Section 744.740 – Responsibility of insurer using third party administrator.
(1) An insurer who uses the services of a third party administrator is responsible for determining the benefits, premium rates, underwriting criteria and claims payment procedures applicable to the coverage and for securing any reinsurance. The rules pertaining to such matters must be provided in writing by the insurer to the third party administrator. (2) […]
Section 744.708 – Waiver of information requirement.
Upon request from a third party administrator, the Director of the Department of Consumer and Business Services may waive requirements established pursuant to ORS 744.706 for information to be included in or with the application if the third party administrator has a valid license or other document of authority as a third party administrator issued […]
Section 744.710 – Issuance or denial of license.
(1) If the Director of the Department of Consumer and Business Services determines that an applicant has satisfied all requirements for a license as a third party administrator, the director shall issue the license to the applicant. The director shall not issue a license if the director determines that the third party administrator, or any […]
Section 744.712 – Expiration and renewal of license; rules for renewal.
(1) A license of a third party administrator expires on its expiration date unless it is renewed on or before its expiration date. (2) Unless the Director of the Department of Consumer and Business Services designates another date, a license expires on the last day of the month in which the second anniversary of the […]
Section 744.714 – Registration of persons exempt from licensure.
A person who is exempt from the requirement of a license as a third party administrator under ORS 744.704 because the person acts solely as an administrator of one or more bona fide employee benefit plans established by an employer or an employee organization, or both, for which the Insurance Code is preempted pursuant to […]
Section 744.716 – Notification of change in ownership or control.
A third party administrator shall immediately notify the Director of the Department of Consumer and Business Services of any material change in ownership or control or in any other matter affecting the qualification of the third party administrator for a license as a third party administrator in this state. [1991 c.812 §10]
Section 744.718 – Suspension, revocation or refusal of issuance or renewal of license.
(1) The Director of the Department of Consumer and Business Services shall suspend, revoke or refuse to renew a license of a third party administrator if the director finds that the third party administrator: (a) Is in an unsound financial condition; (b) Is using such methods or practices in the conduct of business so as […]
Section 744.720 – Agreement between insurer and third party administrator.
(1) A third party administrator licensed under ORS 744.702 may transact business as a third party administrator only pursuant to a written agreement between the third party administrator and the insurer. The agreement shall contain all provisions required by this section. However, any provision that does not apply to the functions to be performed by […]
Section 744.722 – Relationship of insurer and third party administrator regarding payments.
(1) When an insurer uses the services of a third party administrator: (a) Payment to the third party administrator of any premiums or charges for insurance by or on behalf of the insured party shall be considered to have been received by the insurer. (b) Payment of return premiums or claim payments forwarded by the […]
Section 744.724 – Books and records.
(1) Except as provided in subsection (4) of this section, a third party administrator shall maintain and make available to the insurer complete books and records of each transaction performed on behalf of the insurer. The books and records shall be maintained in accordance with prudent standards of insurance recordkeeping and must be maintained for […]