OAR 839-001-0700: Definitions for Regulations Pertaining to Moneys Collected from Employees for Group Health Insurance Coverage and Notification of Various Parties on Termination of Group Health Insurance Coverage

As used in ORS 652.710 and in OAR 839-001-0700 to 839-001-0800, unless the context requires otherwise: (1) "Bureau" means the Bureau of Labor and Industries of the State of Oregon. (2) "Commissioner" means the Commissioner of the Bureau of Labor and Industries. (3) "Contract" includes a group health insurance policy. (4) "Contractor" includes any person who enters into an agreement with an employer to provide health care services to employees. "Contractor" also includes any person who enters into an agreement with an employer to provide insurance coverage pursuant to the terms of a group health insurance policy. (5) "Employ" includes to suffer or permit to work. (6) "Employee" means any individual employed by an employer. (7) "Employer" includes any person acting directly or indirectly in the interest of an employer in relation to an employee. (8) "Group health insurance policy" as used in ORS 652.710(3) has the same meaning as that defined in 743.522. (9) "Health care services" includes services that provide medical and surgical attention, hospital care, x-rays, ambulance, nursing or other related service or care for sickness or injury. Health care services also include services that are provided under the terms of a group health insurance policy. (10) "Home address" means the last known mailing address as recorded in the employer's records. (11) "Insurer" as used in ORS 652.710(3) has the same meaning as that defined in ORS 731.106 and includes a contractor as defined in section (4) of this rule. (12) "Promptly be paid" or "Promptly pay" means that trust funds are paid no later than the date agreed to by the employer and the contractor. (13) "Termination" or "Terminated", as used in ORS 652.710(3), means the cessation of coverage on the last day of the period through which coverage is paid up; provided, however, that a group health insurance policy that provides for a grace period for paying premium on the policy terminates on the final day of the grace period. Termination of coverage under a group health insurance policy also includes the amendment or reissuance of a policy to delete one or more classes of certificate holders from coverage. (14) "Trust funds" means all moneys collected by an employer from employees of the employer or moneys retained from the employee's wages for the purposes of providing or furnishing to the employee’s health care services pursuant to a contract. (15) "Violation" means a transgression of any statute or rule or any part thereof and includes both acts and omissions. (16) "Working day" means any day the business of the employer is open for business to its customers or day the employees of the employer are actually working on the employer's business.