2021 Oregon Revised Statutes
Chapter 735 - Alternative Insurance
Section 735.515 - Charges for services not covered by contract.


(a) "Dental services contract" means a contract between an insurer and a provider or a group of providers to provide dental health services for enrollees. "Dental services contract" does not include a contract of employment or a contract creating legal entities and ownership thereof that are authorized under ORS chapter 58, 60 or 70, or other similar professional organizations permitted by statute.
(b) "Enrollee" means a person entitled to receive dental health benefits from an insurer.
(c) "Provider" means a person licensed or otherwise authorized by the laws of this state to administer dental health services in the ordinary course of business or practice of a profession.
(2) A dental services contract may not restrict the price that a provider may charge for services provided to an enrollee unless the services are covered by the insurer. [2010 c.74 §2]
Note: 735.515 was added to and made a part of the Insurance Code by legislative action but was not added to ORS chapter 735 or any series therein. See Preface to Oregon Revised Statutes for further explanation.

Structure 2021 Oregon Revised Statutes

2021 Oregon Revised Statutes

Volume : 18 - Financial Institutions, Insurance

Chapter 735 - Alternative Insurance

Section 735.005 - Definitions for ORS 735.005 to 735.145.

Section 735.015 - Purpose.

Section 735.055 - Association board of directors; appointment; compensation, expenses of members; quorum.

Section 735.065 - Required association functions; assessments.

Section 735.075 - Discretionary association functions.

Section 735.085 - Plan of operation; submission to director; approval of plan; compliance with plan; rules.

Section 735.095 - Contents of plan of operation.

Section 735.150 - Definitions for ORS 735.150 to 735.190.

Section 735.152 - Application of laws.

Section 735.154 - Rules.

Section 735.156 - Confidentiality of documents and materials; public disclosure.

Section 735.158 - Certificate of authority; restriction on types of insurance; requirements for certification; requirements for corporations; fees; expiration and renewal of certificate.

Section 735.160 - Business name.

Section 735.162 - Capital and surplus requirements; form permitted; security for branch captive insurers; dividends and distributions.

Section 735.164 - Incorporation of pure captive insurer and association captive insurer; application; fee; approval; alien captive insurer; application of corporation laws.

Section 735.166 - Investment requirements for association captive insurer.

Section 735.168 - Allowable risks for captive insurer; risk distribution pool; annual actuarial opinion; rules.

Section 735.170 - Rating organization.

Section 735.172 - Reporting; contents; filing date; waiver of annual statement for alien captive insurer; rules.

Section 735.174 - Examination; frequency; scope; payment of expenses.

Section 735.176 - Compliance with sound actuarial principles.

Section 735.178 - Suspension or revocation of certificate of authority.

Section 735.180 - Branch captive insurer as pure captive insurer; rules.

Section 735.182 - Examination of branch captive insurer and alien captive insurer; payment of charges and expenses.

Section 735.184 - Requirements for foreign captive insurer to provide insurance in this state.

Section 735.186 - Management of assets of captive reinsurer.

Section 735.188 - Application of captive reinsurer for certificate of authority.

Section 735.190 - Incorporation of captive reinsurer.

Section 735.200 - Legislative findings; purpose.

Section 735.205 - Definitions for ORS 735.200 to 735.260.

Section 735.210 - Formation of market assistance plans; rules.

Section 735.215 - Findings prior to formation of joint underwriting association; hearing.

Section 735.245 - Conditions for policyholder surcharge.

Section 735.265 - Liquor liability insurance risk and rate classifications; rules.

Section 735.305 - Definitions for ORS 735.300 to 735.365.

Section 735.310 - Qualifications for risk retention group; plan of operation; application; notification to National Association of Insurance Commissioners.

Section 735.315 - Foreign risk retention groups; conditions of doing business in Oregon; prohibited acts.

Section 735.320 - Relationship to insurance guaranty fund and joint underwriting association.

Section 735.330 - Purchasing groups; notice of intent to do business; registration; exceptions.

Section 735.400 - Purposes of ORS 735.400 to 735.495.

Section 735.405 - Definitions for ORS 735.400 to 735.495.

Section 735.410 - Conditions for procuring insurance through nonadmitted insurer; rules.

Section 735.415 - Qualifications for placement of coverage with nonadmitted insurer.

Section 735.417 - Insured required to report and pay taxes on independently procured insurance covering Oregon home state risks.

Section 735.420 - Declaration of ineligibility of surplus lines insurer.

Section 735.425 - Filing by licensee after placement of surplus lines insurance.

Section 735.430 - Surplus Line Association of Oregon; fees.

Section 735.435 - Evidence of insurance; contents; change; penalty; notice regarding Insurance Guaranty Association; rules.

Section 735.455 - Authority of licensee; rules.

Section 735.460 - Records of licensee; examination.

Section 735.465 - Monthly reports; rules.

Section 735.470 - Premium tax; collection; payment; refund; rules.

Section 735.480 - Suspension or revocation of license; refusal to renew; grounds.

Section 735.485 - Actions against surplus lines insurer.

Section 735.490 - Jurisdiction in action against insurer; service of summons and complaint; response.

Section 735.495 - Short title; severability.

Section 735.500 - Requirements for certification as retainer medical practice; disclosures; rules.

Section 735.510 - Notice to department of specified changes to practice.

Section 735.515 - Charges for services not covered by contract.

Section 735.520 - Oregon Essential Workforce Health Care Program; supplemental payments to eligible employers; requirements for participation; rules.

Section 735.530 - Definitions for ORS 735.530 to 735.552.

Section 735.532 - Registration of pharmacy benefit managers; fees; rules.

Section 735.533 - Denial, suspension or revocation of registration as pharmacy benefit manager; basis; complaint; rules.

Section 735.534 - Claim reimbursement; maximum allowable costs; documentation; rules.

Section 735.536 - Requirements for pharmacy benefit manager’s reimbursement for cost of drugs; rules.

Section 735.540 - Definitions for ORS 735.540 to 735.552.

Section 735.542 - Pharmacy claims audits; requirements.

Section 735.544 - Pharmacy claims audits; standards for review of claims.

Section 735.546 - Pharmacy claims audits; auditors.

Section 735.548 - Pharmacy claims audits; validation of claims.

Section 735.550 - Pharmacy claims audits; reports of findings; opportunity to resubmit claim and to contest finding.

Section 735.552 - Pharmacy claims audits; exception for fraud.