ORS 243.860: Definitions for ORS 243.860 to 243.886.
Edition: 2025 EditionEffective: 2026-01-01Last verified: 2026-09-07
As used in ORS 243.860 to 243.886, unless the context requires otherwise: (1) “Benefit plan” includes but is not limited to: (a) Contracts for insurance or other benefits, including medical, dental, vision, life, disability and other health care recognized by state law, and related services and supplies; (b) Self-insurance programs managed by the Oregon Educators Benefit Board; and (c) Comparable benefits for employees who rely on spiritual means of healing. (2) “Carrier” means an insurance company or health care service contractor holding a valid certificate of authority from the Director of the Department of Consumer and Business Services, or two or more companies or contractors acting together pursuant to a joint venture, partnership or other joint means of operation, or a board-approved provider or guarantor of benefit plan coverage and compensation. (3) “District” means a common school district, a union high school district, an education service district, as defined in ORS 334.003, or a community college district, as defined in ORS 341.005. (4)(a) “Eligible employee” includes: (A) An officer or employee of a district or a local government who elects to participate in one of the benefit plans described in ORS 243.864 to 243.874; and (B) An officer or employee of a district or a local government, whether or not retired, who: (i) Is receiving a service retirement allowance, a disability retirement allowance or a pension under the Public Employees Retirement System or is receiving a service retirement allowance, a disability retirement allowance or a pension under any other retirement or disability benefit plan or system offered by the district or local government for its officers and employees; (ii) Is eligible to receive a service retirement allowance under the Public Employees Retirement System and has reached earliest service retirement age under ORS chapter 238; (iii) Is eligible to receive a pension under ORS 238A.100 to 238A.250 and has reached earliest retirement age as described in ORS 238A.165; or (iv) Is eligible to receive a service retirement allowance or pension under any other retirement benefit plan or system offered by the district or local government and has attained earliest retirement age under the plan or system. (b) Except as provided in paragraph (a)(B) of this subsection, “eligible employee” does not include an individual: (A) Engaged as an independent contractor; (B) Whose periods of employment in emergency work are on an intermittent or irregular basis; or (C) Who is employed on less than a half-time basis unless the individual is employed in a position classified as a job-sharing position or unless the individual is defined as eligible under rules of the Oregon Educators Benefit Board or under a collective bargaining agreement. (5) “Family member” means an eligible employee’s spouse or domestic partner and any unmarried child or stepchild of an eligible employee within age limits and other conditions imposed by the Oregon Educators Benefit Board with regard to unmarried children or stepchildren. (6) “Local government” means any city, county or special district in this state. (7) “Payroll disbursing officer” means the officer or official authorized to disburse moneys in payment of salaries and wages of officers and employees of a district or a local government. (8) “Premium” means the monthly or other periodic charge, including administrative fees of the Oregon Educators Benefit Board, for a benefit plan. (9) “Primary care” means family medicine, general internal medicine, naturopathic medicine, obstetrics and gynecology, pediatrics or general psychiatry. (10) “Total medical expenditures” means payments to reimburse the cost of physical and mental health care provided to eligible employees or their family members, 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. [2007 c.7 §1; 2013 c.731 §15; 2017 c.489 §10]
Official history and status
History: Note: 243.860 to 243.886 were enacted into law by the Legislative Assembly but were not added to or made a part of ORS chapter 243 or any series therein by legislative action. See Preface to Oregon Revised Statutes for further explanation.
Administrative rules citing this section
- OAR 111-001-0005: Uniform and Model Rules of Procedure — authority
- OAR 111-005-0020: Definitions — authority
- OAR 111-005-0042: Intermediate Procurement Process — authority
- OAR 111-005-0047: Renewal Process — authority
- OAR 111-005-0055: Responsible Proposer — authority
- OAR 111-005-0080: Contract Amendments — authority
- OAR 111-010-0015: Definitions — authority
- OAR 111-015-0001: Eligible Individuals — authority
- OAR 111-020-0001: Initial Employee Group Phase-in — authority
- OAR 111-020-0010: Entities Electing to Join OEBB — authority
- OAR 111-030-0010: Medical, Pharmaceutical, Dental and Vision Plan Selection Criteria — authority
- OAR 111-030-0011: Bronze Medical Plan Offering — authority
- OAR 111-030-0035: Optional Benefit Plans Selection Criteria — authority
- OAR 111-030-0040: Long Term Care (LTC) Benefit Plan Selection Criteria — authority
- OAR 111-030-0045: Employee Assistance Program (EAP) Plan Selection Criteria — authority
- OAR 111-030-0046: Development of Health Savings Accounts (HSA) — authority
- OAR 111-030-0047: Development of Flexible Spending Accounts — authority
- OAR 111-030-0050: Premium Rate Structure Selection Process and Limitations — authority
- OAR 111-040-0001: Effective Dates — authority
- OAR 111-040-0005: Termination Dates — authority
- OAR 111-040-0011: Returning to Benefit Eligible Status — authority
- OAR 111-040-0015: Removing an Ineligible Individual from Benefit Plans — authority
- OAR 111-040-0020: Open Enrollment — authority
- OAR 111-040-0025: Correcting Enrollment and Processing Errors — authority
- OAR 111-040-0030: Late Enrollment — authority
- OAR 111-040-0040: Qualified Status Changes (QSCs) — authority
- OAR 111-040-0050: Declination of Coverage — authority
- OAR 111-040-0055: Surcharges — authority
- OAR 111-050-0001: Continuation of Group Medical and Dental Insurance Coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA) — authority
- OAR 111-050-0010: Eligibility for Retiree Insurance Coverage — authority
- OAR 111-050-0015: Medical, Dental and Vision Termination Dates for Early Retirees — authority
- OAR 111-050-0016: Life and Accidental Death and Dismemberment Termination Dates for Early Retirees — authority
- OAR 111-050-0020: Initial Enrollment — authority
- OAR 111-050-0025: Effective Dates — authority
- OAR 111-050-0030: Correcting Enrollment and Processing Errors — authority
- OAR 111-050-0035: Late Enrollment — authority
- OAR 111-050-0045: Termination Dates — authority
- OAR 111-050-0050: Removing an Ineligible Individual from Benefit Plans — authority
- OAR 111-050-0060: Continuation of Coverage for Eligible Employees Covered under the Federal Family Medical Leave Act — authority
- OAR 111-050-0065: Continuation of Coverage for Eligible Employees Covered under the Oregon Family Leave Act — authority
- OAR 111-050-0070: Continuation of Coverage for Eligible Employees during an Approved Leave of Absence. — authority
- OAR 111-050-0075: Continuation of coverage for Eligible Employees on Active Military Service — authority
- OAR 111-050-0080: Portability and Conversion of Coverage — authority
- OAR 111-060-0001: Use of Social Security Numbers — implements
- OAR 111-070-0075: Administration of SB 551 Program — authority
- OAR 111-080-0001: Payment Methods and Dates — authority
- OAR 111-080-0005: Overpayments and Underpayments — authority
- OAR 111-080-0030: Appeals and Administrative Reviews — authority
- OAR 111-080-0040: Eligibility and Policy Term Violations — Definitions — authority
- OAR 111-080-0045: Eligibility Violations — authority
- OAR 111-080-0050: Policy Term Violations — authority
- OAR 111-080-0055: Eligibility Verifications and Reviews — authority
- OAR 111-080-0060: Dependent Eligibility Verifications and Review Appeals — authority
- OAR 111-080-0065: Hospital Payments — authority
- OAR 111-080-0070: Exempt Hospitals — authority
This rule cites
- ORS 243.860 — resolved
- 243.886 — resolved
- ORS 334.003 — resolved
- ORS 341.005 — resolved
- ORS 243.864 — resolved
- 243.874 — resolved
- ORS chapter 238 — target_record_not_published
Cited by
- ORS 243.864: Duties; rules; contracts; personnel.
- ORS 243.870: Long term care benefit plans.
- ORS 243.878: Board authority with respect to health benefit plans; termination of participation.
- ORS 243.880: Oregon Educators Benefit Account; continuing appropriation; monthly deposits.
- ORS 243.882: Monthly participation assessment; purposes; maximum account balance.
- ORS 243.884: Oregon Educators Revolving Fund; continuous appropriation to board; purposes; rules; moneys paid into fund.
- ORS 243.886: Limitations on district participation in benefit plans; exceptions.
- OAR 111-005-0015: Renewal, Screening and Selection for Benefits, Vendor and Personal Services Contracts
- OAR 111-005-0040: Extensive Procurement Process
- OAR 111-060-0001: Use of Social Security Numbers
Official source: https://www.oregonlegislature.gov/bills_laws/ors/ors243.html