Oregon Health Insurance

Oregon (OR)

Individual Health Insurance Regulations

When it comes to insurance, medical insurance is crucial to protect your family against sickness or injuries. An appropriate health plan can save you from huge medical bills and secure your family's health. It is advisable to assess your budget and family's health care needs, before purchasing health coverage. If you live in Oregon, you can choose from various options of health insurance. The Oregon Insurance Division controls the regulations under which the Oregon health insurers can sell private health coverage to individuals and families.
In Oregon, individual medical insurance policies are not required to be sold on a guarantee issue basis, so they are subject to medical underwriting. The underwriting process allows the health carrier an opportunity to review the past and present health conditions of the applicant and offer full coverage under the terms of the health plan or deny coverage based upon the applicant's health history and status. Oregon law does not mandate that insurance carriers offer standardized individual medical insurance policies. All individual health plans will offer a unique design and provide benefits offered at the carrier's discretion and as outlined in the health plan description. Insurance carriers are permitted a 6-month look back and 24 months exclusionary period pertaining to the pre-existing conditions of applicants who are not able to provide credit for prior coverage. Elimination riders are not permitted under Oregon law. For persons that have had 6 months of prior creditable coverage, the insurance companies must offer guaranteed issue coverage.
Search for plans and the costs associated with them using the search box above. We provide individual, family, Medicare supplemental, group and student health plan quotes for you to compare on all states and zip codes. Remember that having coverage leads to a healthier lifestyle as you are able to get regular doctor checkups and therefore a low-cost premium.

Oregon (OR)

Small Group Health Insurance Regulations

Oregon small business group insurance regulations apply to a company who employs 2 -50 employees. Under Oregon law, small group health plans are offered on a guarantee issue basis, which provides that no group can be turned away or denied health insurance coverage based on the overall health of the group or an individual employee. Guidelines to join the employer-sponsored medical plan may require that all employees fulfill a specified waiting period before becoming eligible to join but must be offered health coverage once the specified period has been satisfied. Insurance carriers are permitted to exercise a 6 month look back, 6-month exclusionary period on all applicants who are not able to provide proof of prior creditable coverage. This provision provides the insurance company an opportunity to gather medical history concerning pre-existing conditions and to impose a 6-month exclusionary period during which treatment of the pre-existing condition will not be covered under the terms of the health policy. Group rates are based on modified community rates which are determined by family makeup, age, and geographic location of employer with a rate adjustment factor of 1.43. To be eligible for coverage, an employee must work over 17.5 hours a week for more than half the calendar year.

Oregon COBRA and Continuation Coverage

Federal COBRA laws apply to companies that employ more than 20 people. The federal COBRA laws require the employer to provide the option to a departing employee to remain on the group health plan for a minimum of 18 months. In special cases, some persons may be entitled to 36 months of continued COBRA coverage under federal law. Under COBRA you are entitled to the same benefits that you had under your employer's group plan and the benefits might include drug, dental, and vision care. The COBRA recipient is responsible for paying the insurance premiums that the employer was paying for the coverage along with 2%.
Under Oregon state mini-COBRA laws, all companies classified as a small business for the purpose of receiving health coverage must offer their employees an additional 9 months of continuation coverage. To be eligible to receive a continuation of benefits under the Oregon state mini-COBRA law, the employee must have been insured under the employer-sponsored group health plan for a minimum period of three months prior to the employee's date of termination. Upon their election of continuation of coverage, the employee, at their sole expense, may continue to receive benefits under the group health plan. A written request for continuation of coverage must be made by the applicant within 31 days of the date of termination of employment. For persons exhausting their COBRA coverage, Oregon law requires the individual insurance carriers the responsibility of offering guaranteed issue coverage to all residents who have had 6 months of prior coverage.