73rd OREGON LEGISLATIVE ASSEMBLY--2005 Regular Session
Enrolled
Senate Bill 501
Sponsored by Senators COURTNEY, MONNES ANDERSON; Senators BATES,
DEVLIN, MORRISETTE, WALKER
CHAPTER ................
AN ACT
Relating to health insurance; and declaring an emergency.
Be It Enacted by the People of the State of Oregon:
SECTION 1. { + Section 2 of this 2005 Act is added to and made
a part of ORS 743.730 to 743.773. + }
SECTION 2. { + (1) Each carrier offering a health benefit plan
shall submit to the Director of the Department of Consumer and
Business Services on or before April 1 of each year a report that
contains:
(a) The following information for the preceding year that is
derived from the exhibit of premiums, enrollment and utilization
included in the carrier's annual report:
(A) The total number of members;
(B) The total amount of premiums;
(C) The total amount of costs for claims;
(D) The medical loss ratio;
(E) The average amount of premiums per member per month; and
(F) The percentage change in the average premium per member per
month, measured from the previous year.
(b) The following aggregate financial information for the
preceding year that is derived from the carrier's annual report:
(A) The total amount of general administrative expenses,
including identification of the five largest nonmedical
administrative expenses and the assessment against the carrier
for the Oregon Medical Insurance Pool;
(B) The total amount of the surplus maintained;
(C) The total amount of the reserves maintained for unpaid
claims;
(D) The total net underwriting gain or loss; and
(E) The carrier's net income after taxes.
(2) A carrier shall electronically submit the information
described in subsection (1) of this section in a format and
according to instructions prescribed by the Department of
Consumer and Business Services by rule after obtaining a
recommendation from the Health Insurance Reform Advisory
Committee.
(3) The advisory committee shall evaluate the reporting
requirements under subsection (1)(a) of this section by the
following market segments:
(a) Individual health benefit plans;
(b) Health benefit plans for small employers;
Enrolled Senate Bill 501 (SB 501-B) Page 1
(c) Health benefit plans for employers described in ORS
743.733; and
(d) Health benefit plans for employers with more than 50
employees.
(4) The department shall make the information reported under
this section available to the public through a searchable public
website on the Internet. + }
SECTION 3. { + Notwithstanding section 2 (1) of this 2005 Act,
a carrier described in section 2 (1) of this 2005 Act shall
submit its first report to the Director of the Department of
Consumer and Business Services on or before July 1, 2006. + }
SECTION 4. Notwithstanding section 2 (1) of this 2005 Act, a
carrier shall include the information described in section 2
(1)(a)(F) of this 2005 Act beginning with the annual report for
2007.
SECTION 5. { + Section 6 of this 2005 Act is added to and made
a part of the Insurance Code. + }
SECTION 6. { + (1) An insurer offering a health insurance
policy that covers hospital, medical or surgical expenses, other
than coverage limited to expenses from accidents or specific
diseases, shall provide coverage for the following colorectal
cancer screening examinations and laboratory tests:
(a) For an insured 50 years of age or older:
(A) One fecal occult blood test per year plus one flexible
sigmoidoscopy every five years;
(B) One colonoscopy every 10 years; or
(C) One double contrast barium enema every five years.
(b) For an insured who is at high risk for colorectal cancer,
colorectal cancer screening examinations and laboratory tests as
recommended by the treating physician.
(2) For the purposes of subsection (1)(b) of this section, an
individual is at high risk for colorectal cancer if the
individual has:
(a) A family medical history of colorectal cancer;
(b) A prior occurrence of cancer or precursor neoplastic
polyps;
(c) A prior occurrence of a chronic digestive disease condition
such as inflammatory bowel disease, Crohn's disease or ulcerative
colitis; or
(d) Other predisposing factors.
(3) Health care service contractors, as defined in ORS 750.005,
and trusts carrying out a multiple employer welfare arrangement,
as defined in ORS 750.301, are also subject to this section. + }
SECTION 7. { + Section 6 of this 2005 Act applies to health
insurance policies issued or renewed on or after January 1,
2006. + }
SECTION 8. { + This 2005 Act being necessary for the immediate
preservation of the public peace, health and safety, an emergency
is declared to exist, and this 2005 Act takes effect on its
passage. + }
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Enrolled Senate Bill 501 (SB 501-B) Page 2
Passed by Senate May 10, 2005
Repassed by Senate July 28, 2005
...........................................................
Secretary of Senate
...........................................................
President of Senate
Passed by House July 26, 2005
...........................................................
Speaker of House
Enrolled Senate Bill 501 (SB 501-B) Page 3
Received by Governor:
......M.,............., 2005
Approved:
......M.,............., 2005
...........................................................
Governor
Filed in Office of Secretary of State:
......M.,............., 2005
...........................................................
Secretary of State
Enrolled Senate Bill 501 (SB 501-B) Page 4