PROPOSED AMENDMENTS TO HOUSE BILL 4156

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HB 1- (LC ) //1 (LHF/ps) Requested by Representative MALSTROM PROPOSED AMENDMENTS TO HOUSE BILL 1 1 1 1 1 1 1 1 1 1 0 1 On page 1 of the printed bill, line, after the semicolon delete the rest of the line and line and insert creating new provisions; and amending ORS B.00, B.01, B., B.1, 0.0 and 0... After line, insert: SECTION 1. Section of this 01 Act is added to and made a part of the Insurance Code. SECTION. (1)(a) There may be no deductible or other costsharing requirements, other than a flat dollar copayment, applied to prescription drugs covered as a pharmacy benefit or as a medical benefit in at least percent of all individual, small employer and group health benefit plans that are offered by a carrier in each geographic area served by the carrier. Any flat dollar copayment must be: (A) Reasonably graduated from one cost tier to the next higher cost tier; and (B) Proportional across all tiers. (b) As used in this subsection, tier means a group of prescription drugs, within a drug formulary, to which defined cost-sharing requirements apply. () A health benefit plan is excluded from the count of individual, small employer and group health benefit plans offered by a carrier in

1 1 1 1 1 1 1 1 0 1 0 a geographic region served by the carrier if the health benefit plan is: (a) Offered by a carrier as a plan that qualifies for a health savings account and that requires a deductible on prescription drugs to qualify for a health savings account; or (b) A catastrophic plan as defined in ORS.. SECTION. ORS B.00 is amended to read: B.00. For purposes of ORS.00,.00,.0,., B.00 to B.1 and B.1 and section of this 01 Act: (1) Actuarial certification means a written statement by a member of the American Academy of Actuaries or other individual acceptable to the Director of the Department of Consumer and Business Services that a carrier is in compliance with the provisions of ORS B.01 based upon the person s examination, including a review of the appropriate records and of the actuarial assumptions and methods used by the carrier in establishing premium rates for small employer health benefit plans. () Affiliate of, or person affiliated with, a specified person means any carrier who, directly or indirectly through one or more intermediaries, controls or is controlled by or is under common control with a specified person. For purposes of this definition, control has the meaning given that term in ORS.. () Affiliation period means, under the terms of a group health benefit plan issued by a health care service contractor, a period: (a) That is applied uniformly and without regard to any health status related factors to an enrollee or late enrollee; (b) That must expire before any coverage becomes effective under the plan for the enrollee or late enrollee; (c) During which no premium shall be charged to the enrollee or late enrollee; and (d) That begins on the enrollee s or late enrollee s first date of eligibility for coverage and runs concurrently with any eligibility waiting period under HB 1- //1 Proposed Amendments to HB 1 Page

1 1 1 1 1 1 1 1 0 1 0 the plan. () Bona fide association means an association that: (a) Has been in active existence for at least five years; (b) Has been formed and maintained in good faith for purposes other than obtaining insurance; (c) Does not condition membership in the association on any factor relating to the health status of an individual or the individual s dependent or employee; (d) Makes health insurance coverage that is offered through the association available to all members of the association regardless of the health status of the member or individuals who are eligible for coverage through the member; (e) Does not make health insurance coverage that is offered through the association available other than in connection with a member of the association; (f) Has a constitution and bylaws; and (g) Is not owned or controlled by a carrier, producer or affiliate of a carrier or producer. () Carrier means any person who provides health benefit plans in this state, including: (a) A licensed insurance company; (b) A health care service contractor; (c) A health maintenance organization; (d) An association or group of employers that provides benefits by means of a multiple employer welfare arrangement and that: (A) Is subject to ORS 0.01 to 0.1; or (B) Is fully insured and otherwise exempt under ORS 0.0 () but elects to be governed by ORS B.0 to B.01; or (e) Any other person or corporation responsible for the payment of benefits or provision of services. HB 1- //1 Proposed Amendments to HB 1 Page

1 1 1 1 1 1 1 1 0 1 0 () Dependent means the spouse or child of an eligible employee, subject to applicable terms of the health benefit plan covering the employee. () Eligible employee means an employee who is eligible for coverage under a group health benefit plan. () Employee means any individual employed by an employer. () Enrollee means an employee, dependent of the employee or an individual otherwise eligible for a group or individual health benefit plan who has enrolled for coverage under the terms of the plan. () Exchange means an American Health Benefit Exchange described in U.S.C. 1,, and 1. () Exclusion period means a period during which specified treatments or services are excluded from coverage. (1) Financial impairment means that a carrier is not insolvent and is: (a) Considered by the director to be potentially unable to fulfill its contractual obligations; or (b) Placed under an order of rehabilitation or conservation by a court of competent jurisdiction. (1)(a) Geographic average rate means the arithmetical average of the lowest premium and the corresponding highest premium to be charged by a carrier in a geographic area established by the director for the carrier s: (A) Group health benefit plans offered to small employers; or (B) Individual health benefit plans. (b) Geographic average rate does not include premium differences that are due to differences in benefit design, age, tobacco use or family composition. (1) Grandfathered health plan has the meaning prescribed by rule by the United States Secretaries of Labor, Health and Human Services and the Treasury pursuant to U.S.C. (e) that is in effect on January 1, 01. (1) Group eligibility waiting period means, with respect to a group health benefit plan, the period of employment or membership with the group HB 1- //1 Proposed Amendments to HB 1 Page

1 1 1 1 1 1 1 1 0 1 0 that a prospective enrollee must complete before plan coverage begins. (1)(a) Health benefit plan means any: (A) Hospital expense, medical expense or hospital or medical expense policy or certificate; (B) Subscriber contract of a health care service contractor as defined in ORS 0.00; or (C) Plan provided by a multiple employer welfare arrangement or by another benefit arrangement defined in the federal Employee Retirement Income Security Act of 1, as amended, to the extent that the plan is subject to state regulation. (b) Health benefit plan does not include: (A) Coverage for accident only, specific disease or condition only, credit or disability income; (B) Coverage of Medicare services pursuant to contracts with the federal government; (C) Medicare supplement insurance policies; (D) Coverage of TRICARE services pursuant to contracts with the federal government; (E) Benefits delivered through a flexible spending arrangement established pursuant to section 1 of the Internal Revenue Code of 1, as amended, when the benefits are provided in addition to a group health benefit plan; (F) Separately offered long term care insurance, including, but not limited to, coverage of nursing home care, home health care and communitybased care; (G) Independent, noncoordinated, hospital-only indemnity insurance or other fixed indemnity insurance; (H) Short term health insurance policies that are in effect for periods of three months or less, including the term of a renewal of the policy; (I) Dental only coverage; HB 1- //1 Proposed Amendments to HB 1 Page

1 1 1 1 1 1 1 1 0 1 0 (J) Vision only coverage; (K) Stop-loss coverage that meets the requirements of ORS.0; (L) Coverage issued as a supplement to liability insurance; (M) Insurance arising out of a workers compensation or similar law; (N) Automobile medical payment insurance or insurance under which benefits are payable with or without regard to fault and that is statutorily required to be contained in any liability insurance policy or equivalent selfinsurance; or (O) Any employee welfare benefit plan that is exempt from state regulation because of the federal Employee Retirement Income Security Act of 1, as amended. (c) For purposes of this subsection, renewal of a short term health insurance policy includes the issuance of a new short term health insurance policy by an insurer to a policyholder within 0 days after the expiration of a policy previously issued by the insurer to the policyholder. (1) Individual health benefit plan means a health benefit plan: (a) That is issued to an individual policyholder; or (b) That provides individual coverage through a trust, association or similar group, regardless of the situs of the policy or contract. (1) Initial enrollment period means a period of at least 0 days following commencement of the first eligibility period for an individual. (1) Late enrollee means an individual who enrolls in a group health benefit plan subsequent to the initial enrollment period during which the individual was eligible for coverage but declined to enroll. However, an eligible individual shall not be considered a late enrollee if: (a) The individual qualifies for a special enrollment period in accordance with U.S.C. 00gg or as prescribed by rule by the Department of Consumer and Business Services; (b) The individual applies for coverage during an open enrollment period; (c) A court issues an order that coverage be provided for a spouse or HB 1- //1 Proposed Amendments to HB 1 Page

1 1 1 1 1 1 1 1 0 1 0 minor child under an employee s employer sponsored health benefit plan and request for enrollment is made within 0 days after issuance of the court order; (d) The individual is employed by an employer that offers multiple health benefit plans and the individual elects a different health benefit plan during an open enrollment period; or (e) The individual s coverage under Medicaid, Medicare, TRICARE, Indian Health Service or a publicly sponsored or subsidized health plan, including, but not limited to, the medical assistance program under ORS chapter 1, has been involuntarily terminated within days after applying for coverage in a group health benefit plan. (0) Multiple employer welfare arrangement means a multiple employer welfare arrangement as defined in section of the federal Employee Retirement Income Security Act of 1, as amended, U.S.C. 0, that is subject to ORS 0.01 to 0.1. (1) Preexisting condition exclusion means: (a) Except for a grandfathered health plan, a limitation or exclusion of benefits or a denial of coverage based on a medical condition being present before the effective date of coverage or before the date coverage is denied, whether or not any medical advice, diagnosis, care or treatment was recommended or received for the condition before the date of coverage or denial of coverage. (b) With respect to a grandfathered health plan, a provision applicable to an enrollee or late enrollee that excludes coverage for services, charges or expenses incurred during a specified period immediately following enrollment for a condition for which medical advice, diagnosis, care or treatment was recommended or received during a specified period immediately preceding enrollment. For purposes of this paragraph pregnancy and genetic information do not constitute preexisting conditions. () Premium includes insurance premiums or other fees charged for a HB 1- //1 Proposed Amendments to HB 1 Page

1 1 1 1 1 1 1 1 0 1 0 health benefit plan, including the costs of benefits paid or reimbursements made to or on behalf of enrollees covered by the plan. () Rating period means the 1-month calendar period for which premium rates established by a carrier are in effect, as determined by the carrier. () Representative does not include an insurance producer or an employee or authorized representative of an insurance producer or carrier. () Small employer means an employer who employed an average of at least one but not more than 0 full-time equivalent employees on business days during the preceding calendar year and who employs at least one fulltime equivalent employee on the first day of the plan year, determined in accordance with a methodology prescribed by the Department of Consumer and Business Services by rule.. In line, delete 1 and insert. On page, delete lines through and insert a prescription drug; or (c) Impose new utilization controls on a prescription drug, including but not limited to prior authorization or step therapy. (1)(a) Subsection (1) of this section does not prohibit a carrier, during a plan year, from: (A) Adding to a prescription drug formulary a prescription drug newly approved by the United States Food and Drug Administration; (B) Reducing a deductible, copayment, coinsurance or other cost sharing applicable to a prescription drug; or (C) Eliminating one or more utilization controls applicable to a prescription drug. (b) Subsection (1) of this section does not prohibit a pharmacist, when dispensing a prescription drug, from substituting a generic equivalent drug or an interchangeable biological product for the prescribed drug or product in accordance with ORS.1 or.. (1) A carrier that offers a small employer health benefit plan that re- HB 1- //1 Proposed Amendments to HB 1 Page

1 1 1 1 1 1 1 1 0 1 0 imburses the costs of prescription drugs sold by a retail pharmacy or administered by a health care provider shall make publicly available on the carrier s website, without the necessity of entering a password, a user name or personally identifying information, all of the following: (a) The prescription drug formulary for each health benefit plan, electronically searchable by drug name. (b) Notice of any change to the prescription drug formulary due to the deletion or addition of a drug, no later than hours after the effective date of the change. (c) Notice of any change to the prescription drug formulary other than changes described in paragraph (b) of this subsection, such as changes to drug strength or form, no later than 1 calendar days after the effective date of the change. (d) The cost sharing typically paid by an enrollee for each drug on the prescription drug formulary, indicated by the following dollar ranges: (A) $0 or less. (B) More than $0 but not more than $0. (C) More than $0 but not more than $00. (D) More than $00 but not more than $1,000. (E) More than $1,000. (e) Any prior authorization, step therapy or other utilization control applicable to each drug on the prescription drug formulary.. In line, delete and insert. On page, delete lines 1 through and insert a prescription drug; or (c) Impose new utilization controls on a prescription drug, including but not limited to prior authorization or step therapy. ()(a) Subsection () of this section does not prohibit a carrier, during a plan year, from: (A) Adding to a prescription drug formulary a prescription drug newly approved by the United States Food and Drug Administration; HB 1- //1 Proposed Amendments to HB 1 Page

1 1 1 1 1 1 1 1 0 1 0 (B) Reducing a deductible, copayment, coinsurance or other cost sharing applicable to a prescription drug; or (C) Eliminating one or more utilization controls applicable to a prescription drug. (b) Subsection () of this section does not prohibit a pharmacist, when dispensing a prescription drug, from substituting a generic equivalent drug or an interchangeable biological product for the prescribed drug or product in accordance with ORS.1 or.. (1) A carrier that offers a group health benefit plan that reimburses the costs of prescription drugs sold by a retail pharmacy or administered by a health care provider shall make publicly available on the carrier s website, without the necessity of entering a password, a user name or personally identifying information, all of the following: (a) The prescription drug formulary for each health benefit plan, electronically searchable by drug name. (b) Notice of any change to the prescription drug formulary due to the deletion or addition of a drug, no later than hours after the effective date of the change. (c) Notice of any change to the prescription drug formulary other than changes described in paragraph (b) of this subsection, such as changes to drug strength or form, no later than 1 calendar days after the effective date of the change. (d) The cost sharing typically paid by an enrollee for each drug on the prescription drug formulary, indicated by the following dollar ranges: (A) $0 or less. (B) More than $0 but not more than $0. (C) More than $0 but not more than $00. (D) More than $00 but not more than $1,000. (E) More than $1,000. (e) Any prior authorization, step therapy or other utilization control HB 1- //1 Proposed Amendments to HB 1 Page

1 1 1 1 1 1 1 1 0 1 0 applicable to each drug on the prescription drug formulary.. In line, delete and insert. On page, delete lines through and delete page and insert a prescription drug; or (c) Impose new utilization controls on a prescription drug, including but not limited to prior authorization or step therapy. (1)(a) Subsection () of this section does not prohibit a carrier, during a plan year, from: (A) Adding to a prescription drug formulary a prescription drug newly approved by the United States Food and Drug Administration; (B) Reducing a deductible, copayment, coinsurance or other cost sharing applicable to a prescription drug; or (C) Eliminating one or more utilization controls applicable to a prescription drug. (b) Subsection () of this section does not prohibit a pharmacist, when dispensing a prescription drug, from substituting a generic equivalent drug or an interchangeable biological product for the prescribed drug or product in accordance with ORS.1 or.. (1) A carrier that offers an individual health benefit plan that reimburses the costs of prescription drugs sold by a retail pharmacy or administered by a health care provider shall make publicly available on the carrier s website, without the necessity of entering a password, a user name or personally identifying information, all of the following: (a) The prescription drug formulary for each health benefit plan, electronically searchable by drug name. (b) Notice of any change to the prescription drug formulary due to the deletion or addition of a drug, no later than hours after the effective date of the change. (c) Notice of any change to the prescription drug formulary other than changes described in paragraph (b) of this subsection, such as changes to HB 1- //1 Proposed Amendments to HB 1 Page

1 1 1 1 1 1 1 1 0 1 0 drug strength or form, no later than 1 calendar days after the effective date of the change. (d) The cost sharing typically paid by an enrollee for each drug on the prescription drug formulary, indicated by the following dollar ranges: (A) $0 or less. (B) More than $0 but not more than $0. (C) More than $0 but not more than $00. (D) More than $00 but not more than $1,000. (E) More than $1,000. (e) Any prior authorization, step therapy or other utilization control applicable to each drug on the prescription drug formulary. SECTION. ORS 0.0 is amended to read: 0.0. (1) The following provisions apply to health care service contractors to the extent not inconsistent with the express provisions of ORS 0.00 to 0.0: (a) ORS 0.1, 0.1 and 0.1. (b) ORS 1.00 to 1., 1.1, 1.1 to 1., 1., 1., 1., 1.0, 1. to 1.0, 1., 1.0, 1., 1., as provided in subsection () of this section, ORS 1., 1.0, 1.0, 1.0, 1., 1., 1.1, 1. to 1.0, 1.0 to 1., 1.0, 1.1, 1., 1., 1.0, 1., 1.0, 1.0 and 1. to 1.. (c) ORS.1,.0,.0,.,.0,.0,. and.1 to., not including ORS.. (d) ORS.0 to.00,.00,.10 to.,.,. to.0 and. to.0. (e) ORS.01 to.0. (f) ORS.00 to.0. (g) ORS.001 to.00,.01,.01,.01,.0,. to.1 and.1 to.. (h) ORS.00,.00,.00,.00,.0,.01,.01,.00, HB 1- //1 Proposed Amendments to HB 1 Page 1

1 1 1 1 1 1 1 1 0 1 0.0,.0,.0,.0,.0,.00,.0,.00,.0 to.,.0,.0,.0,.1,.,.,.,.,.,.,.,.,.,.0,.0 to.,.0 to.,. and.0. (i) ORS A.0, A.01, A.01, A.00, A.0, A.0, A.00, A.0, A.0, A.01, A.0, A.0, A.00, A.0, A.0, A.0, A.0, A.0, A.0, A.00, A.00, A.0, A.0, A.0, A.00, A.0, A., A., A., A.0, A.1, A.10, A.11, A.1, A., A., A.1, A., A.1, A.1, A.1, A., A.1, A.0, A. and A.0 and section, chapter 1, Oregon Laws 01. (j) ORS B.001, B.00 to B.1, B.1, B.10, B.1 to B.0, B.0, B., B., B., B.0, B., B., B., B., B., B., B., B.0 to B., B., B.00, B., B.0, B., B.0, B.0, B.1, B., B. to B., B.00, B.0, B.0, B.0, B., B.0, B.1, B., B., B.0, B., B.0, B.0, B., B.01, B.0 and B.00 and section of this 01 Act. (k) The following provisions of ORS chapter : (A) ORS.001 to.00,.0,.01,.01,.01,.0 to.0,.0,.0 to.0,.01 and.0, relating to the regulation of insurance producers; (B) ORS.0,.0,.1,.1,.,.1,.,.0,. and., relating to the regulation of insurance consultants; and (C) ORS.00 to.0, relating to the regulation of third party administrators. (L) ORS.00 to.10,.,.0 to.0,.00,.0, HB 1- //1 Proposed Amendments to HB 1 Page 1

1 1 1 1 1 1 1 1 0 1 0.0,.0,.,.1,.,.,.0,.,.0,.,.0,.,.0 and.0. () The following provisions of the Insurance Code apply to health care service contractors except in the case of group practice health maintenance organizations that are federally qualified pursuant to Title XIII of the Public Health Service Act: (a) ORS 1., if the group practice health maintenance organization wholly owns and operates an in-house drug outlet. (b) ORS A.0, unless the patient is referred by a physician, physician assistant or nurse practitioner associated with a group practice health maintenance organization. () For the purposes of this section, health care service contractors are insurers. () Any for-profit health care service contractor organized under the laws of any other state that is not governed by the insurance laws of the other state is subject to all requirements of ORS chapter. ()(a) A health care service contractor is a domestic insurance company for the purpose of determining whether the health care service contractor is a debtor, as defined in U.S.C.. (b) A health care service contractor s classification as a domestic insurance company under paragraph (a) of this subsection does not subject the health care service contractor to ORS. to.. () The Director of the Department of Consumer and Business Services may, after notice and hearing, adopt reasonable rules not inconsistent with this section and ORS 0.00, 0.00, 0.0 and 0.0 that are necessary for the proper administration of these provisions. SECTION. ORS 0.0, as amended by section 1, chapter 1, Oregon Laws 01, section, chapter, Oregon Laws 01, section, chapter, Oregon Laws 01, section, chapter, Oregon Laws 01, section, chapter 0, Oregon Laws 01, section, chapter, Oregon Laws 01, section HB 1- //1 Proposed Amendments to HB 1 Page 1

1 1 1 1 1 1 1 1 0 1 0, chapter, Oregon Laws 01, section, chapter 0, Oregon Laws 01, section 0, chapter 1, Oregon laws 01, section, chapter 0, Oregon Laws 01, section, chapter 1, Oregon Laws 01, and section, chapter, Oregon Laws 01, is amended to read: 0.0. (1) The following provisions apply to health care service contractors to the extent not inconsistent with the express provisions of ORS 0.00 to 0.0: (a) ORS 0.1, 0.1 and 0.1. (b) ORS 1.00 to 1., 1.1, 1.1 to 1., 1., 1., 1., 1.0, 1. to 1.0, 1., 1.0, 1., 1., as provided in subsection () of this section, ORS 1., 1.0, 1.0, 1.0, 1., 1., 1.1, 1. to 1.0, 1.0 to 1., 1.0, 1.1, 1., 1., 1.0, 1., 1.0, 1.0 and 1. to 1.. (c) ORS.1,.0,.0,.,.0,.0,. and.1 to., not including ORS.. (d) ORS.0 to.00,.00,.10 to.,.,. to.0 and. to.0. (e) ORS.01 to.0. (f) ORS.00 to.0. (g) ORS.001 to.00,.01,.01,.01,.0,. to.1 and.1 to.. (h) ORS.00,.00,.00,.00,.0,.01,.01,.00,.0,.0,.0,.0,.0,.00,.0,.00,.0 to.,.0,.0,.0,.1,.,.,.,.,.,.,.,.,.,.0,.0 to.,.0 to.,. and.0. (i) ORS A.0, A.01, A.01, A.00, A.0, A.0, A.00, A.0, A.0, A.01, A.0, A.0, A.00, A.0, A.0, A.0, A.0, A.0, A.0, A.00, A.00, A.0, A.0, A.0, A.00, A.0, A., HB 1- //1 Proposed Amendments to HB 1 Page 1

1 1 1 1 1 1 1 1 0 1 0 A., A., A.0, A.1, A.10, A.11, A.1, A., A., A.1, A., A.1, A.1, A.1, A., A.1, A.0, A. and A.0. (j) ORS B.001, B.00 to B.1, B.1, B.10, B.1 to B.0, B.0, B., B., B., B.0, B., B., B., B., B., B., B., B.0 to B., B., B.00, B., B.0, B., B.0, B.0, B.1, B., B. to B., B.00, B.0, B.0, B.0, B., B.0, B.1, B., B., B.0, B., B.0, B.0, B., B.01, B.0 and B.00 and section of this 01 Act. (k) The following provisions of ORS chapter : (A) ORS.001 to.00,.0,.01,.01,.01,.0 to.0,.0,.0 to.0,.01 and.0, relating to the regulation of insurance producers; (B) ORS.0,.0,.1,.1,.,.1,.,.0,. and., relating to the regulation of insurance consultants; and (C) ORS.00 to.0, relating to the regulation of third party administrators. (L) ORS.00 to.10,.,.0 to.0,.00,.0,.0,.0,.,.1,.,.,.0,.,.0,.,.0,.,.0 and.0. () The following provisions of the Insurance Code apply to health care service contractors except in the case of group practice health maintenance organizations that are federally qualified pursuant to Title XIII of the Public Health Service Act: (a) ORS 1., if the group practice health maintenance organization wholly owns and operates an in-house drug outlet. (b) ORS A.0, unless the patient is referred by a physician, physician HB 1- //1 Proposed Amendments to HB 1 Page 1

1 1 1 1 1 1 1 1 0 1 0 assistant or nurse practitioner associated with a group practice health maintenance organization. () For the purposes of this section, health care service contractors are insurers. () Any for-profit health care service contractor organized under the laws of any other state that is not governed by the insurance laws of the other state is subject to all requirements of ORS chapter. ()(a) A health care service contractor is a domestic insurance company for the purpose of determining whether the health care service contractor is a debtor, as defined in U.S.C.. (b) A health care service contractor s classification as a domestic insurance company under paragraph (a) of this subsection does not subject the health care service contractor to ORS. to.. () The Director of the Department of Consumer and Business Services may, after notice and hearing, adopt reasonable rules not inconsistent with this section and ORS 0.00, 0.00, 0.0 and 0.0 that are necessary for the proper administration of these provisions. SECTION. ORS 0. is amended to read: 0.. (1) The following provisions apply to trusts carrying out a multiple employer welfare arrangement: (a) ORS 0.1, 0.1 and 0.1. (b) ORS 1.00 to 1., 1.1, 1.1 to 1., 1. to 1.1, 1., 1., 1., 1., 1.0, 1., 1.0, 1., 1.1, 1.1 to 1., 1., 1., 1., 1., 1.1, 1. to 1.0, 1.0 to 1., 1.0, 1.0 and 1. to 1.. (c) ORS.0 to.00,.10 to.,.,. to.0 and. to.0. (d) ORS.01 to.0. (e) ORS.001 to.00,.01,.01,.01 and.0. (f) ORS.00,.00,.00,.00,.0,.01,.00,.0, HB 1- //1 Proposed Amendments to HB 1 Page 1

1 1 1 1 1 1 1 1 0 1 0.0,.0,.0,.0,.0,.,. and.. (g) ORS A.0, A.01, A.01, A.00, A.0, A.0, A.0, A.00, A.0, A.01, A.0, A.0, A.00, A.0, A.0, A.0, A.0, A.0, A.0, A.00, A.00, A.0, A.0, A.0, A.00, A.0, A., A., A., A.0, A.1, A.10, A.11, A.1, A., A., A.1, A., A.1, A., A.1, A.1, A., A.1, A.0, A. and A.0. (h) ORS B.001, B.00 to B.1 (except B.1 to B.1), B.1 to B.0, B.0, B., B., B., B.0, B., B., B., B., B., B., B., B., B.0, B.1, B.0, B.0, B.1, B., B., B., B., B., B.00, B.0, B.0, B.0, B., B.1, B., B.0, B.0, B.0, B. and B.01 and section of this 01 Act. (i) The following provisions of ORS chapter : (A) ORS.001 to.00,.0,.01,.01,.01,.0 to.0,.0,.0 to.0,.01 and.0, relating to the regulation of insurance producers; (B) ORS.0,.0,.1,.1,.,.1,.,.0,. and., relating to the regulation of insurance consultants; and (C) ORS.00 to.0, relating to the regulation of third party administrators. (j) ORS.00 to.10,. and.0 to.0. () For the purposes of this section: (a) A trust carrying out a multiple employer welfare arrangement shall be considered an insurer. (b) References to certificates of authority shall be considered references to certificates of multiple employer welfare arrangement. HB 1- //1 Proposed Amendments to HB 1 Page 1

(c) Contributions shall be considered premiums. () The provision of health benefits under ORS 0.01 to 0.1 shall be considered to be the transaction of health insurance. () The Department of Consumer and Business Services may adopt rules that are necessary to implement the provisions of ORS 0.01 to 0.1. SECTION. Section of this 01 Act and the amendments to ORS B.00, B.01, B., B.1, 0.0 and 0. by sections to of this 01 Act apply to health benefit plans for which the Department of Consumer and Business Services has not approved rates on the effective date of this 01 Act.. HB 1- //1 Proposed Amendments to HB 1 Page 1