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 741.500 – 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 741.220 – Financial and performance audits of health insurance exchange accounts; report of audit.
(1) The Oregon Health Authority shall keep an accurate accounting of the operation and all activities, receipts and expenditures of the authority with respect to the health insurance exchange. (2) The Secretary of State shall conduct an annual financial audit of the authority’s revenues and expenditures in carrying out ORS 741.001 to 741.540. The audit […]
Section 741.222 – Annual reports to Legislative Assembly.
(1) The Director of the Oregon Health Authority shall report to the Legislative Assembly each year on: (a) The financial condition of the health insurance exchange, including actual and projected revenues and expenses of the administrative operations of the exchange and commissions paid to insurance producers out of fees collected under ORS 741.105 (6); (b) […]