HB 2002 (ch 389) Expansion of small employers group pool for small group health insurance
HB 2002 strengthens the health insurance marketplace for Oregon small businesses by:
- Expanding the rate band from 2.5:1 to 3:1, allowing a 50 percent deviation from the geographic average rate.
- Expanding the small employer group pool to include businesses employing up to 50 employees, and
- Allowing variations from the rate band to be based on additional factors. These include the ages of dependents of enrolled employees; the level of contribution by a small employer and by employees; the level of tobacco use by enrolled employees and dependents; the level at which enrolled employees and dependents engage in health promotion, disease prevention, or wellness programs; and the extent to which there are periods of uninterrupted coverage. Adjustment may also be made to reflect a small employer’s expected claims experience.
Effective: June 13, 2007.
HB 2213 (ch 390) Cost of health services, transparency for consumers
HB 2213 requires health insurers to provide consumers with advance estimates of average costs for specific medical procedures and services. The estimate of the out-of-network costs will include the difference between the insurer's allowable charge and the billed charge for the procedure or service.
HB 2213 also requires health insurers to submit to the DCBS director:
- Upon request by the director, the methodology used to determine allowable charges for out-of-network procedures and services;
- For approval, a written explanation of the method used by the insurer to determine the allowable charge, to be provided to enrollees upon request; and
- Information prescribed by the director as necessary to evaluate the effect of the requirements of this legislation for disclosure of advance estimates of average costs for specific medical procedures and services
The requirements for estimates become operative July 1, 2009.
HB 2224 (ch 544) Review and approval of policy forms for life insurance, annuities and disability insurance
HB 2224 streamlines the review of certain life insurance policy forms that have already been approved under consumer protection standards established by the Interstate Insurance Product Regulation Commission. Specifically, the bill authorizes the DCBS director to approve use of policy forms for specific categories of life insurance, annuities, or disability insurance in this state without specific review of filed policy forms by DCBS, but only if the commission has approved the forms and the DCBS director determines that the commission’s approval process, taken as a whole, gives policyholders substantially the same protection as or better protections than the approval process available under Oregon law. The DCBS director will specify by rule the insurance categories to which this authority will apply.
HB 2224 took effect June 22, 2007, and stands to be repealed on Jan. 2, 2012.
HB 2348 (ch 128) Coverage of medical expenses arising from use of alcohol or controlled substance
HB 2348 requires an individual health insurance policy to cover the medical treatment of injuries or illnesses caused in whole or part by the insured’s use of alcohol or a controlled substance to the same extent as treatment of injury or illness not caused by the use of alcohol or a controlled substance. Before this change, the law authorized individual policies to exclude coverage for loss resulting from insureds being intoxicated or under the influence of a controlled substance other than as directed by a physician.
This required coverage is extended to individual policies issued by health care service contractors. This requirement did not apply to health care service contractors before this legislation.
HB 2517 (ch 374) Mandated coverage for prosthetic, orthotic devices
HB 2517 requires individual and group health insurance policies to cover medically necessary prosthetic and orthotic devices. Coverage includes all medically necessary related services and supplies, and repair or replacement. An “orthotic device” is defined as a rigid or semi-rigid device supporting or affecting a limb, back, or neck, and a “prosthetic device” is defined as an artificial limb replacing an arm or leg.
The DCBS director will adopt and annually update rules listing the prosthetic and orthotic devices covered by this bill. The list must include at least the list of devices listed in the Medicare fee schedule for durable medical equipment, prosthetics, orthotics, and supplies.
HB 2700 (ch 182) Mandated coverage of contraceptives and related services
HB 2700 requires a health benefit plan or student health insurance policy to cover prescription contraceptives if the plan or policy includes a prescription drug benefit. The bill also requires coverage of related outpatient consultations and other necessary services, if the services are covered for other drug benefits. These requirements also apply to prescription drug benefit programs. The bill provides an exemption for religious employers.
HB 2700 also requires hospitals to inform victims of sexual assault about emergency contraception and treatment options, and to provide emergency contraception upon request. HB 2700 further prohibits public bodies from hindering access to contraception by consenting adults.
HB 2918 (ch 872) Mandated coverage for developmental disorders
HB 2918 requires a health benefit plan to cover medical services for a child (younger than 18 years old) with a pervasive developmental disorder. Medical services must include rehabilitation services and may be subject to provisions of the health benefit plan that apply to covered services, such as co-payments and deductibles, and treatment limitations. The bill defines a pervasive developmental disorder as a neurological condition that includes Asperger’s syndrome, autism, developmental delay, developmental disability, or mental retardation.
This mandated benefit is exempt from automatic repeal under ORS 743.700.
HB 3103 (ch 391) Public access to health insurance ratemaking filings
HB 3103 requires DCBS to make carriers’ rate filings for individual, portability, and small employer group health benefit plans available for public inspection. DCBS will implement this bill by posting filings on the DCBS Insurance Division’s website. The bill authorizes the director of DCBS, upon request by a carrier, to exempt any part of the filing that the director determines to contain trade secrets and that would harm competition if disclosed.
HB 3321 (ch 752) Health insurance, group insurance for associations
HB 3321 exempts health benefit plans issued to a small employer group through an association health plan from the statutes governing small employer group plans, if the association plans meet standards for initial premiums, do not discriminate in membership based on enrollees’ health status, and maintain high retention rates. This exemption applies to health benefit plans issued or renewed on or after the effective date of this bill and before Jan. 2, 2014. The bill requires DCBS to monitor association health plan data and report the findings to the next Legislative Assembly, and applies equally to out-of-state association plans.
HB 3321 also subjects master policies issued in another state to an association, trust, or multiple employer welfare arrangement to review and approval by DCBS before coverage under the master policy may be marketed to Oregon residents.
Effective July 12, 2007.
HB 3484 (ch 560) Life insurance, group policies; access to coverage
HB 3484 authorizes DCBS to include annuity premium in its assessment of Oregon-generated premium amounts for the purpose of funding DCBS regulation under the Insurance Code. Before this change, annuity premium had been exempt for this purpose. The bill reduces minimum membership requirements for a group of people to be insured under a group life insurance policy, to require that no fewer than two lives be insured when the policy is issued. The bill also allows premiums for a group life insurance policy to be paid by the group policyholder, or by persons insured under the policy, or both. Before this change, state law did not allow an individual to pay group life premiums directly.
Effective: June 22, 2007.