Health and life insurance

HB 4128:​ Requires Coverage of Certain Craniofacial Anomalies (Chapter 322, 2011 Oregon Laws)

HB 4128 requires health benefit plans to cover medically necessary dental or orthodontic services for treatment of craniofacial anomalies. Craniofacial anomalies are narrowly defined to mean "a physical disorder identifiable at birth that affects the bony structures of the face or head, including but not limited to cleft palate, cleft lip…." HB 4128 does not provide treatment for temporomandibular joint disorder or maxillofacial conditions that result in overbite, cross bite, malocclusion, or similar irregularities of the teeth.

HB 4128 is a new health insurance mandate. Due to the timing of passage of HB 4128, this mandate is not included as an "essential health benefit" in the benchmark plan Oregon submitted to meet the implementation requirements of the federal Affordable Care Act, so the costs attributable to this mandate in plans offered through the Oregon Health Insurance Exchange will be the responsibility of the State of Oregon.

  • Effective Date: Jan. 1, 2013
  • Applicability: Policies and certificates issued or renewed on or after Jan. 1, 2013
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