Oregon Proposes Worksite Health Billing Changes

September 17, 2002 at 08:00 PM
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NU Online News Service, Sept. 17, 6:15 p.m. – Oregon insurance regulators are trying to make it harder for insurers to sell workers individual health insurance policies at the worksite.

The Oregon Department of Consumer and Business Services has proposed regulatory changes that would prohibit insurers from collecting individual health policy premiums by "list billing," or sending bills that list the premiums due from each worker at a given employer to the employer.

Insurers could still sell individual health policies through the worksite, but the insurers would have to arrange to collect the premiums from the individual workers, officials say.

Oregon regulators say they are making the changes because they believe Oregon statutes require insurers to provide coverage for employees of small employers through group plans, rather than individual plans.

"Individual plans do not provide the same level of benefits and protections that small group plans do," according to a statement of need written by Joel Ario, the Oregon department's insurance administrator.

"For instance," Ario writes, "small employer coverage must be offered to employees on a guaranteed issuance basis without regard to the actual or expected health status of any eligible employee, but individual coverage is not issued on that basis."

Under the current rules, Oregon prohibits employers from using individual health policies to cover workers if the employers pay any portion of the premiums. But the state does allow list billing, on the assumption that some employers might allow insurers to sell individual policies to workers on an entirely voluntary, worker-paid basis.

The proposed changes would affect sections 836-053-0021, 836-053-0430 and 836-053-0440 of the Oregon Administrative Rules.

Members of the public have until Nov. 14 to comment on the proposed changes.

Links to the text of the proposed regulatory changes, a summary and a hearing notice are available at http://www.cbs.state.or.us/external/ins/docs/rules/proposed/rulemake.htm

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