, other than a dental or vision care item or service.

(2) No later than 45 days following the end of a calendar quarter, the Public Employees' Benefit Board shall pay an assessment at the rate of one percent of all medical claims received and the administrative costs associated with the claims received during the calendar quarter.

(3) The assessment shall be paid to the Department of Consumer and Business Services and shall be accompanied by a verified report, on a form prescribed by the department, together with any information required by the department.

(4) The assessment imposed under this section is in addition to and not in lieu of any tax, surcharge or other assessment imposed on the board.

(5) If the department determines that the assessment paid by the board under this section is incorrect, the department shall charge or credit to the board the difference between the correct amount of the assessment and the amount paid by the board.

(6) The board is entitled to notice and an opportunity for a contested case hearing under ORS chapter 183 to contest an action of the department taken pursuant to subsection (5) of this section.

(7) The assessment paid by the board under this section shall be considered part of the board's administrative expenses. [2009 c.867 §3]

Note: Section 3a, chapter 867, Oregon Laws 2009, provides:

Sec. 3a. Section 3 of this 2009 Act [743.951] applies to medical claims received by the Public Employees' Benefit Board, or a person that contracts with the board to pay medical claims under a self-insured health benefit plan, during the period from October 1, 2009, through September 30, 2013. [2009 c.867 §3a]

Note: 743.951 to 743.965 and 743.990 were added to and made a part of the Insurance Code by legislative action but were not added to ORS chapter 743 or any series therein. See Preface to Oregon Revised Statutes for further explanation.