72nd OREGON LEGISLATIVE ASSEMBLY--2003 Regular Session
SA to HB 2537
LC 2027/HB 2537-23
SENATE AMENDMENTS TO
HOUSE BILL 2537
By COMMITTEE ON RULES
August 5
On page 1 of the printed bill, line 2, after the second
semicolon delete the rest of the line and insert 'amending ORS
735.700, 735.702 and 735.710; and declaring an emergency.'.
Delete lines 4 through 32 and delete pages 2 through 5 and
insert:
' { + SECTION 1. + } ORS 735.700 is amended to read:
' 735.700. As used in ORS 735.700 to 735.740, unless the
context requires otherwise:
' (1) 'Board' means the Insurance Pool Governing Board
established under ORS 735.704.
' (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.
' (3) 'Class of employee' means an employee classed as either
management or nonmanagement employee.
' (4) 'Eligible employee' means an employee of an employer who
is employed by the employer for an average of at least 17.5 hours
per week { + , + } { - who elects to participate in one of the
group benefit plans provided through board action, and - } sole
proprietors, business partners, and limited partners. The term
does not include individuals:
' (a) Engaged as independent contractors.
' (b) Whose periods of employment are on an intermittent or
irregular basis.
' { - (c) Who have been employed by the employer for fewer
than 90 days. - }
' (5) '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 { + , or any other dependents
eligible under the terms of the health benefit plan selected by
the employee's employer + }.
' (6) 'Health benefit plan' means a contract for group medical,
surgical, hospital or any other remedial care recognized by state
law and related services and supplies.
' (7) 'Premium' means the monthly or other periodic charge for
a health benefit plan.
' { + SECTION 2. + } ORS 735.702 is amended to read:
' 735.702. { - It is the intent of the Legislative Assembly
by enactment of ORS 735.700 to 735.740 - } To increase access to
health insurance and health care { - by providing - } { + ,
the Insurance Pool Governing Board shall provide + }:
' (1) Information about health benefit plans and the premiums
charged for those plans to self-employed individuals and small
employers in Oregon;
' (2) Direct assistance to health insurance agents and health
insurance consumers regarding health benefit plans;
' (3) A central source for information about resources for
health care and health insurance; and
' (4) Health benefit plans for small employers { - that have
not provided a group health benefit plan for eligible employees
for a period of at least one year - } .
' { + SECTION 2a. + } { + Section 2b of this 2003 Act is
added to and made a part of ORS 735.700 to 735.740. + }
' { + SECTION 2b. + } { + Health benefit plans for small
employers offered by the Insurance Pool Governing Board under ORS
735.710 (8) that are not eligible for a subsidy under ORS 735.724
may be offered only to small employers that did not provide a
health benefit plan for eligible employees on July 1, 2003, and
to small employers that begin business operations on or after the
effective date of this 2003 Act. + }
' { + SECTION 3. + } ORS 735.710 is amended to read:
' 735.710. (1) In carrying out its duties under ORS 735.700 to
735.740, the Insurance Pool Governing Board { - shall - } { +
may + }:
' (a) Enter into contracts for administration of ORS 735.700 to
735.740 including collection of premiums and paying carriers.
' (b) Retain consultants and employ staff.
' (c) Enter into contracts with carriers or health care
providers for health benefit plans { - , including contracts
where final payment may be reduced if usage is below a level
fixed in the contract - } .
' (d) Set premium rates for eligible employees and small
employers.
' (e) Perform other duties to provide low-cost health benefit
plans of types likely to be purchased by small employers.
' (f) Establish contributions to be paid by small employers
toward the premiums incurred on behalf of covered eligible
employees.
' (2) Notwithstanding any other health benefit plan contracted
for and offered by the board, the board shall contract for a
health benefit plan or plans best designed to meet the needs and
provide for the welfare of eligible employees and small
employers.
' (3) The board may approve more than one carrier for each type
of plan contracted for and offered, but the number of carriers
shall be held to a number consistent with adequate service to
eligible employees and family members.
' (4) Where appropriate for a contracted and offered health
benefit plan, the board shall provide options under which an
eligible employee may arrange coverage for family members of the
employee.
' (5) In developing any health benefit plan, the board may
provide an option of additional coverage for eligible employees
and family members at an additional cost or premium.
' (6) Transfer of enrollment from one health benefit plan to
another shall be open to all eligible employees and family
members under rules adopted by the board.
' (7) If the board requests less health care service or benefit
than is otherwise required by state law, a carrier is not
required to offer such service or benefit.
' (8) { + The board may contract for and offer + } health
benefit plans for small employers { - contracted for and
offered by the board must - } { + that + } provide a sufficient
level of benefits to be eligible for a subsidy under ORS
735.724 { + as well as health benefit plans for small employers
that are not eligible for a subsidy under ORS 735.724 + }.
' (9) The board may employ whatever means are reasonably
necessary to carry out the purposes of ORS 735.700 to 735.740.
Such authority includes but is not limited to authority to seek
clarification, amendment, modification, suspension or termination
of any agreement or contract which in the board's judgment
requires such action.
' { + SECTION 4. + } { + Section 5 of this 2003 Act is added
to and made a part of ORS 735.700 to 735.740. + } { + + }
' { + SECTION 5. + } { + (1) The Insurance Pool Governing
Board shall submit to the Director of the Department of Consumer
and Business Services any information requested by the director
for the purpose of assessing the impact of the amendments to ORS
735.700, 735.702 and 735.710 by sections 1, 2 and 3 of this 2003
Act.
' (2) The board shall report the results of the assessment
conducted under subsection (1) of this section to the
Seventy-fourth Legislative Assembly. The report shall include,
but not be limited to:
' (a) The demographics of small employers obtaining health
benefit plans from the board;
' (b) The carriers with whom the board has contracts to offer
health benefit plans for small employers; and
' (c) The premiums charged for health benefit plans for small
employers. + }
' { + SECTION 6. + } ORS 735.700, as amended by section 1 of
this 2003 Act, is amended to read:
' 735.700. As used in ORS 735.700 to 735.740, unless the
context requires otherwise:
' (1) 'Board' means the Insurance Pool Governing Board
established under ORS 735.704.
' (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.
' (3) 'Class of employee' means an employee classed as either
management or nonmanagement employee.
' (4) 'Eligible employee' means an employee of an employer who
is employed by the employer for an average of at least 17.5 hours
per week { - , - } { + who elects to participate in one of the
group benefit plans provided through board action, and + } sole
proprietors, business partners, and limited partners. The term
does not include individuals:
' (a) Engaged as independent contractors.
' (b) Whose periods of employment are on an intermittent or
irregular basis.
' { + (c) Who have been employed by the employer for fewer
than 90 days. + }
' (5) '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 { - , or any other
dependents eligible under the terms of the health benefit plan
selected by the employee's employer - } .
' (6) 'Health benefit plan' means a contract for group medical,
surgical, hospital or any other remedial care recognized by state
law and related services and supplies.
' (7) 'Premium' means the monthly or other periodic charge for
a health benefit plan.
' { + SECTION 7. + } ORS 735.702, as amended by section 2 of
this 2003 Act, is amended to read:
' 735.702. To increase access to health insurance and health
care, the Insurance Pool Governing Board shall provide:
' (1) Information about health benefit plans and the premiums
charged for those plans to self-employed individuals and small
employers in Oregon;
' (2) Direct assistance to health insurance agents and health
insurance consumers regarding health benefit plans;
' (3) A central source for information about resources for
health care and health insurance; and
' (4) Health benefit plans for small employers { + that have
not provided a group health benefit plan for eligible employees
for a period of at least one year + }.
' { + SECTION 8. + } ORS 735.710, as amended by section 3 of
this 2003 Act, is amended to read:
' 735.710. (1) In carrying out its duties under ORS 735.700 to
735.740, the Insurance Pool Governing Board { - may - }
{ + shall + }:
' (a) Enter into contracts for administration of ORS 735.700 to
735.740 including collection of premiums and paying carriers.
' (b) Retain consultants and employ staff.
' (c) Enter into contracts with carriers or health care
providers for health benefit plans { + , including contracts
where final payment may be reduced if usage is below a level
fixed in the contract + }.
' (d) Set premium rates for eligible employees and small
employers.
' (e) Perform other duties to provide low-cost health benefit
plans of types likely to be purchased by small employers.
' (f) Establish contributions to be paid by small employers
toward the premiums incurred on behalf of covered eligible
employees.
' (2) Notwithstanding any other health benefit plan contracted
for and offered by the board, the board shall contract for a
health benefit plan or plans best designed to meet the needs and
provide for the welfare of eligible employees and small
employers.
' (3) The board may approve more than one carrier for each type
of plan contracted for and offered, but the number of carriers
shall be held to a number consistent with adequate service to
eligible employees and family members.
' (4) Where appropriate for a contracted and offered health
benefit plan, the board shall provide options under which an
eligible employee may arrange coverage for family members of the
employee.
' (5) In developing any health benefit plan, the board may
provide an option of additional coverage for eligible employees
and family members at an additional cost or premium.
' (6) Transfer of enrollment from one health benefit plan to
another shall be open to all eligible employees and family
members under rules adopted by the board.
' (7) If the board requests less health care service or benefit
than is otherwise required by state law, a carrier is not
required to offer such service or benefit.
' (8) { - The board may contract for and offer - } Health
benefit plans for small employers { - that - } { + contracted
for and offered by the board must + } provide a sufficient level
of benefits to be eligible for a subsidy under ORS 735.724
{ - as well as health benefit plans for small employers that are
not eligible for a subsidy under ORS 735.724 - } .
' (9) The board may employ whatever means are reasonably
necessary to carry out the purposes of ORS 735.700 to 735.740.
Such authority includes but is not limited to authority to seek
clarification, amendment, modification, suspension or termination
of any agreement or contract which in the board's judgment
requires such action.
' { + SECTION 9. + } { + The amendments to ORS 735.700,
735.702 and 735.710 by sections 6, 7 and 8 of this 2003 Act
become operative on January 2, 2008. + }
' { + SECTION 10. + } { + Sections 2b and 5 of this 2003 Act
are repealed on January 2, 2008. + } { +
' SECTION 11. Section 12 of this 2003 Act is added to and made
a part of ORS 735.700 to 735.740. + }
' { + SECTION 12. + } { + The Insurance Pool Governing Board
may renew health benefit plans for small employers offered by the
board on or after the effective date of this 2003 Act that are
not eligible for a subsidy under ORS 735.724. + }
' { + SECTION 13. + } { + This 2003 Act being necessary for
the immediate preservation of the public peace, health and
safety, an emergency is declared to exist, and this 2003 Act
takes effect on its passage. + } ' .
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