75th OREGON LEGISLATIVE ASSEMBLY--2010 Special Session

                            Enrolled

                         House Bill 3666

Sponsored by COMMITTEE ON HEALTH CARE (at the request of Blue
  Cross/Blue Shield of Oregon)

                     CHAPTER ................

                             AN ACT

Relating to electronic health insurance administration; and
  declaring an emergency.

Be It Enacted by the People of the State of Oregon:

  SECTION 1.  { + Sections 2, 3 and 4 of this 2010 Act are added
to and made a part of the Insurance Code. + }
  SECTION 2.  { + As used in sections 3 and 4 of this 2010 Act:
  (1) 'Explanation of benefits' means claim processing advice or
notification of action on claims.
  (2) 'Payment, remittance and reconciliation information ' means
all information required for premium billing or invoicing,
facilitating timely electronic payment of premiums due,
delinquency notification, final billing notification or
termination of coverage.
  (3) 'Plan renewal information' means all correspondence and
materials related to an offer to renew insurance provided by an
insurer to a health insurance purchaser.
  (4) 'Quote information' means all correspondence and materials
related to an offer to insure or a rate quotation provided by an
insurer to a health insurance purchaser.
  (5) 'Sale and enrollment information' means all information
documenting the sale of a policy or certificate of health
insurance, the renewal of a policy or certificate of health
insurance, the enrollment of members in a group health insurance
plan or the enrollment of an individual in an individual health
insurance plan, including but not limited to:
  (a) The application for insurance;
  (b) Initial and ongoing documentation required by the insurer
to be provided by an insured to establish eligibility and
enrollment, adjudicate and process claims and prove prior
creditable coverage or duplicate coverage;
  (c) Premium information;
  (d) Documentation of the payment of a premium; and
  (e) Membership identification cards. + }
  SECTION 3.  { + (1) In the administration of small employer
group health insurance or individual health insurance, an insurer
may communicate one or more of the following by electronic means:
  (a) Quote information.
  (b) Sale and enrollment information.
  (c) Payment, remittance and reconciliation information.
  (d) Explanation of benefits.
  (e) Plan renewal information.

Enrolled House Bill 3666 (HB 3666-A)                       Page 1

  (f) Notifications required by law.
  (g) Other communications, documentation, revisions or materials
otherwise provided on paper.
  (2) Electronic administration of small employer group or
individual health insurance plans shall be transacted using
secure systems specifically designed by the insurer for the
purpose of electronic health insurance administration. + }
  SECTION 4.  { + (1) An insurer who elects to offer discounted
rates for a health insurance plan utilizing electronic
administration shall include the schedule of discounts for
utilization of electronic administration as part of a small
employer group health insurance or individual health insurance
rate filing. The rate discounts may be graduated and must be
proportionate to the amount of administrative cost savings the
insurer anticipates as a result of the use of electronic
transactions described in section 3 of this 2010 Act.
  (2) Discounted rates allowed under this section shall be
applied uniformly to all similarly situated small employer group
or individual health insurance purchasers of an insurer.
  (3) Discounts in premium rates under this section are not
premium rate variations for purposes of ORS 743.737 (8) or
743.767. + }
  SECTION 5.  { + Sections 2, 3 and 4 of this 2010 Act do not
require an insurer to offer discounted rates for a health
insurance plan utilizing electronic administration or require a
small employer group or an individual health insurance purchaser
to use electronic administration. + }
  SECTION 6.  { + This 2010 Act being necessary for the immediate
preservation of the public peace, health and safety, an emergency
is declared to exist, and this 2010 Act takes effect on its
passage. + }
                         ----------

Passed by House February 11, 2010

      ...........................................................
                                             Chief Clerk of House

      ...........................................................
                                                 Speaker of House

Passed by Senate February 20, 2010

      ...........................................................
                                              President of Senate

Enrolled House Bill 3666 (HB 3666-A)                       Page 2

Received by Governor:

......M.,............., 2010

Approved:

......M.,............., 2010

      ...........................................................
                                                         Governor

Filed in Office of Secretary of State:

......M.,............., 2010

      ...........................................................
                                               Secretary of State

Enrolled House Bill 3666 (HB 3666-A)                       Page 3