Rehabilitation, Liquidation and Conservation of Insurers
Definitions for ORS 734.750 to 734.890
(1)“Account” means one of the three accounts created under ORS 734.800 (Oregon Life and Health Insurance Guaranty Association).
(2)“Association” means the Oregon Life and Health Insurance Guaranty Association created under ORS 734.800 (Oregon Life and Health Insurance Guaranty Association).
(3)“Contractual obligation” means any obligation under a covered policy or contract or a certificate under a group policy or contract.
(4)“Covered policy” means any policy or contract or a certificate under a group policy or contract to which ORS 734.750 (Short title) to 734.890 (Association not to be used in sales or solicitation) apply.
(5)“Disability insurance” means health insurance that provides income payments to an insured wage earner whose income is interrupted due to an accident or illness. “Disability insurance” does not include workers’ compensation insurance.
(6)“Impaired insurer” means a member insurer that is subject to an order of rehabilitation under ORS 734.063 (Court order) or an order of conservation under ORS 734.200 (Conservation or ancillary receivership of foreign and alien insurers) after September 13, 1975. “Impaired insurer” does not include an insolvent insurer.
(7)“Insolvent insurer” means a member insurer that, after September 13, 1975, is placed under an order of liquidation by a court of competent jurisdiction with a finding of insolvency.
(8)“Long term care insurance” has the meaning given that term in ORS 743.652 (Definitions for ORS 743.650 to 743.665).
(9)(a) “Member insurer” means any insurer currently authorized to transact in this state any kind of insurance to which ORS 734.750 (Short title) to 734.890 (Association not to be used in sales or solicitation) apply, regardless of whether the insurer’s authorization to transact insurance was, in the past, suspended, revoked, not renewed or voluntarily withdrawn.
(b)“Member insurer” does not include:
(A)A hospital or medical service organization, whether for-profit or nonprofit;
(B)A health maintenance organization;
(C)A fraternal benefit society;
(D)A mandatory state pooling plan;
(E)A mutual assessment company or other person that operates on an assessment basis;
(F)An insurance exchange; or
(G)An organization that has a certificate of authority limited to the issuance of charitable gift annuities under ORS 731.038 (Application of Insurance Code to charitable organizations that issue charitable gift annuities).
(10)“Premiums” means direct gross insurance, including annuity, premiums written on covered policies, less return premiums thereon and dividends paid or credited to policyholders on such direct business. “Premiums” does not include premiums on contracts between insurers and reinsurers or any premiums on policies or contracts excluded under ORS 734.790 (Application).
(11)(a) “Principal place of business” means:
(A)For a plan sponsor or a person other than a natural person, the state in which the natural persons who establish policy for the direction, control and coordination of the operations of the entity as a whole primarily exercise that function, as determined by the association after considering the following factors:
(i)The state in which the primary executive and administrative headquarters of the entity is located;
(ii)The state in which the principal office of the chief executive officer of the entity is located;
(iv)The state in which the executive or management committee of the board of directors of the entity conducts the majority of its meetings; and
(v)The state from which the management of the overall operations of the entity is directed.
(B)For a benefit plan sponsored by affiliated companies comprising a consolidated corporation, the state in which the holding company or controlling affiliate has its principal place of business as determined using the factors set forth in subparagraph (A) of this paragraph.
(C)For a plan sponsor of a benefit plan for which more than 50 percent of the participants in the benefit plan are employed in a single state, the state in which those participants are employed.
(D)Absent a specific or clear designation of a principal place of business for a plan sponsor of a benefit plan established or maintained by two or more employers or jointly by one or more employers and one or more employee organizations, the principal place of business of the association, committee, joint board of trustees or other governing body of the employer or employee organization that has the largest investment in the benefit plan.
(b)As used in this subsection, “plan sponsor” means:
(A)The employer for a benefit plan established or maintained by a single employer.
(B)The employee organization for a benefit plan established or maintained by an employee organization.
(C)For a benefit plan established or maintained by two or more employers or jointly by one or more employers and one or more employee organizations, the association, committee, joint board of trustees or other governing bodies of the parties that establish or maintain the benefit plan.
(12)“Resident” means a person to whom contractual obligations are owed by a member insurer and who resides in this state on the date a court order is entered that determines the member insurer to be an impaired insurer or an insolvent insurer. A person may be a resident of only one state, which in the case of a person other than a natural person shall be its principal place of business. A citizen of the United States who resides in a foreign country, or resides in a United States possession, territory or protectorate that does not have an association similar to the association created under ORS 734.800 (Oregon Life and Health Insurance Guaranty Association), shall be considered a resident of the state of domicile of the insurer that issued the policies or contracts. If a person could be covered by the association of another state, whether as an owner, payee, beneficiary or assignee, ORS 734.750 (Short title) to 734.890 (Association not to be used in sales or solicitation) shall be construed with the laws of the other state to result in coverage by only one association.
(13)“Structured settlement annuity” means an annuity purchased to fund periodic payments for a plaintiff or other claimant in payment for or with respect to personal injury suffered by the plaintiff or other claimant.
(14)“Supplemental contract” means a written agreement entered into for the distribution of proceeds under a life or health insurance policy or an annuity contract.
(15)“Unallocated annuity contract” means an annuity contract or group annuity certificate that is not issued to and owned by an individual, except to the extent that any annuity benefits may be guaranteed to an individual under the contract or certificate. [1975 c.251 §6; 1987 c.414 §180; 1991 c.811 §1; 2011 c.142 §1]
Atty. Gen. Opinions
State is not liable for losses incurred by Oregon Medical Insurance Pool and pools' policy holders bear ultimate risk of pools' insolvency, in that there would be no source of funds to pay benefits under their policies, (1989) Vol 46, p 155