68th OREGON LEGISLATIVE ASSEMBLY--1995 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 460
House Bill 2191
Ordered printed by the Speaker pursuant to House Rule 12.00A (5).
Presession filed (at the request of Fiscal Policy Analysis
Division, Department of Administrative Services)
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 interest-bearing account for state employee benefit
plans. Authorizes State Employes' Benefit Board to offer direct
payment of benefit costs. Authorizes board to determine level of
benefit plan costs. Modifies definition of 'benefit plan' and '
carrier' to authorize board to contract with additional
providers. Prohibits benefit board from self-insuring life
insurance or disability insurance. Requires certain reporting and
certain plan regulations if benefit board self-insures.
A BILL FOR AN ACT
Relating to state employee benefit plans; creating new
provisions; amending ORS 243.105, 243.125, 243.130, 243.135,
243.145, 243.165, 243.175, 243.182, 243.185, 243.195, 243.205
and 243.215; and repealing ORS 243.180.
Be It Enacted by the People of the State of Oregon:
SECTION 1. ORS 243.105 is amended to read:
243.105. As used in ORS 243.105 to 243.205, unless the context
requires otherwise:
(1) 'State agency' means every state officer, board,
commission, department or other activity of state government.
(2) 'Eligible employee' means an officer or employee of a state
agency who elects to participate in one of the group benefit
plans described in ORS 243.135. The term includes state officers
and employees in the exempt, unclassified and classified service,
and state officers and employees, whether or not retired, who
receive a service or disability retirement allowance under the
Public Employes' Retirement System. The term does not include
individuals:
(a) Engaged as independent contractors;
(b) Whose periods of employment in emergency work are on an
intermittent or irregular basis;
(c) Who are employed on less than half-time basis unless the
individuals are employed in positions classified as job-sharing
positions or unless the individuals are defined as eligible under
rules of the State Employes' Benefit Board;
(d) Appointed under ORS 240.309;
(e) Provided sheltered employment or made-work by the state in
an employment or industries program maintained for the benefit of
such individuals; or
(f) Provided student health care services in conjunction with
their enrollment as students at the state institutions of higher
education.
(3) 'Administrator' means the Administrator of the Personnel
Division.
(4) ' { - Health - } Benefit plan' { - means a contract for
group medical, surgical, hospital or any other remedial care
recognized by state law and related services and supplies and
shall include - } { + includes, but is not limited to, contracts
for insurance or other benefits based on life; supplemental
medical, supplemental dental, optical, accidental death or
disability insurance; group medical, surgical, hospital or any
other remedial care recognized by state law; and related services
and supplies. 'Benefit plan' includes + } comparable benefits for
employees who rely on spiritual means of healing. { + ' Benefit
plan' does not include any long term or short term self-insured
disability plan or any self-insured accidental death
coverage. + }
(5) 'Premium' means the monthly or other periodic charge for a
benefit plan.
(6) 'Payroll disbursing officer' means the state officer or
official authorized to disburse moneys in payment of salaries and
wages of employees of a state agency.
(7) 'Carrier' means an insurance company or health care service
contractor holding a valid certificate of authority from the
Director of the Department of Consumer and Business Services, or
two or more companies or contractors acting together pursuant to
a joint venture, partnership or other joint means of
operation { + , or a guarantor of benefit plan coverage and
compensation approved by the board or any other authorized
benefit plan provider approved by the board + }.
(8) 'Family member' means an eligible employee's spouse and any
unmarried child or stepchild within age limits and other
conditions imposed by the board with regard to unmarried children
or stepchildren.
(9) 'Board' means the State Employes' Benefit Board.
SECTION 2. ORS 243.125 is amended to read:
243.125. (1) The { + State Employes' Benefit + } Board shall
prescribe rules for the conduct of its business. Members of the
board who are not members of the Legislative Assembly shall
receive no compensation for their services, but shall be paid for
their necessary and actual expenses while on official business.
Members of the board who are members of the Legislative Assembly
shall be paid compensation and expense reimbursement as provided
in ORS 171.072, payable from funds appropriated to the
Legislative Assembly. The board shall study all matters connected
with the providing of adequate { - health care - }
{ + benefit plan + } coverage for state employees on the best
basis possible with relation both to the welfare of the employees
and to the state. The board shall design benefits, devise
specifications, analyze carrier responses to advertisements for
bids and decide on the award of contracts. Contracts shall be
signed by the chairman on behalf of the board.
(2) Subject to ORS 183.310 to 183.550, the board may make rules
not inconsistent with ORS 243.105 to 243.205, 243.215 and 292.051
to determine the terms and conditions of eligible employee
participation and coverage { + and the method of payment for
benefit costs + }.
(3) The board shall prepare specifications, invite bids and do
acts necessary to award contracts for { - health - } benefit
plan
{ - and dental benefit plan - } coverage of eligible employees
{ - for a one- or two-year period - } .
(4) The board may retain consultants when it determines the
necessity and shall, subject to the State Personnel Relations
Law, employ such personnel as are required to perform the
functions of the board.
SECTION 3. ORS 243.130 is amended to read:
243.130. In designing benefits and devising specifications, as
required by ORS 243.125, the { + State Employes' Benefit + }
Board shall give primary consideration to { - health care - }
{ + benefit plan + } cost containment principles including:
(1) Multiple choices for employees and beneficiaries.
(2) Fixed employer subsidy to produce a personal financial
interest on the part of the employee.
(3) Fair market rules to protect both insurance providers and
covered employees.
(4) Competition between organized provider groups.
SECTION 4. ORS 243.135 is amended to read:
243.135. (1) Notwithstanding any other benefit plan contracted
for and offered by the { + State Employes' Benefit + } Board,
the board shall contract for a health benefit plan or plans best
designed to meet the needs and provide for the welfare of
eligible employees and the state.
(2) The board 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 their family members.
(3) Where appropriate for a contracted and offered
{ - health - } benefit plan, the board shall provide options
under which an eligible employee may arrange coverage for family
members.
(4) Payroll deductions for such costs as are not payable by the
state may be made upon receipt of a signed authorization from the
employee indicating an election to participate in the plan or
plans selected and the deduction of a certain sum from the
employee's pay.
(5) In developing any { - health - } benefit plan, the board
may provide an option of additional coverage for eligible
employees and their family members at an additional cost or
premium.
(6) Transfer of enrollment from one plan to another shall be
open to all eligible employees and their family members under
rules adopted by the board. Because of the special problems that
may arise in individual instances under comprehensive group
practice plan coverage involving acceptable physician-patient
relations between a particular panel of physicians and particular
eligible employees and their family members, the board shall
provide a procedure under which any eligible employee may apply
at any time to substitute a health service benefit plan for
participation in a comprehensive group practice benefit plan.
SECTION 5. ORS 243.145 is amended to read:
243.145. (1) The { + State Employes' Benefit + } Board shall
have authority to employ whatever means are reasonably necessary
to carry out the purposes of ORS 243.105 to 243.205, 243.215 and
292.051. Such authority shall include but is not limited to
authority to seek clarification, amendment, modification,
suspension or termination of any agreement or contract which in
the board's judgment requires such action.
(2) Upon providing specific notice in writing to the carrier,
employee organization, Oregon Department of Administrative
Services and affected, eligible employees, and after affording
opportunity for a public hearing upon the issues which may be
involved, the board may enter an order withdrawing approval of
any
{ - health - } benefit plan. Thirty days after entry of the
order, the board shall terminate all withholding authorizations
of eligible employees and terminate all state participation in
the plan.
(3) The board by order may terminate the participation of any
state agency if within three months the state agency fails to
perform any action required by ORS 243.105 to 243.205, 243.215
and 292.051 or by board rule.
SECTION 6. ORS 243.165 is amended to read:
243.165. (1) There { - hereby - } is created { + , separate
and distinct from + } { - in - } the General Fund { + , + } an
account to be known as the State Employes' Benefit Account, the
balances of which are continuously appropriated to cover { + the
costs of benefit plans and + } administrative expenses incurred
in connection with the administration of ORS 243.105 to 243.205,
243.215 and 292.051. { + All interest, if any, shall inure to
the benefit of the account. + }
(2) There hereby is appropriated to the State Employes' Benefit
Account all refunds and dividends from any carrier or contractor
because of any agreement or contract entered into between the
carrier and the { + State Employes' Benefit + } Board and,
subject to ORS 243.185, an amount not to exceed two percent of
the monthly state and employee contributions for any benefit
available under ORS 243.105 to 243.205, 243.215 and 292.051.
SECTION 7. { + Section 8 of this Act is added to and made a
part of ORS 243.105 to 243.205. + }
SECTION 8. { + (1) The State Employes' Benefit Board may offer
as a benefit plan choice, either in addition to or in lieu of
plans provided for in ORS 243.135, direct payment of benefit plan
costs. The board may by rule impose conditions on payments to
benefit plan providers.
(2) Whenever the board offers any self-insured benefit plan, it
must include authorized providers and coverage mandated by law
for so long as mandated by law.
(3) The board shall not self-insure life insurance.
(4) If the board exercises the option to self-insure, the board
shall provide a report biennially to the Legislative Assembly, as
part of the budget process, concerning the self-insurance program
and the status of the State Employes' Benefit Account established
under ORS 243.165.
(5) The board shall comply with the Insurance Code reporting
requirements for self-insured city and county plans, as described
in ORS 731.036 (6). + }
SECTION 9. ORS 243.175 is amended to read:
243.175. (1) The monthly contribution of each eligible employee
for { - health - } benefit plan coverage described in ORS
243.135 (1) shall be the total cost per month of the benefit
coverage afforded under the plan or plans, for which the employee
exercises the option, including the administrative expenses
therefor, less the portion thereof contributed by the state.
(2) The state contribution shall be the amount necessary to pay
the cost of the { - health - } benefit plan or plans,
including the cost of enrollment of all family members and the
eligible employees, including the administrative expenses
therefor, or the amount appropriated or otherwise authorized
therefor by the Legislative Assembly, whichever is the lesser.
(3) When more than one individual shares a single position that
is classified as a job-sharing position, the state shall
contribute to obtain coverage for the individuals a total amount
not greater than the amount referred to in subsection (2) of this
section to obtain coverage for one individual in the same
position. The individuals shall receive credit for the state
contribution in such proportions as they and the employer agree
upon, and each individual who desires coverage shall make further
contribution in such amounts as may be appropriate to comply with
subsection (1) of this section.
SECTION 10. ORS 243.182 is amended to read:
243.182. The { - health - } benefit contributions made by
employees and the state pursuant to ORS 243.175 { - and dental
benefit contributions made by employees and the state pursuant to
ORS 243.180 - } may be expended { - , respectively, - } solely
for { - health - } benefit plans { - and dental benefit plans
or may, if determined by the board to be appropriate, be
commingled and expended for either health benefit plans or dental
benefit plans, or both health benefit plans and dental benefit
plans - } .
SECTION 11. ORS 243.185 is amended to read:
243.185. Subject to legislative approval of budgetary
authorization for operation of the { + State Employes'
Benefit + } Board and its administration of the { - health - }
benefit plans and other duties under ORS 243.105 to 243.205,
243.215 and 292.051, an amount not to exceed two percent of the
state and the employee contributions, as described in ORS 243.155
and 243.175, shall be forwarded by each payroll disbursing
officer to the board and deposited by it in the State Treasury to
the credit of the State Employes' Benefit Account to meet
administrative and other costs authorized by ORS 243.105 to
243.205, 243.215 and 292.051.
{ - However, no such assessment shall be required for any month
in which the balance in the account exceeds five percent of the
monthly total of state and employee contributions. - }
SECTION 12. ORS 243.195 is amended to read:
243.195. Upon receipt of the request in writing of an eligible
or participating employee so to do, the payroll disbursing
officer may deduct from the salary or wages of such employee the
amount of money indicated in such request for payment of the
applicable amount set forth in contracts made by such employees
or in their behalf for benefits under ORS 243.105 to 243.205,
243.215 and 292.051. The payroll disbursing officer may disburse
funds in payment of premiums to the carrier { + , + } { - or
health service - } benefit plan contractor { + or State
Employes' Benefit Account + }.
SECTION 13. ORS 243.205 is amended to read:
243.205. The payroll disbursing officer shall submit reports to
the State Employes' Benefit Board regarding { - health care - }
{ + benefit plan + } coverage for eligible or participating
employees as the board considers desirable.
SECTION 14. ORS 243.215 is amended to read:
243.215. Any eligible employee unable to participate in one or
more of the plans described in ORS 243.135 (1) solely because the
employee is assigned to perform duties outside the state may be
eligible to receive the monthly state contribution, less
administrative expenses, as payment of all or part of the cost of
a { - health - } benefit plan of choice, subject to the
approval of the { + State Employes' Benefit + } Board and such
rules as the board may adopt.
SECTION 15. { + ORS 243.180 is repealed. + }
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