Bill Text: OR SB723 | 2013 | Regular Session | Introduced

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Bill Title: Relating to public employees health benefit plans; declaring an emergency.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Failed) 2013-07-08 - In committee upon adjournment. [SB723 Detail]

Download: Oregon-2013-SB723-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 3499

                         Senate Bill 723

Sponsored by Senator BATES

                             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.

  Authorizes Public Employees' Benefit Board and Oregon Educators
Benefit Board to contract with coordinated care organizations to
provide health coverage to public employees.
  Declares emergency, effective on passage.

                        A BILL FOR AN ACT
Relating to public employees health benefit plans; amending ORS
  243.105, 243.107, 243.125, 243.145, 243.256, 243.285, 243.860,
  243.864, 243.876, 243.878, 243.879 and 243.884; and declaring
  an emergency.
Be It Enacted by the People of the State of Oregon:
  SECTION 1. ORS 243.105 is amended to read:
  243.105. As used in ORS 243.105 to 243.285, unless the context
requires otherwise:
  (1) 'Benefit plan' includes, but is not limited to:
  (a) Contracts for insurance or other benefits, including
medical, dental, vision, life, disability and other health care
recognized by state law, and related services and supplies;
  (b) Comparable benefits for employees who rely on spiritual
means of healing;   { - and - }
  (c) Self-insurance programs managed by the Public Employees'
Benefit Board { + ; and
  (d) Membership in a coordinated care organization + }.
  (2) 'Board' means the Public Employees' Benefit Board.
  (3) 'Carrier' means an insurance company or health care service
contractor holding a valid certificate of authority from the
Director of the Department of Consumer and Business Services, or
two or more companies or contractors acting together pursuant to
a joint venture, partnership or other joint means of operation,
or a board-approved guarantor of benefit plan coverage and
compensation.
   { +  (4) 'Coordinated care organization' has the meaning given
that term in ORS 414.025. + }
    { - (4)(a) - }  { +  (5)(a) + } 'Eligible employee' means an
officer or employee of a state agency who elects to participate
in one of the group benefit plans described in ORS 243.135. The
term includes state officers and employees in the exempt,
unclassified and classified service, and state officers and
employees, whether or not retired, who:
  (A) Are receiving a service retirement allowance, a disability
retirement allowance or a pension under the Public Employees
Retirement System or are receiving a service retirement
allowance, a disability retirement allowance or a pension under
any other retirement or disability benefit plan or system offered
by the State of Oregon for its officers and employees;
  (B) Are eligible to receive a service retirement allowance
under the Public Employees Retirement System and have reached
earliest retirement age under ORS chapter 238;
  (C) Are eligible to receive a pension under ORS 238A.100 to
238A.245, and have reached earliest retirement age as described
in ORS 238A.165; or
  (D) Are eligible to receive a service retirement allowance or
pension under another retirement benefit plan or system offered
by the State of Oregon and have attained earliest retirement age
under the plan or system.
  (b) 'Eligible employee' does not include individuals:
  (A) Engaged as independent contractors;
  (B) Whose periods of employment in emergency work are on an
intermittent or irregular basis;
  (C) Who are employed on less than half-time basis unless the
individuals are employed in positions classified as job-sharing
positions, unless the individuals are defined as eligible under
rules of the board;
  (D) Appointed under ORS 240.309;
  (E) Provided sheltered employment or make-work by the state in
an employment or industries program maintained for the benefit of
such individuals; or
  (F) Provided student health care services in conjunction with
their enrollment as students at a public university listed in ORS
352.002.
    { - (5) - }  { +  (6) + } 'Family member' means an eligible
employee's spouse and any unmarried child or stepchild within age
limits and other conditions imposed by the board with regard to
unmarried children or stepchildren.
    { - (6) - }  { +  (7) + } 'Payroll disbursing officer' means
the officer or official authorized to disburse moneys in payment
of salaries and wages of employees of a state agency.
    { - (7) - }  { +  (8) + } 'Premium' means the monthly or
other periodic charge for a benefit plan.
    { - (8) - }  { +  (9) + } 'State agency' means every state
officer, board, commission, department or other activity of state
government.
  SECTION 2. ORS 243.125 is amended to read:
  243.125. (1) The Public Employees' Benefit Board shall
prescribe rules for the conduct of its business and for carrying
out ORS 243.256. The board shall study all matters connected with
the providing of adequate benefit plan coverage for eligible
state employees on the best basis possible with relation both to
the welfare of the employees and to the state. The board shall
design benefits, devise specifications, analyze carrier  { + and
coordinated care organization + } responses to advertisements for
bids and decide on the award of contracts. Contracts shall be
signed by the chairperson on behalf of the board.
  (2) In carrying out its duties under subsection (1) of this
section, the goal of the board shall be to provide a high quality
plan of health and other benefits for state employees at a cost
affordable to both the employer and the employees.
  (3) Subject to ORS chapter 183, the board may make rules not
inconsistent with ORS 243.105 to 243.285 and 292.051 to determine
the terms and conditions of eligible employee participation and
coverage.
  (4) The board shall prepare specifications, invite bids and do
acts necessary to award contracts for health benefit plan and
dental benefit plan coverage of eligible employees in accordance
with the criteria set forth in ORS 243.135 (1).
  (5) The board may retain consultants, brokers or other advisory
personnel when necessary and, subject to the State Personnel
Relations Law, shall employ such personnel as are required to
perform the functions of the board.
  SECTION 3. ORS 243.145 is amended to read:
  243.145. (1) The Public Employees' Benefit Board shall have
authority to employ whatever means are reasonably necessary to
carry out the purposes of ORS 243.105 to 243.285 and 292.051.
Such authority shall include but is not limited to authority to
self-insure and to seek clarification, amendment, modification,
suspension or termination of any agreement or contract that in
the board's judgment requires such action.
  (2) Upon providing specific notice in writing to the carrier,
 { +  the coordinated care organization, + } the affected
employee organization or organizations, the Oregon Health
Authority and affected, eligible employees, and after affording
opportunity for a public hearing upon the issues that may be
involved, the board may enter an order withdrawing approval of
any benefit plan.  Thirty days after entry of the order, the
board shall terminate all withholding authorizations of eligible
employees and terminate all board-approved participation in the
plan.
  (3) The board by order may terminate the participation of any
state agency if within three months the state agency fails to
perform any action required by ORS 243.105 to 243.285 and 292.051
or by board rule.
  SECTION 4. ORS 243.256 is amended to read:
  243.256. (1) A hospital that provides services or supplies
under a benefit plan offered by the Public Employees' Benefit
Board shall be reimbursed using the methodology prescribed by the
Oregon Health Authority under ORS 442.392 and may not be
reimbursed for each service or supply provided.
  (2) This section applies to hospital payments made by a carrier
 { + or coordinated care organization + } under a contract with
the board and to hospital payments made under a self-insurance
program administered by a third party administrator on behalf of
the board.
  (3) This section does not apply to reimbursements paid by a
carrier { + , coordinated care organization + } or third party
administrator to a hospital that is not subject to the
methodology prescribed by the authority under ORS 442.392.
  SECTION 5. ORS 243.285 is amended to read:
  243.285. (1) Upon receipt of the request in writing of an
eligible employee so to do, the payroll disbursing officer
authorized to disburse funds in payment of the salary or wages of
the eligible employee may deduct from the salary or wages of the
employee an amount of money indicated in the request for payment
of the applicable amount set forth in benefit plans selected by
the employee or selected on the employee's behalf for:
  (a) Group health and related services and supplies, including
such insurance for family members of the eligible employee.
  (b) Group life insurance, including life insurance for family
members of the eligible employee.
  (c) Group dental and related services and supplies, or any
other remedial care recognized by state law and related services
and supplies, recognized under state law, including such
insurance for family members of the eligible employee.
  (d) Group indemnity insurance for accidental death and
dismemberment and for loss of income due to accident, sickness or
other disability, including such insurance for family members of
the eligible employee.
  (e) Other benefits, including self-insurance programs, that are
approved and provided by the Public Employees' Benefit Board.
  (2) Moneys deducted under subsection (1) of this section shall
be paid over promptly:
  (a) To the carriers  { + or coordinated care organizations + }
or persons responsible for payment of premiums to carriers { +
or coordinated care organizations + }, in accordance with the
terms of the contracts made by the eligible employees or on their
behalf; or
  (b) With respect to self-insurance benefits, in accordance with
rules, procedures and directions of the Public Employees' Benefit
Board.
  SECTION 6. ORS 243.860 is amended to read:
  243.860. As used in ORS 243.860 to 243.886, unless the context
requires otherwise:
  (1) 'Benefit plan' includes but is not limited to:
  (a) Contracts for insurance or other benefits, including
medical, dental, vision, life, disability and other health care
recognized by state law, and related services and supplies;
  (b) Self-insurance programs managed by the Oregon Educators
Benefit Board;   { - and - }
  (c) Comparable benefits for employees who rely on spiritual
means of healing { + ; and
  (d) Membership in a coordinated care organization + }.
  (2) 'Carrier' means an insurance company or health care service
contractor holding a valid certificate of authority from the
Director of the Department of Consumer and Business Services, or
two or more companies or contractors acting together pursuant to
a joint venture, partnership or other joint means of operation,
or a board-approved provider or guarantor of benefit plan
coverage and compensation.
   { +  (3) 'Coordinated care organization' has the meaning given
that term in ORS 414.025. + }
    { - (3) - }  { +  (4) + } 'District' means a common school
district, a union high school district, an education service
district, as defined in ORS 334.003, or a community college
district, as defined in ORS 341.005.
    { - (4)(a) - }  { +  (5)(a) + } 'Eligible employee' includes:
  (A) An officer or employee of a district who elects to
participate in one of the benefit plans described in ORS 243.864
to 243.874; and
  (B) An officer or employee of a district, whether or not
retired, who:
  (i) Is receiving a service retirement allowance, a disability
retirement allowance or a pension under the Public Employees
Retirement System or is receiving a service retirement allowance,
a disability retirement allowance or a pension under any other
retirement or disability benefit plan or system offered by the
district for its officers and employees;
  (ii) Is eligible to receive a service retirement allowance
under the Public Employees Retirement System and has reached
earliest service retirement age under ORS chapter 238;
  (iii) Is eligible to receive a pension under ORS 238A.100 to
238A.245 and has reached earliest retirement age as described in
ORS 238A.165; or
  (iv) Is eligible to receive a service retirement allowance or
pension under any other retirement benefit plan or system offered
by the district and has attained earliest retirement age under
the plan or system.
  (b) Except as provided in paragraph (a)(B) of this subsection,
'eligible employee' does not include an individual:
  (A) Engaged as an independent contractor;
  (B) Whose periods of employment in emergency work are on an
intermittent or irregular basis; or
  (C) Who is employed on less than a half-time basis unless the
individual is employed in a position classified as a job-sharing
position or unless the individual is defined as eligible under
rules of the Oregon Educators Benefit Board or under a collective
bargaining agreement.
    { - (5) - }  { +  (6) + } 'Family member' means an eligible
employee's spouse or domestic partner and any unmarried child or
stepchild of an eligible employee within age limits and other

conditions imposed by the Oregon Educators Benefit Board with
regard to unmarried children or stepchildren.
    { - (6) - }  { +  (7) + } 'Payroll disbursing officer' means
the officer or official authorized to disburse moneys in payment
of salaries and wages of officers and employees of a district.
    { - (7) - }  { +  (8) + } 'Premium' means the monthly or
other periodic charge, including administrative fees of the
Oregon Educators Benefit Board, for a benefit plan.
  SECTION 7. ORS 243.864 is amended to read:
  243.864. (1) The Oregon Educators Benefit Board:
  (a) Shall adopt rules for the conduct of its business and for
carrying out ORS 243.879; and
  (b) May adopt rules not inconsistent with ORS 243.860 to
243.886 to determine the terms and conditions of eligible
employee participation in and coverage under benefit plans.
  (2) The board shall study all matters connected with the
provision of adequate benefit plan coverage for eligible
employees on the best basis possible with regard to the welfare
of the employees and affordability for the districts. The board
shall design benefits, prepare specifications, analyze carrier
 { + or coordinated care organization + } responses to
advertisements for bids and award contracts. Contracts shall be
signed by the chairperson on behalf of the board.
  (3) In carrying out its duties under subsections (1) and (2) of
this section, the goal of the board is to provide high-quality
health, dental and other benefit plans for eligible employees at
a cost affordable to the districts, the employees and the
taxpayers of Oregon.
  (4) The board shall prepare specifications, invite bids and
take actions necessary to award contracts for health and dental
benefit plan coverage of eligible employees in accordance with
the criteria set forth in ORS 243.866 (1). The Public Contracting
Code does not apply to contracts for benefit plans provided under
ORS 243.860 to 243.886. The board may not exclude from
competition to contract for a benefit plan an Oregon carrier
 { + or coordinated care organization + } solely because the
carrier  { + or organization + } does not serve all counties in
Oregon.
  (5) The board may retain consultants, brokers or other advisory
personnel when necessary and shall employ such personnel as are
required to perform the functions of the board.
  SECTION 8. ORS 243.876 is amended to read:
  243.876. (1) Upon receipt of a request in writing from an
eligible employee, the payroll disbursing officer may deduct from
the salary or wages of the employee an amount of money indicated
in the request for payment of the amount set forth in benefit
plans selected by the employee for the employee and family
members.
  (2) Amounts deducted under subsection (1) of this section shall
be paid over promptly:
  (a) To the Oregon Educators Benefit Board, the carriers { +  or
coordinated care organizations + } or the persons responsible for
payment of premiums to carriers  { + or coordinated care
organizations + } in accordance with the terms of contracts for
benefit plans; or
  (b) With respect to self-insurance benefits, in accordance with
rules and procedures adopted by the board.
  (3) The payroll disbursing officer shall submit reports to the
board regarding claims experience and benefit plan coverage for
eligible employees as the board considers desirable.
  SECTION 9. ORS 243.878 is amended to read:
  243.878. (1) The Oregon Educators Benefit Board may employ
whatever means are reasonably necessary to carry out the purposes
of ORS 243.860 to 243.886. This authority includes, but is not
limited to, authority to self-insure and to seek clarification,

amendment, modification, suspension or termination of any
agreement or contract.
  (2) Upon providing specific notice in writing to the carrier,
 { +  the coordinated care organization, + } the affected labor
organization or organizations, the districts, the Oregon Health
Authority and the affected eligible employees, and after
affording opportunity for a public hearing on the issues that may
be involved, the board may enter an order withdrawing approval of
a benefit plan. Thirty days after entry of the order, the board
shall terminate all withholding authorizations of eligible
employees and terminate all board-approved participation in the
plan.
  (3) The board by order may terminate the participation of a
district in a benefit plan if, within three months, the district
fails to perform an action required by ORS 243.860 to 243.886 or
by board rule.
  SECTION 10. ORS 243.879 is amended to read:
  243.879. (1) A hospital that provides services or supplies
under a benefit plan offered by the Oregon Educators Benefit
Board shall be reimbursed using the methodology prescribed by the
Oregon Health Authority under ORS 442.392 and may not be
reimbursed for each service or supply provided.
  (2) This section applies to hospital payments made by a carrier
 { + or coordinated care organization + } under a contract with
the board and to hospital payments made under a self-insurance
program administered by a third party administrator on behalf of
the board.
  (3) This section does not apply to reimbursements paid by a
carrier { + , coordinated care organization + } or third party
administrator to a hospital that is not subject to the
methodology prescribed by the authority under ORS 442.392.
  SECTION 11. ORS 243.884 is amended to read:
  243.884. (1) There is created the Oregon Educators Revolving
Fund, separate and distinct from the General Fund. Moneys in the
Oregon Educators Revolving Fund are continuously appropriated to
the Oregon Educators Benefit Board to cover the board's expenses
incurred in connection with the administration of ORS 243.860 to
243.886. Moneys in the Oregon Educators Revolving Fund may be
retained for limited periods of time as established by the board
by rule. Among other purposes, the board may retain the funds to
pay premiums, control expenditures, stabilize premiums and
self-insure. The board may establish subaccounts within the
Oregon Educators Revolving Fund.
  (2) The following moneys shall be paid into the Oregon
Educators Revolving Fund:
  (a) All unused employer contributions for benefit plans;
  (b) All refunds, dividends, unused premiums and other payments
attributable to an employee contribution or employer contribution
made from a carrier  { + or coordinated care organization + }
that has provided benefit plans administered by the board; and
  (c) All interest earned on the moneys in the fund.
  SECTION 12. ORS 243.107 is amended to read:
  243.107. A person employed by a public university listed in ORS
352.002 or the Oregon Health and Science University may be
considered an eligible employee for participation in one of the
group benefit plans described in ORS 243.135 if the State Board
of Higher Education, or the Oregon Health and Science University
Board of Directors for Oregon Health and Science University
employees, determines that funds are available therefor and if:
  (1) Notwithstanding ORS 243.105   { - (4)(b)(F) - }  { +
(5)(b)(F) + }, the person is a student enrolled in an institution
of higher education and is employed as a graduate teaching
assistant, graduate research assistant or a fellow at the
institution and elects to participate; or
  (2) Notwithstanding ORS 243.105   { - (4)(b)(B) - }  { +
(5)(b)(B) + } or (C), the person is employed on a less than
half-time basis in an unclassified instructional or research
support capacity and elects to participate.
  SECTION 13.  { + 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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