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April 1, 2008 HB 2002 effective:
Oregon small groups now include groups of 2 to 50 employees.
The number of allowed rating criteria for use in calculating
your rates has increased significantly. Which factors an insurance
company uses in their rate calculations can have a correspondingly
significant impact on your premiums. This will affect existing group
premiums on the group's next renewal. The following factors can now
affect your rates:
- Employee Age
- Dependent Ages
- Dependent and Employee Tobacco Use
- Geographic Location of the Business and/or the Employee's Residence
- Plan Benefit Design
- How Long You Have Been with the Insurance Company
- How Much the Employer Contributes to the Cost of Coverage
- How Many of the Company's Employees are Enrolled in the Plan
- Medical Claims Experience (+ or - 5%)
- Participation in a Wellness Program
You are not required to offer health insurance to employees
of your small business (2-50 employees). If you do offer
health insurance, there are some very specific state
and federal rules and regulations that you have to pay
attention to. We have summarized the important ones
on the web pages in this small business section.
The rules tell you what insurance plans have been approved
by the state for group health insurance use. You are
only allowed to use plans approved by the Oregon Insurance
Division. This excludes to use of individual plans as
an employee benefit and we have included the State Insurance
Bulletin covering this subject. If your are self-employed
or do not meet Oregon's small group requirements, you
can use an individual policy and it may be considered
a business expense.
The rules also tell you how to determine who is an eligible
employee for insurance purposes. You are given flexibility
in determining the number of hours worked per week for
an employee to be considered full time and eligible
for health insurance. You are also given flexibility
in determining a probationary period of up to 90 days
for newly hired employees.
The rules also specify the minimum contribution you have
to make toward an employee's health insurance premium,
which is 50% of the employee only rate.You can choose
to pay more and even cover all or part of the coverage
for an employee's dependents if you wish. You also must
meet labor laws that specify equal treatment for all
similar employees.
Plan
availability varies by the county and, in some cases,
the zip code of where your business is located. Some
areas of the state are limited to as few as three good
options while other areas provide 10 or more choices.
We offer coverage from 9 different insurance companies
in Portland, for example. Premiums are driven by the
cost of medical care in a given geographical area; therefore
your rates will also likely vary depending on where
your business is located.
If
you do not find the information you need here, please use the "Have
You Help Us" choice at the top of this page to let us know.
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