Changes in the 2008 plan for ODS group administrators

The Oregon Legislature passed the following healthcare-related bills that affect your fully-insured group benefits. These regulations provide mandatory coverage for group plans in effect beginning January 1, 2008. Most ODS standard policies currently meet or exceed the required coverage; however, for those not meeting the requirements, the benefit will be administered as stated for all policies in effect on January 1, 2008. Our contract filings with the Insurance Division are not effective until April 1, 2008. Therefore, actual language changes in your handbook will be reflected in new and renewing groups April 1, 2008, and after.

Senate Bill 8 – Oral Anti-Cancer Medication A health plan that provides coverage for cancer chemotherapy treatment must also provide coverage for orally-administered anti-cancer medication.

Senate Bill 491 – Cochlear Implants If a policy provides for reimbursement of cochlear implants, the insured is entitled to coverage of bilateral cochlear implants.

House Bill 2007 – Domestic Partners This bill requires that an individual plan, continuation plan and a non-ERISA plan afford a registered same sex domestic partner the same rights as a spouse. This new law applies to non- ERISA employers, whether they are fully insured or self-insured. ODS will also apply HB 2007 to fully insured ERISA groups, as the Insurance Division views their authority to be over fully insured ERISA employers.

House Bill 2517 – Prosthetics This bill requires coverage of prosthetic and orthotic devices that are medically necessary to restore or maintain the ability to complete activities of daily living or essential job-related activities and that are not solely for comfort or convenience, based on the list of prosthetic and orthotic devices and supplies in the Medicare fee schedule for durable medical equipment.

House Bill 2700 – Prescription Contraceptives This bill requires a health benefit plan or student health insurance policy to cover prescription contraceptives if the plan or policy includes a prescription drug benefit.

House Bill 2918 – Pervasive Development Disorder (PDD) This bill expands the coverage for children under 18 years of age who have been diagnosed with PDD. PDD includes: Asperger’s syndrome, autism, development delay, developmental disability or mental retardation.

If you have any questions, please contact your insurance agent or your ODS account representative at 503-243-3948

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