ORS 415.011
Oregon Health Authority regulation of financial solvency of CCOs to align with regulation of domestic insurers

  • rules

(1)

The Oregon Health Authority may adopt rules to carry out the provisions of ORS 415.012 (Definitions for ORS 415.012 to 415.430) to 415.430 (Liability of member of CCO to pay provider for cost of care).

(2)

The authority shall adopt rules for regulating the financial solvency of coordinated care organizations that align with the following provisions of the Insurance Code regulating domestic insurers, to the extent the provisions regarding insurers are applicable to coordinated care organizations and are in accordance with ORS chapters 413 and 414:

(a)

ORS 731.385 (Standards for determining whether continued operation of insurer is hazardous);

(b)

ORS 731.504 (Limit of risk);

(c)

ORS 731.508 (Approved reinsurance);

(d)

ORS 731.509 (Legislative intent) (1) to (10) and (12);

(e)

ORS 731.574 (Annual financial statement) (1) to (5);

(f)

ORS 731.730 (Insurer filings with National Association of Insurance Commissioners);

(g)

ORS 731.988 (Civil penalties);

(h)

ORS 732.235 (Voluntary dissolution of insurer);

(i)

ORS 732.517 (Purpose of ORS 732.517 to 732.546) to 732.546 (Severability), other than ORS 732.527 (Approval of acquisition by chief insurance regulatory officials of two or more jurisdictions), 732.531 (Acquisition of assets or insurance of mutual or reciprocal insurers) and 732.541 (Jurisdiction over person obtaining or attempting to obtain control);

(j)

ORS 732.548 (Definitions for ORS 732.517 to 732.596);

(k)

ORS 732.549 (Subsidiaries);

(L)

ORS 732.551 (Registration of insurer members of holding company systems);

(m)

ORS 732.552 (Registration statement);

(n)

ORS 732.553 (Certain information not required to be disclosed);

(o)

ORS 732.554 (Changes in registration information);

(p)

ORS 732.556 (Requirement that certain persons provide information to insurers);

(q)

ORS 732.558 (Termination of registration by director);

(r)

ORS 732.564 (Registration for affiliated insurers);

(s)

ORS 732.566 (Exemption from ORS 732.517 to 732.596 by director);

(t)

ORS 732.567 (Presumption of control);

(u)

ORS 732.568 (Disclaimer of affiliation);
(v)
ORS 732.569 (Annual enterprise risk report);

(w)

ORS 732.574 (Standards for transactions within holding company);
(x)
ORS 732.576 (Dividends and distributions);

(y)

ORS 732.578 (Liability of officers and directors of insurer that is subject to registration);

(z)

ORS 732.592 (Recovery from parent corporation or holding company if domestic insurer ordered into liquidation or rehabilitation);

(aa)

ORS 733.010 (Assets allowed) to 733.050 (Increase of inadequate reserves);

(bb)

ORS 733.140 (Disallowance of “wash” transactions) to 733.170 (Accounts and records);

(cc)

ORS 733.510 (Investments of insurers) to 733.680 (Acquisition and retention of personal property generally);

(dd)

ORS 733.695 (Investment of funds in obligations that are not investment quality) to 733.780 (Prohibited investments); and

(ee)

ORS 734.014 (Definitions).

(3)

Rules adopted by the authority in accordance with ORS 731.385 (Standards for determining whether continued operation of insurer is hazardous) that establish minimum standards for risk-based capital may not require a coordinated care organization to take preventive or corrective measures to increase the coordinated care organization’s capital, surplus or reserves to achieve more than 200 percent of the minimum risk-based capital. [2019 c.478 §53]

Source: Section 415.011 — Oregon Health Authority regulation of financial solvency of CCOs to align with regulation of domestic insurers; rules, https://www.­oregonlegislature.­gov/bills_laws/ors/ors415.­html.

415.001
Reinsurance program for coordinated care organizations (CCOs)
415.011
Oregon Health Authority regulation of financial solvency of CCOs to align with regulation of domestic insurers
415.012
Definitions for ORS 415.012 to 415.430
415.013
Powers and authority to enforce ORS 415.012 to 415.430 and 415.501
415.015
Prohibited conflicts of interest of officer or employee of Oregon Health Authority with responsibility for enforcement
415.019
Right to contested case hearing
415.055
Confidentiality of complaints
415.056
Confidentiality of reports regarding certain financial information
415.057
Authorized use of confidential reports regarding financial information
415.061
Definitions for 415.061 to 415.067
415.062
Compliance self-evaluative audit document privileged
415.063
Permissible use of compliance self-evaluative audit document by Oregon Health Authority
415.064
Waiver of privilege
415.065
Petition for in camera hearing on privilege of compliance self-evaluative audit document
415.066
Exceptions to privilege of compliance self-evaluative audit document
415.067
Other applicable privileges not waived by release of compliance self-evaluative audit document
415.101
Requests for information
415.103
False or misleading filings prohibited
415.105
Investigations authorized
415.107
Examinations and audits
415.109
Conduct of examination
415.111
Report of examination
415.115
Annual audits
415.119
Immunity from suit arising out of investigation, examination or provision or dissemination of information
415.203
Opportunity to cure impairment of required capitalization
415.204
Grounds for order of supervision
415.205
Period of supervision
415.251
Jurisdiction of delinquency proceedings
415.252
Exclusive remedy
415.253
Oregon Receivership Code inapplicable
415.261
Petition for delinquency proceeding
415.263
Cooperation with Oregon Health Authority in delinquency investigation or proceeding
415.265
Injunction prohibiting waste or disposition of property upon petition for delinquency proceeding
415.280
Petition for order for rehabilitation or liquidation of CCO
415.281
Court order for rehabilitation or liquidation proceeding against CCO
415.284
Appointment of special deputy directors to assist in supervision of CCO or delinquency proceedings
415.300
Rehabilitation proceeding
415.330
Grounds for order to liquidate
415.333
Powers of Oregon Health Authority in liquidation proceeding
415.335
Order to liquidate
415.340
Oregon Health Authority to be appointed receiver in delinquency proceeding
415.341
Immunity from civil liability for receivers
415.350
Right to assets of CCO fixed as of date of order to liquidate
415.400
Filing proof of claim against CCO declared by court to be insolvent
415.401
Requirements for proof of claim
415.402
Preference of claims
415.403
Priority of preferred claims
415.404
Contingent claims
415.405
Priority of special deposit claims
415.406
Priority of secured claims
415.420
Attachment or garnishment prohibited during delinquency proceeding
415.422
Voidable transfers or liens
415.424
Offsets of mutual debts or credits
415.430
Liability of member of CCO to pay provider for cost of care
415.500
Definitions
415.501
Procedures for review of material change transactions
415.505
Conflicts of interest prohibited
415.510
Quadrennial study of impact of health care consolidation
415.512
Fees
415.900
Civil penalties
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