Laws & Rules

Proposed rules:

Qualified Health Plan Addendum for Indian Health Providers:

Adopts the Qualified Health Plan Addendum for Indian Health Providers, and requires insurers to use the addendum when contracting with Indian health providers for services to be offered as part of a plan certified by the Exchange as a qualified health plan.

Statement of Need, Notice of Proposed Rulemaking, Proposed Rules OAR 945-020-0040, QHP Addendum for Indian Health Care Providers 945-020-0040

Administrative Charges and Fees - Stand Alone Dental Plans:

Establishes the 2014 administrative fee to be paid by insurers offering stand alone dental plans through the Exchange.

Hearing Date:	July 16, 2013, 10 a.m.
Pertains to:	Establishes the 2014 administrative charge for insurers offering stand alone dental plans through the Exchange: OAR 945-030-0030 and 945-030-0040
Filed:	June 14, 2013
Last day for public comment:	July 23, 2013, 5 p.m. Submit comments to: public.comment@coveroregon.com

Statement of Need, Notice of Proposed Rulemaking, Proposed Rules OAR 945-030-0030 and 945-030-0040,

Eligibility Standards and Application Process:

Establishes eligibility standards and the application process for enrollment in a qualified health plan, and for insurance affordability programs available through the Exchange.

Hearing Date:	July 23, 2013, 10 a.m.
Pertains to:	Establishes eligibility standards for enrollment in a qualified health plan and insurance affordability programs available through the Exchange, and describes the application process. OAR 945-040-0010 through 945-040-0090
Filed:	June 6, 2013
Last day for public comment:	July 30, 2013, 5 p.m. Submit comments to: public.comment@coveroregon.com

Statement of Need, Notice of Proposed Rulemaking, Proposed Rule OAR 945-040-0010 through 945-040-0090,

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TEMPORARY RULES:

• Administrative charge for operating expenses – 945-030-0030 through 945-030-0040 (.pdf)

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Rules:

• Adoption of model rules of procedures for ORHIX – OAR 945-001-0001 through 945-001-0011 (.pdf)
• Employee criminal records check and fitness determination rule – OAR 945-010-0001 through 945-010-0101 (.pdf)
• Certification of plans as Qualified Health Plans – OAR 945-020-0010 through 945-020-0020 (.pdf)
• Administrative charge for operating expenses – OAR 945-030-0010 through 945-030-0040 (.pdf)
• Certification of Insurance Producers – OAR 945-050-0010 through 945-050-0020 (.pdf)

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2012 Legislation:

Governor Kitzhaber on March 8, 2012 signed House Bill 4164, which provides for legislative approval of the Oregon Health Insurance Exchange’s Business Plan and makes several technical changes to the laws governing the exchange. The bill passed the House 55-5 and the Senate 26-4. Specifically the bill does the following:

• Acknowledges approval of the Oregon Health Insurance Exchange Corporation business plan by deleting the requirement from statute.

• Fixes a drafting error so that the corporation can establish a line of credit and financial accounts in federally insured banks and credit unions.

• Clarifies that the corporation is subject to certain provisions of the Public Contracting Code. This provides a process for the corporation to use when a contract bidder protests an award and enables the corporation to keep proposals confidential until after the notice of intent to award a contract is issued.

• Exempts carriers providing benefit plans to the corporation from the requirements in the small group market that apply to insurance plans for employers with 50 or fewer employees. This will allow the corporation to design and pilot innovative plans for its employees, which could potentially become product offerings in the Exchange in the future. 

• Permits school districts and community colleges to opt out of the Oregon Educator Benefit Board to enroll in coverage through the Exchange beginning in October 2015. The corporation is directed to seek federal waivers to allow the districts to obtain coverage in the Exchange. A waiver is needed because employers with 100 or more employees are not allowed in the Exchange until 2017 (at the state’s option).

To read the bill in its entirety, click here (.pdf).

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2011 Legislation:

Senate Bill 99 established a public corporation to operate the Oregon Health Insurance Exchange in the public interest for the benefit of the people and businesses that obtain health insurance coverage through the Exchange. Governor Kitzhaber signed Senate Bill 99 on June 17, 2011. The Oregon Senate passed Senate Bill 99 with a vote of 24-5, and the House passed the bill 48-12.

• Senate Bill 99 (.pdf)