Bill Text: OR SB166 | 2013 | Regular Session | Enrolled
Bill Title: Relating to electronic communications from health insurers; and prescribing an effective date.
Sponsorship: Committee Bill
Status: (Passed) 2013-05-24 - Effective date, October 1, 2013. [SB166 Detail]
Download: Oregon-2013-SB166-Enrolled.html
77th OREGON LEGISLATIVE ASSEMBLY--2013 Regular Session
Enrolled
Senate Bill 166
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)
CHAPTER ................
AN ACT
Relating to electronic communications from health insurers;
amending ORS 743.777; and prescribing an effective date.
Be It Enacted by the People of the State of Oregon:
SECTION 1. ORS 743.777 is amended to read:
743.777. (1) As used in { - subsections (2) to (6) of - }
this section:
(a) 'Explanation of benefits' means claim processing advice or
notification of action on claims.
(b) 'Payment, remittance and reconciliation information ' means
all information required for premium billing or invoicing,
facilitating timely electronic payment of premiums due,
delinquency notification, final billing notification or
termination of coverage.
(c) 'Plan renewal information' means all correspondence and
materials related to an offer to renew insurance provided by an
insurer to a health insurance purchaser.
(d) 'Quote information' means all correspondence and materials
related to an offer to insure or a rate quotation provided by an
insurer to a health insurance purchaser.
(e) 'Sale and enrollment information' means all information
documenting the sale of a policy or certificate of health
insurance, the renewal of a policy or certificate of health
insurance, the enrollment of members in a group health insurance
plan or the enrollment of an individual in an individual health
insurance plan, including but not limited to:
(A) The application for insurance;
(B) Initial and ongoing documentation required by the insurer
to be provided by an insured to establish eligibility and
enrollment, adjudicate and process claims and prove prior
creditable coverage or duplicate coverage;
(C) Premium information;
(D) Documentation of the payment of a premium; and
(E) Membership identification cards.
(2) { + Notwithstanding any other provision of law, + } in the
administration of small employer group health insurance or
individual health insurance, an insurer may { + elect to + }
communicate one or more of the following by electronic means:
(a) Quote information.
Enrolled Senate Bill 166 (SB 166-A) Page 1
(b) Sale and enrollment information.
(c) Payment, remittance and reconciliation information { +
except notices required by ORS 743.499 and 743.565 + }.
(d) Explanation of benefits.
(e) Plan renewal information.
(f) Notifications required by law.
(g) Other communications, documentation, revisions or materials
otherwise provided on paper.
{ + (3) An insurer that elects to communicate by electronic
means shall offer a small employer group member or individual
applying for coverage and coverage renewal the option to receive
by regular mail one or more of the types of communications
described in subsection (2) of this section. + }
{ - (3) - } { + (4) + } Electronic administration of small
employer group or individual health insurance plans shall be
transacted using secure systems specifically designed by the
insurer for the purpose of electronic health insurance
administration.
{ - (4) - } { + (5) + } An insurer who elects to offer
discounted rates for a health insurance plan utilizing electronic
administration shall include the schedule of discounts for
utilization of electronic administration as part of a small
employer group health insurance or individual health insurance
rate filing. The rate discounts may be graduated and must be
proportionate to the amount of administrative cost savings the
insurer anticipates as a result of the use of electronic
transactions described in subsections (2)
{ - and (3) - } { + to (4) + } of this section.
{ - (5) - } { + (6) + } Discounted rates allowed under
{ - subsections (4) to (6) - } { + subsection (5) + } of this
section shall be applied uniformly to all similarly situated
small employer group or individual health insurance purchasers of
an insurer.
{ - (6) - } { + (7) + } Discounts in premium rates under
subsections { - (4) to (6) - } { + (5) and (6) + } of this
section are not premium rate variations for purposes of ORS
743.737 (11) or 743.767.
{ - (7) - } { + (8) + } { - Subsections (1) to (6) of - }
This section { - do - } { + does + } not require an insurer
to offer discounted rates for a health insurance plan utilizing
electronic administration or require a small employer group or an
individual health insurance purchaser to use electronic
administration.
SECTION 2. { + This 2013 Act takes effect on October 1,
2013. + }
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Enrolled Senate Bill 166 (SB 166-A) Page 2
Passed by Senate February 14, 2013
.............................................................
Robert Taylor, Secretary of Senate
.............................................................
Peter Courtney, President of Senate
Passed by House May 9, 2013
.............................................................
Tina Kotek, Speaker of House
Enrolled Senate Bill 166 (SB 166-A) Page 3
Received by Governor:
......M.,............., 2013
Approved:
......M.,............., 2013
.............................................................
John Kitzhaber, Governor
Filed in Office of Secretary of State:
......M.,............., 2013
.............................................................
Kate Brown, Secretary of State
Enrolled Senate Bill 166 (SB 166-A) Page 4
