# ORS § 743.010: 743.010 Health insurance policy and health benefit plan forms

> Oregon · Statutes · In force

URL: https://www.frixlaw.com/law-library/statutes/STATE_OR_T56_C743_S743.010

## Section

- **Citation:** ORS § 743.010
- **Heading:** 743.010 Health insurance policy and health benefit plan forms
- **Jurisdiction:** Oregon
- **Kind:** Statutes
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** OR Code / Title 56 / Chapter 743 / Section 743.010

## Text

(1) In addition to all other powers of the Director of the Department of Consumer and Business Services with respect thereto, the director may issue rules with respect to policy forms and health benefit plan forms described in ORS 742.005 (Grounds for disapproval of policy forms) (6)(a) and (b):

(a) Establishing minimum benefit standards;

(b) Requiring the ratio of benefits to premiums to be not less than a specified percentage in order to be considered reasonable, and requiring the periodic filing of data that will demonstrate the insurer’s compliance;

(c) Establishing requirements intended to discourage duplication or overlapping of coverage and replacement, without regard to the advantage to policyholders, of existing policies by new policies; and

(d) Establishing requirements for carriers offering health benefit plans to spend at least 12 percent of total medical expenditures on payments for primary care.

(2) As used in this section:

(a) “Primary care” means family medicine, general internal medicine, naturopathic medicine, obstetrics and gynecology, pediatrics or general psychiatry.

(b) “Total medical expenditures” means payments to reimburse the cost of physical and mental health care provided to enrollees, excluding prescription drugs, vision care and dental care, whether paid on a fee-for-service basis or as part of a capitated rate or other type of payment mechanism. [1979 c.857 §2; 1997 c.96 §1; 1999 c.987 §4a; 2017 c.489 §§5,15]

Source: Section 743.010 — Health insurance policy and health benefit plan forms; expenditures on primary care; rules , https://www.­oregonlegislature.­gov/bills_laws/ors/ors743.­html (accessed May 26, 2025).

## Nearby sections

- [ORS § 743.004 743.004 Submission of information by carriers offering health benefit plans](https://www.frixlaw.com/law-library/statutes/STATE_OR_T56_C743_S743.004.md)
- [ORS § 743.005 743.005 Protection of health information report](https://www.frixlaw.com/law-library/statutes/STATE_OR_T56_C743_S743.005.md)
- [ORS § 743.007 743.007 Data reporting](https://www.frixlaw.com/law-library/statutes/STATE_OR_T56_C743_S743.007.md)
- [ORS § 743.008 743.008 Reporting requirements](https://www.frixlaw.com/law-library/statutes/STATE_OR_T56_C743_S743.008.md)
- [ORS § 743.010 743.010 Health insurance policy and health benefit plan forms](https://www.frixlaw.com/law-library/statutes/STATE_OR_T56_C743_S743.010.md)
- [ORS § 743.015 743.015 Filing and approval of credit life and credit health insurance forms](https://www.frixlaw.com/law-library/statutes/STATE_OR_T56_C743_S743.015.md)
- [ORS § 743.018 743.018 Filing of rates for life and health insurance](https://www.frixlaw.com/law-library/statutes/STATE_OR_T56_C743_S743.018.md)
- [ORS § 743.019 743.019 Procedure for review of proposed rates for health benefit plans](https://www.frixlaw.com/law-library/statutes/STATE_OR_T56_C743_S743.019.md)
- [ORS § 743.020 743.020 Rate filing to include statement of administrative expenses](https://www.frixlaw.com/law-library/statutes/STATE_OR_T56_C743_S743.020.md)
- [ORS § 743.022 743.022 Premium rates for individual health benefit plans](https://www.frixlaw.com/law-library/statutes/STATE_OR_T56_C743_S743.022.md)
- [ORS § 743.023 743.023 Electronic administration](https://www.frixlaw.com/law-library/statutes/STATE_OR_T56_C743_S743.023.md)
- [ORS § 743.025 743.025 Annual report of information related to prescription drugs covered by health benefit plans](https://www.frixlaw.com/law-library/statutes/STATE_OR_T56_C743_S743.025.md)
- [ORS § 743.028 743.028 Uniform health insurance claim forms](https://www.frixlaw.com/law-library/statutes/STATE_OR_T56_C743_S743.028.md)
- [ORS § 743.029 743.029 Uniform standards for health care financial and administrative transactions](https://www.frixlaw.com/law-library/statutes/STATE_OR_T56_C743_S743.029.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_OR_T56_C743_S743.010. Check the current official text before relying on it. Not legal advice.