Oregon § 743B.283 Submission of methodology used to determine insurer’s allowable charges

Oregon Statutes

§ 743B.283 — Submission of methodology used to determine insurer’s allowable charges

Oregon § 743B.283

Vol.18

Title 56Insurance

Ch. 743BHealth Benefit Plans: Individual and Group

This text of Oregon § 743B.283 (Submission of methodology used to determine insurer’s allowable charges) is published on Counsel Stack Legal Research, covering Oregon primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Or. Rev. Stat. § 743B.283 (2026).

Text

An insurer offering a health benefit plan as defined in ORS 743B.005 must submit to the Director of the Department of Consumer and Business Services:

(1)Upon request by the director, the methodology used to determine the insurer’s allowable charges for out-of-network procedures and services or, if the insurer uses a third party to determine the charges, the methodology used by the third party to determine allowable charges;

(2)For approval, a written explanation of the method used by the insurer to determine the allowable charge, that is in plain language and that must be provided upon request to enrollees directly, or, in the case of group coverage, to the employer or other policyholder for distribution to enrollees; and

(3)Information prescribed by the director as necessary to assess

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An insurer offering a health benefit plan as defined in ORS 743B.005 must submit to the Director of the Department of Consumer and Business Services:
(1) Upon request by the director, the methodology used to determine the insurer’s allowable charges for out-of-network procedures and services or, if the insurer uses a third party to determine the charges, the methodology used by the third party to determine allowable charges;
(2) For approval, a written explanation of the method used by the insurer to determine the allowable charge, that is in plain language and that must be provided upon request to enrollees directly, or, in the case of group coverage, to the employer or other policyholder for distribution to enrollees; and
(3) Information prescribed by the director as necessary to assess the effect of the disclosure requirements in ORS 743B.281 and 743B.282 on the individual and group health insurance markets.