72nd OREGON LEGISLATIVE ASSEMBLY--2003 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 3674
 
                         Senate Bill 907
 
Sponsored by Senator GEORGE (at the request of John Ulwelling)
 
 
                             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.
 
  Permits carrier offering individual health benefit plans to
offer employer-sponsored individual health benefit plan.
  Sunsets January 2, 2010.
 
                        A BILL FOR AN ACT
Relating to individual health benefit plans; creating new
  provisions; and amending ORS 750.055.
Be It Enacted by the People of the State of Oregon:
  SECTION 1.  { + Sections 2, 3 and 4 of this 2003 Act are added
to and made a part of ORS chapter 743. + }
  SECTION 2.  { + As used in section 3 of this 2003 Act, '
employer-sponsored individual health benefit plan':
  (1) Means an individual health benefit plan for which a portion
of the premium or benefits is paid by an employer or for which an
employee is reimbursed, whether through wage adjustments or
otherwise, by the employer for any portion of the premium; and
  (2) Notwithstanding ORS 743.734, does not include a policy of
group health insurance as that term is described in ORS 743.522
or a group health benefit plan for the purposes of ORS 743.733 to
743.737. + }
  SECTION 3.  { + (1) A carrier, as defined in ORS 743.730, that
offers individual health benefit plans may offer one or more
employer-sponsored individual health benefit plans.
  (2) ORS 743.717, 743.729 and 743.767 do not apply to
employer-sponsored individual health benefit plans offered under
subsection (1) of this section.
  (3) A carrier must accept an individual for coverage under an
employer-sponsored individual health benefit plan and must renew
the policy except:
  (a) For nonpayment of the required premiums attributable to the
individual;
  (b) For fraud or misrepresentation by the individual;
  (c) When the carrier discontinues offering or renewing, or
offering and renewing, all of its employer-sponsored individual
health benefit plans in this state or in a specified service area
within this state; and
  (d) When the Director of the Department of Consumer and
Business Services orders the carrier to discontinue coverage in
accordance with procedures specified or approved by the director
upon finding that the continuation of the coverage would not be
 
in the best interests of the individual or would impair the
carrier's ability to meet its contractual obligations.
  (4) The Director of the Department of Consumer and Business
Services shall adopt rules necessary to implement and administer
this section. + }
  SECTION 4.  { + Each carrier that offers an employer-sponsored
individual health benefit plan under section 3 of this 2003 Act
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 sections 2 and 3 of this
2003 Act. + }
  SECTION 5. ORS 750.055 is amended to read:
  750.055. (1) The following provisions of the Insurance Code
shall apply to health care service contractors to the extent so
applicable and not inconsistent with the express provisions of
ORS 750.005 to 750.095:
  (a) ORS 705.137, 705.139, 731.004 to 731.150, 731.162, 731.216
to 731.362, 731.382, 731.385, 731.386, 731.390, 731.398 to
731.430, 731.428, 731.450, 731.454, 731.488, 731.504, 731.508,
731.509, 731.510, 731.511, 731.512, 731.574 to 731.620, 731.592,
731.594, 731.640 to 731.652, 731.730, 731.731, 731.735, 731.737,
731.750, 731.752, 731.804 and 731.844 to 731.992.
  (b) ORS 732.215, 732.220, 732.230, 732.245, 732.250, 732.320,
732.325 and 732.517 to 732.592, not including ORS 732.549 and
732.574 to 732.592.
  (c)(A) ORS 733.010 to 733.050, 733.080, 733.140 to 733.170,
733.210, 733.510 to 733.620, 733.635 to 733.680 and 733.695 to
733.780 apply to not-for-profit health care service contractors.
  (B) ORS chapter 733, not including ORS 733.630, applies to
for-profit health care service contractors.
  (d) ORS chapter 734.
  (e) ORS 742.001 to 742.009, 742.013, 742.061, 742.065, 742.150
to 742.162, 742.400, 742.520 to 742.540, 743.010, 743.013,
743.018 to 743.030, 743.050, 743.100 to 743.109, 743.402,
743.412, 743.472, 743.492, 743.495, 743.498, 743.522, 743.523,
743.524, 743.526, 743.527, 743.528, 743.529, 743.549 to 743.555,
743.556, 743.560, 743.600 to 743.610, 743.650 to 743.656,
743.693, 743.694, 743.697, 743.699, 743.701, 743.706 to 743.712,
743.721, 743.722, 743.726, 743.727, 743.728, 743.729, 743.804,
743.807, 743.808, 743.809, 743.814 to 743.839, 743.842, 743.845,
743.847, 743.854, 743.856, 743.857, 743.858, 743.859, 743.861,
743.862, 743.863, 743.864, 743.866 and 743.868.
  (f) The provisions of ORS chapter 744 relating to the
regulation of agents.
  (g) ORS 746.005 to 746.140, 746.160, 746.180, 746.220 to
746.370 and 746.600 to 746.690.
  (h) ORS 743.714, except in the case of group practice health
maintenance organizations that are federally qualified pursuant
to Title XIII of the Public Health Service Act unless the patient
is referred by a physician associated with a group practice
health maintenance organization.
  (i) ORS 735.600 to 735.650.
  (j) ORS 743.680 to 743.689.
  (k) ORS 744.700 to 744.740.
  (L) ORS 743.730 to 743.773.
  (m) ORS 731.485, except in the case of a group practice health
maintenance organization that is federally qualified pursuant to
Title XIII of the Public Health Service Act and that wholly owns
and operates an in-house drug outlet.
   { +  (n) Sections 2, 3 and 4 of this 2003 Act. + }
  (2) For the purposes of this section only, health care service
contractors shall be deemed insurers.
  (3) Any for-profit health care service contractor organized
under the laws of any other state which is not governed by the
insurance laws of such state, will be subject to all requirements
of ORS chapter 732.
  (4) The Director of the Department of Consumer and Business
Services may, after notice and hearing, adopt reasonable rules
not inconsistent with this section and ORS 750.003, 750.005,
750.025 and 750.045 that are deemed necessary for the proper
administration of these provisions.
  SECTION 6. ORS 750.055, as amended by section 5 of this 2003
Act, is amended to read:
  750.055. (1) The following provisions of the Insurance Code
shall apply to health care service contractors to the extent so
applicable and not inconsistent with the express provisions of
ORS 750.005 to 750.095:
  (a) ORS 705.137, 705.139, 731.004 to 731.150, 731.162, 731.216
to 731.362, 731.382, 731.385, 731.386, 731.390, 731.398 to
731.430, 731.428, 731.450, 731.454, 731.488, 731.504, 731.508,
731.509, 731.510, 731.511, 731.512, 731.574 to 731.620, 731.592,
731.594, 731.640 to 731.652, 731.730, 731.731, 731.735, 731.737,
731.750, 731.752, 731.804 and 731.844 to 731.992.
  (b) ORS 732.215, 732.220, 732.230, 732.245, 732.250, 732.320,
732.325 and 732.517 to 732.592, not including ORS 732.549 and
732.574 to 732.592.
  (c)(A) ORS 733.010 to 733.050, 733.080, 733.140 to 733.170,
733.210, 733.510 to 733.620, 733.635 to 733.680 and 733.695 to
733.780 apply to not-for-profit health care service contractors.
  (B) ORS chapter 733, not including ORS 733.630, applies to
for-profit health care service contractors.
  (d) ORS chapter 734.
  (e) ORS 742.001 to 742.009, 742.013, 742.061, 742.065, 742.150
to 742.162, 742.400, 742.520 to 742.540, 743.010, 743.013,
743.018 to 743.030, 743.050, 743.100 to 743.109, 743.402,
743.412, 743.472, 743.492, 743.495, 743.498, 743.522, 743.523,
743.524, 743.526, 743.527, 743.528, 743.529, 743.549 to 743.555,
743.556, 743.560, 743.600 to 743.610, 743.650 to 743.656,
743.693, 743.694, 743.697, 743.699, 743.701, 743.706 to 743.712,
743.721, 743.722, 743.726, 743.727, 743.728, 743.729, 743.804,
743.807, 743.808, 743.809, 743.814 to 743.839, 743.842, 743.845,
743.847, 743.854, 743.856, 743.857, 743.858, 743.859, 743.861,
743.862, 743.863, 743.864, 743.866 and 743.868.
  (f) The provisions of ORS chapter 744 relating to the
regulation of agents.
  (g) ORS 746.005 to 746.140, 746.160, 746.180, 746.220 to
746.370 and 746.600 to 746.690.
  (h) ORS 743.714, except in the case of group practice health
maintenance organizations that are federally qualified pursuant
to Title XIII of the Public Health Service Act unless the patient
is referred by a physician associated with a group practice
health maintenance organization.
  (i) ORS 735.600 to 735.650.
  (j) ORS 743.680 to 743.689.
  (k) ORS 744.700 to 744.740.
  (L) ORS 743.730 to 743.773.
  (m) ORS 731.485, except in the case of a group practice health
maintenance organization that is federally qualified pursuant to
Title XIII of the Public Health Service Act and that wholly owns
and operates an in-house drug outlet.
    { - (n) Sections 2, 3 and 4 of this 2003 Act. - }
  (2) For the purposes of this section only, health care service
contractors shall be deemed insurers.
  (3) Any for-profit health care service contractor organized
under the laws of any other state which is not governed by the
insurance laws of such state, will be subject to all requirements
of ORS chapter 732.
  (4) The Director of the Department of Consumer and Business
Services may, after notice and hearing, adopt reasonable rules
not inconsistent with this section and ORS 750.003, 750.005,
750.025 and 750.045 that are deemed necessary for the proper
administration of these provisions.
  SECTION 7.  { + Sections 2, 3 and 4 of this 2003 Act and the
amendments to ORS 750.055 by section 5 of this 2003 Act are
repealed on January 2, 2010. + }
  SECTION 8.  { + The amendments to ORS 750.055 by section 6 of
this 2003 Act become operative on January 2, 2010. + }
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