Section 741.500 – Required documentation; rules.
(1)(a) The Oregon Health Authority shall adopt by rule the information that must be documented in order for a person to qualify for: (A) Qualified health plan coverage through the health insurance exchange; (B) Premium tax credits; and (C) Cost-sharing reductions. (b) The documentation specified by the authority under this subsection shall include but is […]
Section 741.510 – Confidential information; public officer privilege; permitted uses of confidential information.
(1) Except as provided in subsection (3) of this section, documents, materials or other information that is in the possession or control of the Oregon Health Authority for the purpose of carrying out ORS 741.002, 741.310 and 741.500 or complying with federal health insurance exchange requirements, and that is protected from disclosure by state or […]
Section 741.520 – Agreements with other agencies regarding sharing and use of confidential information; contents.
(1) The Director of the Oregon Health Authority may enter into agreements governing the sharing and use of information consistent with this section and ORS 741.510 with other state or federal health insurance exchanges or regulatory authorities, the Department of Consumer and Business Services, the Department of Revenue, law enforcement agencies or federal authorities. (2) […]
Section 741.540 – Complaints and investigations confidential; permitted disclosures.
(1) A complaint made to the Oregon Health Authority or the Department of Consumer and Business Services with respect to any prospective or certified qualified health plan, and the record thereof, shall be confidential and may not be disclosed except as provided in ORS 741.510 and 741.520. No such complaint, or the record thereof, shall […]
Section 741.800 – Insurer to notify health care provider of qualified health plan coverage.
Upon receipt of any inquiry from a health care provider regarding the eligibility, coverage or benefits of an insured under an enrollee’s plan, an insurer shall notify the health care provider, in the manner prescribed by the insurer, that the coverage is provided through a qualified health plan. [2015 c.580 §3]
Section 741.801 – Insurer to notify health care provider that enrollee is in grace period; effect of failure to provide notice.
(1) As used in this section and ORS 741.800: (a) “Enrollee” means a person who is: (A) Enrolled in a qualified health plan purchased through the health insurance exchange; (B) Responsible for paying the premium on the qualified health plan and has paid at least one premium; and (C) Receiving an advance payment of the […]
Section 741.802 – Authority to produce written informational materials.
The Oregon Health Authority shall produce written materials containing information for consumers about the requirements for paying the premiums for qualified health plans. The authority shall distribute the materials to health care providers upon request. [2015 c.580 §4; 2021 c.569 §35]
Section 741.900 – Civil penalties.
(1) The Director of the Oregon Health Authority, in accordance with ORS 183.745, may impose a civil penalty for a violation of ORS 741.390 of no more than $10,000. (2) All penalties recovered under this section shall be deposited in the Health Insurance Exchange Fund. [2011 c.415 §25; 2015 c.3 §34; 2021 c.569 §36]
Section 741.310 – Requirements for purchase of insurance through exchange and for participation of insurers in exchange.
(1)(a) Individuals and families may purchase qualified health plans through the health insurance exchange. (b) The following groups may purchase qualified health plans through the Small Business Health Options Program: (A) Small employers as defined in ORS 743B.005; and (B) Districts and eligible employees of districts that are subject to ORS 243.886, unless their participation […]
Section 741.340 – Health benefit plans offered through exchange.
The Oregon Health Authority, in developing and offering the health benefit package required by ORS 413.011 (1)(j), may not establish policies or procedures that discourage insurers from offering more comprehensive health benefit plans that provide greater consumer choice at a higher cost. The health benefit package approved by the Oregon Health Policy Board shall: (1) […]