(2) Coverage under a student health insurance policy may be mandatory for all students at the institution, voluntary for all students at the institution, or mandatory for defined classes of students and voluntary for other classes of students. As used in this subsection, "classes" refers to undergraduates, graduate students, domestic students, international students or other like classifications. Any differences based on a student’s nationality may be established only for the purpose of complying with federal law in effect when the policy is issued.
(3) When coverage under a student health insurance policy is mandatory, the policyholder may allow any student subject to the policy to decline coverage if the student provides evidence acceptable to the policyholder that the student has similar health coverage.
(4) A student health insurance policy may provide for any student to purchase optional supplemental coverage.
(5) Student health insurance coverage for athletic injuries may:
(a) Exclude coverage for injuries of students who have not obtained medical release for a similar injury; and
(b) Be provided in excess of or in addition to any other coverage under any other health insurance policy, including a student health insurance policy.
(6) A student health insurance policy may provide that coverage under the policy is secondary to any other health insurance for purposes of guidelines established under ORS 743B.475.
(7) A student health insurance policy may provide, on request by the policyholder, that all or any portion of any indemnities provided by such policy on account of hospital, nursing, medical or surgical services may, at the insurer’s option, be paid directly to the hospital or person rendering such services. However, the amount of any such payment shall not exceed the amount of benefit provided by the policy with respect to the service or billing of the provider of aid. The amount of such payments pursuant to one or more assignments shall not exceed the amount of expenses incurred on account of such hospitalization or medical or surgical aid.
(8) An insurer providing student health insurance as primary coverage may negotiate and enter into contracts for alternative rates of payment with providers and offer the benefit of such alternative rates to insureds who select such providers. An insurer may utilize such contracts by offering a choice of plans at the time an insured enrolls, one of which provides benefits only for services by members of a particular provider organization with whom the insurer has an agreement. If an insured chooses such a plan, benefits are payable only for services rendered by a member of that provider organization, unless such services were requested by a member of such organization or are rendered as the result of an emergency.
(9) Payments made under subsection (8) of this section shall discharge the insurer’s obligation with respect to the amount of insurance paid.
(10) An insurer shall provide each student health insurance policyholder with a current roster of institutional and professional providers under contract to provide services at alternative rates under the group policy and shall also make such lists available for public inspection during regular business hours at the insurer’s principal office within this state.
(11) As used in this section, "student health insurance":
(a) Means that form of health insurance under a policy issued to a college, school or other institution of learning, a school district or districts, or school jurisdictional unit, or recognized student government at a public university listed in ORS 352.002, or to the head, principal or governing board of any such educational unit, who or which shall be deemed the policyholder, that is available exclusively to students at the college, school or other institution.
(b) Does not include a student health benefit plan as defined in ORS 743.551. [1995 c.623 §2; 2011 c.637 §289; 2013 c.681 §15]
Structure 2021 Oregon Revised Statutes
Volume : 18 - Financial Institutions, Insurance
Chapter 743 - Health and Life Insurance
Section 743.004 - Submission of information by carriers offering health benefit plans.
Section 743.005 - Protection of health information report.
Section 743.007 - Data reporting.
Section 743.008 - Reporting requirements; rules.
Section 743.018 - Filing of rates for life and health insurance; rules.
Section 743.019 - Procedure for review of proposed rates for health benefit plans; rules.
Section 743.020 - Rate filing to include statement of administrative expenses; rules.
Section 743.022 - Premium rates for individual health benefit plans.
Section 743.023 - Electronic administration; discounted rates; requirements.
Section 743.031 - Stakeholder work group to recommend uniform standards.
Section 743.038 - Consent of individual required for life and health insurance; exceptions.
Section 743.039 - Alteration of application for life or health insurance.
Section 743.040 - Personal insurance, insurable interest and beneficiaries.
Section 743.044 - Life insurance for benefit of charity.
Section 743.046 - Exemption of proceeds of individual life insurance other than annuities.
Section 743.047 - Exemption of proceeds of group life insurance.
Section 743.049 - Exemption of proceeds of annuity policies; assignability of rights.
Section 743.104 - Scope of ORS 743.100 to 743.109.
Section 743.106 - Reading ease standards for life and health insurance policies.
Section 743.107 - When director may authorize lower standards.
Section 743.154 - Acceleration of death benefits; rules.
Section 743.168 - Incontestability.
Section 743.171 - Incontestability and limitation of liability after reinstatement.
Section 743.186 - Policy loan.
Section 743.187 - Maximum interest rate on policy loan; adjustable interest rate.
Section 743.192 - Payment of claim; payment of interest upon failure to pay proceeds.
Section 743.204 - Standard Nonforfeiture Law for Life Insurance; applicability.
Section 743.207 - Required provisions relating to nonforfeiture.
Section 743.210 - Determination of cash surrender values; applicability to certain policies.
Section 743.215 - Calculation of adjusted premiums.
Section 743.216 - Adjusted premiums; applicability.
Section 743.218 - Requirements for determination of future premium amounts or minimum values.
Section 743.219 - Supplemental rules for calculating nonforfeiture benefits.
Section 743.221 - Cash surrender values upon default in premium payment.
Section 743.225 - Prohibited provisions.
Section 743.228 - Acts of corporate insured or beneficiary with respect to policy.
Section 743.230 - Variable life policy provisions.
Section 743.231 - "Profit-sharing policy" defined.
Section 743.234 - "Charter policy" or "founders policy" defined.
Section 743.243 - Restrictions on form of coupon policy.
Section 743.247 - Notice to variable life insurance policyholders.
Section 743.268 - Advancement of policy loans.
Section 743.271 - Periodic stipulated payments on variable annuities.
Section 743.272 - Computing benefits.
Section 743.273 - Standard provisions of reversionary annuities.
Section 743.275 - Standard Nonforfeiture Law for Individual Deferred Annuities; application.
Section 743.278 - Required provisions in annuity policies; exception.
Section 743.284 - Computation of benefits.
Section 743.293 - Minimum forfeiture amounts for annuity policies; rules.
Section 743.298 - Penalties, fees or charges; rules.
Section 743.303 - Requirements for issuance of group life insurance policies.
Section 743.306 - Required provisions in group life insurance policies.
Section 743.327 - Payments under policy; payment of interest upon failure to pay proceeds.
Section 743.333 - Termination of individual coverage.
Section 743.336 - Termination of policy or class of insured persons.
Section 743.348 - Certain sales practices prohibited.
Section 743.351 - Eligibility of association to be group life policyholder; rules.
Section 743.356 - Continuing coverage upon replacement of group life policy.
Section 743.358 - Borrowing by certificate holders under group life policy.
Section 743.360 - Alternative group life insurance coverage.
Section 743.371 - Definitions for credit life and credit health insurance provisions.
Section 743.372 - Applicability of credit life and credit health insurance provisions.
Section 743.373 - Forms of credit life and credit health insurance.
Section 743.374 - Limits on amount of credit life insurance.
Section 743.376 - Duration of credit life and credit health insurance.
Section 743.378 - Charges and refunds to debtor.
Section 743.380 - Claim report and payment.
Section 743.402 - Exceptions to individual health insurance policy requirements.
Section 743.405 - General requirements for health insurance policies.
Section 743.406 - Required provisions in group health insurance policies.
Section 743.414 - Time limit on certain defenses; incontestability.
Section 743.416 - Due date for first premium payment.
Section 743.417 - Grace period for subsequent premium payments; cancellation and nonrenewal.
Section 743.420 - Reinstatement.
Section 743.423 - Notice of claim.
Section 743.435 - Payment of claims.
Section 743.444 - Change of beneficiary.
Section 743.456 - Other insurance in same insurer.
Section 743.459 - Insurance with other insurers; expense incurred benefits.
Section 743.462 - Insurance with other insurers; other than expense incurred benefits.
Section 743.465 - Relation of earnings to insurance.
Section 743.472 - Permissible reasons for cancellation or refusal to renew.
Section 743.495 - Use of terms "noncancelable" or "guaranteed renewable"; synonymous terms.
Section 743.498 - Statement in policy of cancelability or renewability.
Section 743.521 - Leased workers; offering group health insurance.
Section 743.522 - Additional groups designated by director.
Section 743.523 - Certain sales practices prohibited.
Section 743.524 - Eligibility of association to be group health policyholder; rules.
Section 743.526 - Determination of whether trustees are policyholders; consequences; rules.
Section 743.535 - Health benefit coverage for guaranteed association.
Section 743.536 - "Blanket health insurance" defined.
Section 743.550 - Student health insurance.
Section 743.551 - Student health benefit plans; rules.
Section 743.650 - Long Term Care Insurance Act; purpose; application.
Section 743.652 - Definitions for ORS 743.650 to 743.665.
Section 743.655 - Rules; disclosure; contents of policy.
Section 743.656 - Eligibility for benefits; providers required to be covered.
Section 743.658 - Notice of lapse or termination; rules.
Section 743.662 - Rescission of policy and denial of claims.
Section 743.664 - Offer of nonforfeiture benefit; rules.
Section 743.680 - Definitions for ORS 743.680 to 743.689.
Section 743.682 - Application of ORS 743.680 to 743.689.
Section 743.683 - Policy contents; standards for benefit and claims payments; rules.
Section 743.684 - Filing of policy; loss ratio standards; insurance producer compensation.
Section 743.685 - Outline of coverage; information brochure; rules.
Section 743.787 - Definitions for ORS 743.788.
Section 743.788 - Prescription drug identification card.