Bill Text: OR SB162 | 2013 | Regular Session | Introduced

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Bill Title: Relating to association health plans; declaring an emergency.

Spectrum: Committee Bill

Status: (Failed) 2013-07-08 - In committee upon adjournment. [SB162 Detail]

Download: Oregon-2013-SB162-Introduced.html

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     77th OREGON LEGISLATIVE ASSEMBLY--2013 Regular Session

NOTE:  Matter within  { +  braces and plus signs + } in an
amended section is new. Matter within  { -  braces and minus
signs - } is existing law to be omitted. New sections are within
 { +  braces and plus signs + } .

LC 211

                         Senate Bill 162

Printed pursuant to Senate Interim Rule 213.28 by order of the
  President of the Senate in conformance with presession filing
  rules, indicating neither advocacy nor opposition on the part
  of the President (at the request of Senate Interim Committee on
  Health Care, Human Services and Rural Health Policy)

                             SUMMARY

The following summary is not prepared by the sponsors of the
measure and is not a part of the body thereof subject to
consideration by the Legislative Assembly. It is an editor's
brief statement of the essential features of the measure as
introduced.

  Exempts association health plans from requirements applicable
to small employer health benefit plans.
  Declares emergency, effective on passage.

                        A BILL FOR AN ACT
Relating to association health plans; amending ORS 743.734 and
  section 13, chapter 752, Oregon Laws 2007; and declaring an
  emergency.
Be It Enacted by the People of the State of Oregon:
  SECTION 1. ORS 743.734, as amended by section 13, chapter 500,
Oregon Laws 2011, is amended to read:
  743.734. (1) Every health benefit plan shall be subject to the
provisions of ORS 743.733 to 743.737, if the plan provides health
benefits covering one or more employees of a small employer and
if any one of the following conditions is met:
  (a) Any portion of the premium or benefits is paid by a small
employer or any eligible employee is reimbursed, whether through
wage adjustments or otherwise, by a small employer for any
portion of the health benefit plan premium; or
  (b) The health benefit plan is treated by the employer or any
of the eligible employees as part of a plan or program for the
purposes of section 106, section 125 or section 162 of the
Internal Revenue Code of 1986, as amended.
  (2) Except as provided in ORS 743.733 to 743.737, 743.764 and
743A.012, no state law requiring the coverage or the offer of
coverage of a health care service or benefit applies to the basic
health benefit plans offered or delivered to a small employer.
  (3) Except as otherwise provided by ORS 743.733 to 743.737 or
other law, no health benefit plan offered to a small employer
shall:
  (a) Inhibit a carrier from contracting with providers or groups
of providers with respect to health care services or benefits; or
  (b) Impose any restriction on the ability of a carrier to
negotiate with providers regarding the level or method of
reimbursing care or services provided under health benefit plans.
  (4) Except to determine the application of a preexisting
condition exclusion for a late enrollee who is 19 years of age or
older, a carrier shall not use health statements when offering
small employer health benefit plans and shall not use any other
method to determine the actual or expected health status of
eligible enrollees. Nothing in this subsection shall prevent a
carrier from using health statements or other information after
enrollment for the purpose of providing services or arranging for
the provision of services under a health benefit plan.
  (5) Except as provided in this section and ORS 743.737, a
carrier shall not impose different terms or conditions on the
coverage, premiums or contributions of any eligible employee of a
small employer that are based on the actual or expected health
status of any eligible employee.
  (6)(a) A carrier may provide different health benefit plans to
different categories of employees of a small employer that has at
least 26 but no more than 50 eligible employees when the employer
has chosen to establish different categories of employees in a
manner that does not relate to the actual or expected health
status of such employees or their dependents. The categories must
be based on bona fide employment-based classifications that are
consistent with the employer's usual business practice.
  (b) Except as provided in ORS 743.736 (9), a carrier that
offers coverage to a small employer with no more than 25 eligible
employees shall offer coverage to all eligible employees of the
small employer, without regard to the actual or expected health
status of any eligible employee.
  (c) If a small employer elects to offer coverage to dependents
of eligible employees, the carrier shall offer coverage to all
dependents of eligible employees, without regard to the actual or
expected health status of any eligible dependent.
  (7) Notwithstanding any other provision of law, an insurer may
not deny, delay or terminate participation of an individual in a
group health benefit plan or exclude coverage otherwise provided
to an individual under a group health benefit plan based on a
preexisting condition of the individual if the individual is
under 19 years of age.
   { +  (8) A health benefit plan issued to a small employer
group through an association health plan is exempt from
subsection (1) of this section. For purposes of this subsection,
an association health plan is group health insurance described in
ORS 743.522 (1)(b). + }
  SECTION 2. Section 13, chapter 752, Oregon Laws 2007, as
amended by section 4, chapter 81, Oregon Laws 2010, and section
10, chapter 500, Oregon Laws 2011, is amended to read:
   { +  Sec. 13. + }  { +  (1) + } The amendments to ORS 731.146,
731.484, 731.486
  { - , 743.734 - }  and 743.748 by sections 6 to 8, chapter 752,
Oregon Laws 2007, and   { - sections 13 and - }  { +  section + }
18   { - of this 2011 Act - }  { + , chapter 500, Oregon Laws
2011, + } become operative on January 2, 2014.
   { +  (2) The amendments to ORS 743.734 by section 13, chapter
500, Oregon Laws 2011, and section 1 of this 2013 Act become
operative on the effective date of this 2013 Act. + }
  SECTION 3.  { + This 2013 Act being necessary for the immediate
preservation of the public peace, health and safety, an emergency
is declared to exist, and this 2013 Act takes effect on its
passage. + }
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