SB 1003. Association Health Plans

The passage of HB 3321 (2007) allowed group health insurers more flexibility in selling association and trust health benefit plans to small employer groups. The bill established protections to keep groups insured under these plans from losing coverage due to high claims, and made out-of-state association and trust health plans subject to the same requirements as Oregon-based associations. One of the protections established by HB 3321 was the requirement that associations maintain a retention rate of 95% in order to maintain their status.

Some associations have been struggling to maintain this retention rate and some have failed altogether. SB 1003 allows associations to seek a waiver of the retention rate. DCBS would establish standards to review the requests.

Oregon Insurance Division Director Teresa Miller has stated that she intends to use the following criteria for granting waivers from the 95% requirement:

• Loss ratios of the small employer groups remaining in the association as well as the loss ratios of the small employer groups that left the association;
• Reasons small employers left the association;
• Rate increases facing small employers that left the association compared to rate increases facing small employers remaining in the association; and
• Any other reasons the association health plan fails to meet the retention rate.

Action: Passed House and Senate

HB 3611. Deductibility of Individual Health Insurance Premiums.

HB 3166 started the session as an attempt to make premiums for individual health plans deductible. However, when the bill received a fiscal impact statement of $160m/year, the House Health Care Committee began discussing ways to make the plan revenue neutral. The first idea they had was to cap the deductibility of premiums for group plans. The proposal received a fair amount of consideration, and eventually was sent to the Revenue Committee for analysis.

Action: Moved to House Revenue for further review

HB 3659. Temporary High Risk Pool for Health Insurance

The Oregon Medical Insurance Pool (OMIP) is the state's high-risk health insurance pool. The current budget for OMIP is $407.1 million. The program insures about 18,000 Oregonians who fall into one or more of the three following eligibility categories:

1. Those who are unable to obtain commercial medical insurance because of pre-existing health conditions;
2. Those who are eligible for portability coverage but have no access to commercial portability plans; and
3. Those who are eligible for an 80% Federal Health Coverage Tax Credit because they lost their jobs due to foreign trade or their company declared bankruptcy and they fall under the Pension Benefit Guarantee Corporation.

OMIP enrollees cover about 50% of the program's medical and drug claim costs through premium payments, with the remaining cost covered by an assessment on commercial insurers doing business in Oregon.

National health reform legislation proposals have included an expansion of state high-risk pools as an interim way to make health insurance available to more uninsured people. Both the House and Senate versions of health care reform packages contain provisions that require the Secretary of the U.S. Department of Health and Human Services to establish a Temporary National High Risk Pool Program. HB 3659-A creates a fund that would contain any Federal Funds received from the federal government for a high-risk pool program. Monies in the fund are continuously appropriated to the OMIP Board. Expenditures from this fund could be limited by the Legislative Assemblyalthough expenditures from the OMIP are currently non-limited.

Action: Passed House and Senate

HB 3664. Health Coverage for Foster Children

Creates a new eligibility category in the Oregon Health Plan for individuals from ages 18 to 21 who, immediately prior to their 18th birthdays, were in a foster family home or licensed child-caring agency or institution. Currently, children (under 18) in foster care are eligible for Medicaid-funded health care. HB 3664 would extent that eligibility through a child's 21st year.

The 1% commercial premium tax passed in 2009 funds an expansion of public health coverage to children. Through this program, children in households with incomes up to the 300% of the federal poverty level can receive Medicaid or subsidized commercial health insurance depending on their specific household income. The Department of Human Services testified that it will have adequate premium tax revenue to fund the original Health Care for All Oregon Children program as well as this proposed expansion. For the rest of the 2009-11 biennium, the expansion is expected to cost $0.5 million in premium tax revenue, (to $1.3 million total funds). In 2011-2013, it will cost $1.8 million in premium tax revenue, ($4.6 million total funds).

Action: Passed House and Senate

HB 3665. Dental Services Contracts

Most companies that sell dental benefit plans require, as part of their contract with dentists, that these dentists give a discount to plan enrollees for services not covered by the plan. House Bill 3665A prohibits dental service contracts from requiring such a discount on charges for noncovered services.

Action: Passed House and Senate