2007 ORS 735.710¹
Additional duties of office
  • rules

(1) In carrying out its duties under ORS 735.700 (Definitions for ORS 735.700 to 735.714) to 735.714 (Renewal of health benefit plans for small employers) and 735.720 (Definitions for ORS 735.720 to 735.740) to 735.740 (Sanctions for violation of program requirements), the Office of Private Health Partnerships shall:

(a) Enter into contracts for administration of ORS 735.700 (Definitions for ORS 735.700 to 735.714) to 735.714 (Renewal of health benefit plans for small employers) and 735.720 (Definitions for ORS 735.720 to 735.740) to 735.740 (Sanctions for violation of program requirements), including collection of premiums and paying carriers.

(b) Retain consultants and employ staff.

(c) Enter into contracts with carriers or health care providers for health benefit plans, including contracts where final payment may be reduced if usage is below a level fixed in the contract.

(d) Set premium rates for eligible employees and small employers.

(e) Perform other duties to provide low-cost health benefit plans of types likely to be purchased by small employers.

(f) Establish contributions to be paid by small employers toward the premiums incurred on behalf of covered eligible employees.

(g) Establish procedures by rule for the publication or release of aggregate data relating to:

(A) Applicants for enrollment and persons enrolled in the Family Health Insurance Assistance Program;

(B) Health benefit plans for small employers offered by the office; and

(C) Other programs operated by the office.

(2) Notwithstanding any other health benefit plan contracted for and offered by the office, the office shall contract for a health benefit plan or plans best designed to meet the needs and provide for the welfare of eligible employees and small employers.

(3) The office may approve more than one carrier for each type of plan contracted for and offered, but the number of carriers shall be held to a number consistent with adequate service to eligible employees and family members.

(4) Where appropriate for a contracted and offered health benefit plan, the office shall provide options under which an eligible employee may arrange coverage for family members of the employee.

(5) In developing any health benefit plan, the office may provide an option of additional coverage for eligible employees and family members at an additional cost or premium.

(6) Transfer of enrollment from one health benefit plan to another shall be open to all eligible employees and family members under rules adopted by the office.

(7) If the office requests less health care service or benefit than is otherwise required by state law, a carrier is not required to offer such service or benefit.

(8) Health benefit plans for small employers contracted for and offered by the office must provide a sufficient level of benefits to be eligible for a subsidy under ORS 735.724 (Application to participate in program).

(9) The office may employ whatever means are reasonably necessary to carry out the purposes of ORS 735.700 (Definitions for ORS 735.700 to 735.714) to 735.714 (Renewal of health benefit plans for small employers) and 735.720 (Definitions for ORS 735.720 to 735.740) to 735.740 (Sanctions for violation of program requirements). Such authority includes but is not limited to authority to seek clarification, amendment, modification, suspension or termination of any agreement or contract that in the office’s judgment requires such action. [Formerly 653.745; 2003 c.742 §§3,8; 2005 c.238 §§3,4; 2005 c.262 §§3,4; 2005 c.727 §§3,4; 2005 c.744 §§19,20]

Note: See note under 735.700 (Definitions for ORS 735.700 to 735.714).

1 Legislative Counsel Committee, CHAPTER 735—Alternative Insurance, https://­www.­oregonlegislature.­gov/­bills_laws/­ors/­735.­html (2007) (last ac­cessed Feb. 12, 2009).
 
2 OregonLaws.org contains the con­tents of Volume 21 of the ORS, inserted along­side the per­tin­ent statutes. See the preface to the ORS An­no­ta­tions for more information.
 
3 OregonLaws.org assembles these lists by analyzing references between Sections. Each listed item refers back to the current Section in its own text. The result reveals relationships in the code that may not have otherwise been apparent.