[MyOEBB] SB1067 & how it affects OEBB

[MyOEBB system updates]

INFORMATION ONLY - NO ACTION REQUIRED


Dear Business Managers, Superintendents & Benefits Administrators:

This past August, just as OEBB was beginning our Open Enrollment period, Governor Kate Brown signed Senate Bill 1067A into law. This law won't take effect until October 2019, but we realize many collective bargaining agreements may also extend beyond this date. Therefore, it is important that OEBB-participating entities understand its impacts.

Upcoming legislative sessions could bring about more changes, and we will continue to keep you informed if/when additional changes occur. In the meantime, the bullet points below should help you understand the impacts of the law as it currently stands.


Here are the changes OEBB members can expect if the current law remains in place as written:

Plans offered by OEBB - October 2019


  *   Members enrolled in OEBB as a subscriber (the benefits-eligible individual whether an active employee, early retiree or COBRA participant), may not enroll as a dependent under another OEBB or Public Employees' Benefit Board (PEBB) plan. OEBB subscribers may enroll as a dependent in another employer plan that is not OEBB or PEBB.
  *   Children may be covered under only one state plan - either through OEBB or PEBB. They may not be covered as dependents under two plans, unless one plan is through another employer that is not OEBB or PEBB.
  *   An OEBB subscriber will no longer be eligible to receive "opt out" payments if the subscriber:
     *   "opts out" of OEBB coverage; and
     *   is enrolled as a dependent under another OEBB or PEBB plan.



  *   An OEBB subscriber will still be eligible to receive "opt out" payments if the subscriber:
     *   "opts out" of OEBB coverage; and
     *   is enrolled as a dependent under another employer plan that is not OEBB or PEBB.



  *   OEBB will perform an enrollment audit each year to be sure enrolled members are eligible.



  *   OEBB and PEBB are now legally required to keep annual premium increases from exceeding 3.4 percent





Hospital reimbursement cap beginning October 2019


  *   A carrier that contracts with OEBB for plans with inpatient and outpatient hospital services must limit hospital claim payments to:
     *   200 percent of Medicare for in-network hospitals; or
     *   185 percent of Medicare for out-of-network hospitals.
  *   Certain hospitals are excluded from the above requirement, including:
     *   A type A or B hospital as defined in ORS 442.470
     *   A rural critical access hospital as defined in ORS 315.613
     *   A hospital that:
        *   is in a county with a population under 70,000; and
        *   is a sole community hospital; and
        *   has Medicare payments composing at least 40 percent of the total annual patient revenue.


  *   A provider reimbursed under this cap may not bill or collect from the patient any balance above the cap.
If you have additional questions, please contact OEBB Member Services at 888-469-6322 or send an email to: oebb.benefits at state.or.us<mailto:oebb.benefits at state.or.us>.

Thank you,
[LindaSignature]
Linda Freeze
OEBB Benefits Manager
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