Bill Text: OR HB3293 | 2011 | Regular Session | Introduced
Bill Title: Relating to benefit plans offered by local governments; appropriating money; declaring an emergency.
Spectrum: Committee Bill
Status: (Failed) 2011-06-30 - In committee upon adjournment. [HB3293 Detail]
Download: Oregon-2011-HB3293-Introduced.html
76th OREGON LEGISLATIVE ASSEMBLY--2011 Regular Session
NOTE: Matter within { + braces and plus signs + } in an
amended section is new. Matter within { - braces and minus
signs - } is existing law to be omitted. New sections are within
{ + braces and plus signs + } .
LC 250
House Bill 3293
Sponsored by COMMITTEE ON HEALTH CARE
SUMMARY
The following summary is not prepared by the sponsors of the
measure and is not a part of the body thereof subject to
consideration by the Legislative Assembly. It is an editor's
brief statement of the essential features of the measure as
introduced.
Creates Local Government Benefit Board. Requires Governor to
appoint members of board for four-year terms. Directs board to
contract for health benefit plans for officials, officers and
employees of local governments. Requires board to adopt rules.
Permits payroll officers to deduct amounts for benefit plans from
eligible enrollee's wages.
Creates Local Government Benefit Account and Local Government
Benefit Board Revolving Fund. Requires amount not to exceed two
percent of monthly employer and eligible enrollee contributions
for benefit plans to be deposited in Local Government Benefit
Account. Appropriates to board moneys from account and fund to
cover administrative expenses.
Prohibits local governments, on and after October 1, 2012, from
offering health benefit plans other than health benefit plans
provided by board. Provides exceptions.
Requires board, before October 1, 2012, to enter into contracts
for health benefit plans. Requires board to offer range of health
benefit plan designs sufficient to ensure that, when health
benefit plans are first provided to local government, local
government and eligible enrollees can choose health benefit plans
that are comparable in design to, and are not more expensive
than, health benefit plans provided by local government
immediately before purchase of health benefit plans provided by
board.
Declares emergency, effective on passage.
A BILL FOR AN ACT
Relating to benefit plans offered by local governments;
appropriating money; and declaring an emergency.
Be It Enacted by the People of the State of Oregon:
SECTION 1. { + As used in sections 1 to 13 of this 2011 Act,
unless the context requires otherwise:
(1) 'Benefit plan' includes but is not limited to insurance, as
defined in ORS 731.102, and health benefit plans paid for by
local governments for the benefit of local government officials,
officers or employees.
(2) 'Carrier' means an insurer or a health care service
contractor holding a valid certificate of authority issued by the
Department of Consumer and Business Services.
(3) 'Eligible enrollee' means:
(a) An official, officer or employee of a local government who
elects to participate in one of the benefit plans described in
sections 3 to 7 of this 2011 Act; and
(b) An official, officer or employee of a local government,
whether or not retired, who has reached the applicable retirement
age and who:
(A) Receives a payment or distribution under the Oregon Public
Service Retirement Plan; or
(B) Is eligible to receive a payment or distribution under any
other retirement benefit plan offered by the local government.
(4) 'Family member' means the spouse of an eligible enrollee,
the child or stepchild under 26 years of age of an eligible
enrollee and any other relatives of an eligible enrollee as
prescribed by the Local Government Benefit Board.
(5) 'Health benefit plan' means:
(a) Health insurance, as defined in ORS 731.162;
(b) Health care services provided by a health care service
contractor, as defined in ORS 750.005, that are paid for by local
governments for the benefit of local government officials,
officers and employees; or
(c) Health care services provided to officials, officers and
employees of a local government and paid for by the local
government directly or through a third party administrator.
(6) 'Local government' has the meaning given that term in ORS
174.116.
(7) 'Local service district' has the meaning given that term in
ORS 174.116.
(8) 'Payroll disbursing officer' means the officer or official
authorized to disburse salaries and wages of officials, officers
and employees of a local government.
(9) 'Premium' means the monthly or other periodic charge,
including administrative fees of the Local Government Benefit
Board, for a benefit plan. + }
SECTION 2. { + (1) There is established in the Oregon Health
Authority the Local Government Benefit Board consisting of 11
members appointed by the Governor, including:
(a) One member representing a rural city government;
(b) One member representing an urban city government;
(c) One member representing a rural county government;
(d) One member representing an urban county government;
(e) One member representing a rural local service district;
(f) One member representing an urban local service district;
(g) One member representing nonmanagement city employees;
(h) One member representing nonmanagement county employees;
(i) One member representing nonmanagement employees of local
service districts;
(j) One member from a labor organization that represents local
government employees; and
(k) One member with expertise in health policy or risk
management.
(2) The term of office of each member is four years, but a
member serves at the pleasure of the Governor. Before the
expiration of the term of a member, the Governor shall appoint a
successor to take office upon the date of that expiration. A
member is eligible for reappointment. If there is a vacancy for
any cause, the Governor shall make an appointment to become
immediately effective for the unexpired term.
(3) A member of the board is not entitled to compensation, but
may be reimbursed from funds available to the board for actual
and necessary travel and other expenses incurred by the member in
the performance of the member's official duties in the manner and
amount provided in ORS 292.495.
(4) The board shall select one of its members as chairperson
and another as vice chairperson, for such terms and with duties
and powers necessary for the performance of the functions of such
offices as the board determines.
(5) A majority of the members of the board constitutes a quorum
for the transaction of business.
(6) The board shall meet at times and places specified by the
call of the chairperson or of a majority of the members of the
board.
(7) The board may retain consultants, brokers or other advisory
personnel when necessary and, subject to any applicable
provisions of ORS chapter 240, may employ staff required to carry
out the duties of the board.
(8) The board shall adopt rules to carry out the provisions of
sections 1 to 13 of this 2011 Act. + }
SECTION 3. { + (1) The Local Government Benefit Board shall
contract for benefit plans best designed to meet the needs and
provide for the welfare of eligible enrollees and local
governments.
(2) The board may approve more than one carrier for each type
of benefit plan offered, but the board shall limit the number of
carriers to a number consistent with adequate service to eligible
enrollees.
(3) The board shall provide options under which an eligible
enrollee may arrange coverage for family members under a benefit
plan. The eligible enrollee may be required to pay an additional
premium for this coverage if the coverage of the family member is
not provided by the local government.
(4) A local government shall provide that payroll deductions
for benefit plan costs that are not payable by the local
government may be made upon receipt of a signed authorization
from an eligible enrollee indicating an election to enroll in the
benefit plan or plans selected and allowing the withholding of
those costs from the eligible enrollee's pay.
(5) The board shall adopt rules providing that transfer of
enrollment from one benefit plan to another is open to all
eligible enrollees and family members. + }
SECTION 4. { + (1) The Local Government Benefit Board shall
design benefit packages, prepare specifications, analyze carrier
bids and award contracts for health benefit plans for local
governments in accordance with this section and section 3 (1) of
this 2011 Act.
(2) The board shall make available to eligible enrollees
comprehensive health benefit plans, health benefit plans
providing dental only and vision only coverage, and fully insured
long term care benefit plans described in section 6 of this 2011
Act. Contracts shall be signed by the chairperson on behalf of
the board.
(3) In considering whether to enter into a contract for a
health benefit plan, the board shall place emphasis on:
(a) Enrollee choice among high-quality plans;
(b) Encouragement of a competitive marketplace;
(c) Plan performance and information;
(d) Local government flexibility in plan design and
contracting;
(e) Quality customer service;
(f) Creativity and innovation;
(g) Plan benefits as part of total employee compensation; and
(h) Improvement of enrollee health.
(4) The board may not deny consideration of a carrier's bid
under subsection (1) of this section on the basis that the
carrier serves a limited geographic region in this state if the
benefit plan meets the criteria of subsection (3) of this
section.
(5) The premium established by the board for a health benefit
plan may not include the cost of enrollment of the eligible
enrollee and administrative expenses for the benefit plan.
(6) The board may adopt rules not inconsistent with sections 1
to 13 of this 2011 Act to determine the terms and conditions of
participation by eligible enrollees and their family members in
health benefit plans and the coverage provided under those
benefit plans. + }
SECTION 5. { + (1) In addition to contracting for health
benefit plans, the Local Government Benefit Board may contract
with carriers to provide other benefit plans, including but not
limited to life, supplemental medical, supplemental dental,
supplemental vision, accidental death or disability insurance.
(2) The premium established by the board for a benefit plan
described in subsection (1) of this section may include the cost
of enrollment of the eligible enrollee and administrative
expenses for the plan.
(3) If the board does not contract for a benefit plan described
in subsection (1) of this section, a local government may
contract for the benefit plan on behalf of the officials,
officers and employees of the local government. A benefit plan
entered into by a local government is subject to approval by the
board before the plan becomes operative. + }
SECTION 6. { + (1) The Local Government Benefit Board shall
make available to eligible enrollees and family members one or
more fully insured long term care benefit plans. For purposes of
this subsection, the board shall prescribe that 'family member '
includes the parents of the eligible enrollee and the parents of
the spouse of the eligible enrollee.
(2) The board, in consultation with the Public Employees
Retirement System, shall develop long term care benefit plan
specifications, eligibility rules, underwriting guidelines and
consumer educational materials.
(3) The board's educational materials for eligible enrollees
shall provide information on the potential need for long term
care, methods of financing long term care and the availability of
long term care benefit plans offered by the board.
(4) Participation in any long term care benefit plan made
available by the board is voluntary and is subject to reasonable
underwriting guidelines and eligibility rules established by the
board.
(5) Unless otherwise agreed to by the local government, the
eligible enrollee is responsible for the payment of the long term
care benefit plan premium established by the board. + }
SECTION 7. { + (1) The Local Government Benefit Board may
provide and administer flexible benefit plans under which
eligible enrollees may choose among taxable and nontaxable
benefits as provided in the federal Internal Revenue Code.
(2) In providing flexible benefit plans, the board may offer:
(a) Health benefit plans as described in section 4 of this 2011
Act.
(b) Other benefit plans as described in section 5 of this 2011
Act.
(c) Any other benefit that may be excluded from an eligible
enrollee's gross income under the federal Internal Revenue Code.
(d) Any part or all of the local government contribution for
benefit plans in cash to the eligible enrollee.
(3) In developing flexible benefit plans, the board shall
design the plans to best promote the welfare of eligible
enrollees and affordability for local governments.
(4) The board may pay some or all of the cost of administering
flexible benefit plans with funds from which the board is
authorized to pay general administrative expenses incurred by the
board.
(5) The board shall adopt rules necessary for the establishment
and administration of flexible benefit plans.
(6) The board may contract with private organizations for
administration of flexible benefit plans in accordance with rules
adopted under subsection (5) of this section. + }
SECTION 8. { + (1) Upon receipt of a written withholding
authorization from an eligible enrollee, a payroll disbursing
officer may deduct from the salary or wages of the eligible
enrollee the amount of money indicated in the request, for
payment of the eligible enrollee's share of the cost of benefit
plans selected by the eligible enrollee.
(2) Amounts deducted under subsection (1) of this section shall
be paid over promptly:
(a) To the Local Government Benefit Board, the carriers or the
persons responsible for payment of premiums to carriers in
accordance with the terms of contracts for benefit plans; or
(b) With respect to self-insured local governments, in
accordance with rules and procedures adopted by the board.
(3) The payroll disbursing officer shall report to the board
information specified by the board in a manner and form specified
by the board. The board may not impose reporting requirements
under this subsection that are unduly burdensome or costly to
local governments. + }
SECTION 9. { + (1) The Local Government Benefit Board may
enter an order withdrawing approval of a benefit plan after
providing sufficient notice in writing to the carrier, any
affected labor organization, local governments and eligible
enrollees of the plan, and affording opportunity for a public
hearing on the issues that may be involved. Thirty days after
entry of the order, the board shall terminate all withholding
authorizations of eligible enrollees and terminate all
board-approved participation in the plan.
(2) The board may terminate the participation of a local
government in a benefit plan if the local government fails to
perform, within three months after the action is due, an action
required by sections 1 to 13 of this 2011 Act or by board
rule. + }
SECTION 10. { + (1) There is created the Local Government
Benefit Account, separate and distinct from the General Fund.
Moneys in the account are continuously appropriated to the Local
Government Benefit Board to cover the board's administrative and
other expenses authorized by sections 1 to 13 of this 2011 Act.
(2) Subject to section 11 of this 2011 Act, an amount not to
exceed two percent of the monthly employer and eligible enrollee
contributions for benefit plans available under sections 1 to 13
of this 2011 Act shall be deposited in the account. + }
SECTION 11. { + Subject to legislative budgetary authorization
for operation of the Local Government Benefit Board and the
board's administration of benefit plans and other duties under
sections 1 to 13 of this 2011 Act, an amount not to exceed two
percent of the monthly employer and eligible enrollee
contributions for benefit plans shall be forwarded by each
participating local government to the board and deposited by the
board in the State Treasury to the credit of the Local Government
Benefit Account to meet the board's administrative and other
expenses authorized by sections 1 to 13 of this 2011 Act. The
board shall ensure that the balance in the account does not
exceed five percent of the monthly total of employer and eligible
enrollee contributions for more than four consecutive months. + }
SECTION 12. { + (1) There is created the Local Government
Benefit Board Revolving Fund, separate and distinct from the
General Fund. Moneys in the Local Government Benefit Board
Revolving Fund are continuously appropriated to the Local
Government Benefit Board to cover the board's administrative and
other expenses authorized by sections 1 to 13 of this 2011 Act.
Moneys in the fund may be retained for limited periods of time as
established by board rule for purposes including paying premiums,
controlling expenditures, stabilizing premiums and self-insuring.
The board may establish subaccounts within the fund.
(2) The following moneys shall be paid into the Local
Government Benefit Board Revolving Fund:
(a) All unused employer and eligible enrollee contributions for
benefit plans;
(b) All refunds and dividends from a carrier that has provided
benefit plans administered by the board; and
(c) All interest earned on the moneys in the fund. + }
SECTION 13. { + (1) Except as provided in subsection (2) of
this section:
(a) A local government may not provide or contract for a health
benefit plan unless the plan is provided and administered by the
Local Government Benefit Board under sections 1 to 13 of this
2011 Act.
(b) Eligible enrollees of a local government may participate in
benefit plans provided and administered by the board.
(2) A local government is not required to offer health benefit
plans made available by the board if the local government:
(a)(A) Is self-insured;
(B) Has an independent health insurance trust established and
functioning; or
(C) Has a contract with a carrier to provide health benefit
plans to officials, officers and employees of the local
government; and
(b)(A) Premiums for health benefit plans offered by the local
government are equal to or less than premiums for health benefit
plans made available by the board; and
(B) Health benefit plans offered by the local government
contain substantially the same benefit packages as health benefit
plans made available by the board.
(3) Once a local government offers to its officials, officers
or employees one or more health benefit plans made available by
the board, the local government may not thereafter offer health
benefit plans other than those made available by the board.
(4) A local government is obligated to bargain with its
organized employees or with the exclusive representative of its
organized employees concerning the local government's costs of
benefit plans. + }
SECTION 14. { + As used in sections 15 and 16 of this 2011
Act, ' benefit plan,' 'carrier,' 'eligible enrollee,' 'local
government' and 'premium' have the meanings given those terms in
section 1 of this 2011 Act. + }
SECTION 15. { + Notwithstanding section 13 of this 2011 Act, a
local government is not required to offer to its officials,
officers or employees health benefit plans made available by the
Local Government Benefit Board:
(1) Before October 1, 2012; or
(2) With respect to represented and unrepresented employees of
the local government, during the term of a collective bargaining
agreement that expires after June 30, 2012, provided the contract
with the carrier of the health benefit plan offered under the
agreement continues in effect and does not expire on or before
June 30, 2012. + }
SECTION 16. { + (1) Before October 1, 2012, the Local
Government Benefit Board shall enter into contracts for health
benefit plans for eligible enrollees in accordance with section 4
of this 2011 Act.
(2) The board shall offer a range of health benefit plan
designs sufficient to ensure that, when health benefit plans are
first provided by the board to a local government, the local
government and eligible enrollees can choose health benefit plans
that offer coverage substantially similar to and that are not
more costly than the health benefit plans the local government
provided immediately before the purchase of the health benefit
plans made available by the board. The board shall determine
premiums for health benefit plans based on the health benefit
plan designs and the aggregated experience of all local
governments participating in the health benefit plans. + }
SECTION 17. { + Notwithstanding the term of office specified
in section 2 of this 2011 Act, of the members first appointed to
the Local Government Benefit Board:
(1) Two shall serve for terms ending July 1, 2012.
(2) Two shall serve for terms ending July 1, 2013.
(3) Three shall serve for terms ending July 1, 2014.
(4) Four shall serve for terms ending four years after the
effective date of this 2011 Act. + }
SECTION 18. { + This 2011 Act being necessary for the
immediate preservation of the public peace, health and safety, an
emergency is declared to exist, and this 2011 Act takes effect on
its passage. + }
----------
