(a) A person’s eligibility to purchase or to continue to purchase a qualified health plan through the health insurance exchange;
(b) A person’s eligibility for a premium tax credit for purchasing a qualified health plan or the amount of the person’s premium tax credit; or
(c) A person’s eligibility for cost-sharing reductions for qualified health plans and the amount of the person’s cost-sharing reduction.
(2) The legal presumption described in ORS 40.135 (1)(q) does not apply to a notice that is served by regular or electronic mail in accordance with subsection (1) of this section.
(3) Except as provided in subsection (4) of this section, a contested case notice served in accordance with subsection (1) of this section that complies with ORS 183.415 but for service by regular or electronic mail becomes a final order against a party and is not subject to ORS 183.470 (2), upon the earlier of the following:
(a) If the party fails to request a hearing, the day after the date prescribed in the notice as the deadline for requesting a hearing.
(b) The date the authority or the Office of Administrative Hearings mails an order dismissing a hearing request because:
(A) The party withdraws the request for hearing; or
(B) Neither the party nor the party’s representative appears on the date and at the time set for hearing.
(4) The authority shall prescribe by rule a period of not less than 60 days after a notice becomes a final order under subsection (3) of this section within which a party may request a hearing under this subsection. If a party requests a hearing within the period prescribed under this subsection, the authority shall do one of the following:
(a) If the authority finds that the party did not receive the written notice and did not have actual knowledge of the notice, refer the request for hearing to the Office of Administrative Hearings for a contested case proceeding on the merits of the authority’s intended action described in the notice.
(b) Refer the request for hearing to the Office of Administrative Hearings for a contested case proceeding to determine whether the party received the written notice or had actual knowledge of the notice. The authority must show that the party had actual knowledge of the notice or that the authority mailed the notice to the party’s correct address or sent an electronic notice to the party’s correct electronic mail address.
(5) If a party informs the authority that the party did not receive a notice served by regular or electronic mail in accordance with subsection (1) of this section, the authority shall advise the party of the right to request a hearing under subsection (4) of this section. [2013 c.678 §2; 2015 c.3 §29; 2021 c.569 §30]
Structure 2021 Oregon Revised Statutes
Volume : 18 - Financial Institutions, Insurance
Chapter 741 - Health Insurance Exchange
Section 741.001 - Health insurance exchange; legislative intent.
Section 741.002 - Duties, powers and functions of Oregon Health Authority; rules.
Section 741.003 - Duties and powers of director.
Section 741.004 - Health Insurance Exchange Advisory Committee.
Section 741.008 - Criminal records check; fingerprints required; persons subject to requirement.
Section 741.105 - Charges and fees to be paid by insurers and state programs; rules.
Section 741.222 - Annual reports to Legislative Assembly.
Section 741.300 - Definitions.
Section 741.340 - Health benefit plans offered through exchange.
Section 741.342 - Small Business Health Options Program.
Section 741.500 - Required documentation; rules.
Section 741.540 - Complaints and investigations confidential; permitted disclosures.