70th OREGON LEGISLATIVE ASSEMBLY--1999 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 1781

                         Senate Bill 767

Sponsored by Senator TROW (at the request of Michael Saslow)


                             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.

  Requires Medicare supplement insurance outline of coverage to
include statement specifying that policy does not provide
coverage for costs of assisted living arrangements, residential
care, adult day care or adult foster home care and does not
necessarily provide coverage for long term nursing home or home
care costs.
  Directs Senior and Disabled Services Division to develop
outreach program to educate Oregonians about long term care needs
and options.

                        A BILL FOR AN ACT
Relating to long term care; creating new provisions; and amending
  ORS 743.685.
Be It Enacted by the People of the State of Oregon:
  SECTION 1. ORS 743.685 is amended to read:
  743.685. (1) In order to provide for full and fair disclosure
in the sale of Medicare supplement policies, no Medicare
supplement policy or certificate shall be delivered in this state
unless an outline of coverage is delivered to the applicant at
the time application is made.
  (2) The Director of the Department of Consumer and Business
Services shall prescribe the format and content of the outline of
coverage required by subsection (1) of this section. The director
shall consult with the Governor's Commission on Senior Services
concerning the content and format of the outline of coverage,
especially in reference to the ease with which senior citizens
may understand the form and compare the coverage provided under
the policy to which the outline of coverage refers. For purposes
of this section, 'format' means style, arrangements and overall
appearance, including such items as the size, color and
prominence of type and arrangement of text and captions. The
outline of coverage required by subsection (1) of this section
shall include at least the following:
  (a) A description of the principal benefits and coverage
provided in the policy;
  (b) A statement of the renewal provisions, including any
reservation by the insurer of a right to change premiums and
disclosure of the existence of any automatic renewal premium
increases based on the policyholder's age;   { - and - }
  (c) A statement that the outline of coverage is a summary of
the policy issued or applied for and that the policy should be
consulted to determine governing contractual provisions
 { - . - }  { + ; and
  (d) A statement specifying that the Medicare supplement policy
does not necessarily provide coverage for all long term nursing
home or home care costs, and does not provide coverage for costs
of assisted living arrangements, residential care, adult day
care, adult foster home care or related drugs, treatments and
services. + }
  (3) Insurers shall fill out the standardized form and have the
completed information included on the form approved by the
director before selling supplemental Medicare coverage in this
state.
  (4) In the purchase or renewal of a Medicare supplement policy,
a copy of the outline of coverage must be used in explaining
policy coverage to a purchaser and shall be provided to the
applicant at the time the sales presentation is made. The
completed outline of coverage shall be considered part of the
sales presentation materials for the purposes of ORS 742.009.
  (5) The insurer shall obtain acknowledgment of receipt or
certify delivery of the outline of coverage at the time of sale.
  (6) The director may adopt by rule a standard form and the
contents of an informational brochure for persons eligible for
Medicare, which is intended to improve the buyer's ability to
select the most appropriate coverage and improve the buyer's
understanding of Medicare. Except in the case of direct response
insurance policies, the director may require by rule that the
information brochure be provided to any prospective insureds
eligible for Medicare concurrently with delivery of the outline
of coverage. With respect to direct response insurance policies,
the director may require by rule that the prescribed brochure be
provided upon request to any prospective insureds eligible for
Medicare, but in no event later than the time of policy delivery.
  (7) The director may adopt by rule captions or notice
requirements, determined to be in the public interest and
designed to inform prospective insureds that particular insurance
coverages are not Medicare supplement coverages, for all health
insurance policies sold to persons eligible for Medicare, other
than:
  (a) Medicare supplement policies; or
  (b) Disability income policies.
  (8) The director may adopt rules governing the full and fair
disclosure of the information in connection with the replacement
of health insurance policies, subscriber contracts or
certificates by persons eligible for Medicare.
  SECTION 2.  { + The Senior and Disabled Services Division, in
cooperation with the Department of Consumer and Business
Services, shall develop and implement a citizen outreach program
to educate Oregonians regarding their potential long term care
needs and the options available to meet those needs, including
but not limited to the role of long term care insurance. + }
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