Oregon Statutes 743.526 – Determination of whether trustees are policyholders; consequences; rules
(1) An insurer may not offer a policy of group health insurance described in ORS § 731.098 (3) that insures persons in this state or offer coverage under such a policy, whether the policy is to be issued in this or another state, unless the Director of the Department of Consumer and Business Services determines that the requirements of this section and ORS § 731.098 (3) are satisfied.
Terms Used In Oregon Statutes 743.526
- Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
(2) The director shall determine with respect to a policy whether the trustees are the policyholder. If the director determines that the trustees are the policyholder and if the policy is issued or proposed to be issued in this state, the policy is subject to the Insurance Code. If the director determines that the trustees are not the policyholder, the evidence of coverage that is issued or proposed to be issued in this state to a participating employer, labor union or association shall be deemed to be a group health insurance policy subject to the provisions of the Insurance Code. The director may determine that the trustees are not the policyholder if:
(a) The evidence of coverage issued or proposed to be issued to a participating employer, labor union or association is in fact the primary statement of coverage for the employer, labor union or association; and
(b) The trust arrangement is under the actual control of the insurer.
(3) An insurer shall submit evidence to the director showing that the requirements of subsection (2) of this section and ORS § 731.098 (3) are satisfied. The director shall review the evidence and may request additional evidence as needed.
(4) An insurer shall submit to the director any changes in the evidence submitted under subsection (3) of this section.
(5) The director may adopt rules to carry out this section. [1989 c.784 § 12; 2005 c.22 § 494; 2013 c.681 § 56]
[1979 c.797 § 2; 1981 c.395 § 1; renumbered 743B.340 in 2015]
[1967 c.359 § 463; 1981 c.752 § 13; 1997 c.716 § 23; 2013 c.681 § 57; renumbered 743.406 in 2015]
[1977 c.402 § 5; 1991 c.182 § 6; renumbered 743B.341 in 2015]
[1985 c.634 § 2; renumbered 743B.342 in 2015]
[1967 c.359 § 464; 1985 c.747 § 71; 1989 c.784 § 23; 2015 c.588 § 3; renumbered 743B.460 in 2015]
[1987 c.782 § 2; repealed by 1989 c.1044 § 7]
[2001 c.943 § 5; renumbered 743.521 in 2015]
[1967 c.359 § 465; renumbered 743.536 in 2015]