(1) Subject to ORS 744.704, a person shall not transact business or purport or offer to transact business as a third party administrator in this state unless the person holds a third party administrator license issued by the Director of the Department of Consumer and Business Services. (2) For purposes of ORS 744.700 to 744.740, a person transacts or purports or offers to transact business as a third party administrator if the person: (a) Directly or indirectly solicits or effects coverage of, underwrites, collects charges or premiums from, or adjusts or settles claims on, residents of this state or residents of another state from offices in this state, in connection with life insurance or health insurance coverage; or (b) Acts as a pharmacy services administrative organization, as defined in ORS 735.538, or as an organization that advises or represents pharmacies that are members of the organization, or that enters into contracts on behalf of members, in matters that are related to procuring or supplying prescription drugs. (3) A pharmacy services administrative organization, as defined in ORS 735.538, is exempt from the requirement to obtain a license under ORS 735.538, if the pharmacy services administrative organization is not owned by a pharmacy benefit manager and generates revenue only from monthly service fees that a pharmacy pays for services that are not connected to drug pricing or volume. (4) Nothing in ORS 744.700 to 744.740 exempts a third party administrator from any other applicable licensing requirement when the third party administrator performs the functions of an insurance producer, adjuster or insurance consultant.
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